Getting to grips with Theory A and Theory B

[Martin]

Hello

I've been doing a lot of reading recently and have begun visiting two OCD support groups which I've found very instructive. Because of this better I understand the not-insignificant role OCD has played in my life since adolescence.

Because of this, I've been able to marginally reduce time wasted on rituals recently. But I want to take this further and 'break' the OCD. In doing that I am trying to formulate a suitable definition of the Theory A / Theory B paradigm suggested in the literature, that I am content with and accept, i.e. I'm 'trying to get my head around it' before I move on.

Therefore I would ask whether the following is a plausible explanation or not?

Theory A: The danger is real according to the OCD, i.e. 'My problem is that I have left the front door of the house unlocked. Because of this I need to repeatedly check that the door is locked'.

Theory B: The danger is imaginary because the OCD is skewing my perception causing anxiety and ritualising, i.e. 'My problem is that I worry that I might have left the front door of the house unlocked. Because of this I can stop or reduce the checking or other rituals'.

Any advice would be welcome.

Thanks

Martin.

[taurean]

Well yes that seems a pretty good appraisal of what theory A and B is all about.

Essentially it's a behavioural exercise which you work out geared to your own OCD,

The goal of the exercise is to to prove to yourself that the OCD is a false message, and you don't need to carry out ritualistic behaviour to stop the thing that you fear happening.

I am a big fan of this method, which is well utilised in "Break Free From OCD", because a lot of people struggle to attrinute their behaviour to OCD, and it's a good way to assist with that.

[Martin]

Thanks Taurean. Now that I understand what the Theory A / Theory B paradigm concerns, I can try to carry out a few experiments of my own.

Oddly enough though, "Break Free From OCD' by Challacombe, Bream Oldfield and Salkovskis is a fine book but I'm not completely happy with it, hence my attempts to work out my own definition of the Theory A / Theory B paradigm.

Still, one man's meat...

Edited September 5, 2014 by Martin

[legalseagull]

Personally I would get rid of the first sentence in theory B. To me it seems like you're reassuring yourself by convincing yourself that 'the danger is imaginary'. Beating OCD is about accepting uncertainty and taking risks. Just my opinion, others might disagree. Good luck with it, it seems like you're making a determined effort to beat OCD.

[Guest legend]

Personally I would get rid of the first sentence in theory B. To me it seems like you're reassuring yourself by convincing yourself that 'the danger is imaginary'. Beating OCD is about accepting uncertainty and taking risks. Just my opinion, others might disagree. Good luck with it, it seems like you're making a determined effort to beat OCD.

spot on

[Martin]

I will have to think about this. I had thought to include definitions of each theory and then examples of their application.

Thanks to the respondents though

Martin.

Edited September 6, 2014 by Martin

[Guest Adam Samson]

Personally I would get rid of the first sentence in theory B. To me it seems like you're reassuring yourself by convincing yourself that 'the danger is imaginary'. Beating OCD is about accepting uncertainty and taking risks.

I agree with you, legalseagull. It is slowly sinking in to me that I cannot eliminate all risk from my life. My worst fear is a real possibility, albeit improbable and albeit not as calamitous as I suppose. No matter how hard I clean something, it will never be 100% free of all foreign substances. No matter what precautions I take, the food going into my mouth will contain some obnoxious chemicals. I live in a dirty world and I can't coccoon myself in a sterile antiseptic squeaky-clean bubble. But the vast majority of the time, it is OK to eat food that is less than 100% pure because the tiny amount of impurities present do not cause any significant effect at such low concentrations (even though they could kill me if I consumed them neat.)

I am currently reading "Break Free From OCD" by Salkovskis et.al for the first time and I've just reached the chapter about Theory A / Theory B. I too am unhappy about the wording and would prefer to adapt it to the following:

Theory A: The danger is real and is reasonably likely.

Theory B: The danger is real but almost impossible. My OCD is distorting my perception of the likelihood.

Applying my version of Theory A / Theory B to your situation, Martin, I would say:

Theory A: "My problem is that I may have left the front door of the house unlocked. Therefore I need to thoroughly check that the door is locked, taking 15 minutes or longer if necessary to make doubly sure that I'm not mistaken."

Theory B: "I have almost certainly locked the front door. My problem is that I worry excessively that I may not have checked it adequately. I do not need to check more than once because the chance of the door still being unlocked after checking once is so small that further checking does not justify the use of my time."

Another thing in the book I struggle with is the vicious flower. I understand the overall principle that OCD involves multiple vicious circles that act like a self-propagating nuclear chain reaction or like a snowball rolling down a hill and growing in mass and speed as it goes. But I am baffled when I try to think about each vicious circle specifically and apply it to my own situation!

Something in the book I find very helpful is the hypothetical door-to-door salesman who tries to sell you an insurance policy that is absolutely guaranteed to protect you from every calamity in the universe, but it comes with a premium of £1 million per month. OCD is like that. If you do what OCD tells you that you need to do to stay completely safe, you will ruin your life by the excessive time-wasting and mental strain. But if you settle for "probably OK", the monthly premium is affordable and you will still be able to enjoy life.

Overall I find the book very helpful.

[taurean]

i find the book helpful.

Risk was part of my professional life for 44 years as an insurance man.

When risk becomes a player in OCD, there will be the usual inherent fear - contamination exposures or failure to check properly.. The OCD blows up the element of risk there may be to an exagerrated degree, triggering the compulsions of cleaning, decontaminating checking,re-assurance seeking.

The behavioural experiments of the book are geared to showing up this exagerration and weaning people away from it in a practical way, so that they can break free and regain what OCD was taking away from their lives.

For me it's a way of seeing things for what they are , and linked where needed to exposure and response prevention it's a good way of tackling irrational fears leading to compulsions.

.

[Martin]

I'm not saying that I find 'Break Free From OCD' to be unhelpful. As someone who lectures students in various IT courses at two universities in London, if a particular course has no set or recommended text book, I'm frequently asked if I can recommend a book. My usual answer is that a particular book may be considered ideal by one student, but another may have a contrary point of view. This principle applies here as well, hence the preference for a subjective version of the theories.

In any case, my current OCD relating to said front door is that I am now able to not check it at all if I'm going out for a brief time, perhaps an hour, yet if I know I'm going to be out for a long time, the door is checked by the usual pushing, poking and prodding and so on. Fortunately though, this ritualising has seen a reduction from an average of fifteen minutes to just under ten minutes. Interestingly, I don't unlock the door then lock it again. So this brings me to Adam's changes to my original version of the A / B theories:

Theory A: "My problem is that I may have left the front door of the house unlocked. Therefore I need to thoroughly check that the door is locked, taking 15 minutes or longer if necessary to make doubly sure that I'm not mistaken."

Theory B: "I have almost certainly locked the front door. My problem is that I worry excessively that I may not have checked it adequately. I do not need to check more than once because the chance of the door still being unlocked after checking once is so small that further checking does not justify the use of my time."

I think the changes are very good and improve upon my originals. Given what I've said though, I believe I simply need to apply the last sentence of Adam's version of Theory B more actively.

At the risk of appearing as if I need to be reassured, does this sound rational?

Edited September 24, 2014 by Martin