Times have really changed during the last couple of months. Countries all over the world are battling a viral pandemic that is not only affecting the human body, but the mind as well. The virus is causing great damage to not only the elderly but young folks with no comorbidities. More hospitals in the U.S. and Italy are seeing younger people being admitted and even intubated! This virus is causing panic and skyrocketing anxiety levels; it has become a psychological war.
It’s nearly impossible to have a conversation without someone mentioning the novel coronavirus, which has spread to more than 196 countries and territories. With over 414,661 confirmed cases and more developing every day, someone in your own community may be affected. . .[. . .]
As every day passes, we continue to remain with unanswered questions as to how we should live our lives. Health officials tell us to practice social distancing and to remain at home, yet this is resulting in massive job losses, economic fluttering and mental health problems. It’s not easy to stay at home after you’ve been used to living a productive life.
The breath as a symbol as well as the direct observation of the arising and passing of experience. The antidote to living in our heads. Helping to develop a skillset of attention.
The real culprit of OCD may not be what you originally thought.
It is not uncommon to hear an OCD sufferer make a comment such as “OCD thoughts are ruining my life,” or “I have to get rid of these thoughts!” This refrain is echoed by many of my clients who lament their unwanted, intrusive thoughts and the seemingly endless struggle to suppress, neutralize, and explain away their thoughts.
The common belief, whether explicit or implicit, is that the presence and content of the thoughts are the problem, and getting rid of them will restore hope, confidence, and happiness.
But OCD is not a thought problem — it’s a feeling problem. In other words, if the thought did not have the accompanying painful feeling, you would ignore the thought, call it “weird,” and simply move on without compulsions or a second thought.
Allow me to unpack this as it may seem like what I’m saying is controversial or missing some important point about OCD.
Obsessive Compulsive Disorder is a condition marked by a pattern of unwanted, intrusive thoughts, feelings, images, sensations, or urges that take the form of a Feared Story. This story tells the sufferer of a potential, and as of yet fictional, outcome or truth about their actions, intentions, character, or future. This story, being completely unwanted, makes the sufferer feel an overwhelming sense of anxiety.
To deal with this anxiety and to get back to a sense of normalcy, confidence, and comfort, the OCD sufferer will then engage in overt or covert compulsive behaviors as an anxiety management strategy. Compulsions can include avoidance, reassurance seeking, mental review, rituals, and other repetitive acts. Once done, the sufferer gets a false sense of security that unfortunately reinforces the anxiety cycle.
OCD’s deception is that you have to struggle with and resolve the content of the thought. You have to clarify, rectify, and examine the thoughts to determine whether they are true or false. For example, the contamination OCD sufferer believes he must be sure that his hands are fully clean, or at least clean enough, before they can interact with anyone.
In the brief overview of the OCD cycle above, you likely noticed that I mentioned thoughts and feelings. Wouldn’t this suggest that OCD is both a thought and a feeling issue? Yes, but in practice not really. People with OCD often get wrapped up in three potential issues; the trigger, the feared story, and the feeling. Ultimately, freedom from OCD requires you to face down the feeling, because OCD is a feeling problem.
OCD can be triggered by almost anything, including things we see, random thoughts we have, sensations we experience, and objects we encounter. Everything that you and I will ever encounter, think, feel, or experience is neutral until we place some value upon it. Meaning it is neither good nor bad, right nor wrong. Is a knife good or bad? It can be used to open to letter, but it can also be used to open a person. How about therapy? It is both good and bad. It can bring about profound positive life transformation, but it can also be emotionally draining, time-consuming, and costly.
Likewise, triggers to one’s fears are also neutral. Yet those with OCD and anxiety disorders exaggerate the meaning and importance of triggering thoughts or images as they relate to the Feared Story.
Each fear has any number of neutral associations. Remember the knife example? It doesn’t have just one meaning or significance. A knife can conjure thoughts of cooking shows. It can cause someone to think of their dad’s fishing knife or Julius Caesar. The thought of a knife can also spark thoughts of suicide, harm, or crime.
If you blame the trigger (i.e. the feared thought or object) and label it as the problem, you are being misdirected. OCD, and the history of repeated compulsions, exaggerate the importance of a select number of mental associations. Over time, the other neutral or positive associations are downplayed or ignored leaving the feared associations as seemingly the only associations for these thoughts or experiences.
