Most times, a Harm OCD attack is not a simple attack. Harm OCD attacks in various layers, at various levels. When you first learn to use the principles of ERP to deal with your Harm OCD, you expect that if you stand up to Jay and decide not to do what he asks you to do, he will meekly shut up. But that is a mistake. Jay does not shut up. He gets more aggressive in the beginning. If Jay wants you to believe you are responsible for the harm happening in the world, he will do whatever it takes to make sure that you keep believing that.
So, when you first refuse to listen to Jay, he gets angrier and ramps up the assault. The assault may not just be with regard to the first thought. While you are managing the assault of the first intrusive thought, another thought might pop up out of nowhere and add more complexity. It is like being at war and being attacked from all sides. The enemy is not only capable of sending in more troops but also does not stop at basic weapons. The more you disarm, the more it seems to send. Look at the figure 4.9 that illustrates how thoughts may impact you from various directions.
Figure 4.9: Layers of Harm OCD
As you can see, not only can a thought lead to many layers, which can lead to further layers, but also, a thought can lead to a totally different thought, which can again lead to multiple layers. In the futile endeavor to attain certainty, you try to solve all these questions, in vain. But your Harm OCD is capable of asking more questions than you can answer. The race to find answers to all the questions your Harm OCD can pose keeps you stuck in the loop.
Think of Jay like a toxic boss in a new job. He asks you to do his personal chores like getting him coffee, doing his paperwork, and so on. You know you should be standing up for yourself and setting boundaries but you don’t dare to. Until one day when you pluck up the courage to stand up to him. He asks you to get coffee for him and even though you are afraid, you refuse to do so. If your toxic boss is used to mute compliance from you, will he take a refusal well? Will he just say ‘Okay, don’t bother, I will get it myself?’ No. He is likely to get angry and scream at you.
So, he says ‘How dare you say no to me? I am your boss and you have to follow my orders’. It scares you more and you comply. He wins. But suppose you decide to stand up to that threat as well and still refuse to get him coffee. He may ramp up the threats and may say something like, ‘I will make sure you lose your job’. That is even scarier than what he said earlier and you give in to the fear. He wins. But if you refuse again, he says, ‘I will also make sure you never get hired in the industry again’. Again, it scares you, and if you comply, he wins. But, if at this point you still refuse, you notice that he begins to cool down. So, you were trembling with fear but you still haven’t needed to get him coffee and you have survived the episode and won the battle.
But your troubles aren’t over yet. The next day again the same thing happens. He asks you to get him coffee. You are scared again. And you notice that other people in office are also giving you the cold shoulder. Or are being outright nasty. If you give in at any stage on that day, he wins and the equation remains as before. But if you survive the onslaught of his threats and insults, another day passes by, another battle is won. Then another and then another. Until one day, your boss realizes that you are not going to get him coffee and he stops asking. It is then that you win the war.
Another analogy is the ‘anger management’ analogy. Assume that you are in an anger management class, I am the coach and it is my responsibility to assess you whether you pass or fail. To test you, all I have to do is to hurl insults at you and have you tolerate them, without getting angry. So, I start off with the most innocent insult I can think of, and you clear that without getting angry. So, I raise the level. I call you another name that is a little more insulting than the first one. You were not expecting it but you still take it on the chin. Good.
But I’m not done yet. I hurl another large, juicy insult at you. This gets you agitated but you remember it is a test and that if you tolerate my insults you will pass. So, you grin and bear it even though you do not appreciate it. But then I wallop you with a really vicious insult. By now you’ve had it. You get angry and you snap back. I shake my head and declare you as having failed the test. You continue to be in the class. Instead, if you had held on just a little more and tolerated the fourth and the fifth insult, you could have passed the class.
Your Harm OCD is like that. Say, you get the urge to claw your mother’s face with your nails and you don’t like that. The possible compulsions are to stay away from your mother. But you choose not to do the compulsions because you know Jay is asking you to do them. So you get anxious but tell Jay, ‘I don’t care if I am getting the urge to claw my mother’s face, I will still visit her’. Jay gets upset and more aggressive and says, ‘Oh, but wouldn’t that hurt your mother?’, and you begin to wonder if the thought is real. If you decide to stay away and do the compulsion, Jay wins. If you don’t, and despite the rising anxiety you say, ‘Yeah, maybe, but I don’t care. I am still visiting her’.
Jay begins to fear losing control and gets more aggressive. The next thought is, ‘Oh that means you do not care about your mother and that makes you evil’. You are far more anxious than ever before but again, you respond by saying, ‘Yes, I don’t care about my mother and I am evil’. Then Jay does not have anything to say and begins to withdraw, and your anxiety begins to come down. Battle won. Similarly, the next few times it happens, if you choose to stand up for yourself despite how anxious Jay’s assault makes you feel, eventually Jay will stop bothering you about evilness, and you would have won the war. So, if you want to recover, the only way out is to fend off every attack from Harm OCD with acceptance even if it feels difficult.
These are the layers of Harm OCD’s attack. For every layer you learn to manage, your Harm OCD throws up another and attempts to make you give in. If you can survive these layers by standing up to your Harm OCD and not doing any compulsions, no matter how anxiety inducing and difficult it is, eventually you will learn to manage your trigger.