OCD and Distraction

musical notes

I’ve previously written about my son’s stay at a world-renowned residential treatment program for obsessive-compulsive disorder. After being there for nine weeks, we felt it was time for Dan to come home and prepare to go back to college. He was reluctant to leave the program as well as the staff with whom he’d grown so close, and they encouraged him to stay. Dan kept saying to us, “If I go back to school, I won’t have time to concentrate on my OCD!” Even back then, this rationale made no sense to me. No time to concentrate on your OCD? Wouldn’t that be a good thing? While he was mainly referring to having time to work toward recovery, he also thought this recovery had to be the main focus of his life. My husband and I, on the other hand, believed he needed to get out of the treatment center and back to his life, as scary as that might be. He needed to interact with his friends, engross himself in his studies, reconnect with his family, resume old hobbies and explore new passions. In short, he needed to get back to living a full life, which would help distract him from his OCD.

In this context, I believe distractions are good. But are they always beneficial when dealing with OCD? I don’t think so. Distraction, like avoidance, might become a type of compulsion, a way to counteract the anxiety and fear stemming from an obsession. Indeed, many well-meaning people, including some therapists, encourage the use of distraction by saying things like, “Just think of something else.” For example, if you are dealing with a harm obsession, just switch your thoughts to cuddly kittens or puppies (oh, if only it were that easy to “switch our thoughts”), or perhaps distract yourself through an activity, like listening to your favorite music. Anything to get your mind off that tormenting obsession. Unfortunately, these distractions will offer only temporary relief, at best, and the obsessions will likely return, stronger than ever. Those who are familiar with Exposure and Response Prevention (ERP) Therapy will realize this use of distractions is counter-productive. What OCD sufferers really need to do is to not distract themselves from the anxiety, but to allow themselves to feel it, in all its intensity. In that way it is a true exposure.

So it seems to me there are different types of distraction. Living life to the fullest can provide what I call proactive distractions. Keeping busy takes Dan’s focus off OCD and allows him to enjoy his life. He’s not giving OCD any more of his time than he has to. This is a good thing. But a distraction that’s a direct response to an obsession is what I call a reactive distraction. It is similar to a compulsion in that it reduces anxiety in the moment, but ultimately allows OCD to strengthen.

The same activity might be a proactive or reactive distraction, depending on the circumstances. For example, Dan loves listening to all kinds of music, and he does this regularly for enjoyment. To me, this is proactive distraction. My guess is there were times, when his OCD was more active, that he’d listen to music  in an attempt to suppress the anxiety caused by his obsessions. This would be what I call reactive distraction. Not so good.

I’d love to hear your thoughts on OCD and distraction. As we know, OCD is complicated, and understanding all the issues that surround it isn’t easy. But that’s not to say we can’t keep trying! The more we can decipher OCD’s tricky ways, the better position we’ll all be in to fight it.

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24 Responses to OCD and Distraction

  1. Great post, Janet! What a great distinction between the kinds of distraction that are helpful vs. harmful in OCD. I completely agree that what’s helpful in treatment is full engagement in the exposures and meaningful engagement in activities that aren’t dictated by the OCD.

  2. willitbeok says:

    “What OCD sufferers really need to do is to not distract themselves from the anxiety, but to allow themselves to feel it, in all its intensity. In that way it is a true exposure.”

    Yes, yes, yes!! I really like what you say in this post. So, so true. It’s so hard for me to get my husband to understand that telling me “Everything’s OK” is actually harmful because it causes me to rely on that false reassurance instead of accepting uncertainty.

    • You bring up a great point. It’s so important for loved ones to understand how OCD operates, so that they can react appropriately. Of course your husband’s instinct is to reassure you, but as we know, following our instincts when it comes to OCD isn’t always the right thing to do. Thanks for sharing!

