Graphing my OCD Recovery with Data
One question that I often see from OCD sufferers is: “How long will it take me to recover? What does the journey to OCD recovery look like?” So I thought that it would be helpful for readers of my blog to explain my own OCD recovery journey, the process, and some of my key learnings on the way.
I am a data junkie. I process and analyze lots of data as part of my day job. When I’m training for marathons, I analyze information about my heart rate and mile splits. So a more data-driven approach to OCD recovery felt natural to me, because I could hold myself accountable to actual results, and also be able to understand any underlying trends or patterns about how my progress was going.
Before going further - I want to set the disclaimer that this was my own recovery journey, and what worked for me personally. Even if the underlying principles of OCD recovery (e.g. ERP) are the same for everyone, your own personal recovery journey might look different. Some exceptional people might recover in 1 or 2 months of dedicated ERP. Some people may take longer. As you can see from my chart below, it took me approximately 5 months. I say this because I don’t want to discourage anyone if they feel like they are making progress too slowly - OCD recovery can and will differ from person to person. If someone says, “I recovered in a month!” and you’ve been struggling with ERP for a year, don’t assume that you are doing something wrong or feel discouraged. OCD recovery is highly personal to each individual and you shouldn’t benchmark your own progress against someone else’s. No matter what, you should trust in the process and trust that a dedicated CBT regimen like ERP or ACT will help you recover, no matter how long it takes.
That being said, going into more detail on my own recovery process: I already covered my journey separately in this blog post, so I won’t spend much time here rehashing the same details. At a high level, I hit rock bottom in 2019 and truly felt like I had to recover from OCD no matter what it took, because at that point I was completely debilitated by OCD and barely able to function. I began researching Exposure Response Prevention (ERP) techniques after hearing it mentioned on several podcasts and finding research indicating that it was often used as the Gold Standard for OCD recovery. At that point in my life, I was willing to do anything to free myself from OCD, so I decided to go all-in on ERP and ride it out, no matter what happened.
I will cover more details about ERP in a later blog post, but at a high level, ERP is all about eliminating the response to your triggers. It is focused on eliminating your compulsions. Note that ERP is NOT focused on eliminating your anxiety, and that is key to understand when you first begin ERP. So many people go into ERP expecting that it will help reduce their anxiety, when in reality, your goal should be solely focused on eliminating your compulsions while accepting any anxiety that comes along with it. In fact, when you first start ERP, it is common for anxiety to skyrocket because you’re no longer doing the compulsions which used to provide relief to your brain. This phenomenon often causes people to give up, or say that “ERP doesn’t work,” when in reality it’s just a natural result of cutting out the compulsions that your OCD depends on. Imagine an alcoholic who drinks heavily - if you take away their drinks for a day, they will get severe withdrawal symptoms and feel quite horrible. But you don’t see people saying: “clearly that means the recovery process doesn’t work, better give them more alcohol!” No, of course not! It’s the same with OCD recovery. It will be uncomfortable at first, and your anxiety very well could increase greatly when you first start ERP - but that’s a natural byproduct of cutting out the compulsions, and it means you’re on the right track! That leads me to my first learning about OCD recovery:
Trust your actions; not your feelings.
When you suffer from OCD, your feelings are a lie. Your brain may be overloaded with anxiety and telling you: “If I’m having so much anxiety/fear/discomfort, then something must be wrong! Please do the compulsions to make the anxiety go away!” Anxiety is not an indication that anything bad is happening - it’s just a faulty wire in our brain that is ringing the false alarm bell. Instead, choose to trust your actions by refusing OCD compulsions and eliminating your responses to triggers, no matter how much anxiety pops up.
When I started ERP in 2019, I wanted to hold myself accountable for reducing the amount of compulsions I was doing, because I knew that was the only way to recover. I used the NOCD app (free on the iOS store, but if you don’t want to download an app you can always just track your log on a piece of paper) to keep a written log of every single time I did a compulsion. So every day, when I caught myself doing a compulsion (e.g. checking the door multiple times, or replaying conversations in my head to try and assure myself nothing bad had happened, or re-reading emails at work to ensure I hadn’t accidentally typed anything wrong) I would mark it down in my log and also record the matching anxiety level (from a scale of 1-10). At the end of the week, I would tally up the amount of compulsions I had done, and the sum of all my anxiety scores, and make a promise to myself to try and reduce that amount the next week. If I did 80 compulsions in one week, then my goal for the next week was to get it down to 70 compulsions. And then to 60. And so on. As long as I was reducing the amount of compulsions I was doing, I knew I was making progress, no matter how anxious I felt. The results of my journey are graphed below:
A few key takeaways from my chart:
I hit my “peak” in Week 2 of practicing ERP, where I did 80 compulsions in one week and had an Anxiety Score of 239. This reinforces the fact that ERP is often most difficult at the beginning, but you need to stick with it even with the heightened sense of anxiety that may come from actively cutting out compulsions.
