The need to confess...

One of the most aggravating aspects of Obsessive Compulsive Disorder (OCD), is the compulsion to confess. I might imagine that I have said or done something to offend a friend, or a stranger. I might imagine that I have broken the law, or forgotten to turn off my oven before leaving the house, or any of a hundred and one different scenarios my mind can conjure up. All tailor-made to drive me to distraction.

These thoughts create a sense of discomfort or guilt, so I feel as though I need to confess to someone in order to be reassured that I didn't do anything bad. Whilst this makes me feel better, it can put strain on relationships because people become frustrated with my need for constant absolution and reassurance. This is not to say all confessions are problematic. It is good to confess when you mess up, and many people find confession helps them to adhere to their core values (East Bay Behavior Therapy Center).

The problem arises when this urge to confess is a compulsion driven by the need for reassurance. However, such compulsions can be managed using tested strategies. One such strategy is Exposure and Prevention (ERP).

ERP has two components.

1. Exposure Treatment

2. Response Prevention Treatment

In ERP you commence by exposing yourself to situations which create the least anxiety and work to resolve that anxiety without resorting to a compulsion (OCDuk).

Sometimes you create strategies to follow in solving a problem, such as organising your home in a way that makes finding something easier, or creating a checklist to make sure you have everything you need before leaving your home. For situations where a strategy is not as easy to create, there are self-talk methods.

For instance, if your compulsion is to stay at home because you're uncertain what may happen if you go out. a way to manage that is to tell yourself that life is often uncertain and that it is okay not to know what will happen.

In her book Is Fred in the Refrigerator? Shala Nicely outlines how she would talk to her OCD and tell it "That (whatever situation OCD is worried about) may or may not happen, but I choose to live with that uncertainty, because life is uncertain, and that is okay."

When I first learned about ERP I looked for low stress situations such as losing my keys. In times past, this would have me frantically scrabbling through my bag, hyperventilating as I imagined all kinds of terrifying scenarios about being locked out of my car, house, or workplace. When I deliberately exposed myself to this situation, I could make a conscious choice not to let my anxiety ramp up. I'd calmly and methodically search through my pockets, look in my purse, and if the keys weren't in those places, I'd expand the search to less likely places and reason out where else they might be.

Creating designated places for my keys; a particular pocket in my bag, the back pocket of my jeans, and a specific hook at home, gave me a clear pathway to follow when I need to find them.

Once I had gained confidence that I can handle missing keys calmly, I moved on to some of my more challenging compulsions. Telling myself not to go back and check, and not to seek reassurance through 'confession.'

Although these may seem like a small things to others, overcoming these small compulsions gave me the confidence to work on the bigger issues.

It's a long road, but I choose to travel is despite the uncertainties. "Life is uncertain, and that is okay" (Shala Nicely).