When you scapegoat the trigger as the problem, you believe minimizing your contact with it will make the obsession about it go away. Unfortunately, avoiding the trigger leads to isolation and reinforces the false notion that the trigger is the problem, resulting in greater fear of the trigger and the feared story it spawns.
The Feared Story
Our brain tells us stories all day. Some we like. Some we don’t. OCD tells us stories too, and they are catastrophic, threatening, and at odds with who we are. These Feared Stories are a combination of distorted thoughts and mental images about the result of actions, one’s character, or an inevitable future that concludes in something terrible.
Some people blame the Feared Story as the problem within OCD. They think that if they were to simply get rid of the thoughts, think the opposite of the thought, prove that the thought is wrong, or simply “just think right” that their OCD would evaporate. They believe OCD is a thought problem.
To their point, treatment for OCD and anxiety disorders commonly begins by challenging the feared story using rational thought to develop a broader, reality-based view of the fear. This exercise helps the sufferer develop confidence that their intrusive thoughts are likely irrational, overvalued, and not deserving of excessive and exhausting compulsive responses.
When I challenge the Feared Story in session, my clients are quick to point out how their Feared Story is wrong. They usually say, “I know this doesn’t make sense,” then proceed to point out all the reasons why it doesn’t make sense, and they are right!
For example, a client with Pedophile OCD (POCD) might say, “I’m not a pedophile because I’ve never been attracted to a child in the past. I’ve never wanted to do anything sexual with a child. Whenever I have the thought about molesting a child, I always get anxious and have never felt feelings consistent with my typical feelings of attraction when I think about adults.”
Here is the actual problem of OCD. The feeling. More specifically, it is the feeling that makes you engage in compulsive behavior, which subsequently reinforces the OCD cycle. Chasing down and embracing that feeling with a welcoming and accepting posture desensitizes you to the feeling over time. Conversely, if you are unwilling to feel the feeling, but instead rely on compulsions and avoidances, desensitization cannot happen.
Remember, we are able to acknowledge that the trigger is neutral, and has a number of alternative associations. Additionally, we are very capable of telling ourselves why the Feared Story is irrational and wrong. However, we are unable to convince ourselves to not feel something because feelings are largely out of our control.
While not bad or wrong, feeling anxiety in an OCD moment is unwanted. Typically speaking, we say anxiety feels bad, but it by itself is not “bad.” It is an unwanted feeling state at the moment you’re feeling it. When we ride a roller coaster or see a horror movie, we expect to feel butterflies in our stomach, feel our heart racing, and feel jumpy. You know, anxiety feelings. But in this context, we paid good money for the experience! So, the feeling itself is not bad, just unwanted at that moment and inconsistent with the level of actual risk.
Generally speaking, people with OCD are capable of combating their feared thoughts with rational alternatives. However, compulsions exist because a feared thought comes with, or takes the form of, an uncomfortable and unwanted feeling that overwhelms the sufferer.
Despite developing a list of rational observations and objections to the Feared Story, it does nothing long term because the issue has never been a matter of “right thinking,” but of an intolerance of the feeling brought on by the Feared Story.
Similarly, when it comes to OCD, sometimes the feeling isn’t just anxiety, but sadness, loneliness, anger, apathy, or emptiness.
The goal of Exposure and Response Prevention treatment is to intentionally feel this feeling, acknowledge this inconsistent emotional response, and let it remain without compulsive behaviors until it passes. Remember, it will always pass.
Counterintuitively, your job in Exposure and Response Prevention is to engage the feeling. It’s the enemy and the problem. The solution is to show that you’re stronger than it by calling its bluff that the feeling is heralding in something terrible and that you are not strong enough to shoulder the uncomfortable experience. You are strong enough, and the terrible outcome probably is not coming. Stand firm and let the storm pass.
Feel the Pain, See the Results
If you are not ready to do this, you are going to have a hard time overcoming your anxiety. But you can start small, and progressively work up. If you are consistent and keep pushing yourself, you will eventually find more mental and emotional strength and freedom.
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Beware the downfalls of hubris if you want others to like you.
