I was inspired to write this brief post after having a handful of former patients ask me about this “phenomenon”. The common concern goes like this…”I’ve been doing well for so long and anxiety is not a barrier in my life but, recently the fact that I’m not that anxious has made me anxious.” In comes the backdoor spike, as it is often called.
Because you aren’t anxious for one moment, month, or year, OCD would LOVE for you to now believe that this is because everything you feared most is true.
Tom: I no longer get anxious when I see young kids ride by my house.
OCD: That’s because you ARE a pedophile. I’ve been trying to convince of this for years.
Susan: I cut up vegetables with my daughter in the highchair next to me and didn’t have any intrusive thoughts or anxiety.
OCD: Well, clearly that means that you WANT to kill your daughter. Any good person who had a knife so close to their kid would be scared. You are a terrible mother.
Lee: I changed in the locker room with several other guys this morning and it wasn’t difficult at all.
OCD: Clearly because you are gay and LOVED being around all of those naked men. If you were not gay, you would be uncomfortable. I told ya Lee!
As difficult as these moments are, if they resonate with you then you might be in a good place in your recovery. The key is to treat these instances the same way you would any of the other uncertainty that OCD feeds you. Try using ART, Acceptance with Rational Thought. Let’s use Susan as an example. If Susan is using ART effectively she might respond to OCD like this: “Yep, I might choose to kill my daughter after I get done chopping these cucumbers but, this is the same song and dance I’ve heard from you before.” Comprehensive OCD treatment is far more complex than simply using ART but, it can be a quick go-to for those who have already experienced the multiple skill sets that treatment provides, including exposures.
Have you experienced a back door spike before? If you are a clinician, feel free to share any tips on how you encourage your patients to manage these experiences.