We all experience intrusive, unpleasant thoughts. One might know that a loved one is making a car journey, and suddenly think that he or she might die in an accident. We may also think that we might inadvertently cause harm to another. Perhaps you find an elderly relative’s conversation boring, and imagine yourself saying, ‘Why don’t you just shut up!’ As a result of such thoughts you might feel upset or embarrassed. For some people, however, these thoughts are frightening. Supposed you feared that your thought might cause an accident, or that you might actually say rude things that relative. These fears can lead to obsessive-compulsive disorder, a very distressing psychological problem.
The thoughts may lead to actions, for example washing one’s hands to prevent infection. This in itself is not necessarily bad, quite the contrary, but it can become excessive; perhaps you’re tempted to wash seven or eight times in a row and many times a day. Sometimes sufferers avoid people they fear they may hurt or offend. Sometimes they may even doubt their own memories, ‘I don’t think I told her to shut up, but maybe I really did without realising it!’ When such actions and thoughts become excessive, and especially when they interfere with normal life, we call this Obsessive Compulsive Disorder (OCD). In a nutshell, the things we do to avoid causing harm make us more worried about causing harm.
Let’s take an example. Bob is driving one day when it occurs to him that he might have struck a pedestrian and knocked her down, without realising it. He stops his car and looks back to check. He doesn’t see a body in the road, but now he worries that he might hit someone in the future. He starts stopping to check at every opportunity. Soon he worries all the time and avoids driving whenever possible.
Cognitive-Behavioural Therapy (CBT) can help with this. It does not teach you to control frightening thoughts, because you can’t control your thoughts. No one can control their thoughts, but you can learn to ignore them. If you start ignoring such thoughts, they may become stronger at first. You may feel as if you’re doing something risky, that if you stop taking precautions something terrible might happen. But in fact, if you persist, the opposite happens; the thoughts gradually lose their power over you. Of course, as in all forms of therapy, the client does the hard work, but we have learned many ways to help people look at their frightening thoughts in a new way. Getting free from the tyranny of obsessions and compulsions may look hard at first, but people who stick with therapy often describe a new sense of freedom.