O.C.D. is the acronym for Opt-out, Consider, Decide. This is a self-applied technique for helping you face your obsessions and to further assist you in resisting giving into compulsions during your exposures; or in any situation where you might find yourself being triggered.

How does this work?

Well first, when you’re faced with an obsession OPT-OUT provides you with an opportunity to step back and CONSIDER two options. These two options are to help you DECIDE clearly whether to (1) step back in to the irrational moment whereby you give into the compulsion or (2) whether to stay out and resist doing this negative reinforcing behaviour.

What type of compulsions does O.C.D. help with?

All compulsions whether open, such as handwashing; or hidden ones which might be praying or mental reviewing.

Why is it important to resist giving into compulsions?

It’s important because OCD sends us incorrect messages that “something is wrong” or “doesn’t feel right”. This overwhelms us with exaggerated gut feelings of fear and dread. When we give into compulsions we find relief from this type of distress. Yet, this is temporary relief, hence the term negative reinforcing behaviours.

So what is the best way to resist the compulsions?

Well, when you OPT-OUT you get the chance to stand back and observe your unwanted intrusive thoughts objectively. You are then provided with a vital moment of awareness in which to use your critical thinking skills. During this crucial moment your choice is to CONSIDER whether going back in will be worthwhile. You will have a brief moment to gauge whether what you are experiencing is based on fears and beliefs lacking in reason or logic, or a legitimate and true concern. If your instinct is with the first one, then you can decide to stay out and ask no questions thereafter. Do bear in mind that when you make the decision to stay out you will also be agreeing to ride out associated anxiety until it begins to subside, and it will, usually around 30 to 60 minutes.

But how can I tell the difference; I mean what if it’s a legitimate concern?

Most likely you’ll automatically figure out that you are dealing with a legitimate issue because you won’t feel threatened, yet more concerned about problem-solve rationally.

So if the problem is obsessional this means the  O.C.D.  strategy offers the chance to act quickly, and before anxiety wins the moment, is that right?

Yes, you get the chance to stay out and follow through with your EXPOSURE where RESPONSE PREVENTION is the aim. With practice response prevention helps you build distress tolerance, leading ultimately to habituation. Thus, the overall outcome during graduated exposures with ritual prevention can, and does, lead to recovery?

What about doubts and “what-ifs?” creeping in, what then?

When facing your obsessions and you endure the dreaded “what-ifs” one helpful thing to do is change your self-dialogue. Doing this helps you live with uncertainty, since certainty can’t ever be guaranteed. Altering your dialogue contributes to starving your obsessions. For example, your new response might be: “Maybe (name fear) will happen; maybe it won’t”… “Maybe I did cheat on my partner; maybe I didn’t”… “I might have caused an accident; I might not have either” … “Perhaps I left the stove on; on the other hand perhaps not”, and so on. With practice this does get better.

What about magical thinking, this makes me feel like something bad could happen?

I guess reminding yourself that magical thinking gives you a sensation that makes you believe something could/has/will happen, but that a sensation isn’t factual, is helpful. Basically, thoughts cannot make things happen. They do not convert to action. This tells you that there is actually no need to give into compulsions to prevent perceived danger or to “feel right”.

But what if you’re wrong?

In this instance, I’d say your experiences would likely be showing you otherwise.

Finally, what can a person do if they step back in and gives in to the compulsion?

It’s simple. Try again next time. There are no failures when a person faces their obsessions, just doing that alone is an achievement, so I would say to anyone to keep practising exposures with response prevention and you will get there eventually.

Photo credit: cbtbaltimore

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