Category Archives: Exposure & Response Prevention

13 Bad Questions to Ask About an Obsession

In this conversation with a man who has OCD, 14 questions are asked.

It’s not that 13 of them are really bad to ask. Most of them are just kind of pointless.

Let’s hear from this man with OCD:

He visits the local Home Depot every morning to check all of the standing lamps that are for sale.

  1. I ask, “Why are you checking them?”

He replies, “I want to make sure none of the electrical cords are frayed.”

2. “How come?” I ask.

“Well, if someone buys a lamp with a defective electrical cord, their house could catch fire and people could die in the fire.”

He’s doing what he’s doing so that he can feel at peace. He’s been tricked into thinking that if he checks the electrical cords, his anxiety will lessen.

3. I ask him about this. “How would it feel to skip checking the electrical cords one day?”

“The guilt would weigh on my mind. It would nag at me. If I heard about a house fire on the news, the first thing I’d feel is guilt. The second thing I’d feel is a desperate need to know what caused the fire.

I’d be on the Internet trying to learn about the fire. I’d call the Fire Chief as many times as it took to get an answer. I’d want to know if the fire was caused by a lamp bought at this Home Depot. I wouldn’t be able to rest until I knew if it was my fault.

So I keep checking these cords so that I can have peace of mind. Otherwise every fire I hear about, I’m going to feel guilty. I’m going to wonder if I could have prevented that fire.”

4. “So once you’ve checked the cords and you’re done for the day, you experience a peacefulness and your anxiety is gone?”

“Nah. It’ doesn’t work out like that. I’m always worried that I didn’t check every lamp thoroughly.”

He’s getting tripped up on the degree of influence he thinks he has. He’s not tuned into probability. He’s focused on the pivotal role he thinks he plays as to whether something happens or not.

5. I’m curious. “How do you make sure the cords aren’t defective?”

“I run my hands up and down every cord. I’m looking for splits.”

6. I challenge him a bit. “Hmmmm, could the cord still be defective after you check it?”

“What do you mean? I run my hand up and down each cord three times. I doubt it.”

7. “Couldn’t the cord be defective not on the outside but in the inside? Not visible to the eye and not detected by touch?”

“Yeah, I guess so.”

8. “So then why do you bother with checking? Your method doesn’t sound foolproof.”

“I don’t know it just makes me feel better. I feel relieved and when I leave the store I feel I’ve made the world a safer place.”

9. “The world or just Home Depot?”

“Okay, well Home Depot anyway.”

He has no sense of responsibility to check any other potential fire hazard. He only feels responsible for this one aisle of lamps in this one store. 

10. “Are you doing what you’re doing to make Home Depot a safer place or to reduce your anxiety and guilt feelings?”

“I just don’t want the feeling of responsibility if something happens. I don’t want to have to be checking the news and calling the Fire Chief all the time.”

11. “So when you do hear about a fire, you don’t think it’s something you failed to do?”

“Yeah, as long as I went to the store and checked those cords, I don’t think it’s my fault. I don’t feel guilty. Weird, I know.”

12. “Hmmm…what about all the other cords in Home Depot? Cords attached to appliances, vacuums and tools for example. Do you check those too? And, aren’t there several Home Depots around? Shouldn’t you be doing this in all of the stores?”

“No, that would take too long.”

“So I’m beginning to think Home Depot isn’t as safe as you think. I’m thinking you can’t possibly do enough to protect the people who shop at Home Depot.”

13. “Is it necessary to check the same cords every single day?”

14. “What do you suppose can happen to them in 24 hours?”

He replies, “Probably nothing, but it’s safer to make sure.”

Even when the likelihood of something happening is statistically unlikely, the potential for harm is still terribly exaggerated in his mind.

This has been a lot of conversation with a man, who is worried that if he doesn’t check certain electrical cords, he’ll be plagued with guilt feelings, and perhaps be indirectly responsible for causing harm.

A lot of the questions challenge his automatic thinking process and try to help him see the holes in his theory.

But only 1 of the 14 questions is brilliant. 

Out of all the questions he was asked, only one question leads to a life changing solution.

Which question do you think could begin to interrupt his way of thinking?

What if Exposure & Response Prevention (ERP) Makes Me Worse?

“Can My OCD Get Worse With ERP? 

On Facebook and in my own practice, that question gets asked a lot. It sounds very similar to the question children ask before getting an injection, “Is this going to hurt?”

The doctor tells the truth, “Yes, it’s going to hurt! But, not for long.”

Engaging in ERP is not something your brain will immediately register as a good thing. You’re going out of your comfort zone and all the bells and whistles in your amygdala will be sounding off! “DANGER! DANGER! DANGER!”

That’s why many people choose not to do ERP. It doesn’t feel right. It doesn’t feel good. Your brain will tell you to turn back.

It’s hard to find a pace that is “just enough.” It’s scary to move forward with exposure exercises. You won’t want to provoke your anxiety. You’ll worry it’s too much.

But, how else can you become desensitized? How else can you disprove OCD and throw it under the bus for being such a liar?

“Just enough” is the sweet spot. Some people flood and go for the big guns. “Let’s just get this over with” and they take on their worst nightmare. For them, that’s “just enough.”

Not everybody can confront their fears that way. 

Find a pace that challenges you and then build momentum. Do one thing that scares you and hit it with repetition. Then do something else that scares you, “just enough” and repeat, repeat, repeat. Keep building.

You’ll discover you can tolerate a lot more than you thought you could. And…your confidence will grow.

Growing Means Ouch

In 1979, Open Heart surgery was practically barbaric. The scar I have is 100 times wider and longer than people who have the surgery nowadays. Sometimes I feel like Frankenstein.

I’ll never forget that tube down my throat and having to be suctioned. The tears rolled down my face the first few times. Then I got used to it. Nowadays people have the breathing tube removed and leave ICU within 18 to 24 hours of surgery. I was kept on life support for over 72 hours.

