This year at the OCD Conference I spent all of my time at the Exhibition Hall. I was exhibiting, “ERP in a BOX“™ and as a result, hundreds of people told me about their challenges with OCD. I’ve never talked with so many people at once about ERP and it was energizing.
People from all over the world stopped by and shared their stories. We had a lot of laughs with two women from Japan and had a thought-provoking conversation with a young man from Germany who is working hard for the USA on climate change.
I was especially concerned about a couple who stated there is no therapist in India to help them learn about Exposure and Response Prevention. I encouraged them to come back to the USA, rent an apartment and attend an intensive outpatient program like Rogers Behavioral Health.
I met a Mom and Dad who told me how their son had been hijacked by OCD. Thankfully, he broke free and their story brought me to tears. I told them I wanted to meet their son and they introduced me to him later on. His eyes were bright and he grinned from ear to ear. As soon as I laid eyes on him I said, “up top” and we shared a “high-five.” I know how hard he had to work to get free.
What Happened at the OCD Conference
I met two of the girls that were in the movie UNSTUCK. (Which, by the way, should have won an Oscar Award for Documentary Feature.) It was an incredibly moving experience to watch hundreds and hundreds of people thank these kids and their parents for raising awareness about OCD and ERP.
A very energetic and brilliant doctor introduced herself to me. I wish she saw patients because she reminded me of an OCD whisperer!!!! Instead, she is devoting her time to very important research for the OCD Genetic Study @SUNY Downstate Medical Center. She’s hunting down the OCD gene.
One of the most unique exhibits was a nonprofit organization called pickingme.org. It wasn’t uncommon to see people at this table with stickers on their face and arms. (It’s better to pick at the stickers than the skin.)
Well-known for his treatment of skin picking, the famous Fred Penzel stopped by our exhibit and chatted with us for a while. He’s quite the history buff in addition to being a leading OCD specialist. The doctor who usually treats celebrities with addiction, Dr. Drew, was in the house as a keynote speaker. He only breezed through the Exhibit Hall so we didn’t get to chat.
I’ve seen on Facebook and Twitter “A Penny For Your Intrusive Thoughts” and met one of the founders of this movement. It can be a triggering site for people with OCD. Not that there’s anything wrong with that. Right??? It’s an opportunity to practice using #bossitback skills!
This is something I am asked about all the time: Deep Transcranial Magnetic Stimulation. This is a noninvasive brain treatment and its FDA application for the treatment of OCD is pending. The doctor at this exhibit approached me inquiring about my availability to help with this research. Yeesh…I don’t know how but I’d certainly try to find the time. TMS and ERP combined to reduce the volume of white matter…KAPOW!
Near our exhibit, an OCD Foundation affiliate out of Jacksonville Florida had a table displaying very cool FEARLESS swag from Natural Life. If you’re looking for gifts to give people with OCD this is a meaningful place to check out.
One of my favorite moments was being able to hug people I’ve only known through Facebook or through this blog. (I’m so glad you came by to say hello!!!) And finally one of the highlights of the weekend was to see an OCD thriver break out with dance and song at karaoke! She was belting it out! Now that’s a healthy coping skill!
Each year I attend the conference it’s apparent that OCD awareness is reaching new and brighter heights. It was validating to hear so many people say that “ERP in a Box” is brilliant. But, it was invigorating to meet so many OCD thrivers because of ERP! You know what I say, “Nobody is healed until everybody is healed!” I’m not going to stop thinking of ways to beat OCD.
This and so much more happened at the OCD Conference! Save the date. The next one will be 7/19-21 in Austin Texas.
Let’s talk about ERP. The initials of ERP stand for Exposure & Response Prevention (preventing the response anxiety is telling you to take) or otherwise known as Exposure and Ritual Prevention.
ERP is the most highly recommended type of therapy used to treat OCD. It’s what’s called an evidenced-based intervention. Evidence from studies has proven ERP is very effective. Basically, you expose yourself to something that makes you uncomfortable and you do nothing to alleviate the discomfort.
First, you build a hierarchy of people, places, things or situations that trigger your anxiety or discomfort. You place them on the hierarchy (ladder) in terms of easiest to hardest to face. “If you were going to face this fear would this be easier to face than this?” Then you make a plan to gradually climb the hierarchy from easiest to hardest. You’ll know it’s time to move to another step when you’ve become bored or desensitized with the step you’re on.
I once knew a boy who was afraid of crickets. He couldn’t go outside because he was terrified that a cricket would land on him and bite him. He designed a hierarchy of gradually exposing himself to being near crickets. It started with being in a room with crickets living in a secure container. He ran into the room counted to 10 and ran out of the room as fast as he could. Gradually he increased the amount of time to 2 minutes. Eventually, he was quite comfortable being in a room with crickets in a secure container. He could even hold the closed container in his lap. The next phase was to open the lid of the container, and through similar incremental steps, he worked his way up to place his hand in the container.
The response he had to prevent during these exercises was to not reassure himself that crickets were harmless or couldn’t get out of the container. He had to accept the possibility of escape and being bitten. He talked like this to prevent himself from neutralizing his anxiety. This is Response Prevention. He tolerated the discomfort and in fact, I encouraged him to say he wanted the anxiety. He said, “I hope I’m anxious. I don’t care anymore. I want to be able to go outside and play with my friends. So go ahead. Make me anxious.”
