Television shows like "Monk" have brought humor and attention to the very serious illness Obsessive Compulsive Disorder (OCD). In this disorder people develop rituals to manage their anxiety and obsessive thoughts. Their thoughts and rituals can be very time consuming and upsetting, seriously disrupting their lives and relationships. But there are also millions of people who do not have OCD, but nonetheless struggle with obsessive thoughts. This group does not use rituals to quell anxiety, but instead simply go round and round with their uncomfortable thoughts, getting more and more anxious as they go. In this article I will talk about this subset of people who frequently find themselves obsessing about something and feel unable to get the thought out of their minds. I will first talk about the nature of obsessive thoughts and will then outline some ways to manage them and reduce the anxiety that causes them.
In order to understand obsessive thoughts better, it's important to understand the typical common features of obsessive thinkers. First of all, obsessive thinkers tend to have a high level of anxiety. This might be situational--you have a lot of stress in your life for a week or two and find that your mind gets fixated on certain thoughts during that time period but once your stress level decreases, your thought patterns change as well--or it might be more long-term. In either case (but especially if your anxiety and obsessing is frequent), learning to manage anxiety can help reduce the frequency and intensity of obsessive thoughts.
Because most obsessive thinkers are anxious, most obsessive thoughts share the theme of anxiety or fear. Many obsessive thoughts involve a concern with some potential disaster or hurtful scenario. For example, you might worry constantly about someone breaking into your apartment, your partner leaving you, getting sick, etc. Sometimes the worry is not even specific but is more of a general dread that "something bad will happen". One of the problems with these kinds of worries is that, because bad things DO happen occasionally, it can often feel like the worry was warranted or confirmed. This sense that you were right to worry as much as you did (even if you were worried for 3 years before something sort of bad even happened) serves to perpetuate further worries.
(As a quick aside, to highlight the difference between people who have obsessive thoughts/anxiety and people who have true OCD, those with OCD try to find ways to "undo" the potential danger they imagine in their obsessive thoughts by performing rituals. So, for example, if someone with OCD had the obsessive thought that something bad would happen to them, they may begin try to prevent this imagined bad thing from occurring by tapping their right foot three times. The ritual doesn't ACTUALLY prevent anything bad from happening but it helps to calm the anxiety that is generated by the obsessive thought. )
Often obsessive thoughts are irrational or exaggerated and obsessive thinkers might even be aware of this. This can be really frustrating; if you're aware that your worry is unlikely or doesn't make sense, why does it still feel so upsetting? Why can't you just stop? This frustration is frequently made worse by others telling you, "Don't worry about it" or "Relax!" If you could "just relax", you already would have!
Another common characteristic of obsessive thoughts is that when you try to resist them they often intensify. So someone keeps telling you to relax and so you really try. You try to stop thinking, "What if my girlfriend breaks up with me? What if she cheats on me?" You try to force the thought out of your mind. And what happens? It gets worse! You then begin to think, "But if I don't think about it or pay attention to potential signs, then I won't notice. I will be hurt and I won't see it coming. " It feels too dangerous to stop thinking about it! The paradox here is that trying to stop thinking obsessive thoughts makes them worse, but accepting the thoughts can ease them. I will discuss this idea of acceptance further later in the article.
Okay, so you know you have obsessive thoughts, you (at least sometimes) know they are irrational, and you know you need to do something to help change this pattern. Now what? The first step is to be very determined to work on changing your thought pattern. It's not easy and will take determination and persistence for you to succeed. The second step is recognizing that it doesn't really matter what you're worried about, but more that you're worried. Begin to recognize that the specific content of your worry is secondary to the level of anxiety you feel. Anxiety as a general experience is easier to manage than the content of any particular obsessive thought (this is because if you think about the content and try to convince yourself that it's unwarranted, you will get very frustrated and engage in mental arguments with yourself about why it's important to worry about). The final step in this process is learning to accept your obsessive thoughts instead of resisting them. This is the least logical step and probably the scariest for someone who worries a lot. But think about it this way: instead of getting upset that you're having obsessive thoughts, judging yourself for them and increasing your anxiety about them, learning to say, "Here go my thoughts again" or "It's okay that I had that thought- it's just a thought" might not eliminate the thought right away but diffuses the anxiety associated with it.
There are some specific strategies that can help you move through these steps. The first strategy is postponing. This involves acknowledging that you are someone who tends to worry and that, rather than trying to push away all obsessive thoughts, you're going to allow them but you're going to find a way to feel more in control of them than you have in the past. So you schedule a time to worry. At 4pm today, I will spend 15 minutes worrying about someone breaking into my house. If you find yourself beginning to obsess over this thought before 4pm, you mentally remind yourself that it's not time yet. When 4pm arrives, you can either begin obsessing, or postpone it again. This kind of scheduled worry allows you to accept the obsessive thought and simultaneously feel more control over it.
The second strategy is learning to change the way you obsess. This is a multi-step process that involves recognizing that you're having an obsessive thought, reminding yourself that it's okay to occasionally have this kind of thought, remembering that the specific content of your worry is not important (resist the temptation to analyze it), and finally, developing specific behaviors that help you distract yourself from the thought and emotion associated with your obsession. For example, some distraction techniques include: listening to music, dancing, watching TV, exercising, talking to a friend (about something ELSE!), writing out your worry again and again until you get bored by it, etc. All of these techniques alter the emotions and anxiety level you feel in relation to your obsessive thought. Once you've done this once, the next time the thought comes up it is likely to feel less scary and more controllable.
The third thing that can help you manage obsessive thoughts and the anxiety associated with them is learning to relax your body. Anxiety frequently leads to muscle tension and/or rapid, shallow breathing. These physiological changes consistent with a fight/flight response send the message back to our brains that we're in danger and it's necessary to worry. So if you can relax your body and reduce the physical symptoms of anxiety, this can interrupt the negative feedback to your brain. Some ways to relax your body include: deep breathing, yoga, cardiovascular exercise, massage, stretching, etc.
Finally, when you're trying to manage obsessive thoughts, it is important to try to face the situations that you usually try to avoid. Every time you avoid something out of fear, the fear gets stronger. For example, if you obsess about the idea that touching a doorknob will give you germs and make you sick, and you have avoided touching doorknobs for 3 months and never gotten sick during that time, your belief that touching doorknobs will make you sick has likely increased. Disconfirming your worry requires that you prepare yourself to face the dreaded experience. Preparation for this kind of task involves reminding yourself of how committed you are to overcoming obsessive thinking and worry, remembering that you have found some ways to feel more in control of your thoughts, and knowing that you have some ways to relax your body when you start to feel anxious. Approaching the feared situation armed with this knowledge can help you to confront your obsessive thought head-on and, over time, reduce its power.