 

I was in my late teens and didn’t want the surgery. At first I denied I had the problem and tried to negotiate with my doctor. But, he told me I had a hole in my heart the size of a quarter. The surgery had to be done or I’d be dead before age 40.

My life depended on this barbaric surgery. They sawed through my bones and wired them back together.

After the first day of surgery I refused pain medicine. I leaned into the pain. I wanted to get out of that hell hole. Every time I so much as sneezed, I thought I was tearing the stitches that held my heart repair together.

I mustered through. I wanted out of that place. I wanted to live my life. Within 10 days of surgery I was playing tennis.

My Strangely Wrapped Gift

A few months after surgery I went on a date with a young man who came highly recommended by my co-workers. He picked me up at the store and my co-workers said, “have fun!”

Against my wishes he drove me to his house. His parents weren’t home. He brought out an astrology book and told me the stars indicated we would make good sexual partners. I told him no. He said yes.

I thought quickly. I told him I just had open heart surgery. He saw the red, swollen scar. I told him I would die if I was traumatized. He was angry. “You should have told me about this.” He brought me back to the store. I was safe.

Doesn’t look or feel like a gift

In so many ways, open heart surgery was my strangely wrapped gift. 

Just because something hurts or scares you doesn’t mean you shouldn’t do it. When deciding whether or not to do ERP, consider the track record of people who have done it.

It’s a mighty fine track record.

And, I hope those of you who have done it will leave a comment and encourage those who are on the fence about it. There are people who need to hear from you. How bad was it before ERP? How terrifying was ERP? How’d you make out? Please leave your anonymous comment.

Remember this, wherever you are, it’s where you’re supposed to be. We will always be given opportunities to grow and learn. Lean into it.

OCD is a strangely wrapped gift. It doesn’t feel like it at first. Neither did open heart surgery. 

I Used to Be Afraid of Elevators. I Took Steps to Overcome It.

“I took steps to overcome my fear of elevators.” Ha-Ha funny play on words. But, what does it mean?

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You took action steps to work towards being able to ride elevators? Or, you’re being sarcastic and you “overcame” your fear by avoiding elevators and taking the stairs?

Which is true?
  1. Your life will be better if you take action on the things you avoid.
  2. Your life will be better if you avoid unpleasant and seemingly dangerous things.

Are you picturing Captain Obvious right now?captainobviouschooseoption

There’s no way avoidance can make life better. Right? Hmmm…then why do so many people avoid unpleasant things? Why do people procrastinate? Why do people avoid triggers that cause anxiety?

Avoidance must make life better! Otherwise, why do people do it?

I searched the Internet for evidence that avoidance makes life better. It’s what people do so there’s got to be value in doing it. Right?

I Googled: “How Does Avoidance Makes Life Better.” Here are just 6 of the 28,000,000 results. They all say the same thing:

Avoidance Causes Anxiety to Snowball

The More You Avoid, the More Likely You Will Keep Avoiding

Avoidance Simply Produces More Anxiety

The Price You Pay for Temporary Relief

Avoidance Prevents You From Learning the Situations You Fear Aren’t Even Dangerous or Nearly As Unpleasant As You Think

Avoidance Solves One Problem But Creates Another

The list goes on and on. But, I could not find any bit of research to prove avoidance makes life better.

Every shred of evidence pointed to the fact that it makes life worse. Not the anxiety, the avoidance. The avoidance makes life worse.

So what to do? Become AWARE of the truth! 

I saw this acronym for AWARE at Uncommonhelp.me:

Accept the anxiety. It’s here to stay. Live your life with anxiety.

Watch the anxiety. Don’t evaluate it as good or bad. It just is. It’s not dangerous. Only your reaction to anxiety can be dangerous.

Act normally. Act as if you don’t have anxiety.

Repeat the above steps!

Expect to handle whatever. Whatever happens, happens. You’ll handle it.

160_f_54867862_hlxe0hmehr89ftlthjyx5yfp6n4jh6fpI know what you’re thinking. It’s easier to avoid than confront. It’s too hard to “Feel the Fear and Do It Anyway.”

 

If you’ve been avoiding for awhile, of course it seems easier to avoid than confront. Hello Captain Obvious!

But, if you could remember the first days you avoided, it was hell. You beat yourself up. You lost sleep over it. You were torn up over what to do. It was so hard to get it perfected. It was hell!

Try this challenge:

Walk through your house for 72 hours touching nothing and nobody. Nobody can be be in the same room you’re in at the same time. Be very careful not to brush up against anything. If you think you brushed up against anything, go back out of the room and come back in. Don’t sit down. You can only squat. You can only eat Cheerios using chopsticks. When you sleep the only way you can be in bed is if you first wash the bottom of your feet while sitting on the edge of your bed. And you can only sleep, no matter how cold you are, on top of the covers looking up at the ceiling, with your hands folded behind your head.

The first 24 hours you do this, you’ll be agitated and stressed. The second day, it’ll still be hard but you’re getting better at it. By the third day, everyone around you is properly trained to stay away. You’ve figured out a few tricks to make it easier to avoid. You’re tolerating this kind of life better than you were the first 24 hours. Imagine in two weeks how much easier it will be.

Avoiding is only easy because it’s what you’ve been doing. It didn’t used to be this easy! You’re tolerating avoidance better now, than you did in the beginning. 

The same can be said about confronting. At first it’s anxiety provoking. You’ll feel indecisive and lose sleep. But, in time, it’ll get easier and you’ll tolerate the anxiety. 

You get good at what you practice. You can teach yourself to tolerate anything over time.

Don’t say, “Confronting my fears is easier said than done.” Once upon a time avoiding was hard. But you did it anyway. 

Your Life Will Be Better If You Take Action on the Things You Avoid 

Is Anger Making Your OCD Worse or Better?

What Role Does Anger Play in the Symptoms of OCD?

