OCD

Help, I can’t stop thinking!

rb-calm-woman-eyes-closed-0809-mdnMany of us feel that our thoughts are out of our control. We think about work long after we have left, we worry about the future and keep going over things that have gone wrong in the past. Meanwhile, life seems to be slipping by.

Modern psychology also recognises that compulsive thinking can lead us into stress, anxiety and depression. Worrying about our problems seems important, but it leaves us feeling worse and believing we have less power to change things.

Mindfulness helps by giving us the mental space to stand back, recognise what’s happening and explore alternatives. Here are some helpful approaches associated with mindfulness and meditation.

1. Learning to let go of thoughts

Even a short period of meditation shows that focusing the mind on the body and the breath leaves you feeling calmer and more settled. Everyone finds that thoughts arise in their minds and the practice involves gently guiding our attention back to the breath. In doing this again and again we are learning to let go of thoughts and regain control of what our minds are doing.

2. Noticing that thoughts are just thoughts, not facts

Troubling thoughts reinforce a powerful belief about our situation: I must keep going; only I can do this; if this fails it will be a disaster. Thoughts like this are associated with stress. There is something wrong with me; it has all gone wrong; here I go again. Thoughts like this tend to foster depression.

When we think like this, we believe that the thought is telling us the truth: I really must keep going; there really is something wrong with me. The practice of letting go of thoughts allows us to stand back from them. Then we see that they are just thoughts and we can explore them without necessarily believing them. For many people this is a revelation. It’s liberating to see that thoughts are not facts, just things that happen in the mind. Seeing thoughts in this way makes them less powerful. Then you can explore them, asking if they are true and discovering what you really believe.

3. Accepting difficult thoughts

Often we know it’s unhelpful to keep thinking in certain ways and tell ourselves I wish I could switch off, or I must stop worrying. But we end up like the person who tries not to think about pink elephants. The more we try to control our thoughts by force, the stronger they grow. Our whole life can seem like a fight and battling with thoughts is part of this.

Mindfulness training encourages us to accept that troubling thoughts are a part of our experience, rather than fighting them. We learn to notice these thoughts when they come up without pursuing them or believing that they are true. We can even befriend them.

People with Post-Traumatic Stress Disorder (PTSD) and Obsessive Compulsive Disorder (OCD) experience this especially strongly and mindfulness can be very helpful in working with these conditions. It also helps in avoiding slipping back into depression, which is why medical practitioners recommend Mindfulness Based Cognitive Therapy to avoid relapsing into depression.

4. Thinking Clearly and Creatively

Of course, thinking isn’t always unhelpful. Reflection, analysis and clarity are all very important. Mindfulness can help us to think more clearly because we are less prone to distractions and more able to notice when feelings are colouring our thoughts. It also fosters creativity because it opens up the connections between thinking, feeling and intuition.

Ralph Waldo Emerson wrote: ‘A man should learn to detect and watch the glimmer of light that flashes across his mind from within.’ Those glimmers are there in all of us: messages from the part of us that truly understands and sees connections and possibilities. That is the basis of creativity. The faculty that lets us detect and watch those glimmers is mindfulness.

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Researchers teaching subjects to control brains with MRI scans

Tiffany Crawford: For centuries, yogis have imparted the secrets of healing through meditation and self-awareness.

Now researchers at the University of British Columbia say they’ve found a way to eventually help people combat depression or obsessive-compulsive disorders through similar methods using MRI technology.

In this first-of-its-kind study, published in the April edition of NeuroImage, researchers say participants were able to control their thoughts better when they watched their brain activity on a functional magnetic resonance imaging (fMRI) screen.

The research suggests that awareness of negative or detrimental thoughts — made possible by seeing them on a screen — allows research subjects to control those thoughts.

Many patients who suffer from depression, anxiety or obsessive-compulsive behaviour are not aware of negative thoughts, said co-author Kalina Christoff, a psychology professor at UBC. The technology could be used in the future as a tool to help them become more aware.

Participants in the study watched feedback on the fMRI from their rostrolateral prefrontal cortex, the area of the brain responsible for self-reflection.

They were asked to alternate their thoughts, in 30-second intervals over four six-minute sessions, between their external surroundings — their bodies, current events — and introspective thoughts.