  3. Hi, really interesting post, like you say this is really complicated, and some of the stuff about distractions and avoidance sounds very familiar to me. I tend to use avoidance the most, the thing about using music as a distraction also sounded familiar, I do tend to use music a lot, and just recently have started to count things like windows on buildings or trees along a road as a means of distraction. I understand that these things could just become other compulsions, like chocolate, sex, or alcohol possibly.

    Also other conditions can make things more complex also, and increase the avoidance, and compulsions further. Sometimes I have completely conflicting thoughts about what to do due to avoidance, and compulsions, the depression sometimes kicks in, and I also become hypervigilant due to PTSD. It’s a difficult road to navigate isn’t it. I guess the main thing is that people are treated as individuals, i’m sorry I don’t really understand about proactive and reactive distractions, but I understood most of the other things you said. Hope i’ve made sense there, and this comment gets through ok this time.

    • Hi There, It turns out your comments ended up in my Spam Folder……I apologize! Thank you so much for your insight, and yes, it does get complicated. As you say, additional disorders can make everything even more problematic. As far as understanding proactive (normal everyday activities that you enjoy doing and keep your mind busy) and reactive (more like a compulsion, a distraction that wards off anxiety) distractions , I wouldn’t worry about it, since I made the terms up anyway :). Glad I finally found your comment!

  4. Tina Barbour says:

    Your post brings up some interesting thoughts (your posts always make me think–in a good way!). I can see where reacitve distractions can be harmful. But some of the distractions that I used in conjunction with “Brain Lock” actually helped me. I found that if I could get away from the scene of the compulsion–quite literally get away–I could soon forget about the obsession and compulsion altogether. Now that was more refocusing–not sure if that’s the same as distraction. I found that many of my harm compulsions died down from practicing this.

    On the other hand, I do understand what you’re saying about avoiding dealing with the anxiety. Sitting with anxiety has helped me, too, especially when it’s my thoughts that are driving the anxiety. I keep pushing my thoughts towards the anxiety until they are spent. I’m not sure where the line is where a distraction is helpful and where it is harmful. I’m going to have to think more on this. Sorry if this comment is confusing, Janet. I always appreciate you bringing up important issues to discuss and consider.

    • Your comment isn’t confusing, Tina (at least I don’t think it is :) ). I always appreciate your thoughtful contributions. In the first paragraph it sounds like you are describing a way to avoid doing a compulsion by refocusing…….to me that makes more sense than using a distraction AS a compulsion………if that makes any sense! The bottom line is you’ve had success with your refocusing, and I will never argue with success! Thanks for sharing!

  5. Krystal Lynn says:

    Dr. Jeffery Schwartz wrote a book “You Are Not Your Brain” which details 4 steps to change unhealthy thinking, change bad habits, etc. I read the book a long time ago, I can’t remember if it was written specificall for OCD, but it was useful for OCD. The four steps are to Relabel, Reframe, Refocus and Revalue. Relabeling means to attribute those thoughts we have to a false message, not a real emotion or an action you really must take. A obsessional thought is a good example here. When you reframe, you acknowledge that the thoughts and action are the result of a false message, not who you are. In the reframe section, he explains the cognitive distortions in OCD, such as catastrophizing, all or nothing thinking, magical thinking, etc. Next, you refocus where you basically process your thoughts in a healthier way. Rather than doing a compulsion, you go for a walk, for instance. He stresses that the goal is NOT to distract yourself, but to keep yourself from participating in your bad habit. Finally, you revalue, whereby you learn to differentiate between real emotions and false thoughts and signals perpetuating from OCD. .
    I was a tad confused..If you refocus, are you not in fact distracting yourself? After a lot of success and failure on my part, there is a difference but you have to work really hard to know when to refocus and not have it be a distraction …OR even worse, make whatever you do when you refocus into a new compulsion.
    I think OCD is as complex as our brains are. Sometimes I have to totally and literally sit on my hiney and the only refocusing I do is some relaxation breathing to get through an OCD incident and other times I know it is appropriate to get out and take a walk.