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As a therapist who specializes in the treatment of OCD, I notice a trend. Clients struggle with feelings of anger. The anger is directed outward and/or inward. 

If the anger is directed outwards there could be verbal outbursts and even aggression towards property or people. There are heated arguments at home, holes punched in walls and sometimes the police are called.

Anger directed inwards is usually manifested by self-loathing and depression. People hit themselves and/or say horrible things about themselves. They often say, “I don’t deserve this kindness, or to feel good or be loved.”

For some the anger only surfaces when compulsions are being resisted. If they increase their compulsions, their anger significantly decreases. If compulsions are prevented, anger rises.

Anger As a Defense Mechanism

Initially, having OCD can result in the development of maladaptive defense mechanisms. A common one is to detach emotionally. This is a common reaction to repeated trauma, which is exactly what an untreated OCD can be. Trauma and torture.

Having OCD can be very traumatic. The anxiety can be overwhelming. To be protected from the unbearable fear and pounding negativity the brain fragments, compartmentalizes and encodes in a way that causes emotional numbness.

Feelings are essentially sealed off. However, one emotion presides. ANGER. That’s because anger creates heat where there is no life. When a client is detached from their feelings, they don’t even experience anxiety during exposure exercises. They get mad, but not anxious. I say, “Thank goodness you’re alive and kicking!”

Being detached from all emotion except anger can be very disconcerting to someone with OCD who has intrusive thoughts of harm. “Why am I having these horrible thoughts without anxiety. I’m angry. What does this mean? I’m having violent thoughts but I have no remorse. What’s wrong with me. Am I going to act on these thoughts?”

Compulsions Are Used to Alleviate Anxiety and/or Anger. 

When a ritual is interrupted a person with OCD will react with either anxiety or anger. If they’re anxious, they’ll likely be drawn to some form of reassurance. If they’re angry over the ritual being interrupted, they might yell. A door might be slammed. “Thanks a lot. Now I have to start this all over again.”

A person with OCD manages their anxiety with compulsions. There might be a story attached to the compulsion. “I shower like this to protect my child from getting sick.” But, that’s just the story behind the compulsion. The real reason for the compulsion is to alleviate anxiety.

Likewise, a person with OCD manages their anger with compulsions. Anger doesn’t seem like an acceptable, or safe emotion to have. There might be a story attached to the compulsion. “I stay away from knives to protect my family.” But, that’s just the story behind the compulsion. The real reason for the compulsion is to alleviate anger.  

Why Does it Matter?

What difference does it make if compulsions are done to alleviate anxiety or anger? In either case compulsions have to be resisted in order to be set free. So what does it matter if there’s anxiety or anger underneath the compulsion.

Everybody aways talks about the anxiety attached to OCD. “I do this ritual because I’m afraid something bad will happen.” “I do this because I won’t sleep if I don’t do it.” This is just talking in code. What’s really being said is, “I do what I do to alleviate anxiety.” 

In this case, I would help the person with OCD learn to tolerate anxiety. Much of my blog is about this. Can the same be said for anger? Should anger be tolerated?

Experiencing anxiety is not a health hazard. But, resisting anxiety is. Resisting anxiety is detrimental to one’s heart, immune and digestive system, and hormone production. Resisting only causes stress levels to rise. The same can be said about anger. 

What to Do About Anger?

 

Practice Mindfulness Exercises

Notice anger the same way anxiety is noticed. 

  • Notice the angry thoughts without judging.
  • What is the speed of your thoughts?
  • What is the anger saying?
  • What is the anger seeing?
  • How does the anger feel?
  • Do I feel hot or cold?
  • What body sensations am I feeling?
  • What is the speed of my heart?
  • Am I experiencing any muscle tightness? 
  • What is my breath like?
  • What position are my eyes in?
  • What is my facial expression?

Talk to anger with loving attention.160_f_118764193_rvbtrzf2f0wveh4bctpacdsnzevmd9hv

  • “Wow, that feels like anger. OK, I can handle it. This is a good opportunity to practice noticing without judging or acting.”
  • Ask, “Do I have a desire to remain angry?”
  • “What are my options?”
  • “Can I assert myself with kindness?”
  • “If I engage in a compulsion to alleviate this anger, will it be conducive to my well-being?”
  • “I wish to take responsibility for my actions rather than blame others.”
  • “I accept that life is unfair and bad things happen. It’s ok. I can handle it.”
  • “I have a right to be angry. It’s okay. I can work through it in a healthy way.” 

Feeling and Acting Are Not the Same

160_f_117123901_l3wbln8gaasor1gcaaclumz22wiczfhaThere is a difference between accepting anxiety and acting anxious. Feeling anxious must be accepted.

Acting anxious is engaging in compulsive behavior and/or mental rituals. Acting anxious looks like avoidance and reassurance-seeking. Acting anxious, like rocking back-n-forth, or rubbing hands feeds anxiety. It’s okay to feel anxious, but it’s of no benefit to act anxious.

There is a difference between accepting anger and acting angry. Having OCD is not an excuse for lashing out or mistreating self or others. You can say what you mean, but you don’t have to say it mean.

Fueling anger triggers the amygdala and kicks you into “danger” mode. Fueling anger can shut down logic and cloud judgment which leads to irrational and unreasonable thinking, which leads to regret and hurtful decisions. Anger is an acceptable emotion but fueling it is of no benefit to a brain that is already sounding false alarms.

Be aware when you’re experiencing anger. If you don’t pay attention to it, you’re building a fire. The anger is uncomfortable and you’re naturally going to worry about it or want to get rid of it.

Instead of channeling your energy towards avoiding or getting rid of anger, acknowledge it. Notice it. Recognize your urge to do a compulsion is an effort to alleviate anger.

Turn towards the anger and practice mindfulness exercises.

An Open Letter to Those of You Loving Someone with OCD

This is a letter to those of you who are coping with OCD. Either you have it or someone in your family has it.

