A couple months ago, I wrote a blog post titled Do You Need a Therapist?, which addresses my thoughts on this oft-asked question by people suffering from OCD. As a follow-up to that, I also wanted to write a short blog post specifically on another frequently asked question: do you need medication to recover from OCD?

I am an avid endurance athlete. I love running marathons and cycling outdoors on my bike. There’s just something freeing about being able to step out the door, away from all of life’s distractions and general busy-ness, and having an hour or two completely to myself and the open road. My daily workout session is always something that I look forward to, as it’s a chance to do something I love, an opportunity to grow and challenge myself physically, and also a time to take a step back and practice mindfulness (focusing on things like my breathing, the pounding of my feet on the pavement, my heart rate, and the feel of the wind on my face).

There are a number of athletes that I follow on Youtube and one of them (Tyler Pearce, aka Vegan Cyclist) made an interesting video the other day discussing how he has “failed” at certain points in his life, but how he was able to learn and grow from those failures and ultimately become stronger. In particular, when describing his personal fitness journey, he says: “Growth is not being comfortable.”

Something that I believe a lot of OCD sufferers struggle with (at least, I know I did) is dealing with the inability to move on from past mistakes or actions, whether real or perceived. When we struggle with OCD, we struggle with the ability to accept uncertainty and to live mindfully, because we often get too caught up in our heads catastrophizing on “what if?” scenarios. What if I left the stove on and I’ll come back home to find out my house burned down? What if I accidentally typed something nasty in that work email I sent and I’ll get fired tomorrow morning? What if that bump in the road was actually me hitting and killing someone? What if, what if, what if…?

Your brain can come up with a million different ways to create uncertainty and force you into compulsions like rumination and checking, because that’s how it gets relief. The problem with this, as I’ve detailed in this blog post, is that by doing the compulsions, you are reinforcing the OCD cycle in your brain and inadvertently making this disorder stronger. The key to beating OCD lies in mindfulness and acceptance.

For this week’s blog post, I wanted to write about a good recovery lesson that I learned towards the tail-end of my recovery process. If you’ve been reading my blog regularly, you’ll know how much I harp on Exposure Response Prevention (ERP) as being absolutely necessary for facilitating your OCD recovery - it is often regarded as the Gold Standard for OCD treatment for a good reason! When implemented properly and executed consistently, ERP absolutely will work.

When you’re first starting out with practicing ERP, common exercises will include things such as exposing yourself to your triggers and purposefully preventing the response. So for example, if you have an obsessive fear of contamination and compulsively wash your hands to negate that fear, you might do something such as touching a contaminated surface and then steadfastly refusing to wash your hands. That’s a very common and simple example of an ERP exercise, and it works extremely well by breaking the OCD cycle which I explain here.

As you get farther along in recovery and get comfortable tackling bigger and more stressful exposures, it’s easy to get wrapped up in the desire to seek out new exposure opportunities in order to practice ERP and improve your mental health and fitness. And that’s great - but it can also be a double-edged sword. This was something in particular that I began to realize as I felt more and more confident in my recovery - I had such a burning desire to be free from OCD that I would purposefully seek out or create OCD exposures to practice response prevention. So as an example, I would purposefully think terrible thoughts in my mind as a way to “prove” that I wasn’t affected by them.

For this week’s blog post, I was reflecting on some general advice and guidance that I had learned (or was taught to me) during my own recovery journey, and which might be useful to share with readers of my blog who are struggling with OCD.

Something that I get asked relatively frequently is: “do you still get intrusive thoughts or anxiety once you’ve recovered from OCD? What does recovery even mean? Is that even possible?”

It’s a great question, and I also think it deserves a nuanced answer. OCD is such a complex mental disorder that it’s difficult to set one standard of recovery for everyone, because every person has different obsessions, compulsions, and mindsets. For something like the flu, it’s very easy to understand if you are recovered or not. It’s a black and white answer: either you have the flu or you don’t. But it’s much trickier to say this for OCD.

My high level definition of OCD recovery means having the knowledge, skills, and mindset you need to handle any uncertainty, thought, or feeling that may pop up in every day life. Note that I did NOT say OCD recovery means "never" getting anxious, or “never” getting intrusive thoughts. Indeed, I think that is a fundamental fallacy that many people who are beginning their OCD recovery journeys fall for. You might say: “I hate these intrusive thoughts! I can’t stand the sense of anxiety I get from them. I can’t tolerate uncertainty. I want to recover from OCD so that I never get these thoughts and feelings ever again!”

Training your mental health and fitness is basically the same as training your physical health and fitness.

What do I mean by that? Let me explain. I think that most people, even those who aren’t necessarily gym-goers or athletes, can fundamentally understand the basics of training and improving your physical fitness. People go to the gym and lift weights, and if you do this consistently, you gradually build up the amount of weight that you can lift. Or with running - people start out running and can barely make it half a mile before being out of breath. But if they follow a training plan and run consistently, they might be able to run a full marathon (26.2 miles) in a year or two! It’s very easy and intuitive to understand how you can improve your physical health and fitness - all it boils down to is consistent training and quality workouts.

So, how does this tie back to mental health, and more importantly, OCD recovery? A common theme that I see with OCD sufferers (and something which I experienced myself, going through recovery) is that they are afraid to improve their mental fitness. They are used to, and comfortable with, doing the compulsions, ruminations, and being afraid of their intrusive thoughts. All of this is only strengthening OCD’s hold on you and degrading your mental health - it’s basically the equivalent of letting your brain sit on the couch all day eating nachos. What you need to be doing instead is improving your mental fitness through ERP exercises - refusing to do compulsions, refusing to ruminate on your obsessions or trying to figure out “what if” scenarios, and refusing to let feelings of anxiety/uncertainty/fear/etc… control your life.