OCD and Distraction
I’ve previously written about my son’s stay at a world-renowned residential treatment program for obsessive-compulsive disorder. After being there for nine weeks, we felt it was time for Dan to come home and prepare to go back to college. He was reluctant to leave the program as well as the staff with whom he’d grown so close, and they encouraged him to stay.
Dan kept saying to us, “If I go back to school, I won’t have time to concentrate on my OCD!” Even back then, this rationale made no sense to me. No time to concentrate on your OCD? Wouldn’t that be a good thing?
While he was mainly referring to having time to work toward recovery, he also thought this recovery had to be the main focus of his life. My husband and I, on the other hand, believed he needed to get out of the treatment center and back to his life, as scary as that might be. He needed to interact with his friends, engross himself in his studies, reconnect with his family, resume old hobbies and explore new passions. In short, he needed to get back to living a full life, which would help distract him from his OCD.
In this context, I believe distractions are good. But are they always beneficial when dealing with OCD? I don’t think so. Distraction, like avoidance, might become a type of compulsion, a way to counteract the anxiety and fear stemming from an obsession. Indeed, many well-meaning people, including some therapists, encourage the use of distraction by saying things like, “Just think of something else.”
For example, if you are dealing with a harm obsession, just switch your thoughts to cuddly kittens or puppies (oh, if only it were that easy to “switch our thoughts”), or perhaps distract yourself through an activity, like listening to your favorite music. Anything to get your mind off that tormenting obsession. Unfortunately, these distractions will offer only temporary relief, at best, and the obsessions will likely return, stronger than ever.
Those who are familiar with exposure and response prevention (ERP) therapy will realize this use of distractions is counterproductive. What OCD sufferers really need to do is to not distract themselves from the anxiety, but to allow themselves to feel it, in all its intensity. In that way it is a true exposure.
So it seems to me there are different types of distraction. Living life to the fullest can provide what I call proactive distractions. Keeping busy takes Dan’s focus off OCD and allows him to enjoy his life. He’s not giving OCD any more of his time than he has to. This is a good thing. But a distraction that’s a direct response to an obsession is what I call a reactive distraction. It is similar to a compulsion in that it reduces anxiety in the moment, but ultimately allows OCD to strengthen.
The same activity might be a proactive or reactive distraction, depending on the circumstances. For example, Dan loves listening to all kinds of music, and he does this regularly for enjoyment. To me, this is proactive distraction. My guess is there were times, when his OCD was more active, that he’d listen to music in an attempt to suppress the anxiety caused by his obsessions. This would be what I call reactive distraction. Not so good.