If the symptoms of OCD are so painful, why do I want clients to lean into the pain? Tolerate the pain. Do nothing to get rid of the pain. In fact, seek pain. It sure sounds as if I like to torture people!
I’m an OCD specialist. My private practice is dedicated to helping people with OCD. So my entire day is spent figuring out ways to make people anxious by confronting fear.
- “Really, you think that’s contaminated? Oh good. Let’s touch it.”
- “Hmmmm. You think you might hurt someone? Prove it. Hold this knife to my stomach.”
- “Oh no! Did you just run somebody over? It sure sounded like it to me!”
- “I don’t know if you have OCD. Maybe it’s something else.”
If you’re not familiar with Exposure & Response Prevention(ERP) then you’ve got to be thinking I’m into torture. My clients would laugh about this and in jest nod their heads at one another…like uh huh. They’ve heard me say many times, “Oh! That makes you anxious? Good! We want that!” ? They reply, “Oh no. Why did I ever tell you I’m afraid of that. Oh no.”
A few clients over the years have dropped out of therapy looking for a gentler approach. While visiting a friend the other day, I saw a former client who was stuck in his driveway, taking the same steps over and over. Sweat was dripping down his face. He’d been stuck awhile. I helped him get unstuck and asked how it was going with his new therapist. He replied, “She’s not as tough as you.”
I’m tough because I see the potential in my clients. I want them to be the best they can be. I know there’s a way to be set free. If a client is not open to ERP, I ask “well, how’s your way working out?” Everybody always answers, “not well.”
Once someone told me my “take no prisoner” approach was unpleasant. I wasn’t sure what “take no prisoners” meant so I researched it. If I’m guilty of a “take no prisoner” approach then it means I’m determined and could care less about people’s feelings. I really gave this some thought.
It’s true to say that I’m determined. If you tell me you want to beat OCD then you better believe I’m going to give 110% to help you do it. I’m one of the most laser-focused committed therapists you’ll ever meet. Tell me you want to defy OCD and I’m going to make sure you get what you want.
So yes, to call me determined is an accurate description. But, sometimes my asset is my liability. There are times I start fighting harder than my client and that’s a problem. I work too long with people who don’t fight as hard as me. Who never do any work at all. And yet, I keep trying.
Meanwhile there are people on a waiting list to see me. People who want to do the work. Sometimes my “take no prisoner” determination keeps others from getting my help. I struggle with saying, “I’ve got to give up for now.” There’s a quote, “Do not try my patience I have perilously little of it.” Actually, I have dangerously too much of it.
The other description of “take no prisoners” would mean that I don’t care about feelings. It’s not true that I don’t care about people’s feelings. When I see the pain and agony my client is going through I am deeply affected. In fact, I’m at high risk for becoming preoccupied with someone’s suffering.
This is called, compassion fatigue and like many therapists, I have to take care of myself so I don’t become fatigued. I love rubbing my dog’s belly, watching good vs. evil movies (where the good guy always wins), gardening, competing (hard) in racquetball, cooking without recipes, playing board games, and blowing off steam at karaoke (see video below). These activities help me stay strong and healthy so that I can help someone do the hardest thing they’ve ever done.
I’m also comforted by knowing that my client who is in pain will one day be set free by all their hard work. I’ve witnessed 100’s and 100’s of people get better when they thought they never could. I rely on this knowledge to help me be strong and stay the course.
ERP works but it doesn’t always provide immediate relief. Anxiety is high and the urge to do a compulsion is strong. When a client does an exposure exercise I don’t get stressed when I see the fear in their eyes. Not because I’m into torture! Because I know ERP is like insulin to a diabetic.
It’s when they won’t do ERP and play mental Kung Fu–those are the times I’m stressed and at risk for burn out. OCD manipulates people into avoidance and even paralysis. It’s only weapon is to make you focus on obtaining a certain feeling. Like the young man stuck in his drive way. I helped him “just wrong it.” Who cares you don’t feel complete or “just right!” Is this how you want to live? Do what you want to do.
Some people will do anything to not be uncomfortable when that is the only thing they need to do! Be uncomfortable! It’s not dangerous, it’s unpleasant! SO WHAT!!!! ¯\_(ツ)_/¯
Perhaps the confusion about whether or not I care about people’s feelings comes from telling clients thoughts and feelings aren’t facts. Just because you’re afraid doesn’t mean there really is danger. People with OCD will spend hours trying to get a certain feeling. This is why I tell them feelings aren’t the solution, they’re the problem.
I’m rephrasing a Martin Luther King quote here a bit: “We will wear <OCD> down by our capacity to suffer, to face suffering, and do what’s necessary to make the change.”
I’m not into torturing. I’m into wearing OCD down with a willingness to be uncomfortable.
ERP will feel like torture if you don’t do it enough. You’ve got to hit it hard with repetition and frequency. Don’t swing to miss. Swing to hit.
You can wear down OCD. My motto: Find a way when there seems to be no way.
I’d love to hear from you in the comment section. Have you discovered it takes twice as much energy to swing and miss as it does to swing and hit? Or that the only way out is in?
Here’s the video I promised of me blowing off steam. As you can see, I’ve got a lot of it.