Your OCD is not you

In my work with helping clients to manage their OCD, we talk about OCD as an internal bully who is constantly trying to gain our attention and have us engage in rituals.

The OCD bully seeks to control our lives every day. It attacks areas which are important to us by presenting us with scenarios where we have either done something bad in the past or may do something bad in the future. Sometimes it tells us we're bad just for experiencing an intrusive thought.

OCD likes to plant a seed of doubt in our minds because this is how it gets our attention. When we doubt ourselves, we feel anxious. In order to get rid of our anxiety we seek answers which will reassure us. We do this in various ways, for example by arguing with the thought, trying to figure out the finer detail of a situation, rationalising it, seeking reassurance from others or researching information. Any behaviour which we engage with in the moment to make ourselves feel more certain forms a compulsion. It's this compulsive behaviour which gives our OCD the fuel it needs in order to control our lives.

To help us separate ourselves from our internal bully it can be really helpful to imagine an invisible line between ourselves and the other entity which is OCD, which is constantly attacking us throughout the day. This can be a useful first step to regaining control of our lives. Once we get to know our bully, it becomes easier to start managing it. We talk a lot in sessions about how OCD operates day to day and how incredibly cunning it is in terms of getting a foot in our door and taking over our life.

When working against our internal bully week after week, instead of running away from situations which feel triggering to be in and protecting ourselves by engaging in rituals, I encourage my clients to invite the triggers into their lives willingly. We can think of this as giving our internal bully a hug instead of running from it.

This allows us to spend a short space of time in the triggering situation and to practise a different response to it. We completely give up control in that moment and allow the anxiety in, waiting for it to rise, peak and then drop down slightly. When this happens we can move away from the exercise.

This process forms an ERP (Exposure and Response Prevention) task. ERP tasks help to show our brain over time that we don't need to do anything to control our anxiety. It will regulate itself when we give up our efforts to control it. When we work with this approach our intrusive thoughts over time start to feel less strong and to appear less frequently in our lives.

I often describe this process as stepping outside of ourselves in the moment to see how our OCD reacts to our new behaviour. We can think of this as conducting a small case study of our relationship with OCD. Over time, as we make these kinds of tasks into a daily routine our brain begins to understand that we are not surrounded by danger every day. Our fears, while they are there for a reason, are completely irrational.

It's very easy to become consumed by a particular theme and to view this as the main problem. The reality is that the content of our OCD themes is not important. What is important is our reactions to it.

OCD loves to surprise us. Sometimes it comes up with new themes or variations on a current theme. Other times it chooses to bring back an old theme which we haven't worried about for a while. It feels scary when something new jumps up at us and demands our attention.

However, what is really important to remember is that this is the same bully wearing different clothes. When we look at the behaviour of our bully this is always the same; it grabs our attention and raises our anxiety or discomfort, then it urges us to engage with a repetitive ritual (mental or physical) designed to help us feel more secure in the moment. As long as we comply with OCD's demands, we remain stuck in a vicious cycle.

I always work collaboratively with my clients at their own pace. This is very important since the ERP process needs to feel manageable for my clients. The tasks should feel challenging to engage with, but not overwhelming. Over time they generally begin to feel much easier to deal with.

It's important to know that we are not responsible for creating our OCD. OCD happens to us and the only thing we can do is learn how to manage it better so that it doesn't present too much of a problem in our lives. When we do, it can also become easier to understand who we are underneath all those intrusions and what we would like to do with our lives in the future.

If you would like help with managing OCD, please find an OCD specialist experienced in working with Exposure and Response Prevention. For information and support please consider reaching out to the charity OCD Action.