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The Four Challenges of Recovery
What's it going to take to get better? There are four challenges
that lie in front of you as you begin to face your obsessions and
compulsions:
Challenge 1: Be determined to conquer this problem. This is a tough
problem to overcome. You really need to spend some time making sure that
you're ready and willing to go through short-term suffering for
long-term gain. You need determination because you have to take the risk
to experiment with behaviors that are totally opposite of what you would
tend to do in these situations. You're going to have short-term doubts,
and you have to be willing to overcome those short-term doubts and have
a kind of faith in this approach.
The second challenge as you begin is to gain the perspective that
your worries are excessive, or irrational. The symptoms that your
worries produce are so powerful and so disturbing that you get
distracted by them and believe they represent true concerns. I am asking
you to begin to practice a new belief, and it is this: when these
obsessions occur, the content of the obsessions is irrelevant. It is
meaningless, it is purposeless. Your obsessions represent an anxiety
problem. The topic of your anxiety is not the issue, even though your
anxiety leads you to believe that it is.
This is not an easy task to accomplish when you are dreading that you
might pass on deadly germs, kill your own child or cause a terrible
accident. Nonetheless, I am asking you to step away from those thoughts,
to get perspective on them, and say, "Wait a minute, I have an
anxiety disorder. What is an anxiety disorder all about? It's about anxiety,
not about this content."
Try not to get into a battle of logic in your head. If you try to convince
yourself of how illogical your worries are, you may become very
frustrated, because you'll have a hard time being certain about
anything. You'll always find a thread of doubt you can follow. So don't
get caught in this trap of logic. Instead, keep stepping back mentally
and saying, "I need to be addressing my anxiety, not this
specific topic".
Your OCD is going to encourage you to do just the opposite. It's
going to push you to think this is all about whether you really locked
the door. Or it will get you to try to reassure yourself that you did
actually make the appropriate decision. Or that you have not
contaminated something. You'll work hard to get the right reassurance.
And it's totally the wrong thing to be doing... You are falling right
into the clutches of OCD. So this is a very important challenge to meet:
address your symptoms of anxiety, not your fearful thoughts. Don't be
fooled!
The third challenge: Is as you begin: consider that ritualizing is not
the only way to reduce your anxiety. Most people with this problem
believe that if they don't ritualize, they will remain distressed
forever. If you share this belief, you must be willing to challenge it
in order to discover that there are other ways to reduce your distress.
It will be extremely difficult to give up your compulsions unless you
are willing to experiment with new behaviors. You need to be willing to
explore options to ritualizing.
Do you remember the old joke of the guy who every morning gets up at
6:00 and stomps around the outside of his house. His neighbor finally
comes out and says, "What in the world are you doing? Every
morning, I look out my window when I'm fixing my breakfast, and there
you are in your bathrobe stomping around the house." The guy says,
"Oh, well, I'm keeping the elephants away."
"Elephants? There are no elephants in this neighborhood."
And the first man says, "See how well it works!"
So, he never challenges his belief. That's what people do. They say:
"The ritual was the only way I could possibly have shaken loose of
my terrible distress, and I need to keep using it."
To resist your compulsion is really a courageous thing to do. Because
you are having to resist this powerful belief that something terrible is
going to happen if you do.
The fourth and last challenge is: decide to accept your
obsessions instead of resist them. This is the toughest of all four, and
it is the most important. This one is the basis of all the self-help
interventions we'll talk about. Because the more you resist your
obsessions, the stronger they become. It's as though your solution to
the problem actually increases the problem. You resist the symptom, and
it persists.
So you need a new inner voice that says, "It's OK that I'm
obsessing right now." This is not saying, "it's OK in the next
20 minutes to do it"; it's not saying, "I'm going to continue
to do it." But I am asking you to say, "It's OK that I just
had that thought." I know that sounds like a crazy thing to say.
You are trying desperately to rid yourself of these terrible thoughts,
and I instructing you to accept them! Accepting the obsession generally
looks like a bad idea to people.
But what's the other choice? The other choice is to say, "It's terrible
that I had that thought." And what's the reaction that you're going
to have physiologically when you make that statement? That statement's
going to produce more anxiety.
