Areas › Worry and anxiety › Obsessions and compulsions
Offer choices rather than instructions. With a problem that runs on control, being told what to do gives that control somewhere to dig in.
Two or three real options, the trade-offs said plainly, and then the pick is genuinely theirs. That holds for the big decisions too, like moving to a more intensive programme. People who go in having chosen tend to stay, and people who go in having been told tend to leave, and the leaving usually gets called resistance when it was mostly about who decided.
Obsessive thoughts and compulsions respond well to a specific kind of therapy. What is here is for understanding them, not for treating them by yourself.
Qur’an and Sunnah
He has chosen you and placed no hardship in your religion (Quran 22:78). What is asked of a person is not pitched at the maximum, so taking the lighter route first is not taking a lesser one.
وَجَٰهِدُواْ فِي ٱللَّهِ حَقَّ جِهَادِهِۦۚ هُوَ ٱجۡتَبَىٰكُمۡ وَمَا جَعَلَ عَلَيۡكُمۡ فِي ٱلدِّينِ مِنۡ حَرَجࣲۚ مِّلَّةَ أَبِيكُمۡ إِبۡرَٰهِيمَۚ هُوَ سَمَّىٰكُمُ ٱلۡمُسۡلِمِينَ مِن قَبۡلُ وَفِي هَٰذَا لِيَكُونَ ٱلرَّسُولُ شَهِيدًا عَلَيۡكُمۡ وَتَكُونُواْ شُهَدَآءَ عَلَى ٱلنَّاسِۚ فَأَقِيمُواْ ٱلصَّلَوٰةَ وَءَاتُواْ ٱلزَّكَوٰةَ وَٱعۡتَصِمُواْ بِٱللَّهِ هُوَ مَوۡلَىٰكُمۡۖ فَنِعۡمَ ٱلۡمَوۡلَىٰ وَنِعۡمَ ٱلنَّصِيرُ
Strive hard for God as is His due: He has chosen you and placed no hardship in your religion, the faith of your forefather Abraham. God has called you Muslims––both in the past and in this [message]––so that the Messenger can bear witness about you and so that you can bear witness about other people. So keep up the prayer, give the prescribed alms, and seek refuge in God: He is your protector––an excellent protector and an excellent helper
Qur’an 22:78read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
There is a real menu to offer here. A meta-analysis found therapy delivered by phone, computer or internet outperformed control conditions and was not clearly worse than face to face, though the trials were few. In a trial with 152 young people, starting online and stepping up to in-person sessions only when needed worked about as well as in-person from the outset, while using far less clinician time. Neither study tested whether letting the person choose changes anything.
Dèttore D, Pozza A, Andersson G. (2015). Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials.. Cognitive behaviour therapy doi
Aspvall K, Andersson E, Melin K, Norlin L, Eriksson V, Vigerland S, Jolstedt M, Silverberg-Mörse M, Wallin L, Sampaio F, Feldman I, Bottai M, Lenhard F, Mataix-Cols D, Serlachius E. (2021). Effect of an Internet-Delivered Stepped-Care Program vs In-Person Cognitive Behavioral Therapy on Obsessive-Compulsive Disorder Symptoms in Children and Adolescents: A Randomized Clinical Trial.. JAMA doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Nobody fights a plan they picked themselves.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
If you are stuck on whether having a thought makes you a bad person, that question is a symptom and not a case waiting to be settled. Name it as scrupulosity and let it stand unanswered.
If every step you try keeps not working, however small you make it, that is information rather than failure. A more intensive programme is the next thing to look at, and it should be put to you as an option.
Agree a short phrase to use at home. Saying I am having OCD worries tells a parent what is going on without handing them the worry to solve.