My experience has shown me that healing from anxiety/OCD is possible when combining exposure therapy with mindfulness practices and training. In the long run, and with practice, it’s the mindfulness practice itself that becomes the exposure therapy. I learned to turn towards the difficult sensations of OCD, anxiety, and panic and get curious about their felt experience in the body. By getting curious about OCD, I learned to ride out the anxiety habit loops that perpetuated my suffering.
I have been suffering from anxiety and difficult emotions since I was a kid. My earliest memories from first grade are colored with sadness and obsessive thinking patterns. During my darkest hours where OCD was completely running my life, I spent 10-12 hours a day obsessing. I remember the years when I was living at home after college completely trapped and debilitated by my thoughts and terrified of the anxiety surging through my body. I would go to the computer after dinner and often stay searching online until 6am in the morning when my Dad was waking up to go to work. I was only able to wean myself off the computer and away from the obsessions keeping me on it by the intense shame, sadness, and fear I felt thinking that he may see that I was still awake.
13 years ago when I was first diagnosed with OCD I felt some relief that I was finally able to put a name to something that had always felt off with me. Yet, there was also a sense of sadness and confusion over what my life might look like in the future. I read many books on OCD in the years after diagnosis. I also started to do exposure therapy (the gold standard behavioral treatment for OCD and other anxiety disorders involving intentionally exposing oneself to the source of one’s anxiety), yet I was still very much unclear about what the end game was. What was the point of all this therapy? What life could I expect to lead in the future? What was a healthy mind actually like? All these years later I am convinced that the mind and body can change in astonishing ways and that mindfulness and compassion are some of the most powerful tools to bring forth that change.
Today I have very few thoughts that would be considered OCD thoughts, yet what has changed is my relationship to those thoughts. Through deliberate practice of training in mindfulness and compassion I have trained myself to catch many of the thoughts that come into the mind and appreciate them for what they are- simply events of the mind. Exposure therapy, started the journey and has been helpful over the years. However, I have found that exposure therapy could only take me so far. This is because it’s not really the triggering events that the mind is afraid of. Instead, it is the physical sensations of anxiety, fear, anger, ect that occur in the body. We resist the unpleasant sensations in the body by performing various physical and mental rituals or compulsions. While often lowering anxiety in the immediate short term, these compulsive behaviors ultimately fuel more unpleasant sensations of anxiety which starts the cycle of resistance all over again. The ultimate goal of a therapeutic meditation training is to train oneself to actually be with these unpleasant sensations in a friendly way. This is true healing.
Six years ago I joined a Mindfulness based stress reduction course which is an 8 week mindfulness training course. The course kind of dropped me into the deep end and we were instructed to meditate daily for up to 45 minutes by doing a body scan, or a meditation on the breath or other types of meditation. I remember when I first started to meditate my OCD thoughts were so incredibly compelling. When the magic moment came where I noticed my mind was off in thought and was encouraged to gently return to the breath, the OCD thoughts would often compel me to stay with them a little bit longer. However, if I have learned anything from this whole process, it’s that the brain is astonishingly malleable. Each and every time I was able to pull myself away from the OCD thoughts and put my attention back onto my breath, I was actually rewiring my brain. As I kept practicing I started to notice that I could actually watch a thought come and go on its own accord. These thoughts didn’t necessarily have any meaning unless I gave them meaning by following them.
At some point I learned that I could use mindfulness techniques to actually turn towards the difficult sensations of anxiety. If my OCD fears were not of the external events themselves but of the physical body sensations and emotions that were happening in my body, I could consciously choose to locate the sensations of OCD in my body and get curious about them. What I learned is that we can actually use mindfulness to turn towards the anxiety as it’s showing up in our bodies and short circuit the obsessive feedback loop allowing the anxiety sensations and difficult emotions to come and go as they please. By training our awareness to look at the anxiety and get curious about it and where it’s located in the body, what it feels like etc, we are training ourselves to gain more and more courage to be with the difficult sensations. The more we are able to be with the difficult sensations, the less we jump back into our mind and perpetuate the OCD feedback loop. As we gain the courage to accept the unpleasant sensations just as they are, we let them ride themselves out.
A couple of years ago I was on a meditation retreat and a number of events set off a massive bout of full blown panic that lasted for almost a year. I tried everything to work with it but the honest truth was that it was so difficult that I just wanted to get rid of it. It was constant 24/7 suffering that never went away. I tried to do exposure therapy and just simply live my life, but the panic was still omnipresent. After a while, I decided to trust my mindfulness practice and dip my toe in the water. I turned towards the panic just a little bit. The panic was ultimately about being terrified of the sensations of fear and anxiety in my body and of the physical sensations of breathing. I had a hunch that if I could progressively train myself to be with those sensations then I could be free from the panic loops in my mind. Over time I progressively brought my awareness to different parts of the body starting with the parts that felt the most safe and moving to the parts that felt the most unsafe. I was training myself to hold the difficult sensations with mindful awareness and compassion. I also tried to be acutely aware of the panic thoughts, watching them like a sentinel as they entered my mind. I was able to see that if I noticed them when they appeared in the mind then they wouldn’t have much of an impact on my body sensations. However, if I wasn’t aware of them, they would produce more sensations of panic in my physical body.
At times, when things got really really difficult and threatened to overwhelm my mindfulness, I used the compassion techniques that I was learning. With compassion we learn to treat ourselves and our lived experience with friendliness. We learn to meet our own needs and soothe ourselves. I learned that sometimes when I was turning towards the difficult it was simply too strong and I had to turn away for a bit and let the intensity of the panic ride itself out. I would turn to compassion meditation. My body would be raging with panic and I would turn to memories of my dog or my family loving me. Alternatively, I would offer myself some caring touch. With continued practice my body started to respond to my compassion practice with a warm feeling that was able to hold the panic.
The beautiful thing about mindfulness and compassion is that it’s a journey that never ends. The more we practice the more we find the courage to be with more and more of life’s varied experiences. We can get curious about these experiences and allow them to move through us on their own accord. When we stop resisting life we actually start to suffer less and over time we are able to open to more joy and beauty. I know that there will be many difficult times ahead, but I feel some courage knowing that I have practices that can hold me in difficult times. Life contains all sorts of suffering even as it contains immense beauty and wonder. However, if the choice is between the difficulties of OCD and the difficulty of the courageous and life affirming act of turning towards our difficult experiences, then I believe the latter is worth the risk. With mindfulness and compassion we can love ourselves no matter what and embrace the totality of our experience of being alive! I am learning every day to become friends with the anxiety as it visits the mind and let it go when it’s time for it to leave. That’s the real freedom!