Stopping Your Compulsions

Now we are going to talk about compulsions, or rituals. We've already explained how rituals tend to persist because they provide temporary relief from your obsessions. But the solution can be as bad as the problem. Rituals can begin to take more and more of your time, and eventually dominate your life.

Ultimately, getting rid of your OCD symptoms means giving up the rituals. For now we propose that you temporarily delay the goal of ridding yourself completely of the compulsions, so that you can focus your efforts on specific, smaller modifications. Little changes. Reachable goals, to prepare yourself for successful resistance in the future.

In this section, we will describe four techniques you can use to start to prepare yourself to give up the rituals. The fifth self-help technique we will present will help you stop ritualizing altogether.

The first four self-help practices can be applied while you work on letting go of your obsessions. Or, if you'd prefer, you can first work on your obsessions and then start changing your compulsions.

Now let's look specifically at the techniques. This material is also covered in Chapter 6 of the self-help book Stop Obsessing!.

There are no rules as to which you should try first or which will work better for certain rituals. However, when you chose one technique, give it enough opportunity to work for you. Don't simply dismiss a method because it isn't helpful the first few times.

We know just how much courage it takes to challenge your obsessions and compulsions. These symptoms can be powerful, and a tentative commitment for change will not be enough. Winning the battle requires that you be persistent in following a new plan of action. Again and again, people with OCD have proven that they can improve their lives dramatically by actively following through on their decision to give up their obsessions and compulsions. You too can join them by searching inside for strength and determination.

There's no need for you to tackle your problem alone. If you are hesitant to begin the program, or if you start losing your momentum after a few weeks, then seek the help of a trained mental health professional, find out if there is a local support group for OCD, or ask a friend to help you implement the self-help program.

Best of luck in your commitment.

Stopping Your Obsessions Self-Help

• Self-Help Practice 1
• Self-Help Practice 2
• Self-Help Practice 3
• Self-Help Practice 4
• Self-Help Practice 5

Self-Help Practice 1: Postpone Ritualizing to a Specific Later Time

We have already discussed how to postpone your obsessions. Many of the same principles apply to compulsions as well.

Postpone Your Ritual

1. Mentally agree to pay attention to your ritual.
2. Choose a specific time in the future when you will return to it.
3. As that time arrives, either start ritualizing or consider postponing the ritual to another specific time. Whenever possible, choose to postpone.

If you have more than one ritual, select one you think might be the easiest to postpone. Then the next time you feel compelled to ritualize, delay it for a specified length of time. This is a mental ploy that will help you resist the ritual successfully because it requires resistance for only a short period of time. How long you postpone the ritualizing is a judgment you make based on what you think you can accomplish. Sometimes waiting thirty seconds is all you can tolerate. Other times, postponing for half a day is possible.

But please remember: that urge is just going to grab you. It's going to hit you instantly, and all you will be able to think about is ritualizing.

You've got to drive a wedge between your urge and your action. Even stopping for thirty seconds is a worthwhile effort. Thirty seconds! It's not that long! Really focus on getting any length of time to pass before you impulsively ritualize.

This practice will help in two ways. First, you will begin to tolerate longer periods of distress instead of instantly reducing the discomfort through ritualizing. Second, successful postponement will enhance your sense of control.

Like anxiety and distress, urges to ritualize decrease on their own over time, as long as you don't act on those urges. If you succeed in postponing the compulsive actions for several hours, you might discover that you no longer feel so compelled to engage in them when your selected time to ritualize arrives. Through this experience, you begin to believe that there may be other ways besides ritualizing to reduce your distress. Letting time pass and becoming distracted by other thoughts and feelings can decrease the urge to ritualize. As time goes by and your urge to ritualize diminishes, you will gain a sense of perspective, and with that perspective comes a greater sense of self-control.

