What is OCD
OCD, or obsessive-compulsive disorder, is a common ailment that countless people suffer from all over the world. It is the medical term for a problem that according to research afflicts approximately 2% of the population. OCD is slightly more common in females than males and it often starts already in childhood, when the child 7-10-years old.
The term OCD refers to a cognitive disturbance, or malfunction in thinking, where a person suffers from worry-thoughts, or fears that something awful has happened or will happen. A person suffering from OCD is unable to ignore his or her worry-thoughts and typically uses means to deal with them that only aggravate the worries they are meant to quiet down.
Worry-thoughts are actually normal; everyone has them. The difference between those who suffer from OCD and those who don’t lies in the ways in which people respond to their worry-thoughts. Some responses tend aggravate worries, whereas others are much more helpful in terms of calming the worries down.
The aim of this blog is to familiarize you with diverse ways of responding to worry-thoughts; to make a distinction between ineffective and effective responses and to offer you suggestions of how to learn to respond to your worries in more effective ways.
There are two kinds of OCD symptoms; obsessions and compulsion. An obsession is an apprehension, or a distressful worry-thought that something dreadful may have happened or will happen. When worry-thoughts pop up in one’s mind but fade soon thereafter to give room for other thoughts, they are not obsessions but regular passing-by worries. An obsession is a sticky worry-thought that does not leave the person alone but keeps haunting them despite the fact that they try to do things to get rid of the worry-thought. In other words, the term ‘obsession’ refers to upsetting and sticky thoughts, worries or fears.
The term compulsion refers to something a person does in order to get rid of a worry-thought. Imagine that the thought pops up in your mind that your hands are dirty (even if you already washed them a moment ago). You can try to get rid of that worry-thought in a several ways, one of which is by washing your hands again. Washing your hands, in this case, is a compulsion, or an action by which you are trying to rid yourself of the worry-thought that your hands are dirty. Let’s take another example. A thought occurs in a child’s mind that something bad may have happened to his or her mother. One way the child can try to get rid of that worry-thought is by checking, or by making sure that his or her mother is alive and well. Checking, in this case, is a compulsion, or the action, the child performs to try to get rid of the disturbing thought that something bad may have happened to his or her mother.
Worry-thoughts pop up occasionally in everyone’s mind. Metaphorically speaking we all have a region I our brain, a kind of a generator, or dynamo, that is specialized on feeding worries into our awareness. We will use the name nucleus worrius of that imaginary brain region. The task of nucleus worrius is to generate worries and to launch them into our conscious awareness. Some of worry-thoughts generated by nucleus worrius call for action while others are noise best treated by ignoring them and allowing them to fade naturally away from our awareness.
Imagine that it is winter, and you are walking on the ice of a lake. Your nucleus worrius feeds into your awareness the following thought: “This ice deck may be weak”. You take a split of a second to assess the relevance of the worry-thought and come to the conclusion that the ice may indeed be fragile. You quickly move away from the ice to the safety of terra firma. Your nucleus worrius has been responsible for your safety.
Overactive and underactive nucleus worrius
The human nucleus worrius can be hyperactive and it can be sub-active. In some individuals their nucleus worrius is so sub-active that it can be said to be dormant. These people are fearless and seem to worry about nothing. You yell at your fearless friend: “Come away from the edge! It’s dangerous. You can easily fall!” to which they respond by saying: “No worries. I won’t fall. I have good balance.” You can understand your friend better if you think that they have a sub-active nucleus worrius that fails to feed worry-thoughts into their awareness.
The nucleus worrius can also be overactive in which case it is incessantly feeding worry-thoughts into one’s consciousness, one scarier than the other.
“Did I leave the stove on?” “Is the third Word War starting?” “Do I have a brain tumor?” “Am I sexually deviant?” “Is my spouse cheating on me?” “Am I going crazy?” “Did I make a fatal mistake?”
All of us need to find ways of getting to terms with our nucleus worrius. If we give it too much attention, it can take the upper hand and begin to run the show.
Nucleus worrius: “Are your hands perhaps dirty?”
You: “I just washed them.”
Nucleus worrius: “But they can still be dirty.”
You: “Why would they be if I just washed them?”
Nucleus worrius: “But did you wash properly? Did you also wash in between the fingers?”
You: “Yes, I did was properly.”
