A bite-sized summary of decades of OCD research and professional practice
In the fall of 2019, when we were all still attending large-scale gatherings without a second thought, I was invited to the annual International OCD Foundation Conference, where I was presented with the Patricia Perkins Service Award by my longtime colleagues at the IOCDF. Along with this award, I was granted five minutes to address the crowd that had assembled at the JW Marriott in Austin, Texas.
Five whole minutes to step up to the podium during this plenary session and sum up everything I wanted to say to my respected peers and fellow professionals.
Five glorious minutes to recap several decades’ worth of education and research and experimentation and trial and error, culminating in my life’s work.
Sure. No problem.
. . .
- In the beginning, this work is frightening. This work is difficult. Doing the work takes immense courage. But it’s not complicated. In fact, it’s quite simple once you learn what to do and decide that you’re ready to do it.
- You must treat the work as a mental game—a game you can win. You have a challenger named Anxiety, and Anxiety (aka OCD) comes equipped with a cunning strategy. You must learn its strategy and then create your own counter-strategy in order to win. Part of your job is to tell Anxiety, “I’m not playing your game! I’m playing by my own rules!”
- Exposure therapy doesn’t work. Don’t do exposure. Instead, do exposure with attitude. That works. The attitude to adopt is: “I want to do this. I want what I don’t want. I want whatever scares me.”
- You have to own the work. Don’t blindly follow the steps out of a book; make sense of them! Don’t just comply with your therapist’s instructions; collaborate to create a set of instructions that work for you! And once you decide on your plan, then you must commit to it one hundred percent. You must want to do the work. You must OWN the work.
- This is an aggressive sport. Taking on Anxiety is nothing short of a boxing match. So, you need an attacking offense. You’ve got to bring it. You’ve got to say, “Hey, OCD, if I’ve got to take what you’re dishing out, then give me two servings, and give them to me NOW.”
- This work is all about uncertainty, doubt, and discomfort. I’m not suggesting that you say: “Maybe I ran someone over with my car and killed them, or maybe I didn’t. I’m not sure. I can handle that.” Eek. NO ONE can handle that. The good news is, this work has absolutely nothing to do with your specific theme, your topic, or your content. You should NOT wrestle all day with the possibility that you might have run someone over… or might have burned your house down. No! Instead, I’m suggesting that you generate some generic doubt, distress, and uncertainty. Better yet, I’m suggesting that you seek it out. Do something that makes you feel uncertain. Then keep marching on. “Good!” you can say to yourself, “I’m here to handle uncertainty.”
- This game is played and won moment-by-moment. Don’t worry about the long-term. Don’t think ahead to the final round. Think about right now.
- OCD is terrifying. I know, I’ve said this already (see #1), but it bears repeating. This stuff is scary. But we can simplify it. YOU can simplify it. If we were to write a play based on your interactions with Anxiety, it might go something like this:
OCD: Boo.
You: AH!
You: I’m treating that as an obsession.
You: I’m SO done with that. [You turn away.]
You: Whew. Sitting with uncertain is hard. But I can do it. I can handle this.
Repeat.
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Further reading: “Stopping the Noise in Your Head: The New Way to Overcome Anxiety and Worry,” HCI Books, 2016.
