The OCD Center of Los Angeles discusses resistance and certainty-seeking in OCD and related anxiety based conditions. Part one of a two-part series.
When treating clients with Obsessive-Compulsive Disorder (OCD) and other anxiety based conditions, two of the most important topics we discuss are “resistance” and “certainty-seeking”. People suffering with these conditions often have unpleasant and unwanted thoughts, feelings, and bodily sensations, and resistance to these experiences is a normal, natural reaction. Simply put, when faced with something uncomfortable or painful, we humans instinctively resist it, and quickly look for ways to reduce our discomfort through avoidance. But unfortunately, while resistance may internally feel like the correct response to our uncomfortable thoughts, feelings and sensations, it actually serves to inflame them.
For most people, it seems counterintuitive to reduce resistance and allow uncertainty to remain in the face of these uncomfortable internal experiences. Many are likely to think something along the lines of “I must find a way to keep this thought, feeling, or bodily sensation from happening again”. But this philosophy of resistance in regards to our unwanted internal experiences will actually cause them to become more powerful. As illogical as it may seem, oftentimes the best solution is to lower our resistance, surrender, and accept what is being offered.
If you encountered a mountain lion while on a hike, what would you do? Your natural, instinctual inclination would be to respond to the message that your body is sending you. Your sympathetic nervous system would respond and your body would begin to release hormones including adrenaline, to prepare you to perform optimally if you need to fight or flee. You would experience physiological reactions such as shortness of breath, rapid heart rate and trembling associated with these changes. Every cell in your body would be screaming for you to turn and run to safety.
But responding to these physiological messages could actually get you killed. The Mountain Lion Foundation of California explains that you should make direct eye contact with the animal, stand up as tall as you can, wave your arms, speak slowly and firmly, and throw rocks or branches at it. Under no circumstances should you turn your back to it and run or crouch down. If you become panicked and respond with fear, it will trigger the animal’s natural instinct to chase you. You will become prey and the mountain lion the predator.
In order to make the decision to respond in a different and more effective way than your body is telling you to, you must use meta-cognition. The simplest definition of meta-cognition is “thinking about thinking.” We have thoughts, and we have thoughts about our thoughts. Meta-cognition is the process that is at work when we are using Mindfulness Based Cognitive Behavioral Therapy. It allows you to notice the space that exists between receiving information (“OMG, there is a mountain lion!”) and responding to that information (“Do I want to listen my body and run, or should I stand my ground and throw my water bottle at this wild, vicious creature?”). You can then make the decision to maintain your composure and do the illogical action, because you understand that it will save your life.
When dealing with the unwanted thoughts, feelings and sensations experienced in OCD and related anxiety conditions, resistance to your situation is not the answer. Mindful acceptance is almost always a better way to respond to these uncomfortable internal experiences. There are many other examples that I use with clients that reiterate this theme. Imagine you are driving in a car and the traffic suddenly stops in front of you. You glance in your rear-view mirror and realize that the person behind you is not paying attention and is about to slam into you. In this situation, it is wise to allow your body to roll with the impact and avoid tensing your muscles to brace for it. It has been said that the reason that drunk drivers are the ones who survive car accidents is that they are more relaxed and do not anticipate the collision.
This is also what the expression, “roll with the punches” means – accepting the punch that is being presented to you as a means of diffusing it. The phrase was derived from the boxing technique where one would lean back or to the side when being hit by an opponent in order to better absorb the punch and avoid receiving the full force of the blow.
If you were in a body of water and didn’t know how to swim, to avoid drowning your natural tendency would be to wave your arms, yell for help, and perhaps splash around in the water. But it is actually the depletion of oxygen and energy that cause people to drown, and these intuitive activities would get you there sooner. A better idea is to fill your lungs with air and to lay face down in the water so that you can create buoyancy. The best way to survive is to completely surrender to the situation rather than resisting and struggling.
All of these analogies illustrate how resistance may seem like the correct response, but ends up making the situation worse. If you choose to simply allow your thoughts, feelings and bodily sensations to run their natural course, they will rise and fall on their own. When it comes to OCD and anxiety, you can draw upon the imagery of these analogies to encourage yourself to be courageous in making a counterintuitive decision. Feel free to comment below with your own analogies for resistance, as it would be great to hear more examples that have helped people.
