DEAR DR. NERDLOVE: I have been experiencing frequent anxiety attacks triggered by my obsessive-compulsive disorder (OCD). These compulsions often create irrational beliefs that feel real, such as the thought that if I fail to perform a certain action, something bad, like death, will occur. Although I am aware that these thoughts are not grounded in reality, my mind convinces me otherwise, making it difficult to resist them.
Recently, my anxiety and OCD symptoms have intensified. They often manifest together, leaving me overwhelmed, emotional, and increasingly isolated. My relationship with C, whom I deeply love, has also become a trigger. Despite her constant reassurance that I am enough for her and that she loves only me, my intrusive thoughts create scenarios — such as her being unfaithful — that feel vivid and convincing, even though I know they are not true.
C’s participation as a muse in upcoming events has heightened my insecurity. While I understand that I cannot and should not control her choices, my thoughts still make me anxious, particularly when imagining other people, especially boys, approaching her. Although I trust that she will not entertain them, the mere idea distresses me.
The Over-Thinker
DEAR THE OVER-THINKER: I wish you explained what you mean by “participating as a muse in upcoming events”, because I am honestly scratching my head as to what that would entail.
But frankly, that’s more about my curiosity than anything else. Even if I could say “well, by participating in this, she’s doing X and Y which precludes Z, so that’s something you don’t need to worry about”, that wouldn’t actually help. This isn’t about rational thinking or trusting your partner, this is about unwanted and intrusive thoughts – ones that you know are irrational and unrealistic but that still bother you anyway.
This is where I have to reiterate that this is a job for a mental health professional, not me. Dr. NerdLove, after all, is not a real doctor, and even if I were, this is an area where you’re almost certainly going to want the assistance of a therapist and likely a psychiatrist or medical professional who could prescribe medication to help with the anxiety.
What I can do, though, is tell you that I’ve had my own struggles with those sorts of unrealistic-but-still-troubling thoughts and feelings. My ADHD combo plate came with a side of Rejection Sensitive Dysphoria, which had the “lovely” effect of leaving me in a near-constant state of being convinced that not only were people mad at me but that every relationship I had was a mouse’s whisker away from crumbling all around me. And even when there was no rational evidence for this, my cursed-ass brain would invent it, turning even the most anodyne and banal interactions into something fraught with layers of meaning.
So, y’know, I get it.
Now, again, I’m going to emphasize that anything I recommend is based purely on what I did to get through the worst of it; it took getting diagnosed and medicated to really turn down the volume on my RSD. So, I can’t stress enough that this is a discussion to have with your therapist.
The first thing I would suggest is to mentally remind yourself that what you’re imagining isn’t real. You know yourself enough to know that you have these intrusive thoughts and that they’re not based on logic, evidence or even reality. It’s just brainworms, gnawing at your insecurities and dripping poison all over your imagination. Reminding yourself that these are irrational anxieties, not truth, can help give yourself a little breathing room. That, in turn, gives you an opportunity to say “but if I look at this like I was giving advice to my best friend who was dealing with this situation, I would point out that C is doing X and regularly does D, E and F, which someone who didn’t care about me wouldn’t do.”
That doesn’t make the thoughts go away, but the push-back bolstered by actual behavior does help make them less intense, less immediate and easier to name them and to turn your attention away. Naming those thoughts has the benefit of separating them – they’re not things that are happening, nor are they things that define you, they’re just thoughts you are having at that moment. That level of separation helps cut the intensity and the “reality” of them. Similarly, turning your attention away is easier and more effective than trying to force them away. It’s a little like mental judo; it’s easier to redirect energy than it is to stop it. By naming the thought and redirecting your attention elsewhere, you deflate the thoughts’ power over you and cut off bandwidth to them. No feeling, no matter how intense, can last very long without being actively fed; by reducing the bandwidth you give them, you reduce the amount of time they linger and the impact they have on your immediate feelings.
The next thing is to remember that part of what makes these thoughts so stressful and hurtful is that our brains treat what we imagine as being real. An argument we imagine with our partner hurts just as much as one we have in real life, in no small part because it feels real to our brain. We are, for all intents and purposes, hurting our own feelings.
However, the fact that it’s happening in our imagination and that our brains treat it as real also gives us the ability to change them. So, you want to stop being a passive observer of these imaginary scenarios. Instead, you should take control of them and defang them by taking away the things that make them so intense or painful. When you realize you’re having these thoughts, remember that you’re the one who’s generating them and take control… and then make them ridiculous. Fighting a fear tends to reinforce that fear, but laughing at it makes it impotent.
Let’s say that you have a moment where you imagine someone hitting on C at an event and you’re having a hard time turning your attention away. Rather than trying to push past the thought or forcing it away, change it. As the scenario plays out, imagine that the guy’s voice keeps getting higher and higher like he just sucked down a balloon full of helium. Or maybe change his face so that he looks like Garfield. Imagine it playing out the same way except now it’s in black and white and upside down and everyone’s talking in Mid-Atlantic accents like it’s a film from the 1940s. Picture the dude dressed like a clown hobo or wearing the silver-tinfoil suits of an old Flash Gordon serial. Imagine a sitcom laugh track that plays every time he finishes a sentence.
The more you inject unreality and unserious things into the image, the less “real” and less intense it becomes. This lessens its ability to affect you, simply because the absurdity undercuts the emotion behind it; your brain can’t take it seriously as a threat when there’s a live studio audience hooting and jeering at the dude after all or when he looks like an outtake from Robot Monster.
I would also suggest looking into some self-directed cognitive behavioral therapy exercises; CBT is famously very effective at dealing with OCD issues and intrusive thoughts. Having some techniques in your back pocket to deal with these moments can be very helpful.
As I said though: these are stopgaps, things that I used to hang on until the moment had passed. This is very much a matter to bring to a therapist, not a loudmouth with an advice column. Hie thyself to a shrink who deals with OCD and intrusive thoughts, TOT. The sooner you do, the sooner you’ll start getting these moments under control.
Good luck.
Please send your questions to Dr. NerdLove at his website (www.doctornerdlove.com/contact); or to his email, doc@doctornerdlove.com