Nucleus worrius: “How can you be so sure? You could have been careless. I bet your hands are still dirty.”
You: “C’mon, it’s impossible to have 100% clean hands. Does it matter if they are just a bit dirty?”
Nucleus worrius: “So, you don’t care even if someone would contract a serious illness lose their life because of your dirty hands?”
You: “Ok, well, I’ll wash them one more time then to make sure.”
Nucleus worrius: “Gotcha! I succeeded in getting you to wash them once again. I’m looking forwards to continue this game as soon as you have finished washing them. This is fun!”
Nucleus worrius appears to enjoy having the upper hand. This is the reason why it is important for people with an overactive nucleus worrius to discover means of keeping it at bay, controlling it or calming it down.
Calming down an overactive nucleus worrius
If one wants to overcome OCD, one must learn the skill of calming down one’s overactive nucleus worrius. People who suffer from OCD often lack this skill. They suffer from distressing worry-thoughts and use whatever means they can find to free themselves from these thoughts. However, they often use methods that don’t work, or make the problem worse, methods, that may give temporary relief but stimulate the overactive nucleus worrius rather than help to calm it down.
In order for you to heal from OCD, you must learn better means of responding to the worry-thoughts generated by your nucleus worrius.
Ineffective means of calming down the nucleus worrius
Before we look at useful mans of responding to the worry-thoughts produced by an overactive nucleus worrius, it may be useful to take some time to examine some of the means that persons with OCD often use that tend to stimulate rather than calm down the overactive nucleus worrius.
Many people who suffer from an overactive nucleus worrius try to overcome their worry-thoughts by initiating a conversation with their nucleus. In this inner debate the person tries to reason with their nucleus worrius by explaining it why its proposed worry is unjustified.
Reasoning is an ineffective means of calming down the nucleus worrius because it doesn’t understand rational thinking, probability or logic. On the contrary, any rational arguments that you may come up with will only trigger the nucleus to produce whatever counterarguments it is able to invent. Your rational arguments invite the nucleus worrius to enter into a dispute with you. The more you try to disprove its worries with reason, the smarter it becomes in questioning your arguments.
You are in an airplane when your nucleus worrius suddenly feeds you with a worry: “This airplane may crash and then we will all die.”
You respond with a rational counterargument: “Car traffic is statistically much more dangerous than aviation. Airline accidents are rare.”
Nucleus worrius: “Rare or not but this particular plane could fall killing everyone.”
You: Why would this one fall?
Nucleus worrius: “Why not this this one. Even if it’s rare for planes to crash, it has happened before, and this particular plane can be the one.”
You: “I don’t believe that this plane with crash.”
Nucleus worrius: “Did you hear that weird sound? Did you see that worrisome look on the face of that stewardess?”
You: “That sound is probably just a normal sound from the engines. And the stewardess, if she looked worried, can be worried just about anything.”
Nucleus worrius: “That’s it. She could be worried about anything. Particularly about something that’s wrong with this airplane! This plane will crash any minute!”
You cannot win an argument with nucleus worrius. Reasoning with your nucleus is like feeding the fire. It prompts the nucleus to become obstinate and to start to defend its worry-thought and to relentlessly challenge each one of your counter-argument one by one. Reasoning stimulates the nucleus worrius and only serves to make it more pig-headed.
Particularly children, but also many adults, try to free themselves of their worry-thoughts by seeking reassurance from other people. Children usually seek reassurance from their parents and adults from their spouses or their friends. The reassurance offered by another person can offer relief for a moment but in the long run it steams up the nucleus worrius. Reassurance provided by another person does not help the worrier to get rid of their worry-thoughts on their own. The worrier becomes dependent on other people while their relationships quickly start to suffer as other people may initially be willing to provide reassurance but soon get tired of it and start to become annoyed of the repeated requests for reassurance.
- Did I say something stupid while the guests were here?
- No, you didn’t say anything stupid.
- Are you sure? What if I said something stupid?
- Take it easy. You didn’t say anything stupid. We all talked about normal stuff.
- Tell me once more that I didn’t say anything stupid.
- You didn’t say anything stupid. Everything you said was normal stuff.
- Good, if that’s the case but why were guests looking so weird when they were leaving?
- I don’t know. I didn’t notice that anyone was looking weird. But whatever the case, you didn’t say anything stupid.
