I recently received the following email from a reader:
“I was wondering what your thoughts were on intrusive thoughts and anxiety problems or what some people call pure ocd. I have had problems for as long as I can remember. There is so much information out there it gets confusing. I don’t believe these are illnesses I believe alot is learned or habitual. I am alot better thanks to my own hard work, but intrusive thoughts are one of the harder things to shake. Thank you.”
Within the APA’s diagnostic and statistical manual intrusive thoughts are incorporated in the category obsessive-compulsive disorder. In other words, according to the APA, if you’re experiencing intrusive (or obsessive) thoughts, it is because you have a mental illness called OCD. This putative illness is routinely attributed to a neurological aberration and is “treated” with drugs. I have critiqued this standard psychiatric approach to behavioral problems elsewhere, and need not repeat it here. The current question is: how can one better conceptualize these matters?
For the behaviorist, thoughts are best conceptualized as behaviors. They are largely internal, but behaviors nonetheless. Thoughts are not something that happen to us, rather they are things that we do.
Once we start considering thoughts in this light, it becomes clearer why we think as we do and why a certain kind of thought might come to dominate our cognitive content.
Just as our overt habits are formed essentially by reinforcement, so it is for our “inner” habits. Many people, for instance, are habitual counters. They count almost everything they come across. If they are performing a chore, they count the number of items involved even though there is no need or purpose for this. The likely reason for this is that within our culture, young children receive a great deal of reinforcement for counting. The small child who successfully counts to five on the fingers of his hand is rewarded with smiles, hugs, etc.. Later, in school, a high premium is attached to the ability to count, and punishment and ridicule are meted out to those who fail in this area. In addition, counting is one of those activities that can be done successfully without any great effort or inconvenience. There is a sense of success and accomplishment in counting that isn’t as readily available in other areas. A great many people on seeing a small group of cows in a field will count them almost without being aware of having done so. Similar considerations apply to other intrusive/obsessive thoughts.
One must also distinguish between obsessive-compulsive behaviors that are a problem and those that are not. Most men, for instance, in professional/managerial positions wear neckties every day when they go to work. By any standard this is compulsive behavior, but for most people it’s not a problem, and many of these individuals would feel very uncomfortable without this item of apparel.
A common obsessive thought is the notion that dangerous germs are everywhere and that contact with other humans has to be particularly avoided. The problem here, of course, is that there is a grain of truth underlying this obsession, and most parents encourage their children to exercise an appropriate measure of caution in this regard. A small number of children take the measure to extremes, however, probably because for some random reason this kind of concern was particularly reinforced at a critical juncture. Some people with these kinds of obsessions have poor social skills, and it is easy to see how the obsessive thought serves as an effective rationalization for avoiding people. The solution here, of course, is to improve the social skills.
So what can you do? There are a number of approaches. Firstly, trying not to think about the particular obsession tends to be counter-productive. Distraction is a more successful tactic. Let’s say, for instance, that the intrusive thoughts usually occur at your desk and distract you from your work. Identify your least favorite task – say filing or preparing financial reports or whatever. As soon as you realize that the intrusive thoughts are present, get up from your desk and tackle the unpleasant job. What you’re doing essentially is punishing yourself mildly for having the intrusive thought.
If you ever go to a psychologists’ conference/meeting, you will probably notice a number of individuals wearing thick rubber bands around one of their wrists. At odd moments during the lectures they snap these bands painfully against their skin. Again, it’s a way of delivering a punishment for an intrusive thought. I’ve never used this technique, largely because on the few occasions I’ve gone to conferences I have usually found my own daydreams more interesting than the lectures.
I’ve always been a big believer in friends helping friends. Consider discussing the problem with a trusted friend. A problem shared really is a problem halved.
At the risk of stating the obvious, ask yourself whether the intrusive thoughts are really a problem. If they are not terribly distressing, perhaps it’s better to just live with them – even indulge them?
Few details were provided in the email, so I’ve had to confine myself largely to generalities. But I hope that you may be able to develop these thoughts and apply them to your own circumstances.