How do you overcome OCD thoughts?

Hi Jay, 

Thanks for getting in touch. 

If I am understanding you correctly you are struggling to manage thoughts that you describe as the "what if's", this is leading to anxiety. You acknowledge that even though you know the answers and you can factually prove the answers, the emotions that are felt with the "what if" make it really difficult to find a sense of peace and ultimately a conclusion. Due to this you employ your compulsive behaviors to try and find the peace but they don't work...

There is a theoretical model that explores the impacts of thoughts, feelings and behaviors, and their impact on each other. I feel like this may resonate with you because your thought (the "what if"), creates a feeling (anxiety), which then leads to a behavior (the compulsive actions that you take).

There are a number of points where you could tackle this - it depends what works for you and there may be elements of trial and error whilst you work out what management or coping strategy works best for you. 

Option 1. You could tackle the thought (which I think is already where you are at right now) 

At this point I would usually recommend exploring a thought record, there's lots of examples online, if you search online to locate them - i've included an example of the questions below, you simply place these into a table format or structure them how you feel appropriate on a page. I am conscious that it appears as though you already have a form of thought record, even if it is just something that you do yourself, in your own head - although it may help to write it down perhaps? 

A thought record explores:

The situation or trigger (the thing that caused the thought)

What feelings did this bring up for you? - rate the intensity of the feeling from 0-10 (0 being not to bad and 10 being the most intense feeling ever!)

What unhelpful thoughts and images did this bring up for you - this is probably where your "what if's" would be noted.

What facts and evidence do you have to support the thoughts?

What facts and evidence do you have that do not support the thoughts?

What is an alternative or more realistic thought or perspective? - How could you reframe your thought? 

Then finally, in the thought record you would explore how the feeling has changed since these actions have been taken and re-rate it to see if the intensity has changed. 

I feel like this may be going over old ground for you, as I am conscious that in your question you make reference to finding evidence and factually being able to prove the answers to your what ifs, but that this doesn't help. I wonder if there are elements of the thought record that are new however, such as:

writing the thoughts down and the explorations down - it sounds like such a small thing but sometimes it's a really good way to acknowledge the thoughts and the evidence and give them space, outside of your head, which can feel like a break from the thought pattern... 

perhaps in rating the feelings you will see a change, however small it may be and this could empower you to recognize that your actions are working, they're just not perhaps quick fixes you may be looking for?

reframing or exploring alternative thoughts

This could act as an extension on what you have already started so it might be worth a try if it is bringing anything new to the table for you?

2. You could tackle the behavior - you have identified that when the "what if" creates the "anxiety" you resort to your compulsive behaviors which you know don't bring you the peace you are searching for, so what does bring you peace? What brings you happiness? (come out of the context of the anxiety for a moment and consider times when you do feel at peace, happy, relaxed, what are you doing?) If you have things that bring these feelings, then perhaps invite yourself to try these as new coping strategies, if they don't work, you always have your compulsive behaviors as an extra back up (we aren't taking these away at first, we are simply looking for alternatives that could replace them in the long term). If you aren't sure or don't have examples that bring these feelings then some options to try are: 

- getting out in nature - this can really help to reset us - find somewhere green, it could be a local park, a nature reserve, a field etc. If you live near to other "nature" such as beaches, forests etc. then utilize these too. Whilst out in nature, try to stay in the moment and tune into your senses (what can you hear? what can you see? what can you smell, taste, touch? immerse yourself in the textures, the colors, notice how you feel) 

- there are breathing exercises and grounding techniques you could try. Never under estimate the power of deep breathing! Again, you can find different examples on most search engines. The great thing about breathing is that you can do it anywhere and it's something you will be quite familiar with already - haha! In order to breathe for calming though:

Focus your attention on your breathing, and include this focus periodically throughout every day so it becomes part of your everyday routine (this makes it easier to call upon it, in times of stress and anxiety).

You can be standing up, sitting down, lying down whatever works for you, or whatever you happen to be doing at the time. Make sure you are comfortable though and in a position where you can focus on your breathing and don't need to be focussed on anything else. Consider your clothing, position of your body and ways you can relax and feel less restricted. 

Take in a big deep breath allowing the air to flow in to you body, count to five, slowly, as you count, feel the air work its way up through your nose, down and into your lungs, notice the subtle changes in your body, the cool/warm air (depending on the season/location of course) coming into your body and how it gradually changes temperature, with the warmth of your body as it moves its way down into your lungs, feel your lungs fill from the bottom to the very top - pause for a moment - perhaps count to five as you hold in the breath and then, gradually allow the breath to start flowing back out of your lungs, feel your lungs empty, as the air from the bottom pushes the air at the top of your lungs out into the world around you. Pause and hold again for five, repeat this process and consider the effects it has on your physical and emotional sensations and feelings. 

3. You could tackle the feeling - this can sometimes be the trickiest approach but some people do prefer it! You know the feeling is anxiety. It can help sometimes to accept that feelings are allowed and that no matter what, you will feel them. This is somewhat outside of your control however, you can choose what you do about it when you do feel the feeling. - hopefully that makes sense! Notice what lets you know you are anxious - you know that it is driven by thoughts but how does it feel in your body? Do any other emotions show up alongside it? If it was a color what color would it be? What sound would it make? Really get to know what anxiety means to you. Knowing can lead to understanding and understanding can lead to normalizing which can in turn reduce some of the other feelings created by stressing/worrying/anxiety relating to the feelings of being anxious. 

You can also look at strategies and ways to reduce the feeling. Some of the ideas I mentioned earlier around breathing, getting out in nature etc. these self care strategies can also help to reduce and even eliminate anxiety in certain scenarios.

It's definitely something that requires practice, regardless of whether you choose to focus on the thought, the feeling or the behavior. Allow yourself to be compassionate with yourself and feel free to write how you are feeling down. This can help to separate yourself from the thoughts, feelings and behavior, and that space can then allow for reflection. 

I really hope that this information is helpful however, please feel free to get in touch if you require anything further. 

Thanks 

Kim