Understanding Mental Compulsions
What might not stand out as obvious as physical compulsions such as hand washing or checking; mental compulsions may go unseen and pose their own risk. At times, mental compulsions can be confused with just average thinking. As the mental compulsions continue to cycle, the OCD continues to feed. Mental compulsions can be easily misidentified, even by your therapist! Mental compulsions can come in many different shapes and sizes. I’d like to talk about some of the common ones below.
Rumination: Rumination is common mental compulsions that is so easily engaged with and in a very sneaky way. Rumination can be viewed as over thinking or dwelling over the causes or consequences of certain things. When I am ruminating, I might easily go to the worst case scenario or thoughts that are heavily negative. Thoughts about the past, present or future. Thoughts that might repeat all throughout the day and can go on uncontrollably. Rumination can be disguised as problem solving. Convincing myself that I am overthinking and dwelling over this topic because I feel that I “need to”. But where rumination becomes an issue is when that balance of thinking about an idea on an average sense tips the scale to the side of an obsession and keeping me in the rumination. Look to distinguish between average thoughts/problem solving and rumination. Rumination we see the urgency, the pressure. A sense that I need to figure this out now and everything else falls by the waist side. Rumination might look like a search for certainty. As with many aspects of OCD, the search for certainty, 100% certainty, becomes the very idea that keeps us stuck in the OCD cycle. The 100% certainty does not exist, almost being an illusion, an unattainable metric. But OCD is more than happy to keep you searching for that 100% certainty, keeping you engaging in compulsions while OCD keeps feeding. Rumination will keep us in the anxiety long term and not offer the solution we are looking for. Rumination is extremely common and one of the driving forces that keeps us in the OCD cycle.
Mental Review: Mental review, a mental compulsion of replaying situations, conversations, memories, experiences repeatedly. Again we see a feeling of needing to be 100% certain arise when we are mentally reviewing something. Thoughts such as “Did I say something offensive to my co worker”, I can mentally review that conversation over and over again in my head. Looking for that feeling of certainty that that I didn’t say something offensive. Often I might look to mentally review to ensure that I didn’t engage in my fears. To disprove the doubt and get that certainty. But like we saw with rumination, that 100% certainty becomes an unattainable metric and in my efforts to get it, this compulsion is feeding the OCD beast.
Distractions: Distractions, another form of avoidance. A distraction might be very automatic. Hop on my phone, check social media, play a game. All in an attempt to distract away from what I am thinking and feeling. Try to look at the motivation for my distraction. If I see that my motivation to distract is so that I can avoid feeling these distressful emotions or intrusive thought, I can attribute this to being a compulsive behavior. In therapy, I will look to help you learn how to change the relationship you have with your thoughts and emotions. That you can learn how to manage the emotions and thoughts without it leading into a compulsive behavior like a distraction. Therapy allows you to notice and observe these thoughts and emotions without engaging with them.
Self Re-assurance: Self-reassurance, as opposed to reassurance when I am trying to get certainty from other people; self-reassurance is a tricky mental compulsion that can try to mask itself as a positive behavior. I will give you the example, I have the thought that I said something racist to my co-worker. I try to self reassure myself that I would never say something racist and that I am not a racist. But OCD creeps in and says “what if you did this time?”. And it throws a doubt at me, a doubt that attacks my values and leads me to engaging in a compulsion so it can feed on that. Self-reassurance becomes a compulsion when it steers towards finding that 100% certainty and perfection. The self-reassurance might look like a thought you might use repeatedly that gives you that short term relief. Short term relief but long term distress. Self-reassurance can be done in a non compulsion sense and may work for some people but with OCD we walk a fine line and when we fall off that line, we fall into compulsions.
Thought Replacement: Similar to self-reassurance, with thought replacement we are trying to replace that negative thought with a positive one. I might try to replace that intrusive, unwanted thought or image with something that is more pleasant and not as scary. Its like trying my hardest, gritting my teeth to think about how relaxing the beach, and how soft the sand is with my sole motivation with just trying to push away the negative, intrusive thought that I might have said something offensive to my co-worker. I might not care about that imagery of the beach, but I’d rather think of that then have these scary intrusive thoughts. I look at my behavior, why am I engaging in this thought replacement. I might see that I am avoiding trying to sit with something uncomfortable. That I am avoiding those intrusive thoughts or feelings. But when I tell my brain and OCD that I want to avoid something, OCD makes it that much harder to avoid it and pushes it to the forefront of my mind. My avoidance strengthens the OCD and keeps me stuck.
In reviewing our mental compulsions, we see how tricky they can be and how easy I can do them. I can be engaging in a mental compulsions on my drive to work, at the doctors, at church or out to dinner with my partner. In therapy, I can help you to learn and see that the obsessions and thoughts are not dangerous. That the illusion OCD presents it to be is simply just that, an illusion. Something that cannot hurt you. In therapy, you can learn to change the relationship with your thoughts and emotions and learn how to respond in a way that does not fuel your OCD. My goal is to help you learn more about these compulsions. That once you learn more about your OCD, I can show you the techniques to manage it better. Knowledge is going to be power and once you understand all facets of your OCD, you are able to take back control of your life.
