One of the sneakiest features of OCD is the backdoor spike. When you get into therapy, you learn to handle these doubts. You also understand that your doubts are not rational. The fact that they cause anxiety is an indication that these thoughts are irrational. With sufficient exposures and response prevention, you soon reach a point where harm thoughts affect you very little or not at all.

However, your OCD may not want to let go. It may want to latch on to you for some more time. So, when the core obsession of wanting to hurt someone stops causing anxiety, your OCD may add another layer on top and cause fresh anxiety. Your new obsession may be ‘Since the thought of punching my girlfriend in the face is not causing me anxiety, it must mean I have secretly always wanted to hurt her. What if it has never been Harm OCD?’ Thus, the thought about not being anxious about a harm intrusive thought anymore begins to cause anxiety. This anxiety has been called the backdoor spike, and is a part of Meta OCD. The backdoor spike is your OCD’s desperate last-ditch attempt to keep you hooked.

Just as you got over your original obsession by accepting the uncertainty and facing your fear head on, you also need to accept the uncertainty of the backdoor spike and face the fear head on. Just as you said ‘Jay is telling me that I want to hurt my girlfriend.  I’m going to accept this uncertainty and live with the doubt even if things go wrong eventually’ you now need to say ‘Jay is telling me I may never have had Harm OCD.  I’m going to accept this uncertainty and live with the doubt even if things go wrong eventually.’

Acceptance of uncertainty, regardless of the nature of the doubt is the only way out. Recognize the layers and stay one step ahead. Particularly for the backdoor spike, do realize that no anxiety is in fact proof of recovery from OCD.

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