The fMRI would only pick up the introspective thoughts that were being actively contemplated by the participant. Researchers were not told what the participants were thinking about.

Then by watching levels go up or down Read the rest of this article…

on a thermometer-like bar on the fMRI screen, the participant was able to see whether there was an awareness of thoughts. The technique does not differentiate between particular self-reflective thoughts so there is no way to tell whether the participant was fretting over an exam or obsessing about being overweight, for example.

“If the bar is low that means you are not aware of your thoughts,” said Christoff. “You might be having thoughts you are not aware of. But if the bar is increasing it means you are successfully paying attention to your thoughts.”

People who are coping with anxiety, trauma or depression often have negative thoughts of which they are not aware — until they become angry or grumpy and snap at people, she said.

“We think this helps train you to become more self-reflective.”

Christoff said in followup training sessions, all the participants had higher scores of self-reflection and were much more able to observe their thoughts after the training than before.

By using the technology to target the areas of the brain responsible for self-reflection, Christoff said, people who battle depressive thoughts might be able to modify them as they become more aware of them.

“If a depressed person thinks, ‘The world is horrible and everybody is against me,’ and they don’t notice, it will bring their mood down and they’ll feel more depressed,” she said. “And because they feel that, they’ll have even more horrible thoughts.

“The way to break the cycle is to look at that thought and turn your attention and to say, ‘Well this is just a thought — it doesn’t necessarily reflect reality.’ And often that improves the mood.”

The idea then would be to use the MRI technology in conjunction with cognitive behavioural therapy, a type of psychotherapy that aims to help people struggling with depression learn to recognize that their thinking can contribute to the sad moods and despair.

“We’d like to see if we can speed up this process or enhance it by having additional MRI training sessions that can tell them whether or not they are becoming aware,” said Christoff.

The study could also have implications for treating people with post-traumatic stress disorder. Soldiers who come back from Afghanistan, for example, often have obsessive thoughts. And so with the MRI training psychologists could help them “catch” repetitive thoughts before they do too much damage.

Christoff admitted the process was very similar to meditation, a practice that is included in many disciplines of yoga.

“By training your thoughts anyone can benefit. You don’t have to have a clinical condition. This is very similar to meditation. And in that similarity these training methods could have the same benefits that meditation can have. You are training yourself to be more aware.” © Copyright (c) The Vancouver Sun

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“When In Doubt, Make Belief,” by Jeff Bell

When In Doubt, Make Belief

Have you ever driven away from your house and found yourself wondering whether you’d remembered to close the garage door? Probably.

Have you ever gone back, checked to make sure that the door was closed, driven away, and then had to come back yet again to make doubly sure? And then repeated the entire exercise again? Probably not, but if you have, then you may be one of the millions of people who struggle with obsessive compulsive disorder, or OCD.

Jeff Bell is a well-known author, speaker, and radio news anchor. He’s found himself checking the garage door not once, but twice, or three, or more times, on each occasion driving away with less, not more, reassurance about the security of his garage door. He lives with OCD, which is the topic of his latest book, When In Doubt, Make Belief. If at this point you’re thinking, “Well, I may have gone back to to check the garage door, but I’ve never had to do it repeatedly, so I guess this book isn’t for me,” I suggest you think again.

Title: When In Doubt, Make Belief
Author: Jeff Bell
Publisher: New World Library
ISBN: 9781577316701
Available from: Amazon.com (paperback), Amazon.com (Kindle edition), Amazon.co.uk.

When Jeff wrote his first book — an OCD “coming out” memoir, if you will — he was overwhelmed by the interest shown by the public and the media. At first he assumed the interest was due to the “freak factor” — people interested in his bizarre psychological condition — but he soon realized that the fascination was fueled not by the strangeness but by the familiarity of the condition. We all experience irrational doubt. We all experience obsessions and compulsions. At times, each of us has acted irrationally and against our best interests because of fear, anxiety, and other powerful habits that drive our actions. Bell has something to say to each of us.

One universal topic he explores is the tendency to see life in black-and-white terms, with everything appearing as part of a dichotomy: good or bad, right or wrong. Who has not fallen into this way of thinking? Bell introduces examples of black-and-white thinking that will resonate with every reader: e.g. someone accuses us of thoughtlessness, and then black and white thought patterns tell us that if one person thinks we are thoughtless, then that must be so, and therefore everyone must think that we are thoughtless, and therefore no one likes us, and therefore we’re going to be unpopular for the rest of our lives. Sound familiar? We may not think like that all the time, but we’ve all thought like that at some point.

