How Can I Tell What’s an Intrusive Thought? (and why this is a trap!)
Something that I struggled with during the worst parts of my battle with OCD, and something which I’m sure many others have challenges with, was asking myself: how can I tell if the thoughts I’m having are intrusive thoughts? Of course, it’s easy to say: intrusive thoughts are unwanted and you should just ignore them. But I would often second guess myself and wonder: do I secretly want these thoughts? Do I actually enjoy them? Maybe they’re not intrusive thoughts and they’re actually “real” thoughts that I want to happen! Oh no, what does that mean about me??
If this sounds like you, then my advice is to take a step back, breathe, and continue reading.
The 5-Step OCD Recovery Primer
I’ve been wanting to put something like this together for a long time - basically a “primer” on key topics that everyone should read and understand as they go through their OCD recovery journey. This is not meant to be an exhaustive and fully detailed recovery plan, but more of a rough outline covering the key topics and steps along the way. I’ve created the 5-Step Primer below, with links to other blog posts I’ve written on the various topics, which will help keep things organized and direct you to the most relevant topics. Use this as a resource to help structure your own personal recovery plan and/or to help supplement any formal therapy you are receiving from a licensed mental health professional. As a disclaimer, I am not a certified psychologist or psychiatrist, but I believe this 5-Step Primer will be helpful for anyone going through the OCD recovery journey.
Do You Need a Therapist?
A question that I see commonly asked on OCD help forums and social media communities is: do I need a therapist to recover from OCD? Whether due to the cost of treatment, availability (or lack thereof) of qualified professionals, or even the perceived social stigma of “having to get help for a mental illness,” many people seem reluctant or unable to get a therapist to help them recover from OCD. Hence the question - is a therapist really required?
It’s a bit of a complicated topic, which is why I wanted to dedicate a blog post to it. No, a therapist is definitely not required. Many people (including myself!) have recovered from OCD without seeing a therapist. Can a good therapist be helpful and beneficial on your OCD recovery journey? Absolutely, and if you can find a knowledgeable and qualified professional, they are worth their weight in gold. But - and here is a big caveat - seeing an unqualified therapist, or someone who is not specialized in treating OCD, can actually make your disorder worse - so be very careful when selecting a professional for treatment.
Recovery is an Action
A common question that I see from OCD sufferers is: “How long will it take before I achieve recovery? How long do I need to practice ERP/ACT before I consider myself recovered?”
My (somewhat cheeky) answer is: you can be recovered now! Recovery is a choice that we make; it is an action that we do. We can choose to do compulsions, or we can choose to spend our time and energy focused on value added actions. One choice takes us deeper into OCD, and the other choice towards the path to recovery.
The “Mission Accomplished” Fallacy
The title of today’s blog post comes from the (now infamous) speech that former US President George W. Bush gave on May 1, 2003, declaring the end of major combat operations in Iraq whilst a giant “Mission Accomplished” banner was displayed proudly in the background. Looking back in hindsight, this was a major gaffe as the United States’ involvement in Iraq would drag on for nearly another decade, with thousands of more deaths, both soldier and civilian. Declaring that the job was done so prematurely ended up aging incredibly poorly in retrospect.
What does this have to do with OCD recovery? It relates to the tendency that some people have to abandon their ERP and ACT work once they start feeling better, without necessarily having fully recovered from OCD.
Acceptance and the “Self as Context”
If you read any OCD recovery resource (my blog included), you’ll see Exposure Response Prevention (ERP) listed as the Gold Standard for OCD treatment - and for good reason. ERP is a fundamental Cognitive Behavioral Therapy (CBT) framework for any effective OCD recovery program and if you are serious about recovery, you owe it to yourself to look into ERP and start implementing its practices and mindset into your daily routine.
However - one area that I feel ERP doesn’t touch on enough is the idea of self acceptance, which is the idea that regardless of whatever intrusive thought or uncomfortable feeling we are experiencing, we can still love ourselves and do the things that we care about in life. ERP focuses strongly on identifying compulsions and eliminating them, but the gap I see there is oftentimes people start practicing ERP and will say “I’ve eliminated X compulsion using ERP, but I still feel horrible!” (of course, you could argue that focusing on how you’re feeling is a compulsion as well, but I find this isn’t helpful for people who are still in the early phases of ERP and OCD recovery).
Courage is Not the Absence of Fear
I love this quote by FDR, not just as a general tip applicable to many facets of life, but because for OCD sufferers specifically, it neatly and succinctly summarizes the right attitude you need to be taking when learning how to recover from OCD.
OCD, at its core, is a mental disorder that preys upon our fears. People often think that the compulsions (checking, rumination, etc…) are the cause of OCD, but these are merely the symptoms. The root causes of OCD are the obsessions and fears that are driving us to perform those compulsions. For example, someone who is terrified of getting sick or catching a disease may compulsively wash their hands. Someone who is afraid of burning their house down may compulsively check that the stove is off. Someone who is afraid that they may have accidentally hit someone on their last car ride may compulsively check for dents or bloodstains on their car, or scan the news to ensure there hadn’t been a vehicular homicide in their area. OCD feeds off of our fears.