I can’t imagine how frightened you were when your loved one was first snatched up by OCD. Everything was suddenly turned upside down. I’m sure you were terrified that things would never be the same.

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In the beginning you tried to do whatever made your loved one less anxious. It hurt so much to see your child or family member in such agony. So you tried to end the horror as best you could.

Enabling and Reassuring Doesn’t Work

160_F_87314604_cXY7LMNX2XytR4PZrfpMnu823xukjMrCYou offered constant reassurance and tried over and over to use common sense and logic to get rid of your loved one’s fear and worry. But that part of the brain didn’t seem to be functioning properly. (There’s no logic in OCD!) So you ended up talking and talking until you were blue in the face.

You complied and met every OCD demand because it just seemed easier. You even joined in on some of the rituals like saying “I love you” five times or washing your hands when they weren’t even dirty.

160_F_76900683_xLdS4hkfytRXqf2KOLFEtKVyObB0sn7gYou kept the environment free of triggers and censored people’s words to keep them from triggering your child or family member. People stopped visiting because they didn’t want to make the situation worse.

You lost a lot of sleep and resorted to lecturing and giving the cold shoulder. You lost your cool many times. You thought, “This is so ridiculous. Just stop it!” 

I hope you know that you were coming from a place of love, not doubt, when you cried. And a place of fear, not hate, when you yelled or walked away in frustration. 

Your loved one has a problem with self-compassion. I don’t have to meet you to know you have the same problem. Maybe you weren’t always resourceful but you were always doing your best. Always.

In desperation or out of convenience, you kept enabling and reassuring. But, the relief was only temporary. OCD seemed to just get bigger and bigger. It robbed all of you of everyday pleasures and new experiences. The world got smaller with every passing day.160_F_101490863_zrPBrMmSdlxiWuDh94SwpgK0sRPut9ci

You thought all the reassurance would help ease the anxiety but it actually made it worse. The demands were getting more intense and frequent. Accommodating wasn’t helping anything other than providing one very brief moment of relief.

And then your prayers were answered. You found out that giving in was actually feeding OCD. 

Gradually Stop Accommodating

You knew that if you stopped feeding OCD your loved one would protest. Things were going to get worse before they got better. You worried: What if we’re biting off more than we can chew? 

160_F_111735791_JTouzhQEZie5tshllaRTtlFzFqSq38mDBut, you believed that in order to get a better outcome, the approach needed to change.

You stopped giving in and your loved one cried, “Don’t you love me? Why aren’t you helping me?” Talk about being stabbed in the heart—ouch.

You got tougher and your loved one accused you of not understanding, “You just don’t get it! I’m all alone now.” Ouch that hurt too.

You stopped enabling but your loved one put you to the test, and said, “Fine, “I’ll go without.” Oh no! So afraid. What if things get worse now?

Support Your Loved One, Not OCD

You validated your loved one’s feelings, “I know this is hard. I can tell this is causing you a lot of pain.” Validate. Acknowledge. But, don’t take away the pain. Soften into the pain. It’s hard to be anxious when you want to be anxious.

160_F_88892850_k54dF5pbMxv6ZBXVl1U40GHXPK8Hh43HYou also showed how much faith you had in your loved one’s ability to overcome, “You’re stronger than you think. I know that you can do this. It’s hard, I know. You’ve done hard before. You’re not alone. I’m going to help you boss it back. I’m not going to feed OCD anymore, but I will help you defeat it.”

As time passed you remained patient. You stayed the course and your loved one began to understand there would be no more avoidance. Your message was loud and clear: THE FEAR HAD TO BE CONFRONTED.

Your loved one had no other way out—but in. No more avoiding.

  • OCD said, “Leave.” Nope, everybody stayed.
  • OCD said “Don’t go.” Everybody left.
  • OCD said, “Avoid.” Everybody leaned in.
  • OCD asked, “What if?” Everybody shrugged and said, “Whatever.”
  • Your loved one sought reassurance, “Could this happen?” You put it back on them, “I don’t know.”
  • “Will it be okay?” You shrugged, “We’ll deal with it. Whatever happens, happens.”
  • OCD warned, “You’re getting too anxious. You can’t handle it. Do something.” You all said, “Good. We want that anxiety. We need to practice handling it.”

It wasn’t easy to Boss it Back. But feeding OCD wasn’t easy either. It was scary bossing it back, but feeding it was scary too. Both seemed like poison.

Boss it Back or Feed It
Boss it Back or Feed It

You picked the right poison. Which ended up being the antidote—the healing potion.

The catastrophes have ended. Life has returned. No more tiptoeing. Your loved one still has weird thoughts. But, they’re fewer and fewer.

There are still triggers but nothing a good shrug or “yup” can’t fix.  ¯\_(ツ)_/¯ 

Honestly, I’m really happy today because I’ve learned that a number of kids, near and dear to me, have returned to school this week with nothing more than a tiny little hiccup. (I’m thankful for the hiccups because they will only build more skills and cause more mastery.)

What About Those Who Are Still Being Accommodated?

I’m thinking now of those who haven’t been set free. Family members who continue to accommodate and reassure. There’s not a lot of bossing it back going on but, there’s a lot of tension. It feels like a hostage situation, I know. 

Perhaps you have OCD and are reading this, realizing the ways YOU are being accommodated and enabled. Whether you’re requiring your family to accommodate you, or just passively allowing it—how’s it working out? Everything you want is on the other side of fear. Go get it!

If you are a family member who is enabling, write down all the ways you are doing this—feeding OCD. Rate each one in terms of which ones you think would have the least impact on your loved one’s life if you stopped doing it.

160_F_85393917_Ld7cw3wo904aefXzfIgDbj04rNRYBVjMDiscuss the list, and your ratings with your loved one. Then ask him or her to rate the same list and to “feel free to add to the list” any missed accommodations. Compare the two lists and acknowledge all the difficulties your loved one faces.

