Anxiety Mastery Program

Obsessive-Compulsive Disorder (OCD)

Brief Diagnostic Guide

The person with obsessive compulsive disorder (OCD) suffers from obsessions, i.e., recurrent and persistent disturbing thoughts, urges, or images that cause intense fear or other distress. The person engages most often in behavioral (checking, washing, ordering, reassurance-seeking) and/or mental compulsions (counting, praying, replaying events to figure them out). The role of compulsions is to neutralize the obsession or prevent an imagined disaster from occurring. The role of mental compulsions can be to “figure things out,” often with the hope of feeling better as a result. There is often avoidance of situations that could trigger the obsession and thus one avoids the perceived need to ritualize.

Dealing with Unwanted/Repugnant Obsessions: The Challenges

What price do you want to pay to be well? If you decide to get untangled from the OCD and are willing to truly work on the concepts that follow, you will not simply read through them but ponder on and put them into practice. They only work when you practice on them repeatedly.

Unwanted/Repugnant/Unacceptable Obsessions

OCD is both biological and psychological, with the psychological/behavioral components predominating. Biological factors shape the brain, and so do psychological. Unwanted obsessive thoughts are usually aggressive, inappropriate sexual, or religious (scrupulosity) in nature. When you wonder why something so foreign to your values invades your mind, remember that OCD seeks out what is important to you, where you are most vulnerable.

Ponder on this: 1) OCD is clever: It gets you where it is most important and therefore where you are most vulnerable.

Purposeful Thinking vs. Obsessive Thoughts

Purposeful thinking is when you purposefully focus your mind on something: you plan what to prepare for dinner, you plan a meeting at work, you plan what your priorities are at work and you execute them, you plan on how to spend your day, you think of what you will talk about with a friend you are planning to call.

The mind occupies itself with unfocused thinking much of the time; we are very often unaware of it. In contrast to purposeful thinking, these blips that come and go through the mind have no inherent meaning; and whether positive, negative, or neutral, they are OK. We pay attention when they happen to come to our awareness.

Obsessive thinking is defined by repetitive patterns of thinking in many people, including individuals with OCD. In OCD, the mind has a compelling need to obsess and to make you believe in the content. But as you have seen above, the content of un-purposeful thoughts don’t matter. You cannot prevent obsessions from coming to your mind, just like you can’t control what pops into your head when unfocused. Un-purposeful thoughts have no value unless you decide to attach meaning to them. It follows that it does not matter if you have a particular thought or you don’t. It is a problem only if you believe your obsessions.

Unfortunately, a great number of individuals with unwanted obsessions take them so seriously that they engage in behavioral or mental rituals to desperately try to neutralize or undo the obsession or to figure out the OCD.

As you have seen above, obsessions do not need to be taken seriously. Your work entails bringing greater awareness and putting the thoughts in perspective: seeing them for what they are, blips in the mind. When you realize that unplanned thoughts are not important, then you will be free. You are a free person once you accept that you can have any thoughts. While you cannot prevent the thoughts from coming to begin with, you can control your response. Bring awareness to the forefront without judgment. Be open to dispassionate observing: “There is that old thought again.” “The old thoughts want to get attention again.” Talk back to them. Use humor. Or let them do their thing, while you observe how they carry on.

Ponder on this: 2) Un-purposeful thoughts are meaningless blips; learn to accept any blips your mind conjures up. Don’t get attached to them. The rituals can be given up once you decide that the obsessions don’t matter.

Self-Judgment

Don’t let OCD define who you are. You don’t need to judge your un-purposeful mind ramblings, which consist of all kinds of thoughts. It does not matter how repugnant they are. If you are going to judge what kind of person you are, by all means, don’t use the OCD to judge yourself by!

Ponder on this: 3) Don’t set yourself up: It is unfair to judge oneself by OCD.

What You Can Control

The thoughts are there, but they are only thoughts. Use your higher thinking power to bring insight into the OCD. Don’t look so much into your head. You can make choices of what to dwell on. You can dwell on the unwanted obsessive thoughts (mental ritualizing) or focus on living now. Living should always take precedence over thinking. The more you focus on living now, the better off you will be and you’ll move forward. Put your energy into things you can control in the present, and make some good plans for the future. Accept your thoughts and then focus on other things. Behavior is what takes you forward, not indulging in negative thoughts and feelings.

Ponder on this: 4) Each and every time you make another choice than engage in behavioral or mental rituals, you move forward and get the upper hand on your OCD.

The Good News!

As you learn to be less attached to your unwanted thoughts and refrain from ritualizing (thus not feeding them), these thoughts tend to weaken.