People new to OCD treatment often walk through the door with more than a few misconceptions. Here are some common ones:
Misconception 1: Anxiety is bad.
Actually, anxiety is a normal, functional, biologically-based phenomenon that every person is capable of experiencing. The only people who are truly anxiety-free are dead people. The rest of us (the living ones, at least) will find that anxiety will be a part of our lives, at least to some extent.
Some anxiety is good and can be helpful. For example, it’s probably good to have some anxiety when you’re studying for a test. This anxiety can help motivate you to prepare sufficiently. Similarly, it’s probably good to have some anxiety about doing dangerous things, such as driving too fast — this anxiety might just save your life.
Of course, not all anxiety is good or functional. Some anxiety spikes occur for no good reason and don’t have an upside. These false alarms make us feel bad for no good reason. Panic disorder is the perfect example of this. In panic disorder, your fight-or-flight system gets continually reactivated in situations where it isn’t warranted. Treatment of panic disorder involves learning to disregard the danger messages attached to your panic symptoms.
The goal of OCD treatment (or the treatment of any anxiety disorder, for that matter) is not to eliminate anxiety, but rather to recalibrate your anxiety system so that there are fewer false alarms, and anxiety is again serving a useful purpose.
When you finish OCD treatment, you’ll still have anxiety. It just won’t be standing in your way like it is now.
Misconception 2: Avoidance is an effective solution for anxiety.
There is no denying that avoidance is an effective solution for reducing anxiety. However, the anxiety-reducing effects of avoidance are short-lived and come at a great cost. Reliance on avoidance as a coping strategy may reduce your anxiety in the short-term, but it dramatically increases anxiety over the long-term. If avoidance is left unchecked, anxiety often grows to a point where it becomes debilitating and interferes with our functioning.
Why does this happen? In essence, avoidance brainwashes us to believe that if we didn’t avoid, the worst would have happened.
Let’s examine this in relation to a common contamination OCD thought:
“Germs are everywhere. If I don’t touch the dirty doorknob, then I won’t get sick.”
Avoidance of the doorknob prevents anxiety from spiking, which can bring relief. We feel like we dodged a bullet. It feels good to not be anxious. However, avoidance reinforces the belief that doorknobs are dangerous (even if they’re not). The more we avoid, the more distorted our perceptions of situations become until we come to solidly and steadfastly believe in whatever nonsense our brains are telling us. The more consistently we avoid doorknobs, the more we start to avoid other things that are similar to doorknobs. Before long, we’re afraid to do the things that we used to do. Every action becomes colored through thoughts and fears.
Avoidance reduces short-term anxiety, but ultimately, it increases long-term anxiety. OCD treatment emphasizes avoiding avoidance.
Misconception 3: I should avoid situations that cause me anxiety.
Anxiety is not the enemy, and we should not adopt strategies or lifestyles that are structured around minimizing anxiety. Again, sometimes anxiety is a normal and useful response to a given set of circumstances. Sometimes the best thing we can do for ourselves is to allow ourselves to feel anxiety without hiding from it. This is also helpful for maintaining perceptions of danger that are properly calibrated.
OCD treatment involves embracing opportunities to be uncomfortable in order to recalibrate your perceptions of danger.
Misconception 4: OCD treatment is supposed to help me know that, once and for all, (INSERT YOUR FEAR HERE) won’t happen.
The problem with this idea is that, sometimes, bad things do happen. The fears that tend to torment us are always just plausible enough that our brains can’t readily dismiss them.
People do get in car accidents. There are murderers and pedophiles in the world. Some people contract AIDS. Houses burn down. Airplanes crash. Bad things happen.
Trying to perfectly convince yourself that these things can’t or won’t happen is often a fool’s errand. In fact, the harder you work to believe that they can’t or won’t happen, the more often these fears will revisit you.
Moreover, OCD likes to go for worst case scenarios, distort probabilities, disregard science, and defy the cause-and-effect rules of our world. OCD thrives on what-ifs, remote possibilities, magic, and superstition.
Because you can’t effectively battle magic with logic, ultimately you have to surrender your need for certainty.
This doesn’t mean that you have to convince yourself that the worst will happen. It simply means that you have to give up efforts to predict or control the future and work on co-existing with the unknown.
At its core, OCD treatment involves accepting uncertainty.
Exposure and response prevention (ERP) for OCD and mindfulness tools can be incredibly helpful for learning to relate differently to your fears. I’ll talk more about these OCD treatment strategies in other posts.
Questions? Comments? What other misconceptions exist about anxiety and OCD treatment? Sound off below.