The next step shouldn’t be done unless you’re prepared to follow through. I recommend you do this with the help of a therapist who specializes in OCD. An OCD therapist will tell you that accommodation has been tied to poor treatment outcomes. A nonOCD specialist is likely to get caught in the trap of reassuring your loved one a lot.

You can also find expert help and guidance in several books. There are numerous books to guide you through the process too. 

There are some people with OCD who will threaten harm to self or others if they are not enabled. Do not be held hostage with this threat. If your loved one makes such a threat, or goes on a hunger strike, take your loved one to the emergency room or call 911 immediately. Don’t mess around! 

But, in many cases, your loved one will (begrudgingly) go along with this plan. They don’t want to live like this either! A 25 year old feeding OCD for almost 10 years now, was asked by someone else’s parent, “What do you wish your parents had done differently?” He answered, “Not accommodate me.” WOW!!! High Five!

Explain Why Things Have to Change

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Explain to your loved one the current method of accommodating isn’t working. “There’s only temporary relief and that’s not good enough! At this rate, we’re all just hamsters in a wheel.” Try to gain permission to stop the enabling. It can be done gradually by withdrawing some of the easier accommodations.

If you don’t get permission to stop, that’s okay. Your loved one will probably be overwhelmed by this conversation but in their heart, they know it’s what’s best.

You’ll be tested. Mean what you say, but don’t say it mean. Explain if they don’t want to participate in the planning you’ll be picking the accommodations that will be stopping yourself. Look at the calendar with your loved one and write down the day you are going to stop each accommodation.

An Example of An Accommodation

Let’s use the example of contamination fears. Are you opening doors for your loved one so that s/he can avoid germs? This is an example of YOU feeding OCD. It’s one thing if your loved one unfortunately chooses to feed OCD, but why are you? Your loved one might still feed OCD by using a Kleenex to open the door but at least you’re no longer reinforcing the fear! 

What If You’re the One with OCD?

If you’re the one with OCD being accommodated, do yourself a favor! Get your life back by telling people who love you to stop enabling you! With calendar in hand, sit down with your enablers and say, “This is the day you’re going to stop this accommodation. I’ll need your encouragement but please stop feeding my OCD.”

Accommodating someone with OCD and offering plenty of reassurance is usually the mistake everybody makes in the beginning. If you conduct a cost/benefit analysis on accommodating you’ll discover the costs outweigh the benefits.

Hopefully, you’ll continue to get more informed about how enabling someone with OCD is actually…disabling. Just start with gradual changes and hopefully you’ll make good progress.

Bonus: If you want a Quick Guide for 6 kind and gentle ways to stop accommodating your child, Click HERE. It’s great for the fridge! Once you click, just check your email.

By the way, the Quick Guide? It’s good advice for adults with OCD too. ac41290798310afdf52eccaaf1ba73af

As always, your comments are welcome and really make my day. But, in addition to commenting, if you know someone who’s coping with OCD share this post with them!

Nobody’s healed until everybody’s healed!

A Skill Everyone with OCD Needs: Sitting

What does it mean to “sit with unwanted, intrusive thoughts” and how does someone with OCD do it? Especially when the thoughts are frequent and intense.

If you’re like most people you’ve got weird, sometimes scary thoughts. If you’ve got OCD, how you experience those thoughts can get very complicated and time-consuming. 

An OCD therapist won’t analyze your thoughts. Instead you’ll be shown how to “sit” with your thoughts. “Sitting” with your thoughts doesn’t necessarily involve a chair. It means “experiencing” your thoughts in an accepting way.

No matter how ugly or bad, just allow the thoughts to be in your mind. Do nothing compulsive to get rid of the thoughts. Do nothing to get rid of the anxiety that comes with the thoughts.

What follows is a conversation I often have with clients about how to sit with thoughts. Warning: This conversation may increase your anxiety. (Not that there’s anything wrong with that.)160_F_88915066_1sYtf7AaBRW7oQrfnvqHd9DFguwdyQSq

Client: My mind is a constant chatterbox. I’m not getting a break from my thoughts.

Me: What are the thoughts about?

Client: I’m worried I might hurt people. I know I never would in a million years. But, it’s the kind of OCD I have. I’m worried something bad will happen.

Me: Are those thoughts wanted?

Client: No! They’re totally unwanted!

Me: Are they intrusive?

Client: Believe me these thoughts interfere with my life. I can’t even concentrate.

Me: So they’re pushy. 160_F_51672290_vN6Fz6qCSl8iTh08mMoAOhndpJwF4ymp

While you’re trying to do other things the thoughts hammer away at you. Like a sideshow playing in your head?

Client: Yeah. It’s a sideshow and it’s not fun. I’m frightened by these thoughts. Sometimes it’s not just a show playing off to the side. It’s the only show playing in my head!

Me: So sometimes you aren’t doing anything else but having the thoughts.

Client: Yeah there are days I’m in an OCD trance.

Me: What are you trying to accomplish when you’re in this trance?

Client: I’m trying to feel certain that nothing bad happened or is going to happen. 160_F_74848595_0ay6BB5CpNyM7DvZTAC3IEuWKpSm3LEt

Me: You’ve spent 100’s of hours trying to get certainty?

Client: Probably 1000’s of hours.

Me: How’s it going? Have you achieved certainty about this yet?

Client: Not yet. Why? Is there another way to get rid of the sideshow?

Me: You can get rid of the sideshow by playing the sideshow.

Client: I don’t get it. You want me to voluntarily play the sideshow? This sideshow isn’t fun!160_F_2992219_D7LMNPunABCDj7qrFGQZa6UdABT0sF

Me: Yeah, gladly let the sideshow play. In fact, invite the thoughts.

Client: You want me to welcome the thoughts that scare me?

Me: It’s not the thoughts that scare you. It’s your interpretation of the thoughts that scare you. It’s the way you experience the thoughts. Lots of people get the same weird thoughts as you, but don’t get scared by them. OCD makes you experience the thoughts as if they’re real. You can change the way you experience the thoughts.

