Those Pesky Obsessions
Everyone has experienced obsessions. An obsession could involve worrying about that stove burner that you may not have turned off. It could be worrying about lab results when there is no reason to worry. Or, it could be thoughts about symmetry and quantity that arouse urges to straighten or count things.
Obsessions are pesky and often burdensome thoughts that keep recycling through your mind long after their usefulness has been served. Most often, an obsession is a thought that you wish you could stop thinking about. An important feature of an obsession is that it raises your immediate anxiety level. Obsessive thoughts bring discomfort that make a person seek relief from the tension.
Here is where compulsions come in. Obsessions create the need. Compulsions offer to meet the need. Compulsions are usually behaviors that answer a particular obsessive thought. After suffering under the anxiety and weight of obsessions, the related compulsions can feel so very good. You may worry about germs excessively (obsession) and then want to wash or clean (compulsions) to relieve the tension created by the obsession. You may worry about an unlocked window or door (obsession) and then feel compelled to check (compulsion) one more time to reassure yourself that everything is okay.
But compulsions are tricky. They are like fish bait with a hook inside. They promise relieve from the heightened tension of obsessions, but they end up hooking you in more tightly to the original obsession. Think about the simple reward mechanism involved if I obsess about locked windows and doors. I obsess about the unlocked window and can’t sleep. Then I check the window for the 4th time and feel better. By repeating this, I carve the neural pathway of the obsession-compulsion dance a little deeper. I become more and more convinced that my compulsive behavior, in this case checking, is the direct cause of my short-term relief. The hook is set.
How to Pry Off the Grip of a Compulsion
So the obsessive thoughts raise anxiety or tension and drive the urge for the compulsive response. When a man or woman is locked into this dance, it feels impossible to stop the compulsions without first getting rid of the worrisome, obsessive thoughts.
But we now know that the cycle is broken not by focusing on the obsession, but by refusing to engage in the compulsion even when the urge to do it feels so compelling. Rather than trying to make one’s self worry less, it seems to work better to focus one’s energies on stopping the compulsions.
Here’s how the process might look for you if you have obsessions and compulsions around germs and contamination.
- Step One is choose one compulsion that might be a little easier to tackle. For example, deliberately preparing a snack without washing one’s hands.
- Step Two is to do the action that elicits the obsessive worries about germs. In this case, it would be to prepare the snack without washing.
- Step Three is to expect the the urge to wash to increase along with the rising tension or anxiety.
- Step Four is to just wait it out. Eat the snack, do what you can to calm yourself, and make sure that you don’t wash your hands. Instead of washing, you watch your anxiety rise to a peak and then slowly subside.
- Step Five is to stage numerous situations like this, until they become very easy.
- Step Six is to stage a new situation with slightly more difficulty for resisting the compulsion.
Of course, there is more to it than these six steps, but this is the heart of the process. It’s called “Exposure/Response Prevention.” Exposure refers to the decision to expose yourself to a situation that elicits your obsessive worries and thoughts. Response Prevention refers to your deliberate refusal to comply with the urge to perform the compulsive behavior, that is, to prevent your response (to wash again) which feels so “right.”