This article was initially published in the Winter 2020 edition of the OCD Newsletter
For millennia, human beings have glanced up at the stars and wondered how it all came to be. Today, cosmologists attempt to understand what they see by reverse engineering the timeline of the universe. That is, they work backwards to deduce the first few seconds of its existence. Understand how it all begins, and you understand why it’s currently doing what it’s doing.
The OCD “universe” can be understood similarly. Obsessions swirl around your mind while black holes of anxiety and physical discomfort draw in neighboring thoughts, emotions, and distressing images. As this happens, behaviors are born. As they mature, these behaviors exert an increasing influence on the thoughts, emotions, and physical sensations that give rise to them. What begins as a small hot spot of discomfort expands into a complex galaxy of obsessions and compulsions. Understand how OCD begins, and you better understand why it’s doing what it’s doing (and ultimately, how it will all come to an end).
So what can we imagine happened at the beginning of the OCD universe, in those crucial moments when OCD first made its appearance? Some answers can be found in the histories of individuals with OCD. Many recall a time in their life prior to OCD’s arrival, a time when they were fine — until they were not. As one individual with OCD recounted, “I was doing well at age eight or nine until I saw a knife in the kitchen and wondered what prevented me from using it in a violent way.” In this example, the perception of the knife was quickly followed by a distressing thought. This sequence represents moments one and two on our universe timeline.
In a matter of seconds, his OCD universe expanded rapidly. “I was so horrified. I fled to my room and tried my best not to think about the knives. I simply couldn’t do it despite my best efforts.” Here, anxiety in response to a distressing thought led to the fighting, fleeing, and freezing responses that would eventually define his compulsions.
If you haven’t noticed, such “survival responses” are all behaviors, and this fact is critically important: We are biologically programmed to act in the presence of a threat. Undoubtedly, we have evolution to thank for this. We perceive a threat and then experience nervous system activation. This activation takes the form of anxiety (or in some cases, physical or psychological discomfort). Once triggered, this activation is followed by an urge to do something in order to escape a perceived threat and increase our chances of survival. The sequence ends when we engage in that final “doing.”
The origin of the OCD universe is now revealing itself. OCD begins as an experience of uncomfortable thoughts, emotions, or physical sensations. These experiences are then labeled as unwanted and threatening. Once labeled as such, the experience triggers fight-flight-freeze responses. Behavioral responses that succeed in reducing the threat are stored in our brains as adaptive responses. When next in the presence of this threat, we feel compelled to engage in these very same responses. They become “what we do” in this particular situation. This “doing” is of course adaptive when our fears are rational. However, when our fears are irrational (as is the case in OCD), this “doing” becomes compulsive and exerts a gravitational pull on the uncomfortable experiences that gave rise to them. Thus they all hold together in this manner. The physics of the OCD universe are now becoming clear.
Let’s extend our metaphor and consider the idea of a multiverse, or multiple universes. Epidemiological studies inform us that approximately two percent of individuals occupy the OCD universe. The other 98%, however, live in the conventional universe — one that looks and feels very different from the OCD universe. That two universes even exist raises a number of intriguing questions: Why does this happen, given that individuals with and without OCD report the same types of intrusive experiences over the course of their lifetimes? Do the very first few seconds of each universe matter? And if so, how do these moments determine who will ultimately occupy which universe?
As we examine our conventional universe, we can make one immediate assertion: unwanted experiences in the conventional universe do not give rise to the rapid expansion seen in the OCD universe. In the conventional universe, intrusive thoughts, emotions, and physical sensations roam freely and do not remain in orbit around each another. The difference seems to be tied to the behaviors that are born in response to upsetting experiences: In the conventional universe, they are conspicuously absent. It would seem then that the OCD universe requires the gravitational pull of survival responses in the absence of true danger. Without them, upsetting experiences drift away, and the conventional universe unfolds.
Upon further examination, we see that upsetting experiences in the conventional universe are permitted as part of the complex nature of being human. They are not resisted so much as accepted for what they are: scary thoughts, upsetting emotions, and uncomfortable sensations. Moreover, these upsetting experiences are not labeled as threats, and as such, they do not trigger the fight, flight, or freeze responses that expand the OCD universe. Without that expansion, there can be no OCD universe. Might we apply this knowledge to devise a way of traveling between universes?
Here’s what we know so far: misplaced survival responses that follow intrusive thoughts, emotions, or physical sensations give rise to the OCD universe. In other words, compulsions, avoidance, and paralysis maintain obsessions in awareness by providing the necessary gravitational pull to hold the whole system together. Remove that gravity, and the system unravels. Upsetting thoughts return to the choir of other thoughts, intolerable emotions ease, and physical sensations dissipate.
We have found the elusive wormholes, the structures that allow you to travel from one universe to the other. The key to this travel involves disrupting the immediate sequence of events upon OCD’s arrival. Since OCD arrives each day anew, you will have plenty of opportunities to practice navigating out of the OCD universe.
So how can you accomplish this? Pay very careful attention the next time OCD makes an appearance. It will arrive as an uncomfortable experience. Begin by taking a deep breath and trying to remain relaxed. This stance will counter any freezing response from you. Next, mindfully observe the intrusive thought, memory, image, emotion, or physical sensation with the keenness of a cosmologist and study its every move. See if you can do so without making assumptions, getting pulled into the past or future, or judging your inner experience as right or wrong, good or bad. Your direct observation here represents an approach response and counters any urge to flee. Finally, do your best to block compulsions, since these behaviors constitute fighting responses.
You have now denied OCD the survival responses that fuel its rapid expansion. Stay on this course as long as you can. You are traveling through a wormhole, and it will be a bumpy ride. As you practice honing these maneuvers over and over, you will eventually learn to pass through the wormhole with greater and greater ease. You will know you have arrived back in the conventional universe when your mind can once again experience the lightness and joy of living in a world with far weaker emotional gravity.
Copyright © 2020, David J. Keuler, PhD Author, Healing from Obsessive-Compulsive Disorder: A Mindfulness-Enhanced CBT Approach to Regaining Control and Restoring Peace of Mind