- I believe you if you say so. But are you sure? Or are you saying that just to try to calm me down?
Reassurance is related to reasoning. In reasoning the person argues with their own nucleus worrius. In reassurance, the person recruits another person to argue with their nucleus worrius. In both cases the nucleus worries can prolong the argumentation forever, hone its persistence, and strengthen its grip on you.
Some of the worries generated by the nucleus worrius are of the kind that it is possible to get rid of them by checking the state of affairs. Did I forget the stow on? You don’t have to think about, you can check whether you did or not. Did I lock the door? You can check that too. Did I blow the candles? Let’s make sure they are no longer burning. Did I write something obscene into the email I sent? Let’s take a peek at the sent items and read the text again.
The problem is that if the nucleus worrius is overactive, it will not necessarily calm down from checking. It can easily resuscitate a worry that has already once been successfully set aside through checking: “Yes, it’s true that you already checked but did you check properly?” says the nucleus worrius and forces you to figure out a means of getting rid of the same worry-thought again. You can check again the state of affairs, but this method is bad because it can provoke your nucleus worrius to start pestering forever. It can torment you with the same worry again and again as soon as you have gotten rid of your worry with checking.
Checking tends to initiate a game of cat-and-mouse. You perform checking and that allows you to have a brief moment of relief from your overactive nucleus worrius but in its mischievousness it will start to reiterate the same worry-thought to you again and again as if it didn’t have anything else in mind than exhausting you and wearing you out.
4. Superstitious rituals
Human being is a superstitious being. We know that it doesn’t make a difference whether we knock on wood or not when we tell other people that a problem has been gone for some time. But we still do it. Just in case. Almost all people have some sort of superstitious rituals. For example, many athletes are known for performing all sorts of series of movements or rituals when starting a competition that they imagine will help them to succeed in the competition.
It is therefore no surprise that many people who suffer from overactive nucleus worrius discovers that they can try to rid themselves of their worry thoughts by performing some superstitious ritual that they hope will help them get rid of their worry-thought.
Nucleus worrius: “Did you notice? You just used that ominous word that can cause dreadful things to happen.”
You: “I did use that word and it’s true that dreadful things can happen as a result. But let me do something to prevent that dreadful thing from happening. I will repeat within my mind another word three times. When I do that, it ensures that nothing bad will happen despite the fact that I accidentally used that bad word in my sentence.”
The nucleus worrius calms down for a moment. It likes superstitious solutions. It’s a great advocate of superstition because it’s power and hold of you is based on superstition. It rejoices every time the person uses superstitious means to try to get rid of its worry-thoughts. It knows that the more superstitious the person is, the easier it is for it to pester you. After all, most of the worry-thoughts that it produces are based on the superstitious idea of painting the devil on the wall.
“Good, good!” your nucleus worrius sighs every time you try to evade its worry thoughts by using superstitious rituals. “How nice of you to try to get rid of these worry-thoughts that I have sent to you by superstitious rituals. The more superstitious you are, the easier it is for me to tantalize you. Hah!”
Not unlike people who suffer from fears, also those who suffer from worry-thoughts often resort to avoidance behavior. For example, a person who suffers from high anxiety can manage their problem by avoiding high places, or a person who is afraid of crowds can manage their problem by avoiding all situations in which there is a risk of having to be in a crowded place. Similarly, people who suffer from worry-thoughts can also deal with their problem by deliberately avoiding any situations that may provoke their worry-thoughts. For example, a person may suffer from the worry-thought that while driving a car they may have hit someone without noticing it themselves. The person may solve their problem by refusing to drive a car and using public transportation instead or requesting someone else to drive them to places. A fresh mother may suffer from worry-thoughts that involving the fear that she might all of a sudden do something to harm her own baby. The mother could solve her problem by giving the baby to be cared by someone else.
Avoidance is a solution that comes with a high price. It allows the person to avoid facing and dealing with their problem but the price they pay is narrowing their life which in the worst case leads to a life that is confined within the walls of their own home. Avoidance does not help to overcome worry-thoughts – it only feeds the mechanism that produces them.
