Tuesday, February 1, 2011

The Purpose of Therapy for OCD vs. the Goal of Therapy for OCD

Motivation Mind Map
I remembered something the leader of my OCD support group said, "The goal of treatment is to live with uncertainty. The purpose of treatment is to reclaim your life." Sometimes in the short term all I can see is the goal of Exposure Therapy, which is to tolerate uncertainty until the anxiety recedes, or to use the fancy word, until you "habituate" to the anxiety. And often I read comments on the OCD Support Group that reflect a fear that the goal of Exposure Therapy is to suffer, "learn to live with the anxiety" or give up the possibility of any peace.

It helped me to connect the pain of doing Exposures with the purpose of doing them. My therapist didn't ask me to do Exposures just for the sake of doing them, or because it was "correct treatment"--he asked me to do them so I could reclaim my life. The first time I met with him, he listened to my history of having OCD, and said that OCD was a disrespecter of my person. I was struck by this. Much of what is important to me was lost inside the OCD. Connecting with what I value, love, am passionate about, gives me motivation to do my Exposures. I love making art, and this often gives me the fuel to defy the OCD pull toward compulsing, and therefore losing many hours in my day to rituals.

Jeff Bell, IOCDF Spokesman, in his new book When in Doubt, Make Belief: An OCD-Inspired Approach to Living with Uncertainty, argues that human beings are motivated by what they value, by making a difference, and doing things for the greater good:
As seen through the distorted lens of unhealthy doubt, "good"
choices are those that reduce our anxiety, while "bad" choices are
those that increase our fear and introduce uncertainty.
Some of the choices that I want to make, cause me anxiety, and my OCD tendency would be to label them bad, and this crashes directly into an essential part of my soul that knows I want to make these choices, that there are things I want in this life, things I desire to accomplish and experience. With OCD it's hard to inhabit your own life. When I think about all I've lost to compulsions, I feel a deep grief, but every Exposure I do allows me to move back into my own life.

What are some good choices that you've made that *increased* your anxiety, but which you chose anyway, because they were in the service of something important to you?

Jeff Bell's Memoir Rewind, Replay, Repeat
What do you want your life to be about? Action and Commitment Therapy for OCD


  1. Just this past weekend. It is one of my values to live an "authentic" and "honest" life. I am trying to be true to myself and say what is on my mind - even if it does make people think that I'm crazy, or even worse a lesbian.

  2. Good post. I've been wanting to quit exposure therapy because it feels like some kind of torture. Focusing on the good things I want to do in spite of OCD might help.

  3. Pure O Canuck--I hear you on the being true to yourself. I had so many layers of feeling defective, that I rarely would say what I really thought about things. It takes courage to step out and be yourself!

    Abigail--It really helped me to focus on what I wanted to do in order to have the courage to do exposures.

  4. Thanks for this post, I enjoyed it – it seems like your work in therapy has been helpful, thanks again --

  5. Paul--I'm glad you enjoyed the post. Exposure therapy/CBT has been instrumental in helping me reclaim my life.