There’s a good reason we are devoting an entire chapter of this book to self-compassion: it’s typically a foreign concept to those of us with OCD! This makes sense, if you think about how mean OCD is to the people who have it. After listening for so long to OCD’s demeaning voice, many people unconsciously make the disorder’s voice their own, and their self-talk starts to become critical, judgmental, and demoralizing. Unfortunately, this just makes someone with OCD feel more isolated, fearful, and exhausted.
But fortunately, there is a healing alternative: self-compassion. Through developing the skill of self-compassion, people with OCD can learn to gently acknowledge painful emotions, recognize they are not alone, and give themselves encouragement and support. In this chapter, we’ll discuss empathy and compassion as foundations for self-compassion, the three core elements of self-compassion, how to create a self-compassion coping statement, and how to avoid misusing self-compassion in response to your OCD.
We love working with people who have OCD. They are considerate, incredibly compassionate, and overflowing with empathy (sometimes to their own detriment!). They also tend to be smart, creative, and quick-witted. But the majority of OCD sufferers have one major flaw. They are mean.
What? Didn’t you just say that people with OCD are considerate and compassionate? Why yes, we did. And they are. To other people. But often people with OCD treat themselves, well, terribly.
You may be thinking, “But that’s not true!” And maybe it isn’t, all the time. But do you often let others off the hook for stuff that you’d never in a million years let yourself get away with? Do you find that you frequently talk to yourself in a way in which you’d never address anyone else you cared about? Do you play down or ignore your positive qualities, saying, “They don’t count!” while recognizing the benefits of those same qualities in others? Do you set a low expectations bar for others that they can easily hop over, but for yourself set an extremely high bar, way up in the clouds, that you don’t stand a chance of clearing? It may be hard to admit, but you’d never treat a friend (and maybe not even an enemy!) the way you treat yourself at times.
So why in the world are people with OCD so mean to themselves? We can all, at least partly, blame OCD.
OCD is a paragon of meanness, and there are three ways it lays the foundation for people turning on themselves. First, OCD tells sufferers that they are special (McGrath 2006). That label might seem like a good thing, but what it really means is that OCD sufferers apply rules to themselves differently than to everyone else. (It’s akin to feeling you suffer from “terminal uniqueness,” a term used by some in Alcoholics Anonymous to describe those who tend to feel unredeemable and set apart from others, even in a room full of people suffering from the same addiction.) There are “majority rules” and “OCD rules,” and OCD rules are always more stringent, complicated, and time-consuming than the majority rules (the rules for everyone else).
People following majority rules can run over a pothole and keep going, but people with “hit and run” OCD, for instance, must follow OCD rules and turn the car around and go back and check to make sure they didn’t leave a wounded victim behind them. It doesn’t matter that OCD rules typically make no logical sense and may cause more danger than they prevent (for example, driving while staring at the rearview mirror or endlessly looping the same block, looking in the median for bodies). Logic doesn’t matter when it comes to OCD specialness. OCD tells its victims (and we mean the people with OCD, not the people they are allegedly running down or otherwise hurting) that they can’t be “normal” like everyone else. The “normal” person can come home from a long trip and collapse on the couch in their clothes, but the OCD sufferer insists on abiding by the “special” rule of showering and changing clothes, lest they track a contaminant from the outside onto their couch, unleashing havoc in the hygiene ecosystem. This specialness makes OCD sufferers feel disconnected from others, overburdened by responsibility, and somehow more dangerous and culpable than other people.
OCD also demands that those who have it achieve perfection, especially in following OCD rules. Like an unyielding turn-of-the-century schoolmaster poised with a ruler over a child’s bare knuckles, it will not accept anything less. OCD always wants its rituals done perfectly. And yet, paradoxically, it changes the rules constantly and keeps redefining what perfect is. A person with morality- or relationship-themed OCD might feel that she knows exactly what she has to confess to her partner to receive OCD’s absolution, but as she turns to walk away, hearing the taunting whisper of OCD, “Are you sure you told him everything?” she turns back and is compelled to share even more. She must share perfectly, because OCD rules are meant to help it achieve certainty, and OCD often conflates perfection and certainty. In OCD’s twisted logic, if something is perfect, it is more likely to be certain, and OCD thrives on the illusion of certainty. Much as we try to appease OCD’s demand for certainty, nothing in life is certain, except for death and taxes (and your mother’s calling during the most climactic scene of the season finale of your favorite show).