At the top of his hierarchy was a plan to go outside where there were crickets freely living in a garden. But before he did that, he said he would need to take his shirt off and allow crickets to climb all over his body. Yikes! First, he did this with his shirt on and then eventually he took his shirt off. Crickets were crawling and hopping all over him. He was pretty tense at first, but suddenly he started to giggle, “It tickles.”
Every now and then I think I hear one of his crickets chirping in my office. I’m reminded of his courage and determination. He makes me smile. I know the bravest people in the world.
I tried to resist compulsions before, and it didn’t work. I felt worse! Why should I try again?
Resisting compulsive behavior and mental acts is a long process. The process has a beginning, middle and no end. At any time during the process you can:
expect to have setbacks
anticipate having POLS (Persistent, On-fire, Lasting, Sinking- feelings)
doubt resisting is worth the pain and agony
continue to have unwanted, intrusive thoughts even though you’re resisting compulsions
Contemplate this truth: Resisting compulsions is going to be the worst and best thing you’ve ever done.
In the beginning, more times than not you will think, “Resisting compulsions isn’t working.” If you think it’s not working, does that make it real? Does it mean you’re not getting better if you don’t feel better?
Does it mean you’re getting better only if you feel better? Such as when you’re performing a mental act or compulsion. Upon completion, you probably have some relief. It’s only temporary, but let’s admit it, briefly, you feel better. Does that mean you’re getting better because you’re feeling better?
Not at all. To get better, you’re not going to feel better at first. Is that okay with you? Will you commit to resisting compulsions even though you’re going to have POLS? Besides, when you’re performing compulsions, you still have POLS.
Do this now: Put your hand on your heart and vow to do whatever it takes to get healthy.
“That’s easier said than done.”
Of course! You’ve performed your rituals and mental acts to the point of automation. In other words, you’ve habituated to your compulsions. You’ve gotten used to them. Breaking a habit is hard! Does that mean you shouldn’t break it?
There is an excellent technique for this kind of automatic compulsive behavior. I call it “recontaminating the scene of the crime.” The crime is the compulsion. So whatever the compulsion “fixed,” your job is to unfix it. Recontaminate the scene by reintroducing the anxiety. For example, if you:
counted car door handles before you pulled out of a parking space, pull back into the spot and this time back out without looking at the car door handles.
sanitized after touching a doorknob, go back and touch the doorknob and resist washing.
rewound and replayed a conversation you had earlier to see if you said something bad, go ahead and say something bad.
scanned the environment to see if you dropped identifying information about yourself, drop part of your social security number in the parking lot and walk away.
checked the faucet too many times, turn the faucet back on and let it drip. Walk away. Don’t check.
The most critical part of recontaminating the scene is what you say to OCD while you’re doing it. Your words must be tough. Like this, “Oh yeah OCD? You think something bad is going to happen now that I recontaminated? OK OCD. Whatever happens, happens. Time will tell.”
Resisting compulsions is going to be the worst thing you’ve ever done. It’s also going to be the best thing you’ve ever done.
The Top 8 Reasons Why Resisting Compulsive Behavior Can Backfire
#1 Did you resist compulsions for the right reason?
The reason to resist compulsions is not to get rid of unwanted thoughts or anxiety. That can be the prize but never the goal. Put your nose to the grindstone—focus heavily on the work not the bonus.
The right reason to resist compulsions is to learn how to be incredibly strong, perceptive and empathic. It’s the exercise of learning that is life-changing. Resist compulsions because you like working hard to learn how to be grateful and optimistic in dark times. Value the challenge, not the reward.
#2 Did you think Control was all you needed?
“I can control my thoughts” is the same thing as saying “I can control my compulsions.” The name of the game is not CONTROL. Trying to control is what got you into this mess. It’s about surrender. Read on.
Don’t expect to control: Frantic Effort to Avoid Reality
#3 Did you put in an honest day’s work?
You need a strong work ethic. What is a strong work ethic? Stop asking others to help feed OCD with reassurance or safety behaviors. Be more cooperative with your team. Just because you don’t like what they’re telling you doesn’t mean you shouldn’t hear them out.
If you don’t put in the time, then the work won’t get done. Get a lot of therapy done each day. Be productive. This is no time to avoid—or be idle. You’re in the fight of your life. Climb your exposure hierarchy with a vengeance. Get to it!
Even after you’ve climbed your hierarchy go back and climb it again. Find some other fears to face. It’s how you keep your brain sharp and your OCD dull. This is a life-style, not a one shot fix.
People who have a strong work ethic are led by values—not fear. They are distinguished from others by their dedication, integrity, and self-discipline. Put your nose to the grindstone and focus heavily on your therapy. Let nothing get in your way of an honest day’s work.
Are you: Finding Excuses And Reasons?
The Top 8 Reasons Why Resisting Compulsive Behavior Can Backfire
#4 Was there a pity party goin’ on?
If you think it’s unfair that you have OCD then your ability to power up and find strength will be quite limited. The sooner you accept you have this neurological condition and do something about it—the sooner you will do something about it!
Asking, “why is this happening to me” is not going to get you anywhere but deeper into the hole. When you’re resisting compulsions, you have to talk tough. “Oh yeah, OCD? You think if I don’t do this compulsion something bad will happen? Well, time will tell. Whatever happens, I’ll deal with it. I’d rather take the risk than live like this.”
You’re in the fight of your life. Stop wishing you weren’t. It is what it is. If you think like a victim, you will feel like a victim and then act like a victim. Wipe “I wish” from your vocabulary. Stop saying “I can’t.” Yes, you can.
