Obsessive compulsive disorder - OCD treatment and therapy from NOCD

“Just Sit With It”

By Sina Tadayon

Jan 29, 20245 minute read

“Just sit with it.” How many times have you heard that before, those magical four words? No four words have ever been so much easier said than done.  If you have obsessive-compulsive disorder (OCD), this may ring especially true for you, as the idea of “sitting with it” is often mentioned during the treatment process for OCD. But what does it really mean to “sit with it”? How can the act of doing nothing really be an answer? 

Often, through stories, we can gain insight into the complexities of our experiences, finding our own challenges and triumphs mirrored in them. This also applies when it comes to understanding OCD. In the context of OCD treatment, the journey of enduring and confronting deep-seated fears and anxieties goes beyond storytelling; it’s a real, tangible experience for many.

Understanding ERP through cinema

Take, for instance, this scene from “Enter The Dragon” (1973), in which Bruce Lee has just finished whooping 100 armed henchmen. On his way out, he runs into a room, and boom, one door slams shut. He tries to bolt the other way, but boom, another door slams. He’s trapped, with no way out. What does he do? He doesn’t freak out or lose it; he just sits down and does nothing, zen-like. Mr. Handman, the big bad villain, starts throwing threats his way. Bruce Lee? Still does nothing. He gets it—there’s no point in banging on the doors or trying to kick them down. The smartest move is to “sit with it,” save his energy, and wait for those doors to open back up.

In this defining scene, Bruce Lee’s decision to remain calm amidst turmoil is a vivid illustration of Exposure and Response Prevention (ERP) therapy, a cornerstone treatment for OCD. By facing OCD triggers without resorting to compulsive behaviors, individuals practicing ERP, much like Lee in that room, can learn to tolerate anxiety and uncertainty. This process not only embodies the principles of ERP but also demonstrates the kind of psychological resilience that is crucial in overcoming OCD.

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ERP therapy was developed specifically to treat OCD and has helped many people who struggled with the condition regain their lives. All therapists at NOCD have specialty training in OCD and ERP.

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The role of uncertainty

In hindsight, all anxiety is uncertainty. Anxiety often emerges from a fear of the unknown or unpredictable. In the case of OCD, this uncertainty can drive behaviors that, on the surface, may seem irrational but are, in fact, attempts to reduce anxiety and achieve a sense of certainty.

For example, consider someone with OCD who grapples with obsessions about causing harm to others. They might be 99.99% certain that these intrusive thoughts don’t align with their true intentions. Yet, the lingering 0.01% doubt, though minuscule, can be profoundly distressing and serve as a potent fuel for anxiety.

What often happens next is a brain response that’s meant to be protective. The brain, viewing this anxiety and discomfort as a threat, can convince itself that performing certain compulsive actions—such as checking things repeatedly, organizing excessively, or engaging in ritualistic tapping—can provide a sense of tangible certainty and therefore reduce anxiety. While these compulsions may offer temporary relief, they don’t address the root of the issue. It’s like if Bruce Lee were to bang and kick on those closed doors.

These compulsions offer only fleeting relief. Anxiety, like any other emotion, will not just keep shooting up; it will eventually plateau and diminish naturally on its own. However, engaging in compulsions, when viewed in the broader context, does more harm than good. They are short-term solutions that fail to address the underlying issue and can, in fact, exacerbate the cycle of OCD.

Parallels in story and therapy

It’s mind-boggling to me how everything really parallels…

To create diamonds, nature insists on subjecting carbon to immense pressure and searing heat…

Olympic athletes understand that greatness arises from countless hours of pain, injury, and setbacks…

Overcoming addiction demands confronting inner demons and enduring withdrawal…

OCD is no different. What that means is that in order to beat it, in order to grow, you must struggle. No struggle, no growth; no limitation, no story.

Think about it. Was Rocky really Rocky until he had the chance to fight Apollo Creed? Was Luke Skywalker really himself before confronting Darth Vader? Would Harry Potter have been the chosen one if it wasn’t for Lord Voldemort?

All of them needed to be tested first, in order to become the heroes we know and love. Don’t you want the same for yourself?

It has been shown that when you engage in challenges, your body responds at a genetic level, tapping into parts of yourself you hadn’t known and literally making you more than you are. While limits of this transformation are still being explored, it serves as a testament to our brain’s neuroplasticity—its ability to adapt and rewire itself in response to new experiences. Facing the challenges of OCD, for example, prompts our brains to form new neural pathways, which can enhance our resilience and uncover hidden strengths.

Why do we grow when we’re thrust into new environments? Take, for instance, flying into a country where you don’t speak the language or know the culture. Every second you are in this new place, you’re facing challenges: trying to read signs at the airport, figuring out how much to pay the cab driver, eating that weird-looking thing you think is a fish, or using a toilet that doesn’t look like one. In these moments, you’re constantly struggling, yet through this struggle, you grow enormously.

I’m not suggesting that ERP, or sitting with anxiety, is easy. As a matter of fact, engaging in ERP to manage OCD can feel like the most difficult thing to do. Whatever trivial thought your mind is harboring as an obsession can also, in turn, make itself seem as if the very nature of your existence depends on it—which, subjectively speaking, is a pretty gnarly thing to just sit with. But I guess that’s the point, isn’t it? The bigger the limitations, the bigger the story.

What’s your story going to be?

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