What OCD Has Taught Me About Buddhism (and Vice Versa)

by Matt B. on November 15, 2014

A condensed version of this essay appears in Shambhala Sun.

In the first of the Lotus Sutra allegories, a man must convince his children to put aside their toys in order to escape a burning house. To do so, the man contrives an even more tempting set of playthings – the three ‘chariots’ of the Buddhist teachings.

Like almost everyone, I spend most of my time in the grip of ignorance, attachment, and aversion. And like almost everyone, I require the rescue we see in the Lotus Sutra. But in one sense, my challenges feel different than the average citizen of samsara.

I have obsessive-compulsive disorder, or OCD. As I’ve written elsewhere, the cycle typically begins with

what psychologists call ‘intrusive thoughts’ – unwanted, painful thoughts or images that invade one’s consciousness, triggering profound fear and anxiety. This is the ‘obsessive’ part of OCD, and it can arise in even the most mundane circumstances. Sitting here typing, for example, I sometimes feel modest pain in my fingers, and my mind kicks into gear: You’re typing too much and causing permanent damage to your hands. Feel those little irritations at the second knuckle of your left ring finger? Those are the harbingers of arthritis. This is how it starts.

All around this mental tickertape, tension begins to build — a tidal lift that threatens to drown me if I don’t take immediate action. It’s hard to overstate just how world-shrinkingly claustrophobic this can feel, or just how much I am tempted to do to make the feeling go away. And here’s where the mental terrorists make their demands. Type slower. Put your wrist guards on. Stop typing altogether. Then you won’t have to feel this way. These are the ‘compulsions’ — ritual behaviors meant to alleviate anxiety.

This process is immensely confusing, in part because I don’t have a handle on the source of my intrusive thoughts. Some of them, after all, bear at least a tenuous relationship to reality – repetitive stress injury does happen – even if the fears I feel and the consequences I imagine are wildly out of proportion to the situation at hand.

Other times, however, the intrusive thoughts part company with reality entirely. While putting my glasses on, for example, I sometimes imagine that I’ve inadvertently scratched my eye with my fingernails. My mind quickly generates a whole host of potential repercussions – an inability to read or write, and ultimately, blindness itself.

Terrified, I immediately scan my memory. Do I remember any contact between my fingers and my eyes? Did I feel any pain? Unfortunately, the fear flooding my system distorts everything, and I find myself unable to recall events clearly from even a moment before.

In an effort to sort through the fog, I sometimes find myself visualizing what it would have felt like to scratch my eyes. I sense my fingers converging on my eyes, feel the pressure of contact, undergo the cutting sensation. Unfortunately, this only confuses things further. Now, I have the memories I was looking for, but I can’t discern whether they ‘really happened’ or whether I made them up. Memory and imagination blur, and I’m left even more anxious than before.

For me, living with OCD means having a mind which fabricates events that never happened and projects consequences that never will. On a day-to-day level, then, the greatest source of suffering in my life isn’t a refusal to leave a burning house. It’s my desire to flee a house that isn’t burning at all.

*          *          *

I was diagnosed at 18, and for the next year-and-a-half, I did my damnedest to deny that the diagnosis meant anything. I was already spending huge portions of my day wrapped up in obsessive-compulsive cycles; the last thing I wanted was to devote even more time to therapy. Eventually, though, the pain became so constant that I conceded.

I began taking Lexapro, an antidepressant, and tried out a series of psychologists. Some of these therapists wanted to chat, to relate with my experiences by sharing similar stories of their own. Others tried to examine and deconstruct the unrealistic assumptions that fueled my fears. The best of the bunch – Dr. B. – did the least overt psychologizing: he simply provided a space in which I could pour out the almost impossibly concentrated anxieties that had accumulated throughout the week.

I left many of my conversations with Dr. B feeling ever so slightly hopeful, as if I’d taken the first creaky steps toward resurrection. The trouble was that it was just a feeling; I hadn’t learned any techniques to sustain my momentum. Over the next several days, the effects would wear off, and I would be sucked right back into the vortex.

About five years ago, I volunteered to participate in a research study on OCD. In exchange, I received several months of free treatment in a form of cognitive behavioral therapy known as exposure and response prevention (ERP). In ERP, the OCD sufferer exposes himself to the stimuli that trigger his fears and then deliberately refrains from the compulsions that arise. The idea is that as the sufferer leans into his fears rather than reacting to them, the triggering stimuli begin to lose their power.

During the first few months of treatment, I spent several hours each day conducting a variety of different exposures. Sometimes, I would write a paragraph like the following that captured a particular set of fears.

