Can Philosophy be Helpful in Treating OCD?

[deValentin]

The idea that philosophy could be of some help in psychotherapy came, among others, from Albert Ellis who is the founder of Rational Emotive Behavior Therapy (REBT) seen as the first form of cognitive behavioral therapy (CBT). He “drew heavily from Stoic philosophy, particularly the writings of Epictetus, to develop his therapeutic approach, emphasizing that it's not events themselves but our interpretations of them that cause emotional distress” (Google).

I pondered for a while over that thought from Epictetus: “What upsets people is not things themselves, but their judgments about these things”, and I felt it does correctly fit OCD experiences. For instance, some people hear a short thumping sound while driving and think nothing of it. Others associate it with an emotionally charged possibility of having hit a pedestrian and become obsessed with it. What Epictetus is telling us is that it’s not the sound by itself that is distressing, but the association they create in their minds between the sound and the vivid possibility they may be responsible for having caused great harm. In the same manner, people with OCD associate sensory cues (red spots on the sidewalk or knives on the countertop), mental images (of self committing awful acts or catching a dreadful disease), or thoughts (what if the worst happens? or what if I miss crucial information?) with highly dramatized possibilities of receiving or causing harm, and the goal of therapy is to slowly break those automatic connections with exposure and response prevention.

From time to time, I’ll post quotations from Stoic philosophers and how they help me manage my OCD. Any feedback is welcome.

[Natureloverpeace]

Ellis, Beck, etc. had a huge impact on CBT. Yes, a person with OCD interprets intrusive thoughts that impact what they value differently than those without OCD. Those with OCD are able to let intrusive thoughts go that aren’t associated with things they value.

I think of the thoughts, feelings, behavior triangle that is used in CBT. A different outcome can be achieved when any one of those three elements of the triangle is changed.

People with OCD interpret, or give meaning, to their thoughts that mostly isn’t based on reality although there may be some reality there and they take that and enter into “what if” thinking. Of course, this causes great distress and so the mental and/or physical compulsions are done to negate the distress. The distress is relieved temporarily but this teaches the brain that the intrusive thoughts have meaning even though they don’t so the intrusive thoughts are reinforced. Bingo, we have an OCD cycle that reinforces itself and grows stronger without effective treatment.

[Natureloverpeace]

Trying to use reason or logic on OCD doesn’t work because there will always be more “what ifs”. Using reason is a key component of Stoic philosophy.

[deValentin in reply to Natureloverpeace]

Thank you for your feedback. I find your first response very insighful. Personally, I would qualify the second one this way. Trying to use reason or logic alone on OCD doesn’t work because there will always be more “what ifs”. Using reason is a key component of Stoic philosophy, but not the only one. For instance, Seneca's quote, "The greatest remedy for anger is delay", emphasizes the importance of taking a moment to pause and reflect before reacting to anger. Delaying tactics are also a great tool in combating chronic overworrying and OCD.

[80_Zil_ian]

Thanks for the post, it is very good. The hard part for me is that most of the time I’m dragged into several minutes of completely illogical waves of thoughts and situation dramatizations before being able to call myself to reason.

When I try to show myself that imagining the situation that way is either senseless or an overestimation, it generally works. Unfortunately, my response time for this is still much slower than the speed at which I can create those unreal situations in my mind.

[deValentin in reply to 80_Zil_ian]

You make a very good point. What happens when the mind can create imagined possibilities at a faster rate than it can get accustomed to them? Stoic philosophers answered that question by distinguishing two things: the genuine passions and the effect of environmental or mental triggers on the mind. For instance, people may love their country so much that they’re willing to sacrifice their lives to defend it against a potential enemy. Stoics called that “virtuous emotion” a “good passion”. We have some control over it; we can choose to cultivate it or not. At the same time, the same people may experience some anxiety at the start of the battle when they see the enemy approaching. Stoics called that feeling a “proto-passion”. We’re not responsible for it; it’s automatic. It goes away in the heat of the battle or with habituation.

So, in regard to OCD, we can’t stop intrusive thoughts from popping into our minds. We’re not responsible for it; it’s automatic. However, if we set worthwhile goals in our lives, undesirable intrusive thoughts will tend to fade on their own and desirable ones will tend to take their place. It takes time and regular efforts though. It’s at least my experience.