“Perfect” is also unattainable. Like a pigeon being chased by enthusiastic toddlers around the outskirts of a fountain in a city park, perfection is always just out of reach. And while chasing pigeons is fun, chasing certainty and perfection is not. Perfection is actually the terrible state of being on the edge of disaster. Anything that disrupts perfection in any way necessarily destroys it. So those in search of the perfect not only feel exposed, unworthy, and incapable, but are also mired in a sense of perpetual failure.
OCD yells at its victims, and its tone is arrogant, condescending, and unyielding:
Sometimes OCD will make a snide comment like these. Other times it will launch into a brief harangue. At its worst, it launches into a running diatribe lasting for hours or days. After enough of this, self-confidence drains out, to be replaced by a sticky, toxic mixture of shame and exhaustion.
This axis of specialness, perfection, and mental abuse creates an inner torture chamber. Being “special” leaves the person with OCD feeling all alone, in OCD-imposed solitary confinement. The quest for perfection turns the thumbscrews a little harder and leaves sufferers feeling like they are never good enough, no matter what they do. And the mental flagellation adds insult to injury, so they feel drained of energy and, at times, utterly hopeless. As a result, slowly but surely, OCD sufferers unconsciously take OCD’s vicious voice and make it their own. People on the outside can treat OCD sufferers with compassion, but with a bully on the inside, the kindness of others won’t suffice. What’s required is a competing voice inside the OCD sufferer’s mind to heal and give strength.
“When we’re caught up in our pain, we also go to war against ourselves. The body protects itself against danger through fight, flight, or freeze (staying frozen in place), but when we’re challenged emotionally, these reactions become an unholy trinity of self-criticism, self-isolation, and self-absorption. A healing alternative is to cultivate a new relationship to ourselves described by research psychologist Kristin Neff as self-kindness, a sense of connection with the rest of humanity, and balanced awareness. That’s self-compassion.”
—Christopher Germer, The Mindful Path to Self-Compassion (2009, Location 19–20 of 282)
Germer articulates the effect of the emotional pain inflicted by being held captive in OCD’s torture chamber—and what we can do about it. Let’s begin our discussion of self-compassion for OCD by exploring its foundation: empathy and compassion.
All of us have offered sympathy to others at times, most often when someone loses a loved one and we send sympathy cards or offer our condolences in other ways. Empathy may seem similar to sympathy, but they are actually quite different concepts. Empathy is being present with someone while they are struggling, by recognizing how that person is probably feeling and then communicating that understanding without judgment. You don’t have to have been through the same experience to feel and offer someone empathy. You only have to imagine how it might feel, based on your own emotional experience, and communicate that to the person, without judging her.
Brené Brown, in a talk she gave to the RSA (Royal Society for the Encouragement of Arts, Manufactures and Commerce; later turned into an animated video by Katy Davis), says, “Empathy fuels connection. Sympathy drives disconnection” (Brown 2013). In the video, a fox is clearly having a tough time, and a bear demonstrates empathy by taking her perspective, not judging her, and then sharing with her that he understands how she feels. The video shows the fox in a deep, dark hole; the bear climbs down to join her and says, “I know what it’s like down here, and you’re not alone.”
Giving sympathy is a little different. It’s feeling sorry for something that is happening to her and is not happening to you. Sympathy is illustrated in the video when a deer comes by, sticks his head down into the hole where the bear and fox are stuck, and comments that it must be bad being down there in the hole. He is “up here” and they are “down there”—he is separated from them.
