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Obsessive-Compulsive
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Introduction | Understanding Causality | Unconscious Guilt |
Healing Guilt through Cognitive-Behavioral Treatment | Summary

 
IN ORDER to provide a remedy for something, it is necessary to understand its cause and its purpose. So let’s begin there.

  
Understanding Causality

As I say on the page about depression and anxiety, we know from scientific research that the brain and the mind have a mutual influence on each other and that even though mental disorders may have a material cause in brain neurochemistry they can also have a final cause in psychological activity.

  

Think, for a moment about the building in which you may now be sitting. We can ask, “What is the cause of this building?” just as you might ask about the cause of OCD. Well, in his philosophy, Aristotle (Physics, ii, 3) described several different types of causes that are relevant even today.


  

The material cause refers to “that out of which a thing comes to be and persists.” In this sense, for example, the steel and concrete and glass—the materials—are the cause of a building.

The formal cause refers to the form—or plan, or pattern—by which the essence of something is stated. In this sense, the design and blueprints are the cause of a building.

The efficient cause refers to “the primary source of the change or coming to rest.” In this sense, the construction company is the cause of a building.

The final cause refers to “that for the sake of which” a thing is done. In this sense, the owner’s desire is the cause of a building.

  

Now, as Aristotle himself said, “it follows that there are several causes of the same thing.” In psychological practice this means that symptoms of OCD, for example, which, in scientific [1] medical language, might be “caused” by a chemical imbalance in the brain (material cause) can, at the same time, be “caused” by repressed anger (final cause).

Psychologically, locating and treating this unconscious final cause of the symptoms can be the most critical aspect of the treatment because it can have a curative effect on the other causes as well. Using medication to treat only the material cause, however—as if it were the rational and only cause—will leave the final cause untreated and free to continue exerting its harmful psychological and spiritual influence.

  
Unconscious Guilt

In this regard, psychological research into early infant development has shown that experiences of rage, and subsequent feelings of guilt, happen to us all right from early infancy. Every parent will make mistakes in empathic bonding with a child, and every child will feel emotionally hurt by those mistakes and will crave the satisfaction of revenge: to hurt the other “as I have been hurt.”

These impulses to hurt others are universally human and do not mean that anyone experiencing them is “bad.” As adults, anyone—even those we care about, and even innocent babies—can irritate us. Nevertheless, many adults, because of parents who controlled them with manipulation and guilt, have grown up lacking a social structure of deep faith and trust in God’s mercy, and so, when they experience these impulses for revenge, will not say openly to God, “I know these impulses are contrary to love; for the sake of love I renounce them and rather than hurt others I desire to seek the good of others.” Instead they will try to hide their impulses from others—and from themselves. 

Therefore, both psychological theory and clinical practice lead us to the truth that OCD, at its core, is a neurotic way of coping with feelings of guilt that seem too “bad” to admit to anyone—not even to God and not even to oneself. It’s similar to Lady Macbeth, in Shakespeare’s play Macbeth, crying, “Out, damned spot!” as she tries compulsively to rub the stain of Duncan’s murder from her hands.[2] 

Now, unlike Lady Macbeth, you may not have actually killed someone, but the unconscious motive for your compulsive rituals can be found in obsessive thoughts or mental images of resentment, hostility and violence because someone has injured you, insulted you, obstructed you, or hurt you in some emotional, physical, or material way. Moreover, this hurt is more often than not a matter of what someone has failed to do for you, rather than what a person has done to you.[3] 

  

To someone untrained in the psychology of the unconscious, it may seem difficult to understand this logically, but whatever you are afraid of doing is what some part of you has an unconscious desire to do.[4] Maybe you have to check the stove in endless repetition to make sure you have turned it off, because you’re afraid of starting a fire. Well, unconsciously, some part of you probably desires to set the whole house on fire to get revenge for having been cheated by someone. Maybe you have to wash your hands in endless repetition because they feel unclean. Well, unconsciously, some part of you probably desires to use those hands to strangle someone who has neglected your needs in some way. Maybe you have to keep checking to make sure you backed up the data on the computer at work because you’re afraid the work project might fail. Well, unconsciously, some part of you probably desires the project to fail because you’re unhappy with your job—and on and on it goes. 

