WHAT IS OCD?
OCD is a condition that brings about unwanted intrusive thoughts.
While everyone experiences fleeting, intrusive thoughts from time to time, the problem for OCD sufferers like us is we place importance on them so they can flash across our minds hundreds or thousands of times a day.
As these thoughts can be sometimes disturbing, we try to minimise them by carrying out some form of mental or physical action, which then becomes a compulsion.
By doing this, what we often don’t realise is that we’re actually inviting these thoughts to visit us more frequently – leading them to become an obsession we simply can’t shake, no matter how hard we try.
Like many mental health conditions, there’s no single individual cause of OCD. Often, it comes about through a number of different factors, which can include genetics and certain activity in an area of the brain called the Amygdala.
The World Health Organisation has recorded that OCD is one of the top 20 causes of illness-related disability for people 15-44 years of age, affecting people of all genders, ethnic groups, backgrounds and lifestyles. OCD at its worst can be extremely debilitating, making day to day life a struggle.
But there is hope for a better life.
What are intrusive thoughts?
An intrusive thought is a thought, image, or urge that pops into your head for no reason. These thoughts can be about anything – from violence, religion or sex, to health and the meaning of life. If these thoughts aren’t addressed and treated, they can increase and become extremely debilitating. Someone might suddenly have the thought of steering their car into oncoming traffic; walking over to a stranger and pushing them; or shouting out something offensive in a meeting.
What are compulsions?
Think of a compulsion as anything a sufferer would do as a way of trying to minimise anxiety and stop their intrusive thoughts. Compulsions come in many forms. They can be a physical ritual, such as counting, tapping or washing your hands excessively. Often the compulsions are invisible to the outside world in the form of ruminations, happening inside someone’s mind and not necessarily picked up by others; such as avoidance behaviours, mental checking or continuously trying to make sense of the thoughts or “work them out”.
OCD Themes / Thoughts
As we briefly covered above, OCD affects us all differently. It’s not simply about hand washing and keeping things organised. While there can be similarities in people’s situations and conditions, OCD tends to latch on to what we as individuals fear most.
OCD is often classified into different sub-types, or themes. While this can be useful to help with our understanding and how to break down the fears, it’s important to note that “themes” are simply descriptors of the types of thoughts occurring – it is all OCD, there are no different “types” of OCD.
Common sub-types include harm OCD; relationship OCD; sexual orientation and paedophilia OCD; contamination OCD; suicidal OCD; solipsism or religious OCD or existential OCD, but really OCD can latch in almost any area of life. If there is a fear there, OCD has something to latch to. That’s why it makes sense if one of us is very scared of the idea of one day being in a loveless marriage, it’s highly likely Relationship OCD will rear its head. Or if someone is afraid they might harm others, it’s likely Harm OCD will be their prominent fear. By simplifying how we view OCD and seeing it as simply “what do I fear, and how I can work to reduce that fear” is how we can break the cycle. Some people suffer with only one theme; others may experience many types, which can change and morph over time.
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I am you:
“One of the reasons many of us can end up feeling hopeless is because when one fear is conquered another can immediately take its place. Unconditional self and life acceptance helps us to uproot the beliefs fuelling our fears so that once and for all we can be free from the anxiety cycle.”
What is ERP?
Exposure with Response Prevention (ERP) is a form of behavioural therapy that involves gradually confronting a feared situation and resisting compulsions. Challenging but effective, ERP often begins by establishing a hierarchy of triggering situations. Exercises are put together that are designed to address the easiest first, working up to more challenging exposures.
What is uncertainty?
Uncertainly exists in everyone’s lives. We may feel safe in our home or in our car, but uncertainty does exist even in those situations you experience no fear in, and we’re comfortable with that. OCD heightens the feeling of risk in everyday situations that other people may not find scary. For people suffering, we need to expand the idea of being comfortable with uncertainty, with not knowing everything that’s going to happen – and learn to live with uncertainty.
To recover from OCD we need to give up the internal fight of “needing to know”. We can never gain 100% certainty that all our fears are OCD but our brain will lead us to believe that if we just check something that’s worrying us one more time (like have we turned the iron off for example) we will finally gain relief. However, this is how years, even decades, can be handed over to OCD. We need to take back control of our life and live it on our own terms.
Why aren’t I recovered, even though I’ve done ERP and live with uncertainty?
Many people don’t recover through ERP and acceptance of uncertainty alone. Without breaking down philosophies and beliefs that are particularly rigid, exposures can’t make their way into our everyday thinking to make a positive difference.
If you’re still very scared of something, no matter how many times you have put yourself into those scary situations, it’s often the case that the fears need breaking down too. This can be achieved through unconditional self and life acceptance.
Let’s look at a rational fear as an example to illustrate this. If you were to be dangled over a cliff edge 100 times with a fraying rope, it is a realistic response to be terrified that you might fall to certain death. So there is no amount of times you could put yourself in this scary position that would entirely eliminate the fear. We can apply this to OCD suffering, if there is even the tiniest chance in the mind of the sufferer that the fear could come true, it will feel very real and no amount of exposure will have the brain believe otherwise. Yes the response and levels of anxiety will likely have come down and for many – exposures and uncertainty are enough. But for many, they are left wondering if they are untreatable.
I am you:
“On my journey to recovery, I tried so many different routes and avenues and eventually decided to dedicate my life to learning about OCD and anxiety through researching anxiety pioneers, stoicism and ancient philosophy. When I came across Rational emotive behaviour therapy (REBT), a type of cognitive-behavioural therapy developed by psychologist Albert Ellis, I realised I was onto something. It focuses on helping people change their irrational beliefs. When I applied the teachings of REBT to my own recovery the results were incredible. I’ve now made it my mission to help as many people with OCD understand and apply rational thinking to their own OCD recovery and it has so far helped hundreds of people just like you.”
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Rational thinking and breaking down irrational beliefs
When we think irrationally, things can appear terrifying, rational thinking turns down the strong response in the body and brings calmness. As we break down our irrational beliefs fuelling the cycle we maintain inner peace as we adopt the rational alternative – creating an inner distance between ourselves and the OCD conflict.
Our recovery programme involves reading two of Albert Ellis’s most prominent and ground breaking books to understand how rational thinking can be applied to breaking down your fears.
Unconditional self-acceptance
Dr. Albert Ellis was the founder of REBT, which teaches us to accept that we are human and fallible.
What’s involved in recovery?
Irrational beliefs and fears are what make OCD an ongoing problem. Our programme helps sufferers to work through their fears and reduce the responses, working towards recovery.
Key ingredients for recovery include: exposures; facing fears; eliminating compulsions, reassurance and avoidance; changing our relationship with anxiety; and what I found to be the additional elements required to finally getting me over the line to recovery – changing our life philosophies and breaking down our irrational beliefs and fears; building a healthy life structure to provide the right framework for OCD recovery.
It’s important to change our relationship with OCD and give ourselves a rounded understanding of OCD so we can feel more comfortable with the path ahead. It can be seen as a bully inside that’s untreatable, but it’s only scary because that’s our perception of it. Recovery isn’t easy, and people don’t just ‘snap out’ of it. It’s a difficult journey that needs time, understanding, persistence and support.
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