If you postponed ritualizing from, say, 8:00 A.M. to 10:00 A.M. and you still experience the urge, try to postpone it again. Say to yourself, "I'll wait until noon and see how I'm doing then." If you can continue postponing, your urge will eventually fade away. If you cannot postpone again, apply one of the following two practices: either think and act in slow motion during the ritual, or change some other aspect of your ritual. We'll talk about these choices next.

Self-Help Practice 2: Think and Act in Slow Motion During the Ritual

Another way to change your ritual pattern is to purposely slow down the thinking and physical movements that occur during the ritual itself.

Perform the Ritual in Slow Motion

1. Select one ritual (typically a checking behavior)
2. Slow down your thinking and physical movements during the ritual
3. Pause at several points to take a calming breath and let go of tensions
4. When ready, let go of the ritual completely and tolerate the distress that follows

There are two major benefits to this practice. First, when you are distressed you often feel tense, pressured, and rushed. By slowing down your thoughts and actions, you decrease the intensity that accompanies the ritualizing. Without that intensity, the ritual may not be as compelling and consequently will lose some of its power.

The second significant benefit of slowing down during a ritual is that you will remember more of the details of your action. Have you noticed times, just after you've completed a ritual, when you can't quite remember how well you ritualized or if you ritualized enough? You feel safe momentarily but seconds later start doubting whether you carried out your ritual adequately. This probably led you into another round of rituals. As you physically and mentally slow down, you can better remember the details of your actions. Since this technique provides you with a stronger memory of your actions, it will reduce your doubts.

Slow-motion practice can be used with many behavioral rituals. It is especially effective with checking rituals since it seems to reduce this doubt about your actions. For instance, if you wish to practice slow-motion checking of a door, approach the door slowly, pause a few moments to take a Calming Breath while you casually study the lock. As your hand reaches the lock, notice the sensation of the metal on your fingers. If it is a dead bolt lock, then turn it ever-so-slowly. Listen for the "click" as the bolt drops into place. As soon as you hear it, pause for a moment. Hold your hand in place for fifteen more seconds while asking yourself, "Is this door locked?" When you respond, "Yes," drop your arm slowly and then slowly walk away.

When you practice this slow-motion procedure, be sure to incorporate either the Calming Breath or Calming Counts. By interspersing them several times throughout the practice, you can help keep your physical tension at a minimum. This, in turn, will help your concentration and your memory. Listen to the tape entitled "Practicing the Breathing Skills" to remind yourself of these brief relaxation techniques.

Self-Help Practice 3: Change Some Aspect of Your Ritual

When choosing this practice, you decide to change any of a variety of characteristics within your compulsive pattern. To do so, you first need to analyze the specific manner in which you ritualize.

Change Some Aspect of the Ritual

1. Select one ritual
2. List all its characteristics (specific actions, order, repetitions, physical stance, etc.)
3. Begin altering some elements of your ritual
4. Practice those changes regularly over the next few days
5. Every three or four days, modify the ritual pattern again
6. When ready, let go of the ritual completely and tolerate the distress that follows

Choose one ritual and analyze its characteristics. Take a pencil and paper and jot down all the specific details you can think of. Describe your exact motions and thoughts, in the order they occur. After you've done this then go back and consider the following characteristics. List the particulars of your ritual based on each of these categories:

• your specific actions
• specific thoughts you have
• the order of the action
• the number of repetitions needed, if any
• the particular objects you use
• how you stand or sit during the ritual
• how you're feeling, and
• any triggering thoughts or events.

Look over your list. Just look at how many different opportunities you have to make a small change in your ritual. Each item you listed offers another opportunity. Begin altering some elements of your rituals, and practice those changes regularly over the next few days. This process will be the beginning of bringing this seemingly involuntary behavior under your voluntary control - not by totally stopping the ritual but by consciously manipulating it.

Here are some examples:

Change the order in which you ritualize. For instance, if when you shower you start by washing your feet and methodically working your way up to your head, reverse your order by beginning with your head and working your way down.

