Tip #27 Extinction vs Instinct

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:

Instinctive Response

  • Relief Seeking – running away
  • Exerting an effort, cognitively or behaviorally, to neutralize the threat
  • Reassurance seeking
  • Reacting with intolerance toward being anxious

Extinction Response

  • 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.


  1. Thank you so much for your blog. I’m 24 and engaged to a very, very understanding and compassionate man. I have never met someone so tolerant and compassionate, he reminds me of how you described your partner in one of your articles. We try to live on the hope that we will be like you wrote, that ROCD no longer affects your relationship and you’re very happy. I love this man a lot and have gone through a lot with him, it seems every time I make a bigger commitment it kicks into high gear, first I got very anxious about moving to where he lives and felt the desperate need to ‘ruminate’ until I felt certain, then when he asked me to marry him I said yes with my whole heart and felt overjoyed until the OCD kicked in and totally took over the next few days. But it seems to respond well to stability and my fiancé was just very calming and kept us in good normal routines, and within a week it went back to the normal degree.
    I’m struggling at the moment keeping the anxiety in check, this is the hardest part of it I feel, and it’s triggered by us planning our wedding. I’m trying to do as you say and just learn to live with the uncomfortable, I do mindfulness every day and it seems to contribute to an easier approach. I also keep going with the plans because I know I just won’t feel 100% certain no matter how logically certain I am, and learn to accept that. I feel that continuing with the plans is a little exposure in a way.
    I found this article in particular very good because I realise even though I thought I was free from compulsive behaviour I do all of the above quite often. I should print this out and stick it on my wall!!!
    Thanks again for your help…


    1. Annika this is one of the best comments in the blog. You are doing everything right at the moment. If needed, I would also consider medication and therapy. If you need to chat just drop me an email.

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