Note: All parts of the guide have been updated as of Sep 2022 after much discussion from those suffering from SOCD and my own experience. In particular I have considerably adjusted the ERP approach, as I now believe that is better to simply avoid doing any explicit rituals, rather than trying to literally do nothing, which seems to have been causing some issues for people.
This unit the final part of the guide. To see all units in the guide, click here.
If you’ve been doing the exposures correctly, hopefully your anxiety has dropped significantly. If it hasn’t, it might mean you’ve done something incorrectly in Modules 1 or 2. Return to Modules 1 and 2 as often as required, particularly for new obsessions.
Don’t stop too early
You might feel soon enough that there’s so little anxiety that there’s no point in even keeping the reminders there any more, and so you can remove them. However, be careful with this. Don’t stop if there’s even a bit of anxiety or there’s still one or two obsessions you’re not completely comfortable with. Destroy it completely. Otherwise it can come back or just be something which continues to annoy you.
However, you will reach a point where you can stop all kinds of exposures. This is a new stage in your recovery. You’re no longer trying to ‘actively’ recover, and that can have its own challenges. You will actually now probably go long periods totally forgetting about the obsessions.
But what happens now is that you’ll get those obsessions randomly popping up here and there in your mind. Again, your job is to not engage in any compulsion and just get on with whatever you were doing. This shouldn’t be too difficult in the beginning, but the ‘randomness’ of it can affect you. Now you’re not the one reminding yourself, but it’s just coming out of nowhere from your brain. Still, this shouldn’t be too much of an issue.
Dealing with long term relapse
Longer term however, there are more significant risks. I speak from my own experience; though I largely overcame my sensorimotor OCD several years ago (in 2012 to be precise), I had a major ‘reoccurrence’ four years after that point.
What often happens is that after you’ve gone several months (or years) without really thinking about the obsession, you forget what you did right. You might start to feel a bit of anxiety at noticing it again after so long. You can easily fall into a negative thought process “I’ve had relief and been living normally all this time, and now this thought is back, which might ruin my life again!”. Another negative thought that can creep in is ‘What if I fluked it? What if I got lucky didn’t really recover, and now it’s going to go back to how it was!?’ These are anxiety inducing thoughts, and hence you now have more anxiety associated with the obsession…which then means it remains in your mind even more, and the cycle can begin again. It’s easy for rituals to begin to solve it, whether that’s trying to control it, researching about it, or just trying to ‘figure it out’ again.
This is what happened to me, and I basically had to re-learn what I did the first time around. Just do what worked the first time; interrogate those thoughts again and bring back the exposures, until the anxiety is back to zero. Fortunately, usually the anxiety won’t be as bad as it was the first time, because you will be more confident you can get over this again, and the recovery period will hopefully be shorter as well. Just as you recovered the first time, you can do so again.
Overcoming sensorimotor OCD
I believe full recovery is possible from SOCD. You can live a normal life where this doesn’t really bother you at all.
However, I think as people who are susceptible to this, we have to be on guard against any kind of OCD thoughts or habits which might build up. You have to know yourself. It’s as simple as maybe recognising you are subtly annoyed by being reminded of an obsession, or avoiding certain activities you know would trigger you. Don’t let yourself live with 1/10 OCD; there’s no reason to. Don’t fear any kind of obsession; rather face them head on. Do whatever exposures you need to do. It might even pay to do exposures every so often even once recovered, like once every month, just to make sure nothing develops.
Ultimately, you want to become the kind of person who is completely resilient to awareness of sensations. You truly don’t care whether they are there or not. That’s when you have true freedom from SOCD. As a result, you will eventually forget about these obsessions. But remember, it’s not the obsessions you want to get rid of, but the anxiety and pain associated with them. It’s an amazing feeling to be aware of your sensations and just be totally fine with it, without even a hint of anxiety or discomfort.
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