“OCD loves to play this game with us but only if we play by its rules.” CBT is often used at the beginning of therapy to establish the rules that we are going to use in our work with OCD – it is necessary that the rules are fair, realistic, and helpful in leveling the playing field. The cognitive (thought-based) component of treatment often focuses on identifying problematic thoughts and beliefs that create an unfair playing field such thoughts and beliefs include:
· All thoughts are important.
· All thoughts mean something about me.
· If I have a bad thought that must mean that I’m a bad person.
· Things are either clean or dirty.
Therapy begins by exploring the ways that our thoughts and beliefs cause us pain and allow our OCD to run our lives. Humans are predisposed to believing that our thoughts are important and worthy of being taken seriously. After all, thinking and the thinking brain are a huge part of what makes us unique on this planet. The problem is that what happens when I have a thought that doesn’t align with my values or is horrific or disgusting in nature. It is important to begin therapy by trying to adopt the new belief that “thoughts are just thoughts” – not all thoughts or beliefs are helpful, truthful, or valid. Once we begin to see thoughts for what they are we level the playing field and begin to turn the tide in our work with OCD.
This new belief is not easy to adopt however as most of us have been taught that we do indeed have control over our thoughts and that our thoughts are meaningful. And while this is certainly true of some thoughts it definitely isn’t true of all thoughts. Two of my favorite thought experiments that shine a light on how little control we actually have over our thinking brains go like this:
1. For the next 10 seconds try to not think of a polar bear, ready, go…
2. Empty your mind of all thoughts and think nothing as I say “Peanut butter and…”
Did you think of a polar bear? Of course, we all did. Did you think the word “Jelly”? Of course, we all did, unless you thought “Bananas” or “Oatmeal” or “Bacon.” But still, the point is the same, you thought something, we all thought something and we didn’t have much if any control over what we thought - we just thought it - thoughts are just thoughts.
Accepting that our thoughts are just thoughts begins to give us the level playing field that we need for our ERP work to be successful.