Empathy alone, however, doesn’t take us very far. After all, a torturer’s ability to know what his victim feels would only make him more sadistic! So you also need the desire to improve the condition of others or oneself, to reduce suffering. Empathy is identifying with what is going on in the self and others, but compassion is really getting into what’s going on and helping to make it better. The Dalai Lama described the difference between compassion and empathy as follows: if you see a man who is being crushed under a rock, empathy would be imagining how he must feel, and compassion would be helping him get out from under the rock! (Lama, Tutu, and Abrams 2016).
In chapter 36 of her book Comfortable with Uncertainty (2003), Pema Chodron says, “Compassion practice is daring. It involves learning to relax and allow ourselves to move gently toward what scares us. The trick to doing this is to stay with emotional distress without tightening into aversion; to let fear soften us rather than harden into resistance” (Location 85 of 229).
Therefore, in many ways being compassionate is akin to something most of us with OCD can relate to: exposure therapy. In exposure therapy, you allow yourself to feel scary emotions, with the goal of helping yourself overcome OCD. Further, in ERP, if while doing exposure people tighten up against the anxiety and push it away, they only make themselves more scared, and the exposures become much harder and last much longer, so suffering prevails. The key for both exposure and compassion is to accept the uncomfortable feelings that are present, with the intention of improving the sufferer’s condition.
Now let’s look at how you can take the concept of compassion and apply it to your struggle with OCD. Self-compassion builds on compassion and empathy; think of it as wanting to make yourself feel better when you’re in pain (Goldstein 2012). Note that this is not a free ride to do compulsions or to avoid your ERP. Compassion is doing something helpful to reduce suffering, not just an anesthetic to avoid pain. A self-compassionate response, as defined by Kristin Neff in her book Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind (2011), would include three components: mindful awareness of feelings, a sense of common humanity, and self-kindness. As we take a look at each of these in turn, we will show you how to put together your own self-compassion coping statement to use as a tool for finding self-compassion in your challenges with OCD.
Let’s apply what you’ve learned about mindfulness in chapter 1 to the concept of self-compassion. To develop self-compassion, you’ll want to start by observing (being mindful of) how you are feeling in the present moment. Further, you’ll want to be aware of those feelings in a way that’s “gray” as opposed to “black or white.” Everyone is susceptible to all-or-nothing thinking every now and then, but people with OCD find themselves at one end or the other of the black or white continuum quite frequently. If you describe your feelings in a black or white fashion, you might end up with descriptions of your emotional experiences that are extreme, swinging like a pendulum from one end of the spectrum: “I don’t feel anything. I just feel numb,” to the other: “I’m so anxious that I feel paralyzed!” While everyone will feel these intense emotions now and then, usually our non-exposure experience of emotion is less extreme.
Finding the gray in your emotional experiences is important, because if you are too black-and-white, that may be an indication you are over-identifying with those feelings. When you are fused with your emotions, you feel you are your emotions, unable to stand back from them and see them from the perspective of a nonjudgmental, impartial observer. If you feel fused with your emotions, it’s as if they rolled in super glue and stuck themselves to you. The trouble is, then your emotions are in charge. If they want to run away screaming, well, you’re super-glued to them, so you end up fleeing right along with them. Or, if they want to throw a tantrum, you have no choice but to flail your arms and yell and scream, because that’s what your emotions want. Emotions can be loud and bossy, and being overidentified with our emotions puts them in control.
The Mindfulness Workbook for OCD describes feelings as “basically thoughts about physical sensations. You get a lump in your throat, tightness in your chest, sweaty palms, and dry mouth, and then you call it something: guilt, for example. You say, That means guilt” (Hershfield and Corboy 2013). Being mindfully aware of feelings means that you simply recognize that you are having emotions. Then you label them nonjudgmentally, such as “I’m feeling guilty right now.” Labeling them judgmentally, which isn’t helpful, would sound something like, “I’m feeling guilty again. Why does this happen to me? I want this feeling to go away!”