Watch out for: Failure ExpectedAnd Received
#5 Did you enter the combat zone unwillingly or hesitantly?
Did you enter your OCD recovery program with boots on the ground? If you knew your loved one in the military didn’t go into combat yelling “BOOYAH” and instead was pleading, “No please…” you’d question his or her readiness. Can you afford to have OCD question your readiness?
The moment your eyes open—your feet hit the floor, you are in COMBAT. YOU NEED TO HIT THE FLOOR RUNNING. Resist compulsions and stick to the plan. Feelings don’t matter in combat. Second guessing your mission won’t save your life.
To help you remember BOOTS on the GROUND put a pair of old unused boots near your bed. Look at them when you wake up and remember you’re entering a combat zone. Until you master the skill of resisting compulsions, you’re in the fight of your life.
Drills develop skills. You’ll get good at whatever you practice. You can’t build skills on the run. Stay and fight.
Don’t: Forget Everything [you’ve learned] And Run!
#6 You didn’t surrender during the combat.
Resisting compulsions is not the traditional combat zone. Your combat is different. For you to outwit and outplay OCD, you need to proudly fly a white flag that reveals you’re surrendering.
Whatever OCD says might happen if you resist a compulsion, nod your head and agree. “Yes, maybe that is so. Time will tell. Whatever happens, happens. I will deal with it. It will be horrible, but I will handle it.”
After all, this ain’t your first rodeo. You’ve been through plenty of real-life situations. And you probably dealt with them better than most.
You’re really good in an actual crisis. It’s the things in your imagination that creep you out. But when push comes to shove, you’re the one who holds your head above water while others are drowning.
YOU ‘RE SO FREAKIN’ STRONG! BOOYAH!
Do: Face Everything And Rise!
The Top 8 Reasons Why Resisting Compulsive Behavior Can Backfire
#7 Did you stay in the moment?
OCD is the most significant force you will ever be up against. It knows what you fear. It will work very hard to keep you from ever having to feel that fear. OCD is not your enemy. It’s trying to protect you from feeling afraid.
Just because you’re afraid doesn’t mean something is wrong. But, OCD doesn’t know this! Just because you’re startled or anxious—it doesn’t mean stop.
If it’s not happening, now…it’s not happening. Stay in the moment. Live one moment to the next. OCD has no clue what this means. Do you?
“In this moment, right here, right now I’m pretty okay.”
Did you: Forget Everything’s [Actually] All Right?
Contemplate this truth until you understand it clearly: OCD doesn’t get the meaning of anxiety or weird thoughts. It can’t differentiate reality from imagination. You can’t count on OCD to lead the way.
#8 Did you give up too soon?
When things go wrong, as they sometimes will When the road you’re trodding seems all uphill When care is pressing you down a bit Rest if you must, but don’t you quit Oh, no, don’t you quit Whoa, no
Success is failure turned inside out The silver tint on the clouds of doubt But you never can tell how close you are It may be near when it seems so far, ooh Gotta stick to the fight when you’re hardest hit And when things go wrong, oh, you must not quit Oh, no, don’t you quit
You got to stick to the fight When you’re hardest hit And when things go wrong No, oh, no, don’t you quit
Don’t give up the fight Don’t give up You better not give up the fight Don’t give up Oh, no, no ~Caron Wheeler “Don’t Quit”
No Matter What, Stick To It
It takes a lot of patience, intention, and mindfulness. Arm yourself with inspirational stories of people who persevered and carried on even in the face of difficulty or adversity.
Think of all the famous stories we know about people who had stick-to-it-ness. Your story is no different.
Even after failing to land a role and being called too ugly, most Academy Award nominations, Meryl Streep never gave up on acting.
Steven Spielberg was rejected by the USA film school three times.
After his first performance, Elvis Presley was told, “You ought to go back to driving a truck.”
Dr. Seuss was turned down by over 25 different publishers.
At age 30, Steve Jobs was fired from the company he founded.
Ludwig Van Beethoven’s music teacher said he was hopeless.
Oprah Winfrey was told she “wasn’t fit for television.”
The Day You Quit Is The Day You Were Going to Win!
Thomas Edison’s teacher told him he couldn’t learn anything.
Colonel Sanders became a world-known figure by marketing his “fingerlickin’ good” Kentucky Fried Chicken (KFC). His recipe was rejected over 1,000 times before it was given a chance.
Before winning six NBA championships and receiving five Most Valuable Player awards, Michael Jordan was cut from his high school basketball team.
The Beatles were rejected by a recording studio that said, “They have no future in show business.”
And Albert Einstein’s parents and teachers said he would never amount to much.
The secret ingredient all of the above people had is stick-to-it-ness. This ingredient is available to you too.
Contemplate this truth: A setback is a setup for a breakthrough.
Yes, Face Everything And Rejoice!
Today’s Best Advice On How to Resist Compulsions:
If you’re struggling with resisting compulsions, review the above 8 principles and see which ones need improvement. Don’t quit. Keep at it. Resisting compulsions is a marathon comprised of a series of sprints.
You are the blue sky. It may seem cloudy and the thunder may roll, but the blue sky always, always comes back.
This post concludes the series, “The Best Advice on How to Resist Compulsions.” Let me know which one(s) helped you the most. If I overlooked a topic that you have questions about please ltell me in the comment section! Other topics covered in this series:
Compulsions feed the troubled wolf…the OCD. So of course in order to beat OCD, compulsions must stop.