I understand that you may be in doubt about whether your thoughts, feelings, and bodily sensations are real or OCD. You may be saying, “If I only knew for certain that they were just thoughts, then I would be willing to stop resisting.” Part two of this series will discuss “certainty-seeking”, which is the other main strategy that is crucial to discontinue when learning to better manage OCD and anxiety.
•The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions. In addition to individual therapy, the center offers six weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment. To contact the OCD Center of Los Angeles, click here.
Thank you for posting this helpful read. My challenge is the “Mindful Awareness” thing. It’s difficult to be in the moment when my mind is constantly reminding me that I’m unsafe and need to be fearful (of who knows what). It’s easy to give into the OCD and quite the fight to refocus my attention. The way I’ve been dealing with it is by riding it out (not resisting). It’s a rollercoaster– right when you think it’s over, another thought comes, and then all over again. And that is my daily routine. I am not and would rather not seek medication as I am adamant on treating myself by using the methods described above as well as some other ones. I’ve been reading so many books and articles on how these “brain exercises” really work. If it’s scientifically / medically proven, then why would I be the only person in the world that it didn’t work for? It’s gotta work (and I– you, we– need to be faithful in that!) To all those out there with OCD– learn all you can, consider all techniques and methods of treatment, and most of all– do what’s best for YOU! You are not alone, but when you are– remember that you have weapons to go into battle with OCD. Print this article out and put it into your holster 🙂 Keep strong… – G
Thank you for reading our article. I’m glad to hear it was helpful in your journey to reduce your resistance to your OCD symptoms. It can be very challenging, so expect that you will feel overwhelmed at times. Try to avoid waiting for something to “work.” This falls under the category of trying to change what is present in the moment, which only leads to additional suffering.
Live with all thoughts, feelings, sensations, and images the way you would if you knew they were going to be here forever. Ask yourself, “How would I handle them differently if I knew for sure that they were never going away?” This can lead you to find a way to peacefully co-exist with them.
Oh, I just love this post and all of the analogies of how following our intuition to resist and/or avoid can cause more harm than good. OCD, of course, is not a “logical” disorder, but I never thought of all the other examples in our lives where our natural intuition can steer us wrong. Thanks for this post, and I plan on quoting it in one of my future blogs.
Thank you for your comments regarding our article on resistance and OCD. I appreciate your thoughts and I’m glad the article was helpful.
Thank you. Great article, and I know a teenager who will be glad to read it too.
I’m 46 and have been doing this for many many years. I know very well that I have kicked some “seasons'” butts and fast when I was most decisive about not letting myself react. I have a great story, but it does involve my Faith, so I’m not sure if you’d want me to put it here.
The analogies are great, and they’ve always been in my own mind as I’ve tried to convince myself to handle OCD. I’ve always referred to myself and my OCD as drowning due to my persistent flailing.
Again, thank you for your beautiful clear explanation. As I said I know a teen who is very sad because her fight is getting harder by the day.
I am glad that the blog article was a helpful reminder of the work that you have been doing to manage your OCD over the years. I hope that your teen can also benefit from facing uncertainty and lowering resistance, something that is rather counterintuitive but effective! Best wishes to you both.
Thank you very much for this post. I will try to bear everything you have said in mind but I find it incredibly hard and my OCD is causing me a lot of stress in my day to day life and really effecting my accedemic work. I will keep trying though.
Actually, she’s not my teen, and sadly I’m not even in the same state. She’s my niece’s friend. She confided in me a year ago. Her struggles are huge and she’s so young. She’s in Calif. Is there any assistance for programs offered anywhere? So far all she’s been given is meds, but no tools to help her fight her battle. She’s up and down in depression and defeat.
Our program is located in Southern California, where we have four offices. If your friend’s neice is interested in treatment, she can contact us via our website at https://ocdla.com/. Thanks.
You can do it, Chris. My heart hurts reading your words that it is causing you stress in day to day life. I so can empathize. I don’t know if this is a comfort to you, or if it will sound bad, but after almost 40 years of this, I’ve just come to accept that it will interrupt my “normal” life and the less I pretend, the more comfortable I and the people around me are. I used to spend so much energy trying to hide that I wasn’t normal but now I just say it like it is. If I think going someplace with friends will send me, I just say it and they are more understanding.
Thank you for such a wonderful article. I have mild ocd pure ‘o’ for last 45 years. I came to know about it only in 2008. Now I am above 60. When I was reading your real safety tips I felt as if I am sitting with my mother and she is telling me all these when I was just a small kid.