Bell also discusses, in terms that are very familiar to me as a Buddhist, the difference between healthy (intellect-based) and unhealthy (fear-based) doubt. Intellect-based doubt is founded on reason, logic, and rational investigation, and leads us towards a constructive engagement with our experience, to greater awareness, and to growth and learning. Fear-based doubt is supported by irrational assumptions and black-and-white thinking. Rather than leading to clarity, it causes a spike in anxiety, catastrophic thinking (a never-ending series of “what-if” questions), and leads us to engage in actions that are neither appropriate nor helpful. Ultimately, fear-based doubt is a vicious cycle, where doubt creates and perpetuates itself.

Although some of the pathological patterns of OCD are common to us all, Bell takes pains to remind us that OCD is a specific biochemical brain disorder, and not a psychological condition that people slip into and out of.

Fortunately, Bell does much more than simply describe the pathology of doubt. He outlines four general principles — reverence, resolve, investment, and surrender — that contain 10 practical steps by which we can get out of doubt. These 10 steps are deeply grounded in spirituality. He encourages us to:

  1. Choose to see the universe as friendly
  2. Embrace the possibility in every moment
  3. Affirm our universal potential
  4. Put our commitments ahead of our comfort
  5. Keep sight of the big picture and the Greater Good
  6. Claim and exercise our freedom to choose
  7. Picture possibilities and direct our attention [away from destructive thinking and towards constructive thoughts]
  8. Act from abundance in ways that empower
  9. Accept and let go of what we cannot control
  10. Allow for bigger plans than our own to unfold.

For Bell, belief is the opposite of doubt. The 10 strategies outlines above are ways of changing our decision-making from being doubt driven to being belief-driven. It’s important for us to believe in ourselves, to learn to trust, respect, and have compassion for others, and to have faith in life itself. Belief, the way Bell uses the term, seems to encompass what Buddhists would term shraddha (an emotional attitude of confidence and trust) and samyak-drshti (accurate views regarding ourselves and the world we live in). Belief, for Bell, is a choice. It is something we can create (hence the title of the book). The very first step he outlines in “making belief” — choosing to see the universe as friendly — is a conscious choice to see the universe as supporting us to the full extent that we are willing to draw upon it. The universe, then, is seen not as endlessly trying to trip us up, but as an endless series of opportunities for pursuing our own greater good. This is an inherently spiritual outlook, and I believe that any spiritual seeker would benefit from exploring Bell’s plentiful, and hard-won, insights.

Here’s one more example of Bell’s spiritual insight: “The key to living with uncertainty is learning to embrace the discomfort of uncertainty.” When faced with doubt, many of us panic. Gripped by panic, we grasp after this short term palliatives that promise to relieve us from our doubt but simply perpetuate it. These are what Bell calls “false exits” from the vicious cycle of doubt. This perspective will be familiar to anyone who has read the work of the American Buddhist nun Pema Chödrön, or the existentialist-inspired Buddhist writer, and author of “The Faith to Doubt,” Stephen Batchelor.

When In Doubt, Make Belief is a clearly laid out book, full of honest introspection on the part of the author, and bringing in the lived experience of a wide variety of people (some OCD sufferers, some not) as quotations and in the form of interviews with the author. The book contains diagrams neatly summarizing the principles and practical steps that create a belief-based life. Each chapter ends with a handy summary of the main points. For a man who has been crippled by doubt for much of his life, Bell has done a marvelous job of attaining clarity.

Bell honestly acknowledges, however, that he is still working with the issues he raises, and that he is not always able to put into practice his own strategies. In fact, he discusses the kind of internal dialogues he has with his doubt — personified as Director Doubt — dialogues in which Bell is forever being accused of being a fraud for not having completely eliminated OCD from his life. In response to this inner bullying, Bell reminds himself (and us) to concentrate on progress rather than perfection. He explains how he assesses each day in terms of how he has demonstrated his passion for life, how he has demonstrated kindness to others, and how he has demonstrated “grace of self.” I can’t help feeling that all of us would benefit immensely from asking ourselves those three questions at the end of each day.

