Free Brain Lock: Free Yourself From Obsessive-Compulsive Behavior by Jeffrey M. Schwartz, Beverly Beyette Page B

your father’s going to die. You just have to say to yourself, ‘Okay, whatever happens, it’s better than living this life.’ Just do the Four Steps and keep the faith.” What a deep insight that is! Today, Michael says, he’s “down in the dirt with my OCD.” The smart money won’t bet against someone who can fight like that.
    At UCLA, we have many case histories of OCD-related contamination fears. In the case of Jack, a temporary worker, actual physical pain was the impetus for him to seek help for his compulsive hand washing. He couldn’t face another winter with red, raw, cracked hands. He washed his hands so much that his young daughter called them his “soap popsicles”—icy cold with the smell of embedded soap that he could never quite wash away. In treatment, he learned that when he refuses to give in to the urges to wash his hands, nothing catastrophic happens. “I know if I don’t do it that it’s not going to be the end of the world.” Before, he always felt as though “catastrophe was just around the corner. My safe places—my car, my home—were all going to be invaded if I didn’t do those compulsions.”
    It is not vital that Jack, and other patients, successfully Relabel every time an urge to do a compulsion arises. But if they give in and perform the compulsion, it is vital that they recognize mindfully that it is a compulsion and that, this time, they were unable to resist it. This is much more useful than Relabeling in an offhanded automatic manner . When you Relabel automatically, it becomes a ritual in itself and has no meaning. There is nothing magical about saying to yourself, “Oh, that’s an obsession.” Following doctor’s orders in that fashion—mechanically, without thinking about what you are doing—is not helpful. Mindful awareness is. So you say, “The feeling is too strong. I don’t have the strength to fight it this time, so I’ll look to see if I locked the door.” Then, when you do check the door, do it carefully, with mindful awareness, so you’ll be ready to fend off the urge next time. You don’t say, “Let me just make sure the door is locked.” That’s a sure prescription for endless compulsive checking.
    ASSERTIVE RELABELING
    At UCLA, patients are asked to write essays in which they describe their symptoms and how they respond to them—another type of self-directed therapy. These essays have also provided us with an extraordinary library of knowledge on OCD. Since OCD patients tend to be bright, creative people, their ways of expressing what they go through in battling their disease make for fascinating reading.
    Joanne, who’d suffered for years from a small voice in her head repeating negative thoughts over and over like a broken record, told of seeking a cure in a self-help book. The author suggested she snap a rubber band on her wrist as a distraction technique whenever her mind started playing its OCD tricks. Joanne wrote, “All I got was a sore wrist the first day.” What eventually made her better was not a rubber band, but the Four Steps. She first began to feel that she had some control over her life when she told herself, “If I don’t want to get hit by the train [the negative obsessive thoughts], I have to getoff the track and let the train go by.” She was applying a technique we call “working around” her OCD. Today, with the help of behavioral therapy and medication, Joanne is able to say, “The sun shines on my soul.”
    Mark, a young artist, described a true-life OCD experience that reads like a pilot for a horror film. His OCD started in childhood with prayer rituals and, by his early 20s, had shifted focus to a cleaning compulsion. He would have to clean his apartment twelve times (twelve was a “good” number) and then “find some girl and have sex in order to cosmically sort of switch the energies back the right way,” so a member of his family would not die. Using a woman in that way made him feel bad, so he would