This week, we’re answering questions from our users via Instagram (@treatmyocd). We received tons of great suggestions: people wanted more about different subtypes of OCD, including Relationship OCD, Homosexual OCD, Pedophilia OCD, and Rumination. People were also curious about how to talk to friends and family about OCD, and to learn more about comorbid disorders (here’s an article about OCD and eating disorders, but we owe you more, and they’re coming!!).
This week, we’re talking about that scary fear that OCD might never go away, what to do when people say “I’m so OCD!!!”, mindfulness for when OCD feels out-of-hand, and how to live a value-based life no matter when obstacles land in your path.
Question: I worry I’ll never recover. How do I manage this fear?
During really bad OCD days, tolerating distress for even a few minutes can feel like an overwhelming task, and picturing a future free from OCD can be motivating. But even the most hopeful people can feel discouraged after a particularly hard course of exposure response prevention (ERP) doesn’t provide noticeable results, or when a therapist doesn’t pan out to have the expertise he or she claimed. If you’re worried about never recovering, rest assured: this worry is normal. But there’s actually a surprising flipside to focusing on an OCD-free future, which can be detrimental to treatment.
ACT, or Acceptance and Commitment Therapy, teaches us to accept how we feel and what we’re going through, while identifying our values, and living our lives accordingly. Acceptance and value-based living contribute to psychological flexibility, or the ability to enter a situation with openness, rather than fear or anxiety. Living in fear of never recovering doesn’t give you a whole lot to actually work towards. But identifying specific goals and values and moving towards them (as opposed to moving away from what you don’t want) is a more effective way to feel better, and helps you live the type of life you value, even when OCD is present.
Practicing ACT doesn’t mean that prioritizing your values will make your OCD thoughts go away. But over time, it can help you change the relationship you have with your decision making processes. Even if OCD is present, you can still engage in the activities and relationships that give your life meaning. Here’s an example: you value helping animals, and have always wanted to be a veterinarian, but your fear of germs has kept you from pursuing your goal. Contamination exposures are hard, but if you keep in mind not just your interest in recovery, but also your goal of becoming a vet as you practice these exposures, you’ll derive motivation from working towards something you really care about.
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Question: I really don’t like when people throw around ‘OCD,’ as in: “I’m so OCD!” How do I tell them OCD isn’t just about neatness or hand washing?
When people throw around ‘OCD’ as a synonym for ‘neat,’ they usually do it out of ignorance. It’s likely a well-meaning person who just doesn’t know what OCD is really about, and can you blame them? It’s not like OCD gets talked about a whole lot, which is part of the reason it’s so often misdiagnosed, misunderstood, or mistreated in people who really suffer. This is a great opportunity to contribute to the destigmatization of OCD (and mental illness in general) by educating the offending speaker on what OCD really is. Some people might feel comfortable saying something like: “actually, OCD is a really serious mental disorder, and I’d love to tell you about how it’s affected me and my life.” You might be surprised to hear people’s reactions – sometimes, a little vulnerability opens the conversation about how mental illness has affected all kinds of people in ways you wouldn’t expect.
Some might feel really uncomfortable confronting someone or talking about OCD in public. They might try sharing information about OCD in a different way (through social media, or just with people close to them). Don’t want to share that you have OCD? You can always share facts – like, did you know 1 in 40 people meet the criteria for OCD? Or that the average age of onset is typically childhood, adolescence, or young adulthood? No need to talk about your own experience if you don’t want to. But you have the right to let people know that ‘OCD’ isn’t just a term that means ‘clean.’
Question: How do I calm down when OCD gets out of hand?
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I think every single person who struggles with OCD can relate to this challenge. There’s two ways that OCD gets out of hand: in the moment (especially during an exposure), and in a larger sense, affecting daily life for a period of days, weeks, or even months. Mindfulness exercises can be useful in both situations, but in different ways. If you’re experiencing an immediate increase in anxiety, using mindfulness to calmly observe your surroundings can help you return to the moment. Use all five senses to experience what’s around you. What do you see? Do you smell anything? What colors are around you? Do you hear any noises? What does the temperature feel like? What does your breath sound like? What do your feet feel like on the floor? Make sure you’re breathing as you notice. Over the course of months and years of practice, mindfulness can become a part of your daily life, and you might find yourself incorporating practices like this one into daily activities, like brushing your teeth. It might not make OCD go away, but it will help you to feel more present and grounded in the moment, changing your reaction to the way OCD makes you feel.