Episode 33

OCD, Relapse and Relapse Prevention

In this Episode of Purely OCD, Lauren and Kelley talk about the process of recovery and the experience of relapse for those with OCD. They discuss some of the most critical aspects of relapse prevention. They also consider the degrees of the term “relapse” and what really constitutes a relapse in the realm of OCD recovery. 

Kelley: A lot of time people say: “How do I keep it at bay? Do I do once a week imaginal exposures and doing active exposures”…The reality is there’s no format. My protocol is always make anxiety feel uncomfortable. Always take the opportunity when your anxiety twinges, lean in. That’s your shot do it.

Lauren: Like a little 8 Mile Style, “You better lose yourself in the music the moment you own it…[implied “You only get one shot!”]” (A little Eminem goes a long way)

If you get one shot, or one opportunity…

Except there are a LOT of opportunities to lean in to anxiety twinges.

Kelley and Lauren discuss what leads to relapse:

Lauren: The reason people relapse is that they start to resist their anxiety again… Oftentimes when new content pops in it’s like GASP Oh no!

Kelley: This one is different

Lauren: “This one is different” If I had a dollar for every time I heard that phrase or said that phrase myself, frankly.

Kelley: You and I both have said that.

Lauren: Probably to each other.

Kelley: Yes.

Lauren regales Kelley and the audience with the tale of a recent obsession of the Sensorimotor OCD variety:

Lauren noticed that she had the experience of feeling her tongue against the back of her teeth and also recognized her tongue felt heavy. Initially she resisted. “How do I get rid of this feeling?” But resisting doesn’t work. Unconditional acceptance of thoughts and feelings – accepting them without intention of getting rid of them – supports recovery. So, anyway, #tensetongue

Recovery is all in the pivot. We will get caught in compulsions sometimes. We will start to resist uncomfortable thoughts and feelings automatically. It’s when we realize that we are performing compulsions that we have the opportunity to pivot back to acceptance of thoughts, feelings and uncertainty.

Kelley and Lauren address a question: Does a relapse sometimes feel worse?

Lauren and Kelley both note that sometimes it does feel worse. There can be hopelessness around relapse because of catastrophic thinking about what the resurgence of symptoms means for the future. Of course, we don’t know what the future holds. There’s also a tendency to get stuck in comparison related to what recovery was like before, and this can keep people chasing after a certain experience and emotion. This is a recipe for disaster.

Then there’s the fear of relapsing. Lauren and Kelley talk about how to navigate this fear by: 

• accepting uncertainty about the future 
• being where you are – so if you’re not relapsing in this moment, then deal with that if it comes up.

Kelley and Lauren address a question related to the fear of never recovering after experiencing a relapse.

When Clients reach out to us typically that’s the response which is “Oh my gosh! I have all the information I do have the skills how come it’s not working?” Well likely it’s because we’re not using them appropriately.

Kelley Franke, LMFT

It’s important to remember that thoughts and feelings are a part of recovery and that, therefore, the presence of thoughts or feelings cannot be a measure of recovery.

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Disclaimer: This information is meant to be general information not unique to any individual. Before following any guidance or advice found on this site or in the Purely OCD Podcast a visitor or listener should always consult with their own licensed healthcare practitioner. The Purely OCD Podcast and Website are not therapy or intended as a replacement for therapy. They are for educational purposes only.