1. To give mindfulness a try as a treatment for OCD, follow George Hofmann’s (2013) instructions here:
Keep your attention on your breath and be fully aware in this moment—of sights, sounds, smells, sensations, and thoughts.
Acknowledge each thought as it pops up, let it go, and return to your breath. Don’t analyze it, dwell on it, or ruminate over it, just let it come into your head and slide right back out.
If you’re having trouble, try labeling the thoughts.
The intent of mindfulness for OCD is to stay aware of what is going on around you, as well as what is going on inside you.
Practice, practice, practice!
2. Begin by getting comfortable, adjusting your position as needed so you can start to relax.
To begin the relaxation process, imagine that you are at the top of a stairway. At the bottom of the stairway is a state of peace, calm, and relaxation.
Take note of how you are feeling right now, at the top of the stairway.
Imagine taking a step down the stairway...a single step closer to relaxation.
Further descend the stairway, going down toward relaxation...down...down...to a state of calm and relaxation.
Picture yourself going slowly down the stairway, one step at a time. It is a comfortable, safe descent to a place of relaxation. Move down step by step, at your own pace, becoming more and more relaxed with each step you take.
Take another step down...and another...more deeply relaxed with each step.
You might even become a bit sleepy as you get closer and closer to relaxation. That's okay. Allow your mind to drift and your body to relax, heavy and comfortable.
Moving down the stairway, down, down...almost to the bottom now...when you reach the bottom you will be pleasantly relaxed.
Take the last few steps down to the bottom of the stairway...
Reaching the bottom now...a state of calm and relaxation. You are now feeling peaceful and relaxed.
Now, in this calmer state, consider the obsessive thoughts that tend to be problematic for you. People who experience Obsessive Compulsive Disorder (OCD) often feel helpless against obsessive thoughts. It can feel like the only way to get rid of the thoughts is to give in to certain behaviors, or compulsions.
You may feel compelled to avoid things, check things, count, worry, or do some other repetitive behavior. The best way to get rid of obsessive thoughts for good is to resist the compulsive behaviors and ride out the anxiety. Nothing bad is going to happen if you resist the compulsions.
Notice the obsessive thoughts right now, without taking any action to relieve this anxiety. Notice the thoughts that you are having. Focus on the thing that you are worrying about.
These thoughts will not last forever. They will go away soon, without you following through on compulsive behaviors. The urge to engage in these behaviors will pass. The anxiety will go away. Just experience this anxiety right now, without fighting it, allowing the anxiety to happen.
You are safe. Nothing bad is going to happen. You are okay, and you are riding this out.
It's perfectly okay to distract yourself. Let's try it, right now, by focusing on breathing.
Take a deep breath in...hold...and breathe out.
Breathe in...and out...
In...and out...
In...out...
Keep breathing slowly, concentrating on your breathing...focusing all of your attention on each breath you take.
(Pause)
Now focus on your muscles. Notice where there is tension in your body...and notice where your body feels relaxed.
Choose one area of tension, and allow this area to relax. Breathe in...and as you breathe out, let the muscles loosen, giving up tension.
Feel this area becoming more relaxed.
Now choose another area of tension, and relax the muscles there.
Continue to scan your body for areas of tension, relaxing each tense spot that you find.
(Pause)
Notice how you are feeling now. You are probably feeling more relaxed. See how you can relax your body, and feel more calm, without needing to act on the obsessive thoughts. Notice that by focusing on something else, such as concentrating on relaxing your muscles, you get some relief from the obsessive thoughts.
When thoughts come up, simply notice them, and then direct your attention to something else. You do not need to fight the thoughts, or try to make them go away...the thoughts will go away on their own.
All you need to do is make yourself as comfortable as you can, so that you are able to get through this stressful time. You will get through this. You are doing well.
If you start to feel too anxious, just focus on your breathing, or on relaxing your muscles, and feel the anxiety decrease.
Create a picture in your mind now, of yourself in the situation related to your obsessive thoughts. For example, if your thoughts are about contamination, imagine yourself touching a feared object. If your thoughts are about the need to check to see if the stove is off, imagine yourself getting ready to leave the house. If you have thoughts about the need to wash your hands, picture yourself standing in front of a sink. Imagine yourself in whatever situation the obsessive thoughts are about.
See yourself in this situation. What would the most healthy, effective response be? Imagine a response that does not involve compulsions...one that you would do if you did not have any obsessive thoughts.
Picture yourself doing the behavior you avoid, or doing a different behavior than the one you usually do. For example, picture yourself touching an object you are afraid to have contact with, and imagine it going just fine. See yourself leaving the house without checking the stove, and imagine yourself as you keep going, without looking back.
Create all the details of the scenario in your mind. Rehearse a new behavior in your mind...as if the obsessive thoughts have no power over you.
The obsessive thoughts do not have any power over you. You can endure the anxiety that comes up, and you will not have to endure it for long because the anxiety goes away. You only need to ride it out...waiting for the anxiety to pass...