To help yourself step back from emotions, notice where they are manifesting in your body, which helps you see them as interpretations of body sensations. For instance, “I’m feeling guilty right now. I can feel the tightness in my chest.” In finding them in your body, you’re not trying to minimize your emotions. Instead, you’re trying to experience them more impartially. Consider the observation of Viktor Frankl we mentioned in chapter 1: that there is a space between stimulus and response in which we have the power to choose our response. If we are overidentified with our emotions, the space that Frankl describes seems very, very small. However, if we can learn to become mindfully aware of our emotions, we can dissolve the super glue bonding us to our emotions and gain more emotional freedom.
Above all, remember this about the mindfulness aspect of self-compassion: you are being truly honest about the situation. Mindfulness asks you to recognize your obsessive thoughts as exactly that; thoughts, not threats. Mindfulness as a function of self-compassion means recognizing the truth: this experience is hard. Once you have acknowledged this, you can begin opening up to or allowing for the difficulty of some of these experiences.
Take a current experience where you’re being self-critical, and write how you’re feeling. For example, if you’re being hard on yourself because your OCD has tried to stage a comeback recently, your mindful awareness of feelings might be, “I’m feeling discouraged because I’m having OCD symptoms.” Keep it simple and direct. Remember, you are just making an honest statement about your experience in this moment. Hang on to what you write. We’re going to add to it in the following sections.
Common humanity refers to the recognition that whatever it is you are experiencing, other people are experiencing it, too, and you are not alone in feeling the way you feel. One of the hardest things about having OCD is the isolation it causes. People with OCD have these incredibly painful thoughts that do not at all reflect who they are—egodystonic thoughts, in clinical speak. A dad may think he’s going to shoot his child with a gun (even though he doesn’t own one or harbor any violent tendencies). A teenage boy may feel that if things in his room aren’t exactly as they should be, he won’t be able to stand the uncomfortable feeling and it will ruin his entire day (even though he’s not superstitious and doesn’t even really care how his room looks). It’s precisely because these thoughts don’t line up with your identity that you find them intrusive.
All of these thoughts cause feelings of shame. Shame and vulnerability researcher Brené Brown (2010) defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging” or simply as the “fear of disconnection,” both of which describe well how so many people with OCD feel. She further draws a distinction between shame and guilt: guilt is “I did something bad,” and shame is “I am bad.” The shame created by having intrusive thoughts leads to even more shame, as OCD uses the very presence of these thoughts as evidence of the underlying obsession, “I am a bad person,” which is the fear at the core of so much OCD. Just having OCD can be intensely isolating, and shame makes it even worse. It’s no wonder that many people with OCD have an extreme fear of disconnection that shakes them to their very core.
This fear of being disconnected from others is why many people with OCD suffer in silence. As OCD therapists, we often hear, “It took me so long to get treatment because I was afraid that if I told anyone what was going through my mind, they would think I was crazy or that there was something seriously wrong with me.” The prevalence of shame and the feeling of disconnection in people with OCD is why the common humanity element of self-compassion is so critically important. Common humanity is recognizing that there are other people out in the world who are probably in situations similar to yours and who probably feel much like you do. This doesn’t mean we are comparing ourselves to others—when we do that, we rarely end up in an equal position. We either seem to be worse off than they are, so we pity ourselves, or we feel better off than they are, so we pity them. Pity, like sympathy, is disconnecting, when we are actually looking for a feeling of connection. Instead, by thinking in terms of common humanity, we are recognizing our shared humanity—that we all experience pain, loss, sadness, grief, and other unpleasant feelings, that we all suffer at times, and that none of us is alone in our suffering, no matter how isolated we feel.
The trick to recognizing our shared humanity, however, is to make it feel credible. If you say, “I’m sure someone else out there is suffering right now,” while that is probably true, it’s too general to be all that comforting, and it can even bring up thoughts of how many people are suffering more than you are, an unhelpful distraction. By making your awareness of common humanity a little more personal to your situation, you can increase your sense of connection.
To add the common humanity element to your self-compassion statement, craft a sentence or two that captures the awareness that what you are feeling could be shared by others. Going back to our previous example, if you’re being hard on yourself because your OCD has tried to stage a comeback, your statement of common humanity might be, “OCD is a chronic condition, so I bet other people who have the disorder struggle with lapses now and then and also find it frustrating.” Again, keep what you write. We’re going to add the final element to it in the next section.
