Metacognition: the Degree to Which a Possibility of Harm or Imperfection is Disturbing Us Partly Depends Upon Our Frame of Mind

[deValentin]

I just watched a video made by the International OCD Foundation “The Metacognitive Approach to OCD Treatment and Self-Help”. In it, Mike Heady, one of the panelists, compares an OCD episode to watching a horror movie. In the middle of the film, as you experience the physical symptoms of sensing danger, the person sitting next to you sneezes, and you’re suddenly brought back to reality and realize you’re just watching a movie even if your senses are still in a state of alarm. For Mike Heady, metacognitive therapy is trying to create that sneeze for us while we’re in the grip of OCD. Metacognition is thinking about thinking, the meaning we attribute to our thoughts, being aware of how we react to our thoughts. Metacognitive therapy aims at changing our inappropriate responses to our thoughts. Broadly speaking, the panelists (Michael Heady, Reid Wilson, Sally Winston) were saying, “Changing our frame of mind will change the degree to which a possible harm or imperfection is affecting us, and then exposure and response prevention can take place and become much more manageable".

I realized it’s to some extent what’s happening to me when I play scrabble. In the heat of the game, when my desire to win is strong, I feel the need to pick my letters from the bag a certain way to increase my chances of getting good letters (magical thinking). Intellectually, I partly know it’s ridiculous, but emotionally I feel different. I have to make an effort if I want to pick my letters in a detached, neutral fashion (form of ERP). In the times I’m not engrossed in the game, I fully return to realistic thinking and my whole self recognizes that there is no connection whatsoever between the manner I pick letters from the bag and the type of letters I get. So, whether or not I’m driven to indulge in magical thinking depends upon my frame of mind.

Can I apply that knowledge to my OCD self-treatment? I think I can because, while in the throes of OCD, my thinking becomes somewhat distorted. I temporarily close my mind to the possibility that OCD may not help me solve my problems. I refuse to consider the possibility that the price to pay to engage in compulsive behaviors may be too high, or that the relief provided by seeking too much certainty may only be short term. The realization that my mind is closing itself to realistic possibilities like those described above (metacognition) is a sure sign that, before I make any decision or pursue any goal, I need to take a pause and let the passing of time restore in me a more objective judgment.

[deValentin]

Thank you for your encouraging words and insights. In my journey towards OCD recovery, I was first a fervent adept of ERP alone. Now, I'm realizing more and more that some metacognitive work is also necessary like the strategies you're suggesting.