OK. Let us start with a question. What is the end goal when treating rOCD? Think about this for 1-2 minutes. I will give my answer at the end of this post but explain the answer first.
I would like to share with you today an excerpt from an excellent article from Dr. Steven Phillipson, one of the most knowledge people in regards to OCD, specially the obsessive type (in my humble opinion!).
The article talks about two types of responses that are generated when we feel anxious about something: an instinctive response and an extinction response. You can only have pick one at a time. Imagine this, you have an ROCD thought and what do you do? Pick an instinctive response or extinction response? These are what they look like:
- Relief Seeking – running away
- Exerting an effort, cognitively or behaviorally, to neutralize the threat
- Reassurance seeking
- Reacting with intolerance toward being anxious
- GET AN ANSWER!
- Choosing to accept the possibility that the risk is valid, yet not seeking escape
- Making an allowance for one’s own brain to create these upsetting ideas
- Creating mental space and tolerance toward the persistent nature of the unwanted thoughts and experience
- “Letting it be there”
- Focus on management strategies
- Not relief seeking!
OK. I will let you think about these for the next couple of days and how you can change and give you the answer to my initial question. If you answered that you need to find answer to your ROCD question or to be completely “cured” than you are following an instinctive response. What does this mean in practice? It means that you are not helping the brain heal itself but rather reinforcing the anxiety cycle.
The best answer to what is the end goal of treating ROCD is: being comfortable with the uncomfortable. Still having ROCD thoughts but not being bothered by them. Everyone has ROCD thoughts, even “normal” people. The difference is that their extinction responses are automatic.