OCD, fear, shame and a pathway to healing

“I just can’t seem to walk past young children and I get these intrusive thoughts that make me sick. They go against anything that I stand for and I feel that there is something wrong with me. I wonder why I am like this”.

This is just one of the types of statements that I have heard from clients whom I work with and who have obsessive compulsive disorder (OCD). It is an anxiety condition that I specialise in and work in which causes many of my clients a great deal of distress.

OCD is a complex disorder but it is highly treatable and like any disorder, the quicker that treatment is provided and the younger the client, the better the chances of an outcome. However, change is possible at any age given the neuro-plasticities of our brain and there is always a therapeutic window to reduce the impact of intrusive and OCD-related thoughts on clients. For example, clients gain from exposure and response prevention work and acceptance and commitment therapy (ACT). These are just some of the therapies that can assist clients, as well as psycho-educational work which empowers them into knowing potential triggers that may affect their OCD.

As we all know from Hollywood movies, the image that is portrayed around OCD behaviours is one of cleaning and checking, which are physical compulsions that are carried out to provide some mental relief to individuals. This is just one sub-theme of OCD and there are many from POCD (paedophilia OCD) to ROCD (relationship OCD). The key thing to stress here is that the intrusive thoughts that people with OCD have are ego-dystonic and they go against the values, beliefs and actions of individuals who experience the intrusive thoughts.

This means that clients are not compelled to carry out what their intrusive thoughts may be hinting, commanding or suggesting. They are repulsed by the thoughts. The additional impacts of the intrusive thoughts are a lingering lack of self-confidence in themselves, a belief that they are somehow ‘evil’ or ‘wrong’ and a belief that they have a lack of control over their thoughts.

It is important to mention that intrusive thoughts are not a form of psychosis. Individuals do not lose their rational selves, or their decision-making capabilities. They simply fuse and believe in the intrusive thoughts which raise their anxiety and stress levels and it is this physical change that also adds to the ‘gravity’ of the thought and the belief that the thought must be dangerous and true. That is why they get caught up in it; in summary, it is the severity of the thought, the repulsive or difficult nature of it, the anxiety and stress it creates and the corresponding belief that it must be true and needs acting against, which drives the ruminations and the OCD.

The process of healing

The process of healing is for people with OCD to have the space and support to feel confident in voicing their fears and intrusive thoughts. By airing their intrusive thoughts, the fear can be sucked out of them, showing them for what they are; just words, and it also helps clients to reframe the thoughts as ‘just words that come into their minds’. This is one way of reframing intrusive thoughts and destigmatising them.

Finally, I have seen how clients with OCD have dropped their shoulders with relief as though a great weight has been lifted off them when they voice their intrusive thoughts. For many, they have been carrying them for years, a secret that was never theirs because it was not a part of their values and beliefs.

The power of therapy work therefore cannot be underestimated in facilitating people with OCD to feel accepted, acknowledged and most of all - humanised.