  

Most likely you don’t like to talk about these thoughts and fantasies, or the suppressed desire for revenge—perhaps going all the way back to infancy—that drives them, because you find them so repugnant that you want to neutralize them before they reach full conscious awareness.[5]

  

AN EXAMPLE

Transient thoughts (that is, fantasies) of hurting someone are actually very common—so common, in fact, that they could be called “normal” human responses to feeling irritated by someone.
 
For example, a mother holding her infant while standing at the edge of Niagara Falls could suddenly think of throwing the child into the water. Now, such a thought could be an
unconscious reaction to the mother’s irritation at the responsibility of caring for her new child.
 
But does having the thought mean that the mother is actually in danger of carrying it out? Not at all. The thought, like any fantasy, is only the result of a juxtaposition of images in the moment—the roaring water and the infant—that suggest the intellectual possibility that the infant could be thrown into the water.
 
So, if the mother were to interpret the fantasy, she could say to herself, “Ah, yes, a child is a lot of responsibility, isn’t she? Yet, with Christ’s help and guidance, I can accept the task.”
 
But if the mother fears the fantasy, she can deceive herself into believing that the fantasy never occurred, and she can develop obsessive-compulsive defenses to protect herself from the guilt of feeling resentment toward her child. Then, later that night, she might feel the compulsive need to spend hours rearranging the clothes in her closet according to the most elaborate of rituals, to appease the nagging belief that if she doesn’t do it—and do it perfectly—her baby will die.

  

In the OCD response to guilt, therefore, you attempt to keep your guilt secret and to resolve it through your own superstitious efforts. You create rituals, and you unconsciously make mistakes in carrying them out, and you feel guilty about it all. But it’s all an artificially created guilt, taken in controlled doses, that serves to hide the real guilt of your anger at persons who have hurt you somehow.

  
Healing Guilt
Through Cognitive-Behavioral Treatment

In the current medical realm, expert consensus guidelines indicate that Cognitive-Behavioral Therapy (CBT), not medication, is the initial treatment choice for OCD. For OCD treatment to be in harmony with Christianity, however, the treatment must not just suppress the symptoms, it must teach you to live a holy lifestyle purged of vindictive hostility. Rather than live in guilty fear about your fantasies, you can learn to face the anger behind the fantasies with trust in God’s protection.

This treatment has several parts: (1) stopping compulsive behaviors, (2) stopping obsessive thoughts, (3) purging “revenge” from your life, and (4) understanding that your salvation depends not on your perfection but on your willingness to grow in love.

 
1. Stopping Compulsive Behaviors

The basis for all CBT treatment for OCD is a concept called Exposure and Response Prevention. This involves exposing yourself to what you fear, and then deliberately preventing the defensive OCD response. In plain English, this all comes down to forcing yourself to not do what you fear not doing (such as not washing your hands when you touch a door handle or not organizing your closet as a response to thoughts that someone will be harmed if you don’t organize your closet).

The psychological core of Exposure and Response Prevention is to learn that distressing feelings and thoughts are not actually dangerous. The part of your brain that pushes you into an OCD impulse when you experience guilt is a primitive part of the brain that understands behavior, not language, and that has been conditioned to equate emotional distress with physical danger. When your body feels the first distress of guilt, your brain interprets it as a danger and sends out the signal to pump out fight-or-flight chemicals that cause physiological arousal.

Now, if you believe that there is a danger, and that you have to perform some OCD ritual to fight against it, you only encourage your brain to keep on pumping out more fight-or-flight chemicals, and eventually this process escalates and you succumb to the OCD impulse. Moreover, you can’t stop the impulse by telling yourself to stop it. As I said before, the part of your brain responsible for the OCD impulses doesn’t understand language. It only understands behavior—and this brings us to the real solution to the problem.