Client: Well, my OCD makes me think about hurting people. Don’t you think that’s pretty scary?

Me: Your OCD doesn’t make you think about hurting people. That sort of thought crosses everybody’s mind at one time or another. The way you experience such a thought…your opinion of that thought…that’s OCD.

Client: Well, I don’t like these thoughts and I’m trying to get rid of them. That’s what I want.

Me: That’s what I mean by changing the way you experience the thoughts. In all your efforts to get rid of the thoughts…using compulsions and mental acts…the reassurance-seeking…has the sideshow ever stopped?

Client: It might take a while to get the compulsion to work but, yes…I can stop the sideshow and get relief by using a compulsion.

Me: For how long do you feel relief? How long before you’ve got to do another compulsion or mental act? How long before you need more reassurance?

Client: It could be minutes.

Me: Seconds?160_F_102006633_DhS9SMhx1UmDC5y3ahKUlAlxHh709e3D

Client: Yes, sometimes.

Me: How’s this technique of yours working out? Is your brain resetting and learning anything new about fear when you do a compulsion. Haven’t you become a reassurance-junkie?

Client: Okay, I get it. It’s not working well. I waste a lot of time and it hurts my relationships. I avoid anything that triggers my thoughts.

Me: So let’s turn up the volume on the sideshow!

Client: You want me turn up the volume? I thought you’d show me how to turn down the volume!

Me: I am!

Client: By turning up the volume, I’m turning down the volume?160_F_11335624_tjRrHVDwRVuxDQjCHBdg6c13z1BUD2lx

Me: Maybe! (No reassurance from this therapist!) Wanna try it?

Client: Oh wow. I don’t know. How do I just let the thoughts be there?

Me: It all comes down to one thing. It’s not about the content of your thoughts. What you’re thinking really doesn’t matter. It’s about your opinion of your thoughts. Right now you’re opinion of the thoughts are that they’re unwanted and intrusive. Yes?

Client: Absolutely.

Me: What if you experience these thoughts in a different way? Stop thinking of them as interfering and disruptive? Just keep doing whatever you need or want to do even though there are horrific thoughts playing in your mind.

Client: I do that most of the time. I go on about my business but the thoughts are still there! I don’t want these thoughts!

Me: What if you weren’t resisting these thoughts? Would you be in such pain and agony?

Client: How can I not resist such frightening thoughts? These thoughts feel real to me. I’ve got to resist them. I’ve got to prove I’m not a danger to anyone.

Me: What if you welcome and invite the thoughts?

Client: If I invite the thoughts I’ll become my thought. I’ll do bad things.

Me: Well, let’s test that out. If you think the thought, “Tammy I’m going to kill you.” Let’s see if that happens.

Client: No, I don’t want to kill you. I don’t want to think that.

Me: So you if you think it, it will happen? Okay, don’t think about killing me. Don’t do it. Stop thinking about killing me.

Client: Oh man…I can’t help it. You put it in my mind. I’m thinking it now.160_F_77155475_bfmBcVI52k9CtRFmpr1IFveKMKfUVZTw

Me: Great let’s see if you kill me. Here, let’s give you a knife.

Client: OMG.

Me: So you’re holding a knife and thinking about killing me. Have you become your thoughts?

Client: No. I haven’t killed you.

Me: Thanks I appreciate that. Does your thought about killing me end up being dangerous or unpleasant?

Client: Unpleasant.

Me: Is that something to be afraid of—an unpleasant feeling?

Client: No. I don’t need to be afraid of something unpleasant. I can handle discomfort.

Me: Instead of saying these thoughts are unwanted and intrusive say, “These thoughts are fine to have. They’re unpleasant but I can tolerate them. In fact, I invite them to stay in my mind.”

Client: That’s easier said than done.

Me: C’mon you can’t convince me trying to obtain certainty about anything is easy. No matter which way you go…it’s hard. You’re willing to work hard to get certainty. How about working just as hard to live with uncertainty?

Client: No, you’re right. I spend hours trying to get certainty with a compulsion. What do you mean by inviting these ugly thoughts?

Me: Hint…stop calling them ugly. Call them fascinating. It’s a PARADOXICAL approach. It contradicts logic. It’s absurd but that’s how you defy OCD. It’s using REVERSE PSYCHOLOGY on OCD.

Client: Will this get rid of the thoughts?

Me: OMG! Stop trying to get rid of the thoughts!!! The thoughts need to be experienced. Just change the way you experience them.

I used to hate math class. I would excessively hum so that I’d get kicked out of the classroom. That wasn’t working out too well when it was time to take a test. My brain hadn’t learned anything by being in the hallway. So I decided I better stop humming and start listening. I stopped resisting having to be there. I changed the way I experienced math class. I willingly attended the class. My brain got updated and my grades improved.

Awesome Life Changing Tip: Don’t resist your thoughts. Don’t try to think about them less. Think about them more. “I am open and willing to experience these thoughts and feelings.”

Warning: If you have “Hit and Run” OCD the following two paragraphs may increase your anxiety. (Not that there’s anything wrong with that.)

A person with “Hit and Run” OCD will do everything they can to get certainty that they haven’t hit anybody. They try not to go anywhere that involves driving. If they do drive, they’ll spend hours circling back looking for bodies, watching the news, checking their car or just waiting until no one is around before they move their car. 

Here’s a script using a paradoxical approach: Even though there are pedestrians walking around I’m just going to drive away and not look back. I’m not going to go back and check to see if I hit someone. I’m not going to check the news. I might have hit 160_F_56537437_h6tWFtsEYVOzg8QxmU4h05fORKqEP6txsomeone. There’s probably body parts dangling form the grill of my bumper. But I’m not going to check. There might be a trail of blood leading from the scene of the accident right to my house. The police are going to follow the blood and put me in jail. My family will disown me. I’ll be shunned forever. I don’t know if I ran anybody over. But, I’m not going to go back and check. I want to live my life. I’ve got to move on.”

