If I were to sum up what I’ve learned from my OCD recovery over the past 15 years, I’d borrow this quote from Daniel Kahneman’s Thinking, Fast and Slow:
“Nothing in life is as important as you think it is when you’re thinking about it.” p. 402.
In this post, I’m going to share the new metaphor I use to explain how to do my Shoulders Back method for OCD mental compulsions, along with the steps that helped me get there.
OCD mental compulsions: the pas de deux in our minds
To make the metaphor I’m going to share make sense, I need to give you a glimpse into how OCD taught me to have conversations with it in my head. I’ve always liked to think things through, figure things out, and make connections that help my experience of the world make more sense. And OCD learned to use that against me.
One day in seventh grade, I had the intrusive thought that I might have head cancer. In this excerpt from my memoir, you can see how OCD turned my penchant for trying to figure things out to its advantage:
But from the moment my mind locked on the idea that my hair loss meant head cancer, I had become the principal dancer in a doom-themed mental ballet that played on for months, with few, if any, intermissions. As my hair continued to disappear, I’d pull on my mental tights and toe shoes and spin pirouettes around the idea that I was dying. I felt pulled back and forth across my mind’s stage by my audience: hecklers outnumbering fans twenty to one, their shouts alternately filling me with hope and despair.
“You’re too young to die!” one would call in a serene, lilting voice.
As I danced, frantic to find and hold onto that reassurance, loud, booming catcalls inevitably drowned it out. “Children die all the time! What makes you think you’re immune?”
Another voice, soft and kind, tried to make itself heard above the echoes of doom. “There’s no way you have head cancer. I don’t even think head cancer exists!”
As I turned on the stage toward that voice—that relief—it would only be followed by menacing snarls. “Of course you have cancer. What else could cause your hair to fall out like this? And if you hadn’t hit your head on the bottom of the pool years ago, you stupid girl, none of this would be happening! Do you hear me? It’s all your fault!”
Panicked, I’d try to focus on the voices that offered reassurance, logic, reason—but they always slipped away, muffled by relentless catcalls from scythe-carrying specters of death who never left the theater. The theater where my mind and I engaged in a never-ending, exhausting pas de deux.
Excerpt from Is Fred in the Refrigerator? Taming OCD and Reclaiming My Life, p. 35.
With that picture in mind, here’s how I deal with mental rituals today.
How to get stuck in OCD rumination
Let’s say that I have another intrusive thought about head cancer (because hey, that happens sometimes), and my OCD tries to latch onto it.
Scenario A: I get stuck doing OCD mental compulsions because I’m talking with OCD, like we’re old buddies having coffee together in a café:
Intrusive thought: “What if that bump on your head means head cancer?”
OCD: “Oh my gosh, that would be horrible! We have to figure this out! We have to do something!”
Me: “Ugh, you’re right, that would be awful. And I know people who’ve had head and neck cancers. I thought maybe head cancer wasn’t real as a kid but now I know it is. But no, I’m talking to OCD. I need to stop doing this.”
OCD: “No, this is real this time! I mean, you’re not a spring chicken anymore, so you could have head cancer. Wouldn’t that be the ultimate irony? You actually get head cancer after being worried about it all those years ago!”
Me (feeling a surge of adrenaline): “You’re right. That’s just the kind of weird thing that would happen to me. I mean, a bat ran into my arm, for Pete’s sake! I should probably just make an appointment at the dermatologist and get it looked at.”
OCD: “That’s a good idea! You should see if they have same-day appointments! This is urgent and we need to know!”
We’re now off to the races with this mental ritual. Not only did I ignore the health anxiety advice I’ve written about, but I acted like OCD’s worries were highly relevant. In doing so, I’ve shown my brain how important they are, so it will keep cycling those thoughts through my head.
How to step out of the OCD mental compulsions cycle
Let’s take a look at Scenario B. Let’s say I’m at a table having coffee when the intrusive thought comes. Here’s how I’m currently handling those intrusive thoughts:
Intrusive thought: “What if that bump on your head means head cancer?”
OCD: “Oh my gosh, that would be horrible! We have to figure this out! We have to do something!”
Me: “Ugh, you’re right, that—” I realize what I’m doing, get up, and walk out of the café.
That’s the metaphor. I choose to mentally get up from the café chair and leave the conversation.
Now, how am I doing this?
- I remember the quote: “Nothing in life is as important as you think it is when you’re thinking about it.” I know that while it’s hard to stop having this conversation, I’m making the topic important by focusing on it.
- I then choose to put my shoulders back and my attention elsewhere. Sometimes this is my breathing, like I’d do if I were meditating. Sometimes I move my attention to what’s physically around me. Sometimes I put my mental attention back where it was supposed to be—whatever I was thinking about when OCD so rudely interrupted me.
- Sometimes OCD follows me out of the mental café and continues to try to make its point. That’s fine. I go back to #1 and start again.
Sometimes, an hour later, I can’t even remember what OCD was so upset about. I treat that as a surprisingly delightful side effect that may or may not happen the next time. My focus is practicing non-participation and returning my attention to my life.
Avoidance vs directing your attention
What I’m suggesting may seem like I’m trying to avoid the scary thoughts. And no, I’m not.
I’m avoiding having the conversation with OCD. That is the key difference. The conversation is the mental compulsion.
OCD is welcome to keep talking. I stop participating in the conversation and put my attention back on the life in front of me. Sometimes the thought fades quickly. Sometimes it keeps talking. Either way, I keep practicing leaving the conversation and the café.
The skill of getting up and leaving the mental conversation
I didn’t learn how to do this overnight. It took me years to figure out how to successfully redirect my attention. And I had to do a lot of mental weightlifting to get the mental muscles necessary to get up and walk away. That’s why I wanted to share this post with you, in hopes it might take you less time to reclaim your life from mental compulsions than it took me.
My mental weightlifting routine was as follows:
- I did lots and lots and lots of “may or may not” ERP scripting. Out loud, while standing in a Shoulders Back power pose. I did this because giving myself something else to do instead of talking to OCD was the only way I could successfully interrupt the pas de deux going on in my head. (See my main mental compulsions page for the 4 posts I’ve written about ERP scripting).
- I then practiced doing what I call “Man in the Park” Shoulders Back, where I recognized there was a man in the park (OCD) yelling something at me, and my goal was to walk by him without acknowledging him in any way. This took a lot of practice, and at times it felt like using a crowbar to pull my attention to what I cared about instead of OCD’s soapbox.
- I then started learning how to just get up and walk away. With “Man in the Park” Shoulders Back, I was often still hearing OCD at some level and having to choose over and over and over to keep walking—that’s the crowbarring my attention that I referenced. What’s different about getting up and leaving the conversation is that I’ve gotten good enough at redirecting my attention that I often don’t hear OCD afterwards. It’s still back at the café crying into its hot chocolate while I’ve moved on with my life.
By the way, this method of getting up and leaving the conversation is also the same skill I’ve learned to use at night to step out of thinking loops (regardless of whether OCD is involved) so I can sleep.
The “get up and leave the conversation” method may seem incredibly challenging right now, or it may feel like a great thing to try based on where you are with your own recovery. And either is totally fine. Meet yourself compassionately where you are, work with an ERP therapist skilled in handling mental rituals, or give Kimberley Quinlan’s Rumination Reset a try*. The goal is to find what works for you to interrupt these silent rituals that can keep OCD in charge.
You’re not obligated to finish the conversation with OCD before you get up and return to your life.
*I believe in her approach to ERP so strongly that I’m an affiliate for her courses.
