Compulsions fuel OCD. They maintain it and make it worse. If an obsession is a nasty boomerang that you desperately want to get rid of then a compulsion is the act of attempting to throw it away. The more effort you put in to getting rid of that problem the more viciously it will come back and smash your face to bits. Compulsions temporarily get rid of the problem but they make the situation so much worse. OCD is the most accurate boomerang ever. It will come back every time. So the trick is to stop throwing. Stop trying to get rid of it. In order to embrace uncertainty and live a fulfilled life an OCD sufferer needs to stop performing compulsions. This is easier said than done because our minds tell us that compulsions are the most important things in the world. We are made to believe it is the compulsions that are keeping us safe. But that is a lie. They are keeping us unwell.
Compulsions are not the sole privilege of people with OCD. Quick fixes, light relief and vices serve the function of helping the majority of people to escape from feelings they do not want to feel, such as stress, anxiety or low mood. A common example would be a colleague declaring in the office that a bottle of wine will need to be cracked that evening due to the day’s difficulties. Another would be someone pulling out their phone in a group conversation during that awkward silence. It is interesting to look at the function of these actions. The wine will relax and perhaps comfort a mind “frazzled” by stress and tension. The phone is a great barrier to an environment which feels problematic, maybe protecting an individual to the frightful notion that the silence is because of them.
When these avoidance strategies snowball to consistent repetition we can become dependent on them. In some circumstances they can end up being the only way an individual copes with any feelings at all. Heroin is very good at avoiding feelings. I used to work in substance misuse and a recurring theme, or perhaps the only one, was that clients used their chosen drug to continuously escape the trauma of emotional pain. This comes as no surprise when considering the amount of service users who have suffered some type of serious abuse. The burden of having to deal with the issue is so great that any tool, however destructive, can seem like the only way to temporarily ease the pressure.
So there are similarities between addiction and anxiety disorders such as OCD. In order to avoid uncertainty, anxiety and anything else which felt intolerable, I had an impressive war chest of compulsions. I used to: reassure myself that a thought was not true, ruminate on things I had done “wrong” or “right”, get takeaways, get pissed, binge eat sugary foods, constantly check my mood, attempt to feel a certain way, check my pulse, smoke, count movements in my head, hide sharp objects, work out how people view me, spend money wastefully, check I was cured, think of nice things people had said about me, analyse any social situation I found myself in, ruminate on whether I was performing a compulsion, etc.
It would not surprise me if people’s reactions to this list were “well some of them seem quite normal, I do some of those”. I am sure this is true. Some of the compulsions I have mentioned are quite normal. And in some circumstances some of these behaviours could even be classed as relatively healthy. But what made them compulsions for me was the way I used them. All of the above COULD be used by me to attempt to not feel a certain way. This does not mean I cannot get a takeaway if I have been healthy for the rest of the week and feel like a treat. And I can drink alcohol if I feel it adds to my experience in a particular setting too. As long as these actions are adding to my current experience instead of being used to try to take me away from it that is okay by me.
There are some compulsions which are so subtle you have no idea you are doing them. Only recently I realised I had been using a coping technique to deal with sadness for years. When I was in a potentially upsetting situation I continuously had a friend or relative in my head watching me! That individual would complement me or critique my choices in that scenario and I would reason with them to prove I was doing “right”. I was justifying my actions to someone not there! I had placed such a high degree of importance on others’ validation that I had to invent their presence when faced with a difficult scenario. I am now aware of how unhealthy this was. Why could I not get this validation from myself? Why could I not be present with the situation? For the first question I believe that my intolerance of uncertainty resulted in needing to provide justifications for everything I did in order to guard against any future judgement. With that unhealthy desire an ‘imaginary observer’ proves useful. For the second question, I think I could not be present because I interpreted sadness as being an emotion as something to avoid at all costs. Having a friend or colleague (always someone from ‘real life’ that I respected) compliment me in my head was a comforting distraction from the rawness of that present moment reality.