True, using “Reverse Psychology” or a “Paradoxical Approach” is counterintuitive. It doesn’t feel right. Your emotions will tell you this is wrong and to stop it. But, as wrong as it feels, it’s the next right thing to do. 

What You Will Discover

It’s hard to be anxious when you want to be anxious. When you soften into the anxiety it softens too. The byproduct of learning to tolerate anxiety is less anxiety. It’s not the goal, it’s the bonus. Keep your focus on the tedious process, not the result.

Where You Might Get Stuck

It’s unpleasant to accept weird, scary thoughts. You won’t like it. But, how’s resisting thoughts working out? Either way you’ll be anxious. But, only one way will set you free.

You’ll get frustrated because even when you start to accept the thoughts, they’ll keep coming. It takes time for your brain to make the adjustment. But, because you have stepped out side of your comfort zone, you’ll want to quit letting the thoughts be there. You’ll have to fight a strong urge to give in to compulsions for the quick fix. Don’t quit the day before you were going to feel better!

It doesn’t feel right to think about the thoughts more. Your anxiety tells you to think about them less. It’s counterintuitive to bring on unpleasant thoughts. It’s not logical. But neither is OCD. You’ve got to fight irrational with irrational. Illogical with illogical. I know, I know, it’s backwards!

How to Make it Real and Take Action

  1. Click above on the words PARADOXICAL and REVERSE PSYCHOLOGY to follow the links. Try to gain a clear understanding of what it means to be paradoxical. (If anyone wants to leave an anonymous comment about an example please do!)
  2. Write a script that is applicable to your own fear. Similar to the one above regarding “Hit and Run” OCD. One of the most awesome books with pre-written scripts is: Freedom From Obsessive Compulsive Disorder by Johnathan Grayson.
  3. Practice saying,“Good there’s my thought. How fascinating. I can’t wait for the next one.” 
  4. Focus on the process of being paradoxical, not the result of being paradoxical.
  5. Keep on keepin’ on no matter how counterintuitive (wrong) it feels.
  6. Use your dry sense of humor when you’re being paradoxical.
  7. Be kind to yourself. Courage lives within your kindness.

You can change the way you experience your thoughts! You can’t control your thoughts but you can control how you react to them!

Should You White Knuckle Your Way Through ERP?

Do you “white knuckle” it when confronting OCD? How stressful should it be when you’re defying OCD?

Last winter coming home from Rochester, I hit some very scary weather. I was in a state of great fear and tension. I didn’t want to be in this risky situation. It was bumper to bumper traffic on the thruway with tractor trailer trucks barreling through on either side. My hands were clutched so tightly on the steering wheel my knuckles were white.IMG_1153

At the OCD Conference last week, I was hit with the 2nd worst migraine of my life.  It’d been so long since I had one, it didn’t 160_F_103214808_6fDrzTjfFWbLIVFFbOHCbCoZqTKcCrW9occur to me that it was a migraine. I thought it must be a brain aneurysm or a stroke. I was in the middle of a case presentation when my head started to pound.

I couldn’t hear what anyone was saying. I kept nodding my head as if I was part of the conversation. Surely they must see something’s wrong. How embarrassing. I kept willing the headache away. It got worse. The lights seemed so intense. I became nauseous. It was like trying to give birth through the top of my head. 

Finally, in the middle of my presentation I admitted I wasn’t feeling well and excused myself. I said some kind of joke and everybody laughed. I needed to get to my room. Maybe I had some medicine there. I had to take one elevator to get to the other elevator. I had quite a distance to go. I “white knuckled” it all the way to the 26th floor.

I was alone in Chicago and terrified thinking somebody was going to find me dead in the elevator. I worried it would be someone with OCD who, as an exposure exercise, had just told their therapist, “I hope with all my might you die.” I wanted to write a note: “This isn’t your fault. There’s no such thing as Thought Action Fusion. This is a coincidence.” 

I practically crawled into my room and called home. I was reminded what I had done that caused the migraine. I had walked from the hotel to the beach through Toxic Lane. I even wrote about it in my blog the day before. I was paying the price as I’m sensitive to certain odors. The last time this happened was when I lifted the hood of my car and was exposed to radiator fluid.

After an hour and a half, with my head still throbbing, I went back and finished my presentation. I said, “If this is just a migraine, I 160_F_13025714_W1xclkZQdL1neclkC3uj7vn0ZRMtCvxYcan do this.” Again, I “white knuckled” through it. It went well and nobody seemed to see the 12# baby coming out of my head.

I’m sure all of you have experienced a time when you “white knuckled” it.  Hopefully, you’ll share your example in the comment section.

But whether or not you should white knuckle your way through ERP was the conundrum at the OCD Conference this year. I’ve attended this conference many times and there’s always been two or three different philosophies floating around from one workshop to the next. 

This year seemed different. At the end of each workshop there’s usually enough time left for speakers to take questions.  As I listened to their questions I could hear more than confusion in the audience. I could hear panic. 

I heard one father say, “I just want to do the right thing for my kid. I’m confused. In one workshop I hear it’s never good to white knuckle your way through exposure work. If you’re anxiety is higher than a 5 you’re doing the exposure wrong. In another workshop I hear it’s all about peaking anxiety and pushing through, no matter how hard. Please, I just want to do the right thing for my son.” 

Therapists who gathered for lunch were talking about it. “Well, I don’t follow a hierarchy. I just let them face what they are comfortable with at the time.” “Yeah, I don’t push anybody past 10 minutes if the exposure is really hard.” “I don’t do any ERP, it’s too much like torture.” “Oh, I fire my patient if after the 8th session they’re not climbing their hierarchy of fears.”

