You might notice that this post is somewhat similar to the one I posted last week, (How To Win by Not Trying) but I thought it was worth posting a second post on a similar topic because I get so many questions about this. Most new clients come in seeking ways to get rid of their anxiety and I don’t think this is a good place to start treatment.
And this post is a revision of one of my most popular earlier posts, “Winning by Surrendering” , from February 24, 2014.
Anxiety Paradoxes
Anxiety treatment is full of paradoxes. We have evolved over the history of our species to avoid danger - and those of us who are alive now are here, in part, because our ancestors were the ones who could anticipate danger and carefully avoided it and thus survived, while those who weren't as careful didn’t avoid the saber-toothed tiger and became lunch. Thus we are more or less programmed to scan our environment for danger and then carefully avoid it. When the danger is a saber-toothed tiger, avoiding makes perfect sense and is the right choice, but in our current time the dangers we face aren’t often saber-toothed tigers, but more often things such as giving a presentation at work, paying our taxes and worrying about who will win the presidential race. When the danger is a tiger, avoidance makes sense but when the “danger” is a presentation at work avoidance is not the best response. Avoiding presentations will most likely lead to more anxiety in the future because you have now “learned” that avoidance reduces anxiety in the short run.
OCD As An Example
For this discussion, I’ll use obsessive-compulsive disorder (OCD) as an example, but most, if not all, of what I’m going to say applies to all of the anxiety disorders. The paradox is that with anxiety/OCD you win by accepting/surrendering. This doesn't mean that you stop trying to manage your anxiety/OCD, it means that you stop trying to make things perfect, stop trying to figure things out, stop trying to analyze things to death. And rather than avoid what you’re afraid of, you decide to turn and face it. So, for example, you have just touched a doorknob and fear that you have gotten your hands covered with germs and that if you don't wash them immediately you will get sick and die and there's a good chance you will infect your family, they will all get sick and die as well and, worst of all, it will be your fault (if you don’t have contamination OCD this may seem far fetched, but this is exactly how someone with contamination OCD thinks).
You’ve Been Here Before
You have been here many times before and are familiar with this rather scary situation. In the past, you have learned that if you go and wash your hands carefully numerous times then you may achieve a temporary sense of safety from the risk posed by the germs you now think are on your hands. However, as you have learned about OCD (if you’ve been listening to your therapist) you now realize that your attempts to achieve safety ultimately are futile and you are now trying to do things differently. You "surrender" the need to even attempt to be clean because you now recognize that this is part of the OCD, ignore the urges to once again go and carefully wash your hands and just go about your business as if there was no danger in the first place. And you also now realize that when you resist the urge to wash your hands you will feel uncomfortable for some time and you are willing to accept that discomfort, and may even welcome it because you know this means you are on the right track.
Surrender to Win
While there is still a struggle for you, in that you are now trying to resist the urge to wash your hands, so in that sense you aren't "surrendering" at all, but in another sense, you are surrendering the need to be "certain" and you do this because you have come to understand the tricks and maneuvers this devious disorder has used in the past to get you to comply. You accept the uncertainty, surrender (i.e. let go of) any attempts to find safety and don’t wash your hands.
The Futility of Doing Compulsions
Most people who suffer from OCD are, especially at first, unwilling to consider this idea of acceptance/surrender. They mistakenly believe that their quest for certainty will lead to a positive outcome. It is often only after repeated attempts to achieve this mythical state of certainty that people eventually become willing to consider trying something different. Part of OCD's deviousness is that it continues to convince you that if you just try a little harder, try it one more time, think about it a bit more, wash just that one more time, check that door lock just one more time, etc., then relief will come and can feel sure everything is safe and secure. Of course, this is a false promise, but it is seductive and difficult to ignore. I have sometimes used the analogy of a mirage that looks so very appealing in the distance, but which when pursued keeps receding further and further into the distance. Performing the compulsion can be reinforced because when you do wash your hands, check that lock, etc., there is an immediate sense of relief but, if you pay careful attention you will see that this relief is fleeting and is soon replaced by doubt and dread once again. Nonetheless, that immediate relief following doing the compulsion is seductive and gets people caught in a compulsive repetitive cycle. It is only once that cycle is recognized, and the futility of doing the compulsions over and over again is finally accepted and recognized, can you turn to surrendering your attempts to achieve certainty and that is when true recovery starts to happen.
As always, I hope you find this helpful and I welcome feedback. Let me know if there are any topics you would especially like me to address in this blog.
