Refocusing & Modifying

Techniques
 

After many repetitions, concerns about leaving the house, touching a speck
of dirt, or disorder can cause the minds of people with OCD to obsess.
When checking locks, washing hands, or straightening stops these
obsessions, people are also trained to engage in rituals. As soon as
another trigger event is anticipated or experienced, the whole cycle starts
again. Vague feelings of anger or tension can also trigger obsessions. Any
attempts to resist and fight troubling thoughts just create more anxiety and
perpetuate the cycle.

Since the 1980s, this problem has become treatable, both through
medication and behavior therapy. After learning to recognize obsessions
and compulsions and realizing that OCD is harmless, you can start to
interrupt the above cycles by postponing or modifying techniques.

POSTPONE AND REFOCUS

When thoughts are bogus, I change my focus.

Repetitious thought/urges —> Postpone & refocus —> Obsessing/ritualizing

When you notice obsessions or urges, tell them that they will have to wait a
couple of minutes. Then, actively refocus your attention. This is the same
as continuing to read even though you hear a siren in the background. Do
not keep busy to prevent obsessions or compulsions. Take time to relax
and then refocus if unwanted thoughts or urges come. There are numerous
creative and powerful ways to refocus:

• Refocus on something pleasant: take a walk, knit, tap complex
  rhythms, count backwards from one 100 by 3, recite a poem, shoot
  baskets, or work a puzzle.

• Refocus on calming breaths: (1) slowly breathe in through your nose;
  (2) hold for three counts; and (3) exhale through your mouth while
  counting to six. Repeat steps 1–3 two more times. Practice when you
  are not obsessing. Then, when you notice tension building, breathe.

• Repeat a positive thought during your calming breaths to plant it
  deeply in your mind. Thoughts such as “This isn’t me, it’s OCD,” “It’s
  just a chemical, so don’t get polemical,” and “When thoughts are
  bogus, I just refocus” are good for starters.

• Focus on a positive image during calming breaths. Imagine
  antibodies protecting you from germs; your house guarded from
  intruders by a shield; a loving person accepting you with all your
  flaws; or your obsessions floating away like helium balloons.

• Tap acupressure points when obsessions or urges start. This may go
  further than refocusing by removing an imbalance in the body’s
  electrical flow. Tapping the following points (about seven times each)
  can reduce or eliminate obsessions and urges to ritualize

     1.        Tap an inch to the side of the sternum and an inch under the
                collarbone (cb) and the bony ridge directly under the eye pupil
                (ue).
     2.        Use the sequence cb, ue, cb.
     3.        After noticing some calming, further reduce anxiety by moving
                your eyes in a horizontal figure 8 while tapping the outside
                points of your eyebrows, humming a few notes, counting to
                three, and humming again.
     4.        Then, repeat the sequence.

Set a goal to postpone rituals or thoughts with one of the above methods
for one to five minutes and gradually increase your time. Keep a chart of
how long you postpone and the refocusing activity used. If you succeed at
postponing for your goal time, give yourself a treat. If you are not able to
postpone for the planned length of time, set your goal lower.

MODIFY RITUALS AND OBSESSIONS

Obsessive thought or ritual —> Modification —> Obsessions & compulsions

Any time you change something about a habit, you weaken it. The following
offer easy ways to reduce obsessions and rituals:

• Modify obsessions by saying your worries out loud, writing them,
  speaking them in pig Latin, pinching your nose, or singing them to
  the tune of your favorite song.

• Modify images that accompany obsessions by picturing yourself
  dancing on the side of the road instead of jumping out of the car, or
  “stabbing” your husband with a rose.

• Modify compulsions by changing when, what, how, or where you do
  your rituals. You can change the order of the steps in your rituals,
  the objects you use, or the number of times you repeat them.
  Perform your rituals in slow motion, with your eyes closed, standing
  on one foot, or with your non-dominant hand, or add a consequence.
  Every time you indulge your thoughts, make yourself do sit-ups or
  copy sentences from this handout.

     
References

     
Flow charts were adapted from Stop Obsessing! By Edna Foa and Reid
Wilson (Bantam, 1991).

Using acupressure points to treat OCD was developed by Roger Callahan.
Contact Callahan Techniques at 760-345-4737 or www.tftrx.com.  It has
been further modified by Fred P. Gallo, fredgallo@aol.com.