As we know, the front-line treatment for OCD is Exposure and Response Prevention Therapy, where sufferers are forced to face their fears, and accept the doubt and the uncertainty in their lives. An integral part of this therapy includes an initial rise in anxiety, but over time, this subsides. When someone is fully committed to ERP Therapy, it works.
But can it work too well? Can OCD sufferers, indeed can all of us, be so good at accepting the uncertainty of life that sometimes we don’t act appropriately? I’ve previously written about healthy doubt versus unhealthy doubt, where I discuss Jeff Bell’s suggestions for distinquishing between intellect-based and fear-based doubt. I think Jeff gives us invaluable tools to help us differentiate between OCD and actual situations that are cause for concern.
For OCD sufferers who have gone through intense ERP therapy, however, I’m wondering if accepting whatever comes along sometimes becomes the norm. If an OCD sufferer experiences sharp pains in his abdomen, will he automatically assume it’s his OCD making a big deal out of nothing, and delay getting treatment? If another sufferer gets the feeling that her best friend is angry with her, will she just chalk it up to her OCD getting in the way, and not address the situation? Because treatment for OCD often involves doing the opposite of what our instincts are telling us, it’s no wonder that those with the disorder might have trouble trusting their intuition. Indeed, they might ignore it altogether.
To me, not being able to rely on your instincts, on your own inner compass, is a cruel byproduct of having OCD. Sure, we all questions ourselves sometimes. But try to imagine second-guessing everything you think or feel. Is this a valid fear or concern? Or is it OCD? Am I overreacting? Underreacting? How do I know? My friend Bobbi’s excellent post on this subject talks about OCD stripping away a sufferer’s ability to trust him or herself. In her case she was faced with decisions regarding her partner’s health.
So what’s the answer? I don’t know. But I believe those with OCD can figure it out for themselves. Jeff Bell has his way and Bobbi has her way. The bottom line is those with OCD typically do know what is a real cause for concern and what is OCD; they are rational people. They might have to dig a little deeper to figure it all out and to find the courage to trust those instincts they have repeatedly been taught to ignore. But it can be done and hopefully, in the process, they will regain some of the trust in themselves that OCD tried to steal away.
I’d love to hear how others deal with OCD and instincts.