Many people have noticed that it is possible to get rid of worry thoughts temporarily by redirecting one’s attention away from the worry-thoughts to something totally different. One person may do it by listening to music, another perhaps by playing a computer game, and a third one, for example, by watching YouTube-videos from their smart phone. Redirecting one’s attention to something else can help but the method has its downside. When it works it postpones dealing with worry thoughts at a later point in time, but it may do little to help the person learn to become better at dealing with worry-thoughts in a more effective manner.
3. Better means of calming down the overactive nucleus worrius
Everyone experiences worry-thoughts every once in a while, but the vast majority of people (98% to be exact assuming that the estimate of 2% of population suffering from OCD is correct) have found ways of getting rid of them in one way or the other. In other words, worry-thoughts pop up in everyone’s mind but in most people they do not persist, but fade and give away to other thoughts.
What are the means that the majority of people use that help them deal with their worry-thoughts? We have seen that reasoning, reassurance, checking, superstitious rituals and distraction are not very effective means of getting rid of worry thoughts but what are the methods that work better?
1. Reserve a time for worrying
In recent years experts treating patients suffering from insomnia have started to recommend an old therapeutic method to deal with worries that used to be called paradoxical intention but is now known as worry-time.
It means that a person suffering from worries, fears or some other form of apprehension reserves a certain time slot every day during which time they focus on their worries. The worry time can last for example 10 minutes and during that time the person typically sits at a desk thinking deliberately of their worries the entire time.
Worry-time is based on the observation that it is easier for people to rid themselves of spontaneous worry-thoughts if they have reserved, in advance, for themselves a particular time to think about them. When worry-thoughts pop up in their mind during other times of the day they can say to themselves: “I’m not going to think about it now. I will think about that during the time of the day that I have reserved for thinking about thoughts like this.”
If you decide to try worry-time, reserve a predetermined moment every day for thinking about your worries. Set a timer and use a pen and a notepad and write down each and every worry that comes to your mind. Think about each of them. What is the worst thing that could happen? Is there any way for you to prevent the worst thing from happening? What other bad things can happen? Can you think of some additional worries that you might want to write down in your worry notebook? When the timer signals that the worry-time is over, put away your notepad, and start to do other things. You have given yourself time to think about your worries and you don’t have to think about them before your next worry-time. There are no guarantees that this method will work in your case, but it won’t hurt to try. Many people who have used worry-time have found that reading next day the thoughts that they have scribbled down during their worry time has been an eye opening experience.
2. Put your worry-thoughts temporarily on hold
Have you heard about the Guatemalan worry dolls? They are miniature dolls made of pieces of colorful thread, that usually come in small bags containing 4 or 5 of them. Tourists often by them as souvenirs and therefore they have gradually become known all over the world. Guatemalans have used worry-dolls for centuries to help children at bedtime to free themselves of worries that keep them awake and prevent them from falling asleep. The child’s mother, father or grandparent takes one of the tiny dolls from the purse and asks the child to tell the worry to the doll. The doll takes on the worry thus releasing the child for having to think about it. The doll is the placed under the child’s pillow and when the child wakes up in the morning the doll is gone. It has gotten rid of the worry and returned to the purse. There are several dolls in the purse so that if a child has more than one worry, each of the dolls can take on a different worry.
Guatemalan worry-dolls are based on the observation that worries have a tendency to vaporize, fade or lose their intensity if the worrier does not even try to get rid of the worry-thoughts but instead puts them so to say ‘on hold’, to let them wait for being attended to later. When a worry is on hold in a safe and secure place, but not preoccupying the mind, time starts to do its miracle work and the worry starts to diminish until it loses its intensity and power. If you put your worry on hold for some time and you decide not to think about it during that time, your nucleus worrius loses its grip on you and may end up letting go of the worry.
Worry-dolls have proven to be an effective means of helping children suffering from worries, but their use is not restricted to children – also adults can use similar method. For example, you can write your worry on a slip of paper and put the thought metaphorically on hold, (read: remove it temporarily from you mind) by placing the slip in a place you have reserved for them. When half an hour, an hour later, or maybe even next day you return to the slip of paper to read what you wrote on it, you may well find that that particular worry-thought no longer bothers you nearly as much as it did at the time you wrote it down.
Try writing your worry-thoughts on slips of paper, or the notes app of your smart phone. Your nucleus worrius may protest vehemently if you try to throw away its worries just like that, but it doesn’t mind nearly as much if instead of discarding them, you attend to them by writing them down and promising it to give them attention later. Nucleus worrius does not realize how effective your brain is in cleaning itself up of useless thoughts as long as you give it enough time to get the job done.
