If you have OCD you may recognize that your life is spent in a continual vicious cycle of thoughts, feelings, and rituals. One helpful way to start to disrupt this cycle is to change or delay rituals. Let’s say you have an unpleasant thought (for example, having a thought of stabbing your spouse) that happens to “pop” into your head.
If you attach unhelpful meanings to the thought (for example, “having this thought means I’m an evil person who is capable of murdering a loved one”), you will probably feel very anxious as a result. Now, because it is uncomfortable to be anxious, you are likely to find ways to lessen that anxiety. For example, you may repeatedly check to make sure the drawer where you store all the sharp objects (e.g. scissors, knives) is locked and say a prayer to yourself every time you have the “bad” thought. Unfortunately, you find that even though these strategies help you to briefly lessen the anxiety, you need to do them more and more often because your “bad” thought seems to occur even more frequently when you try hard not to have it. You feel trapped because you do not know what else to do but keep using these strategies. The next thing you know, your life is being consumed by the “bad” thought and your constant efforts to control it. This is how the vicious cycle of OCD develops and keeps going:
As you learn more about OCD and become committed (hopefully!) to making changes by fighting back against your obsessive compulsive disorder (OCD), you may be feeling hopeful that exposure and response prevention (ERP) can actually work, and that your life can become a little less stressful and a little more normal, once again. However, feelings of hope may also be shared with feelings of being overwhelmed by just how many areas of your life are ruled by OCD. The more years that OCD has held you hostage, often the greater the areas of disruption. While ERP can be very effective, it may take time, sometimes weeks or months, for you to start to see the positive effects of your ERP efforts. In addition, if you chose to take a systematic approach to using ERP for your OCD and, for example, to do 1-2 exposures a day or about 1-2 hours of work, that still leaves another 22-23 hours when OCD dominates. The following section includes five tools that will be useful in providing you with ideas about how to manage the other 22-23 hours in the day. These tools can be used alone or in a combination that makes sense for your needs:
- Change the ritual: This tool is exactly how it sounds. Just because the OCD demands that you engage in a ritual doesn’t mean you have to do it the exact way your OCD says. Having you, instead of your OCD, decide how the ritual gets done can send a powerful message to your OCD that you will not be bossed about. For example, if OCD wants you to wash your hands after touching a range of “dirty” items, it doesn’t mean you have to wash your hands in the exact way OCD demands: with 3 pumps of soap, 3 rinses and 3 paper towels. Instead you can try for 2 pumps, 3 rinses, and 2 paper towels. Or 2, 2, and 2. OR 1 pump, 2 rinses, and 3 towels. You can decide what it will be, or mix up the number pattern every time. Keep OCD guessing.
- Shorten the ritual: This tool is similar to changing the ritual as above. However, instead of changing the ritual, in this option you can shorten it. For example, if you have a dressing ritual that involves a series of dressing and undressing steps that can last up to an hour to get dressed each day, you can start to shorten this. You can begin by estimating how much time you spend on each step, and then shorten each step by a set amount each day or week. It’s up to you how many minutes and when you’re ready to shorten further, but at least its you whose deciding how long it will take and not the OCD.
- Delay the ritual: For most individuals with OCD, OCD makes demands and wants it done NOW. However, you can send your own powerful message when your actions communicate otherwise by stating, “yeah, I’ll do it, but I’m doin’ it on my timeline not yours.” When OCD makes a demand for action, rather than doing the ritual immediately, try waiting a few seconds to minutes before you do the ritual. Over time you can lengthen this gap by minutes to as much as a few hours before doing the ritual. And there is a bonus side effect- the longer you delay, the weaker your urge to ritualize becomes, and sometimes you may not even feel the need to do the ritual at all! That’s a huge success.
- Slow down the ritual: Some adults with OCD have many rituals spaced so close in time that they feel forced to have to rush through them to get them all done. Unfortunately, this pressure to rush sometimes backfires. This can cause the person to have to go back and re-do the ritual because OCD doubt wiggles it’s way into their brain making them wonder “Did I really get all the soap off?” or “Did I accidentally touch the dirty spot when I left the room?” If this situation occurs with your OCD, this slow-down tool will allow you to be more in control with your actions by doing rituals in a slower or more deliberate way to prevent the need to go back and re-do rituals. For example, rather than rushing through the house checking the window locks at high speed but then worrying a particular lock was not checked properly and having to return to check not only that lock but to re-check all the locks, you can do the first “checking” ritual slowly. As you are checking slowly, you might say, “I’m seeing and feeling that this lock is secure,” as you mindfully notice the lock in the locked position, feeling it with your fingers. If this is done slowly and mindfully once, it can take less time than in the “fast” check, where you found you needed to return and re-check repeatedly.
- No AIR: This final tool allows for a combination of other tools. It stands for No Avoidance, Interaction, or Reassurance seeking. The goal is to eliminate all three of the following behaviours:
- Avoidance only serves to increase the power of OCD. When you engage in rituals, you do so to avoid feelings of discomfort or anxiety, but this keeps you hostage to your OCD. In addition, OCD can also boss people around and tell them not to go places or do things, in other words, to avoid doing things, because its dangerous. It can take a lot of courage, but by engaging in ERP exercises and reducing and eliminating your dependence on rituals, you can learn first hand that you can tolerate discomfort and anxiety better than you expected. As well, rather than reducing your life to a small circle of “approved” activities, starting going places and doing things OCD has previously forbidden. Avoid Avoiding!!
- Interacting with your OCD keeps it hanging around. Although it is hard to ignore OCD given its wide and persistent presence in your life, you do not have to interact with it. Interacting with it occurs when you do the rituals it tells you to do, or you avoid the activities and aspects of your life that it insists are dangerous. Stop interacting with OCD and start engaging with the life you want to live!
- Reassurance seeking is the final area that needs to change to help you take control over your OCD. Seeking less reassurance from others allows you to become stronger in managing your OCD head on, thus reducing the power of OCD.