We get pulled into anxiety disorders when we catastrophically misinterpret our primitive ‘freeze, fight or flee’ stress response reaction. This stress response reaction has two very powerful aspects; it wants to both physically mobilise us and emotionally motivate us to escape the physical threat it erroneously thinks we are facing because we have been behaving (thinking and/or acting) so apprehensively.  

OCD sufferers are in the highest echelon of anxiety sensitivity and so are even more vulnerable to catastrophically misinterpreting higher levels of anxiety than the average anxiety sensitive who constitutes up to 20% of the population. The catastrophic misinterpretation takes place when the sufferer assumes that what they experience from anxiety means that the intrusive thoughts/obsessions they are engaging in are important/true. As a result, the sufferer will engage in apprehensive rituals and/or compulsions to help relieve their anxiety, although this ultimately results in the reinforcement of their anxiety and the creation and reinforcement of their OCD cycle. The more powerful this OCD cycle becomes, the more powerful the experience of anxiety becomes, pulling the sufferer into an anxiety distortion where the sense of risk is blown completely out of proportion and there is an ever-escalating loss of rational perspective.     

Once a catastrophic misinterpretation has taken place, an irrational belief system is formed that results in irrational feelings which trick the sufferer more and more into believing that their OCD fears are true.   

Trauma (usually childhood) also compounds this catastrophic misinterpretation.

Here are some examples:

Harm OCD
The emotional experience of anxiety: A dark sinister dread feeling, like something bad is about to happen.
The physical experience of anxiety: Tingling in the hands.
Intrusive thoughts: “What if I lose control of my hands and harm somebody?!”
Compounding childhood trauma: Being physically and psychologically abused by caregivers and thereby falsely believing that ‘I must somehow be bad’.
Catastrophic misinterpretation/irrational belief system: I’m a danger and should be locked up!
Irrational feelings from the irrational belief system: Shame and guilt.

Transgender OCD
IMORTANT NOTE: Transgender OCD is a sub-category of OCD and characterized by persistent, intrusive thoughts, distress and doubts about gender identity. This has nothing to do with actual gender dysphoria, the diagnosis associated with being transgender. In actual gender dysphoria someone has a natural drive and need to transition because their body and brain don’t feel right in the gender package they received at birth.
The emotional experience of anxiety: Feeling like something is off and not right.
The physical experience of anxiety: Not feeling in body (depersonalisation).
Intrusive thoughts: “What if not feeling right in my body means I want to be another gender?!”
Compounding childhood trauma: Neglect resulting in a loss of sense of self.
Catastrophic misinterpretation/irrational belief system: I want to be another gender and I’m in denial!
Irrational feelings from the irrational belief system: Fear that my life is about to completely change.

Relationship OCD
The emotional experience of anxiety: Whooshes of doom. 
The physical experience of anxiety: Stomach drop, feeling sick.
Intrusive thoughts: “What if this relationship isn’t right!”, “What if I don’t really love them!”
Compounding childhood trauma: Emotional abuse and neglect resulting in a core belief ‘I’m not good enough and will be abandoned’ fuelling an intense fear of being vulnerable in a relationship.
Catastrophic misinterpretation/irrational belief system: I must leave this relationship!
Irrational feelings from the irrational belief system: Resigned feelings of sadness.

Paedophilia OCD
The emotional experience of anxiety: Whooshes of doom and a feeling like evil is looming.
The physical experience of anxiety: Hot and flustered with heart flutters. Groinal response (e.g. pulsing, twitching, vibrating, erection, increased lubrication, even orgasm).  
IMPORTANT NOTE: Groinal responses in OCD don’t indicate true arousal or sexual desire. They occur because the sufferer is anxious about the idea of a sexual attraction and hyper fixated on the groin area as a result which results in sensations in that area. Then more the sufferer notices the groinal responses, the more they occur. Excellent information here: Groinal Responses in OCD: What They Are and Why They Happen - Impulse (impulsetherapy.com)
Intrusive thoughts: “OMG what if I’m attracted to this child!”, “What if I’m going to harm them!!”.
Compounding childhood trauma: Extreme exposure to all things bad from physical, emotional and sexual abuse ready to hook onto in times of high anxiety. The trauma resulting in a core belief ‘Nobody loves me, I don’t fit in, and I will be abandoned’ fuelling an extreme fear of being singled out and abandoned.  
Catastrophic misinterpretation/irrational belief system: I’m a paedophile and should avoid all children!
Irrational feelings from the irrational belief system: Terror, shame, guilt, my world is over.

