The struggle to overcome the scourge of obsessive-compulsive disorder (OCD) almost always begins for the most pragmatic reasons. Your life is being taken over by a strange power that seems to be stronger than you are. In this book, my goal has been to teach you the most effective strategies for neutralizing this opponent called OCD, whose tricks can be so devastating to those who don’t know how to fight back effectively. Like most other bullies and aggressors, much of its power comes from its ability to intimidate the naive and uninitiated. When seen from the clear-minded perspective of the Impartial Spectator, the true nature of this deceptive opponent comes into focus. With this insight, fear and dread begin to fade, and the path to victory comes into view. This is what training yourself to do the Four Steps is all about.
The power of the Relabel step is something that should never be underestimated. It’s the difference between knowing what’s real and living in fear of shadows. When you Relabel and make mental notes and remind yourself, “That’s just OCD—I don’t have to listen to that”—a very powerful process is initiated. A change in the value and meaning that you give to the unpleasant obsessive thought or urge begins. The power of the Impartial Spectator is called into play, which profoundly changes the nature of the interaction between you and your internal opponent. Now the battle is being fought on your home turf—reality—not on the playing field of your opponent, who relies solely on deception and illusion. Always remember that a firm grasp of reality is your greatest ally in the fight against OCD because in the end, fear and false messages are OCD’s only weapons. If you Reattribute those fears to their true causes, as you’ve trained yourself to do, and Refocus on a wholesome behavior for at least fifteen minutes, you may not win every battle, but in the end, you’ll win the war. With the power of your mind, you will change your brain. Where once there was Brain Lock, a freer and more smoothly running thought process is now in place.
People frequently ask, especially early in treatment, “Will I ever be cured?” As I’ve tried to explain through the stories of courageous patients, a cure cannot be guaranteed, especially if you take it to mean that you will never have an OCD symptom again. But if cure means the freedom of never again running scared from the plague of OCD symptoms and not having the direction of your life dictated by the tyrant OCD, then that goal is within the grasp of essentially every person who suffers the misery of OCD. (I know this to be true. I’ve seen it too many times to doubt it.)
The larger meaning of the effort that people put into following the Four Steps is a message about what we all can accomplish when we let go of fear, practice mindful awareness, and decide to take control of our lives. The increased mental power that people with OCD develop, the power to notice small changes and understand their significance and to go forward in the face of pain and fear, have wide-reaching effects not only on the lives of people with OCD but on the lives of those around them. This greater mental power can go beyond the realm of OCD. It can lead you to a much deeper insight into what it means to Revalue your internal experience in light of new and more productive ends and goals. In doing so, you can expand your mental and spiritual horizons in ways you may not have considered before.
Consider the power of the simple question “Why am I doing this?” In many ways the entire Four-Step method boils down to bringing the perspective of the Impartial Spectator more clearly into mind when answering that question. No doubt, new information about how the brain works helps people with OCD answer this key question more realistically and more courageously. Yet it seems crucial to realize that what these new brain discoveries have in essence done is enabled people to see their own minds with greater clarity. And doing so enhances their ability to find their true goals and objectives.
We live in an age when many people who fancy themselves sophisticated thinkers—whether they are doctors, scientists, or philosophers—can state with the greatest authority that the mind is just something that “somehow emerges” from and is fully determined by the physical properties of the brain. Anything that may be called a spirit, they’re too embarrassed even to talk about. Somehow it doesn’t seem sophisticated to them. For them, science must relegate the spirit and the will to the realm of mere superstition. To my mind, this is all very unfortunate. Far worse, I believe it reflects a profoundly false way of thinking. And one of the great accomplishments of our research on OCD, I believe, is that it helps us perceive more clearly just how the conscious and comprehending mind differs from the brain and cannot be solely dependent on it.
Consider what goes on inside a man who is fighting off an OCD symptom using the Four Steps. The intrusive obsessions keep bothering and imposing on him—“Go wash your hands. Go check the stove.” Before training in the Four Steps, he listened right away, which tended to make the Brain Lock worse and worse, tighter and tighter. After Four-Step training, his mental response is very different. He now says, “I know what you are. You’re just OCD, just an alarm system in my brain gone bad. I’d rather be dead than listen to you, you miserable brain circuit from hell.” Then he goes and listens to Mozart or practices his golf swing or whatever. He considers his goals, reflects on his options, exercises his will, makes a new choice, and does another behavior. In this way, he changes how his brain functions. Over time, his brain changes enough so that, with new advances in technology, we can measure the change, even take a color picture of it (as is shown on the book jacket). Now, although some academics may say that this is just an example of the brain changing itself, any sensible person can see that the person in our example is clearly using his mental power to make the effort and do the work that it takes to change his brain and conquer the symptoms of OCD. A genuine spiritual (willful) process has taken place, resulting in a scientifically demonstrable biological change in the body’s main organ of communication—the brain.
