Imagine you are in a playground and a big kid comes up to you threatening to beat you up if you don't hand over your lunch money. He/she is a big bully. You do as he/she says and hand over your money because you are afraid of the consequences. Obsessive Compulsive Disorder (OCD) is like the playground bully but it is one that only you can see. It threatens you with bad things if you don't do what it asks. The bully's threats are called intrusions or obsessions, which are distressing thoughts, images or urges. They repeatedly enter your mind, causing you feelings of anxiety, disgust or unease. As long as you carry out its demands, the bully will spare you it's threats.
For each person with OCD, the bully's demands are different and these are called compulsions. A compulsion is a repetitive behaviour or mental act that you feel you need to carry out to try to and reduce the anxiety brought on by the intrusions. For example, you may have a fear you might harm someone in your family (obsession), so you hide the knives in your kitchen and check you're not dangerous by asking your family or friends for reassurance (compulsions).
In dealing with the OCD bully, you may try extremely hard to prevent the threat of harm to yourself or loved ones. However, in doing so, the bully keeps coming back for more just like the one in the playground. The result is that your intrusive thoughts, images or urges may increase. Intrusive thoughts are actually common for everyone and it is an essential component in life to have them because they actually protect us and help us survive. Most of us, find them unpleasant but meaningless and we ignore them. They don't match our own morals or values. If you have OCD you find it hard to let intrusions go and attach meaning to them such as "I shouldn't be having these thoughts" or "they may be true, something bad could happen!" This increases the amount of threat that is out there and your responsibility to look after yourself or other people.
How CBT can Help. Standing up to the OCD Bully.
Standing up to a playground bully is frightening and uncertain. Who knows what could happen next, the situation might get worse! Fighting OCD feels a bit like that but what tends to happen is that OCD makes you feel scared and gives you empty threats. CBT fights OCD by supporting you to face your fear head on. This is called Exposure Response Prevention and it involves a range of techniques to help you manage your obsessions and compulsions. For example, one method would be to let obsessive thoughts occur without "putting them right" using compulsions. This is difficult and requires motivation, but starts with situations that cause you the least amount of anxiety. Over time, you may find that when you confront your anxiety without carrying out rituals, your anxiety does eventually decrease.
Managing OCD means learning how to stand up to the bully. It is a challenging and scary process, but you can win the fight.
For further information about OCD, you can contact the advice line at OCD action on 0845 390 6232 or visit their website at www.ocdaction.org.uk. You can also contact OCDUK on 0845 120 3778 www.ocduk.org. There are also some great books that can help families and you as an individual.
If you would like to contact me regarding seeking treatment for OCD please click on the contact me page