“There is only one kind of shock worse than the totally unexpected: the expected for which one has refused to prepare.”
- Mary Renault (author)
1. Never think you are cured. OCD is chronic and at this time there is no cure. You can, however, achieve recovery which can be maintained by never forgetting the lessons you have learned in therapy. This means you have to manage your OCD. Those who forget this run the risk of relapse.
2. In therapy you should have achieved the ability to tolerate and coexist with your obsessions without feeling that you have to do compulsions. Your tolerance levels will need to be kept up if they are to continue working for you.
3. Managing OCD means occasionally challenging yourself on purpose, or taking on challenges when life presents you with them, whether unexpectedly or not. You won’t have to work as consistently as you did in active therapy, but you will need to practice occasionally to keep your skills and tolerance up. Look upon unexpected challenges as the absolute best opportunities to practice.
4. Never say never. Just because you have overcome a particular OCD theme does not mean that it will not show up unexpectedly again sometime. New ones can possibly show up also. Be prepared for this and you won’t be caught by surprise.
5. Five basic rules that you will need to follow beyond therapy are as follows:
- Always agree with any obsessions
- Do not argue with, analyze, or question obsessions
- Resist the use of reassurance from either yourself or others
- The use of compulsions can never be justified, no matter how necessary or important they may seem in the moment
- Act on all obsessions immediately. Do not wait or hesitate, even if you are not sure they are obsessions.
6. A lapse is not a relapse. This means that even if you slip up and do a compulsion, all is not lost. For it to be a relapse, you would have to go back to square one and forget everything you learned. No one is perfect, and no one’s recovery can be perfect either. A few examples of damage control would be:
- If you reassure yourself, you can immediately turn it around by saying that of course you were wrong, and that the worst is true and will happen (or did happen)
- If contamination is your problem, you can always recontaminate again
- Should you perform a magical ritual, you can do something to counteract it and ruin the magic
- In the case of repeating actions a special number of times, go back and undo it by doing the action only once or a ‘bad’ number of times
- For those who have to think of or look at special words, images, or numbers, you can always reverse this by looking at or thinking of something associated with bad luck or a bad happening
If you genuinely find yourself at a loss facing a new theme, an old theme, or a new version of an old theme, don’t hesitate to go back for a review or some booster sessions with your therapist. It doesn’t make you a failure or anything like it. Asking for extra help when you really need it is the smart thing to do, rather than letting things go further downhill.
7. Just because you are now feeling better, do not automatically throw away your medication (if you were taking any). If you have had moderate to more severe OCD, the odds are that you may need to stay on your medication. It should never be discontinued suddenly as you risk some withdrawal symptoms. If you do wish to see if you can do without it, talk it over with your physician and work out a schedule for gradually decreasing it. If you start to feel that symptoms are returning as you do this, you can always build it back up to former levels. Also keep in mind that after you discontinue medication, it can take up to several months for symptoms to return, if they are going to, so hold back judgment as to whether going off your meds was really a good idea. No one necessarily wants to be on medication, but it can genuinely make your recovery more durable by keeping symptom levels lower.
8. Open up your life and begin or restore things you once did, or wished you were doing when you were unwell. Don’t maintain your former illness lifestyle. After all, what did you recover for?
9. Be sure to establish a balanced life for yourself. Balance is the key to wellness in general. This means not too much or too little of anything. Pay attention to such things as getting enough sleep, eating properly, getting exercise, doing something productive (such as working or volunteering), having a social life, getting regular medical and dental checkups, and learning new skills.
10. Learn to make more ‘gut-level’ decisions and take a few chances on things. Allow yourself to be more spontaneous. One thing OCD can take away from you is your ability to be spontaneous or to take risks. Remember that everything contains a level of risk.
11. If necessary, see about restoring social relationships that may have dwindled or been damaged during the time you were unwell. It can also be an opportunity to educate those around you about OCD and to take the stigma out of it.
12. Don’t spend time dwelling on what you may have lost to OCD. Your past should not be allowed to cripple your present. It’s a closed book. Instead, look ahead to what you now hope to do with your life in recovery. Your goal should now be becoming the best version of yourself that you can be. Think of the things you still have to be thankful for rather than only focusing on any losses.