Sometimes in the midst of our exposures, we end up doing some sneaky compulsions without realizing that we have done the compulsions. Again, it is impossible to provide all scenarios given the complexity of the disorder, but I shall provide two examples to offer some clarity.
Example One: You are watching a romantic movie with your partner as an exposure and trying to trigger yourself. You feel triggered during intimate scenes and you get the urge to compare if you feel the same level of attraction for your partner or for that hot colleague in office. You know you are not supposed to compare, because comparison is your compulsion. So, you respond to the thought by saying, ‘I don’t care if I am more attracted to my colleague in office, I will continue to be in this relationship with my partner.’
So far, so good. But, while you do not compare your attraction, you may end up providing reassurance to yourself by saying ‘I am very happy with my partner, and the colleague in office is not all that hot’. You did not compare, (which is healthy), but you ended up offering yourself reassurance, (which is unhealthy). Your exposure was not effective because you did not resist doing all your compulsions. You merely replaced one compulsion for another.
Example Two: You are at a party with your partner and your partner seems to be enjoying a little too much with someone she finds hot. It triggers you to see her enjoying with someone else more and you feel the urge to lash out at your partner in front of the other man, demanding that your partner needs to spend more time with you than with him. But you know that would be a compulsion and you decide that despite the difficulty, you will not do it. So, with tremendous control, you paste a smile on your face and brave the evening with other people.
But, while you are not lashing out, you distract yourself by saying ‘I don’t want to think about it because it makes me anxious.’ Sure, in this case you did not lash out at your partner, but you substituted that compulsion with another compulsion such as distraction thereby negating the effect of your exposure.
Whether it is self-reassurance in the first example or distraction in the second, your ROCD would have succeeded in making you do some compulsion. Through some way or the other you are staying engaged with the obsession and hence the exposure is ineffective. If you start to mindfully recognize the other compulsions that you may end up doing inadvertently, you can learn to deal with them when they strike. Agreed, that you may fail in the beginning and end up giving in. But it is fine to give in and start again, rather than to give up altogether.
In the next chapter, we shall explore the concepts of reassurance, deassurance and coping.