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Living with uncertainty

When in Doubt. Jeff BellJeff Bell is a nationally recognized author, speaker, and radio news anchor. His first book, Rewind, Replay, Repeat: A Memoir of OCD, was published in 2007 and quickly established Bell as a leading voice in the mental health community. In this interview he talks about his new book: When in Doubt, Make Belief.

You describe this book as “an OCD-inspired approach to living with uncertainty.” What do you mean by OCD-inspired?

As I recount in my first book (“Rewind, Replay, Repeat”), I spent years battling severe obsessive compulsive disorder (OCD), learning firsthand what the extremes of uncertainty can do to one’s life — in my case, leading me to endless cycles of “checking,” washing, and other debilitating compulsions. I experienced what it’s like to be utterly consumed by doubt and fear, unable to trust even my own physical senses. Because I was fortunate enough to get treatment, I also learned what it takes to confront this so-called “doubting disease.”

Title: When in Doubt, Make Belief
Author: Jeff Bell
Publisher: New World
ISBN: 978-1-57731-670-1
Available from: Amazon.com.

When I went public with my story in early 2007, I was amazed by just how many non-OCD sufferers could relate to my challenges; and the more I traveled the country talking about severe doubt, the more I solidified two conclusions: first, that the lessons I’ve learned from living with chronic uncertainty apply not only to battling obsessions and compulsions, but also to dealing with everyday doubts and worries; and second, that the principles of applied belief that served as guiding beacons through my own darkest years can also offer a way out of the shadows of all kinds of doubt.

So, are you suggesting that everyone has a touch of OCD?

No, not at all. OCD is biochemical brain disorder with very specific diagnostic criteria and mechanics. The challenges its intrusive and disturbing thoughts present typically far exceed those of everyday doubts and worries. That said, I have come to find that there are many critical parallels between OCD and what I call fear-based doubt, specifically when it comes to the counterproductive ways in which we tend to the address the discomfort of both. Because of these parallels, I’ve discovered that OCD offers a powerful laboratory for understanding the mechanics of applied belief. And, if those of us who are biologically predisposed to doubt can train ourselves to believe beyond the flawed processing of our cross-wired brains, I’m convinced that anyone can.

Isn’t doubt often a good thing that serves us well?

Absolutely. That’s why it’s so important to understand the differences between the two distinct forms of doubt that we all battle: doubt based on intellect, and doubt based on fear.

Intellect-based doubt is what we might call “healthy” doubt. It stems from our innate inquisitiveness, human curiosity, and natural inclination to challenge the apparent. It is based on reason, logic, and rational deduction, and it definitely serves us well. It’s this form of doubt that prompts us, for example, to avoid crossing a busy street when we’re not sure whether we can make it to the other side before the flashing “don’t walk” light changes.

Fear-based doubt, on the other hand, is uncertainty based not on reason, logic, and rational deduction, but rather on emotional, black-and-white, and catastrophic thinking. This form of doubt tends to be especially consuming, and when we’re stuck in it, we often lose perspective. We might, for example, decide that we should never cross a street (even with the light), because we once heard about a freak accident in which a pedestrian was killed while crossing a street legally, and we’ve become consumed by a “what-if” question such as What if I too am hit while crossing the street?

How can we know which kind of doubt is driving our decision-making?

Ah, that is often a very difficult question to answer, especially given that the very same fear-based doubt that can distort our thinking is also quite adept at masquerading as intellect-based doubt. Over the years, I have learned to ask five questions that, together, serve as a helpful starting point for deciding what’s driving any particular doubt:

  1. Does this doubt evoke far more anxiety than either curiosity or prudent caution?
  2. Does this doubt pose a series of increasingly distressing “what if” questions?
  3. Does this doubt rely on logic-defying and/or black-and-white assumptions?
  4. Does this doubt prompt a strong urge to act — or avoid acting — in a fashion others might perceive as excessive, in order to reduce the anxiety it creates?
  5. Would you be embarrassed or frightened to explain your “what if” questions to a police officer or work supervisor?

If you answer Yes to these five questions, chances are pretty good that your vantage point is somewhere within what I call The Shadow of Doubt.