Change the frequency. If counting is part of your ritual, alter the numbers and the repetitions you require to complete the ritual. If you always do ten sets of four counts, do twelve sets of three counts. If you must put three and only three packs of sugar into your coffee cup, the put two half packs in and throw the rest away.

Change the objects you use. If you wash with a particular soap, change brands. If you tap your finger in repetitions on your calculator, tap the table just next to the calculator instead.

Change where or how you ritualize. If you have to dress and undress repeatedly, do each set in a different room. Change your posture during the ritual. If you always stand while ritualizing, then sit. If you always have your eyes open, then try your compulsion with your eyes closed.

These are just a few examples. For each component of your ritual, there are as many ways to modify it. Be creative in your ideas for small changes.

There are three benefits to this practice.

First, as is true for the other two practices in the section, you will be able to alter your compulsions without the great difficulty involved in trying to stop them altogether.

Second, by changing important aspects of the ritualistic pattern, you are likely to break the powerful hold of the rituals. You might find out, for instance, that the ritual brings temporary relief even when not performed perfectly. Hence, you introduce flexibility into the pattern. This disruption in the ritual is the beginning of its destruction.

Third, this practice enhances your conscious awareness of when and how you perform your rituals. When you are ready to completely give up ritualizing, this awareness will enable you to recognize the first signs of your urge to ritualize and to stop yourself just before you automatically begin to do so.

Here's an example of how one person applies this technique. We'll call her Ruth. Ruth was a twenty-four-year-old housewife who repeated actions in order to circumvent bad luck. Her rituals were pervasive, involving almost all daily activity. There was hardly a time that she didn't ritualize or worry that she wasn't ritualizing. For example, when cleaning countertops or washing dishes, Ruth became stuck squeezing the sponge in several sets of ten.

In her practice of changing the ritual, she continued squeezing the sponge, but now with each squeeze she passed the sponge from one hand to the other. This change caused considerable distress for Ruth, since she feared that the new routine would fail to protect herself and her loved ones. Nevertheless, she was determined to implement the change. After two weeks, instead of squeezing the sponge, Ruth started a new routine on her own. Now she simply tossed the sponge in the air from one hand to the other ten times. Soon thereafter she was able to resist the urge to squeeze altogether and could clean the counter in a normal manner.

You can see that this practice requires that you create new habits. These new actions are incompatible with your tendency to keep your original rituals unchanged. It is impossible to keep rigid rituals and at the same time continue to change them. This is why it is important to implement this practice. Changing your rituals is a big step toward giving them up entirely.

Self-Help Practice 4: Add a Consequence to Your Ritual

Sometime you will find that you have just performed your ritual without any conscious expectation. In those situations it is impossible for you to postpone or change the ritual, because it's already done! In other times, you know you are about to ritualize, but you feel helpless to postpone or change the pattern.

In these situations, one simple change that can greatly increase your awareness is to add a consequence every time you ritualize.

Add a Consequence to Your Ritual

1. Select one ritual that has been difficult to interrupt through postponing or modifying.
2. Commit yourself to performing a specific consequence after each time you ritualize
3. Select a consequence (put $1 in a jar, walk 30 minutes after work, call a support person, etc.)
4. As your awareness increases prior to the ritual, practice postponing or changing some aspect of the ritual
5. When ready, let go of the ritual completely and tolerate the distress that follows

With this practice, you need not change how or when you ritualize. But each time you do ritualize, you must then perform some additional task. Choose a task totally unrelated to any of your compulsive tendencies and also something that requires you to disrupt your normal routine. Decide to drive to a park and pick up trash for an hour, do some kind gesture for someone you are angry with, practice the piano for forty-five minutes, or hand-copy ten poems from book. Ideally, the consequence you choose will also be one that has some redeeming value. One we use often is exercise - such as taking a brisk walk for thirty minutes.

If these sound like disruptive, time-consuming tasks it's because they are supposed to be! But don't consider them as punishment; they are simply consequences you have added to your ritual. To be effective, the consequences must be costly.