“Self-kindness? Never heard of it!” When we describe self-compassion to our clients and explain how they can use it as an adjunct to ERP, many look at us quizzically when we get to the self-kindness part of the discussion. “How do I do that?” they ask, puzzled, as if we had suggested that they visit Mars for homework before the next session. Self-kindness is a totally foreign concept to so many people with OCD for the very reason we mentioned earlier in the chapter: OCD models being mean to yourself.
So what exactly is self-kindness? The easiest way to describe it is to think about your best friend and how you might treat him. Do you say, “Ignore your pain, weakling. It’s meaningless! Pick yourself up from the floor and get moving!” Do you suggest, “Well, of course this happened to you. You’re worthless! You always make these kind of mistakes and get yourself in these awful situations!” No, clearly you don’t say any of that, because if you did, your best friend might decide not to be your friend anymore. So why in the world would we talk to ourselves like that?
Now think about the types of things you do say (and think) about people you genuinely care about and consider what it might be like to say those same types of things to yourself, giving yourself the care and understanding you deserve. Self-kindness recognizes that it hurts when things don’t go your way, when you feel “not enough,” or when you don’t meet your or others’ expectations. It recognizes that beating yourself up only makes things worse, and that burying the painful feelings by ignoring them only causes further suffering. Punishment, especially self-punishment, simply does not produce the results we are looking for (healthier behavior).
Using self-kindness when you have OCD can be tricky because you don’t want to get into the compulsion of self-reassurance with an OCD obsession. For instance, say that the dad who fears he’s going to shoot his child used to say to himself, “I’m a horrible father. I’m so ashamed that I keep having these horrific thoughts about my little boy.” It might sound like self-kindness for him to instead say, “It will be okay. I wouldn’t do that to my little boy.” Asserting that he is certain his intrusive thoughts are untrue is self-reassurance: a compulsion that is focused only on reducing his anxiety about something bad happening in the future (that he might shoot his son). It weakens his ability to accept uncertainty, and it functions as a form of verbal hand washing (in which thoughts of hurting his son are the contaminants). This just reinforces his OCD and makes it more likely that this obsession will keep haunting him in the future.
What would be a better way for this father to handle this thought in a way that reinforces his ERP? It would be replacing self-reassurance with self-kindness to instead tell himself, “I’m doing the best I can keeping it together with these scary thoughts. I’m going to be kind to myself and give myself a break, knowing that these thoughts still cause me a lot of distress.” Self-kindness, as opposed to self-reassurance, is addressing you in the situation, not the content of your obsessive thought. It’s highlighting your strength and your perseverance in coping with hard thoughts and feelings. Rather than saying “Your problem is not a problem,” self-kindness says, “You can do this. Believe in yourself. You’re worth it.”
Because self-kindness can be so challenging for people with OCD, we’ve developed a three-part formula for the self-kindness portion of the self-compassion statement.
When you a develop a mindful awareness of feelings, a sense of common humanity, and self-kindness, you have the three elements of self-compassion for your situation:
Putting all this together gives you your self-compassion coping statement:
We will explore more about how to use self-compassion and your self-compassion coping statement in chapter 3.
How do you know if your use of self-compassion is starting to be compulsive? The easiest way is to ask yourself if you are trying to reduce your anxiety with self-compassion. You can ask yourself: “Am I trying to bring the fear down, or am I trying to bring myself up?” If you are trying to reduce anxiety, then you are probably using self-compassion as a ritual. Here are some examples of problematic uses of self-compassion and how to correct them:
Sandra is under a lot of stress right now. Since she became pregnant with her first child, her emotions have been all over the place. But what’s worse is she suddenly became aware of the thought, “I might snap and do something to hurt myself.” She’s not suicidal, far from it; she’s excited to bring new life into the world. But her OCD is hell-bent on taking the joy of motherhood away right from the start. Suddenly, being around a knife triggers horrible intrusive thoughts about stabbing herself in the belly, killing herself and her unborn child. When she does laundry, being around bleach triggers vivid thoughts about losing control and spontaneously drinking all the bleach. This all coincides with huge spikes in anxiety, of course. She begins to wonder, “Is it cruel and unusual punishment to force myself to be in the presence of these horrible thoughts? Is it barbaric, even, to ask myself to be in the presence of a knife when I think I could lose my mind at any time and stab myself?” Her self-compassion statement becomes, “I am really overwhelmed right now. Anyone with this kind of OCD would be frightened. I’m going to hide the knives and bleach from view so I do not see them and do not suffer as much.”