You are stronger than the obsessive thoughts. You are much stronger...imagine yourself handling situations in a healthy, uninhibited way...free from obsessive thoughts...free from worries. Rehearse these behaviors in your mind.
(Pause)
For relief from the obsessive thoughts, you can relax your body, which we will do again in a moment. You can also practice the behaviors you have been imagining. The best way to get rid of obsessive thoughts is to actually do new behaviors in real life. Endure the anxiety when it comes up, and it will go away without giving in to the thoughts. The anxiety and the thoughts will go away all on their own.
When obsessive thoughts become too difficult to resist, you can use relaxation to help you through it. All you need to do is to get through some anxiety temporarily...and eventually the obsessive thoughts will go away. They have no power over you now, even though this may be difficult.
You are in control. You are much stronger than the thoughts. You can resist giving into the thoughts. This will get easier and easier to do.
Focus now on relaxation. Every time the obsessive thoughts become problematic, just focus again on relaxation.
Concentrate on your hands. Feel the relaxation in your hands. Feel your hands becoming warmer, and heavier...relaxing...
Follow this relaxation as it spreads to your wrists...lower arms...and elbows.
Feel your upper arms and shoulders relaxing.
Allow the muscles of your neck...face...and head to relax.
Feel your upper back relaxing...and feel the relaxation continue all the way down your back...
Relax your sides...chest...and stomach.
Allow your hips and upper legs to relax...relax your knees....lower legs....ankles....and feet.
Allow a feeling of relaxation to fill your entire body. Let your whole body become relaxed and heavy.
Focus on your breathing...observing each breath moving in and out of your body...watching your breaths...concentrating on your breathing.
Feel yourself becoming even more deeply relaxed as you breathe...more and more relaxed.
So calm...so peaceful...completely relaxed...
(Pause)
Notice how relaxed you are feeling. Such a pleasant, calm feeling.
You were feeling anxious before, but you got through it. You have overpowered the obsessive thoughts that were bothering you. Any time you experience these thoughts again, you can relax and get through it, just like you did now.
Congratulate yourself on having gotten through this. This is proof that you are stronger than the obsessive thoughts. These thoughts have no power over you.
Now it is time to conclude your relaxation experience, while keeping with you a relaxed feeling.
Imagine that you are at the bottom of a stairway. At the top of the stairway is a state of alert and calm. With each step up, you become more and more awake.
Picture yourself beginning to ascend the stairway. Taking a step up, becoming slightly more awake, more alert.
Take another step up, and another, feeling your body and mind reawaken more and more with each step.
Continue up the stairway, nearing the middle of the stairway. Becoming more awake. More alert. Feeling your energy increasing, flowing through your body.
Climb further up the stairway...another stair...and another...more awake with each one. Nearing the top of the stairway. Only three steps left before you reach your usual level of awareness, feeling calm yet alert and energized.
Three...two...one.
3.
Five steps to handle intrusive thoughts
Refer to your thought as just a thought
This thought does not control you and you are not your thought. It is just something harmless in your head.
Automatic thought
Remind yourself that this thought is coming automatically and means nothing. It will not cause you any harm.
Allow the thought to be there
Allow it to be there and let it just remain in the background. Don’t try to get rid of it or judge it.
Breathe
Do some deep diaphragmatic breathing or meditation while allowing the thought to be there. Eventually your anxiety level will decrease.
Live
Do whatever you were engaged in when the thought arrived. Don’t let it stop you from doing the things you want to do.
Practice
Now comes practicing what we preached. We are actually going to recommend that you practice this. Which means we want you to start thinking of your intrusive thought. You might think this is the craziest thing you ever heard. The only way to get rid of your anxiety is to do the thing you are afraid of.
Get a piece of paper and make 5 columns. Write down the situation that triggers the intrusive thought. An example might be when your teen is using the car. In the second column write the common thought you have. Example, my son will get in a car accident. In the third column put from 1-10 your level of distress. Next mark down if you were able to use the 5-step method listed above. In the last column write your level of distress.
The recommendation is to do this every day for a minimum of two weeks. Then re-rate your intrusive thought. Has it decreased? I hope so.
Another common feeling that goes with these intrusive thoughts is shame. You are your own worst critic. Perhaps showing yourself some compassion would also be helpful. Think about what you may tell a friend who was having the same obsessive thoughts. You would most likely be kinder to this person than yourself. Remember, you are struggling, so be kind to yourself.
If you find this exercise too difficult or scary, you may want to do it in the presence of a therapist who can help you go through this at a proper pace for you. Everyone is different.
Some people also find medication to be helpful with their severe obsessive thoughts. Perhaps you may want to get on some medication along with therapy until you have gained the tools you need to work on your intrusive thoughts. If this is something you struggle with, give me a call at 713-304-6554.
Take care,
Debbie
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