This is just a small handful of OCD themes people can experience. In fact, there’s no limit to the number of OCD themes we can experience because we can create an OCD cycle in whichever way we feel compelled by fear and anxiety.

Recovery from OCD requires breaking the OCD cycle of apprehensive obsessions, rituals and/or compulsions that pull us into an anxiety distortion where risk is blown completely out of proportion, and we lose all rational perspective. We do this through Exposure Response Prevention (ERP). This requires Exposing ourselves to situations/people/places/things that trigger the disturbing emotional and physical experience from anxiety and changing our Response – i.e. we work on not engaging in the obsessions and we systematically drop the rituals and/or compulsions. By breaking the OCD cycle over time, risk starts to feel more and more proportionate, and we regain more and more rational perspective.

​Exposure requires facing extreme fears, so it definitely isn’t easy but the rewards for this short-term pain are freedom from debilitating anxiety and OCD. 
​© Amanda Morgan

Here are examples of some of the apprehensive behaviours that keep us trapped in anxiety…
APPREHENSIVELY DISTRACTING FROM ANXIETY: Trying to apprehensively distract ourselves from anxiety and its symptoms and sensations is often one of the first strategies we desperately deploy to try and get rid of anxiety. However, trying to apprehensively distract from anxiety ultimately only reinforces it. This is because whenever we behave significantly apprehensively, our primitive ‘freeze, fight or flee’ stress response concludes we are facing a physical threat, and so then it works to physical mobilise and emotionally motivate us to escape that physical threat it erroneously thinks we are facing, giving us all those frightening symptoms and sensations we call anxiety. And so, although apprehensive distraction may bring some temporary relief from anxiety, we remain on high alert behind the scenes, reinforcing the anxiety and also building fear associations (e.g. if you continuously try and apprehensively distract from anxiety when you go outside or go on transport you will build a fear association with going outside or going on transport). Instead, we must learn how to accept and stay calm in the face of anxiety, thereby allowing it to pass in its own time and for our nervous system to slowly recover.

FEARING THE SYMPTOMS AND SENSATIONS OF YOUR ANXIETY: No matter how bewildering and frightening the symptoms and sensations of anxiety may initially seem, they are simply the symptoms and sensations of our body’s primitive ‘freeze, fight or flee’ survival stress response. If we allow ourselves to get frightened by them then we perpetuate and exacerbate the problem because anxiety is caused by apprehensive behaviour (thinking and acting). Instead, we need to learn to accept these symptoms and sensations and remain calm as we experience them, thereby allowing them to pass in their own time and for our nervous system to slowly recover.

APPREHENSIVELY SEEKING REASSURANCE ABOUT YOUR ANXIETY: Apprehensively seeking reassurance is another strategy we might deploy to try and solve our distressing anxiety. We may apprehensively seek reassurance through our own inner voices, Google, social media, books, and from others. At first, reassurance seems to help, and our anxiety goes down a bit and we feel a sense of relief. But then the doubts come back in the form of ‘yes…but what if…’ and then we have to find some new reassurance for that new ‘what if’ question and so on which can result in our anxiety spiralling out of control. Instead, we have to learn to see anxiety for what it really is; simply our body’s primitive survival stress response designed to help us ‘freeze, fight or flee’ in the face of danger, which we will trigger less and less as we start to systematically drop all the apprehensive behaviour feeding it.   

