Obsessive Compulsive Disorder: Avoidance Compulsion.
What is Avoidance As A Compulsion?
In Obsessive Compulsive Disorder (OCD), avoidance is seen as a compulsive behavior. The goal of avoidance is to not be triggered by whatever one is fearful of. Avoidance can manifest itself it many different ways. A person might physically avoid situations or triggers that set off their obsessions or fears. This could include avoiding walking near playgrounds, avoiding knives or avoiding certain people. Within the OCD cycle, engaging in a compulsion leads to reinforcement of the OCD, making it stronger.
Avoidance behaviors are going to fuel the OCD cycle and keep that person stuck. A person engages in a compulsion in order to get short term relief from their distress and obsessions. Avoidance is a slippery slope. A person might avoid something small and after weeks and months of avoidance, it might grow in size to heavy avoidance. A person might find it difficult to even leave their house if the avoidance becomes too large. This has the potential to cause a significant impact on ones functioning.
Breaking the Avoidance Cycle.
Limiting Avoidant Behaviors: One of the first things we can do in OCD treatment is to learn how to resist and limit these avoidant behaviors. One may start to gradually expose themselves to situations they once avoided. We might be able to understand the core fears underneath the avoidance behaviors. A person may waste their time and not be acting in accordance with their values by never leaving their house and avoiding often. A part of treatment will aim at helping you learn to accept uncertainty and how to let go and resist the urge to avoid. Limiting compulsions will help starve and weaken the OCD.
In Exposure and Response Prevention treatment (ERP), the person with OCD can learn better how to manage their distress without needing compulsions. The short term distress they will feel without the avoidance will be just that, short term distress. Distress that will eventually pass and lead to longer term relief.
Avoidance Compulsion Example:
Carl is a 45 year old, married male and has been diagnosed with OCD for two years. Carl’s obsessions revolve around contamination and fears of catching a disease. Carl is fearful of spreading diseases to other people and is concerned that he will get someone sick. One of Carl’s handful of compulsions is avoidance behaviors. Carl is very avoidant of public places. He will avoid public bathrooms, large crowds, public transportation, medical shows, news reports and doctors offices. This compulsion has been very damaging for Carl as he struggles to leave his house and has begun to avoid certain areas of his home. Avoidance is a compulsion for Carl that is severely impacting his functioning.
Treatment for OCD:
Like all forms of OCD, the gold standard of treatment is exposure and response prevention (ERP). Exposure and Response Prevention (ERP) looks at the idea that triggering situations and thoughts are at the core of OCD. Ongoing exposure to these triggers without engagement in rituals can reduce the severity felt. As a licensed mental health therapist trained in ERP, I will assist you through the exposures and how to implement effective response prevention measures. If you feel that OCD has had a negative impact on your life, you might consider counseling and ERP to learn how to handle it more effectively. Please feel free to reach out for a free consultation, where we can discuss impacts of OCD and benefits of counseling/ERP.