THE FOUR STEPS AND THE REST OF YOUR LIFE
The really big message for people who use the Four Steps is that by strengthening the Impartial Spectator and practicing mindful awareness, you will increase your mental power in every other aspect of your life. Mindful awareness will help you in your relationships with other people, it will help you at work, it will help you with problems of mind wandering and excessive daydreaming. You’ll begin to see improvements in all the problem areas of life in which the cravings to which the mind is so vulnerable cause pain and distress.
For example, consider how much time and energy people spend ruminating and stewing about personal relationships. The Relabel and Refocus steps and use of the Impartial Spectator and mindful awareness are particularly helpful for modulating the intense ruminating that almost everyone does under stress—about boyfriends and girlfriends: Should I ask her out, shouldn’t I, should I call, should I wait? That’s one category. Then there’s the did-the-boss-look-at-me-funny? group and all those What-do-people-think-of-me? Am-I-good-enough? Do-I-look-okay? types of thoughts. And let’s not forget the life-would-be-great-if-only category. At the point that thoughts like these get out of control and start taking on a life of their own, they become extremely unpleasant ruminations. Anyone can become controlled by these types of thoughts. But people with OCD may be particularly vulnerable to them. However, I have seen many patients with OCD teach themselves how to break these streams of ruminative thinking when they learn the power of Relabeling and develop the technical ability to make mental notes. They can then use the Refocus step to get on a better track.
It may sound funny to say that you need to remind yourself of what you’re thinking about, but all people need to develop that ability, and a lot more so than they may realize. As mindful awareness increases and making mental notes (in which you consciously notice your thought stream) becomes more natural, you will quickly realize just how much of the time you spend thinking about things that you didn’t even know you were thinking about. These principles apply to everyone. People with OCD who do the Four Steps develop abilities that are very helpful in life—abilities that people without OCD may never develop. That may be one of the genuine silver linings of having OCD and using the Four Steps to overcome it.
OCD can function like an exercise machine in your head. Just as working out on an exercise machine increases your physical power, working on OCD increases your use of the Impartial Spectator, which will increase your mental powers and insight into both your own and other people’s behaviors. What’s more, your control over your internal mental life, even in things that have nothing to do with OCD, will be greatly enhanced. You will genuinely increase your personal freedom through the exercise of the Four Steps because the essence of having a mind that is free is the capacity to tame and direct the restless wanderings into which the unattended mind inevitably falls. With the making of mental notes, you will come to realize quite rapidly that much of the content of your mental life, of your ongoing thought process, concerns subjects that are not conducive to living a wholesome and happy life.
One of the most amazing things that you learn when exercising mindful awareness and using the Impartial Spectator is how much the mere observation of the content of your thoughts tends to direct them in a much healthier manner. In other words, knowing what you’re thinking at any given moment tends to direct the mind away from destructive ruminations, onto more constructive and wholesome subjects.
Mindfulness itself is an extremely helpful and wholesome mental state. Any moment in which the mind is exercising mindful awareness or using the Impartial Spectator is a moment in which an unwholesome thought cannot arise. Thus, the longer the period that mindful awareness is applied, the stronger the mind becomes and the less you actually experience the unwholesome and destructive types of thoughts that tend to lead to pain and suffering. Unfortunately, however, with unimaginably rapid speed, the mind can make the transition from a wholesome and mindful condition to an unwholesome and negative one. The bright side is that by reapplying mindful awareness, you can reestablish a wholesome mental state just as rapidly. For instance, if a string of unwholesome ruminations on craving or anger, greed or ill will, is broken by making a mental note that “I am now thinking a thought related to greed” or “I am now thinking a thought related to ill will or anger,” the very breaking off of that stream of unwholesome thought processes by wholesome mindful awareness will itself lead to further wholesome thoughts concerning something functional and healthful to both you and others.
This makes the Refocus step much easier to apply. As time goes by and this process becomes more and more a natural pattern of living, your mind will become sharper and more at ease and your life will be smoother and happier.
To sum up: Having OCD is a curse, but your natural ability to use the Impartial Spectator and practice mindful awareness is a blessing. If having OCD leads to your developing wholesome mental abilities that you otherwise might not have acquired, there truly is a silver lining inside of the cloud. That’s what practicing the Four Steps is about.
KEY POINTS TO REMEMBER
• Keep in mind the power of the Relabel step: It’s the difference between knowing what’s real and living in fear of shadows.
• Always ask yourself, “Why am I doing this?” and keep the perspective of your Impartial Spectator in mind when answering.
• Make mental notes to remind yourself what you’re thinking about. Just the act of observing tends to direct thoughts in a wholesome direction.
• Any moment the mind is using the Impartial Spectator, an unwholesome thought cannot arise.