Reader’s Question

I have been diagnosed with Obsessive-Compulsive Disorder (OCD). The biggest obsessive thoughts I have involve a particular girl. I met her in 8th grade, and I became somewhat obsessed with her then (but never did anything because the thoughts I had I didn’t agree with). Now I’m going to be entering 11th grade, and I still can’t get her out of my head. I do not even know her — we’ve barely talked a few times. But every waking moment my mind if filled with her, even though I do not wish it. She’s not even the kind of girl I’d be interested in because aspects of her personality go against my morals. Since school ended the thoughts I have of her have weakened a bit. But recently a friend showed me a photo of her and for whatever reason the thoughts have returned in full force and I feel awful. I’ve taken Paxil before for 7 years and have switched to Prozac. Neither of them seem to help all that much, but I feel better with Prozac than I did with Paxil. What can I do to control these thoughts? At times, I’ve almost felt suicidal.

Our Clinical Psychologist’s Reply

One of the most important findings to come out of the cognitive-behavioral approach to treating obsessions and compulsions (the non-medical treatment of choice for such ailments) is that regarding obsessions as horrible problems that have to be gotten rid of or controlled only compounds the anxiety associated with them and actually helps fuel the obsessional cycle. Although the best course would be to avail yourself of a cognitive-behavioral therapist who specializes in treating OCD, here are some tips:

• Attach less importance and significance to the obsessional thoughts. They are merely a manifestation of the disorder. Spending time ruminating about them, fearing their occurrence, or regarding them as a sign of impending disaster only reinforces their power to disrupt your life. Regard them more as a temporary annoyance that can be dealt with by re-directing your attention to something else.
• Gain an increased sense of self-control by intentionally exposing yourself in graded fashion to the very kinds of things you presently worry will evoke obsessive thinking. For example, you mentioned being shown a photo. Instead of ruminating about the thoughts it initially provoked, you might deliberately expose yourself to it in graded fashion several times, thus “desensitizing” yourself to its power to trigger obsessive thinking.
• Learn anxiety and stress-reduction skills. As an anxiety-based disorder, OCD feeds upon the vicious cycle that develops between the symptom, the anxiety that results after the symptom appears, and the increased intensity of the symptom produced by the anxiety that accompanies it. When you learn to train yourself how to become more calm and composed when stressed, your anxiety levels will diminish and the vicious cycle will be broken.

These are just a few steps you can take to begin making things better. They are likely to be part of a more comprehensive regimen to help you overcome your disorder when you begin working with a trained professional. These steps plus the others you are likely to learn will give you the tools you need to ensure that your symptoms don’t have the power to debilitate you in your social relationships or activities.