Most people who have OCD, and are yet to understand the premise of recovery want their intrusive thoughts to stop. If you read social media posts of people struggling with OCD, many of them talk about needing the 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 if correctly followed their impact on you will lessen considerably, so that even in their presence, you do not feel too anxious.
For you to consider yourself recovering, you will need to have a friendlier relationship with your anxiety. You will need to understand that some amount of anxiety may forever be your companion. Instead of expecting to be at level zero anxiety, you may need to make peace with the possibility that you may have a low grade (level two or level three) anxiety all the time. That may be your new normal.
Intrusive thoughts are a result of the associations that our brains create. The word car may conjure up a different image for me than it might for a small child. That is because my association with the word car is with my black car, whereas a child’s association with the word car may be with his favorite toy car. Or the words ‘Bread and…’ may make someone think of butter, someone of cheese, or someone of jam.
Triggers in OCD are based on the associations created in the mind. So, the association with a romantic movie may bring the thought of being unhappy in the relationship. Hence, a romantic movie that gives rise to the intrusive thought today will definitely give rise to the intrusive thought even after recovery. However, the difference is that today it may be bothersome or even debilitating, whereas tomorrow it may not be. It may become just another thought that you do not attend to.
How does this happen? 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 a 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.
Think of it like this. If you read a funny 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, if you watch a horror movie once, you may feel scared. 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, including ROCD. Even in ROCD, you may get the thoughts that you do not love your partner enough or that your partner is not right for you even after recovery. But since you would have learnt to handle them better, they would not bother you much. Or at all. Between your partner and yourself, get an understanding of these aspects and realign your expectations from recovery, if they have been different so far.
In the next chapter, we shall look at the factors affecting recovery.