I’ve recklessly and carelessly scratched my eyes. As a result, they’ll get worse and worse. I won’t be able to read, write, or do any of the things I enjoy, and I’ll be miserable. And there’s nothing I can do about it.

I would then sit and repeat the paragraph out loud until my anxiety diminished to a level my therapist and I had agreed upon. Other times, I would create shorter versions – just a sentence, or even a phrase – and repeat them in my head.

I also conducted in vivo exposures – impromptu responses to fears whenever and wherever they happened to arise. Riding the train from Brooklyn to my therapist’s office on 168th St., for example, I sometimes became afraid that I was inducing tumors by leaning my head against the vibrating subway car wall. In these instances – when I could summon my courage – I would hold my head against the jittery metal for an extra five or ten or 30 seconds, allowing myself to feel the full weight of my fear and refusing to respond.

I never liked doing exposure work, and not just because it was painful. Mostly, it felt tedious, and I imagined that I ought to be doing something more interesting than practicing getting in and out of bed. But the theory made sense to me, and the practice generated immediate results: I noticed that I was managing daily tasks a bit more easily and feeling a little less overwhelmed.

When I began meditating, I thought I would continue both practices in parallel. Very quickly, though, I noticed what felt like a subtle tension between them. This was strange; from a certain vantage point, ERP and meditation seem deeply complementary. After all, both are driven by the understanding that thoughts are just thoughts – and that the more time we sit with them, the less we will mistake them for reality, and the less reactive we will become.

The difference – or so it seemed at the time – is that ERP is goal-oriented: it aims at these results directly. Meditation – at least in my lineage – doesn’t work this way. One doesn’t plop down on the cushion and say, “Now I’ll work on becoming less reactive.” In fact, one doesn’t practice in order to get anything at all. One simply sits, trusting that the only route to sanity is to stop trying to do things all the time and simply spend time with oneself.[1]

Over time, the tension grew. Despite knowing that my exposure work often led to a deep sense of resilience and empowerment, I continued to dread it. I can’t claim that I lost faith in the techniques, and I certainly can’t claim that they weren’t working. It was simpler than that: my exposure exercises felt too much like the rest of my life – yet another arena in which I was perpetually trying to improve myself, to get away from my experience in the here and now. For a while, I discontinued ERP. I wasn’t sure about the wisdom of this decision, but I was too exhausted to do otherwise.

Recently, though, I’ve come back around. My energy has returned, but more importantly, I’ve begun to grasp ERP at a subtler level. Understood properly, ERP isn’t about escapism, and it isn’t inconsistent with meditation. In fact, one might think of it as a very specific kind of meditation.

Meditation is about facing our own minds and encountering whatever arises. As a result, there’s often a certain randomness to meditation experience: who knows what will pop up? ERP, on the other hand, is about acknowledging that certain thoughts and feelings arise more often than others, and that it can be prudent to prepare ourselves for their arrival.

*          *          *

OCD is an overactive alarm system, a jumpy nightwatchman. Intrusive thoughts trigger a powerful fear response, and because our bodies are built to take fear seriously – to treat it as a sign that danger is afoot – I find myself believing my thoughts and wanting to react. (This is one of OCD’s profound ironies: intrusive thoughts set off profound chain reactions precisely because they’re so outlandish.)

As my anxiety spikes past the red line, I feel pressed to make a choice. Do I continue with whatever I was doing and lean into the fear (knowing, at some level, that this is OCD at work)? Or do I give into my compulsions in an effort to make the fear subside (knowing, at some level, that this will strengthen the cycle in the long term)?

It’s even more complicated than that, however, because, the fears don’t arise in isolation. Rather, they tend to activate entire networks of other fears. I’ll be cutting vegetables for dinner, and it will occur to me that my attention has drifted. I’ll wonder: While I was daydreaming, did I accidentally press the knife blade against a tendon in my finger? Have I cut myself? If I see no signs of damage, I might ask, Was the damage more subtle than that? Have I weakened myself in a way that will make future injury more likely?

In these moments, part of me wants to push through the fears, to clang pots and pans defiantly. Another part believes that I’ve already screwed up, and that I can only make things worse by acting cavalier. I might try to split the difference and continue cooking in a spirit of moderation, moving objects around without being too brash or too tender. But the sweet spot will elude me, and everything I do will feel like a drastic mistake.

