Obsessions, compulsions and uncertainty

Over the past few months, the world has turned upside down in light of COVID-19 and the ensuing global pandemic. We are thrown together into the midst of uncertainty and much of the population are witnessing this type of event for the first time, with it being the first of its kind in more than 100 years.

If we think about someone battling with Obsessive Compulsive Disorder (OCD), we can only imagine the additional stress created by this type of global catastrophe.

As discussed before, OCD is characterised by obsessions, which include recurring thoughts, impulses and images. These tend to be ego-dystonic thoughts i.e. in that they are contrary to the individuals held beliefs and value systems, and therefore cause a huge amount of distress to the individual. Compulsions also commonly feature in OCD, including repetitive and ritual behaviours or mental acts. Typical known fears of someone with OCD include fears around contamination, causing harm and committing unacceptable acts. These fears directly contradict a person’s values.

One factor that has a big impact on someone with OCD is stress. Stress is known to increase OCD behaviours of checking and cleaning, which are the most common reported symptoms, with fifty percent of OCD sufferers reporting these symptoms.

We can learn from this, as we know that a stressful context results in worsening OCD. The current global climate is a breeding ground for mental health problems to arise or be exacerbated. Therefore when we think about managing OCD during COVID-19, stress management is at the forefront.

There are three things we can try to do to manage OCD:

  1. Form a different perspective

New and stressful situations can lead to a lot of uncertainty in our lives. We suddenly find ourselves questioning our own values and ability to cope, people around us or even our view of the future. While we cannot always be certain about some of these things and anxiety is quite a normal response to the current situation, we can be certain in goodness from Allah.

Allah does not leave us to fend for ourselves, quite the opposite. We are never in free fall and even when things feel uncertain, we know that we are exactly where Allah has placed us. Every situation we find ourselves in is a part of His plan for us. Perhaps we have been placed there to learn a life lesson, to avoid a mistake or to build our ability to cope in the face of adversity.

The comfort of this is knowing that we are safe between the magnificent Hands of the One who created us and He will never let us fall into despair, should we reflect and seek comfort in His everlasting and bountiful presence.

[Mention] when the youths retreated to the cave and said, “Our Lord, grant us from Yourself mercy and prepare for us from our affair right guidance.”
[Qur’an 18:10]

There is nothing more comforting than placing one’s hopes in Allah, especially when we have exhausted our own resources.

  1. Look to the Quran and Hadith for guidance

One of the key things in OCD is repeating rituals until one starts to ‘feel’ right. This usually means until anxiety and distress come down. Thinking about it, this is quite a subjective measure. How do we quantify ‘gut feeling’ and there are many ways that repeating something until it feels right can become harmful. One of these is that it interferes with normal day to day function in that what could be a simple task for one person becomes an absolute chore for someone with OCD. Take performing the Wudhu (ablution) as an example. For us it may take 5 minutes while for someone with OCD constantly doubting they have performed each action correctly, this can take hours.

One thing we can do is try to turn to the Qur’an and hadith for a baseline measure of what is expected from our actions. We find much guidance therein, not only on what to do but also how to carry these things out. The more we come back to this as a baseline measure, the more we are able to cut down on relying on this ‘gut feeling’ that is so important to OCD repetitive behaviour.

For example, when we have followed the guidance on Wudhu (ablution) as specified in the Qur’an and Sunnah in all its basic tenets, we can state (with certainty) the Wudhu (ablution) is complete and no repetition is necessary. So maybe we can try to remember we have not been left to guess how to do things and the Most Merciful has not left us to ourselves.

  1. Look after yourself on all levels

OCD skews the amount of importance and focus placed on the intrusive and obsessive thought or related rituals. During this stressful time it may seem difficult if not impossible to begin working directly on the OCD through methods of exposure or gradually cutting down behaviours.

Don’t aim towards that now.

Aim instead to introduce variation in the form of caring for the body, mind and the soul. When we think about the body we think about nutrition, cleanliness, exercise all in moderation. If it is difficult to decide what ‘moderation’ looks like, ask a friend, family member or call up a listening support line to check in with your plan.

Looking after the mind involves giving yourself permission to-switch-off. Remind yourself that your intentions are good and that you have the Most Caring one watching and supporting you at all times. Use relaxation sounds or Qur’an with a beautiful melody or nasheeds (Islamic poetry) to help your focus attention outside of the OCD for a moment.

Looking after the soul is the constant and rational reminder to yourself that you are not alone, you are loved, you were created with purpose and you are in the best Hands. Sometimes it might seem like you are flat on your back, but another way to look at it is that you are in the best position to see the vastness of the skies above you and experience the expansion of the chest within. This ‘opening’ is of utmost importance and reminds us of our connectedness to our Creator. You may find that everyone has their trials and tests and these are all pathways that open to ground us and get back to God.

‘You alone do we worship, and You alone do we ask for help’
[Qur’an 1:3]

So you see, The most Merciful wants us to turn to Him for help, remember Him in hardship and be absolutely certain in His (SWT) Help in a world that is full of uncertainties.

Do you have OCD or know anyone with OCD and how have you coped or helped others to cope with it during COVID-19?

We would love to hear from you!

Tanveen Choudhury

Tanveen Choudhury

Tanveen is an accredited Psychotherapist by profession with most of her experience has been in NHS psychology services and the private sector over the last 9 years. She believes the work of Inspirited Minds is really important as it bridges gaps in mental health provision for people of the Muslim faith. Idiosyncratic therapies and services are a really important part of improving mental health and she hopes that Inspirited Minds will develop into a leader in this area and become an even better resource for mental health professionals locally and globally.

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