Photo by: Sergey Nivens / shutterstock.com

I remember having a tough time with change growing up. This really stood out when I transitioned from grade school to high school. I don’t know how it started, but shortly after grade nine I found myself having an urge to go to the washroom numerous times throughout the day to wash my hands, and this took up a significant portion of the school day. Thoughts of being contaminated with HIV-infected blood would soon take over my mind. I would do anything to avoid door handles or shaking someone’s hand because I was so fearful of becoming contaminated. These thoughts got worse and worse, and I remember developing a lengthy decontamination routine after school that involved extensive washing.

As time went on, the contamination obsessions seemed to disappear but were replaced with intrusive thoughts about something bad happening in the future. For example, the big one was my parents getting in a bad car accident. I then developed extensive safety behaviors/compulsions that would help lower my anxiety and make things feel “just right " but that feeling didn’t last long. My compulsion turned into having to do everything an odd number of times. For example, the lucky numbers were three and five. I would have to continue getting up and sitting down on chairs, walking in and out of rooms three to five times, or if I went over that number, the repetition would continue until the anxiety diminished. This began to take up a significant amount of time and I realized how much it didn’t make sense, but I couldn't stop.

“ If we are not aware of how OCD works, the various techniques we might try to help us can easily turn into compulsions.”

At that time, I did not know about OCD, so there was a lot of self-judgment and guilt towards these strange compulsions. I tried to hide these behaviors as much as I could, but eventually, my family would start to notice. Reflecting on this we never really talked about it. I do remember my parents attempting to bring it up, but I would just deny it and feel more ashamed. They were always very supportive and loving, but it was my own quilt that would motivate me to isolate and distract myself from talking about these strange behaviors. Eventually, I started to become more interested in what was happening and that’s when I realized that it was OCD. I then started watching the odd YouTube video on how to treat OCD and for short periods of time I would feel better when practicing certain techniques, but without the proper guidance from a trained OCD therapist, a lot of these techniques themselves turned into compulsions. For example, when I felt the urge to perform a compulsion instead of physically acting it out, I would mentally tell myself “I am a good person, and everything is ok.” Continually rehearsing this mantra in my mind seemed to bring the anxiety down, and I felt like I was finally showing the OCD who was boss! However, as time went on, I realized that I was using this mantra more and more. If I did not use it when the intrusive thoughts showed up, I began to become very anxious.

Let me interject and bring the discussion back to the here-and-now. As a current OCD therapist, it is my responsibility to talk about the subtle but serious issue of mental compulsions. Like I mentioned above, at that time I believed that using a mantra was helping me overcome the OCD. This was not the case, and it made the OCD stronger. Mental compulsions can be defined as anything that we might tell ourselves to escape/decrease the fear and anxiety associated with intrusive thoughts. At the time, it might help you to refrain from performing a physical compulsion, but in the end, all it is doing is reinforcing the OCD cycle. As these mental compulsions increased it took me more and more away from the present moment because I was using so much mental energy and focus to suppress/control every intrusive thought that came into my awareness.

“ERP helped me change my relationship with my core fears by learning how to face them in a healthy and open manner”

OCD can be very sneaky and sometimes it might be hard to decipher whether this is your OCD or not. That’s what it does -- it causes you to constantly question yourself. It’s like having OCD about your OCD. Therefore, finding a therapist who regularly treats OCD and understands how complicated it can be is very important! If we are not aware of how OCD works, the various techniques we might try to help us can easily turn into compulsions. Like anything that we want to learn, change, improve, etc., it is important to find someone who understands where you are at, what you are going through, and where you want to go. It’s like having an upgraded GPS when driving in a foreign country; it will take you where you want to go a lot faster and save you from a lot of unnecessary suffering and frustration.

During my mid 20’s my OCD had gotten quite strong, and I was beginning to get tired of performing these compulsions for multiple hours a day. I would literally think these thoughts were real, tangible things and if I didn’t act on them by performing safety behaviors/compulsions, these negative scenarios would come true. Being so fused with these thoughts allowed them to take over my life and I realized that I was living in a box controlled by OCD. It’s amazing how much mental and physical energy it would take out of me! I was also tired of being a victim of my intrusive thoughts and feelings by endlessly being caught in the OCD hamster wheel. I was beginning to feel helpless and even more isolated. But then there was a point where I asked myself the question; has listening to these intrusive thoughts and performing these endless rituals helped me live a life that is fulfilling and meaningful? The answer was clear, NO! At that moment I realized that I always had a choice in how I responded to any thought or emotion whether it be positive or negative. This was an empowering experience because I recognized that I was not the content of my thoughts, but rather the witness of them. This helped me create some distance from the OCD, but I also realized that it did not address the fear and anxiety that was still there, it was only now more obvious. Where did this fear come from? What was really motivating me to feel so compelled and have this sense of urgency to neutralize the intrusive thoughts?