Meanwhile, my kitchen – so innocuous just a moment before – will become the site of a thousand old worries, all blooming into new and vigorous life. I’ll remember my concern about repetitive stress injury, and I’ll begin to feel afraid to touch anything. I’ll consider walking out of the room, but I’ll recall old tremblings about walking into walls and damaging my eyes. I’ll shift my footing, only to summon a million voices screaming about disintegrating knees. Eventually, I’ll feel completely boxed in, and I’ll find myself staring – first at the handle of a pot or pan, and then blankly – swamped by the gravity of the situation.

When I fall into this fearful place, I see danger and consequences in every direction. It feels impossible to make good choices, because the strike zone is so vanishingly small. And so I spend a good portion of my day trying to ensure that I won’t fall into this place – avoiding everyday situations, weighing my word choices incredibly carefully, pausing and breathing when my mind starts to spin too quickly. If OCD is an overactive alarm system, I do my damnedest not to trip it – or rather, to trip myself. For years now, I’ve been afraid to be afraid.

*          *          *

Because OCD is so terrifying, frustrating, and depressing, it’s also shot through with a desire for security, for permanent guarantees against suffering. Every day, I feel all kinds of things I don’t want to feel, and it’s the easiest thing in the world to invent rules and guidelines in the hopes that I won’t have to feel them again.

To say it in a slightly more Buddhist valence: OCD is built on the premise that control is possible, and that there’s someone there – some kind of “self” – to do the controlling. But as the dharma points out – and as meditation reveals – this just isn’t true.

I study and practice in the lineage of Chögyam Trungpa Rinpoche. (My teacher, Lee Ray, was one of his students.) Within our sangha, many of us joke that we’ve each come to Buddhism after trying everything else. And there’s some truth to that; after all, meditation forces us to spend time with ourselves, to see what’s going on inside. And like most people, that’s the last thing we want to do.

But there’s also a deep irony in our use of the word ‘trying’ – one that marks the difference between the dharma and just about every philosophy, religion, or form of self-help that I’ve seen. The Buddha’s teachings are clear: most of our suffering is generated precisely because we are constantly trying to be something other than what we are. Trungpa Rinpoche talked about this as the work of ego – that if we only push harder and exercise more discipline, we’ll get exactly what we want out of life: more experiences we like, an ability to steer clear of the ones we don’t, and a pleasant, consistent storyline about who we are.

These, of course, are the snares of samsara – the mirages we spend our whole lives chasing. And there’s only one way that we can begin to see them for the traps they are: by practicing meditation.

*          *          *

For me, meditation has been a revolution, a way of becoming acquainted with the basic spaciousness within. OCD, after all, admits of no space – it is a perpetual hemming-in, the spiky descending ceiling in Indiana Jones and the Temple of Doom.

When I began practicing about two years ago, then, I thought I had found a way out of my incessant battles with OCD. Finally, an hour or two each day in which I didn’t have to take my thoughts and feelings so seriously! In which my entire task was simply to breathe and let everything go. In which there wasn’t any way to screw up.

I should have expected no such reprieve. After all, OCD tends to target and undermine whatever I care about most at a given time. And so it threatened practice, too. As I begin meditating more regularly, the intrusive thoughts mounted their counterattack. What if I was practicing incorrectly, and whatever insights I’d had paled in comparison to the ones I could have if only I’d practiced with more discipline or better form? What if I was taking the wrong attitude toward practice – that instead of working to erode ego and escape the tethers of conceptual thinking, I was chasing new forms of what Trungpa called “spiritual materialism”? And what if I was overdoing it physically? What if, out of the depth of my grasping, I was on the way to injuring my knees and making it impossible to meditate?

In other words, OCD did what it always does: it escalated, raising the tension to a point just beyond what I feel like I can handle. It issued ultimatums: in order for your life to be tolerable, it needs to look a very particular way. And it spat out threats: if you can’t make your life look that way, the abyss awaits.

My samsaric mind very much wanted to take the bait, and on many days, it did. Thankfully, though, I had a new resource: the dharma itself. Through study and practice, I was no longer quite so convinced that the only way to conduct this conversation was on OCD’s terms. Yes, perhaps my life would need to take a particular shape, but it wasn’t clear to me that I was in charge of shaping it – and the perhaps the form it took would have nothing to do with what I envisioned.

*          *          *

I’m always resistant when people try to suggest that there might be an “upside” to OCD. Yes, I am meticulous, and yes, an attention to detail is useful in the world. But OCD differs from meticulousness precisely because it goes well beyond the point of usefulness – in other words, because it’s out of tune with reality.