Hiding the triggers sets into motion a series of other safety behaviors, all of which send the message back to Sandra’s brain that she is somehow a suicide risk when she is not. Safety behaviors in the face of OCD should be called danger affirmations! A more effective use of self-compassion would be to say, “I am having a hard time with my OCD right now. Anyone would be freaked out by thoughts like these. I am going to be kind to myself by refusing to let OCD commandeer my kitchen and laundry room. I will instead stand up for myself and have whatever thoughts and feelings come with it, because I will not be bullied by my OCD.”
Don is doing his taxes, and his OCD tells him that he needs to check the forms one more time to make sure they are correct. If they aren’t, then maybe the IRS will come after him and he’ll land in jail! He checks once, and then again, and then again, and all he wants to do is be done and stick the forms in the envelope and send them in! Don is in emotional pain, so he says, “I’m feeling really anxious right now. I bet anyone with OCD would feel this way. I’m going to be kind to myself and let my partner check the returns one more time, as I can’t do this again.”
That’s not self-compassion. That’s Don giving in to his OCD by having his partner provide reassurance that the forms are correct. He’s delegating his compulsions. A better way to handle this situation would be to amend the statement and his own actions as follows: “I’m feeling really anxious right now. I bet anyone with OCD would feel this way. I’m going to do my ERP and mail this form, and then give myself the rest of the night off to watch football, even though I know I’ll be anxious, and that’s okay, because that means I’m getting better.”
Timothy wants to be a teacher, and lately he’s been wondering if it’s wrong that he thinks little kids are cute. Does that mean that maybe he’s attracted to them, or would hurt them? Does that mean that he should change his career ambitions? When he put together his self-compassion statement, he said, “I’m feeling really depressed because of all these thoughts. Anyone who wanted to be a teacher would feel this way. I’m going to treat myself like the good person I know I am.”
At first glance, there’s nothing wrong with this self-compassion statement. However, at the core of Timothy’s obsession is the fear, “I’m a bad person.” This core fear and the obsession itself cause tremendous shame, which we are trying to address by using self-compassion. However, directly disputing the core fear of “I am a bad person” in the self-compassion statement may backfire, setting off a storm of rumination in Tim’s mind about whether he is or is not a bad person. A better self-compassion statement might be: “I’m feeling really depressed because of all these thoughts. Anyone who wanted to be a teacher would feel this way. I’m not going to beat myself up about having these thoughts right now. I have all kinds of thoughts, and I don’t need to be certain about their meaning.”
We hope this chapter has given you a taste of the power of self-compassion. In our experience, people who incorporate self-compassion into their recoveries from OCD find that it both reduces their shame and increases their feelings of empowerment over the disorder. In addition, it’s really important to recognize that self-compassion is a skill and, just like any other skill, the more you practice it, the better you become at using it and the more you will reap its tremendous benefits.
Consider the two foundations for a joyful life with OCD, mindfulness and self-compassion, in culinary terms. Mindfulness is like an ingredient that brings all the other flavors of a dish to their full potential. If your life is a meal, the addition of mindfulness changes it from being “just food” to being gourmet cuisine. With the addition of self-compassion, you can learn to treat yourself in such a way that you can enjoy the gourmet dish that’s in front of you each and every day.
In the first two chapters of this book, we’ve discussed how learning to observe thoughts and feelings without judgment (mindfulness) and learning to treat yourself with the kindness and respect you deserve (self-compassion) can make long-term management of your OCD a more joyful path. In the next section of this book, we will explore specific strategies for putting these concepts into practice.