Uncomfortable emotions and OCD

vector image people running from uncomfortable emotions
Dr Elaine Ryan
Written by Dr Elaine Ryan Psychologist and Founder of MoodSmith® Elaine obtained her Dr in Psychology from the University of Surrey and has worked in psychology for 20 years. Dr Ryan specialises in Intrusive Thoughts, OCD and anxiety-related conditions.

Learning to tolerate uncomfortable feelings is one of the most important skills you can gain to help you with your OCD. Without this skill, you are likely to carry out compulsions when things get uncomfortable for you, and once you feel compelled to do something to keep your emotions at bay, you are strengthening the cycle of OCD.

How this article will help you. It will briefly explain why you carry out compulsions and how this keeps OCD going before giving you some tools to help you sit with emotions without carrying out compulsions.

Try to think of OCD as having three main parts.

An intrusive thought or obsession causes an uncomfortable emotion, which feels better when you carry out a compulsion. For example, you have an intrusive thought. What if I hurt someone? This thought changes how you feel. You now feel scared, worried and anxious, but feel better when you remove things that could cause harm. Next time you have thoughts of harm, you quickly remove objects that could hurt someone, as this made you feel better the last time.

The problem is this is a quick fix with no long-term benefit. The long-term outcome is obsessive-compulsive disorder; as you obsess, you might hurt someone and feel compelled to remove objects that may harm you. The catalyst to removing the thing, that is, carrying out a compulsion, is what you feel once having an intrusive thought. If the idea did not result in fear, anxiety or disgust, you would not have felt a need to do something about the thought; it makes sense then that coping with the feeling helps to break the cycle of OCD.

Therapists talk about compulsions neutralising intrusive thoughts, but this effect is more of a by-product and does not serve you well. For example, the first time you carry out a compulsion, let’s say, checking if you are attracted to the opposite sex, if your intrusive thought is that your sexual identity is changing. This checking makes you feel better and gives you some reassurance, but this feeling better is a by-product of the compulsion.

It means you must keep carrying out compulsions to feel better each time you have an intrusive thought.

Learning to cope with the bit in the middle, the emotions negate the need to carry out a compulsion to neutralise the thought. Or put another way, learning to tolerate uncomfortable feelings helps to eliminate the third component of OCD, the compulsions.

Recap; think of OCD as having three parts.

When you eliminate the compulsions, you are left with only two components. If you are learning to tolerate the second part, the uncomfortable feelings, you are changing your relationship to what is happening and taking control.

How to tolerate uncomfortable emotions?

Several ways help you cope with your emotions, and you must try some of the ways I shall list below. You check, seek reassurance or carry out compulsions the second you feel anxious, fearful, disgusted or shame. Trying some distress tolerance skills below is the first step to breaking this cycle.

Focus on your breathing

How does this help?

It helps in two ways. Learning to refocus your attention away from the intrusive thought and the compulsion you want to carry out allows you to come out of automatic pilot and focus on something you choose.

Secondly, with time, concentrating on your breathing helps reduce the anxiety spike. When you are calm, you will not feel the same need to carry out a compulsion.

How to do it.
You do not have to lie down or do anything special, as obsessions strike at any time, and you need to learn to focus on your breathing, whatever you are doing, and wherever you happen to be.

Focus on breathing in and out. You can say the words in and out if that helps, or I like to say the word relax as I breathe out. You can focus your attention on the feeling of the air as you breathe in and out through your nostrils.

Label your emotion

How this helps.

Learning to label your emotion allows you to see it as one of a range of feelings you can experience, and with practice, you can change.

How to do it.

When you first get the intrusive thought, imagine I was standing beside you and asking you what you feel. You might tell me, for example, that you are anxious, afraid, nervous, or ashamed. That is the label you apply. I am feeling anxious, or you might wish to label it as an emotion; I am feeling an uncomfortable emotion.

Decide what to do next. You will automatically want to carry out a compulsion, but I want you to take more charge and decide what to do.

For example, label your emotion and ask yourself, what do I need to do to feel better, to change this uncomfortable feeling? You should focus on your breathing, in which case you do that. Or you might need to refocus your attention on your surroundings.

Refocus your attention

How does this help?

It forces you to focus on what is happening rather than getting caught up in the fear attached to the obsession.

How to do it.

Look around you. What do you see? What do you hear? Again, imagine that I asked you to describe your surroundings; only describe it yourself.

Change the emotion.

Why does this help?

Emotions can be heavy, and it is too easy to get absorbed by them, but if nothing in your immediate environment warrants such a negative emotion ( apart from your thoughts), then change it.

How to do it?

It is hard to laugh and feel an uncomfortable emotion simultaneously. Find something funny on youtube or something that will give you a more pleasant emotion. I’m a dog person, and watching videos on dogs can change my feeling from negative to positive.

Are these skills running away from the problem or distraction?

On the contrary, uncomfortable emotions that arise from intrusive thoughts do not reflect your reality. The feeling stems from your thoughts and only your thoughts. Using the power of your thoughts, surroundings, and breath is choosing to change your emotional experience based on something more accurate than an intrusive thought.

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