The most common questions I am often asked are, “What’s the difference between a regular thought and an intrusive one, and how does that become an obsession?” “Why do they cause so much distress and anxiety?” How do they lead to compulsive behaviors?” Let me try to answer these questions and hopefully shed some light on how anxiety can take on a life of its own and cause so much destruction in a person’s life.
How many times have you had a strange, uncomfortable, disturbing or embarrassing thought? I would bet that everyone out there has one several times a day. In fact, the average person has numerous thoughts every day that could be called “uncomfortable” or “strange.” It’s part of being human to have unusual thoughts, and it’s extremely normal to have a disturbing or intrusive thought that is mildly bothersome.
For example, “What if I just drive my car into that pole?” Most people would take that thought and shrug it off by acknowledging that the thought is bizarre but nothing more than a basic impulse in the brain. They move on from that thought without much difficulty, or maybe a minor spike in anxiety that quickly fades away. Another person has a thought, while standing at a crosswalk, “What if I just push that woman into oncoming traffic?” Whoa, that was weird. How could I think that? Am I dangerous to the public for having this thought? What if I am capable of doing such a thing? In this case, the person is taking a thought and running with it.
When the thought intrudes and the person takes it at face value, the internal reactions can be very frightening. For example, the person might imagine, in great detail, a woman falling into the street and being hit by a car. This thought would frighten almost anyone, but it’s incredibly terrifying to the person who suffers from obsessive compulsive disorder. The intrusive thought can lead to high levels of anxiety that don’t just fade away.
This person then might start avoiding other pedestrians, isolating oneself from the general public, or a vast array of compulsive behaviors to try to reduce the anxiety caused by the thought. As you can probably imagine, none of these techniques are effective in the long run. For the person suffering from OCD, compulsive behaviors that reduce anxiety give temporary relief, but unfortunately the thought comes back and the intervals between having the intrusive thoughts often get shorter.
I want to ask a question to those suffering from repeated thoughts that cause such distress and anxiety. Have you ever acted on a thought that you found so distressing, unusual or even revolting? If not, then what does that tell you? So often, sufferers think that their thoughts reflect the negative parts of themselves and that they are possibly even capable of acting upon these impulses. Those thoughts are likely obsessions. They are obsessions because they will not go away, even though you want them to. They are obsessions because they interfere with daily life and seem relentless. On the other hand, if you fantasized about harming someone and found pleasure in the idea, then we are not talking about OCD. But when a person tries so hard to push intrusive thoughts away or to neutralize them, then they are most likely suffering with this disorder.
The way to begin the fight against obsessing and compulsive behavior is to look at these thoughts, and look at ourselves, through the process of cognitive behavioral therapy. Instead of pushing obsessions away or ritualizing, we must go directly at these thoughts, take them on and accept that they will weaken if we stand up to them. If we resist the nagging mental noise that compels us to ritualize, we will find a strength within us that says, “Stay with the discomfort long enough to feel the anxiety reduce without the need to ritualize.” Remember that every time we ritualize, try to stop our thoughts or avoid situations that cause us fear, we are just triggering the obsessions and making them stronger.
Have you ever done the experiment of trying not to think of pink elephants? The result is that you think of almost nothing else. Think about this: Every time we perform a compulsion, we are giving validity to our obsessions. When we avoid situations, we are reinforcing the strength of the thought that produces so much anxiety.
The actions that you take or don’t take will either free you from the constant mental anguish or keep you locked into a battle with your own mind. The process is not immediate but takes time and perseverance. The alternative is to live in a state of high anxiety, with a need for perfection, a constant feeling that things have to be “just right,” or even incessant fear.
I will tell you from my own life experience that short-term relief from obsessions will never give you what you truly deserve — a lifetime of acceptance that thoughts don’t need to be controlled. Once you accept that compulsions do nothing but continue the vicious cycle, you can begin to work at overcoming OCD.
— Jon Lukas MFT is a psychotherapist specializing in cognitive behavioral therapy. He is in private practice and runs The OCD Treatment Center of Santa Barbara, working with adolescents and adults with anxiety disorders. Click here for more information or call 805.453.2347.
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