I wish that I could have answered these questions back then, but at that time I never did get that GPS to take me to where I wanted to go. Fast forward to my late 30’s I started learning about core fears and how understanding one’s core fear can be an important step in overcoming OCD. Common core fears can include shame, guilt, abandonment, death, etc. Becoming aware of our core fear/s can be an important step because it allows us to see the underlying motivators and mechanisms that reinforce OCD. When I finally made the decision to seek treatment for my OCD, my therapist helped me realize that my core fear was an underlying sense of insecurity and guilt. This was very eye-opening for me because this insecurity and guilt were motivating all my compulsions. Reflecting on my OCD journey I recognized that I was always chasing endless fears that were only on the surface. Because of this, the OCD continued to change shape depending on life circumstances, and the OCD would continue to hook me. But, finding a qualified OCD therapist who helped me discover my underlying core fears while at the same time providing the necessary psychoeducation about the OCD cycle shifted my overall perception.

“To truly start living a life free from the grip of OCD we need to address the overall mechanisms that reinforce the OCD cycle.”

As life circumstances got in the way of treatment, I decided to stop therapy, and for a while, I felt like I made a lot of progress. But life is not that predictable. When the next significant change came into my life I began falling back into old patterns, especially during stressful transitions in life. This is a common occurrence, especially when one’s OCD has helped ease the distress associated with changing life circumstances. During these times of change when I felt vulnerable, I recognized that the OCD would find ways to hook me and drag me back into the old patterns. At the same time, I was also practicing various mindfulness techniques on my own which was very helpful overall, but it was not addressing my core fears. Thinking back to some of these mindfulness practices I realized that sometimes even they would develop into compulsions. For example, when an intrusive thought would show up, I would jump into a mindfulness practice to escape those thoughts. Mindfulness can be a very powerful tool when used in the right context, i.e., not escaping from whatever is showing up in the here-and-now, but rather witnessing it with nonjudgmental neutral awareness. Again, this points to the importance of having a therapist who can help you realize when certain practices end up becoming compulsions. This encouraged me to again start treatment. My therapist helped me to understand when and how to practice mindfulness. She taught me how to open up and allow the intrusive thoughts to be there without getting hooked by them. This encouraged me to see my intrusive thoughts in a whole new light. These thoughts slowly become less sticky, and they started to lose their power and grip on me. They were just thoughts, the same as any other thoughts that were coming and going in my awareness. This helped me see that the content of my mind is constantly changing and the more I make space for my thoughts without trying to control or suppress them the less they control my life. My therapist also helped me realize that the many years of reinforcing the various compulsive behaviors had created hard-wired neural patterns in my brain that wouldn't just change overnight, and that this would take practice.

As therapy progressed, we started to gradually introduce Exposure and Response Prevention (ERP). ERP involves exposing oneself to feared stimuli while withholding from performing any mental or physical compulsions that are normally used to lower the fear and anxiety. With continued practice creating new neural pathways and learning patterns that can help us develop healthier ways to handle intrusive thoughts. At this point, it is again important to reiterate the importance of having a properly trained therapist who understands the ins and outs of ERP. Clients can easily use mental compulsions when practicing ERP and this will limit its effectiveness. The therapist should be aware of this and discuss the process thoroughly with the client so that ERP can be done effectively. This also ties into understanding the client’s core fear/s. ERP should be designed so that each exposure challenges the client’s core fear/s.

As I practiced ERP and mindfulness strategies with the guidance of my therapist, I was able to get out of my own way and start to allow the OCD thoughts to be there without reacting to them. ERP helped me change my relationship with my core fears by learning how to face them in a healthy and open manner.

