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Increasing Discomfort

Camille, who was diagnosed with obsessive-compulsive disorder (OCD), had become consumed with worries after her father informed her that he was buying a gun. She thought continually about the possibility of finding the gun and accidentally harming her parents with it. To avoid and neutralize these fears, she compulsively analyzed ways to avoid the danger--she imagined never coming into their house, or searching for the gun and then avoiding the hiding place, or asking her father to get rid of it.

Together, we established that her worry about accidentally shooting her own parents wasn't a reality-based signal or genuine alarm, but a false threat created by her OCD. Thus, her constant analysis of how she should avoid this danger was a chimera built on a falsehood. She experimented with this new frame of reference. She decided to treat her fears about the gun neither as a realistic response to a genuine danger nor as awful symptoms to suppress, but as tiresome noise--those fears were just there, like a mosquito droning in her ear.

The question then became: How best to respond to this pointless background noise? The answer: Camille would purposely try to accept it, even ratchet it up, rather than fight it--feel it, go through it, make it as bad as possible rather than evade it. Once she allowed herself to get into her distress as much as possible, she'd simply tell herself to drop it. In effect, she now had a readymade protocol: "I want to feel uncertain and uncomfortable and worried about the gun. I want to have these fears. That's how I'll get better. So I'm going to fully acknowledge that the worry is here, and then drop the topic as soon as it starts." When the worry popped up, she noticed it, accepted it, and then said quietly to herself, "Drop it!" No thinking, no analysis; she'd just follow the edict. When the topic arises, acknowledge it and then, "Drop it!"

Was this easy for Camille to do? Not at all. Analyzing the problem was her compulsion; it made her feel safe. When she dropped the analysis, she was faced with the dreadful question, "Will I harm my parents?" and had no answer. So she had to hang out with her fear and worry, which put her in considerable doubt and distress. But she was bolstered by her belief in this therapy, by my confident support, and by the success of previous experiments of this kind in the past. Then this experiment worked well, too. She learned that if she let herself feel the worry, while telling herself to drop the compulsive analyzing (which is a kind of tranquilizer), the worry itself gradually faded away--but only if she stayed with her doubt and discomfort. Finally, the entire issue disappeared from her radar screen.

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