Common Recovery Mistakes: Self-Soothing & CBT

There's a common OCD compulsion called self-reassurance, where in order to gain certainty and ease anxiety, a person will reassure themselves (as opposed to asking for reassurance from others). If you understand OCD well, you’ll know that compulsions are what keep the OCD cycle going and reinforce this pattern in the brain.

So while it’s normal to self soothe at times, it's not an effective technique when responding to intrusive thoughts. 

What is self-soothing?

Self-soothing is a term used for when we show up for ourselves either physically, emotionally, mentally or spiritually. When we go through difficult times, whether it’s the death of a loved one, a divorce, or even struggle with a mental health disorder, it’s nice to have friends and family there to provide support, but they don’t always know just what to say or do, and they won’t always be there exactly when we need them. Plus, we all go through lots ups and downs in our lifetimes, some more challenging that others.

One attribute of a mentally and emotionally healthy person is the ability to self-soothe, and to not always rely on others. Here’s what someone going through a break-up might say to themselves to self-soothe:

• “This is hard right now, but I know I’m going to be okay eventually.”
• “I did the best I could and I learned a lot from this relationship.”
• “It is going to hurt for a while, but I’ll get over it eventually.”

These are all healthy, reassuring statements to tell oneself after a break-up. They acknowledge the difficult situation and feelings, put a positive spin on the situation, and provide hope for the future.

Additionally, self-soothing can be physical, spiritual, and emotional/mental and might come in the form of praying, crying, cuddling up in bed, journaling, meditating and the like.

The Problem with Self-Soothing for OCD

The problem when it comes to OCD isn’t the behavior of self-soothing, but when we do it and the intention behind it. Remember, a compulsion is anything one feels the strong urge to do to gain certainty or ease anxiety. Almost anything can become compulsive for someone with OCD if it meets one of those two conditions.

So should I avoid self-soothing if I have OCD?

No, just because you have OCD doesn’t mean you can’t do things for yourself that make you feel heard, comforted and supported. BUT…you DO need to be aware of your intention before practicing self-soothing, as well as paying close attention to what you’re telling yourself.

For example, if you’re telling yourself things like, “this is just OCD” when your OCD obsession or intrusive thought is about whether or not the thoughts are true, then you’re trying to create certainty and therefore likely doing a compulsion. Or you might say to yourself, “I know my partner loves me” when your obsession or intrusive thought is questioning their feelings for you, this is also a compulsion and will make things worse.

Remember, OCD wants certainty, and it will get you to search for it 24/7 if you’ll let it, but once you start down this path of trying to gain certainty, OCD will need more and more of it, giving you more and more intrusive thoughts to seek more certainty. The key to recovery from OCD is to lean into UNCERTAINTY. When we can get comfortable with not knowing the outcome, feeling anxiety in our body, or not being 100% sure, this is when the brain also starts to get comfortable with this uncertainty and stops giving you intrusive thoughts.

So...feel free to tell yourself "I'll be okay," but not in response to the intrusive thought "what if I'm never ok?"

Other CBT Pitfalls

CBT, or cognitive behavioral therapy, is a way of identifying and changing negative or destructive thought patterns. Many of these techniques can be helpful for OCD, including the gold-standard treatment for OCD called ERP, or exposure and response prevention. But, there are also a couple of CBT techniques that easily become compulsive for those with OCD that you want to look out for.

Here are a few of the CBT techniques that are effective for OCD:

1. Exposure and response prevention (ERP) – is used to help the person expose themselves to the feared subjects or objects. While it seems counterintuitive to move TOWARD something that makes you feel bad, it’s actually one of the best things you can do for discomfort or fear. See, when we sense danger, our brain tells us to run away to stay “safe,” but when it comes to OCD, these alarm bells are highly exaggerated. Regardless, the sufferer is usually changing their behavior as if there is real danger, which reinforces the fear response. So someone with ROCD might avoid relationships altogether, break up with their partner, or even withdrawal from intimacy. None of which are productive or helpful. The opposite action is the only thing that will reprogram the brain’s fear response.
2. Identify cognitive distortions – these are negative thinking patterns that are common for many, but especially prevalent for those with OCD. They include filtering, overgeneralization, forecasting, mind reading, black/white thinking, jumping to conclusions, catastrophizing, personalization, blaming, shoulds, emotional reasoning, mislabeling, heaven’s reward and fairness fallacy.
3. Emotional regulation – the anxiety felt when OCD creeps in can be quite overwhelming, so learning to manage the emotions that come with cycles of OCD is crucial. Depression is often experienced by those with OCD, so feelings such as sadness and hopelessness need to be addressed as well.
4. Mindfulness – is the practice of being in the present moment. It’s very important for anyone struggling with OCD due to the fact that the compulsion of ruminating (being in one’s head, usually in the past or future) is one of the most common, and one of the hardest to stop.

Here are some of the techniques that can easily become compulsive or don’t work as well for OCD (especially without doing ERP):

1. Thought reframing – is when you take a negative thought and reframe it into a more positive one. While this isn’t always a bad thing, someone with OCD might use this technique to gain certainty in the situation or get rid of the anxiety. This is when it becomes a problem. The OCD has just been reinforced (temporarily) and while you’ll feel better in the short-term, OCD will then give you more intrusive thoughts with ANY uncertain moment it can. Your ability to handle uncertainty hasn’t been improved at all.
   • Example: changing the intrusive thought, “What if my relationship doesn’t last?” into “My relationship will definitely last.”
2. Cognitive restructuring – this technique is used to explore your thoughts and the validity of them. One might take a thought and question whether or not it’s “true,” looking for the “evidence” on either side. While this is very effective for general life situations, it can very easily lead someone with OCD down the black hole of checking and rumination compulsions. When the “OCD switch” is turned on, it will find all kinds of evidence as to why the (its) thought is true because all OCD wants you to do is run away from the relationship. Hence, why it is giving you intrusive thoughts to begin with.

As you can see, CBT is not all bad, and the above techniques work well for other negative thoughts. There are effective tools for treating OCD, but it’s very important that you are first creating a foundation of ERP, then supplementing the effective CBT tools around your practice of the ERP skills. Only then will you start to see significant progress in your OCD symptoms.

To get help getting to, and staying in the recovery stage for any OCD subset, see the links at the top of tis page.  I've recovered and you can too!