Understanding Life with OCD

PART II

However, it wasn’t a miracle at all – it was the result of a very simple intervention called exposure therapy …

People have been practicing this concept for millions of years; animals – for hundreds of millions.  It’s a natural survival mechanism. If we want something bad enough, we make the choice to go after it, even if it involves taking a risk that feels unpleasant. Whether it’s grabbing a banana off a tree that a lion is standing near, when we’re hungry enough, or facing OCD by refusing to be bossed around by thoughts that make us feel bad. We all take many risks, every day of our lives. 

Why do we shop at stores when all the food could be poisoned? Why do we walk around outside when a meteor could fall on our heads? Why do we drive cars in which we could get killed? Why do we do these risky things? The simple answer is “because we’ve been doing them.”   

When we do something repeatedly that involves a risk, we train our brains to put these things in the “Reasonably Safe Activity File.” When we do these things, we create new “wiring” in our brains for the new behavior. In therapy for OCD, when we willingly and repeatedly expose ourselves to things that cause distress, in time, those things no longer bother us. This is called the process of desensitization. It requires feeling some degree of discomfort but the discomfort is only temporary. The more you work on it, the easier it gets.

The beauty of Exposure Therapy is that it has options:  1) you can choose to do it or not to do it; 2) you can do it as slowly or as quickly as you choose; 3) you can desensitize yourself as much or as little as you want.  

Here’s an example:  Let’s say you’re afraid of tigers, so much so that you won’t even take your child to the zoo. Notice that I wrote “won’t” as opposed to “can’t.” We always avoid things by choice even though it may seem like an impossibility to do certain things. Then, one day you say to yourself, “I want to be able to go to the zoo so I’m going to work on it.”  So, according to option 1 above, you make a decision to work on it by doing exposure therapy. You don’t even have to go to a therapist to be able to do it!  

Next, according to option 2, rather than going right to the tiger cage all at once, you start by just looking at pictures of tigers on the Internet. Then, when you feel ready to take the challenge, you continue with option 2 by first driving past the zoo, then parking in the lot, then going to the ticket booth, and then by going in just a little way. You do each of these things one at a time, repeatedly, over a period of days or weeks and move on to the next level of your “exposure task hierarchy” when you feel ready to take on the challenge. This is what’s called “graded exposure” using the steps on an exposure hierarchy that you have chosen as challenges you will eventually take.  

You keep taking on challenges that are higher and higher on your hierarchy. In doing so, you get closer and closer to the tiger cage until you say to yourself,” That’s as far as I want to go.” I’ve beaten my fear of tigers to the degree that I have chosen and I’m fine with it!” Perhaps you chose to make your goal being able to be 5 feet away from the cage or 25 feet. It’s all up to you.

OCD is not something we get rid of absolutely 100%, permanently. The goal is to diminish it as far as possible. Some people choose to live with their OCD rather than put the effort into defeating it because of the temporary discomfort it requires. In my case, I was suffering so intensely and for so long, I was willing to do just about anything to get well. In my therapy, I did exposures tasks for most of the day, every day. That’s why I got over it in a mere four months.  Since that time, I’ve had a few minor setbacks but nothing nearly as bad as it was at its worst and those setbacks were very brief because I knew what to do and I knew that it would work!

Nowadays, I still have what might be called “little OC moments.”  Notice that the “D” is missing. A problem doesn’t warrant a “D” for disorder until it significantly interferes with your life.

In conclusion, living with OCD can be horrible, bearable, or just a little annoying.  Living with just a hint of OC now and then, as I do, is a breeze!

Alan Carriero is a retired clinical social worker who specialized in treating Obsessive-Compulsive Disorder.  He himself experienced extreme OCD and overcame it more than 30 years ago.  He now works part-time at the Anxiety Resource Center in Grand Rapids, facilitating support groups for OCD and Anxiety Disorders.