Inevitably the client says “I’ll try but that’s easier said than done.”
I respond, “It’s supposed to be hard! Just because something is hard doesn’t mean you shouldn’t do it.”
The relief from a compulsion is only temporary!
Yes, compulsions can provide relief. But, for how long? It’s similar to the relief an addict gets from drugs. It’s a vicious cycle. You just end up needing more. It might initially feel good but on the other hand, it makes you feel powerless and stuck in a hamster wheel.
The relief you get from a compulsion is temporary but the effect is long-lasting. What is the effect? Think about it. You started compulsions to:
get rid of doubt and now you’re more doubtful than ever
feel in control and now you feel out of control most of the time
avoid discomfort and now you’re more uncomfortable than before
improve the way you feel and now you feel worse
feel “just right” and now you always feel “just wrong”
What If Resisting Compulsions Makes Me Feel Worse?
As an OCD therapist, I can’t give reassurance. I have to shrug and say, “Maybe things will get worse.”
However, for educational purposes, I say this one time to every new client: “If you provoke your OCD with exposures and resist the urge to do a compulsion, your chances of getting strong and healthy is very high.”
Besides, ask yourself if compulsions are sustainable. Is this truly something you want to do for the rest of your life? Once you start it’s hard to stop.
You get good at what you practice. Are you sure you want to keep practicing compulsions? All compulsions help you do is avoid. Are you sure you want to get good at avoiding?
The Risks Outweigh the Benefits
In what way do you benefit from doing compulsions? If your answers are the ones below, hopefully, you know this is nothing more than trickery.
Are these the reasons you think you benefit from compulsions?
My compulsions are protective and keep bad things from happening. You’d be rich and famous if that were true.
This compulsion keeps me from feeling gross. No, actually it keeps you from feeling anxious. Gross is just another word for anxious.
The only way I can feel “just right” is by doing this compulsion. How many people stop and think, “I can’t leave my house until I feel just right?” To be concerned with feeling “just right” is exactly what drives you to feel “just wrong.” People who don’t think about feeling “just right” typically feel..just right!
Until the compulsion is completed I won’t be able to sleep. This just means you’ll have to do compulsions every night for the rest of your life in order to sleep. Is that really what you want?
You’ll discover the only benefit to a compulsion is temporary relief from anxiety. That’s it. There is no other benefit. And is that really a benefit–to avoid anxiety for brief moments of the day? Wouldn’t it make better sense to learn how to experience the anxiety?
Every Compulsion Feeds OCD
The only reason you’re performing compulsions is that you don’t <<yet>> know how to experience anxiety. Any other reason is just a story that your very creative brain has made-up.
A question I get asked often:
I’m prescribed drugs to help me feel better, so why can’t I use a compulsion to feel better?
I’m not a chemical warfare expert but there’s a huge difference between the purpose of taking a medication and performing a compulsive behavior. Prescribed medications like Prozac or Luvox help you to experience your anxiety. Compulsions help you avoid anxiety.
If you are having trouble being with your anxiety talk to the person prescribing your medication. Resisting compulsions might initially make you feel panicky, but if it continues and you’re not having much success saying no to OCD, a medication adjustment might help.
Another question often asked:
It seems like I get rid of one compulsion only to develop a new one. How can I make sure I don’t start a new compulsion?
The answer to this question is twofold. 1.) Evaluate the way you are talking to OCD when you’re resisting compulsions. 2.) Consider the possibility that you haven’t come to terms with your lack of control over what actually happens in life.
Evaluate the Way You Talk to OCD
If new compulsions are popping up, perhaps you haven’t really confronted your core fear. You’ve resisted a compulsion which is the “B” of Cognitive Behavioral Therapy (CBT). You’ve changed a behavior. But without the “C” of CBT, you haven’t grabbed the bull by the horns.
When you’re resisting compulsions it’s important to talk tough to OCD. No rationalizing or answering any of OCD’s questions. OCD is trying to convince you that a compulsion will prevent something bad from happening. “If you do this compulsion there will be no harm” or “If you do this you won’t end up abandoned.”
Your response must sound like this, “Yup. You might be right OCD. That might happen. Time will tell.” Just nod your head in agreement and resist the compulsion. You might not feel in agreement with what you’re saying. You’re telling OCD you don’t care but you probably really do.
It’s okay. Keep talking tough. Answer none of OCD’s questions. Shrug at OCD and say, “whatever.” Sound like a broken record and just keep repeating your “I don’t care” act. Fake it ’til you become it. This is a mental Kung Fu game you must play with OCD.
Do You Practice Radical Acceptance?
The answer seems to always come back to whether or not you are willing to see what happens next. Be curious to see what happens in this very moment. The only other choice is to try and control what happens. We know where that gets you. It’s better to accept whatever happens happens.
If in this moment you are experiencing anxiety, be curious about it but not analytical. Curiosity is the opposite of fear.
Now is the time to challenge the dysfunctional belief that you have control over what happens in life. This is not true. Practice radical acceptance, “Whatever happens happens. It is what it is.”
If nobody else has to do these compulsive behaviors neither do you.
Stopping compulsions isn’t just about halting the repetitive behavior. Another compulsion will just pop up. OCD morphs into all kinds of things until you finally start to accept the anxiety. First of all, your obsession is just noise. What really needs your attention is your anxiety.
