Many people and even treatment professionals focus on the ritualistic behaviors and avoidance associated with OCD. The problem with this approach is that it focuses on the symptoms of the issue rather than the cause. I have noticed from my own personal experience and in the cases I have treated that OCD’s attempt to control often comes from a desire to avoid uncomfortable emotions that a person might not even be aware of. In a similar way to trauma, OCD behaviors seek a sense of safety through magical thinking. If I touch the door knob three times, this feeling of impending doom will subside or reduce. We feel this behavior is some how preventing whatever doom we are sensing somewhere deep in our minds.
One of the many problems to the issue of OCD symptoms is they are trying to solve an issue through feelings without engaging said feelings. Touching the door knob makes me feel better, but it never addresses what made me uncomfortable. I feel this magical thinking behavior develops at a time in our lives when we believe in universal justice and connection. If I do something bad, then when something bad happens to me it must be the consequence. And there is always a consequence at some point. This isn’t exactly true. Good things happen for bad people and bad things happen for good people. There is not always a reason for the doom. We cannot plan for or control everything in the world.
The most effective and long term solution to OCD symptoms that I have found has been to address the underlying discomfort or emotion that is driving the need for control. We can do this in multiple ways. Mindfulness allows our brain to speak to us about what we might be avoiding when we intentionally sit and look inward. DBT’s Distress Tolerance skills can help us to manage the process of looking into this discomfort while building a tolerance to it. Talk therapy can teach us to process the emotion or reframe the situation to better understand where these feelings are coming from. EMDR can often use the float back technique to see where this feeling has appeared in life before.
OCD is not about knowledge. It is about feeling. We know we locked the door or turned off the stove. We might have even taken a picture on our phone to ensure this certainty. However, our emotions then go, “but what if” and we start to spiral. This is due to the emotion related to the fear of what we might be missing. It can even go deeper into feeling responsible for not being able to prevent tragedy. Some of these feelings need to be processed and let go of. Others need to be reframed and channeled into new outcomes.
A problem with OCD and anxiety is the urge to avoid and stop the horror movie as the bad thing is happening. We do this in a belief that we cannot handle what happens next. However, we have no idea what is going to happen next as we don’t allow ourselves to even think about it. This gets us stuck in a holding pattern. We have to find a way to play out the entire tape and watch the end of the movie. The resolution only comes after the bad part. If you believe you might be a terrible person and fear this, then let’s believe for a minute you are. Do you want to do terrible things? No? Do you want to do good things? Okay, then be a terrible person who does good things until you can see maybe you aren’t terrible.
I personally had OCD symptoms in my early years. Arithmomania, superstitions, the belief that if I turned one way I would have to turn the other or one day the world would correct the lack of balance and spin me to neutral were some of the symptoms. I don’t have these anymore. I don’t know if OCD is “curable”, but I know it can certainly get better.