Stacey Kuhl Wochner, LCSW, of the OCD Center of Los Angeles discusses resistance and certainty-seeking in OCD and related anxiety based conditions. Part one of a two-part series.
When treating clients with Obsessive-Compulsive Disorder (OCD) and other anxiety based conditions, two of the most important topics we discuss are “resistance” and “certainty-seeking”. People suffering with these conditions often have unpleasant and unwanted thoughts, feelings, and bodily sensations, and resistance to these experiences is a normal, natural reaction. Simply put, when faced with something uncomfortable or painful, we humans instinctively resist it, and quickly look for ways to reduce our discomfort through avoidance. But unfortunately, while resistance may internally feel like the correct response to our uncomfortable thoughts, feelings and sensations, it actually serves to inflame them.
For most people, it seems counterintuitive to reduce resistance and allow uncertainty to remain in the face of these uncomfortable internal experiences. Many are likely to think something along the lines of “I must find a way to keep this thought, feeling, or bodily sensation from happening again.” But this philosophy of resistance in regards to our unwanted internal experiences will actually cause them to become more powerful. As illogical as it may seem, oftentimes the best solution is to lower our resistance, surrender, and accept what is being offered.
If you encountered a mountain lion while on a hike, what would you do? Your natural, instinctual inclination would be to respond to the message that your body is sending you. Your sympathetic nervous system would respond and your body would begin to release hormones including adrenaline, to prepare you to perform optimally if you need to fight or flee. You would experience physiological reactions such as shortness of breath, rapid heart rate and trembling associated with these changes. Every cell in your body would be screaming for you to turn and run to safety.
But responding to these physiological messages could actually get you killed. The Mountain Lion Foundation of California explains that you should make direct eye contact with the animal, stand up as tall as you can, wave your arms, speak slowly and firmly, and throw rocks or branches at it. Under no circumstances should you turn your back to it and run or crouch down. If you become panicked and respond with fear, it will trigger the animal’s natural instinct to chase you. You will become prey and the mountain lion the predator.
In order to make the decision to respond in a different and more effective way than your body is telling you to, you must use meta-cognition. The simplest definition of meta-cognition is “thinking about thinking.” We have thoughts, and we have thoughts about our thoughts. Meta-cognition is the process that is at work when we are using Mindfulness Based Cognitive Behavioral Therapy. It allows you to notice the space that exists between receiving information (“OMG, there is a mountain lion!”) and responding to that information (“Do I want to listen my body and run, or should I stand my ground and throw my water bottle at this wild, vicious creature?”). You can then make the decision to maintain your composure and do the illogical action, because you understand that it will save your life.
When dealing with the unwanted thoughts, feelings and sensations experienced in OCD and related anxiety conditions, resistance to your situation is not the answer. Mindful acceptance is almost always a better way to respond to these uncomfortable internal experiences. There are many other examples that I use with clients that reiterate this theme. Imagine you are driving in a car and the traffic suddenly stops in front of you. You glance in your rear-view mirror and realize that the person behind you is not paying attention and is about to slam into you. In this situation, it is wise to allow your body to roll with the impact and avoid tensing your muscles to brace for it. It has been said that the reason that drunk drivers are the ones who survive car accidents is that they are more relaxed and do not anticipate the collision.
This is also what the expression, “roll with the punches” means – accepting the punch that is being presented to you as a means of diffusing it. The phrase was derived from the boxing technique where one would lean back or to the side when being hit by an opponent in order to better absorb the punch and avoid receiving the full force of the blow.
If you were in a body of water and didn’t know how to swim, to avoid drowning your natural tendency would be to wave your arms, yell for help, and perhaps splash around in the water. But it is actually the depletion of oxygen and energy that cause people to drown, and these intuitive activities would get you there sooner. A better idea is to fill your lungs with air and to lay face down in the water so that you can create buoyancy. The best way to survive is to completely surrender to the situation rather than resisting and struggling.
All of these analogies illustrate how resistance may seem like the correct response, but ends up making the situation worse. If you choose to simply allow your thoughts, feelings and bodily sensations to run their natural course, they will rise and fall on their own. When it comes to OCD and anxiety, you can draw upon the imagery of these analogies to encourage yourself to be courageous in making a counterintuitive decision. Feel free to comment below with your own analogies for resistance, as it would be great to hear more examples that have helped people.
I understand that you may be in doubt about whether your thoughts, feelings, and bodily sensations are real or OCD. You may be saying, “If I only knew for certain that they were just thoughts, then I would be willing to stop resisting.” Part two of this series will discuss “certainty-seeking”, which is the other main strategy that is crucial to discontinue when learning to better manage OCD and anxiety.
•Stacey Kuhl-Wochner, LCSW, is a Licensed Clinical Social Worker at the the OCD Center of Los Angeles, a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related conditions. She can be contacted firstname.lastname@example.org.