Most importantly, every time you are in the process of performing a compulsion acknowledge the repetitive behavior is just your way of avoiding anxiety. The only time the details of your thoughts and beliefs is of any interest is when you’re trying to figure out how to provoke your anxiety.
Provoke your thoughts. Don’t argue with them. Shrug and say, “time will tell” or “maybe, maybe not.” Step toward the threat and embrace the anxiety. Build an ERP hierarchy and move forward.
Notice the anxiety and be with it. You don’t have to like the anxiety. But be grateful for the opportunity to practice your skills
Today’s Best Advice On How to Resist Compulsions:
Finishing a compulsion might feel good. But, it’s temporary. The anxiety returns. In no time at all, another compulsion is needed. Practice radical acceptance. Whatever happens happens. Otherwise more compulsions are likely to pop-up like a whack-a-mole.
When Resisting Compulsions Backfires: Find Out Why
If you have questions about how to resist compulsions be sure to add them to the comment section of this post. I’ll be sure to address your questions and give you…The Best Advice On How to Resist Compulsions
Is it okay to use distraction in order to resist a compulsion? If you don’t know the answer to this question, keep reading. If you think you know the answer to this question…keep reading.
The argument for distracting is twofold.
1.) First, distraction can be used to delay the compulsion. When the urge to perform a compulsion or mental act arises you shift your attention away.
If you delay the compulsion long enough, it’s believed that you might forget all about the urge to do the compulsion. But, if you give in and perform the compulsion, at least you put it off and found a way to do it by distracting.
2.) The second purpose for using distraction is to avoid anxiety.
The evaluation of anxiety, in this example, is that it’s crippling and therefore should be avoided. Stay busy and try not to have any downtime. If while trying to push through a fear you become overwhelmed and panicky, use a distraction to get relief.
So…Is it OK to Use Distraction to Resist a Compulsion?
Authors of “Overcoming Unwanted Intrusive Thoughts,” Martin Seif and Sally Winston state, “As with all anxiety disorders, avoidance of anxiety is both what maintains and strengthens it.” They advise therapists, “Overcoming the disorder means counterintuitively moving clients toward experiences that increase their distress.”
On the other hand, Fletcher Wortmann, an OCD-Thriver and author of Triggered: A Memoir of Obsessive-Compulsive Disorder explains: “There is no shame in occasional escapism.”
At this point, it’s important to note there is plenty of research that proves distraction lessens the limbic system (the fight, flight, freeze) response probably more than any other form of emotional regulation.
That’s why many talk therapists encourage clients to distract from their anxiety by hyper-focusing on the minutia of the environment (using the five senses.) Another technique often taught is to hold an ice cube until the anxiety goes away.
Yet, studies show that focusing attention away from an unpleasant feeling/thought reduces the intensity of the suffering. Likewise, the innovative people at treatmyocd.com have created an app called nOCD, a free mobilized personal treatment app. One of its features is an “SOS” button to assist with distraction.
I downloaded the app and found it to be an excellent resource for people with OCD, especially for those self-directing their Exposure & Response Prevention(ERP) therapy. It’s hard enough to try ERP with a therapist but think about the people who have no access to an OCD therapist.
However, I was concerned about the “SOS” button. Afterall, OCD therapists are discouraged from teaching distraction.
Consider these possible disadvantages of intentional distraction:
You’re only learning how to avoid or delay the anxiety. New pathways won’t be created. Confidence levels will decrease.
Eventually, you’ll find yourself face to face with whatever drove you to distraction in the first place. At some point, you’ll run out of the ability to distract. What will you do when there’s no way to distract? You’re only good at what you practice.
Focusing away from the anxiety means less attention on the opportunity to grow and more attention on living just above the surface.
Distracting may slow down the healing process and for some people, they can’t afford to waste any more time. OCD has already taken too much.
So…Is it OK to Use Distraction to Resist a Compulsion?
I emailed the people behind the app, who by the way have all personally lived with OCD and know exactly what it feels like to live with it each and every day. Their opinion matters a lot to me.
I want to supportthe app but I explained I was concerned about the “SOS” feature which is used for distraction. This was the response they gave for me to include in this blog post:
I understand your approach and agree that distraction isn’t the answer, but it obviously depends on the person.
The SOS feature has really helped people in times of intense suffering and continues to help people get through severe OCD episodes.
I really like what you said about teaching the brain that anxiety at all levels is not only tolerable but wanted. In my personal experiences, really encouraging the anxiety and wanting to feel the intense anxiety can actually make the episodes less intense.
The app saves/tracks data. Makes it so easy to share evidence-based info with your therapist or others who want to learn more.
It’s also important to highlight that each of our team members has personalexperience with the current treatment system: it’s very difficult to find a qualified OCD specialist, it’s extremely expensive, insurance doesn’t usually help much for mental health issues, etc.
I think we’re all on the same page.
There are people who haven’t <<yet>> learned to just go ahead and experience the anxiety. Thankfully, nOCD can help people get through intense anxiety with it’s SOS feature. There’s nothing wrong with getting a reprieve from something you don’t know how to manage.
When you push the SOS button it asks if you’re struggling with an anxiety-producing thought or a strong urge to do a compulsion. The app helps you to face your fear or resist a compulsion. But, if the anxiety gets too overwhelming, hit the SOS button and the app will try to help distract you.
nOCD does far more than help with distraction by the way. The app not only teaches you how to use ERP but also takes you through each step. A video lesson is included and step-by-step guidance is given. nOCD collects and saves all your effort and provides a visual of your progress. This app is a great in-between session tool for people in therapy. For people who don’t have a therapist this app can take you through the same steps a therapist would.