Speaking of this Shadow of Doubt, you warn that within it there are six trapdoors. Can you explain?

I use the “Shadow of Doubt” as a metaphor for that distorted state of mind we find ourselves in when fear-based doubt begins consuming us. When we are stuck in Doubt, we often take futile actions in hopes of ridding ourselves of the discomfort of doubt. These actions are much like trapdoors, or apparent escape routes that only take us deeper into the darkness, and there are six of them:

  1. Checking: physically searching for verification that some feared consequence did not, or will not, happen.
  2. Reassurance-seeking; asking for the assurances of others that some feared consequence did not, or will not, happen.
  3. Ruminating: mentally replaying events, conversations, and other events in search of verification that some feared consequence did not, or will not, happen.
  4. Protecting: performing rituals (such as repeating patterns) and acting in unproductive ways for the sole purpose of warding off feared consequences.
  5. Fixing: performing rituals (often relating to symmetry) for the sole purpose of making things “feel” right.
  6. Avoiding: deliberately avoiding events that trigger anxiety.

While these trapdoors include many common OCD compulsions, they also cover the counter-productive actions people without OCD take in response to their fear-based doubts. Take, for example, a man who just returned from a job interview. His fear-based doubt might suggest to him that perhaps he blew a particular interview question. That doubt is uncomfortable, so he tries to get rid of it, replaying the conversation in his head (ruminating) or perhaps checking his answering machine again and again to see if the prospective employer has called. These actions might not be as potentially debilitating as OCD compulsions, but they’re certainly counter-productive.

So, if trapdoors only leave you further stuck in this Shadow, what is the way out?

In my experience, the answer is a process I call “making belief,” and I’ve come to see it as ten specific strategies for willfully choosing to believe beyond my fear-based doubts — about myself, about others, and about life, itself. Together, these strategies offer Ten Steps Out . . . When Stuck in Doubt.

And these strategies are consistent with those you learned through your OCD treatment?

Yes, I believe that they are. At the very heart of cognitive behavior treatment for OCD is the concept of learning to sit with the discomfort of uncertainty. Through a process known as exposure/response-prevention (ERP), therapists help OCD sufferers learn to confront their “what if” thoughts and willfully choose not to act on their urges to perform compulsions solely aimed at reducing the discomfort of those thoughts. In so doing, people with OCD habituate themselves to this discomfort and benefit greatly from the desensitization. Non-OCD sufferers, I have found, can do the very same thing by exercising their free will in avoiding trapdoors. This concept is hardly a new one; Buddhists, for example, have been practicing embracing uncertainty for thousands of years. And all of the great religious/spiritual traditions offer wonderful insights into this approach, as well.

If the process is so straight-forward, why do so many of us remain stuck in Doubt?

The short answer is that, despite its simplicity, this approach requires enormous motivation.

You often describe having learned that particular lesson the hard way.

Right. I learned the basics of ERP early on in my treatment process. Problem was, I wasn’t committed to doing the hard work of standing up to my doubt bully (as I call the imaginary source of my OCD and fear-based doubts). I wasn’t committed to this notion of making belief. And because of my lack of commitment, I floundered through many years of my therapy.

How did you ultimately turn things around?

Out of necessity, really, I developed a motivational tool I’ve come to call the Greater Good Perspective Shift — a means of shifting my decision making from fear-and-doubt-based to purpose-and-service-based. In shifting my perspective, I was able to stand up to my bully again and again.

Can you give us an example?

Sure. Let’s say I’m at a bookstore, about to give a talk about OCD. Because my doubt bully likes to taunt me with “what if” questions surrounding my potential to harm other people, “he” might pose the question: What if you’re unknowingly carrying some horrific virus that you might then spread to the people who have shown up for your talk? The bully tells me I should go to the restroom and scrub my hands, and suggests that this is the “good” choice because it will reduce my anxiety about harming others. By contrast, he says the “bad” choice would be to go straight to the speaking area and risk contaminating the people who are there. The bully’s motivators of fear and doubt would have me choose the so-called “good” choice, and therefore scrub my hands.

