‘But This Time It’s Different’ and Other Lies OCD Tells: Troubleshooting When OCD Feels Extra Convincing

As those who suffer with Obsessive Compulsive Disorder (OCD) progress through treatment it can be a roller coaster of an experience. In the beginning, people often feel a combination of fear (about what treatment will be like, if they will be judged, worrying they’ll be told it’s not actually OCD, etc.) and relief (finally having a name for what they’ve been going through!). From there everyone goes through treatment at their own pace and in their own way. But over and over I hear some of the same arguments from clients (actually, not from them but from their OCD), arguments about why their OCD still deserves their attention. As people begin to make progress, their OCD will hang on for dear life, attempting various methods of keeping the person hooked. Below is a list of lies that OCD may tell you as you begin to wrestle your life back, and ways to respond to those lies (spoiler alert, the response is definitely not to argue with the OCD).

Intrusive Bodily Sensations: ‘But Now My Body Is Responding Physically!’

What about when intrusive physical sensations are added in to the mix? This one can be very convincing and it can feel like your body is betraying you. But guess what? Just as you don’t have to take every thought that you have seriously, you also don’t have to take every sensation seriously. Try this exercise: hold out your left hand, palm facing up. Focus your attention on it. Observe any slight movements in your fingers or faint tingling in your palm. Did you notice anything? Hmm…it’s almost as if when you focus all of your attention on a body part you inevitably feel things. Things that are probably happening all the time, for all kinds of reasons and don’t necessarily always need your attention. Therefore, this is not reliable evidence for your OCD fears and is not an excuse to stop using your treatment tools.

The Language of Intrusive Thoughts Shifts: ‘But the Thoughts Aren’t ‘What Ifs’ Anymore’

Another argument that I often hear from clients is that their thoughts used to sound more like “what if I really want to hurt someone?” or “what if I actually like these thoughts?”. But then the thoughts shift to more definitive intrusive language such as “I want to hurt someone” or “I enjoy these thoughts”. This shift can feel really distressing, and convincing. But actually it is just OCD doing whatever it can to direct your attention to the threats it thinks it is keeping you safe from. Your job is to treat these more definitive-sounding thoughts the exact same as the what-if sounding thoughts.

 An Obsession Focuses on Something Happening In Your Life: ‘But This Isn’t Hypothetical!’

Sometimes as people move through treatment, or are in the maintenance phase, their OCD begins to focus on something that is happening in their life. This might be a confirmed medical diagnosis, a big decision they need to make, a significant life change, etc. This shift can be sneaky, because by this point in treatment the sufferer has likely caught on to OCD’s usual tricks of coming up with hypothetical, or more unlikely scenarios. But OCD will not go quietly, so it will try to outsmart you by focusing on something more concrete. Maybe OCD has you excessively cleaning after your child had lice or seeking excessive reassurance about which college you should attend. The concern is grounded in reality, but the difference here is that OCD is causing you to go far beyond what others would likely do in those situations. OCD is also making the possibility of a negative outcome feel a lot more probable. In these situations, the uncertainty is not around if there is a real thing to be paying attention to (you already know there is and OCD is using that against you). Rather, the uncertainty is around the amount of attention you should be paying to it and the lengths you have to go to in order to manage it. In these cases, the goal is to handle the situation as someone would without OCD. This may feel difficult to determine but a trained OCD therapist, your loved ones, or a doctor can help guide you through this. The important thing is to work on recognizing when you’re crossing over into OCD territory and utilizing your familiar treatment tools.

A Completely New Theme: ‘But This is So Different From My Old Theme!’ 

Sometimes after a period of well-managed contamination symptoms, obsessions around morality enter the picture. Or someone may feel like they finally mastered their checking compulsions only to be blindsided months or even years later by OCD symptoms about a past event. This can really throw people for a loop and bring on a flood of panic that it is happening again! But the great thing is, it really is nothing new. Sure, you might want to shift the focus of exposures in treatment (or re-engage in treatment if you haven’t been in a while). But really, it’s the same ol’ OCD, just in a different costume.

OCD Themes Show Up in Dreams: ‘But This Proves it, My Subconscious Wants It!’

It can be easy to get caught up speculating about our dreams. After all, sometimes they can be downright strange. The function and purpose of dreams are still not fully understood and are far too random to assign any real meaning, other than that your brain is pulling a bunch of stuff together to create a story. Where it gets the content for that story could be an infinite number of sources and it just simply is not worth your time to try and figure that out. There would be no way of proving or disproving your theory anyway. So instead, just chalk it up to the randomness of the brain and keep it movin’ with OCD-treatment as usual.

The Emotional Reaction Shifts: ‘It just FEELS Different This Time” 

I have heard this one when people begin to have a different reaction to their intrusive thoughts than they are used to. Sometimes they feel less anxiety, which can bring on its own anxiety about why their disturbing thoughts no longer make them as anxious. Or sometimes they believe they feel more certain that their fear is true. Other times it simply can’t be described, but it just feels different than before. The rationale really doesn’t matter. What is likely happening is that, because the brain hates uncertainty so much, it would rather believe the worst than accept that it can’t know 100% for sure. When the mind repeatedly runs into the wall of uncertainty it will try to navigate around that wall by seeking certainty of any kind, even trying to feel certain that the fear is true. Or perhaps there is simply less anxiety because you’re getting your symptoms under control! Regardless, the answer is (you guessed it!) business as usual. No need to investigate why it feels different, just allow it, and move on.

Repeat After Me: “I’m Not Falling For Your Tricks OCD!”

If you haven’t figured it out by now, the promised ‘troubleshooting tips’ really just boils down to one tip: keep treating your OCD the way you always have, because these trouble spots don’t change anything. Exposure and Response Prevention (ERP), Mindfulness, and refusing to engage in avoidance or rituals should continue to be your response, even when OCD tries to convince you otherwise. Managing OCD symptoms in the long term typically means having to navigate the various ways that OCD will try to remain in control. Familiarizing yourself with these common OCD-arguments can help prepare you to stay the course even if they show up. Some people feel discouraged by the idea that they will likely always have to navigate some level of interference from OCD in their lives. But truly, managed OCD symptoms can just be blips on the radar of life, more of an annoyance than a total derailment. OCD is smart, but you’re smarter!