So…Is it OK to Use a Distraction to Resist a Compulsion?
Avoiding anxiety isn’t a drill that develops a skill.
In order to beat OCD, you’ll need to develop the skill of allowing weird thoughts and uncomfortable feelings. You don’t beat OCD by distracting.
But, not all distraction is bad.
Life itself is a distraction. There are people to see, things to do and places to go. Living your life to the fullest may very well distract you from your thoughts and anxiety. Here’s a Mom who explains this concept very well:Proactive vs. Reactive Distractions
I’ve created a Puzzle Book that is in Beta testing. I designed it to be a mild exposure exercise so that people with the doubting disease can confront their dislike for uncertainty. Some of the people testing it for me have already commented that time flies when they work on the puzzles.
The puzzlers expected an exposure exercise with a bit of anxiety. Although this puzzle book is by far the least anxiety-provoking of the 10, I didn’t anticipate it would be such a pleasant distraction!
The point is there was no intention to be distracted. Sometimes an exposure exercise ends up being easier than thought. It makes it easier to go on to the next exposure. Always build momentum.
Today’s Best Advice On How to Resist Compulsions:
Deliberately hitting the “distraction” button when you feel overwhelmed needs to be seen as a stepping stone, not a crutch. If you intentionally distract to avoid and continue this strategy…well, read the disadvantages above again.
If you hit the “distraction” button, learn from it. Maybe you tried something too hard. Find an exposure exercise that challenges you–but doesn’t cause panic.
Be self-reflective about your motive for distracting. If you choose to distract, be mindful of what you’re doing.
If life distracts you…if there are moments you forget you even have OCD…that sounds wonderful to me.
Please feel free to add your thoughts about distraction in the comments. As always, I’ll keep your name anonymous.
Are you addicted to compulsions?
If you have questions about how to resist compulsions add them to the comment section on this post. I’ll be sure to address your questions and give you…The Best Advice On How to Resist Compulsions
There’s More to Being Compulsion-Free Than Just Stopping
Have you ever been in the middle of a compulsion and someone said: “Just knock it off!” And you replied, “If it was that easy don’t you think I would just stop?” The best advice on how to resist compulsions doesn’t include to, “just knock it off.”
Very, very few people with OCD can go cold turkey and “just knock it off.” So many times people have said to me, “I’m just going to stop all of it. Right now. No more compulsions.” They mean it with all their heart. And then they walk to their car performing compulsions.
Going Cold Turkey Has Little to Do With Staying Compulsion-Free
If you want to know what it feels like to just knock it off and go cold turkey, it’s like dumping all kinds of poison in a sess pool and sitting in it. Taking your hands and putting the slop all over your face and body. Breathing it in and doing nothing to save yourself.
If you sat there long enough, believe it or not, you’d become desensitized. But, just like any kind of sobriety, the urge will return. You’ll still want to perform a compulsion.
There’s more to being compulsion-free than just stopping.
The Best Advice On How to Resist Compulsions
Put an end to your compulsions by applying these seven principles:
It’s “whatever” therapy! Talk to your OCD in a nonargumentative manner. “Yup, maybe that will happen. Time will tell.” Don’t reassure OCD. Instead, shrug and say “This could be unpleasant. I’ll just have to find out.” It’s all about the “whatever.” ¯\_(ツ)_/¯ If you can trick your brain into thinking you’re smiling with a pen sideways in your mouth, you can trick your brain into thinking “whatever” with a shrug!
Build a hierarchy. Resist the easiest compulsion first and keep resisting until it no longer bothers you to resist. Then, like climbing a ladder, resist the next hardest compulsion and the next hardest and so forth.
Set your intentions to provoke OCD. Confront a trigger you’ve been avoiding. While confronting the trigger refuse to do a compulsion. Talk to OCD as described in #1. Once this trigger no longer bothers you, move onto the next more difficult trigger.
Apply These Principles to End Compulsions
Easiest first, then hard. If you give in and perform a compulsion, go back and confront the same trigger again and again until there is no compulsive behavior. If you’re stuck, maybe there’s an easier trigger that you skipped or need to go back to.
Don’t stop ’til you reach the top. Build momentum. Keep moving up the ladder of challenges. When it gets easier, ask yourself, “How can I make this harder?” Remember, climb the ladder while always refusing to do a compulsion.
Shift into challenge mode. Wishing you did not have OCD or have certain thoughts is of no use to you. Wishing causes more suffering. It’s important to see your anxiety and thoughts as a challenge–an opportunity to practice your skills. This is no time to play the role of a victim. You don’t have to like anxiety but you do have to want it.
Accept responsibility. If you give into a compulsive behavior, admit what you are doing. No excuses. Own it. Name it. Keep away from the “story” of why your OCD tells you to do the compulsion. “I’m choosing to feed my OCD right now. I know this will make OCD stronger. I’m avoiding discomfort and that’s the only reason why I’m choosing to do this compulsion.” Get this message to your brain every single time you do a compulsion!
Applying these principles will keep you compulsion-free. It’s a slow and difficult place to start, but once you pick up some momentum it gets easier and therefore, goes faster. Rather than shocking your brain, you are rewiring it. This takes time!
It takes time because you are training your brain how to experience anxiety.