3. Discard your worry-thoughts
Imagine that when you were a child you used to have a big brother who took pleasure in teasing you. He teased you, for example, by saying to you things like there are monsters under your bed. The more you got afraid the more fun he had. When you grew up you started to understand that there are no monsters under beds, and you learned to fight him back. When he started to speak about monsters you responded by saying, “Stop it. There are no monsters under my bed. You are being stupid.” He stopped teasing you when he realized that he couldn’t trick you anymore. You defeated him by ignoring his ludicrous fear-mongering.
Children often deliberately scare each other in this way. They project in front of each other various scary images – such as tomorrow there will be end of the world, or that the pet dog of the family has been hit by a car and has died – and then take pleasure in observing the other one’s reactions. From an outsider’s perspective what they are doing appears to be nothing but malevolent bulling but on the other hand one can think of such interaction as a way of rehearsing an important skill of life. When children play this game of deliberately scaring each other, they in a sense, help one another train the skill of handling and dealing with scary fantasies. The scaring game ends when the target learns to respond to the scaring in a way that indicates that he or she refuses to take the scaring seriously and instead shows an ability to ignore it by responding to the fear-mongerer by saying something like: “Rubbish.” “I don’t believe you.” “Give me a break” or “You are being silly.”
Let’s assume that the nucleus worrius in your brain works in much the same way as the big brother in the example above. It actively launches into your conscious mind diverse images of danger and threat not to pester you but to train you and to strengthen you. It wants you to develop a thick skin that will ensure that you will not be disturbed by scary fantasies; that you are able to respond to them by telling them to shove off in a similar way that the child in our example learned to ignore the deliberate scaring his or her big brother.
The discarding of worry-thoughts – or to ignoring them – is a skill that you can practice and become better at, but you will need another person to help you to do that. To practice discarding worry-thoughts, your helper needs to suggest you various random worry-thoughts while you show them that you are able to discard, or ignore, the worry-thoughts that they suggested to you.
I have added to the end of this text a collection of common worry-thoughts. Ask your helper to read them one by one to you aloud and respond to them in a way that shows him or her that you are able to discard or ignore the suggested worry-thoughts. You can do the ignoring, for example, by shrugging your shoulders or rolling your eyes and saying something fitting such “Who cares”, “I cannot be bothered” or “Whatever!”
4. Reject your worry thoughts
Imagine that your nucleus worrius is acting like a child who repeatedly begs you to give them something even though you have tried to make it perfectly clear to them that you are not going to give them whatever it is they are begging for. Let’s imagine the child wants you to buy them a puppy and you have told the in no uncertain terms that you will not have a dog in your house. You feel that you have also explained to the child quite clearly the reasons why you don’t want a dog in your home. Nevertheless, the child continues to harp about the dog. Finally, you don’t have any other choice but to raise your voice and say to the child, “We will not talk about this topic anymore. I don’t want to hear another word about the puppy. I have told you that there will be a dog in this family. Period!” Your stern stance will stop the child’s harping – at least for a while.
The same approach can sometimes also work for worry-thoughts. Give it a try and respond to the worry-thoughts generated by your nucleus worrius in a similar way a strict parent would respond to the persistent begging of a child. Say to your nucleus worrius for example,
“I am not going to be bothered with that thought right now.”
“What you are suggesting is possible, but nobody can know for sure. Time will tell. I’m not going to waste my time thinking about it at this time.”
“I don’t want to think about it now” or
“Yes, yes, maybe, but I have other things to do right now!”
Assertive rejection can be an effective means of dealing with various worry-thoughts, but it’s not easy to learn to use it. Worry-thoughts are scary fantasies or apprehensions that something bad can happen. They are emotionally loaded thoughts and rejecting them assertively is easier said than done. On the other hand, many people who do not suffer from worry-thoughts use regularly this method to rapidly rid themselves of worries that are not worth giving any attention.
Let’s conclude by mentioning one more interesting method of getting rid of disturbing thoughts. This method derives from Eastern meditation traditions. In it you use your imagination to free yourself of disturbing thoughts. The idea is to imagine during meditation that the disturbing thought assumes a form – the form of an object or picture – and appears on the stage of one’s mind where one visualizes it to disappear.
