S2C2. Defining Recovery: What Success Looks like in OCD Treatment

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Most sufferers fail to understand the premise of recovery in the beginning. They want their intrusive thoughts to stop. According to them, recovery would mean no more intrusive thoughts. That is not how recovery works, though. Intrusive thoughts will not stop. I’ll say this again. Intrusive thoughts will not stop. But, if the recovery process is correctly followed, their impact will lessen significantly. Later, even in their presence, you do not feel too anxious.

For recovering, you need to have a friendlier relationship with your anxiety. Understand and accept that some amount of anxiety may forever be your companion. Instead of expecting to be at level zero anxiety, make peace with the possibility that a low-grade (level two or level three) anxiety may be your new normal. So, the thought of sexual acts with your parent/sibling/child may cause high anxiety today, but with practice, even when you get the thought, it may not cause any anxiety, or a low-grade anxiety, which you may be able to dismiss or tolerate. That is considered to be recovery. Don’t worry about the why or how right now. Just remember that getting these thoughts and not feeling anxious or guilty can be achieved and is the objective of recovery. We will discuss the why and how as we go along. The what, however, needs to be clear in your mind.

But how does the anxiety go down for the same intrusive thought that causes so much agony today? This happens through the processes of habituation and extinction. Habituation is the process of fear reduction that is the result of new learning (Benito et al., 2018). When instead of avoiding a trigger, you face it repeatedly, the fear associated with it reduces. This is called extinction (Geller et al., 2019). You get habituated to the situation first through repetition, and then the fear goes extinct.

Like, if you read a joke once, it may make you laugh. If you read the same joke again, you may smile, but it won’t be as funny as the first time. If you read the same joke five times, it will become boring and unfunny. Because you are habituated to it, and repetition has caused desensitization to the humor quotient, rendering it extinct.

Similarly, a horror movie may scare you on the first watch. If you watch it again, you will feel a little less scared. If you watch the same horror movie five times, you will begin to get bored. It will not scare you anymore. That stage where an impulse repeated many times stops causing the same feeling as it did the first time is habituation to the situation and extinction of the emotion it evokes. So, if you face your fear repeatedly, it will stop bothering you, because you may begin to get habituated to it or bored of it, and your fear may become extinct. 

This works for all types of OCD. Between your family and yourself, get an understanding of these aspects so that your expectations are in alignment with the possibilities. Please note that this does not mean that your love for your family is sexual and that you are indeed a pervert. In fact, it means that you love your family dearly and do not want any harm to come to them. You will be a happier person, knowing that your family loves you and that you do not have to avoid them to protect them.

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