Effective Strategies to Manage Obsessive Thoughts and Anxiety

How to help yourself?

Hello, doctor.
I have symptoms of obsessive worry.
In responses from doctors I've seen, it was mentioned that to overcome obsessive thoughts, one should ignore them.
However, I also found online that one can try to correct obsessive thoughts.
Which approach would be more helpful for me? For example, if I touch a doorknob and worry about contracting a disease, is it better to ignore that thought and do something else? Or should I tell myself that I won't get infected? Or should I address the root of the concern by reminding myself that even if I were to get infected, modern medicine is advanced? Or perhaps I could think that pessimistic people will eventually die anyway, so worrying about infection is pointless?
Similarly, if I'm worried that I left the light on, is it better to just ignore it and continue with my tasks? Or should I reassure myself that I just turned it off and seriously recall that moment? Or should I remind myself that if I left the light on, it would only result in a higher electricity bill? What would be the best approach, doctor? Thank you.

Youchong, 30~39 year old female. Ask Date: 2017/07/12

Dr. Ding Shuyan reply Psychiatry

Hello, some problems should be faced, solutions should be devised, and actions should be taken to address them.
For example, if the computer at home is broken, it needs to be repaired or replaced.
These are practical issues that cannot be avoided; only by confronting and addressing them can the problems be resolved.
Obsessive thoughts are not real external threats; they are merely disguised as such, making us feel compelled to confront them.
In reality, obsessive thoughts are just thoughts; they do not exist in the real world, and there is no tangible object to address.
They can be likened to having no real enemy present.
Therefore, it is like punching the air—exhausting oneself without any change in the world, neither gaining nor losing anything.
This is why the best strategy may be to ignore them and redirect attention to other matters.
Even seeking a more rational thought to replace them is unnecessary.
I have seen many individuals with obsessive thoughts improve not because they have come to an understanding, but because they can choose not to dwell on these thoughts.
Of course, it is easy to say this, but difficult to practice.
However, if you can redirect your attention just once out of a hundred times, you reduce your suffering by one instance.
Reducing ten seconds of obsessive thinking or behavior grants you ten seconds of relief.
Do not expect to wake up one day and find these thoughts gone; rather, notice gradually when these thoughts arise and gently yet firmly guide your attention to other matters.
There is no need to feel that you are unusual or strange; everyone has some degree of these worrying tendencies.
To be completely free of them would likely mean being in a vegetative state.
Wishing you all the best, Dr.
Ding Shuo-Yan.

Reply Date: 2017/07/12

More Info

Managing obsessive thoughts and anxiety can be a complex process, especially for individuals diagnosed with obsessive-compulsive disorder (OCD). Your concerns about how to effectively cope with these intrusive thoughts are valid, and it's important to approach them with a combination of strategies that can help you feel more in control and reduce anxiety.

Firstly, it’s essential to understand that obsessive thoughts are often irrational and do not reflect reality. The key to managing these thoughts is to recognize them as just that—thoughts. They do not dictate your actions or define who you are. Cognitive Behavioral Therapy (CBT) is a well-established treatment for OCD that focuses on changing the patterns of thinking that contribute to anxiety. One effective technique within CBT is Exposure and Response Prevention (ERP), which involves gradually exposing yourself to the source of your anxiety (in this case, the thoughts about germs or leaving the lights on) while refraining from engaging in compulsive behaviors (like excessive handwashing or checking).

When you encounter an obsessive thought, such as worrying about germs from touching a doorknob, you might feel compelled to wash your hands repeatedly or avoid touching surfaces altogether. Instead of giving in to these compulsions, try the following strategies:
1. Acknowledge the Thought: Recognize that the thought is present. You might say to yourself, "I am having the thought that I might get sick from touching the doorknob."
2. Challenge the Thought: Instead of trying to suppress it, challenge its validity. You could remind yourself of the facts: "I know that the likelihood of getting sick from this is very low, and I have washed my hands recently."
3. Practice Mindfulness: Engage in mindfulness techniques to help you stay grounded in the present moment. This can involve deep breathing exercises, focusing on your surroundings, or practicing meditation. Mindfulness can help you observe your thoughts without judgment and reduce their power over you.

4. Gradual Exposure: If you’re worried about touching doorknobs, start by touching one and then waiting a few minutes before washing your hands. Gradually increase the time you wait before performing the compulsion. This can help desensitize you to the anxiety associated with the thought.

5. Reframe Your Thinking: Instead of telling yourself that you might get sick, you could reframe it to something more rational, such as, "Even if I do get sick, I have access to medical care, and I can manage it."
6. Limit Checking Behaviors: For worries about whether you turned off the lights, try to limit the number of times you check. You might decide to check once and then move on to another task. If the urge to check arises again, remind yourself that you have already checked and that it’s okay to trust your memory.

7. Seek Professional Help: Since you are already under medical care and taking medication, continue to work with your healthcare provider. They can help you integrate these strategies into your treatment plan and may suggest therapy options that focus on cognitive restructuring and exposure techniques.

8. Support Groups: Consider joining a support group for individuals with OCD. Sharing experiences with others who understand what you’re going through can provide comfort and practical strategies.

In conclusion, managing obsessive thoughts involves a combination of acknowledging the thoughts, challenging their validity, practicing mindfulness, and gradually exposing yourself to the sources of your anxiety without resorting to compulsive behaviors. It’s a process that takes time and patience, but with the right strategies and support, you can learn to reduce the impact of these thoughts on your daily life. Remember, you are not alone in this journey, and seeking help is a strong and positive step forward.

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