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CoronaVirus and OCD

"Funny,“ comments Michael, a 56-year-old client who has struggled with obsessive compulsive disorder his entire life. “Ever since this pandemic broke out, I actually feel calmer than I ever have before. It is fascinating. I thought I would be more anxious than ever being that my obsessive thoughts revolve around catching germs.”

A colleague who practices behavioral and exposure therapy in an anxiety clinic mentioned to me as well that many of the highly anxious clients they see have become calmer in the face of the recent pandemic. How does this make sense?

The answer lies in Michael’s explanation and in the reasoning behind psychoanalysis. “Now that everyone is terrified of germs, I finally feel understood and vindicated.“ What Michael has taught me is that therapy helps to calm people not by reducing the anxiety around the germs, but rather by eliminating the shame about having unwanted anxiety.

People like Michael and others who struggle with their emotions actually suffer from a greater challenge than the negative emotion. Negative emotions are natural and passing. If one can find permission within himself to experience a negative emotion he should be fine to allow it to peak and then settle down with no damage done. What makes us really struggle is the shame surrounding our negative feelings. “What is it about me that is so afraid of dogs while everyone else seems to enjoy playing with them? Why do I run across the street when I see a little puppy coming towards me?“

In psychotherapy we treat the “what is it about me.” We treat the person who is struggling as a result of the symptom. Psychotherapists are concerned that if we simply treat the symptom to help symptom reduction, the “what about me” factor is left unresolved and will almost definitely manifest again in some form. It is similar to cutting off a growth one notices on his body. The protrusion may not be noticeable, but the causes for it to fester have not been addressed. It only appears to be gone.

Now that so many people in Michael’s life are challenged by germs and have become germaphobic, Michael feels less alone. Although his actual anxiety and fear of germs has not disappeared, his shame and self loathing has. Seeing his relations struggling with his challenge makes Michael an ‘old pro’ in his eyes. Michael is not only not a loser, he is now a proud expert. He is like the orange farmer who keeps getting duped into buying grapefruits until Fresca became the most popular invention. Michael is not disrespected by his family and peers at this juncture, they can actually all relate to each other.

The positive effect that the coronavirus is having on some with germaphobic obsessive compulsive disorder highlights the work of good psychotherapy. Our clients need us to spend more energy understanding their challenges in vivid detail. They need to hear us paraphrase what they say and explore their experiences in a way which helps them make sense and meaning of them. If they are understood, they can accept themselves as valid and stop struggling. If we invest so much energy into reducing their symptoms, we have made people into unwanted symptoms. If we can’t fix the symptoms, we throw out the client. Psychotherapy embraces the person and his experiences, seeks to understand and recreate the entire picture. We don’t treat Michael’s OCD, we treat Michael and anguish with him in his struggle of obsessive thoughts.

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