OCD: The Struggle with Compulsive Promises and Fears

Obsessive-Compulsive Disorder (OCD)

Since high school, I have been experiencing strange thoughts where I feel compelled to make promises to myself to do things I don't want to do, or else something bad will happen.
It feels similar to making a vow (for example, I might promise that I will go blind in my next life).
This creates a lot of internal conflict, as sometimes I do the things I promised, and sometimes I don't.
However, when I choose not to do them, I feel very anxious.

There was one instance where I forced myself to do something I didn't want to do, and I thought about reversing the vow (for example, I didn't want to go to the bathroom, but I promised myself that I had to go within ten minutes, or else I would go blind in my next life.
I changed it to promising that if I went to the bathroom, then I would go blind in my next life).
I took this vow very seriously, but ultimately, due to various reasons, I ended up going to the bathroom within those ten minutes.
This made me worry about whether my reversed vow was serious and what the consequences might be.
Sometimes, I have thoughts that if something specific suddenly happens, it means the universe agrees with my vows.
Occasionally, those specific things do happen, which makes me feel like my vows were taken seriously and approved.
This increases my anxiety about not fulfilling them and the fear of going blind in my next life.
However, I genuinely do not want to do those things, so I sometimes choose not to do them, but I remain very anxious about it.
I feel that the sensation of making these vows is very strong, and I am quite worried.
I hope the doctor can provide me with some advice.

Bu guan renhe shengming de shi, 20~29 year old female. Ask Date: 2018/06/30

Dr. Tian Xinqiao reply Psychiatry

Dear User,
Thank you for your message.
It is clear from your letter that you are experiencing significant distress due to obsessive-compulsive symptoms.
The symptoms you described do indeed resemble those of obsessive-compulsive disorder (OCD).
The intrusive thoughts (such as feeling compelled to perform actions you dislike to prevent terrible outcomes) lead you to engage in compulsive behaviors (performing the vowed actions), which can be quite uncomfortable.
Currently, the etiology of OCD cannot be explained by a single factor; it involves a combination of genetic, neurological, personality traits, and real-life stressors that contribute to the development of obsessive-compulsive symptoms.
Treatment for OCD typically includes pharmacotherapy (antidepressants to stabilize serotonin levels in the brain, which can help alleviate symptoms) as well as non-pharmacological therapies (such as cognitive-behavioral therapy and thought-stopping techniques to redirect attention away from obsessive thoughts).
I strongly recommend that you visit our psychiatry outpatient clinic for evaluation and to discuss a treatment plan that is suitable for you with a physician.
Sincerely,
Dr.
Tien Hsin-Chiao

Reply Date: 2018/06/30

More Info

Your experience with obsessive-compulsive disorder (OCD) is a common yet challenging one. The intrusive thoughts and compulsive behaviors you describe, such as making promises or "vows" to avoid negative outcomes, are characteristic of OCD. This disorder often manifests as a cycle of anxiety and compulsive behavior, where individuals feel compelled to perform certain actions or rituals to alleviate their fears, even if those actions seem irrational or unwanted.

Understanding Your Symptoms
From what you've shared, it seems you are caught in a loop of compulsive thinking and behavior. The thoughts that if you don't perform a certain action, something bad will happen (like going blind in your next life) are typical of OCD. This kind of magical thinking—believing that your actions can influence unrelated outcomes—can be distressing and lead to significant anxiety. The fact that you sometimes feel compelled to do things you don't want to do, or to avoid doing things you feel you must do, creates a paradox that can be very frustrating.

The Nature of OCD
OCD is often characterized by two main components: obsessions and compulsions. Obsessions are unwanted, intrusive thoughts that cause anxiety, while compulsions are behaviors performed to reduce that anxiety. In your case, the obsessive thoughts about making vows and the compulsive need to act on those thoughts are creating a cycle of fear and uncertainty.
It's important to recognize that these thoughts are not a reflection of reality. The fear that not fulfilling a vow will lead to negative consequences is a cognitive distortion common in OCD. This can lead to a significant amount of distress, as you are experiencing.

Treatment Options
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for OCD. Specifically, a type of CBT called Exposure and Response Prevention (ERP) is particularly beneficial. ERP involves gradually exposing yourself to the thoughts or situations that trigger your anxiety and learning to refrain from performing the compulsive behaviors. Over time, this can help reduce the power of those thoughts.

2. Medication: Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) or sertraline (Zoloft) are commonly prescribed for OCD. These medications can help reduce the intensity of obsessive thoughts and compulsive behaviors. If you are currently on medication, it’s essential to discuss any concerns or side effects with your doctor, as they can help adjust your treatment plan.

3. Mindfulness and Relaxation Techniques: Practicing mindfulness can help you become more aware of your thoughts without reacting to them. Techniques such as deep breathing, meditation, or yoga can help reduce overall anxiety levels and improve your ability to cope with intrusive thoughts.

4. Support Groups: Connecting with others who have OCD can provide you with support and understanding. Hearing about others' experiences can help you feel less isolated and more empowered in your journey.

5. Education: Learning more about OCD can help demystify your experiences. Understanding that these thoughts are part of a recognized disorder can help you feel less alone and more in control.

Moving Forward
It's crucial to approach your situation with compassion and patience. Recovery from OCD is often a gradual process that requires time and effort. If you haven't already, consider reaching out to a mental health professional who specializes in OCD. They can provide you with tailored strategies and support to help you manage your symptoms effectively.

In summary, your experiences with compulsive promises and fears are indicative of OCD, and there are effective treatments available. By seeking help and employing strategies such as CBT, medication, and mindfulness, you can work towards reducing the impact of these thoughts on your life. Remember, you are not alone in this struggle, and with the right support, it is possible to find relief and regain control.

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