Obsessive Thoughts: Schwartz's Four Step Model
Obsessive thoughts seem to have a will of their own. In most cases, you try to slow them down or control them, but you just manage to achieve the opposite effect and they tend to dramatically increase instead.
When you reject or try to avoid those obsessive thoughts, they simply stay in your mind for longer. Just think of a song you hate and how it stays in your head, no matter how much you try to get it out.
In fact, the more you try to get away from that annoying song, the longer it stays in your head. On the other hand, if you just accept it and leave it alone, the song simply disappears.
We know that exposure-response prevention is the treatment of choice for obsessive-compulsive disorder, particularly when the disorder’s accompanied by ritualistic behaviors. However, in the case of pure obsession, you can choose to record your obsession or write it down and repeatedly expose yourself to it until your anxiety decreases.
Nevertheless, a novel and very effective technique that’s based on cognitive therapy seems to be yielding good results in some patients. This is the four-step technique devised by Dr. Schwartz. In fact, Jeffrey Schwartz is renowned for his investigations into the plasticity of the brain in obsessive-compulsive disorder.
It’s been scientifically proven that people with OCD have an altered level of metabolism in the stellate neural circuit.
Dr. Schwartz has showed that, with his four-step technique, people with this disorder can control their obsessive thoughts. Furthermore, the metabolism of their neural circuit returns to normal levels.
The technique of Schwartz’s four-step model
As the name suggests, the technique consists of four steps of a cognitive nature that the patient has to carry out every time they have an obsessive thought.
The objective of the four-step model is for the patient to form a habit that becomes part of their daily routine. The first three steps are the most important, particularly at the start of the treatment. The four-step technique is based on the “four Rs”.
Relabel obsessive thoughts
Relabeling your thoughts basically consists of giving them their real names, that is, of obsessions and compulsions. Indeed, you need to be aware of what’s happening to you. OCD is an illness, and your obsessions are a product of it, just like your neutralizing behaviors.
Relabeling makes it easier for you to put everything in its place. When you train yourself in relabeling you don’t, for instance, say to yourself “If I don’t count to 100 before I go to bed, I’ll hurt my mother”. Instead, you say, “I have obsessive thoughts because of my OCD and the idea that I’ll hurt my mother if I don’t count to 100 is because of this illness”.
The idea of relabeling is identifying the fact that some of your thoughts are symptoms of your obsessive disorder, and not of you as a person. It means separating your irrational obsession, which has nothing to do with you, from your real harmonious thoughts.
In effect, it means making an effort to stay consciously alert in a state that’s labeled the impartial spectator. This means you have the power of self-observation and are able to recognize what’s real and what’s just a symptom of your disorder. Therefore, you can reject any pathological impulses, until they simply give way and disappear.
Reframe obsessive thoughts
The goal of this step is to attribute responsibility for the symptoms of OCD to the illness itself. Hence, you say, “It’s not me, it’s the OCD”. An OCD that’s either rooted in a biochemical imbalance in the brain and/or mislearning in childhood.
It’s really important to understand the role that the brain plays in the thoughts and impulses of OCD. When you know it’s a psychological or medical condition and not a part of yourself, you’re able to better cope and stop resorting to avoidance behaviors.
Furthermore, the most demoralizing and destructive behaviors that are characteristic of OCD will occur less frequently. In other words, those frustrating attempts at trying to get rid of unwanted thoughts and impulses.
Indeed, as with any other disease, you have to know where each symptom comes from so you don’t end up taking responsibility for something that isn’t yours.
The aim of refocusing is to shift your attention, even if only for a few minutes, to something else that has nothing to do with your thoughts.
Obsessive people develop automatic and rapid habits concerning what they think and do with their thoughts. So, refocusing means you’re aware of what’s happened and you “change gear” to consciously disengage your brain from those damaging thoughts.
Indeed, your mission is to focus your attention elsewhere. In fact, you should have a list of other things you can do to avoid carrying out your obsessive behaviors.
Hobbies are great for this. You can take your dog for a walk, plant some seeds in a pot and water them, paint a picture, or listen to music. In fact, anything you can think of that stops your impulsive behaviors and thoughts. Something that might help is to tell yourself “I’m thinking this because of my OCD. It’s not real. I need to do something else.”
Revaluing basically means launching the “two As”: acceptance and anticipation. Regarding acceptance, if you’ve carried out the above steps correctly, it’ll be easier for you to revalue your problem. Indeed, you’ll realize what it really is and accept it. However, you won’t simply surrender. You’ll try to get better, but you won’t fight against the OCD, because you know that struggling and becoming fixated on control only feeds the disorder.
On the other hand, anticipation means saying to yourself “Okay, I know my OCD is starting up again, but I’m not going to listen to it. I’m going to focus on something else instead, something that’s productive and makes me feel happy”.
In other words, before the OCD starts to bother you, you have to anticipate and act. Don’t let it catch you off-guard.
Schwartz’s four-step technique has proven to be very effective in fighting OCD symptoms. Perhaps the only downside is that it’s quite hard to carry out. Indeed, the patient needs to be really motivated. In addition, they need to practice it religiously until it becomes a habit.
As we mentioned above, the first three steps are the most important. This is because they’re the ones that will help you distance yourself from your OCD and to see it as something that’s outside of you. In fact, to see it as a pathological condition you have to both face and live with but that you can also overcome.