Since coming to these conclusions it became clear what I needed to do. I needed to experience challenging situations exactly for what they were. As with any aspect of recovery, once you become educated on the mechanisms that keep you unhealthy, it is much clearer how to start making healthy choices. That does not make the process easy. I recently experienced an upsetting situation on a personal level. I had to come to terms with some difficult truths about an individual’s health and sit with them for an extended period of time. In the past I would have been imagining a family member letting me know how well I was coping with the situation and I was tempted to start doing this. Instead I just sat with the individual. And I felt sad. It was hard but completely appropriate for the situation. It meant I could properly be there for them and give my full attention. It meant I could come to terms with the reality in front on me.
A big part of recovery from OCD is learning to healthily feel all emotions, something I will go into in more detail in later posts. I am currently reading ‘The Happiness Trap’ by Dr Russ Harris. In it he states happiness in not a fleeting pleasure or gratification (something that a lot of compulsions and quick fixes actually give us quite successfully), but rather the meaning of happiness is a “rich, full and meaningful life”. His reasoning is that anything worthwhile and lasting, such as starting a family or building a career, will have its equal share of pain along with joy. People with OCD, and many others, end up trying so hard to control and avoid feelings they class as ‘negative’ that they end up doing the same with more ‘positive’ ones! Your whole life becomes an attempt to numb a potential nightmare and that hence that nightmare becomes your reality. Recovery is instead the process of embracing all the emotions. Aim for a colourful life, not a grey one.
So how do you stop these compulsions? There are loads of ways! Don’t be like me and start worrying about which technique is “best”! I have spent days performing compulsions, trying to be certain about which technique would be most effective at stopping compulsions! Just find what works for you. My preferred methods revolve around awareness and acceptance. For example, if I feel myself starting to seek certainty I will use a tool recommended on ‘Headspace’, an app which is a great resource to get started with mediation. The listener is instructed to stop thought tangents by bringing them into awareness, by imagining tapping a crystal ball with a feather in your mind’s eye and gently saying “checking”. This brings the unhealthy thoughts into awareness and stops you getting caught up with them. Therefore, if you find yourself beginning to perform a compulsion simply lightly tap that intent with your ‘awareness feather’, thank yourself for doing so well to notice it and then bring your attention to the present moment, ideally onto doing something healthy aligned with your values.
If an intrusive thought arises and knocks you for six it can be ridiculously tempting to try to get rid of it or prove it wrong. A thought of “maybe I just ran someone over” can be met with intense fear and doubt. Stephen C Hayes is an ACT practitioner and author of ‘Get out of Your Mind and into Your Life’. He would suggest “defusing” from the thought by singing “I just ran someone over” to the tune of ‘Happy Birthday’ or ‘Twinkle twinkle’. This can be very effective to see difficult thoughts as simply thoughts, not actually you. Mark Freeman talks about radically accepting the thought in order to accept your darkest fears. If you show your brain you are no longer scared of those deep fears it will eventually stop throwing them at you. So: “Yeah maybe I did just run that person over, they will have died, I will have to go to prison, my family will disown me, I will be alone forever”. I especially like that one. It strangely gives you some perspective when you own that fear instead of avoiding it.
A great thing I’ve done in my recovery is identify all the compulsions that I was performing. I wrote them down and gradually began cutting them out. It massively helps to have a therapist help you with this but I think great strides can be made with education and determination. One thing I noticed with cutting out compulsions is that you end up having lots of spare time when you are no longer trying to control all your internal experiences. It helped to see this as a great opportunity to start doing more things I cared about. I identified a list of healthy actions to turn to if I was ever struggling with the acceptance of a thought or feeling a little “bored”. I know I can always: exercise, call a mate, read, meditate, text family, etc. However I’m feeling. These principles are the foundations of Acceptance and Commitment Therapy and so I highly recommend the work of Hayes, Harris and Freeman already mentioned. Trust me when I say only good, if scary, things can come from replacing compulsions with healthy actions. It’s the way to get better. So put the boomerang down and play another game.