What does a Carmelite nun who lived during the late 1800s in France have to do with overcoming the obsession thoughts and/or compulsions that are symptomatic of Obsessive Compulsive Disorder (OCD)? St. Therese (1873-1897), whose writings composed the beautiful autobiography “The Story of a Soul”, died of tuberculosis as a young adult, yet her message endures to this day. She was declared a Doctor of the Catholic Church in 1997 because of her simple yet profound approach to the spiritual life. Her concepts can even be utilized by those who struggle with the neurobiological effects of OCD with amazingly successful results according to a book by Dr. Ian Osborn a Christian Psychiatrist.
What is Obsessive Compulsive Disorder (OCD)?
OCD is a disorder of the brain and behavior that causes severe anxiety and interferes with a person’s ability to carry out the activities of daily life. It can be described as the mind getting stuck on a thought or image that replays over and over like a broken record. The brain is biologically tricked into thinking that it is experiencing danger. “OCD has become the 10 leading cause of disability in the developed countries”(Reichenberg, DSM-5 Essentials, 2014). The DSM-5 (the professional guide used by mental health professionals) defines OCD as being significant for “the presence of obsessions, compulsions or both.”
Obsessions are (1) “recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress. (2) The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).”
Compulsions are defined by (1) “repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. (2) The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.”
Of additional note: “The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.” The symptoms are not attributable to the use of a substance, medical condition, or another mental disorder.
Traditional Forms of Treatment for OCD
Traditional forms of treatment for OCD include cognitive-behavior therapy in addition to medications such as serotonin reuptake inhibitors. Jeffrey Schwartz in his book Brain Lock: Free Yourself from Obsessive Compulsive Behavior (1996) suggests a 4-step approach to cognitive therapy for OCD which has been effective for some clients. The steps include: (1) Relabeling by recognizing that the thoughts and behaviors are the result of OCD and not from realistic worries. (2) Reattributing it to being caused from a biochemical imbalance in the brain. (3) Refocusing by doing a meaningful activity other than trying to stop the obsession, and finally (4) Revaluing the need to perform the obsession which in itself causes it to weaken.
Therapy of Trust
According to psychiatrist, Ian Osborn in his book, Can Christianity Cure Obsessive-Compulsive Disorder (2008), “in therapy of trust the emphasis is shifted. It is not the rationality of an obsessional fear that is questioned, but rather who should take responsibility for it (p. 161).” The responsibility is shifted to God. His three-step method for Christian OCD sufferers includes:
1. Recognize obsessions when they strike. According to Osborn: “Obsessional thoughts are
intrusive, repetitive, completely unwanted, and recognized (at least in a moment of quiet reflection) as being inappropriate to be thinking. They possess a unique quality that psychiatrists refer to as “ego-alien”: It is as if they come from outside one’s normal sense of self.” These thoughts pose themselves as having an unrealistic feel of urgency.
2. Transfer responsibility to God. Obsborn further states: “…Individuals suffer from obsessions
because of an excessive sense of responsibility for harm to self or others. The tormenting thoughts can be put to rest when the responsibility for harm is transferred to another person.” In this therapy responsibility is transferred to God.
3. Prove your trust; resist compulsions. According to Osborn: “OCD sufferers need to make a concerted effort to lessen their performance, because they consume time, cause embarrassment, injure health, and in the long run cause obsessions to become even stronger. For religious individuals, there is yet another reason to limit compulsions: to prove their trust in God…Devout individuals with OCD must work to resist compulsions. In doing so they demonstrate or prove, both to God and to themselves, how much they trust Him and love Him.” OCD can actually be viewed as an opportunity for spiritual growth. This is where the Little Way of St. Therese comes in. As we can see that trying to “trust God” is potentially wrought with its own set of scrupulosities.
What is “The Little Way” of St. Therese of Lisieux?
According to the Society of the Little Flower, the Little Way by St. Therese was based on the two ideas that (1)God shows love by mercy and forgiveness; and (2) one cannot be perfect in following the Lord in this life. Her understanding of being a disciple of Christ stems from seeking holiness in the ordinary and everyday life. Her “Way” is one of complete trust and surrender to God like that of a little child. It is complete abandonment to God believing that no matter what happens, God is in control. In the Therapy of Trust for OCD, the sufferer transfers the responsibility to God. According to Obsorn who has been challenged with OCD in his own life, this shift has been a tremendous source of healing.
Self-empowered vs. God-empowered
A lot of focus in traditional secular therapy is on self-empowerment. The fact that one transfers responsibility outside of oneself can be a source of criticism from some in the psychological arena. Therapists generally try to make clients more and not less self-reliant. According to Osborn personality responsibility plays a huge role in perpetuating one’s obsessional thoughts and compulsions. However, employing the tactic of transferring responsibility to God makes sense in the context of religious faith.