ENGAGING IN SAFETY OR AVOIDANCE BEHAVIOURS: To get some level of temporary relief from the frightening experience of anxiety and the situations, people, places or things we have come to associate this anxiety with, we may engage in safety and avoidance behaviours. For example, we might make sure we are with someone else in a public place (safety behaviour) or avoid public places completely (avoidance behaviour). Or we might make sure we are always driving when in a car (safety behaviour), or we might avoid being in a car completely (avoidance behaviour).
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However, safety and avoidance are ultimately apprehensive behaviours that reinforce anxiety and train our ‘freeze, fight or flee’ primitive stress response to associate those situations, people, places or things we are putting safety behaviours around or avoiding with a physical threat. And so, when we think about or engage with these places and situations our primitive stress response is immediately triggered, resulting in anxiety and its emotional and physical symptoms/sensations we fear, keeping us trapped in a vicious cycle of anxiety. Ultimately, we need to systematically drop all safety and avoidance behaviours through the process of exposure and see that anxiety isn’t dangerous and passes when we stop fearing it.

TREATING UNWANTED INTRUSIVE THOUGHTS LIKE THEY MEAN SOMETHING/ARE IMPORTANT: Everyone gets unwanted intrusive thoughts from time to time (e.g. “What if I can cope!” or “What if the worst happens!!”). We are particularly vulnerable to them when our anxiety is heightened. However, thoughts are just thoughts and not reality and if we start having a conversation with these kinds of thoughts, we trigger more and more of them. All this apprehensive thinking then triggers our ‘freeze, fight or flee’ primitive stress response which gives us disturbing emotional feelings (e.g. feelings of dread and doom or a feeling like something bad is going to happen, etc.) to try and emotionally motivate us to escape the physical threat it erroneously thinks we are facing. These feelings can then make us feel like our thoughts are true or going to come true (though feeling fusion) and so we get sucked into the thoughts and anxiety more and more and lose rational perspective.

Instead, we need to recognise unwanted intrusive thoughts as just harmless thoughts and not engage with them, letting them drift out of our mind in their own time. We also need to practice not getting tricked by the disturbing emotional feelings from anxiety; they are just the result of our primitive stress response believing we are facing a physical threat and trying to emotionally motivate us to escape.  

© Amanda Morgan

Becoming aware of our feelings and constructively dealing with them is crucial for our personal healing and recovery.

If we grew up in a family that was to some degree dysfunctional the likelihood is that we didn’t get all our healthy needs met. Not getting some of our needs met hurt us and created painful feelings. Since our parents and possibly other members of our family were unable to fully listen to us, support us, nurture and accept us, we often had nobody with whom we could share these painful feelings. We consequently shut these feeling out, away from our awareness (meaning we shut aspects of our True Self out, away from our awareness). Doing this allowed us to survive and function in the world, however, it came at a price. The price is that, as we have continued this behaviour in to adulthood, we have become progressively numb and out of touch with aspects of who we truly are (our True Self).

The aspects of our True Self that we have lost touch with have been unable to grow and evolve. Growing and evolving enables us to feel alive, satisfied and fulfilled. Consequently, because some aspects of our True Self have been unable to grow and evolve, we feel stifled and un-alive; and consequently frustrated, confused, empty, low, depressed, and sometimes distressed.

​Our feelings are incredibly precious and important. They enable to understand what we truly need and want and what we don’t need and want. They also enable us to make sense of the world around us and process and assimilate our experiences, so that we can move forward, grow and evolve. Getting in touch with them and talking about them is therefore healthy and an essential part of our recovery. Although getting in touch with them for the first time may feel incredibly painful, and sometimes frightening and overwhelming, soon enough these feelings start to become our friends. They become our friends because we need them to feel whole, real and alive, and to enjoy a healthy relationship with our Self and others.

Our feelings can be both joyful and painful. The spectrum includes: unconditional love, bliss, joy, compassion, empathy, enthusiasm, contentment, fear, hurt, sadness, shame, guilt, anger, confusion, emptiness, numbness.

The way out of a painful feeling is through it. We may have buried many painful feelings and therefore, as part of our recovery, we need to carefully uncover and process them. This process includes sharing our feelings with safe others. 
© Amanda Morgan ​