In one session, a young man with OCD was asked by a speaker to explain “white knuckling.” He explained: “It’s like being pressured by friends to go on a terrifying rollercoaster ride. I buckle in against my will. I tell myself soon it will be over. Just do it. In one minute this hell will end. I grab the hand rail as tight as I can and wait for it all to be over. When the ride ends I don’t feel any braver. I’m just glad it’s over. I hope they don’t make me do it again.”

Then he was asked to explain what the rollercoaster ride would be like if he wasn’t “white knuckling” it.  The young man answered, “I would not accept the rollercoaster challenge from my friends until I was ready. I’d do it for the experience of it. I’d be curious about my response and everybody else’s. If I was nervous I’d notice it and find where I felt it in my body…feeling the edges of my anxiety. Noticing where it starts. Where it ends. I’d ask what else I was feeling besides anxiety.”

So now I ask which approach is the correct approach to ERP? Don’t do it until you’re ready? Do an exposure exercise only if your anxiety is 5 or below? Experience the anxiety with curiosity, not judgment? Do it just to get the exposure over with? Do you sit with it until the anxiety recedes or do you go about life and desired activities even though your anxiety is still high?

Before I give my two cents, I’d love to hear your ideas. Please leave an anonymous comment!

Do I Like to Torture People Who Have OCD?

If the symptoms of OCD are so painful, why do I want clients to lean into the pain? Tolerate the pain. 160_F_112124725_IAgJplCgrO5mVYTISlvJNNeDama7gUhoDo 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.”

Be Set Free
Be Set Free

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.160_F_7006618_aw6IDdObEjQMy7uY5EuAK9N830oawK3M

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 160_F_90271366_AWiT1etcHqY7nKFyqF8W8oeIPsiUYNWYdanger. 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.

How to Break Free From the OCD Chatter

OCD is quite a chatter box.  During the course of therapy a client will inevitably ask me, “When is this chatter going to stop?” Even 160_F_73837678_GpTq1pfrh5UXtP7jBB5lScBNsXTMPfjVthough the client is doing everything they need to be doing, OCD just won’t shut up! 

I reply with blazing hope. Be patient. You can bear all things during therapy with patience. When the going gets rough hang in there. Don’t quit! I’ve seen 100’s of clients get better, just when they thought they never would.

It’s as if there’s a switch in the brain and it suddenly gets flipped on. When this happens it’s visible on the clients face. After many weeks, sometimes months the client is transformed. And I say, “It’s nice to finally meet you.” And we laugh. It feels so good. 

But it wasn’t easy getting there. Exposure & Response Prevention(ERP) is the scariest thing you’ll ever do. Believe me, pablo-118OCD will tell you not to do it! Every nerve ending in your body will tell you to stop.

Acceptance and Commitment(ACT) therapy is mental Kung Fu. Reverse psychology. Letting the thoughts be there and doing nothing to “fix” them. Agreeing with the thoughts and letting your core values drive your behavior no matter how you feel.

Practicing ERP and ACT is tedious work. There’s a lot of repetition. Things aren’t clear right away. It’s uninspiring at first. Once you disprove OCD it gets a little more inspiring and empowering. But in the beginning and middle it’s slow, tiresome and the symptoms are often unrelieved. 

Patience is the hero. It’s magical. It will protect you while you slowly plod forward. It’s the capacity to accept or tolerate suffering. It’s the ability to continue moving forward despite the lack of relief. 

I made a video for you (see below) and when I finished I had a craving for something sweet. I don’t eat much sugar so I found a bag of very old fortune cookies. I grabbed one and cracked it open to read the fortune. I couldn’t believe the message! Unbelievable!

I can't believe the timing of this message!
I can’t believe the timing of this message!

Check out this video I made for you!

 

 

Do You Want to Defy OCD or Do You Need To?

Defying OCD takes focus. You have to be focused on your needs, skills and wants. One without the other is of no value. 160_F_69325513_kjUZc2oxEDA2PThOUDQUBt6kdGE8okMP

Need: What you have to do
Skill:   What you can do
Want: What you desire to do—based on purpose, and all your hopes and dreams

Need Without Want
I’m thinking of a young woman who has a contamination fear. There is very, very little that she can touch or use in her home. Her OCD has convinced her that if she touches anything inside the house she will contract an unpleasant, long-lasting virus. She is particularly aversive to anything her sister touches and maintains a 3 foot distance from her at all times.

Yet, she uses the same toilet her sister uses. She allows her skin to come in to contact with the same surface her sister’s skin touches. When asked how she manages this she answers, “Well, I don’t have a choice. I need to be able to use a toilet. But, I don’t have to use anything else in the house.”

This woman is focused only on meeting a basic need. It‘s a good example of how you can only get so far by doing what you need or have to do. If you’re not focused on your wants then your actions are based on needs not wants. Doing only what you need to do is not going to take you very far.

Skill Without Want
A lot of times when a person with OCD is stuck they’ll be reminded to use their skills. They’ve spent time in therapy and know how to defy OCD. But, they stopped paying attention, went on automatic pilot and got tricked by OCD. They’ve regressed and are neglecting important needs. A worried, but frustrated loved one says, “C’mon, Boss it Back! Use your skills!” And the person who’s stuck responds, “I don’t care about my skills. Nothing works. I don’t want to fight this fight anymore. OCD is too strong.”

Want Without Skill
It’s not enough to have the desire to Boss it Back. Just the other day a woman said to me, “I want to Boss it Back. I really want to. I don’t want to live like this. I want to be free. I want all my hopes and dreams to come true. I want it so bad. But, I just can’t do Exposure Therapy. I can’t do it. I want to do it. But, it’s too scary to even think about.”

Wanting, Needing and Having the Skills will take you all the way. All three work in harmony 160_F_61978411_WH1ljyTm5Au9EccRXTLYhIq7AU278gmUand need your attention. One without the other isn’t enough.

This is day 27 of a 30 day challenge. It’s important to focus on all three areas: Want, Need and Skill. Conduct an assessment of where you stand in all three areas. Does one area need more of your attention? Are you focusing on all three areas?