Self-Help: Managing Obsessive Compulsive Disorder – Schwartz’ Four Step Method

Managing Obsessive Compulsive Disorder

All of us occasionally get obsessive thoughts and sometimes engage in compulsive behaviours.

But when things reach unmanageable proportions whereby our lives are negatively controlled by obsessive thoughts and increasingly strange compulsive behaviours, then we know we have a problem.

What does Obsessive Compulsive Disorder Look Like?

A person with obsessive compulsive disorder (OCD) experiences irrational thoughts which create high levels of anxiety. They then engage in compulsive behaviours to gain temporary relief from these anxious feelings. This can can include:

• obsessive cleaning
• constant checking
• arranging things with relentless precision
• repeating certain words
• engaging in rituals
• having thoughts of harming yourself or others.

As an example, someone obsessively cleans (compulsive behaviour) to relieve the anxiety caused by tormenting thoughts that life-threatening germs are everywhere and are dangerous to themselves and others (irrational thoughts.)

If you have OCD, you are generally aware that you are engaging in strange behaviours.

If you are reading this article because you worry someone you know might have obsessive compulsive disorder, but they do not seem aware of it, you might want to read our article on the slightly different condition known as obsessive compulsive personality disorder (OCPD).

Cognitive Behavioural Therapy and OCD

Obsessive Compulsive Disorder is a condition which can drive sufferers into a spiral of increasingly bizarre behaviour and cause their loved ones to despair.

The encouraging news is that Cognitive Behavioural Therapy (CBT) is extremely effective when dealing with this difficult and debilitating health issue.

Research demonstrates that CBT, when used appropriately, helps to manage and change the false messages which OCD sufferers experience on a daily, hourly and often minute by minute basis. A trained CBT counsellor can help you to do battle with these irrational, involuntary and intrusive thoughts and reduce your compulsive behaviour.

As with all anxiety disorders, the faster you seek professional help the better. It’s known that as time passes, irrational thoughts become more entrenched as the brain becomes increasingly locked into an anxious cycle.

Self-Help: Jeffrey Schwartz’ Four Step Method

Alongside professional help, it is essential that a sufferer works on making changes themselves.

A very useful self-help method for managing and controlling OCD, which is pioneered by many organisations who work in this area, is Professor Jeffrey Schwartz’ Four Step Method. The Four Steps are: Relabel, Reattribute, Refocus and Revalue.

Let’s look briefly at each step:

1. Relabel.

The key to this step is learning to recognise that your obsessive thoughts and compulsions are evidence of your OCD.

Unfortunately, just wishing thoughts away or ignoring them doesn’t work. And yet this is often what OCD sufferers try to do, as they desperately try not to respond to the bizarre messages they are receiving. It’s crucial to know that this is not an effective strategy.

Although it seems counter-intuitive, the reverse approach is needed. You need to become aware of your thoughts and compulsions, look at them, see them for what they are – incorrect intrusions and false messages from your brain – and relabel them as this.

Pay conscious attention, in the moment (mindfulness), to your thoughts. Keep reminding yourself that these thoughts are unwanted, that they do not represent reality and that they are part of an obsessive disorder.

2. Reattribute.

The key point of this step is to realise that the intrusive thoughts and compulsions are caused by a medical condition and your current brain chemistry.

As Schwartz sums up: “It’s not me – it’s my OCD.” Keep reminding yourself that just because your brain gives you a message doesn’t mean that it is true. Steps one and two work together to help you to correctly recognise irrational thoughts and to understand where these thoughts are coming from.

3. Refocus.

This is the action step. Begin to refocus and distract yourself from the irrational thoughts and compulsive behaviours you feel compelled to engage with.

Schwartz calls this ‘shifting gears.’ Even if it is just for a few moments, distract yourself away from carrying out a compulsive behaviour, or from hearing that repetitive thought in your head. Put some music on, take a walk, phone a friend or do a crossword puzzle. Do anything to take your mind away from your thoughts and compulsions.

This resistance to engage in a compulsive behaviour – to assuage your anxious irrational thoughts – creates key changes. You don’t have to do what your faulty brain chemistry is telling you to do. Keep reminding yourself that your brain is tricking you and become adept at distraction techniques.

4. Revalue.

Over time, and with work on the previous three steps, you can begin to revalue your thoughts and urges. You can watch how your mind works, question the thoughts that you have, and remind yourself that it is the OCD which is causing the intrusive and unwanted thoughts.

You will no longer feel as compelled to believe these tormenting thoughts or need to follow through with the compulsions to reduce your anxiety. As the days, weeks and months pass, the quantity of irrational thoughts you experience will reduce and your compulsions will have less of a hold over you.

Conclusion

Along with your OCD counsellor, you can work on the Four Step Method, or a similar CBT method, and begin to manage this distressing condition. There is hope. With time and appropriate treatment you can get the upper hand over your obsessive compulsive disorder and get your life back under your own control.

© 2012 Ruth Nina Welsh. Be Your Own Counsellor & Coach

Harley Therapy offers highly experienced OCD therapists in three London locations. You can now book a first appointment online. Not in the UK? We now also offer online therapy worldwide.

Do you have questions about OCD? Or would you like to share your personal experience and help others? Feel free to comment below, we welcome hearing from you.