Weirdly, though, a familiarity with neurotic thinking might be its own advantage. After all, the basic Buddhist view suggests that we’re all deeply confused and wildly neurotic. And, at least in one sense, this didn’t come as a shock to me. In fact, it was very reason I had come to practice.

Of course, like anyone new to the Buddhist view, I’ve been surprised to discover just how deep my neuroses go. It isn’t just my weird fears or spastic compulsions; it’s a basic way of being in the world that is dominated by the three kleshas – ignorance, attachment, and aversion. In other words, OCD may be a special species of confusion, but it’s only an additional layer on top of the madness we all share.

*          *          *

Bent in half, sobs moving through my chest like waves, it’s easy to imagine that I’m uniquely disabled. More: it’s easy to believe that my suffering is pointless, nothing more than the short-circuiting of a poorly wired brain. And this belief – that this isn’t real life, and that real life is elsewhere – only compounds the pain.

But practice shows me something else – that along with my neuroses, wisdom is always arising as well. That every experience – no matter how horrific – contains some kind of teaching. And that tallying experiences up like this – into ‘good’ and ‘bad’, ‘helpful’ or ‘unhelpful’ – isn’t particularly useful, anyway. Experience isn’t trying to sell us something, and it doesn’t owe us anything either. It simply is, and the more we practice, the more we become capable of living our lives – and feeling what we feel – without judgment. We start to be tenderer with ourselves, and underneath our suffering, and we sense the existence of a deeper truth about who we are – a basic openness, goodness, and compassion. A flow of easy awareness that doesn’t judge, grasp, and or even want much for itself. OCD may be a Technicolor film festival of worry, but it’s also a blinking neon arrow pointing toward truth.

*          *          *

William James wrote that religions begin with our sense that something is basically wrong – with life, with the world, with existence itself. OCD starts there too. But OCD, like most religions, attempt to solve this problem – to make that feeling go away. Buddhism, on the other hand, suggests that the problem itself is an illusion, the product of mistaken conceptual thinking, and that quelling suffering is a matter of practicing our way to a fuller and fuller realization of that truth.

Descriptions of enlightenment are hard to come by, but here’s one I like. According to Dzongsar Khyentse Rinpoche, to be enlightened is to be free of obsessions. Most of the time, I feel almost parodically far from that ideal. Thanks to practice, though, I have my moments.

 

[1] It’s certainly true that meditation practitioners often identify less and less with their thoughts over time. But this tends to be a byproduct of practice; as soon as we start treating it like a prize to be won, it whisps away.

  • Izabella Hamilton

    This is beautifully written. No comments and I am honored to be the first. I have been doing ERP and mediating. ERP worked so well that i became terrified when i was able to meditte with no thoughts. I felt like i had lost my mind. And then the last two days, i have been trying to have my cake and eat it too, doing little compulsions and telling myself it’s ok because i made progress.

    Right now I am in a meta stage where i do not want the disease at all, or i want a purpose to the disease, or some kind of big revelation from it. I also want to feel less alone so i am doing strange things like reading about chronic illness and amputee’s and trying to draw inspiration from them but it only freaks me out that if something else ever happened to me, I’d have that AND OCD to deal with. I want rhyme and reason in the Universe. Once I learn the lesson of OCD what is the purpose of still continuing to happen? Then i become obsessed with repetition.

    Even finding this website was a compulsion. But I know the answer already. Resistance is the enemy, acceptance is key. I need to accept myself for who i am, and that their might not even be a greater purpose to my illness other than that sh*t happens but life is worth living. And that just has to be enough.

    Bless you for this. Not for me making you an accessory in a compulsion, but because i got to connect with another soul who is thoughtfully going through this.

    I do not want to give you false hope but this is a lapse for me, I have had long long periods without the illness. The weird thing is i always have to accept it will never go away before it goes. OCD is paradoxical. Right now i want to speed up acceptance so that it can go away, but it just doesn’t work that way.

    Sorry for the rambling. I have been asking the Universe “why me?” It sounds cliche but “why not?” If this lovely person has it why not me?

  • http://www.mattbieber.net/ Matt Bieber

    Oh, man, I can relate to so much of this! The fear that comes
    with the retreat or disappearance of intrusive thoughts, the sense that I don’t know who I am without all of these worries, and the concern that I might be…nothing.

    Which, of course, is one of OCD’s ridiculously cruel,
    underhanded tricks. But it’s also something larger, something really worth considering. What do our thoughts have to do with our selves? And I think meditation helps us see it clearly: we don’t need to be thinking all the time in order for life to be worth living.

