Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Obsessing about Obsessing: “Is this really OCD?”

By Stacy Quick, LPC

Apr 07, 20225 minute read

The concept of meta OCD is centered on obsessing over obsessing. Someone dealing with meta OCD begins to question everything from whether they actually have OCD to whether they are doing treatment correctly. It’s an attack on the individual and their experiences, and it can wreak havoc on someone’s life. 

I have worked with many members who have experienced this during treatment. They constantly ask themselves “is this OCD?” and “am I responding appropriately?” At first, it may appear that they are simply trying to do the best they can. It looks like they want to do well and are being diligent in following treatment guidelines. While this is likely true, it can also be true that OCD has found a new avenue. OCD is nothing if not creative! 

“What if it’s not really OCD?”

If you’re dealing with meta OCD, you may begin to personalize and pick apart everything your therapist has taught you about exposure and response prevention (ERP) therapy, viewing every step of treatment as “all or nothing.” As a result, if things don’t feel “perfect,” you might believe you must be doing something wrong. Even if you have regained some parts of your life, you may wonder why you still have residual symptoms. 

This can make you doubt yourself, and wonder whether you missed something during treatment. Maybe you worry that your therapist has messed something up. You may even do frantic research, looking up everything you can find about ERP. You search for inconsistencies, looking to see if what you’re reading matches exactly what your therapist has taught you. 

Meta OCD can look like becoming engulfed in doubts about treatment and about the disorder itself: What if I have this forever? Have I been lying to myself this whole time? What if it is not OCD? Am I using OCD as an excuse? 

Remember,  just like all the other thoughts, images, and urges OCD has thrown at you, meta OCD works the same way. The more you give these thoughts power, the more they will come around. These thoughts, images, and urges need to be viewed passively: they can be there when they arise, but you are not going to give them attention or figure out why they are there.

Everyone may have these types of thoughts, but OCD causes you to get “stuck” on them. People without OCD can shrug them off, but OCD demands answers: What do these thoughts mean, and where do they come from? The truth is that when you have this disorder, there is no actual meaning to these thoughts. It is you who gives them meaning. 

Handling mental compulsions when you struggle with meta OCD

One of the most common ways people give attention to their thoughts is through mental compulsions, like rumination. Mental compulsions involve doing something in your head to solve a problem or to “figure it out.” Do you feel a sense of anxiety and extreme urgency to get answers? Are you mentally reviewing events to be absolutely sure that something occurred? If this sounds familiar, then you are likely still doing compulsions. 

By doing compulsions, you strengthen the idea that there is a real danger, and this will cause your anxiety and fear to come up more often. Living with OCD is like having a faulty alarm in your brain that goes off when you have a thought, image, or urge that you believe to be “bad” or dangerous. 

As contradictory as it may seem, the best way to handle meta OCD thoughts is to accept that they may be true. When you have the thought that maybe you don’t have OCD, say “Well, maybe I don’t.” When you think maybe my ERP therapist is wrong, think “Maybe they are.” Remember that to combat OCD, we must accept that uncertainty is a part of life. You will never be able to provide enough certainty to satisfy OCD – it will always demand more.

OCD is considered a chronic illness, meaning you may have it for the rest of your life. The good news, though, is that it is very manageable. You can live in recovery. OCD doesn’t have to control your life. You don’t have to listen to the lies that OCD tells you. 

ERP teaches you how to shut off the faulty alarm

Using ERP techniques, you will learn how to repair that faulty alarm system in your brain. When you stop doing compulsions, you are teaching your brain that there was never a real danger. When you allow yourself to sit with discomfort and anxiety instead of escaping it, you are learning that you are safe. 

You can tolerate the feelings of panic and fear brought on by intrusive thoughts, images, and urges. You don’t have to enjoy the process – in fact, you probably won’t. I have never met anyone who has told me that they love feeling anxiety. But you can tolerate it, and it will eventually go away on its own without you responding in any way. 

Over time, your brain learns that there is no danger, and the faulty alarm goes off less often. And even when it goes off on occasion, you can tolerate it more and more, and it doesn’t seem as scary. 

Regardless of the content of your OCD, the process of treating OCD is the same. ERP therapy is the gold standard of treatment for OCD. This form of therapy involves specifically targeting the source of your obsessions by directly exposing you to it. In many cases, people find that ERP helps their anxiety subside to the point where they no longer experience intense fears related to their thoughts on a regular basis. 

The best way to practice ERP and manage intrusive thoughts and mental compulsions is to work with a therapist trained in ERP. At NOCD, our therapists specialize in OCD and ERP, and they will provide you with a personalized treatment plan designed to meet your unique needs. Your therapist will teach you the skills needed to begin your OCD recovery journey and will support you every step of the way. They will guide you in taking small steps to reach your goals.

Our team of therapists at NOCD is passionate about the treatment of this debilitating disorder and is trained by world-renowned experts. To learn more about working with a NOCD therapist, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

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