Optimism is generally considered one of the most desirable psychological qualities. We like to be with optimists more than we like to be with pessimists, and we believe that optimism is generally a more successful life strategy. Being a “cockeyed optimist” (in the words of the famous “South Pacific” song) means that you’ll be better able to cope with whatever challenges come your way. To Leuven University’s Vera Hoorens and colleagues (2016), however, being an optimist can come at a price: It may make you look naïve, and you may be in for disappointment when your sunny predictions fail to materialize.
There’s another trap involved with optimism, and it occurs when you fall prey to the hubris hypothesis. As noted by the Belgian team, the hubris hypothesis involves comparing yourself favorably and explicitly with other people. This leads others to believe that you hold disparaging attitudes toward them, because you’re letting them know that you think of yourself as superior. It’s a particular form of pride in which the claims you make about your own worth come at the expense of acknowledging that of other people. The example used by Hoorens et al. contrasts the statement “I am a better friend than others” with “I am a good friend.” When you make the comparative statement with others, you’re showing an explicit form of hubris. When you simply state what a good friend you are, the claim of superiority is implicit, and it’s no harm, no foul to everyone who hears you make that claim.
When optimism involves a similar comparative spin, it’s likely to trigger the same reaction as explicit hubris. If you think the odds of something bad happening to you are lower than the odds of something bad happening to others, according to this view, you’re invoking the hubris hypothesis. Why should you be so immune to misfortune? What makes you so much luckier than the people around you? When it comes to something favorable, why should you be so much more likely than your competitors to get a job for which you’ve applied? In terms of absolute optimism, you can think that you’re qualified for the job. If you’re using comparative optimism, though, you believe you’re more qualified than everyone else, and therefore, you should get the job — and of course, they shouldn’t.
In the two experiments conducted by Hoorens and her team, participants rated the warmth and competence of claimants (people making claims about themselves) expressed in either absolute or comparative terms.
In the first experiment, the researchers presented three scenarios depicting individuals who were either optimistic or pessimistic about living to be old, finding romantic happiness, and experiencing happy family relationships. Absolute optimism was represented by having the claimant project optimism for him or herself without comparison to other students; comparative optimists projected having more positive outcomes than would the average other student. Participants then rated the claimants on five traits reflecting warmth (forgiving, helpful, honest, loving, polite) and five reflecting competence (ambitious, cheerful, competent, independent, intellectual). They also rated how much they would want to be around these individuals. In the second experiment, the claimants also indicated whether they would have more favorable outcomes not just compared to the average other student, but compared to the participant him or herself.
People rated the comparative optimists less warmly than the absolute optimists, and as a result, didn’t want to affiliate with them. The second experiment, with its added feature of having relative optimists believe they were better off than the participants, provided the full test of the hubris hypothesis, because the sunny outcomes expected by the claimants came at the expense of the participants themselves.
The authors concluded, therefore, that “optimism loses some of its appeal when it is expressed in a comparative than an absolute manner and that it does so because comparative expressions of optimism suggest that the claimant views the observers’ future gloomily” (p. 9).
Ironically, most people do prefer to see themselves as “better” than the average person which, of course, is an impossibility. What happens with the hubris hypothesis is that we don’t like it when someone else openly expresses that viewpoint. It’s fine to think you’re luckier, happier, or more likable than everyone else, but if you happen to voice this assessment, you’ll end up facing the exact opposite outcome.
One reason we don’t like hearing others brag in relative terms about their qualities is that, as the Belgian team notes, we’re always processing information about other people through the somewhat egocentric eyes of our own self-images. If your best friend’s mother is constantly trying to show how much better a cook she is than everyone else, you won’t go over there for dinner, no matter how good the food actually is. Her tendency to self-promote puts your own mother, or perhaps you, in the position of seeming inferior. For her part, she won’t see how much she’s offended you and will be puzzled when you turn down invitations that seem so well-intentioned.
In summary, we know that bragging is the kind of behavior that most of us would rather avoid being exposed to. These studies on comparative optimism show, further, that it’s the hubris expressed at the expense of others that make that bragging so objectionable. Optimism is certainly one well-known path to fulfillment. As long as you can express it without casting aspersions on the possible fates of others, you’ll be able to make full use of its advantages.
Copyright Susan Krauss Whitbourne 2017
Hoorens, V., Van Damme, C., Helweg-Larsen, M., & Sedikides, C. (2016). The hubris hypothesis: The downside of comparative optimism displays. Consciousness and Cognition: An International Journal, doi:10.1016/j.concog.2016.07.003