Obsessive Compulsive Disorder (OCD) is an insidious mental disorder characterised by the occurrence of highly intrusive and disturbing obsessions (thoughts) that make the sufferer extremely anxious and force him to perform certain actions – either physical, or mental, or both (compulsions), often repetitively. A sudden and intrusive thought hits the sufferer and there is immense anxiety. No matter what the sufferer does, the thought doesn’t go away. In fact, it only gets louder. After a point, the sufferer learns some actions that may or may not be logically connected to the obsessive thought. The sufferer feels that the performance of these actions will make the obsessive thought go away. For example, one of my clients used to think that if she didn’t comb her hair thrice, her mother would die. This is an example of an illogical compulsion. Others may think that unless they wash their hands often enough, there is a danger of contamination. This, on the surface is a logical action, only the frequency and the discomfort caused to the sufferer if disallowed convert it into an irrational compulsion.
The sufferer has practically no control on these compulsions. No matter how strong willed the OCD sufferer is, OCD learns to stay a couple of steps ahead always, and attacks the sufferer in a manner that renders him weak willed and he ends up giving in to his compulsions. It is almost as if an invisible hand forces him to perform his compulsions and the hand is so strong that the sufferer is not able to resist it. If he tries to resist it, he experiences too much noise in his head. He begins to feel that if he listens to the noise just one more time and gets the compulsion done, it will provide him immense relief. And he ends up giving in.The compulsions can get so severe that the sufferer may end up spending hours every day trying to reduce the noise in the head and his life can become utterly dysfunctional. The compulsions start small but eventually, on account of not being checked end up increasing in both, frequency, and intensity.
To understand OCD, consider this analogy. OCD is like a demon which stays in your head. And it is forever hungry. It torments you to constantly feed it. It feeds off your compulsions. When it is hungry, it comes and yells at you for giving it food. If you try to resist it, it creates a ruckus and frightens you. It wears you down by not relenting at all. And you give in. You give it the food it requires, in the form of compulsions. But that only makes it stronger. And it knows what it has to do the next time it wants food. And with each feeding, it grows stringer and larger.
If you were to decide not to give it food, what would happen? It would yell at you, threaten you, and try and make your life miserable. It would try to intimidate you into giving it the food it wants. But what if, despite all the shouting and threatening, you do not give in? What do you think happens then? Or, let me put it another way? What would happen if someone wanted food and you didn’t give him food? That’s right. He would become weak. And soon lose the intimidating influence he has on you. Exactly in the same manner, if you do not give in to your compulsions, OCD will begin to lose its grip on you. This is achieved through repeated resistance and delay in performing the compulsions, as explained in the Anxiety Graph.
But what if the worst does end up happening, you ask. What if someone with harm OCD actually ends up harming someone? What if someone with religious OCD actually ends up spitting at God or insults God? I have one simple answer to that. Your thoughts don’t have power. Just thinking about them is not sufficient for them to be put into action. Do you enjoy hurting people? If the answer is no, you have to realise that the OCD thought does not have the power to lift your hand, take a knife, and stab someone. Do you enjoy insulting God? If not, then the thought does not have the power to make you spit at Him. It is only a thought. If you learn to be okay with it, if you make peace with the fact that it will constantly keep recurring, and if you believe that you will do no harm, regardless of the urge, you will get better. The thoughts will lose whatever power they have over you and you will have conquered a compulsion. How is that achieved? Through desensitization to the thought. How is desensitization achieved? Through ERP.
Consider this. When you first wanted to learn swimming, the fear of drowning is sure to have gripped you. But, if you are like a majority of other people, you chose to step into the water despite the fear and learned to be okay with the thought of drowning. The possibility existed, but you did not let it stand in your way. And you went for repeated lessons. And you ended up not only not drowning, but also learning swimming.
What about when you wanted to learn driving? Did you not face the fear? Did you not make yourself understand that if you are careful, you will not get into an accident? And di you not become okay with the thought of getting into an accident, with repeated lessons and repeated learning?
Now replace swimming or driving with your OCD fear. What is the way out? That’s right. Facing the fear, being ok with it, getting used to it, repeated lessons in facing the fear, and ultimately, victory over the fears. It works because the process is simple. And time tested.
Sufferers try to deal with their OCDs in various ways. Some try dietary changes, some try meditation, some try medication and some even try Electroconvulsive Therapy (Shock Treatment) or Transcranial Magnetic Stimulation, with varying results. Perhaps, the best treatment for OCD, however is a form of Cognitive Behavioural Therapy called ERP.
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