Because they are costly in time and effort, after some practice you will become aware of the moment you are about to ritualize, and you will hesitate. You will pause to think about whether it is best to start ritualizing, because if you do ritualize, you'll also have to start in on this not so pleasant consequence. This moment of hesitation gives you an opportunity to resist the compulsion in order to avoid that costly consequence.

For example, let's say you must check the stove every time you leave the house for work in the morning. You tend to get stuck touching each knob six times before you walk out the door. Later, when you are on the front porch, you doubt whether the stove is off, and back you go for another round of checking. Several weeks ago you began to use the slow-motion practice every time you checked. This has worked so well that now you check the stove only once and never touch the knobs. But each day, standing out on the front porch, you still become doubtful and must return to the stove for a second quick check "just to be sure."

This would be a good time to implement a consequence. Decide that, starting tomorrow, each time you check the stove again, touch a knob while checking, or even glance at the knobs again while walking through the kitchen, you must take a brisk thirty-minute walk as soon as you come home from work. This means you take a walk before doing anything else: no stopping at the store on the way home; no having a snack after you get home. Just put on your walking shoes and go, regardless of whether it's hot and muggy, raining, or snowing. Soon you will be thinking twice before stepping back inside from the porch "just to make sure."

This technique will work in the same way whether you are a washer who wants to stop washing your hands an second time, a hoarder who wants to stop collecting meaningless materials, or and order who wants to stop straightening up repeatedly. If the consequence you choose does not have this intended effect after numerous trials, then switch to a consequence that seems a little more costly.

Self-Help Practice 5: Choose Not to Ritualize

This, of course, is the option you will continually take as you gain full control of your rituals. Yet it requires determination. You must have a long-term commitment to overcome your problem in order to counterbalance the immediate urge to ritualize. You must be willing to suffer short-term distress in order to achieve your goal of freeing yourself from your symptoms.

Choose Not to Ritualize

1. Expose yourself to the object or situation that stimulates your urge to ritualize
2. Choose not to perform the ritual
3. Practice tolerating the distress until it subsides

All of the previous techniques in this section promote your ability to refrain from ritualizing and help prepare you for this option. Each aids in developing the important position of choice. Working with any of the other options first - Postponing, going in slow motion, changing some other aspectof the ritual, or adding a consequence - helps you choose this last option with less anxiety, stress, and effort than if you used it first. Instead of saying, "I have to stop this," you are much more likely to feel, "I'm ready to stop this."

To decide not to ritualize is to decide to face your anxiety directly, to stop protecting yourself from your distressful feelings through your compulsive behavior. You are willing to feel anxious if that's necessary. In fact, that is a lesson you will learn through your practice of this option. You will discover you can manage your discomfort. To find this out, you will go toward your anxiety instead of away from it.

The best way to do this is to voluntarily initiate contact with whatever it is that brings on your urge and then withhold your rituals. If you have an irrational fear of contamination, touch things you believe are contaminated. If you are afraid you might leave the stove on accidentally, then purposely turn it on and leave the house for half an hour. If you have to have a perfectly clean house, then mess up several rooms and leave them that way for several days at a time. Only through this practice can you discover that your distress passes and so does your urge. Chapters 7 and 8 of Stop Obsessing! provide specific instructions on how to stop your rituals.

But you don't simply have to grit your teeth and bear your distress. Remember to practice relaxation techniques. Use the Calming Breath and the Calming Counts to help let go of your tension. In The Stop Obsessing! Tape Series we provide you with our tape called "Generalized Relaxation and Imagery". This tape will help you let go of your tensions and enjoy twenty minutes of peace and quiet. Because this is a generalized relaxation tape, some people listen to it every day. But another good time to listen to it is when you are resisting your rituals and noticing that you are feeling anxious. Following the tape will help you calm down.

Relaxation is not your only option during these times. In some of these situations, when your tension is high, you won't feel like sitting quietly and listening to a tape. During those times, be sure to refocus your attention on some other task that will hold your interest, like talking to a supportive friend or taking a brisk walk.

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