Another important aspect to mention that may have been a byproduct of my mindfulness practice was the development of more self-compassion. Wait! I know how that might sound but let me explain. Self-compassion is not about butterflies and rainbows, it’s about facing oneself fully and completely and shedding light on our shadow that most of us don’t want to look at. It’s about accepting ourselves fully and treating ourselves as we would treat a good friend. Practicing self-compassion can be an exposure itself because it challenges the way we look at ourselves. And if there is a lot of shame or guilt this might be a hard thing to do. Picture yourself on a high-level baseball team. Would you want a coach that is constantly bringing you down by saying things like, you will never be good enough, or why even bother trying? Or would you like a coach who brought out your inherent strengths, helped foster resilience, and was always supportive? What coach would help you play a better game?

When we can start to accept our shameful and fearful thoughts with kindness and compassion, they begin to lose their grip on us. I understand how this might sound and yes at first it may be hard to do this but starting somewhere is an important first step. Working on this with my therapist helped me realize that every time I was responding to the OCD it was out of fear. So, did I want to stay in that small box and have my life run by fear? Or could I move towards love and acceptance of myself, which includes the good as well as the ugly?

Another important aspect of becoming free from OCD and fostering self-compassion is having a healthy support network. As mentioned earlier, during my younger years with OCD the support was always there, but I felt too ashamed and embarrassed to talk to anyone about it. Because of this, I would internalize it even more, which made it stronger. As I got older and more mature, I began opening up about my OCD and this helped me externalize it and see it from another perspective. I began to realize that having a healthy support network is paramount to helping one overcome their OCD. Family and friends are generally eager to help, but to a family member or friend who doesn’t understand how OCD works they might try and help by constantly giving reassurance, giving facts about certain thoughts, or helping the OCD suffer avoid situations that trigger their OCD. This is all understandable, but in the end, makes the OCD stronger and reinforces the cycle of avoidance. Having an experienced OCD therapist is also a great resource to help educate family and friends about OCD and how to provide the necessary support.

As a therapist who specializes in treating OCD, I am aware that it is easy to become overwhelmed by the content of intrusive thoughts and fears. But to truly start living a life free from the grip of OCD we need to address the overall mechanisms that reinforce the OCD cycle. I understand that the content of these embarrassing, frightening, and immoral thoughts can be overwhelming, and it almost seems like our compulsions are happening automatically. But ultimately, we do have a choice in how we want to respond. When we learn to stop letting OCD boss us around by constantly giving it all our attention, it begins to fade into the background. And how do we do this: by seeking the necessary treatment. Can we accept that uncertainty is a fact of life and the more we attempt to control our inner world of thoughts, feelings, urges, tendencies, emotions, etc., the more they control us? Acceptance of these tough inner experiences helps us focus our attention on the things we care about including our family, friends, careers, etc. This allows us to recognize that we always have a choice in how we respond, irrespective of the anxiety and fear. Putting our values in the forefront of our lives through committed action and acceptance of ourselves fully helps us move through the turbulence. Ask yourself; what has OCD taken away from you? Has it caused you to put your values and goals on hold? Can we refocus on what’s important to us in life and learn to live with uncertainty by embracing life fully? This all sounds good, and I would like to do that someday, but right now I can’t. Does that sound familiar? And who are you listening to when you say this? I understand that stepping off the OCD hamster wheel can be very difficult because it feels like there is nothing else. Freedom from OCD is possible, but it’s up to you to take the plunge!

Now before we end, I wanted to provide you with a brief mindfulness exercise that can help bring us back to the here and now.

Whether you are sitting, standing, or lying down that is fine. First, bring your awareness into your body. This can be done by paying attention to your breath, feeling the sensations in your hands, feet, stomach, back, etc. Now notice how that feels. Pay attention to any sensation in the body. Becoming fully present of any sensation that you are noticing. Place your attention on that sensation fully. What are you feeling? Is there resistance, tension, a feeling of energy flowing throughout the body? Can you go into that feeling fully without any judgment, resistance, or struggle? If there are thoughts arising allow them to be there and continue putting your attention in the body. Now move around, shake out your hands, press your feet firmly on the floor, stretch in any way you feel like.

Simple, right? Maybe it was hard to place your attention in the body, or maybe it was very natural. Either way, it’s ok. Did you feel more present and connected to the here-and-now? And if you did, even for a split second, how did that feel?

This simple exercise is an effective way to connect to the body and to the present moment. And like anything else, the more practice and energy you put into it the more you will get out of it.

If you have made it to this point, congratulations! This is an important step in your OCD journey. Being open and honest with yourself can open the door to a brighter future. I would encourage you to continue leaning into the uncertainty and see if therapy is right for you.