EVENT: Leaving the house

EMOTIONS: anxiety, guilt, frustration

DISTRESS RATING: 7--Feeling distressed, less in control THOUGHTS: “I need to check to make sure all the doors are locked. What if someone came into my house while I'm gone and robbed me? My dog might get out and something terrible might happen to him. I would never be able to handle that because it would be due to me being irresponsible. I better check the doors again just to make sure.”

CAN YOU IDENTIFY THE IRRATIONAL THINKING IN THIS EXAMPLE? There are at least 3 irrational beliefs.

HOW CAN YOU CHANGE THE THINKING? What is another way of thinking about the situation that won't cause the feelings of anxiety, guilt, frustration?

   Cognitive Diary CBT Self-Help

The CBT Tools for Healthy Living app helps you to determine some ways to challenge the irrational thinking. Once you have done that, it is important to read the rational challenges frequently until they automatically come to mind rather than the irrational thinking.

1) Catastrophizing. Those with Obsessive-Compulsive Disorder (OCD) often have difficulty with catastrophizing because they have problems challenging probability. The concept of probability in this situation is examining what is the likelihood that something bad will happen. In a situation such as locking the door, a number of improbable things might need to occur for something bad to happen:

1) The person with OCD who usually has set routines and tends to be overly cautious would have to have left the door unlocked. What is the probablility of that?

2) Then, when that person checked the door when leaving the house, they would have had to make a mistake and erroneously concluded that it was locked when it was unlocked. What is the probability of that?

3) Then, that particular time when they had made a mistake was the time that the burglar would have chosen to check the door. What is the probability of that?

4) And, if someone was planning on burglarizing the home, they would have been deterred by the locked door. What is the probability of that?

I could continue on with all the things that would have to happen for the catastrophic fear to occur. But I think you can see that each of these individual low probability events would have to occur all at the same time. So if we combine the probability for each of them, the catastrophic event becomes less and less probable.

Commonly, with OCD (as well as other anxiety disorders), people think of the worst case scenario and stop at that point because they are overwhelmed with the possibility. However, having them considered what is likely to happen next even if their catastrophic fear occurs helps them to realize that maybe the situation is not as horrible as they might anticipate. For instance, in this situation when asked "So, what if you do leave the door unlocked, your home is burglarized and your dog escapes?" they might realize that the problem is solvable. "I guess if some things are stolen that is not so horrible because they can be replaced. And my dog is likely to stay nearby or come home for dinner."

2) Internal Control. The belief that a person can control all events if they just make the effort is an internal locus of control. The deception in this particular belief is that up to a certain point the concept of effort affecting outcome is a beneficial one. In other words, if you believe that you can have more positive outcomes in your life if you try hard enough you are likely to create more positive situations and outcomes.

However, the logic breaks down when a person believes that they "should" have control over whether something bad happens or not and that if something bad does occur it must mean that they didn't try hard enough. This is inaccurate because the reality is that we can't control everything and that by attempting to do so we may create other problems in our lives. For instance, this belief regarding checking the door to control a bad outcome could potentially cause conflict in relationships when other family members aren't as careful.

3) Blaming. Closely associated with the irrational belief of "Internal Control" is the tendency for those with the responsibility type of OCD to blame themselves and feel guilty. Therefore, the consequence of the "should" is the belief that if anything bad occurs it must be because they were at fault. As a result, many people with OCD are trying to prevent bad things to prevent this feeling of guilt. The illogic with this thinking, however, is that no matter how much attention is given to preventing some particular event, something could still occur because so much of the situation is beyond individual control.

How Can This Thinking Be Changed?
"Nothing horrible is likely to happen, but checking more than once isn't likely to reduce the probability of anything happening. Even if something bad happens, it is not because I'm irresponsible. I'm a cautious person but I can't be responsible for something if I can't have complete control over everything. I can only take reasonable precautions but beyond that it is out of my control. Whatever happens, however, I will deal with it at the time rather than wasting my time, energy, and effort checking my doors repeatedly."