When Thoughts are Sticky; Pure OCD and Generalized Anxiety Disorder
by Hannah R. Goodman
Though I am in recovery from generalized anxiety disorder, (GAD) that doesn’t mean I am cured. GAD can be chronic, with periods of remission and mini flare-ups.
One of the symptoms I struggle with during those mini flare-ups is intrusive thoughts. These thoughts are not necessarily pathological or an indication of a mental illness. If you are a human, you have had an intrusive thought at some point in your life—make that some point in your day!
Intrusive thoughts are basically anxious, scary thoughts that float into your brain, sometimes for no specific reason. The majority of the time, those thoughts float in, and float out, and you can move on with your day.
For me, sometimes I go for long stretches where these types of thoughts don’t really “stick” to me. An anxious thought floats in; I take note of it, and then I can watch it float on by. Other times, when I am having a mini flare-up of anxiety, anxious, scary thoughts stomp into my brain, have a fit, and then don’t leave.
In this state, my thoughts do this OCD-type of thing that I call sticky thinking. This is sometimes referred to as pure OCD. With this type of thinking, you feel like you are grabbing onto each and every disturbing or painful thought and then wrestling it to the ground in the hopes that you will make it go away.
Earlier this year, I found myself in a desperate wrestling match with some very sticky thinking. I was going through some out-of-my-control, work-related stress and noticed that my thinking was becoming more and more sticky with each passing day, to the point where every time I would walk into the kitchen I would think, “There are knives in here. What if I lose control and stab myself?” Or, if I managed to make it all the way to the kitchen and actually pick one up to use to cut up fruit for my daughter or carrots for dinner time, I would immediately worry that if I didn’t cut everything up quickly, I might lose control and stab myself. One morning during this time, I was running around getting my youngest ready for school while also trying to pack my own lunch to take to work when just the sight of a kitchen knife laying on the countertop triggered me. I began to worry and obsess that I might grab the knife and totally lose control and stab myself and then my children would see this and I would forever scar them.
Because this was not my first time in a mini-OCD flare up, there was a part of me that knew I was having these thoughts not because I actually want to stab myself but because I’m are afraid that, somehow—and here is where the irrational brain does its thing—I will lose control, blink out like a computer on overload, and possibly act on this scary thought. It’s the obsessive and compulsive process of if I think it, then I won’t do it because I will scare myself enough.
So, there I was, standing in my kitchen, the blade of the knife gleaming and scaring the shit out of me because of the thoughts I had—What if I lose control and stab myself in the stomach? What if blood goes everywhere? What if I can’t stop and I just go crazy?
Though this only lasted a few minutes, those moments were treacherous, and a lot went on in those moments. My mind went right to— But I don’t want to hurt myself! But what if I can’t stop myself? Oh, no! Why am I having this thought? Then, great, you’re going crazy! See, you can’t be a therapist; you’re sicker than any client you may ever help.
But, unlike what might have happened years ago, I caught myself. I became mindful of what was happening and instead of wrestling with the thought or trying to stomp on it and make it go away, I took a breath and then another, focusing on the in and out of the sensation, and in this act, I began to allow for some space between me and these scary thoughts. In this space, I was able to remember what a therapist once advised for these moments: Tell yourself: Okay, that thought scares me. Of course, it does. That’s fine. Let it be. Do nothing. Just breathe.
This type of self-talk is what helps me to get through a mini flare up—I’m not turning away from or avoiding my thoughts, instead I acknowledge them, and then I focus on the breath, which brings me into the moment. The way I spoke to myself when I first saw the knife was all future-oriented, what-if thinking, the type of thinking that can really amp up my anxiety. However, I caught myself and then basically challenged those thoughts with soothing, rational, in-the-moment self-talk. When I did this, I felt my anxiety lower, I continued to make my lunch and then move on to the rest of the morning.
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I remember the first time I had scary knife thoughts, as I refer to them. I was in my late teens and on vacation with my recently-divorced dad. On that first night, after a day of cross-country skiing, as I waited in the lobby for my dad to go to dinner, an image of the blade of a knife came to me in my mind. I wasn’t hallucinating. It was a clear image of a knife and the sharp tip of it, in my mind’s eye, caused me to cringe a little, almost as if thinking about it would cause it to physically hurt me. I tried to push it away, but it kept returning. Finally, over dinner, I confessed to my father and he simply said, “That’s your anxiety. Don’t worry about it.”
Though my dad wasn’t a mental health provider, he was no stranger to the weirdness of anxiety symptoms and, since he had them himself, he normalized this experience for me.
On and off over the next decade, these thoughts would come in and stick and I would think of what my dad told me and, somehow, I was able to move on.
But, here I was at that kitchen counter: a full-grown adult with the responsibility and stress of small children, work, and marriage, having those same knife thoughts. This time, they weren’t fleeting—they were constant, triggered by anything from a watching “Master Chef” to walking by a knife that lay on the counter in the kitchen. I was in therapy at the time for a “tune up” for my anxiety and told my therapist, who explained what pure OCD is. Knowing that this had a specific name helped and knowing that it was, as my father had indicated years before, another symptom of anxiety I could put it in perspective. That didn’t make learning to cope with these thoughts easy, but it definitely made it possible.
My thinking during these times can not only be scary, but also make me feel like I’m a bad or evil person for having such thoughts. But I then I remind myself that a thought is just a thought, not a behavior. The very fact that these scary thoughts cause anxiety means that I don’t want to act on those thoughts, and, at the same time, a thought only has the power that you give it. I take away the power of irrational, scary thoughts through soothing self-talk and breathing into the present moment.
In the past, I would work very hard to push away, deny, avoid, or repress all scary thoughts, yelling at myself, hiding knives, and avoiding using anything sharp, even a pair of scissors. All that did was increase the power of the thoughts, and then I actually made my anxiety worse because I created more suffering, which is now a secondary pain to the first one.
Secondary suffering occurs when, in an effort to avoid the emotional pain, you shove it away forcibly, and in that act of shoving, you actually become more upset. The best way to explain this is from a video by Vidyamala Burch that I watched when I took the Palouse Mindfulness Course, which shows an example of how secondary pain works. Basically, it’s like the original pain is a blue cushion on your lap, and the secondary pain is piling more and more cushions on top of the original, blue one. It’s like when you feel that first rush of panic, that is painful, but it’s the piling on of “what ifs” and “coulds” that we tend to add to panic that actually makes it a whole lot worse.
My heart is racing and my skin is hot! I’m having a panic attack! (blue cushion)
Oh no! (first purple)
I could die! (second purple cushion)
What if I go crazy? (third purple cushion)
What if I pass out? (fourth purple cushion)
What if I blink out and can’t remember anything and do something stupid. (fifth purple cushion)
When we reach a five cushion pile up, we are at a 10 on the anxiety scale. We might even be in full-blown panic attack mode. This is where the compassionate and rational self-talk can come in—not to push anything away but to actually turn towards it. I like to picture the thoughts as leaves floating by on a stream and I am looking at them passing by. The key for me is not to spend too much time here, to note or acknowledge and then—this is the key part—move on to the next thing.
This has taken a tremendous amount of practice, and even now that I have become really good at it, there are moments—sometimes a lot of moments—when the sticky thought really gets stuck and I will try desperately to pry it off my brain. That’s when I take a step back, breathe, and visualize those thoughts as leaves on a stream and then I get on with my day.