I don’t tell my clients to “knock it off!” And, I hope those who love someone with OCD don’t say it either! There’s more to beating OCD than just “knocking it off.”
Resist Compulsions by Making Little Changes Over Time
People with OCD benefit from the very effective systematic method of resisting compulsions. Set reachable goals and make little changes over a period of time. With each success, you will grow more confident and more tolerant of anxiety.
It may take time and patience, (click for video) but it’s how you win the battle. At the suggestion of resisting compulsions, do you take a big gulp and say, “I’m getting anxious just thinking about it.” My response to more anxiety? “Great! You need the practice!”
It’s time to learn how to experience anxiety without a compulsion.
You can get started today! The first step, of course, is to identify each compulsion. You’ve got to know what you’re resisting, in order to resist!
Today’s Best Advice On How to Resist Compulsions:
For a long-term effect, commit to a systematic plan to stop compulsions. Include all of the above seven principles in your plan. Going cold turkey has little to do with staying compulsion-free.
Check back for the next post which will explain the difference between an observable compulsion and a mental compulsion. It’s important to know the difference because mental compulsions can be very sneaky!
The next several posts on resisting compulsions will include:
What Is a Compulsion?
The True Purpose of a Compulsion
If a Compulsion Makes Me Feel Better, Why Would I Stop?
I Already Tried Resisting and It Didn’t Help
Can You Promise If I Resist It Will Help?
I’ve Got Way Too Much Anxiety to Resist Compulsions
It’s Too Risky to Stop My Compulsions, Someone Else Could Be Hurt
Is it Okay If I Use Distraction to Resist Compulsions?
Resisting Compulsions Just Doesn’t Feel Right
My Compulsions Are Out of Habit Not Fear
If I Stop One Compulsion Another One Will Just Pop Up
How Do I Find the Strength and Willpower to Resist Compulsions When I Don’t Have the Energy?
If you have questions about how to resist compulsions be sure to add them to the comment section on this post. In addition to the topics mentioned above, I’ll be sure to address your questions and give you…
OCD infiltrates. It worms its way into the brain and hijacks it. You begin to forget who you are. This makes OCD sound like a monster.
There is not a shred of evidence that OCD is a monster out to get you. It feels that way, but there really isn’t some kind of wicked creature persecuting you. When you say, “I hate OCD.” You’re hating on yourself.
There is no scientific study that shows there is an organism eating your brain.
There is however, plenty of evidence that cells are still growing and neuroplasticity can happen… with skills & drills.
Translation: You can teach an OCD brain new tricks.
There is also a lot of evidence that self-loathing is detrimental and never brings about positive change. When you hate OCD you only hate yourself.
It feels like OCD is out to get you because the brain is misfiring messages and the central nervous system is responding with body parts. It’s a physiological experience complicated by thoughts.
The key to managing OCD is to stop thinking of OCD as a monster. Think of OCD with empathy. Compassion. And, you’re on your way to freedom.
A young boy was anxious just before his first concert. He was worried he might fall on the stage. What could be said to him that would help the most? What should he do? I took a poll to see what people thought.
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.
I 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
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.
“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
There 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.
There is a weird and wonderful way to outsmart OCD. Weird because it’s uncanny and counterintuitive. Wonderful because it’s so amazingly effective.
In order to outsmart OCD it’s important to first understand it. It helps to know what makes OCD tick. So before we jump into ways to outsmart it, let’s reveal its true nature.
Is OCD a Bully?
OCD isn’t a bully. A bully would try to humiliate you. OCD is obsessed about protecting you from humiliation. A bully would try to make a fool of you in public. OCD doesn’t want you to look like a fool in public.
Unlike a bully, the last thing OCD wants is for you to feel humiliated.
Bullies want to make you uncomfortable. OCD wants you to find comfort. That’s why OCD hates uncertainty, because it makes you uncomfortable. OCD persuades you to do compulsions or mental acts to get rid of discomfort. Unlike a bully, the last thing OCD wants is for you to experience anxiety.
Bullies try to physically and emotionally hurt you. On the contrary, OCD is like a bodyguard, constantly scanning the environment making sure nothing bad can happen or hurt you. A bully pokes and pokes until you bleed. OCD is scared of you bleeding.
Bullies enjoy picking on people. It brings them joy. OCD doesn’t ever experience joy. Everything is doom and gloom according to OCD. Bullies get sadistic pleasure out of putting people down. OCD puts you down not to inflict pain but to keep your expectations low so that you don’t ever feel the pain of disappointment.
OCD isn’t a bully. It’s a bodyguard on steroids.
Why Not Think of OCD as a Bully?
What does it matter if you think of OCD as a bully or a bodyguard?
Because, if you think of OCD as a bully, you’re feeding a victim mentality. If you think like a victim, you’ll feel like a victim and then you’ll act like a victim.
What kind of people have bodyguards? Powerful people. People worth a lot. People with influence.
Is it better to think of yourself as someone who is important enough to be guarded or someone who is a victim and being bullied? Which mentality is going to put more oomph in your punch?
OCD is overly protective. Knowing this and using this weakness will be part of our strategy to outsmart it. Another personality trait of OCD’s is that it’s extremely competitive.
The More You Know About OCD, the Better You Can Outsmart It
OCD is Not a Good Sport
OCD doesn’t play fair. It doesn’t accept defeat. It won’t congratulate you on your victories. Your tendency towards negative self-talk plays right into OCD’s hands.
