Obsessions and Compulsions
Obsessions can become a mental prison, affecting your emotional well-being and your ability to enjoy life. If you find yourself trapped in a cycle of intrusive and recurring thoughts, it is important to know that you are not alone. Many people often, to varying degrees, have obsessive thoughts and compulsive behaviors that they feel they cannot control or that these thoughts control them.
Obsessions are unwanted thoughts, images, or impulses that are persistently repeated and generate intense anxiety. These intrusive thoughts are often accompanied by repetitive rituals or behaviors, known as compulsions, that are performed to relieve anxiety temporarily. The most common obsessions include fear of pollution, excessive doubts, need for symmetry, órden, cleanliness or perfectionism, among others.
Cognitive-Behavioral Therapy is an evidence-based therapeutic approach to treating obsessions and compulsions. Besides, the positive results give the Metacognitive Therapy. We will work in a personalized way to address your obsessions and compulsions, helping you to challenge negative thought patterns and develop effective strategies to manage anxiety.
The basic premise is that thoughts, emotions and behaviors are interrelated. Through therapy, you will learn to identify and question the irrational beliefs and cognitive distortions associated with your obsessions. I will provide you with tools and techniques to replace obsessive thoughts with more realistic and adaptive thoughts.
Gradual exposure to the stimuli that trigger your obsessions, combined with prevention of compulsive response, is a fundamental component of obsession therapy. We will create an exposure plan for you to face your fears in a controlled and progressive manner. As you repeatedly expose yourself to the dreaded situations and refrain from compulsions, your anxiety will gradually decrease.
In addition, I will teach you relaxation techniques, deep breathing and other coping strategies to reduce anxiety associated with obsessions. These tools will help you manage stress, stay calm and respond more effectively to obsessive thoughts.
Some people get to very high levels of obsessions, eventually developing Obsessive Compulsive Syndrome, and think it is impossible to control thoughts or that they control us. This hypothesis is unrealistic and can be refuted with small behavioral experiments. Remember that you have control over your thoughts, emotions and behaviors and not the other way around.
Are intrusive and obsessive thoughts really uncontrollable?
Each of us has ever had automatic, intrusive and/or uncontrollable thoughts. In some people these thoughts appear very frequently, take a long time to go away, affect other areas of life and seem to control it. People come to assume that these thoughts are really uncontrollable and there is no way to make them go away.
BUT
Imagine that you are ruminating on a problem and suddenly the phone rings or somebody knocks on the door. At this time these thoughts disappear. That is, they are not so uncontrollable or intrusive if they vanish with a change of activity. Perhaps it would be useful to find activities that allow you not to sink into your ruminations and, little by little, train your control of thoughts. This way they will not occupy all the space and time of your life.
Over time some of us may begin to think that ruminating and constantly reflecting on problems helps us to solve them. However, the solution really comes through action and not through thought. Moreover, although this solution of rumination does not help to solve our problems, we continue to do so.
On the other hand, we often get used to fighting automatic thoughts. It turns out that it's unproductive. If you’re in quicksand, you probably want to move and escape. However, the more you move, the deeper you sink. Many experiments show that trying not to think about something only makes us think about it more (Metacognitive Therapy is based on these assumptions). Don't you think it's better to accept your thougts, instead of fighting them, and let thoughts pass as something temporary? The clouds come and go but they never stay forever in the same place...
Change your attitudes and cognitions towards obsessive thoughts:
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Do not fight them. If you are away from the shore, it is probably better to relax and float to soon reach the shore than to constantly struggle with the waves and lose all strength. Try to accept your thoughts. What’s more, you can purposely devote a few minutes of your time to them. Observe them and detail all their content. Then you change your activity.
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Accept emotional distress for a while. With intrusive thoughts come negative emotions but if you don’t fight them, they will disappear. You can scratch a mosquito bite to ease the itch for a moment but then it will come back stronger. It is better to hold on for a while to feel the relief later.
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Don’t judge. We tend to judge everything that happens to us. Even though it hurts us, we still do. It is better to get less involved in the judgments we make because excessive discomfort is useless and serves no purpose.
There are several techniques and strategies that might help you when you have problems with you automatic thoughts, for example:
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Here and now. We’re often overwhelmed by thoughts about the future or the past, generating a lot of anxiety. Try to look at the present moment by paying attention to what is around right now: What objects are around? What colors do they have? What does it smell like? What does the fruit taste like? What’s the texture of the chair you’re sitting in? or Do you hear birds or cars on the street? Practice this exercise more often and gradually it will come out automatically. It's a technique number for on this page.
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Rewarding activities. It is crucial seeking pleasurable activities that occupy all your attention. Some people find it at work which helps enough for obsessive thoughts. But apart from this, it is crucial to look for other meaningful activities, such as reading, walking with the dog, going to the movies, listening to the radio, playing on the computer, swimming or running, and it's better to do it with other people nearby. These activities aside from diverting your attention, give you pleasure.
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Get away from the source of your obsessions. If you can get away from the source of your obsessive thoughts, do so. For example, if it's a person who writes or calls you and you find interacting with him/her hurtful, you could block his/her number and all his/her social media profiles. If it's not worth it to break up with the person, you could confront the problems between you and resolve them. Touching an open wound will never heal it. On the other hand, sometimes we become obsessed with facts that we cannot change in any way or that are not in our control. In such cases, it is better to accept them and adapt to them than to constantly fight them. Perhaps knocking on a closed door will get it opened one day, but the goal is not always worth the invested resources .
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Response prevention. Some obsessive thoughts are followed by rituals or compulsive behaviors. If we do not do them, we feel a lot of anxiety. The exercise is just to prevent performing the ritual when automatic thoughts appear, for example, not to answer the person who hurts us, not immediately clean the dirty hands, not to go home to check if the fire is off or not to close all the windows and not to turn off all the lights at home at night having fears of thieves. As it has been said before, anxiety increases when thoughts appear but if you do not perform the compulsion to relieve it, it will gradually decrease. If you see that you can’t stop doing compulsive behavior at once, try setting a limit (5 or 10 minutes) or delaying the period between thoughts and behavior.
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Counterritual. If this doesn’t work for a ritual, you can force yourself to do the ritual more times than you normally do. For example, if you have to go home to check the fire or if you have locked the car door properly, do it 3 or 5 times instead of one. It’s a pretty radical technique but it works.
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Violation of the ritual. If you have several compulsions, you make a list of them and each day you choose one that you are not allowed to perform today. You forbid yourself to perform only 1 but you may perform the rest of them.
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Projection. Draw your obsession as best you can, write a poem about it, sing a song you know but changing the lyrics or speak aloud about your obsession with yourself.
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Social support. Stay with friends and family but talk with them about other issues and concerns without saying anything about your obsession. They may have noticed your obsession. There’s no need to talk about it every time.
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Don’t be alone. You could go to a self-help group of people who have the same problems or go to a therapist to improve the problem.
There are many techniques and strategies but they must be sought and adapted to each specific case. Remember that the treatment of obsessions, whether on your own, or with a specialist, requires time, commitment and patience. Through Cognitive-Behavioral Therapy and Metacognitive Therapy with professional support, you can free yourself from the control of your obsessions and find the way to a fuller and quieter life.