Over the years, I have learned that, when stuck in Doubt, my bully’s arguments as to why a particular choice is “good” are very compelling; after all, they offer me temporary relief! So I find that I need to leave that choice on the table, so to speak. But what if I can reframe the bully’s “bad” choice in such a way that it can literally trump his “good” choice. This newly-reframed choice — a Greater Good choice — must be bigger than the issue at hand; and to this end, I have found, it must be of service to others and/or enhance my own sense of purpose.

Returning to my bookstore example, if I reframe my bully’s “bad” choice as a Greater Good choice, I must consider the Greater Good of not washing my hands. In this case, I can make the argument that foregoing the washing will allow me to be of service to the people who have shown up for my talk (by being available to them, instead of being stuck at the sink!); and, by standing up to my bully, I can enhance my own sense of purpose as a mental health advocate. By shifting my decision-making in this fashion, I am able to fight the compulsive urge to fall through the trapdoor of “protecting” and instead go give my talk.

In my experience, these Greater Good motivators of purpose and service will trump fear and doubt every time . . . IF given the opportunity.

In the final section of this book, you offer what you call profiles of belief in action. How did you choose the people you interviewed for these profiles and what did you learn from them?

My goal from the beginning of this book project was to offer readers the most practical information and examples that I could — not just from the OCD world, but also from all walks of life. I decided to conclude the book by showcasing several individuals I’ve run across over the years who have demonstrated remarkable abilities to navigate the uncertainty in their lives. In the end, I wound up interviewing five such people, including former White House Chief of Staff (and current CIA Director) Leon Panetta and actress/advocate Patty Duke. I believe that, together, their stories offer a wonderful glimpse at the very principles of applied belief about which I write.


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Allow for bigger plans than your own to unfold

When in Doubt. Jeff BellIn When in Doubt, Make Belief, author Jeff Bell uses his personal experience living with severe OCD to offer a practical guide for the uncertainty that has become an inherent part of life in the 21st century, whether we have OCD or not. In this excerpt, he shares step number 10 from the book’s “10 Steps Out When Stuck in Doubt.”

So here we are at the edge of the Shadow, just one step shy of breaking out, one step away from the freedom we’ve been seeking. Are you ready to take this final step?

Before you answer, let’s look back at the nine steps we’ve already taken. And if you’ll indulge me, I’d like to recap my journey through these steps, mainly because I know my own footprints better than any others. By tracing them, I can suggest where these steps may or may not lead.

Title: When in Doubt, Make Belief
Author: Jeff Bell
Publisher: New World
ISBN: 978-1-57731-670-1
Available from: Amazon.com.

Let’s rewind, then, to August 1997. I am deep inside the Shadow of Doubt, about as lost and entrenched as anyone can be in this cold, dark place. My bully, Director Doubt, is producing Oscar-winning horror films, casting me again and again as both the villain and victim. I am spending my days checking and washing, seeking reassurance, avoiding, protecting, and ruminating. Trapdoor after trapdoor lures me in. I am falling deeper and deeper.

And then, out of desperation, I make my Bargain with the Stars, as I’ve come to call my deal with the universe, at first demanding that it give me what I want before I return the favor, but then stumbling into the reality that things actually flow in the other direction. I commit to a Greater Good goal of doing something constructive with my story, going public with it in hopes that others might benefit and that I might give some meaning to all my lost years. In doing all this, I implicitly choose to see the universe as offering me the potential to achieve this goal. I have, in these early days, discovered the power of reverence, taking Steps 1, 2, and 3 in fairly rapid succession.

I begin my Crash Course in Believing and very soon find myself tested by a defiant Director Doubt, determined not to let me run him out of my life. Slowly, though, I develop my resolve, putting my commitment to my book project ahead of my comfort, again and again, and reminding myself of the Greater Good at stake. I take Steps 4 and 5 and survive my bully’s best efforts to sabotage me.

I start to make real progress in my daily battles with Director Doubt and challenge myself to find opportunities to confront him head-on. With increasing detail I picture a life for myself outside Doubt, and I train myself to start directing my attention away from my bully’s “what if” questions and toward my Greater Good goals. I come to trust that the resources I need are at my disposal. Day after day, I record my progress in my journal. Day after day, I keep walking out of the Shadow with Steps 6, 7, and 8.

As my project year passes, I become increasingly adept at the art of surrender, coming to recognize and accept just how much of what I thought I could control I really can’t. I train myself to separate pain from suffering, reminding myself again and again that suffering is optional.

