OCD and Distraction

musical notesThis post originally appeared July 15, 2013….

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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12 Responses to OCD and Distraction

  1. Great post, Janet. And distraction is certainly a tricky topic when it comes to OCD. I remember when I first started treating OCD in my practice. I gave a young lady a task to do at home and her mother asked me whether her daughter should focus on her discomfort or distract herself while participating. I actually had to think about it for a minute, then replied that she should allow herself to feel the discomfort – after all, we want to build up that tolerance to discomfort and uncertainty. On the other hand, it’s good to have “distractions” in life. OCD tries to take away a person’s life, piece by piece (sometimes chunk by chunk) and the best defense is a full, satisfying life.

    • Thanks for sharing your insight, Angie, and I love your last sentence: “OCD tries to take away a person’s life, piece by piece (sometimes chunk by chunk) and the best defense is a full, satisfying life.” YES!!

  2. I think you are onto a very important distinction here. One which I have never heard from any of my doctors or therapists. I may point this out to THEM!

    Thanks Janet – well done!
    -Paul K

  3. Katharina K. says:

    Hallo, my Name is Katharina and I am suffering from sensorimotor ocd (swallowing and breathing)for 15 years now. I made a cognitiv therapy that helped me deal with my familiy issues but not at all with the ocd. My only way of getting any relief was distraction. But as you pointed it out, this is not working very well. Now I decided to make a Exposition Therapie but my Kind of ocd is not very known in Germany and it is hard to find a therapist who really understands the Problem. And I am really scared. Can you give me some advice. Thanks

    • Hi Katharina, I am sorry you are having such a tough time. Sensorimotor OCD is treated the same way as all other forms of OCD – with ERP therapy – and while it is best to have a competent therapist helping you, there are things you can do on your own. Please check out this post:
      Also, perhaps Dr. Seay (or another good OCD therapist) would consider doing some type of virtual sessions with you if you can’t find the right help in Germany. Self-help books might be helpful as well (resources listed in my book or on the IOCDF web site).
      There is definitely hope for you…..you just need to get the right help!
      Good luck as you move forward and feel free to keep in touch.

  4. A great post! I am also a fan of this very necessary distinction. 🙂
    One of the things I’m reminded of from this post is when I was also at the OCD-I and one of the therapists there explained to me how switching songs when I was dealing with the OCD and listening to music, could actually be unhelpful when I’m unable to change the situation and am dealing with a lot of the OCD. So that was an interesting point that I hadn’t thought of prior!

    This also makes me wonder if it may be unhelpful when I’m dealing with a lot of the OCD thoughts and I ‘block it out’ with music, which happens particularly in the early morning hours. Hmph.

    This post also makes me think of a Youtube video I watched once about someone discussing how coping strategies could be a compulsion, which I didn’t agree with because as my therapist can recall, too, not EVERYTHING can be a compulsion. I think in this context it could make more sense but the generalization really pissed me off, ahaha.

    Then of course there’s the complexity of other types of OCD! Sometimes when I read posts like these that start out with nearly questioning the way I do things, I get all ‘wait, what?’ but luckily this post was different, although if it hadn’t been, what an exposure that would have been, too! In that way, I just have to remember that my own experiences may be different from others. And what an important concept that is to keep in mind!

    Overall, what a great post! Thanks for getting me thinking and pointing out those tricky ways of the OCD. 🙂 ❤

    • Thanks so much for your thoughtful comment. Yes, everyone’s experiences differ somewhat, though of course there are commonalities with OCD as well. And most of my posts (unless I quote others) are just my own thoughts and musings about OCD, and I hope people realize this. Seeing how distraction could be helpful as well as hurtful to my son was the impetus for this post. Glad it resonated with you.

      • Mmm, sometimes I get too involved thinking I may be a special snowflake in terms of the OCD I live with, but it is good to be reminded of the commonalities and ways it still acts like itself.
        It’s a good thing to keep in mind when one strolls along the Internet, if your treatment providers have told you something different, listen to them, they know you best. *nods*

        Thank you again for posting it! =]

      • You’re welcome!

  5. ocdtrials says:

    Thank you for the post, that answered a question for me regarding ERP. I read somewhere that delaying a compulsion in response to a trigger/obsession was one way to help, and to do that, I tried to watch funny videos or other information videos, and I thought I was able to “delay” the response for three hours, but when the obsession came back in the end I still did the compulsion. Now I realize that instead of “delaying” for 3 hours, I probably only delayed for a few minutes, because I didn’t really allow myself to feel the anxiety for those full 3 hours–I was distracted by the media I was watching.

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