Some triggers are bigger than others, and on some days the thoughts are stickier than on others. This article offers some guidance regarding how to handle the types of experiences that people with OCD have.
Case #1: An Average Trigger or No Trigger
You’re walking down the street minding your own business when your obsession comes to mind. There may have been a trigger or it may just have occured to you out of the blue. It scares you, and your natural instinct is to start figuring out how to make it go away or whether or not it’s true. Or maybe your natural instinct is to try to push the thought out of your mind. You need to refrain from doing any of the above. Don’t try to push awareness of the uncertainty away, but don’t try to solve it either. Let it be there, do nothing about it, and get back to whatever you were doing. Just remember that this requires a clear decision to refrain from rumination.
Case #2: When the Thoughts are Especially Sticky
Even on a day when the obsession seems to keep coming back, you must stay stalwart in your decision to refrain from rumination. Make the clear decision not to ruminate, and recommit to this decision each time you find yourself pulled back in.
To help you refrain from ruminating, give your mind something else to focus on, like an activity or an unrelated thought process. You’re not trying to forget about the obsession or pretending it doesn’t exist. You are well aware of it. You’re just giving your mind something else to focus on, to support your decision not to ruminate.
Your job is to do absolutely nothing (including rumination) about the obsession. By not doing anything about it, you are giving yourself the opportunity to learn that your fear about it will pass on its own (and pass more quickly when you’re not ruminating).
Case #3: A Major Trigger
Sometimes a trigger will make you feel like you’ve been sucked into a vortex of fear and rumination. It’s like you’ve stepped into another dimension where your worst fear is eminently true and no evidence to the contrary seems to exist. Know that you are not alone in this experience: Most people with OCD have moments like this, when they are completely convinced that the worst is true. This isn’t the time to give into compulsion. This is the time to redouble your commitment to refrain from all compulsions, especially rumination.
Your job in this situation is to weather the storm, while refraining from rumination and any other compulsion as much as you possibly can.
First of all, make sure that you’ve been eating, drinking, and sleeping enough. If you haven’t, address the problem.
Next, it’s time to whip out your distress-tolerance skills such as deep breathing, mindfulness, vigorous exercise, or a hot or cold shower.
Remember to be compassionate toward yourself as you do your best to minimize rumination. It may not be possible to be perfect when you’re this scared, but do the best you can.
By not ruminating or doing any other compulsion, you are giving yourself the opportunity to learn that even intense episodes like this eventually pass on their own, and that you don’t need compulsion/rumination to get you out of them. Refraining from rumination at these times will tend to make these episodes shorter, less intense, and less frequent.