Obsessive-compulsive disorder is often accompanied by some cognitive distortions, which are basically inaccurate beliefs that usually make us feel badly about ourselves. One of the more common cognitive distortions that might occur with OCD is known as black and white (or polarized) thinking. When my son Dan was dealing with OCD but could still drive, this type of thinking was obvious. If he went 25 mph in a 35 mph zone and the driver behind him blew his horn, Dan was convinced he was the worst driver in the world. Not a good driver who was going too slowly, but the worst driver ever. No gray, just black and white. Sometimes a humorous comment from me would make him see how ridiculous this thinking was, but more often than not, this is what he believed.
When I think of OCD and black and white thinking, they really do make the perfect pair. One of the driving forces behind OCD is the need to know with absolute certainty that nothing bad is going to happen. What a perfect example of black and white thinking: Either I am 100% sure that I (and/or those I care about) am completely safe, or I am definitely in great danger. No gray, nothing in between.
But as we know, that’s not how the world works. We live in a world of gray. Dan is a really good driver who goes too slowly sometimes. We try to be safe, but accidents happen. Usually these accidents are no big deal, but sometimes they are. Our world is uncertain.
Like plants in a greenhouse, OCD thrives on black and white thinking, and this cognitive distortion can even sabotage the OCD sufferer’s treatment. Exposure Response Prevention (ERP) Therapy, by its very nature, is slow and tedious and often fraught with setbacks. A sufferer who thinks in black and white may conclude: “I’m a complete failure at ERP Therapy because I gave in to my compulsions today. What’s the use? I’m never going to get better. I shouldn’t even bother fighting.”
I think, for Dan, just being made aware of his tendency toward black and white thinking was extremely helpful. Cognitive Behavioral Therapy to address cognitive distortions (and to get rid of them) is necessary for the OCD sufferer’s recovery. Indeed, we all need to be able to think in shades of gray, so that we can begin to accept, and live with, uncertainty in our lives.
I’d love to hear from those who have been affected by black and white thinking. How hard was it to change your thinking? Have you changed your thinking? How has this cognitive distortion affected your OCD and treatment?