4 Steps in the Self-Treatment of OCD


Step 1: RELABEL
The critical first step is to learn to recognize obsessive thoughts and compulsive urges. You don’t want to do this in a merely superficial way; rather, you must work to gain a deep understanding that the feeling that is so bothersome at the moment is an obsessive feeling or a compulsive urge. To do so, it is important to increase your mindful awareness that these intrusive thoughts and urges are symptoms of a medical disorder.  Recognize that the intrusive obsessive thoughts and urges are the RESULT OF OCD.

Step 2: REATTRIBUTE
The key to this approach to treating OCD can be summed up in one sentence: “It’s not me–it’s my OCD.”  You are working toward a deep understanding of why the urge to check that lock or why the thought that “my hands are dirty” can be so powerful and overwhelming. If you know the thought makes no sense, why do you respond to it? Understanding why the thought is so strong and why it won’t go away is the key to increasing your willpower and enabling you to fight off the urge to wash or check.  The goal is to learn to reattribute the intensity of the thought or urge to its real cause, to recognize that the feeling and the discomfort are due to a biochemical imbalance in the brain. It is OCD–a medical condition.

Step 3: REFOCUS
In refocusing, you have work to do: You must shift the gears yourself.  With effort and focused mindfulness, you are going to do what the caudate nucleus normally does easily and automatically, which is to let you know when to switch to another behavior.  Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes: DO ANOTHER BEHAVIOR.

Step 4: REVALUE
Do not take the OCD thought at face value. It Is not significant in itself.  You must use your knowledge that OCD symptoms are just meaningless signals, false messages from the brain, so you can refocus and shift gears. You must gather your mental resources, always keeping in mind, “It’s not me–it’s my OCD. It’s not me–it’s just my brain.” Although in the short run, you can’t change your feelings, you can change your behavior.  By changing your behavior, you find that your feelings also change in time.

Source: Brain Lock, by Jeffrey Schwartz, MD., Regan Books, 1996.

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