Updated May 30, 2024
Earlier posts have focused on treating the obsessions (thoughts) of OCD and OCD compulsion. This post will focus on the compulsions (behaviors) of OCD.
Why focus on behaviors instead of thoughts? For some Good Therapy SF clients, the ritualization of their behaviors is the primary issue. These behaviors “feel” like the only time they can experience relief from anxiety. Unfortunately the cost of this relief is too high, and the ritualizations start to disrupt their daily life.
Below is a highly effective skill from Stop Obsessing by Drs. Edna Foa and Reid Wilson.
Most rituals have some of the following traits:
Specific actions
Specific thoughts
The order of the action
The number of repetitions
Particular objects used
Physical stances
Corresponding emotions
Locations
Special triggering thoughts or events
If you have compulsions, ask yourself: What traits do I have? After thinking about the traits of your compulsion, here are 4 ways to make a change:
Change the order of the compulsion: In other words, complete all the parts of the ritual, but do them in a different sequence. For example, if you always brush your teeth from the left side to the right, reverse the order by starting on the right and working to the left.
Change the frequency of the compulsion: This is most helpful if counting is part of the ritual. The goal is to alter the number of times you would normally do something. For example, if you normally lock the door eight times, only turn the lock seven times. If the frequency of the compulsion is more complex, try changing the sets and repetitions. For example, 3 sets of 10 would change to 10 sets of 3.
Change the objects of the ritual: There are many ways this can be applied. For example, try to use a different brand of soap if your compulsion is around hand washing. Or if you normally find relief by tapping a piece of furniture, try to tap your leg instead.
Change where or how the compulsion occurs: If possible, this is a useful approach. For example, if you compulsively brush your hair in the bathroom, brush it in the family room (or on the other side of the room if you live in a studio). An option to change the “how” of a compulsion is to perform it with your eyes closed instead of open.
There are a few reasons why making these changes are helpful.
First, simply making any type of change to a ritual is going to be effective. The goal is to break up the rigid and highly regular pattern of behavior. These proposed changes accomplish this, without the struggle of trying to stop the OCD compulsion all at once.
Second, changing aspects of the compulsions helps to “break the powerful magic of rituals.” This happens because you will still find some relief, even if the compulsion is not performed the normal way. This creates flexibility, which is the first step to stopping a compulsion.
Finally, making these changes will increase your awareness of how often the compulsions were performed. This awareness helps to identify the early signs of the compulsion, so you can stop yourself before it happens.
For more information on OCD compulsions and other anxiety disorders, feel free to reach out to Good Therapy SF.