From Weeks 1-6, I made quite tremendous progress. In just 1.5 months, I was able to cut out 80% of my compulsions and my daily anxiety level had dropped quite drastically. Again, I want to re-iterate that the objective of ERP is to eliminate the compulsions, NOT to reduce anxiety. If you maintain that mindset and stay focused on cutting out compulsions, the reduction in anxiety will come as a natural by-product as you begin to free your brain from OCD’s grasp. But in my opinion, if you are focused on reducing anxiety, then you are only hurting your long-term recovery progress.
In Weeks 9 and 12, I had minor spikes where I ended up reverting back and doing some more compulsions. Not ideal, but OCD recovery is not linear and it will not always go perfectly. Sometimes it feels like you take one step forward, and then two steps back. When that happens, it’s important to be kind to yourself and not beat yourself up too much. You haven’t regressed or relapsed in your progress. You simply stumbled, but what matters is picking yourself up and moving forward.
Around Week 14 and onwards, I had cut out 99% of my compulsions and the same triggers and fears that would have spiked my anxiety to maximum levels at Week 1 no longer caused any sort of anxiety or fear to me. At this point, by refusing compulsions and learning to make peace with the sense of anxiety, I had taught my brain that these OCD fears were not real and not worthy of any sort of response. As a result, after teaching my brain that these triggers were no longer threats or things to be afraid of, my brain learned to stop ringing the false alarm bells every time one of those triggers happened. Teaching your brain to beat OCD is a lot like training a puppy; it reacts instinctively to behavioral reinforcement. If you are always doing compulsions and reacting to triggers, you teach your brain that these things are legitimate threats to be afraid of, and it will respond in kind by sending you more anxiety when it perceives these threats. In contrast, if you refuse compulsions and accept the anxiety, you gradually teach your brain that nothing bad actually happens if you don’t do the compulsions, and your brain eventually learns it no longer needs to raise the alarm bells or flood your mind with anxiety whenever a trigger happens.
This leads me to key learning #2:
Consistent, patient, and dedicated practice of ERP is the most important factor to recovery
Think of OCD recovery as if you’re training for a sport. (I’ll use marathon racing as an example, because that’s my personal hobby). You don’t become a great runner overnight, nor in a matter of weeks or months. Nor do you become a great runner if you only train once or twice a week. In order to make real, lasting progress, you have to train consistently and over a long period of time to really see any notable gains or improvement. There isn’t one key workout that suddenly turns you into a good runner - it is the gradual accumulation of minute improvements that you see after training consistently and with discipline over the course of many months and years.
OCD Recovery and ERP is much the same. If you go one day with no compulsions, but then the next day do 20 compulsions, you’re not really making much progress. Or if you practice ERP for two months and say: “I still feel anxious! It’s not working, I’m giving up,” then you’re not really understanding that recovery is a slow, methodical process. You need to stick with it and do the proper workouts (exposure exercises) on a consistent basis over a long period of time to realize success. But if you do that, I promise that you will see huge improvements in your ability to refuse OCD compulsions. This leads me to my third key learning:
Be honest with yourself and hold yourself accountable for OCD recovery
The only person who can “cure” your OCD is yourself. Others can guide you on the path to recovery, but you are the one putting in the hard, sweaty work. You are the one who needs to do the exposure exercises. You need to be the one holding yourself accountable. It’s easy to say: “Just one little compulsion won’t hurt.” Or, “Yesterday was tough. I deserve to have some reassurance today - I’m going to take a break from ERP.” Or, if you do 5 compulsions, you might just count that as 1 compulsion in your log.
If you do these things, the only person you are hurting is yourself. You’re only setting back your progress. I know ERP is quite difficult at first when anxiety is spiking, but you have to trust the process and hold yourself accountable to following your ERP exposure exercises, even when you don’t feel like doing the work. It is not about motivation - it is about having the discipline to do your exercises and workouts and be brutally honest with yourself on your progress. I’ll use my running analogy again - I might wake up one morning and it’s pouring rain outside, and I’ll think to myself: “Boy, I do NOT want to go running right now.” But if my training plan says I’m supposed to go out and run 6 miles - I lace up my shoes and go do it anyways. ERP is all about training your mental fitness, much like training your physical fitness, and having the discipline to do so even when you don’t feel like it.
I hope this blog post helped some of my readers, as I know these are often very common questions. I realize that I highlighted ERP a lot in this post, but didn’t necessarily go into much detail on specific ERP exposure exercises or some of the nitty-gritty aspects of practicing ERP. I will definitely cover that in a future post, as ERP is such a vast and important subject that it requires a separate post of its own (or even multiple ones!)
As always - if you are reading, I hope some of this information provides some helpful insight and guidance into your own OCD recovery journey. Keep in mind that your experience may be quite different to mine, but the core fundamentals of recovery are still the same. Please feel free to reach out with any questions (either to my email in the Get in Touch section) or by leaving a comment directly below.
Eric