    • Krystal Lynn, I think a lot of what you are saying is similar to Tina’s comment. I have heard so much about Dr. Schwartz’s book, but have never read it. It is on my “to do” list! What I find particularly interesting about your comment is the last sentence when you say that sometimes you just “know” what the appropriate action is…….with all our analyzing, I do think you can get to the point where you really know yourself the best and know what to do to help yourself the most. Thanks for your great comment!

      • Tina Barbour says:

        Yes, Krystal Lynn described what I was trying to. Dr. Schwartz wrote “Brain Lock” too. Helped me a lot. You make a good point, too, Janet about how we know ourselves best and know what to do to help. I think when we have a variety of tools to choose from, we can more easily choose what helps us best. And getting treatment gives us those tools.

      • Absolutely, Tina! The bigger the toolbox, the better! (I must start reading Dr. Schwartz’s books!)

  6. The Hook says:

    This world is filled to capacity with distractions – and beyond!
    I cannot begin to imagine how difficult it is to focus when you are suffering from an affliction like OCD.
    Thank you for enlightening me once more.

  7. dcardiff says:

    Hi Janet, I also suffer from OCD and Bipolar Disorder. I have been on medication for the past twenty-five years. I’m now sixty-six.

    I’ve found meditation to be the best solution. With this I can rest my mind. If I find I’m obsessing, I go back to counting my breaths. This seems to clean the slate and I’m able to start a new thought process.

    I hope this helps,
    Dennis

    • Hi Dennis, Thank you so much for sharing. Meditation helps so many people; I’m glad it works for you. I would think as long as counting breaths isn’t a compulsion…….again, after so many years, I’m guessing you know what works for you!

  8. drblogmom says:

    Thank you for a terrific post. I think this is the biggest challenge for OCD sufferers, their friends and loved ones, and the public in general to understand. I constantly hear people telling folks with OCD (especially the parents of the children I work with) to “just breathe and think of something else.” It is that feeling of discomfort that is so important in getting better. At the same time, I think you are right about living a full life. With my own son, it is so important that he has something besides his OCD. I mean, that’s the stuff that makes life worth it!

  9. Deb says:

    I am hoping that we can avoid full time OCD therapy or residential treatment for my son. I think that keeping a foot in the real world is incredibly helpful. Jobs, school, hobbies can help not only distract from OCD but also provide daily exposures.

    Another benefit of real life distractions is the need for social acceptance that occurs with peers/ coworkers. My son is much better able to fight his fears at work or school. He doesn’t want anyone at work to think he is crazy. Around his family and doctors he is not worried about what we think and tends to show his fears and avoid his fears much more openly.

    Even if he is hiding his fear from his friends, I still think that is a form of exposure. Peer pressure forces him to touch or do the thing he is afraid of. It’s peer pressure working in the right direction as far as I am concerned! :) Of course there are times that his fears are so strong at work/ school that he can’t face it. Those situations give us a focus in therapy to use for exposures. Right now my son is terrified to bring his phone to work for fear that it will get dirty. So each therapy session has involved his phone getting dirty.

    Preventative distractions from OCD definitely help. I can’t imagine how a residential treatment center would be able to provide the natural exposures and “normal” moments away from OCD that a job, school, hobby and friends give. Hopefully my son’s OCD slows in growth with this balance. Obviously if it becomes worse we will have to consider more intensive treatment.

    • Thanks so much for your insight, Deb. You bring up some great points, especially about being in a residential program as opposed to the “real world.” I’ve actually been thinking of writing a post on OCD being different in different settings, and if you don’t mind, I just might quote from your comment. Thanks again for sharing. It sounds as if you are doing everything right for your son.

      • Deb says:

        I don’t mind at all. I find that responding to your posts helps me to clarify my own thinking and understanding of what is happening. This is becoming my “support group” so thank you for being here.

      • You’re welcome. I’m glad you’re finding the blog helpful!

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