OCD or not OCD, that is the question?

Like many people I have a mild case of obsessive compulsive disorder (OCD). We all worry (its part of being a sentient being) and have mild fixations about things and for most of us it doesn’t really affect us. On my part – I order the books on my bookshelf by size and I check that everything is OK in the house several times before I leave home. I certainly don’t have the compulsion to tidy up other peoples bookshelves and until recently I only needed to check things were OK a couple of times before leaving the house. Until recently that is. I gradually found myself checking more things, more and more times before I left the house – the cooker, the heating, the windows, the iron (for goodness sake when have I ever done the ironing). On several occasions I found myself turning round while driving on the M25, to go back and check again.

 I can be quite light hearted about this but it was starting to affect my life, and for some people it stops their life all together – they wash till their skin bleeds, they cannot go near other people for fear of germs, they cannot leave the house for fear of leaving the front door open.

 Now people with OCD are not stupid, they know what they are doing does not make sense, but like the drug addict who knows that the next fix may kill them or the smoker that the next cigarette may cause lung cancer, they simply cannot stop their fixation. Many people try to get relief by focusing on their worry, but often this simply makes it worse. I checked everything many, many times before leaving home, but this didn’t help. I just thought of more things that I should have worried about, normally after I had left home. The more I thought about my fear, the more I found things to be frightened of.

 OCD often starts with a trigger event, with me it was obvious, a few years ago I experienced a series of burglaries that left me scared to leave home for fear of what I would find when I got back. I moved to a new and safe neighbourhood with a high security system in my home, but over time that did not help – I simply thought that the house would burn down because of the iron (I even bought one which switches itself off after 15 minutes – it didn’t help) or that I had left my nice expensive high security doors and windows open. When the obsession came, all I could do was to check the doors, the iron, and the windows one more time. It helped for a few minutes, but once I was back on the M25, I simply worried about something else.

In OCD quite often the act is ritualized, this meant that when I checked everything before leaving the house, I followed a ritual, I did not actually concentrate on what I was doing, so I really wouldn’t have known whether I had checked or not. I had simply developed a habit. Secondly I had a fear of making a mistake (in my case leaving something open or switched on). In his book “The brain that heals itself”, Norman Doidge describes how most of us get over mistakes – we realize we have made a mistake – we become anxious about it – we correct the mistake – we move on. For the obsessive compulsive that fourth event doesn’t happen, we simply start worrying all over again. When I read this I got a hallelujah moment. This did not just describe how I felt about leaving the house, it described my entire life.

So what does Norman Doidge recommend? It is very simple really – you disconnect the OCD attack from the event. When I leave the house, the panic I feel is not that I have left the iron on, it is the OCD. Thinking like this gives me distance between the panic attack and the actual event. I can tell myself that it is very unlikely the house will burn down, it is the fact that my brain is slightly mis-wired which is causing the anxiety. I then need to think about something else to take away the panic and to divert my attention – preferably something enjoyable (music, hobby, thinking about something nice). This approach goes against what most therapists do which is to immerse their patients in their fears. According to Doidge such an approach simply strengthens the connection between the OCD and the triggering event, but by separating the event from the fear, we are getting the brain to rewire itself. We can tell ourselves that it is the OCD talking, move on to something nice and the next time the panic comes, it is a little less powerful and eventually our brain automatically switches to the nice feelings as soon as the panic arrives. Once we automatically switch off the panic it is of no use to use and it gradually disappears.

So in my case, I have compiled a list of the things which I need to check before I leave the house. I check them once before I leave the house and tick them off the list – but I really do focus on them when I am doing it. Then if the panic arrives, I look at the list, reassure myself that the list is good (separating the panic from the event) and turn my mind to something nice (I personally find Mozart on the iPod works well). I know that I have a long way to go and eventually I will dispense with the list but every day it is getting a bit better and today I went for a run without checking the list or even thinking about it until I was nearly home.

So how does this relate to hypnotherapy? Well hypnotherapy is very good at allowing us to think logically about things in a relaxed way, to separate our fears from the reality and help us to visualize our new selves and how we will feel when we succeed. There are also specific techniques to help remove the fear. In that sense whether with a therapist or via self hypnosis it is a very powerful tool to help one separate the OCD from the fear. If you do not think you can overcome your OCD on your own I would be pleased to help.

 

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