A Buddhist Approach to OCD

I have struggled with Obsessive-Compulsive Disorder for over half of my life. I am reluctant to say that I have OCD any longer, as in the words of clinical psychologist Amy Mariaskin (2022), I am currently dealing with an OC-normal brain, as opposed to an OC-disorder brain, but boy is it easy to fall into OCD’s trap of seeking reassurance and desiring certainty.

When I was fifteen, my Cognitive Behavioural Therapy (CBT) therapist gave me Jon Kabat-Zinn’s famous multi-disc CD set, but sitting with my own mind in order to find a semblance of calm felt like an insurmountable, impossible task at the time. Doing a guided visualization exercise in her office was all I could muster at that point. Later, on my own accord, I was reintroduced to mindfulness and meditation while working a relatively steady job, living on my own, and far less preoccupied with compulsions after over a decade of CBT, Exposure and Response Prevention, and Acceptance and Commitment Therapy. I kept feeling a pull to the depths of my experience as I was experiencing a nudging to finally make peace with my mind after years of fighting it and feeling victim to it. My dreams of traveling the world, having my own family, and feeling at peace within myself would never happen if I was not invested in understanding my mind and the best possible ways to work with it.

I recently wrote and published an interactive workbook that serves as a Buddhist guide to working with OCD. Through its pages, I aspire to help those that feel at war with their obsessive thinking to touch a sense of calm within that they didn’t know they were capable of. I want them to know that mindfulness and meditation can also be for them. Furthermore, I want them to know that what the Buddha taught centuries ago can help tackle some of the big questions that OCD sufferers may struggle with today, like: How do we live amidst severe uncertainty and doubt? How do we not hold on to thoughts and react to them, even when they feel so real and scary? How can we find joy in the midst of worry and suffering? 

You most likely know what OCD is — some of you may know more than you’d like to — but just in case:  

“Obsessive-compulsive disorder is characterized, first, by recurrent, unwanted, and seemingly bizarre thoughts, impulses, or doubts that evoke affective distress (obsessions, for example, that one has struck a pedestrian with an automobile); and, second, by repetitive behavioural or mental rituals performed to reduce this distress (compulsions, for example, constantly checking the rear-view mirror for injured individuals” (Abramowitz, 2006).  

The Buddha is said to have taught his followers 2,500 years ago:  

We are what we think.  
All that we are arises with our thoughts.  
With our thoughts we make the world.  
Speak or act with an impure mind  
And trouble will follow you 
As the wheel follows the ox that draws the cart.  
Speak or act with a pure mind  
And happiness will follow you  
As your shadow, unshakable.  

-The Dhammapada, 1-2, G. Fronsdal (Trans.) in D. Rothberg’s The Engaged Spiritual Life

“We are what we think,” The Dhammapada teaches, but anyone with OCD knows our thoughts are often unwanted and intrusive. At the same time, our thoughts are not “us,” but also create our world. How can this all be true? Using Gil Fronsdal’s translation from the original Pali text, you may relate to the concept of OCD feeling like the creator of your world. When an obsessive and compulsive mind leads the way, suffering will indefinitely follow. A mind mired in painful and dysfunctional belief systems will lead to painful and dysfunctional results. That is the law of nature when our minds make our worlds. 

The mind can be a nasty, demanding, and compulsive taskmaster. Our minds make it difficult to be present for the natural ebbs and flows of life. It can often feel impossible to be present for what is actually happening in the present. It can feel insurmountable to act with a “pure mind” (“pure” meaning a mind not living in delusion) and therefore, for happiness to follow. 

But we want happiness — all humans do. To help in that universal endeavor, the great Vietnamese Buddhist monk, Thich Nhat Hanh encouraged meditation practitioners “to not turn your mind into a battlefield.” Fighting with the mind goes against its nature. Mindfulness and Buddhist wisdom can help us to cultivate a more pure and easeful mind, so happiness follows like a never-departing shadow. 

When I look back on my life with OCD, I believe that my mind developed unhelpful patterns (obsessions) and irrational coping mechanisms (compulsions) as a desire for control. A control that I, and no human being, could ever achieve. No matter what the OCD story of the moment is, any attempt to diffuse the anxiety through compulsive behavior is ultimately futile. This is “because the uncertainty they are intended to  address can never be completely eliminated” (LeJeune, 2023). 

Uncertainty and life travel hand-in-hand. It took surrendering to doubt and my ultimate powerlessness through therapy to loosen the grip, and in Buddhist terms, to release the clinging around OCD thoughts. The concept of clinging is a key Buddhist theme that is inextricably linked to suffering. In fact, clinging is the cause of suffering according to the Four Noble Truths. But I am getting ahead of myself! 

When the mind is not the enemy anymore, it can become the object of our inquiry, the object of our mindfulness meditation. The mind will always be throwing thoughts at us, like our ears are  always hearing, but over-identifying with thoughts is not the path to a wholesome and easeful life where happiness follows like an unshakeable shadow. The route of wisdom and greater happiness begins with recognizing thoughts as simply passing phenomena, like a sound to the ear or a taste to the mouth.  

Questions for Thought Practice

I invite you to give yourself a few minutes to allow these questions to enter your mind and jot down some notes responding to each in a notebook, or drop these questions into your meditation practice after you feel a greater sense of ease and presence. 

1. How do you normally respond to an intrusive thought? Do you experience a sense of gripping or clinging to intrusive thoughts? Is it the thought itself that causes distress or the reaction to the thought?

2. Do you ever feel the compulsion to control your thoughts? How does that inclination differ from controlling your mouth from tasting or your eyes from seeing? 

3. Can you practice for a moment, noticing thoughts without reacting to them? Is it possible to notice when a thought begins and then when it ends?

4. Can you agree to have a thought, even if you wish it were otherwise?

This piece is adapted from from A Buddhist Guide to OCD: A Thought is Just a Thought, by Naomi Matlow.