Everything is going just as (I) planned.

Before I know it, it’s October 20, 1998. My index-card notations read “Day 365.” My project year is over. My Crash Course in Believing is done. It’s nearly midnight, and I am in my den, poring over my stacks of index cards, marveling over just how far I have come. I am clearly no longer entrenched in Doubt; I have found my way out.

But something is eating at me as I stare at my most recent “obsessions” and “compulsions” tracking cards. These cards are no longer crammed with items, as they were twelve months earlier. But neither are they empty, as I had pictured them. In all my planning, I have envisioned my success story ending with my conquering my OCD, in the sense of putting it behind me altogether. Clearly this is not to be the case.

I struggle with this issue over the next several months, as I begin stringing together my index cards to create a book manuscript. Maybe, I tell myself, I’m supposed to speak out as a “recovering” (and not a “recovered”) OCD sufferer.

A year later, I have finished my manuscript. I am ready to publish it, ready to go public with my story. But I can’t find an agent or publisher willing to take on the project. What’s up with this? Where’s the support of the universe when I need it? Maybe, I reluctantly tell myself, the timing is not yet right.

Another year passes, and another one after that, and yet another. A very successful literary agent takes an interest in my story but tells me my manuscript is not yet ready. She offers me advice and re-sources and puts me back to work. What’s up with this? Maybe, I tell myself, my own thoughts on how best to tell my story were not complete.

I spend another year rewriting and work with my agent to shop the book. Nothing. The rejection letters stack up, and so does my frustration. What’s up with this? Where’s the publisher to help me manifest my Greater Good? Maybe I just haven’t found the right one to read my manuscript, I tell myself.

Soon it is 2003, and the unthinkable happens: I lose my job and, with it, my radio “platform.” Gone is my greatest asset in the eyes of publishers. I don’t understand how the universe could let this happen. I am devastated, but I refuse to let go of my plans to publish my book. I’ve invested far too much in my Greater Good goals, and I know in my gut that they’re still mine to pursue.

Time marches on. Life’s twists and turns lead me in directions I couldn’t have imagined, taking me from a job I loved but lost in Sacramento to one in San Francisco that I had dreamed of holding ever since entering the business. Professionally and personally, things are good. Very good. I continue to hold the line in my battles with doubt, still motivated by the prospect of sharing my story.

And then, at long last, the offer comes in. I have a publishing deal. My book has a home.

On February 2, 2007 — nearly ten years after I’d committed to sharing my story, and nine since I’d thought I had everything in place to do so — Rewind, Replay, Repeat is published. My story is not the miraculous recovery narrative that I’d first envisioned; it is, I am told, much stronger, because it speaks to the ongoing challenge that is OCD. My book reads very differently from the first draft, which I’d thought said everything I wanted to say; it now conveys my message infinitely better. And my radio “platform” too looks very different from when I started my project; it has expanded in ways I couldn’t have imagined.

My point in sharing all this is to explain, in the best way I can, just how Step 10 works. It demands of us that we allow room in our own best plans for even better ones. It requires us to tag the following words to our own affirmations, prayers, and goals: This or something better!

Doing this isn’t easy. It’s human nature to cling to our own plans. And for those of us who’ve had to wrest control of our lives away from doubt bullies, it can be even more challenging to surrender the things we might feel we now control. But this, I’m convinced, is how the universe works. It “sees” a larger, grander plan than you and I can see. It will support each of us in our individual Greater Good pursuits at every turn, but it will also fit these pursuits into what you might call a universal Greatest Good. In making belief, we each do our part to further that possibility.

Now then, are you ready to take that final step?

Jeff Bell is the author of When in Doubt, Make Belief: An OCD-Inspired Approach to Living with Uncertainty He serves as National Spokesperson for the Obsessive Compulsive Foundation, and his story has been featured in The Wall Street Journal, Psychology Today, DETAILS Magazine, and The New York Times. Bell is a 20-year veteran of radio and television news and currently co-anchors the Afternoon News at KCBS Radio in San Francisco. Visit him online at https://www.beyondthedoubt.org.

Excerpted from the book When in Doubt, Make Belief ©2009 by Jeff Bell. Printed with permission from New World Library. https://www.newworldlibrary.com

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