Now let's talk about gaining control over compulsions. Acting out compulsions, or ritualizing, provides temporary relief from obsessional distress but over time can become more rigid and eventually take over our lives. So let's get started.
As I've said before, this is simple but hard work as it means giving up comforting rituals and facing our fear. Remember the Peanuts character Linus and his security blanket, how he sat by the clothes dryer waiting for his blanket to dry? So we'll start out with small steps:
1) Postpone ritualizing to a specific time (we talked about this in my last post on obsessions). Make sure it's a reasonable, do-able delay, then gradually increase postponing time. Your ability to tolerate distress will increase and enhances your sense of control. Chances are the urge to ritualize will decrease on its own, especially if you're engaged in some other activity.
2) Think and act in slow motion doing the ritual. This helps decrease the distress intensity that accompanies the ritual. It also increases your awareness of the ritual as we do so many things without even thinking about it. Awareness makes it easier to interrupt or change the ritual.
3) Change the doing of the problem. For instance, change the order in which you ritualize. Change the frequency. If you clear your throat three times before speaking, clear it twice before and once after (don't worry, you won't create a new ritual). You can also change the location for ritualizing, the time(s) of day you do it, or the objects, if any, you use.
4) Add a consequence to the ritual by adding an additional task that's totally unrelated to your ritual. Especially helpful is a consequence that's beneficial to you or others and is disruptive of your normal routine. Exercise is always good. After you ritualize change clothes and go for a run or do 15 minutes of yoga. To be effective, the consequence must be costly in time and effort as well as beneficial. Knowing there will be a consequence for ritualizing gives you an opportunity to resist the compulsion.
These are all simple, effective self-help practices but what if they're not enough and we have to bring up the big guns, THERAPY? There are so many types out there, what kind is best? It's pretty much agreed among therapists that Cognitive Behavioral Therapy (CBT) is the treatment of choice, specifically Exposure Response Prevention (ERP). Sounds like alphabet soup, doesn't it? Here's an OCD Haiku: Problem OCD
Solution is CBT
Best is ERP.
I mentioned ERP in my 10/22/14 post, "Taking Control Over Panic" , and it's very effective in treating many forms of anxiety in general.
Basically it means deliberately EXPOSING yourself to the thoughts, images,objects and situations that make you anxious and/or start your compulsions. RESPONSE PREVENTION requires choosing not to do a compulsive behavior once the anxiety or obsessions have been triggered. This may sound paradoxical as our usual response is to try to escape the distress or relieve it by ritualizing. But this only makes it stronger.
It will be hard and uncomfortable at first (remember, I said that therapy is simple but hard work) but by sticking with it and refusing to engage in the compulsive behavior over time you'll actually feel a drop in your anxiety level. This is called habituation. Initially this is done under the guidance of a therapist but with time and persistence you'll learn to do your own ERP exercises.
Oh yeah, one last thought before you go off thinking that athletes are OCD when a batter taps the plate three times with his bat, knocks the dirt off his cleats and scratches his crotch, or a basketball player bounces the ball twice and wiggles his butt before shooting a free-throw. What they're actually doing is using those habitual and ritual-like actions to bring themselves into focus and concentration. Thought you just might like to know. See you next time.
Next Time: "MY BARTENDER CURED ME."
Note: These techniques and other great ideas for overcoming OCD can be found in Stop Obsessing by Reid Wilson, PhD. It's also on THEFEARMONSTER's banned book list.