During a recent OCD support group, one of the members shared in graphic detail how OCD convinced him of being a homosexual. He said the feeling was so real that he would get physical confirmation from it and even went so far as to have a homosexual experience to check if he really was homosexual. “How messed up is that!” he said. Everyone in the group identified with how real OCD feels, from the two women that were convinced they could harm their children, to the young man who just got out of an intensive treatment program for contamination OCD yet was still asking his mother if it was safe to touch things. To help me understand their experience better, one of them said, “Picture your daughter just died and well-meaning people are trying to tell you not to think about it. Not to do anything about it. Definitely not to have any sadness or anger about it because that will just give it power.” Wow, that’s all I needed to get a gut wrenching understanding of what these people experience every day.
So what do we, as OCD therapists, have to offer them? How can we help them tame the bully? I laid out several steps that I find to be helpful to my clients because it is important not to keep having conversations about how awful this is, and instead help them get to work.
These are the steps I shared:
- Call it OCD/Bully/Jack Ass: whatever name they give it. This will help them separate themselves from the experience.
- Don’t connect to the content. OCD wins when they believe what it tells them and they share that content with others or just ruminate about it in your mind. Scrupulosity is not about their relationship with God, Contamination OCD is not about germs or cleanliness, and Homosexual OCD has nothing to do their sexual orientation. This is just how the bully, OCD, messes with them because it is an area that matters to them. That’s what bullies do: they mess with our vulnerabilities.
- Live with the uncertainty. OCD will convince them if they just do X, they will know and thus feel better. However, OCD is a liar. The truth is that nothing is certain and your client must embrace uncertainty to live well with anxiety and to tame the OCD bully. When they can say “maybe, maybe not” to whatever OCD tells them, then they have a fighting chance against OCD because they realize that this is about a glitch in their brain giving them false messages.
- Begin to expose themselves to the triggers that cause them so much anxiety. Remember they are not tolerating being a murderer or a homosexual or an unscrupulous person, they are trying to trigger those thoughts and then tolerate them and the ensuing anxiety.
- Chase after the fear. The OCD bully has no power when your clients are chasing after it rather than being victimized by it. Have them look for opportunities to be triggered. Laugh out loud at the absurdity of OCD. Tell OCD that in no uncertain terms, they want to have these feelings and thoughts.
One of my clients just called to share his success in using these strategies. He has severe contamination OCD which has prevented him from going on to get his doctoral degree in education. After years of therapy, he decided to take the risk and go to graduate school. His first week at the school meant living with a group of men who would also be in his cohort. He was terrified that something would trigger his OCD and he would become incapacitated in front of them. We met before he left and made a game plan. He told his peers the first day about his OCD and asked for their help. He found a dumpster every day and took something dirty out of it and placed it, like a trophy, in their apartment. Then he sought out opportunities all day long to contaminate himself. His peers got into it with him and provided some curious but hilarious opportunities for exposure. He called me at the end of his first week and said he had never felt better and believed he had tamed his OCD bully!
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