I agree, of course, that the end result is to get rid of that
obsession. That's everyone's objective. But the technique that you use
and the end result are different. That's why it's called paradox,
which means opposite of logic. And that's why you have to have faith.
First, you're going to accept this obsession, and then you're going to
manipulate it. Why are you going to do it in that order? Because that's
how it works best. So there's a big, big leap of faith here when you
accept your obsession. But if you will really dedicate yourself to
experimenting with this approach for several weeks, I think you will
discover its benefits.
Let's review these four challenges again, first with how people
generally think about this problem, and then with how I am encouraging
you to think as you begin your self-help program.
The first challenge: People say, "I'll always be controlled by
this problem." You want to shift it over to, "I'm now
determined to conquer this problem."
The second position is: "I believe my obsessional concerns are
accurate." I want to shift that one over to: "My obsessions
are exaggerated and unrealistic." The third one: "Rituals are
the only way to reduce my distress." Shift that to, "there are
other options to reduce my distress." The fourth one: "I must
stop these obsessions" is the problem stance. Shift this to,
"I accept these obsessions."
How would you apply this fourth challenge? When you begin obsessing
and worrying, you typically react emotionally to those thoughts and
images, by becoming anxious and afraid. That compels you to ritualize.
The first place to start practicing is anytime you begin to obsess. Take
that opportunity to focus on the idea of permitting the obsession to
exist in that moment. Work on not being afraid of the obsession and not
being mad at yourself that you just had the thought. Wouldn't that be
great, to not get distressed at those momentary worries, to not think
that they mean anything.
Let me tell you a story. When my children were infants, I would carry
them in my arms as I walked around the deck of our home. Every once in a
while, I'd stand at the railing, looking at the beautiful scenery out in
the woods, and then I'd have this flash: I'd see myself accidentally
dropping my child two stories down from the deck, and there she'd lie on
the ground, dead. And then I'd see myself jump over the edge to kill
myself out of my shame that I'd just killed my child. But I'd break my
neck instead, and end up being humiliated and shamed for what I just did
to my son or daughter.
And then I'd step away from the edge of the deck.
It was the same with my kids as toddlers. I'd be reading in the
living room while one of my kids was playing in another room. Then I'd
notice that all was quiet. On a number of occasions I would then think,
"Oh, my God, he's swallowed a penny and he can't breathe, and he's
passed out..." And I'd get up and quickly move to the other room to
check on my child. There he'd be, quietly and safely drawing on the wall
with crayons. Now, I'm sure I've have had those kinds of fantasies over
40 times. Each one took about two or three seconds, with slight
variations.
What is the difference between what I experienced and what someone
with OCD experiences? There are many similarities. The difference is not
about the thoughts that we have but in how we interpret those
thoughts and images. I would say, "I know what that's about, and
that's no big deal." I'd say, "That's because I'm a new
parent. It's my mind's way of reminding me that I need to protect these
fragile children. I know I'm not really about to accidentally drop my
kid."
People with OCD might say, "Oh, my God, I had the thought of
killing my daughter? Why did I think that? I'm not sure I can trust
myself. I might accidentally do that." They decide to doubt their
ability to stay in control.
So this is where you begin in your self-help program. Confront your interpretation
that the content of your obsessive thought means something
terrible about you. I want you to downgrade each obsession to a kind of
momentary glitch in your thinking. The thought doesn't mean anything.
You had a fearful thought, and you got scared by it. That's all. When I
saw in my mind the image of my child lying on the floor not breathing, I
became momentarily scared, and my heart raced. That's an expected
reaction. It's like sticking your finger in the wall socket and getting
shocked. That's all it is. And that perspective is what you should work
toward.
When you notice your obsessions, choose to have them. As soon as you
choose to have your obsessions, they're no longer involuntary. Remember
that the definition of an obsession includes that it is involuntary. So
as you begin to accept your obsession, as soon as you choose to have it
then that involuntary thought is now voluntary. And you've begun to
change the nature of the problem.
This is the direction I am going to take in this self-help program. I
am not asking you to stop obsessing right now, or to stop ritualizing. I
am asking you to change some smaller components of the pattern. You're
going to disrupt the pattern by various means. You're going to modify
your obsession in little ways. You're going to add things to your
ritual. In this way you can gradually learn about your ability to
control your symptoms.
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