Professional Counseling & Psychotherapy

When Worry Presents as a Subtle Form of OCD

With OCD, there is a relationship between the obsession and the compulsion. The obsession raises anxiety. The compulsion lowers anxiety – temporarily!

Here is an example of worry that may reflect a subtle form of OCD. Elizabeth is worried that she may have cancer. Look at the relationship between her obsessive thoughts and the compulsive effort to reassure herself:

Worry (Obsession): “I’m afraid I’ll find out I have cancer.”

Reassurance (Compulsion): “No, I don’t have cancer.”

Worry (Obsession): “Well, but it could be cancer.”

Reassurance (Compulsion): “Come on, you’re being silly, you don’t have cancer!”

The problem is that these compulsive efforts to reassure herself provide only temporary relief at best while increasing her anxiety in the long run.

When you’re dealing with a subtle form of OCD, all manner of effort to reassure yourself can easily backfire and cause you to become increasingly more anxious.

With this subtle form of OCD, it’s actually more helpful to simply be aware of the worrisome thoughts without becoming overly entangled with them by yoyoing back and forth with efforts to reassure yourself.

Rather than resisting the worrisome thoughts, they may simply be recognized as thoughts, not facts, without taking any other action.

For example, “I’m afraid I’ll choke.” becomes “I have a thought of being afraid I’ll choke.”

Another example, “I constantly feel like others are judging me” becomes “I notice the feeling that others are judging me.”

There is no need to become entangled with the content nor any need to control the thoughts.

This highly successful technique for addressing OCD related concerns is known as Exposure/Response Prevention (E/RP). With this technique, the individual holds tight in the presence of their anxiety (Exposure) without performing compulsive behavior including any self-reassurance (Response Prevention). The individual’s anxiety will rise, peak, and then subside all by itself because of a process called habituation. And as the individual gains experience with E/RP, their confidence increases and the struggle with OCD lessens.

Exposure/Response Prevention can be used to successfully treat OCD as well as subtle forms of OCD. In fact, exposure techniques can be used to treat a range of anxiety disorders including social anxiety, simple phobias, panic disorder, hypochondriasis, etc.

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