OCD and Relapsing

by tiverylucky freedigitalphotos.net

by tiverylucky freedigitalphotos.net

As most of us know, overcoming obsessive-compulsive disorder is no easy task. It takes hard work, enormous effort, courage, and dedication. When those with OCD regain control of their lives, it is reason to celebrate. It is an amazing accomplishment – which is why when a relapse occurs, it can be heartbreaking.

In this wonderful article written by Dr. James Claiborn, a relapse is defined “…as a return to the same level of symptoms as before treatment.” Basically, the person with OCD is back where he or she started. Relapsing should not be confused with a lapse, which is a temporary and/or partial return of some symptoms.

I am incredibly thankful that my son Dan has not relapsed since overcoming severe obsessive-compulsive disorder almost seven years ago. Has he lapsed? I’m sure he has. He still  has OCD and while he has the tools to fight and manage his disorder, I’m guessing there are times when anxiety takes over and it’s just too difficult to do what is necessary to keep OCD at bay. But it’s not the end of the world, and I think Dan realizes this. Similar to a dieter who has one piece of chocolate cake, it’s a lapse. You acknowledge it, accept it, don’t beat yourself up over it, and strive to fight harder tomorrow.

Interestingly enough, Dr. Claiborn discusses how the interpretation of a lapse can contribute to an actual relapse. Many people with OCD deal with cognitive distortions such as black and white thinking and catastrophizing. They also have a strong need for certainty, and often live with hyper-responsibility and perfectionism as well. These are all examples of absolute thinking which can affect how they view a lapse. Dr. Claiborn explains:

…If the person has a lot of distress and concludes they need to engage in some compulsive behaviors, then they have experienced a lapse. If they then engage in some absolute thinking, such as, “all my hard work in ERP is a waste because I still have obsessions and I have to do the compulsions,” they are on the path to a relapse.

Not surprisingly, part of a good relapse prevention plan involves addressing this absolute thinking. To put it simply, it’s all how you look at it. While lapses are bound to happen, Dr. Claiborn suggests they be looked at as learning experiences and not signs that a relapse is imminent. There is a lot of good information in his article, which I highly recommend reading.

Once again we see the importance of having a good therapist who really understands obsessive-compulsive disorder and how to treat it. While being skilled in exposure and response prevention (ERP) therapy is of the utmost importance, addressing relapse prevention is also a must. Because when you get right down to it, getting well is only half the battle. The other half is staying that way.

 

 

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4 Responses to OCD and Relapsing

  1. Great points here, Janet. Lapse and relapse is such a sensitive topic. People often feel so afraid of a lapse, especially when they’ve just completed a successful treatment. I think many people (me included as the mom in therapy with my son) want to think it’ll never come back. But it is so important to plan for relapse prevention, and for what to do if one occurs.

    • Absolutely, Angie! Yes, we all just want OCD to go away forever, but we know that rarely happens. So it’s important to have a good understanding of a lapse as well as having a relapse prevention plan in place. Thanks for your insight!

  2. David Stein says:

    If you recover rand then relapse and immediately take measures to restart your recovery you are succeeding. OCD is not like drinking or other addictive conditions. You do not fail only because you relapse. You only fail if you give up. Recovering from OCD is not a race. It is a march to mental health that only stops if you stop. Keep going.
    David S.
    Chicago

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