Anxiety and OCD Treatment
Why Decreasing Anxiety Is Not the Goal of OCD Treatment
High levels of anxiety are common with OCD. Anxiety feels uncomfortable, so it is understandable that people with OCD are looking for ways to feel less anxious – and often ways to feel less anxious as quickly as possible. However, when reducing anxiety becomes the main goal of treatment with OCD, it unfortunately tends to backfire. This principle goes back to the don’t-think-of-a-pink-elephant study, in which participants were instructed not to think about a pink elephant. The study found that trying not to think about a specific thought (also known as thought suppression) actually led to an increase in the exact thought that was trying to be stopped!
This process also occurs with emotions. The more desperate we become not to feel unpleasant feelings (e.g., anxiety, guilt), the more likely we will experience those feelings. Also, when we try to reduce anxiety instead of letting it just be, we are putting pressure on ourselves, which can make us more anxious! We are also putting our attention on the anxiety and monitoring it to see if it goes away, but this makes us more sensitive to any presence of anxiety. Therefore, focusing on anxiety reduction is not a helpful way to approach treatment.
The more we try to control our thoughts and emotions, the more we tend to have the exact thoughts and emotions that we are trying not to experience.
Of course, we want to eventually reach a point where our baseline anxiety is lower, but we want to put that goal on the back burner. Instead, the main goal of treatment is to accept the presence of anxiety. Therefore, the most helpful OCD treatment approaches are acceptance-based. Acceptance-based approaches teach us to welcome uncomfortable thoughts and emotions and to be okay with not feeling okay. Acceptance-based approaches can sometimes cause people to feel less anxious in the moment, which is okay; however, they do not always lead to anxiety reduction in the moment, and that is okay too.
Recovery from OCD can happen when we:
1. Recognize that anxiety is not the enemy.
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2. Truly embrace the presence of anxiety.
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3. Learn that we can do things even when we are feeling anxious.
Since people sometimes feel less anxious when using the acceptance-based approaches, it can lead to a slippery slope of people using the approaches to feel less anxious. In other words, people start using the acceptance-based approaches as another way to control anxiety. One way you can see if you are falling into this trap is to notice if you are thinking, “this isn’t working” when doing an acceptance-based practice because you still feel anxious. If you are doing this, you are not really practicing acceptance of the anxiety and are instead trying to decrease anxiety – which, remember, is ultimately unhelpful and not the goal!
We hope that this introductory Guide has helped you gain a better understanding of why decreasing anxiety is not the primary goal of OCD treatment.
If you would like to learn more about specific ways that you can practice Acceptance of anxiety, in the associated comprehensive Educational Guides we go into detail on the following two topics: