How to Remediate the Lack of Immediate Perceptible Costs to Engaging in Compulsions?

[deValentin]

I just watched an interesting video (Self control: Dan Ariely at TEDxDuke). In it, the speaker said that if you want to be sure you get up in the morning at a certain time and resist your usual temptation to press the snooze button, link your alarm clock to your bank account. For every second you don’t get up, a certain amount of money will be automatically transferred from your bank account to the one of an organization you don’t like. Then you’ll see how much faster you’re motivated to get up.

I said to myself it’s what’s happening with OCD. During an OCD spike there are no external or internal incentives to give up our compulsions. No alarm bells, red lights, or discomfort telling us we’re doing something wrong. The only discomfort we feel is the one caused by something not quite certain, not quite in order, not quite settled. And our only motivation is to remove that discomfort. The fact is there are no immediate perceptible costs in engaging in compulsions because even if performing rituals or ruminating takes time away from more important tasks, we always think that if we keep compulsing we’ll eventually find the peace of mind we’re looking for and that won’t take too long. So, the guilt will only come afterwards, after the OCD spike is over, when it’s too late to do something about it.

If one could see and feel lung cancer cells growing inside oneself with the first cigarette, nobody would smoke. So, how to counteract the lack of immediate penalty to smoking? In my opinion, only exercising one’s judgment and deciding not to smoke can offer a counterweight to the fact that nicotine is a stimulant that doesn’t kill right away.

Likewise, constant worrying or excessive washing, for instance, could increase our chances to solve a problem or avoid an infection. Who knows? One can’t be sure. And we don’t feel bad doing it if we think it may be helpful. A sense of dissatisfaction is only experienced afterwards in moments of lucidity. So, thinking long term and deciding not to engage in compulsions when exposed to triggering circumstances (that is, ERP) are the only tools at our disposal to remediate the lack of immediate penalty to compulsing.

What do you think?