OCD is extremely competitive. The game never ends. Just when the game is tied, it scores again and keeps you in overtime. It wants to wear you down. It pumps its fist when you cry out, “give me a break!” Think about this for a minute. Why does it want you to lose?
OCD wants you to lose more than it wants to win. Why?
It doesn’t think your loss is harmful to you. On the contrary, it sees your loss as helpful to you. As long as you keep losing (giving in to OCD) then you will continue to see it as an authority. As long as you see it as an authority you will defer to it and by the grace of OCD supposedly be kept safe from harm or ill-will.
OCD doesn’t have much strategy in its game because, it can’t use logic or reason. It’s very reptilian in nature. Fight, Flight or Freeze. That’s all it can do, which isn’t much of a strategy. the only strategy it has is to cheat and lie. It tells you that if you do what it says, you will find peace of mind. That’s the lie.
It cheats by asking you unanswerable questions. The questions it asks cannot be answered with certainty. But, it lies to you and tells you that you can get to the bottom of it if you search hard and long enough. Cheater! You might as well be counting the grains of sand on a beach.
OCD doesn’t give up easily. It’s too competitive. All it wants is to make sure you lose. But, remember this, it can’t win unless you play. It can’t win unless you lose.
OCD is a bodyguard on steroids. It’s highly competitive and a poor loser. But, here’s something else about OCD that we can use in our strategy to outsmart it. It’s nothing like you.
OCD is the Opposite of You
OCD is not a mirror reflection of you. In this instance OCD sounds like a bully. Because, bullies always pick on people who are nothing like them. e.g., The jock picks on the nerd. You are the exact opposite of your OCD.
But, again, OCD isn’t picking on you. It’s trying really hard to think of all the things you’re not normally aware of. Why? Because it’s trying to prevent something bad from happening. It thinks about topics you don’t normally think about. It’s like having a second pair of eyes with a mind of its own.
OCD leaves no stone unturned. It brings up random questions that at first seem so bizarre. OCD actually searches for unusual questions and situations. But, it’s particularly fond of asking questions about whatever is precious and sacred to you.
It’s constantly scanning and searching so that you are never caught off guard. Because if you are caught off guard you will be uncomfortable. And OCD doesn’t want you to be uncomfortable.
OCD is hyper. It’s overly protective. It hates to lose. It’s constantly on guard and tries to think of everything. But, here’s something fascinating about OCD. It can’t learn anything new.
Figure Out What Makes OCD Tick and You’ll Practically Stop the Ticking
OCD is Clueless
OCD asks a lot of questions because it’s trying to protect you. And, it’s trying to protect you because it’s void of any information. It doesn’t know anything. It knows nothing. And worse, it can’t be taught anything.
Even if its questions are answered it will keep asking the same question over and over. Because it can’t absorb or hold on to information. It’s incapable of learning anything new. It can’t retain anything.
For example, for those of you who have unwanted, intrusive thoughts of harm, I just told you up above that you are nothing like your OCD. You probably got some temporary relief from reading that.
But, you won’t be able to retain that piece of good news. You might return to this blog everyday to read the above paragraph, “OCD is the Opposite of You.” It doesn’t matter how many times you read that paragraph.
In just a matter of seconds you’re going to go back to worrying that you are your thoughts. You’re going to think that because you think it, you’ll do it. Even though you’ve been reassured many times that you are not your thoughts.
OCD can’t hold on to information. So you can be reassured all day long and the good news won’t stick. OCD is not like fly paper. OCD is clueless because it’s glue-less. Nothing sticks.
OCD is on guard because it’s clueless. It can’t retain information. It can’t use reason or logic. It won’t leave any stone unturned because it can’t learn anything new. But, it won’t stop trying because it’s competitive and doesn’t give up. It’s on a mission to supposedly save you.
There’s one more thing to know about OCD.
8 Proven Ways to Outsmart OCD Will Soon Be Explained!
OCD is Only One Part of You
OCD is part of your brain. Which part of your brain? It’s not really fully understood. Is it an imbalance of glutamate, dopamine or serotonin? Is the amygdala enlarged? Too much white matter in the brain? Some kind of miscommunication going on in the prefrontal cortex or the basal ganglia? Researchers can’t say with certainty.
We’re dealing with a faulty alarm system—that we can say with confidence. Something in the brain wrongfully sounds off alarms and the body needlessly goes into fight, flight or freeze. The fear seems so real.
The toothpick on the sidewalk might cause someone to trip. Pick it up. You pick it up and throw it in the lawn. Wait. A baby could crawl on the lawn and pick up the toothpick and die from choking on it. Pick it up. Put it in your pocket and when you get home, break it into tiny tiny pieces and bury it in 12 inches of dirt.
That whole conversation is a true story of someone with OCD. This chatterbox in his head occurs because of some kind of abnormality or imbalance in the brain. But, listen carefully: Not everything is malfunctioning in the brain.
I’ve been healing from an elbow injury. (Racquetball is tough on the body!) For awhile it was all I complained about—all I thought about. Finally somebody said to me, “You’re not just an elbow. Your elbow is only one part of you.” Thank you dear friend. I needed that!
OCD is only part of a whole. There’s so much more to you. There are other beautiful parts of the brain that can function just fine. Your brain can be a lean mean fighting machine despite having OCD.
Let’s Make Your Brain a Lean Mean Fighting Machine
Now that we understand what makes OCD tick, how can you outsmart it?