Organized Chaos - Volume 5
Living With OCD: The Need To Remain Optimistic
by Steven Josephson, Ph.D.
New York, New York
It has been said many times that "life ain't no picnic." Living with OCD, can truly be a challenge. One can honestly say that having a full rich life is directly related to your ability to control your OCD. You have all heard a million times about how OCD gets better if you practice using exposure and response prevention strategies. However, tremendous courage and optimism is necessary because no matter how hard you try, there are going to be days when it defeats you, leaving you extremely demoralized. I have found it imperative that sufferers establish very finite and realistic goals for themselves on a daily basis. To attempt to stop all compulsions through sheer effort is unsuccessful and self-defeating. When you vacuum a room, you begin in one place and over time clean the whole room. OCD is very much the same. People are advised to begin with two manageable assignments and add to them only when those targets are completely under control and cease to be anxiety-provoking.
Unfortunately, attacking OCD is like the game "Twister." Just when you are working on something new, an old thing that you thought was completely within your grasp resurfaces. Because the task of daily exposure and response prevention requires so much daily effort and frequent exposure to failure, it is helpful to take a step back and think about what scientists have learned about the role of optimism in sustaining our motivation.
Studies demonstrated that when animals felt they had no mastery over their environment, they were at risk for learned helplessness. This state had many properties of depression and became an experimental prototype to use in subsequent studies on human depression. Rats that pressed bars for pellets and did not receive any ultimately stopped trying and manifested a set of behavioral symptoms similar to the human state of 1"giving up." Recent studies have shown that we are thinking animals who actively process what happens in our lives. Our interpretation of these events influence whether we persevere and remain optimistic or whether we pessimistically give up and ultimately feel depressed.
The specifics of these different styles of responding have been studied and we are now in a position to teach people to be more optimistic. When life events occur we ask ourselves a number of key questions:
(1) How big an effect will this have on my life?
(2) How long lasting will the effects be?
(3) Whose fault is it?
Optimists tend to see negative life events as specific and time limited. They believe that things will get better and do not blame themselves but rather take appropriate responsibility.
Pessimists, tend to interpret negative events as permanent and far-reaching and blame themselves. When it comes to positive events, optimists tend to experience them as permanent, generalized and often credit themselves. Pessimists see positive events as due to luck and tend to regard them as specific and temporary. If an optimist gets a good grade on an exam, she would conclude that she is a good student who will always do well. The Optimist believes that she earned the good grade through her own efforts.
The pessimist, on the other hand, believes that he was "just lucky" and that the success on this specific exam is transient at best. Pessimism has been identified as a risk factor for depression and it has been shown to affect performance and health. Pessimists tend to have more illnesses and die younger probably because of weak immune systems and inappropriate use of medical services. Additional studies on athletes, politicians and businessmen support the idea that optimists fare better than their pessimistic counterparts.
In working with OCD, it is important not to confuse optimism with positive thinking. Optimism training focuses on how to apply non-negative, realistic thinking to stressful life events. Depressed OCD sufferers do not benefit as much from behavior therapy. It is crucial to not be pessimistic so that you do not become depressed easily or frequently. Begin to listen to the way you think and catch yourself when you are using catastrophic terms. Once you start to hear yourself blaming yourself or making assumptions ("things are never going to change"), try to challenge those thoughts by thinking of a more useful way of thinking about things. The utility method or asking what you would say to a friend or a loved one (double standard) going through the same thing, these methods are not to be used specifically with OCD negative thoughts but rather with the tendency to be depressed over having OCD.
Focus on practicing exposures, taking risks and tolerating the likelihood of making a mistake. If you can't get yourself to practice doing daily exposures, you can learn from every experience that you do have. Try to feel good about the incredible courage and effort that you are making. Optimism is only a tool, it is not a panacea. It can help you continue to fight and feel more in control of your life.
