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Areas › Worry and anxiety › Obsessions and compulsions
It reads colder written down than it lands in the room. What the person needs is to feel believed. What they do not need is a second person weighing up whether the thing could happen. Put the warmth into the feeling and keep it out of the details, and if they press you for a verdict, you can say honestly that answering would help for a minute and cost them later.
Obsessive thoughts and compulsions respond well to a specific kind of therapy. What is here is for understanding them, not for treating them by yourself.
We know what his soul whispers to him (Quran 50:16). Being fully known has never depended on anyone being told the details.
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وَلَقَدۡ خَلَقۡنَا ٱلۡإِنسَٰنَ وَنَعۡلَمُ مَا تُوَسۡوِسُ بِهِۦ نَفۡسُهُۥۖ وَنَحۡنُ أَقۡرَبُ إِلَيۡهِ مِنۡ حَبۡلِ ٱلۡوَرِيدِ
We created man––We know what his soul whispers to him: We are closer to him than his jugular vein––
Qur’an 50:16read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
In a survey of 353 adults without a diagnosis, unwillingness to sit with distressing thoughts and feelings predicted obsessive-compulsive symptoms over and above the beliefs people held about those thoughts. The struggle against the experience looks like part of the trouble, which is an argument for helping someone stay with a feeling rather than resolve a story. It was a one-off survey of a non-clinical sample, so it shows a link and not a cause.
Abramowitz JS, Lackey GR, Wheaton MG. (2009). Obsessive-compulsive symptoms: the contribution of obsessional beliefs and experiential avoidance.. Journal of anxiety disorders doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Being met in the feeling is what settles someone, while being answered on the content is what brings them back to ask again.
Plenty of people quietly believe that thinking about something bad makes it more likely to happen. It has a name, it is a known part of this condition, and having the belief does not make you dangerous.
Try not to talk the worry through in detail, even with someone kind. Going over the specifics feels like sorting it out, and it is closer to watering it.
Offer choices rather than instructions. With a problem that runs on control, being told what to do gives that control somewhere to dig in.