Two factors majorly impact recovery in Harm OCD – the severity of Harm OCD, and the efforts made by you.
Severity: The first factor is the severity of the disorder. The Y-BOCS test that determines the presence and severity of OCD, provides five levels of severity – mild, moderate, severe, very severe, and extreme. A person who has mild Harm OCD has a better chance of faster recovery than a person who has severe Harm OCD. The biological influence in a person with severe Harm OCD is higher than in one with mild Harm OCD. So, other things being equal, the lesser the severity, the faster the recovery process can work.
Many people assume that the duration for which they have had Harm OCD will also determine whether they will recover or not. That is however not true. Regardless of the duration for which one has had Harm OCD, recovery is possible. It may take longer possibly, if you have had Harm OCD for a long time, because of the psychological inflexibility that may have set in. In the Worksheets for Harm OCD file, the Y-BOCS Test (Goodman et al., 1989a, b) has been provided as PT2. Discuss each question with your partner, understand it well, and complete the assessment to know what your level of Harm OCD is. This is the number that we need to work to bring down.
Efforts: The second and equally important factor on which recovery depends is the effort put in by the person. Recovery in Harm OCD needs a lot of work. Sometimes the process gets derailed here. Some people may want to put in conditional effort. They may say ‘I am willing to work on my Harm OCD but it should not affect my sleep’. Or ‘I am willing to work on my Harm OCD but it should not affect my work’. Or ‘I am willing to work on my Harm OCD but it should not affect my studies’.
Recovery does not work that way. If you fall in a pit (something we shall speak about more in the chapter on acceptance), you would not say ‘I am willing to work on getting out so long as it does not spoil my clothes.’ You would not bother about your clothes or shoes or hair. You would prioritize getting out of the pit over everything else. Similarly, your effort in recovery from Harm OCD should not be conditional effort.
Some people say ‘We shouldn’t have to work on our Harm OCD. What are the doctors doing? What are we paying them for?’ Well, you are paying them for telling you how to put in the recovery effort. Just as merely paying a gym instructor will not automatically get you ripped, paying doctors and therapists does not guarantee automatic recovery. You need to put in the effort of working out in the gym to get ripped and practice ERP to get your Harm OCD under control.
Some people may pretend to work on their Harm OCD but may not practice ERP well, or at all. ERP is not easy. But if one wants to recover, one needs to continue to work on oneself regardless of how difficult and painful the process is.
These, therefore, are the two factors that affect recovery in Harm OCD. Care must be taken by the sufferer and his family to make sure that these issues are borne in mind and addressed adequately.
To-Do: Complete PT2 – Y-BOCS test provided in the ‘Worksheets for Harm OCD’