OCD Fear of Losing Control Over One's Behavior.

Within certain sub types of Obsessive Compulsive Disorder (OCD) fears can be present of losing control over ones behavior. This fear may look like doing a behavior that causes emotional, verbal, mental or physical harm to myself or to others. A person with this sub type might feel hyper-aware of their responsibility to other people and events that happen. There might exist beliefs that the person has to maintain perfect control of their actions, where they feel they cannot make mistakes. A person might feel pressure to avoid a negative consequence from happening. Fears might include something happening to a person that causes them to have a mental breakdown or episode that then causes a great deal of distress.

Common obsessions experienced with a fear of losing control:

• Thoughts that I might accidentally or purposefully harm someone/myself by losing control of ones actions.

• Fears of saying something inappropriate, sexist, or racist.

• Fear of embarrassing oneself.

• Having intrusive images.

• Fears about acting against ones values.

Common Triggers

• Driving

• Using something dangerous like a knife, fork, scissor.

• Being in a situation that holds certain social norms- funeral, wedding, work meeting, interview.

• Intrusive thoughts about losing time, forgetting, or “going crazy”

In OCD, a person might experience intrusive thoughts, images, feelings, or urges that cause distress. As a result of these obsessions, that person may engage in compulsions to try to neutralize, escape, or avoid these fears. Compulsions can be mental or physical rituals.

Common Compulsions

• Avoidance behaviors-topics/items.

• Seeing reassurance.

• Self reassurance.

• Researching.

• Just right behaviors.

• Checking behaviors.

• Confessing.

• Rumination.

Example:

Meredith is 20 years old and recently has been diagnosed with OCD. Meredith is working her first job in an office and feels a lot of pressure to do well. Meredith wants to succeed and is very aware of how she acts as she is one of the youngest employees there. Meredith worries often that she will walk into a staff meeting and say something racist to her boss. Meredith spends time ruminating over this thought, even when she is not at work. Meredith is fearful that something offensive will just come out of her mouth without her control. Meredith avoids meetings when possible or comes in late. Meredith tries to give herself self reassurance that she is not a racist and that she would never do something like that, but she can’t seem to shake this thought. With the obsessive, repetitive and distressful nature of these thoughts and compulsions, Meredith appears to show symptoms of a fear of losing control over her behavior.

Treatment for OCD Fears of Losing Control:

Treatment for this type of OCD, like all forms of OCD is the gold standard of treatment, 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 the impacts of OCD and benefits of counseling/ERP.