Ask the Experts: How can I foster self-compassion with OCD?

Integrative counsellor and therapist Fiyaz Mughal OBE explores how you can let go of self-criticism with OCD

How can OCD impact a person’s life?

Obsessive compulsive disorder (OCD) can have a significant impact on a person’s life. It’s part of the anxiety spectrum of disorders, and thereby linked. The two elements that have the greatest impact are intrusive thoughts, which are most worrying and destabilising, and the compulsions that eat into the time, and take people away from the things that they enjoy and value in life.

Intrusive thoughts may make people feel that they are different, weird, or terrible in some way. They are called ‘ego-dystonic thoughts’. This makes some people withdraw, strengthening the ruminations and reinforcing compulsive behaviours. People may think that they are inherently bad, disconnect from loved ones, and go into compulsive behaviours that further limit their lives.

The impacts of OCD are significant – economically, mentally, and emotionally. It can be a debilitating condition for those who do not have adequate and helpful coping and management techniques.

Can OCD cause feelings of shame and self-criticism, and why does this happen?

While OCD is a difficult condition to manage, many people do, and they live happy and fulfilled lives. However, shame can keep people in a complex cycle of trying to cope with ruminations.

Intrusive thoughts can be so shame-inducing (as well as frightening and emotionally shocking) that they create a barrier for the person to voice them in therapy, or to seek help. The shame of thoughts can restrict people, and this may also extend to the compulsions.

Shame is another layer to the defensive reactions that become multi-layered over time for people living with OCD. The sense of self-isolation and pain can become deeper, and the ability to seek professional help seems even farther away. I would say that there is a core quad of processes that keep the cycles of OCD strong, until they are worked through in therapy: ruminations, shame, compulsions, and hopelessness.

How can counselling help someone with OCD let go of shame?

Counselling can help shine a light on the intrusive thoughts, allowing people to voice them and know that they, as people, are accepted, and that thoughts are just that – thoughts. Voicing the intrusive thoughts takes the power away from them, helping clients to feel that they are not ‘abnormal’ or ‘bad’.

Voicing intrusive thoughts is important to cut through the shame which seeks to keep them internalised. Once the shame starts to fall away, people begin to engage more in the counselling process, and feel able to connect with others, seek help, and also seek to regulate themselves through personal connections.

Vocalisation is important to reduce shame, and this gives people another way of looking at their intrusive thoughts that does not make them connect wholly to their sense of self and personal identity. This can be the start of reducing the internal pulls of intrusive thoughts that draw individuals to get stuck in ruminatory cycles, and repeating compulsive behaviours.

What are your top tips for fostering self-compassion with OCD?

• Try to realise that thoughts are just that: thoughts. Everyone has intrusive thoughts, but it is the degree of believing in them, and engaging with them, that separates those with OCD from those who don’t suffer from the condition.

• Intrusive thoughts do not define you. Intrusive thoughts are fundamentally opposite to the core social and moral values of individuals with OCD.

• Anxiety and OCD are not ‘enemies’ or out to ‘get you’. They are coping mechanisms that your body and your mind use for difficult stressors and life experiences. Historically, these coping mechanisms may have helped you once, but they are not helping now, and reframing this truth can change your relationship with OCD.

• Remember that many people live fulfilled and fruitful lives with OCD. OCD does not hold them back and, in many ways, has shown them the true person that they are – helpful, emotionally caring, empathic, and motivated to help others.