The only way to stop the OCD impulse is to act in a way that tells your brain that there is no danger. At this point, you must deliberately prevent the fight-or-flight anxiety response. First, instead of fast, shallow breathing take long, slow, deep breaths. Second, instead of staring around in a frenzy, close your eyes. Third, instead of clenching your muscles, loosen them. These behaviors will tell your brain that you are not in danger, and subsequently your brain will shut down the fight-or-flight chemicals—and you will experience a calm relief.

  

When done in the context of formal psychotherapy, this process usually entails in vivo exposure; that is, having the psychotherapist present with you to encourage you—“holding your hand,” so to speak—as you encounter actual feared situations and force yourself right then and there to overcome old behaviors.

So what can you do in the Christian self-help context?

Well, as for encouragement, know that “the God and Father of our Lord Jesus Christ is the Father of compassion and the God of all encouragement” (2 Corinthians 1:3).

Furthermore, trust in God to hold your hand: “Since my heart was embittered and my soul deeply wounded, I was stupid and could not understand; I was like a brute beast in your presence. Yet I am always with you; you take hold of my right hand” (Psalm 73:21-23).

  

The end result of this is that you can use your free will to resist the temptation to perform compulsive actions and that you can trust in God to overcome the superstitious fear of not performing them.

So, you ask, “What is trust in God?” and “What does it mean to overcome superstitious fear?” 
 

Trust in God 

To trust in God is to believe in God’s protection. Full trust in God is composed of two separate but interrelated components: trust in God’s justice, and trust in God’s providence.[6]

•  

Trust in God’s Justice. We have all encountered individuals who commit offenses and seem to “get away with it.” Although the irritation that we feel is justified, we can also be drawn into the desire to take matters into our own hands and get revenge. If we remember, however, that every crime—every sin—every offense against love—that a person commits is an offense against God that will be accounted for during his or her judgment at death, then we can understand that no one can evade God’s perfect justice. All sins will be paid for. If the sins are not repented, they will be paid for in hell, but if the sins are repented they will be paid for in Purgatory, thus demonstrating that mercy is a fundamental part of God’s justice.

To trust in God’s justice, then, is to set aside our anger for the injuries inflicted on us because we believe that God administers His own justice according to His will.
 

•  

Trust in God’s Providence. Some individuals have the mistaken belief that “trust in God” means to sit around doing nothing in the expectation that God will do everything for us. But this false belief is based in an avoidance of our taking full responsibility for living holy lives that bear spiritual fruits.

To trust in God’s providence, therefore, does not mean that we do nothing; it means that we believe that, in answer to our prayers, God will guide, protect, and encourage us as we take responsibility for developing and using our talents to serve God.
 

Overcoming Superstitious Fear

You feel the urge to perform a compulsive act because you accept the belief  that something bad will happen if you do not perform a ritual. But understand that a belief is not reality; work to overcome this false belief  with a true belief  in God’s protection. Trust in God that life is not based in superstition. When that inner OCD “voice” responds, “Come on, John. I’m only warning you for your own good. Your fears are perfectly reasonable. So be reasonable and go back and complete the ritual right now, or you’ll be sorry!” say what Christ Himself said when hearing something contrary to His mission: “Get behind Me, Satan! You are an obstacle to Me. You are thinking not as God does, but as human beings do” (Matthew 16:23).

 
2. Stopping Obsessive Thoughts

As creatures of language, we all think constantly. We think more than we need to think, and we think more often than not about frivolous and spiritually useless things. As harmful as this is to a Christian life, some individuals not only think constantly but they also ruminate and dwell upon their thoughts, and then they feel guilty about it all. Once a negative thought gets in your mind, it can torment you for hours and days. The guilt can be agonizing.

Obsessive thoughts, therefore, are self-propagating. The more they breed, the more they drive you away from spiritually healthy things, such as prayer, and the more you believe you are a bad person separated from God. 

The solution is simple: without running from such thoughts in terror, face them with courage and faith.

Scandalous thoughts. If your thoughts tell you to do something (curse God, break that glass, spit on that person, kick that dog, etc.) respond like this: “Yes, it’s true, I’m capable of doing that. Anyone is capable of doing that. But it would be wrong to do it, and for the love of God I won’t do it.”