Thanks for the insightful article! I have had pure o since 8th grade (I am 24 at this time), and I did not realize that I had it until my junior year of college. I have never been diagnosed by a professional, but I have done tons of research and my symptoms are spot on. My themes have changed throughout the years, and my most current one is very distressing. Before reading this article, I had doubts that my previous strategy of ‘let it be’, was just a cop out, and that I was actually sick. I know that it will take time, but I hope & believe that ‘mindful acceptance’ will help me keep my mind at peace 🙂 Love to everyone!
Thank you for your comment.
It is quite common for the theme of one’s OCD to change over time, especially for those with Pure O. Mindful acceptance is crucial to recovery, and by no means a cop out. I encourage you to additionally seek out Cognitive Behavioral Therapy (CBT). A good CBT therapist will help you to integrate mindfulness with Exposure and Response Prevention (ERP), which is the most proactive and effective approach for the treatment of OCD.
Thank You so much for this valuable insight. I am an OCD long-term sufferer. Have had this condition for up to thirty years. Hopefully, there will be more research for OCD and perhaps one day, a cure.
Thank you Georgia – I’m glad you found our article helpful. Take care.
I am currently seeing a therapist for Pure-O. (This current issue just popped up recently and I haven’t been able to discuss it with my therapist)
I have this experience where when I would become exclusive with someone, I would start experiencing anxiety in the morning when I wake up. I would then start to question it and the “natural answer” would be to get out. Currently, I have met someone recently that I really like, and these “unwanted feelings” in my chest get very tight and bothering me. (I guess this is Rocd stuff) – of course, I think this article could relate to me, but the feeling is so strong it almost feels like my anxiety is right. The reason why it is unwanted is because I really like this person & I want to enjoy my experience rather than suffer. How can I apply this to my situation better? Like when I wake up with the anxiety, are there things I can say or do?
(So far, my knowledge would tell me to sit with the discomfort- acknowledge that a feeling is just a feeling)
Your instinct is right on target. The most effective response to unwanted thoughts is to recognize that they are just thoughts, and to willingly sit with the discomfort they produce. It is important to recognize that the goal is not to eliminate the thoughts, but rather to accept them as an acceptable part of life (rather than resisting them and fighting them). If you really accept the presence of an unwanted thought, it ceases to be such a burden. Instead, it becomes just a minor inconvenience.
I have sexual obsessions that i might have sex with someone when i am at sleep without me knowing it.sounds funny.wooh unwanted thoughts.been diagnosed 2005, fluoxetine and rivotril for anxiety. After 7months was off with meds and back to normal.when i got pregnant ocd relapse on 2008.after gave birth back to same meds and for 5 months only.year 2009 till august 2014 no meds and everything is really great.but surprisingly just this sept another relapse. There is no ERP available here in our country,been searching for manuals in the net for i have learned it will be a great help.
All sorts of sexual obsessions occur in OCD. Your obsession of having sex without knowing it is not uncommon, and in fact, we have treated a number of clients with this same obsession.
You should also know that many women with OCD experience a worsening of symptoms during or after pregnancy. I encourage you to read our webpage on Perinatal and Postpartum OCD.
Unfortunately, it is also quite common to live in an area with limited access to mental health care providers who understand how to effectively treat OCD. If you would like to discuss online treatment with one of our staff therapists, you can email us at https://ocdla.com/contactus/.
Hiya I’ve found this article quite helpful I’m currently on anti depressants to help with my OCD wich I mainly suffer with intrusive thoughts – I have a fear something bad is going to happen if I don’t touch wood three times or switch the light on and off twice also not wearing certain items of clothing because I fear it will bring bad luck I also have a problem with certain numbers and words,it’s really effecting me daily and making me stressed and miserable is there any other articles you would recommend me to read?
What you are describing is a type of OCD commonly called Harm OCD. People with Harm OCD worry that they will be responsible for others (or themselves) being harmed. Some fear they will cause harm by direct means (i.e., stabbing someone or running them over), while others fear they will be responsible for causing harm by more indirect, superstitious means (i.e., by having not knocked on wood or by wearing certain items of clothing). Those struggling with this second type of Harm OCD often exhibit what is called Thought Action Fusion, in which they obsess that they can make things happen just by thinking certain thoughts (i.e., if I have a thought that a burglar will break into my house tonight, then a burglar will likely break into my house tonight).