Obsessive thoughts are mental products that seem to go on their own. In most cases, we try to stop them or control them with the paradoxical result that they increase exponentially.
When we deny or avoid obsessing about something, we keep that obsession in our mind for longer. Think of the typical summer song that you hate and that keeps spinning in your head and you need to get it out of there.
The more effort you make to get away from it or avoid it, it seems that it takes more pace, more strength and stays for longer. On the contrary, if you accept it and let it be, the happy song ends up disappearing.
We know that exposure with prevention of response is the treatment of choice for obsessive-compulsive disorder, especially if it is accompanied by rituals. In the case of pure obsessions, we can choose to record our obsession or write it down and expose ourselves repeatedly to it, until the anxiety subsides.
There is a novel and very effective technique based on cognitive therapy that seems to be giving promising results in some patients. It is the technique of the 4 steps of Dr. Schwart. Jeffrey Schwartz is a great researcher on the cerebral plasticity of obsessive-compulsive disorder.
It has been scientifically proven that people with this disorder have an alteration in the metabolism of the circuit of the stellate neurons.
Dr. Schwartz showed that through the 4-step technique, not only can people with OCD control their obsessive thoughts, but even the metabolism of that neural circuit is returning to normal levels.
The technique of the 4 steps of Schwartz
As its name indicates, this technique consists of 4 steps of cognitive character that the patient has to carry out every time an obsessive thought bursts into his mind.
The goal is for the patient to create a habit, so that the technique becomes part of their daily routine. The first three steps are the most important, especially at the beginning of the treatment. The Schwarzt 4-step technique is based on the “4 Rs”:
The re-labeling of thoughts basically consists of giving our thoughts and acts the name they really have: obsessions and compulsions. We must become aware of what is happening to us. OCD (Obsessive Compulsive Disorder) is a pathology and our obsessions are a product of it, as are the neutralizations.
In this way, it will be easier for us to put everything in its place. To train in the re-labeling, you must not say to yourself: “I think I can hurt my mother if I do not count to 100 before going to bed,” if not you should say:
“I have obsessions because of my OCD, so the idea that I’m going to hurt my mother if I do not count to 100 before going to bed alone is a product of the disorder.”
The idea is that you identify that certain mental products you harbor are symptoms of your obsessive disorder and not you as a person. It is to separate the irrational obsession that has nothing to do with the thought that is in tune with you.
This means making the effort necessary to maintain your awareness alert or what we also call the impartial viewer, that is, the power of self-observation with the ability to recognize what is real and what is simply a symptom and reject the pathological impulse until that it starts to give way and disappear.
The objective in this step is to attribute the responsibility of the obsessive symptomatology to the subject that belongs to it, that is, to the OCD itself. The idea is that the person says: “It’s not me, it’s the TOC”. A TOC rooted in a biochemical imbalance in the brain and / or in a childhood misperception.
It is very necessary to understand the role played by the brain in the thoughts and impulses of OCD. If we know that it is a psychological or medical condition and we do not merge it with ourselves, we can gain arguments to avoid the avoidance behavior.
In addition, the most demoralizing and destructive behaviors characteristic of people with OCD will be less frequent: the frustrated attempt to try to get thoughts and impulses out of the way.
Like any other disease that has symptoms, we must know where everything comes from so as not to give us a responsibility that does not correspond to us.
The objective of refocusing is to change our attention, even for a few minutes, to another issue that has nothing to do with our thoughts.
Obsessive people develop an automatic and quick habit according to what they think and do with their thoughts. It is that, having been aware in the previous steps of what happens to you, make a “gear change” and de-automatize the brain in a conscious way.
Your mission is to focus attention elsewhere and have a list of alternative behaviors that you can perform to avoid compulsion.
For this, hobbies are a great alternative. You can go running with your dog, plant seeds in a pot and water it, paint a picture, listen to music or whatever you think that inhibits your impulses. An internal dialogue that can help you is the following:
“I am having a thought because of my OCD, it is not real, now is the time to do something else”.
Reevaluate means, basically, launch the “two As”: Accept and Anticipate. Regarding acceptance, if we have done the above steps correctly, it will be easier for us to begin to reevaluate our problem as what it is and to accept it. We will not resign ourselves and we will try to continue working to improve, but we will not fight against our OCD because we already know that the fight and the fixation with the control only feeds the OCD.
On the other hand, to anticipate means to say to oneself:
“It seems that your OCD already begins to do of its own, you already know that you do not have to pay attention to it, focus on something else that is productive and cheerful”.
Before the OCD comes to bother us, we have to anticipate and act, so that we are not caught unawares.
The Schwartz 4-step technique has been shown to be very effective in combating OCD symptoms; perhaps, against its main “but” is that it is not easy to apply. The patient needs to practice it with motivation and commitment until it becomes a habit.
It is important, as we have said, to work with great intensity the first three steps because they are the ones that will lead us to separate ourselves from our OCD, to see it as an “entity” that is outside of us, that is not us. To see it with the eyes of a pathological condition that we had to live and face, but that it is possible to overcome.