Accusatory thoughts. If your thoughts accuse you of things you have done in the past (telling lies, sexual behaviors, etc.) and tell you that you are doomed, respond like this: “Yes, it’s true, I have done those things. They are wrong, but I have repented and confessed those sins; I no longer do such things, and for the love of God I won’t do such things again.”

Then, after admitting that to carry out these obsessive thoughts would be wrong, and without blaming yourself for having such thoughts, drive them away [7] with one constant, holy thought by reciting the Jesus Prayer to keep you from thinking about anything else.

The Jesus prayer is simple: Lord Jesus Christ, Son of God, have mercy upon me.

The technique, too, is simple: recite the prayer over and over in place of thinking anything else.[8]

Still, as simple as it is, it’s hard work. No sooner will you start to pray than your mind will wander and you will be off in your own thoughts. Once you realize that your mind has wandered from the prayer, stop thinking and return to the prayer. But be gentle with yourself. You don’t have to blame yourself for failing. You don’t have to try to analyze what happened. Just immediately stop thinking and return to the prayer. Then repeat this process over and over.

If you hold in your heart the will to do this and desire it more than anything else—more even than the desire to stay stuck in your fear and disability—you can do it. If you love God, and if you love your soul, you can do it.

 
3. Purging Revenge From Your Life

We are all surrounded by a social world that literally feeds upon hostility—anger on anger, hatred on hatred, lawsuit on lawsuit, weapon on weapon, death on death—enslaving the unwary to a subversive lust for anger and revenge.

Endeavor, therefore, to detach yourself from these social evils.

Do this by purging revenge from your life. Stop watching TV and movies, stop playing video games, stop listening to secular music, stop reading magazines and newspapers, stop watching competitive sports (and stop playing them, if you already do). For the sake of your soul, put all these things out of your mind.

Even though these things are accepted hook, line, and sinker by our secular culture—and even by those who claim to be Christian—they have no spiritual value and are just breeding grounds for the desire to get revenge on others. The same for addictions (smoking, drinking, drugs, obesity, gambling, eroticism); these things breed revenge because by hurting yourself your unconscious intent is to sabotage authority; e.g., your parents and God.

The more that you can purge revenge from your life, the more that you are able to desire the holy rather than desire worldly pleasures, and the more that you can pray constantly rather than fill your head with worldly entertainment, the more progress you will make in overcoming your unconscious slavery to anger, and the more progress you will make in overcoming your superstitious attempts to wash away your hidden anger.

 
4. Salvation Depends on Love, not on Perfection

Christ chose ordinary men, not scholars and theologians, to be His Apostles and disciples. Why? To demonstrate that the Church He was establishing would grow through God’s grace, not through mere human intelligence. So keep in mind that your salvation depends on your willingness to grow in love, not on your human perfection.

Understand, therefore, that intrusive thoughts and fantasies will not, in themselves, obstruct your salvation. These thoughts and fantasies in themselves are, at the worst, venial sins that can be absolved just by admitting that to carry them out in actuality would be wrong. The real danger to your salvation comes from your failure to trust in God’s providence and justice (see above); in so far as you don’t admit the thoughts and fantasies openly to yourself and to God and instead dwell upon fear of them, they will become temptations more than distractions, and you will feel compelled to cast aside love so as to take matters into your own hands to fight temptation with your own intelligence—and you will lose.

When you are praying and distractions interfere with your concentration, say to yourself, “It’s OK. I don’t have to repeat the prayer until I get it perfect. My intent is love; I don’t have to be perfect to love.”

When fantasies intrude into your mind, if you try to fight them they will only get more intense, and you will become more anxious. Instead of resisting, say to yourself, “It’s OK. Flashes of fantasies are products of my intellect, not my will. Let them be. I know that to act on them would be wrong, and I don’t really intend to carry out these thoughts in actions. My intent is love; I don’t have to be perfect in not having intruding thoughts. So let’s return to the Jesus Prayer.”

