20 July 2015

The comfort trap

During my recent interview with consultant psychiatrist Dr Raj Persaud, we discussed whether OCD can be cured, which is something I also wrote about earlier this year.

I've always seen the disorder as a chronic condition that has to be managed in the same way as any chronic physical ailment, such as back pain, eczema or asthma. Dr Persaud, however, was of the firm view that it is completely treatable...if you want it to be.

Since then, I've reflected on our discussion, and on my own situation, and can see that I've become caught in 'the comfort trap', as Dr David Veale and Rob Willson call it in their book, Overcoming Obsessive Compulsive Disorder. That is to say, I'd rather continue to live with some rituals than face the challenge of trying to eradicate them.

The key treatment approach for the condition is exposure and response prevention (ERP). This entails resisting your compulsions and allowing yourself to feel the resulting discomfort and anxiety, which should diminish over time, after repeated exposures. The fact of the matter is, you're going to feel worse before you feel better, and that's a somewhat off-putting prospect. 

My own forays into this therapy have been sporadic. Although I've managed to reduce my symptoms from moderate to mild, I've never grasped the nettle and applied the principles of ERP across the board. Now I realise that this is because I haven't had enough of an incentive to do so.

At its current level, OCD doesn't stop me functioning in any significant way: I'm in a relationship, hold down a job and have a good social life. My remaining compulsions are time-wasting, but haven't taken over my life or stopped me from doing anything I really want to. While that waste of time is regrettable, it has proved insufficient motivation to pursue a full recovery.

Image courtesy of artur84/
How big an incentive do you need, though? I once met a woman at a support group who was unable to touch her children due to her contamination fears, yet still she baulked at the idea of ERP. 'It sounds so hard,' she told the group facilitator. I was mystified: how could any treatment be harder than not being able to hold your own children? Her case shows how tight a grip the disorder can have.

So what would be sufficient reason for me to seek to escape its influence once and for all? The only circumstance I can imagine, would be if I wanted to share my home with somebody else on a permanent basis. That's unlikely to happen, though, as my partner and I both enjoy our independence too much!

Living with OCD is a far from comfortable experience, yet it can sometimes seem that way compared to the alternative of fully engaging with treatment: perhaps a case of 'better the devil you know'? That may seem a strange contradiction, but we're dealing with a strange and complex condition.

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If you have OCD, do you think full recovery is possible?

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