    I totally feel you about wanting OCD to be edifying in some way.
    Like: great, I’ll take it, so long as I can learn something from it. It’s the sheer pointlessness of the suffering that’s so hard to take. Except that the pointlessness is teaching us something, too – something about acceptance, as you say.

    You’re totally right, though – as soon as I fasten on acceptance
    as the key to everything, I want to accelerate it, to accept like a pro. But like you say, it doesn’t work like that – we have to learn to accept everything, including our own inability to accept as much as we’d like.

    Thanks for writing, Izabella.

  • Ryan

    I feel for you. I was tortured by my thoughts for 22 years. No psychologist, psychiatrist or medication really helped, there was nothing anyone could do for me. I turned to meditation as a last ditch effort. Sitting and fully experiencing my thoughts was uncomfortable to put it nicely, but I forced myself to do it. One sitting I counted 1,114 checks in 30 mins. About a year ago I experienced a spiritual awakening, enlightenment. I can honestly say I do not have OCD anymore, or ADHD, anxiety and depression for that matter. I feel like a new person. I feel as if I had a mind transplant into the happiest and most calm person in the world. Meditation IS the way out of the hell of OCD. The most important understanding for me was the acceptance that I was born with OCD, my natural ‘mind state’ or ‘egoic state’ is obsessing, I cannot change that. By meditating I learned to be the watcher and listener of my thoughts, feelings and emotions. Eventually, I moved into the awareness permanently – where it is incredibly peaceful. Everyone has this space. Good luck and keep meditating.

  • http://www.mattbieber.net/ Matt Bieber

    This is incredibly motivating, Ryan. I often think that if
    my life is much the same in twenty years and I still haven’t given myself more fully to meditation, I’ll feel very foolish (and maybe regretful). I don’t want that. Thank you for reminding me of how big a difference meditation has already made for me – and how easy it is to lose sight of even our most powerful personal
    epiphanies.

  • Toby

    Thank you for reminding me not to give up or give in.

  • http://www.mattbieber.net/ Matt Bieber

    Absolutely, Toby!

  • Valar

    That’s very inspiring. I think the taboo against talking about enlightenment has done a great deal of harm to Buddhism in the modern world, where faith alone is not enough to motivate us and we want evidence. Since none of the traditional teachers would discuss in detail what enlightenment actually IS, most people were left wondering, why am I even practicing? Thankfully that taboo is being dismantled, through the work of people like Adyashanti Shinzen Young, etc. and of course yourself.

  • Valar

    Basically what I conclude from all this is that we need better tools, which is why I am part of the Consciousness Hacking movement. I don’t want to look back at myself in 20 years and feel that I haven’t really made progress.

  • Manuel Xavier

    Thank you for sharing your experience. I was never diagnosed with OCD but I do have an obsessive personality. My “rituals” are all inside my head. I have to keep constantly checking if my life has meaning. I don’t know how to put it any better. I keep telling myself: “now, you are a student, a writer, a musician. This way your life will be meaningful”. My way of flirting immortality and the attachment to permanence is by working towards the “work of my life”, so I can go “down in history” as someone who did something important, rather than being a no-one. Being a no-one is a terrifying thought for me. But you know, as Albert Camus said, being a hero is easy, the tough part is being happy. I am constantly obsessing over what I am. “What am I?” But as the buddhist teachings reveal so well: “I am nothing”. So looking for what I am is always going to be painful. Meditation has been helping. I perfectly identify with something you wrote somewhere else:
    «And as he recognises this, a kind of loosening occurs. Not only does he identify less with individual thoughts and feelings, but he also begins to rely less on particular ways of understanding himself. He feels less and less need to summarise his experience, to corral his raging flood of thoughts and feelings into a stable, permanent view of who he is. And as he begins to let go of his constant grasping after solidity, a fuller sense of who he is starts to emerge.»
    Meaning is only in the Now. That’s it. There is no more meaning. When you truly grasp this truth, I think the extra is, ironically, that your life becomes more meaningful. But you can’t go around searching for the meaning of your life. It’s a dead end. Also, don’t fall into the trap of being in the Now in order to make your life meaningful. That’s actually being Somewhere Else. It’s our tricky mind playing games on us (treat her kindly nonetheless!). As Zen practioners put it: meditation has no purpose. Just breathe.
    Thank you, and all the best for everyone out there, struggling with their obsessions. Don’t give up!

  • http://www.mattbieber.net/ Matt Bieber

    Thanks, Manuel!

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