  
Summary

With practice, as you learn to live a genuine Catholic life—detached from the world, trusting totally in God, chaste in body and heart, free from all anger and desire for revenge—you will have no ugly beliefs, thoughts, and fantasies to fear, and therefore no guilt to hide. From then on, whenever any fantasies arise in your mind, you can see them not as ugly and fearful, but simply as warnings that someone has hurt you somehow. Then, knowing you’ve been hurt, and feeling the pain, you can forgive the person who hurt you, and you can turn to God in faith and prayer, believing in and trusting in His protection:

  

When the just cry out, the LORD hears
    and rescues them from all distress.
The LORD is close to the broken hearted,
    saves those whose spirit is crushed.
Many are the troubles of the just
    but the LORD delivers from them all.

  

—Psalm 34:18-20

  
Related Pages

Unfinished business in OCD
Invisible anger in OCD
How a defense is a protection

 
Recommended Reading

Trustful Surrender to Divine Providence

Jean Baptiste Saint-Jure and Blessed Claude de la Colombière.
Trustful Surrender to Divine Providence / The Secret of Peace and Happiness.

 
Extracts from the writings of two influential religious writers and spiritual directors from the 17th century.
 
Read this book to understand and conform to the will of God.
 
TAN Books and Publishers

 

Who wrote this web page?

 

Notes.

1. Note that the whole problem with science is that it is trapped within the box of sin, and, no matter how powerful its instruments, it simply cannot see outside the box.

2. William Shakespeare, Macbeth, Act V, Scene I.

3. This is why your anger can be so easily denied. Rather than stinging like a direct insult, anger resulting from someone’s failure often lurks in the shadows of the unconscious.

4. Imagine that, as you are about to receive from the chalice at Mass, a thought occurs to you: “I could drop this and spill the Precious Blood all over the floor.” This does not mean that you would actually like to drop the chalice, but only that your intellect recognizes the possibility that you could do it. If you push the thought out of your mind and don’t worry about it, everything will be fine. But if you dwell on the thought, allowing it to keep repeating in your mind, then you have an indication that you secretly desire to drop the chalice. In this case, the desire—manifested by the satisfaction of dwelling on the thought—is an expression of your anger at God that in itself derives from your anger at authority in general and which, in turn, specifically derives from anger at your father. Consequently, going to confession because of the “bad” thought about dropping the chalice will be less helpful than going to psychotherapy to resolve your unconscious family conflicts deriving from your childhood.

5. In fact, some persons are so good at repressing these fantasies that they will claim—even to the point of vindictive anger—they don’t even have them. This is why OCD is a disorder particularly resistant to traditional treatment.

6. The sad thing for many children is that they lack any living example of trust in God because their parents really do not live a lifestyle of genuine trust in God. Despite what their parents might say with their lips, and despite all their novenas and devotions, the parents’ fundamental psychological attitude is more often than not governed by attachment to the secular ways of the social world around them. When the children look to their parents’ religion, they see only dry rituals and superstitions. The children are wounded by their parents’ hypocrisy. They resent it. They fear it. They secretly hate their parents for denying them any experience of true faith. So when the children feel anxiety or fear because of their anger, they have nothing to protect them. Their obsessive thoughts feel like demons tormenting them. Because they don’t know how to call upon the name of God to defend them (see Psalm 91), they take matters into their own hands by creating their own compulsive rituals to neutralize their anger. It’s as if they unconsciously use psychological symptoms to “show” their parents that the family lacks any meaningful faith.

7. On another page of this website I explain about understanding your fantasies rather than trying to ignore them. This work of understanding is valuable, but even when you have understood your fantasies they will not just grow wings and fly away. Distractions will keep intruding into your mind as long as you live. The advice on the present web page is therefore intended to help you ward off the distractions you have already understood.

8. You don’t have to be concerned about getting your work done. When you need to think logically, or when you need to pray other prayers, the Jesus Prayer will not interfere. It will cease when you need it to cease; just remember to start it again when you become aware that it has stopped.

 

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