How Do Obsessive Compulsive People Think?
Fear of your thoughts and sensations
Posted Jun 19, 2009
So what do you do when you have these unwanted intrusive thoughts? Do you shout at yourself, STOP? Do you try to get reassurance from someone, "Does this look like cancer to you?" Perhaps you pray for peace, or you have a drink, or you binge eat. Or maybe you ruminate, thinking over and over, "Why am I having these damn thoughts? Am I going crazy?"
How to Understand Your OCD
The diagram below (which, I admit, is a little obsessive itself) is from my book, Anxiety Free: Unravel Your Fears Before they Unravel You. It lays out a detailed schematic on the nature of OCD. Let's take a look at each step.
1. Triggers: These are the events or stimuli that set you off. It could be touching something (contamination), leaving the house (something is unlocked, the gas is on), driving at night (I ran over something), thinking of sex (God will punish me, I will lose control).
2. Odd thoughts or images: You have some thoughts or sensations that you don't like. "Why am I having those bizarre, sick, disgusting, unwanted thoughts?"
3. Negative evaluation of thoughts: You think there is something wrong with your thinking-as if you should only have pure and good thoughts and feelings. You have a lot of "shoulds" about the way you should think and feel. You think that now that you have the thought, you have a responsibility to get reassurance, get control or get rid of it. Having the thought is equivalent to being SENT ON A MISSION. You have become THE THOUGHT POLICE.
5. Demand for certainty: You think you should know for sure whether you will act out, lose control, or are contaminated. Nothing short of perfection and certainty will suffice.
6. Thought-action fusion: You equate having a thought with committing an action. "If I think I will get violent, I will". Or, a thought is the same thing as reality. "If I think I have cancer, then I must be a dead man". Thoughts, actions and reality are all one. All in your mind.
7. Thought-suppression: Your first line of "defense" is to try to stop having these thoughts. You tell yourself, "Don't think that". It works, for three minutes. But your failure to permanently suppress these thoughts leads you to believe
8. "I've lost control": You now equate control in your life to eliminating unwanted thoughts. Now you feel more out of control as you desperately try to control your thoughts more and more. It's like slapping the water and drowning.
9. Compulsions: You now perform some neutralizing ritual. Perhaps you wash your hands excessively, pray, repeat "No", walk a certain way, wash a certain way, arrange things, go back and check, check again. You find yourself frenetically doing these things until you have a
10. Felt sense of completion: You say, "I can stop now because I feel I have done enough. This felt sense of completion now becomes your new rulebook for rituals. "I need to do them until I feel I did enough". You are hooked on your rituals.
11. Avoidance of triggers. You remind yourself, I wouldn't have any of these thoughts if I simply avoided the triggers. So you avoid touching things, avoid public restrooms, avoid shaking hands, avoid movies with Satan, avoid people that make you have feelings that are bad and disgusting feelings. Avoid, avoid and avoid. You are running away from the world.
This is how you think. All in the name of being responsible, conscientious---all in the name of avoiding losing control, going crazy or becoming irresponsible. All because you need to be in control. And it doesn't work. Take a look at the schematic and let us know where you see yourself. In a later post, we will discuss what you can do.
But the first step is understanding how your OCD makes "sense" to you.
To see a bigger image of the chart, please click here.
None of these techniques will help for very long. So what can you do?
In my recent book, Anxiety Free: Unravel Your Fears Before they Unravel You, I lay out a number of things that you can do when you have obsessive thoughts.