If you want to try this method, assume a good position, close your eyes, and concentrate on your breathing until you feel that you have reached a relaxed, calm and focused state of mind. While being in this state, use your imagination and ability to visualize and you’re your mind’s eye give each of the thought that enters your mind a form, or color. Sooner or later, your distressing worry-thought will pop up in your mind. What color or shape does have? When you can picture your worry-thought on the stage of your mind with a form and color, invent a way to visualize discarding it. You can, for example, burn it up or let the sun shrink it into nothing. Use your visualization skill to get rid of our distressful thought.
There are no guarantees that this method will help you, but it may still be worth while trying. If you are aware of having any disturbing thoughts that are difficult to discard and that are useless to think about, it pays to try out different means of freeing yourself of such thoughts. Visualization or the use of imagination is definitely one of them.
6. Directing your worry imaginations
Have you heard the story about Nigel, the boy whose grandmother helped him to overcome his recurring nightmare? (www.kidsskills.org) Nigel’s parents left him for a sleepover at grandmother’s place and at bedtime he started to cry. When grandmother asked him what’s the matter he explained to her that he has the same horrible nightmare every night where he tries to run away from an hostile dog that is chasing him. Grandmother looked at Nigel with a surprised look on her face and said, ”Don’t you know Nigel that there are no nightmares?”
Nigel was perplexed. ”Why you say that grandma? I have the same terrible nightmare almost every night”, he said.
”All dreams have a happy ending”, grandmother pronounced.
”But mine doesn’t!” Nigel sobbed.
”Of course not if you wake up in the middle of the dream and do not watch it till the end”, grandmother explained.
When grandmother had succeeded to convince Nigel of the idea that all dreams have a happy ending, she helped him imagine how his dog dream would end if he would see it till the end. In their fantasy the hostile dog stopped and turned into a large bird that took Nigel for a breathtaking flight that reached the clouds. ”Remember to see the ending of your dream tonight”, grandmother said to Nigel when she was putting him to bed. Nigel nodded to her grandmother with a smile on his face and fell asleep in just a few minutes. That night he didn’t have any dreams and the nightmare with the dog never reoccurred.
If you can think of the worries produced by your nucleus worrius as daydreams, or nightmares occurring in waking state, it becomes possible for you to try to do to your worries what Nigel did to his nightmare; allow your worry fantasy to continue by giving it a positive twist or a happy ending. For example, if your nucleus worrius wants you to think you’re your hands are dirty and that you are likely to infect another person with a serious illness, allow this awake-state nightmare to continue. For example, by imagining that another person indeed become infected with your germ but thanks to getting that germ into their system, their immune defence system is triggered to develop such a strong immunity that it will spare them for many potentially dangerous infections later in life. The old adage teaches that all bad things bring can bring about something good. You may not succeed in quiting down your overactive nucleus worrius, but you can learn to dupe it by deliberately imagining happy endings to the worries that it sends your way.
An overactive nucleus worrius is a common problem that countless people struggle with around the world. Many them try to control their overactive nucleus worrius by using methods that are more likely to stimulate the overactive nucleus than to calm it down. If you are struggling with this condition and you want to overcome it, it can be helpful for you to know which methods tend to make the condition worse and which have been found to be more useful in conquering it.
The purpose of this article is to offer you suggestions about the directions in which to start to look for solutions. There is no one right solutions. At the end of the day it is you who will need to use trial and error to find out the methods that work best in calming down your own nucleus worrius.
Appendix: Worry-thoughts for practicing discarding worries
In this appendix you will find an assortment of common worry-thoughts. Ask a family member, or someone close to you, to act as your “worry-trainer” to help you practice the skill discarding, or ignoring, worry-thoughts.
Ask your worry-trainer to read to you aloud worry-thoughts from the list while you respond to them by shrugging your shoulders, or rolling your eyes, and saying something along the lines of, “Who cares”, “I couldn’t care less!”, “None of my business”, “Not interested” or “Give me a break”. Your job is to convince your helper that you are able to discard or ignore the worry thoughts that they read to you. You should start with “easy” worries and proceed to more difficult worries only as you develop your skill to discard them.
Keep the mood light and give yourself a clap on the shoulder every time you succeed in discarding a worry-thought. Have fun!