I never imagined that I would be treating clients with OCD during a pandemic. This is a unique situation and I myself often question the appropriate amount of hand-washing and hygienic behaviors I should engage in. However, it is important to know that proper hygiene habits,  such as hand washing and washing groceries only provide temporary anxiety relief. If we are concerned that we have missed even a single germ, our limbic system, responsible for emotions, memory, and reinforcing behavior, remains in fight-or-flight mode. Getting to a place of peace and groundedness can be extremely difficult at this time, especially for those who experience OCD. 

Those clients with underlying mental health conditions, specifically obsessive compulsive disorder, may be experiencing a major increase in anxiety in light of the Coronavirus pandemic. It is essential that everyone takes appropriate precautions at this time to keep ourselves and others safe and healthy. However, there is a blurry line between washing your hands appropriately versus excessively during this pandemic, disinfecting your foods incessantly, and other anxiety reinforcing behaviors.

An obsession is an intrusive thought, image, or urge that triggers intense and distressing feelings. An example of an obsession might be, “If I don’t wash my hands 30 times in a row, I will get Coronavirus”. A compulsion is the behavior one engages in in efforts to rid of the obsession, the feelings, and the distress such thinking may cause. An example of a compulsion would be actually washing one’s hands 30 times in a row to be rid of the distress and fear of associated with contracting Coronavirus. . 

Here are some practical steps to help prevent yourself from falling into the obsession and compulsion trap. 

1. The first question to ask yourself is, “Are my obsessions and compulsions causing me distress?” This is a good sign. To be in tune with yourself enough to know that your present behaviors are excessive is important and a first step toward reducing compulsions.
   
2. A major component of reducing compulsions is trusting yourself and developing a clear narrative in your mind that allows room for uncertainty. Rarely can we be 100% sure of anything. For example, “When I take reasonable precautions that are CDC-recommended guidelines, and practice tolerating the uncertainty that remains, I can rest and relax more”. 
   
3. Are you noticing that every time you have a tickle in your throat, a sneeze, or feel hot that you are checking your temperature or experiencing high anxiety? When we constantly check our symptoms to provide us relief, we feed into the narrative that we will only feel less anxious if we engage in this compulsion or checking behavior. This in turn programs our mind to be less tolerant of uncertainty in the future. Practice resisting the urge to check and instead use language such as, “I can trust myself that if I am really feeling sick, I will call my doctor and ask for help”. Checking repeatedly does more harm than good”.
   
4. Normalize your anxiety. It only makes sense that we are all feeling anxious at this time. Living through a pandemic is likely something none of us thought we would ever experience and something no one prepared us for. When we observe our emotions, rather than react to them in fear, we give them the opportunity to transform. This teaches us to observe what is going on for us, rather than to fight it or act to push it away.

For more resources on coping with OCD during Coronavirus, go to: https://iocdf.org/covid19/.

Hannah Tishman, LMSW, is a therapist at Cobb Psychotherapy. If you would like support in incorporating self-care into your life, contact Cobb Psychotherapy and see how therapy can help.