As I’m stepping out of my office into the reception area to get my next patient, Michael, I can see that he is distressed.
“What’s going on?” I ask as we take our seats.
“I’ve been practicing exposure, but somehow I’m not really scared anymore.”
Michael suffers from an obsession that he may be gay. He spends most of his time looking at pictures of men and women, checking to see whether he is attracted to them. He makes endless Google searches about how to know for sure if one is gay and tries to figure out what his thoughts mean. His exposure involved getting used to the thought that he may never be completely certain whether he is gay or straight.
“So, that’s good news, isn’t it?” I probe. “That is, if you are truly allowing yourself to embrace the uncertainty.” I pause, observing the visible discomfort in Michael’s posture and facial expression. “Is that it? Do you think you are not anxious because you are doing some subtle compulsions during the exposure?”
“No, it’s not that.” Michael looks a little embarrassed. “I don’t really think about being gay anymore. And I don’t care that much. Instead, I now constantly feel that I’m keeping things from my wife. I believe in being totally honest in our marriage. But I feel that I’m endlessly doubting what it is about my day that she must know. So, I call and text telling her about everything that’s going on in my day. And, I continue telling her in the evening too. But she is just getting more and more annoyed with me. I think… What do you think, Anna? Is it another obsession?”
I smile. Just a couple of sessions ago Michael bitterly said that he had been dealt the worst of all possible obsessions. He wished he had a fear of contamination or of being sick, since those obsessions would not have attacked the very core of who he was. “How can I live with myself like this, loving my wife and constantly feeling that I am living a double life as I may be secretly gay?” he used to say.
Now, this new obsession drives him to compulsively confess to his wife anything that happens, and he feels just as terrorized by it as by the previous one.
I repeatedly see this happen with OCD – one obsession morphs into another. A person with OCD is almost always willing to trade his or her obsession for any other one as their “obsession of the day” always seems to be the worst. That is, until they get the next obsession, at which time they would almost always prefer to have their previous one back.
This frequently happens when the patient is starting to successfully fight OCD. There is often a palpable turning point in the treatment where the person absorbs enough information and gathers enough strength and resolve to finally rebel against the OCD. After the initial spike, their OCD starts retreating…only to suddenly come back up with a counterattack in the form of a new obsession.
This always reminds me of the indestructible monster, Hydra, from Greek Mythology, who grew two more poisonous, snake-like heads each time one of its own was cut. For an OCD sufferer, the constant emergence of new obsessions that pop out can be discouraging to the point of despair. But, it’s important to keep in mind that it’s just the OCD scrambling to win its territory back. This is the point in the treatment where you can show OCD who the boss is by following these steps:
8 Ways of Coping with a New Obsession
1. Expect it.
Having either the previous obsession return, or a new obsession emerge out-of-the-blue is a normal part of the recovery process. Expecting the disturbing thought to re-occur or morph into another intrusive thought will help you to not feel ambushed or defeated. It will also help you create a plan of how to react to it. Be on the Iookout for thoughts that keep returning. If a thought suddenly feels sticky, this is a sign that a new obsession may be starting to develop and it’s a call for action to face it as soon as possible.
2. See it as an opportunity.
I consider it a great benefit when a new obsession emerges during treatment. It allows you, the patient, to practice all the skills that you learned in therapy with the new obsession. Done correctly, this will increase your confidence in your ability to fight OCD back and continue living a normal life regardless of which new disturbing thoughts it will come up with.
3. Nip it in the bud.
React early! Your OCD will often try to convince you that the new obsession is not really an obsession, but rather just a reasonable concern that needs to be addressed. Don’t listen to the OCD’s lies and immediately do what you have been doing in your treatment with the old obsessions (which is basically labelling the thought as an obsession and doing absolutely nothing about it).
4. Remember that you need to choose to continue living your life regardless of the discomfort that the new obsession brings.
You do not have to like the discomfort (nobody does). But, it is the willingness to move forward without “fusing” with your obsession that is crucial to your recovery. Making room for unpleasant thoughts and feelings without trying to push them away or engage with them, and instead choosing to concentrate on what is important to you will keep you on the right track.
5. Ignore the content!
As you saw in Michael’s example, and as you probably painfully learned yourself, the current obsession is usually the most painful one. The reason for that is that OCD always hits you where it hurts the most. The content of your obsessions is always the opposite of your values; the opposite of who you are. OCD attacks what’s most important to you right now.
But the fact is that the content doesn’t matter. Whether you are afraid of germs or worry that you may stab your loved one with a kitchen knife, all of those obsessions are just thoughts. They are not truths, facts, warnings, impulses, or signs. And, as such, you better treat them equally (that is, allow them to exist without taking them seriously).
It’s not the content of your obsessions that leads to suffering. It’s the process of your engagement with them –- whether it entails giving them meaning or trying to push them away — that gets you hooked.
6. Instead of just dealing with one obsession after another, start destroying the scaffolding of OCD.
If Heracles continued to try and cut Hydra’s heads one by one, he would have gotten nowhere. Worse than that, he would have needed to deal with more and more heads until he would be defeated. To conquer the monster, Heracles had to come up with a plan that was more sophisticated than just cutting those ever reemerging heads.
If you continue chasing away every obsession by creating numerous hierarchies, allocating exposure time, and discussing each obsession in detail in therapy, the progress will be slow. The more effective strategy is to destruct OCD at its core by learning to accept uncertainty, embrace living with doubt, give up the unrealistic idea to try and control your thoughts, acknowledge that there’s a limit to your responsibility to prevent harm to yourself or others, and treat the thoughts as neutral, non-threatening events.
7. Stop resisting!
It doesn’t matter whether you give your thoughts a lot of attention by trying to figure them out or push them away by trying to neutralize them, or if you try to replace them with “positive” thinking. In both cases you get hooked on those thoughts and become entangled with them, thus making them stickier.
What you resist, persists. So better allow the thoughts to just be. Let them come and go without trying so hard to make them go away.
8. Change your attitude.
It is impossible to really overcome OCD without embracing a completely new attitude – one of acceptance. By accepting that your mind may be “sticky” as you have OCD, and committing to changing your reaction to the OCD triggers, you can live your best life.
Feeling empowered by his new understanding of OCD’s sneaky ways, as well as creating a plan of how to cope, by the end of the session Michael seems determined to fight back. But, as he is leaving the office, he hesitates.
“Just one question: this session. Should I tell my wife what we talked about in the session? You said to stop confessing. But, what if this is important to share with her? How do I know for sure if this one is an obsession?”
I make a mockingly vicious face.
Michael laughs: “Right. Sorry. It got me for a second. I guess I’ll never know for sure. Thanks, Anna. See you next week!
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Anna Prudovski is a Psychologist and the Clinical Director of Turning Point Psychological Services. She has a special interest in treating anxiety disorders and OCD, as well as working with parents.
Anna lives with her husband and children in Vaughan, Ontario. When she is not treating patients, supervising clinicians, teaching CBT, and attending professional workshops, Anna enjoys practicing yoga, going on hikes with her family, traveling, studying Ayurveda, and spending time with friends. Her favorite pastime is reading.