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Resisting Compulsions






One major way to reduce the frequency and power of obsessions is by resisting the urge to engage in compulsions. In the short term only, compulsions help to alleviate anxiety associated with obsessions. By engaging in a compulsion, however, you are also verifying that the obsession was true or valid, increasing the likelihood that it will come up again. Therefore, it is very important to identify ways to resist urges to engage in some kind of compulsion.

Exercise 9.7 Steps to Take to Resist Compulsions

If you suffer from OCD, one of the most important things, and one of the hardest things, you can do for yourself is to resist compulsions. People have likely told you, “Why don’t you just resist the urge to check the door ten times, to wash your hands, or to (perform whatever other ritualistic or neutralizing compulsions you might have)? ” What people don’t realize is that it’s almost like asking someone who is starving to resist the urge to eat a delectable pizza that is right within reach. Resisting compulsions is not easily done, but fortunately we have some tips for you, and with these DBT strategies, you might find that you become better and better able to avoid compulsive behavior. In doing so, you are taking a big step on the path to recovery.

1. The first step is to identify the urge or desire to act, to perform the compulsion. To do this, you have to use your mindfulness skills to notice and get familiar with how you feel when you have the desire to do compulsive behaviors. For some people, it’s a feeling of uneasiness in the chest or abdomen, a feeling of things crawling on your skin, a sense of being “pushed” to do something, a feeling of doom or anxiety that something terrible has happened or will happen, and so on. Get familiar with what you feel like when you want to do a compulsive behavior.

2. The next step is to remind yourself that with compulsive behavior, any fear or anxiety you feel probably is what we would call a “false alarm.” This means that whatever you’re afraid might happen if you don’t do the compulsive behavior probably won’t happen at all. It’s highly unlikely that you actually forgot to lock the door, ran over someone in the street, will contract a terrible illness from touching a doorknob, or will be subject to eternal torment in hell because you cursed. Your mind might try to convince you: Well, you never know. How can I know for sure? What if I didn’t lock the door, or what if God is angry with me? How do we ever know for sure? I might as well just do the neutralizing or compulsive behavior just in case. The problem is that with particular obsessions and compulsions, we really don’t know for sure. In this case, you have to practice acceptance of the uncertainty factor, and just let these thoughts occur without acting on them.

3. The next step is to use opposite action by doing the opposite (or something close to it) of what you feel like doing. If you have contamination-­ or germ-­related obsessions and compulsively wash your hands after you touch doorknobs, then the idea would be to seek out and touch as many doorknobs as possible without washing your hands. This might be a tall order at first, so perhaps just start by telling yourself to stay away from all places where you could wash your hands, and purposely avoid hand washing. Similarly, if you’re driving and think you might have run something or someone over, just keep driving, even though it’s the last thing you want to do and your whole mind and body are screaming at you to go back and check. The same thing goes for the desire to engage in “checking” behaviors (checking your door and so on) and for religious compulsions, which often involve neutralizing “bad” things you might have done or said. For religious compulsions, let’s say you took the Lord’s name in vain, swore, or wore a shirt with “profanity” on it. The opposite action would be to purposely do this over and over again without any corrective or neutralizing actions.

4. The next step is to immerse yourself mindfully in whatever activity you are doing in the moment. If you have done the opposite action, and now you’re walking or driving to work, making food, or talking with someone, your job is to simply throw yourself into whatever activity you are currently engaged in. Let that activity be your whole world in that moment. If obsessive thoughts or urges to engage in compulsive actions start creeping in, just notice them, and keep throwing your mind back into whatever you’re doing. Immersing yourself in your current activity is one of the best ways to fill up your brain so that there’s less room for obsessions and compulsions to enter.

5. If you are having a very hard time doing any of this, then use distraction strategies to get your mind occupied and to resist the urge to engage in compulsive behavior. By your resisting a compulsion, your anxiety will increase considerably. In addition, the obsession might get stronger or worse. As a result, you will feel a very strong urge to engage in some kind of compulsion. Distraction, as we’ve mentioned, is one of the distress tolerance skills, and it turns out to be one of the best ways to avoid acting on impulses or urges. Get your mind busy with distracting activities that fill up your brain so that there’s little room left for your compulsions or obsessions. Do a crossword or sudoku, have a stimulating conversation with someone, eat strongly flavored food, work out vigorously at the gym, go for a run, or do some other activity that grabs your attention. Keep doing it until the urge to act on the compulsion is a little weaker and more manageable, and then do steps 2, 3, and 4.


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