Stacy G. Smith, MS, LPC
Sneaky Games OCD Will Play
1.) Make you "Figure Out" the Meaning of an Intrusive Thought, Image, or Feeling
The act of "Figuring Out" is a compulsion. By nature, OCD thoughts cannot be reasoned with, argued, or "figured out." Contemplating the meaning of a thought, why you are having it, and what it means about you, only serves to keep you caught in the OCD cycle. As you're trying so hard to come up with answers, OCD is sitting back on the couch, feet up, beverage in hand, watching you struggle. The goal of treatment is to accept and tolerate the uncertainty of what your thoughts, images, and feelings mean. Therefore, the next time you catch yourself "figuring out" a thought, kick OCD off that comfy couch by saying, "I'm going to choose to accept the uncertainty of this thought, and use my time more productively and meaningfully."
2.) Substituting One Ritual for Another
When working hard to refrain from a ritual, you may unknowingly be engaging in a new ritual to take its place. For example, you may have reduced the reassurance you seek through a family member, but now find yourself using your friends, or the internet, for reassurance. Instead of driving around the block to ensure you did not harm someone, you may increase the number of times you look in the rearview mirror. A physical ritual may also be substituted for a mental ritual; for example, instead of silently repeating prayers or visualizing "good" outcomes, you may find yourself tapping or repeating a behavior in a "just right" manner. OCD also loves to trick you into using subtle rituals. For example, when walking past a feared location, you may do so quickly, or with your head turned away. Remember, the use of rituals is what keeps OCD alive and thriving. If you are working hard to refrain from a compulsive behavior, OCD will notice - it will start to feel threatened, and as a result, trick you into engaging in a new ritual it can use as fuel. OCD is sneaky, but with daily practice being mindful of your behaviors, you can be one step ahead of this sneaky game OCD can play.
3.) Convince You the Content of Your Thoughts is Important
When it comes to treating OCD, it may be surprising to hear that the content of your obsessions is irrelevant when it comes to proper treatment. Whether your thoughts focus on harm, contamination, religion, or sexual content, the treatment of choice is still Exposure and Response Prevention (ERP) - Exposing yourself to the obsessional trigger, while refraining from using any means to reduce your discomfort. OCD may convince you that some obsessional themes are more important than others, need to be taken more seriously, and that ERP does not apply. This is not the case, no matter how convincing that OCD voice may seem.
4.) Make you question whether you even have OCD.
This is just another trick OCD will use to sabotage your treatment, make you rethink whether ERP is necessary, and whether the discomfort from engaging in these exercises is worth it. You may question whether you have Bipolar Disorder, or Schizophrenia, and begin to think of reasons to justify a diagnosis other than OCD.
5.) Point out negative events of your day after refraining from a ritual.
When engaging in an ERP exercise and refraining from a ritual, OCD can have you focus on various mishaps, large or small, throughout the day, then convince you the reason for each of them was because you did not perform your ritual, or did so "incorrectly." You may have thoughts such as, "if only I did that one quick ritual, none of those bad things would have happened." Remember, unfortunate events happen for a variety of reasons. Instead of trying to figure out why each happened, make it a goal to focus on all the good, or "okay" moments that are happening. OCD plays the game of putting blinders up to the more positive aspects of your day in order to justify doing more rituals. You don't need to fall for it.
6.) Help distract you during an ERP exercise.
Distraction is a compulsion, which OCD can cleverly convince you to use as a helpful tool during an ERP exercise. When distracting yourself, you are not fully engaging in the exercise, which involves feeling the discomfort without actively engaging in means to reduce it. Distraction prevents you from focusing on the response prevention part of treatment, which is the most important part! Again, this is OCD's way of sabotaging your efforts.
7.) Make You Figure Out How Your Symptoms all Started
Many individuals, including therapists who are unfamiliar with the treatment of OCD, will be convinced that it is important to get to the "root" cause of OCD symptoms, in order to move forward with treatment. You may find yourself thinking back to your childhood, perhaps blaming your parents, or trying to think of that very first moment you realized you were engaging in a ritual. The truth is, ERP is a treatment that operates independently of the origin of your symptoms. Often, we may never know what triggered your symptoms, but what we do know is that repeatedly engaging in compulsive behaviors is what is maintaining them. If you find yourself with a therapist who insists on exploring your childhood, or finding a "root" cause for your thoughts and behaviors, you can share with them that they are falling for an OCD trap!
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