Dr Victoria Ross, Clinical Psychologist & Guest Contributor
The hotly anticipated holiday of the year has arrived, you’ve packed your bags and are fully ready to kick back, leaving the stresses of everyday life, back home. Perhaps you had hoped that this time, even OCD might be so kind to give you a break to have a proper holiday. That this one time, you would get a breather from the incessant torment associated OCD. If only.
If you have lived with OCD for any amount of time you probably know only too well that OCD does not take holidays. In fact, it is quite the opposite. Many people find that OCD symptoms worsen during holidays. So much so, that many avoid taking holidays altogether.
It’s not all bad news, however. There are several ways to reduce the burden of OCD while travelling. Ways which can free you up to have a fulfilling and restful break, even with OCD in tow. I will outline what happens to OCD when on holiday and provide my five top tips to help you cope while travelling.
Why travelling with OCD is difficult
Travelling can be stressful for most people. Whether it be the last minute packing, traveling through airports, organising little people, language barriers or the endless decisions. Added to this, our usual structure, routine and coping mechanisms tend to promptly fall away. Therefore, holidays create a perfect storm for an increase in obsessive rumination, intrusive thoughts (thoughts, image, sensation, urge) and compulsions (mental or physical). We know that OCD will take up whatever space that is available to it, so this is both understandable and expected.
OCD operates in a sneaky and opportunistic way, often with many guises. In my experience, those who suffer from OCD will experience a variety of themes (e.g. fears about paedophilia, existential, contamination, harm, sexual, relationships, just right, somatic, real event etc). So, if you are familiar with paedophilia intrusions, then don’t be surprised if it switches to contamination or relationship-based intrusions with the headline “This one is new so it must be real”. It’s bit like a game of hungry hippos – you hit one down and before you know it, another pops up.
Preparation and connecting to values
Why are you going on holiday in the first place? What is your motivation? What do you want to get out of the holiday? Often it can be helpful to remind ourselves of the “why” behind the “what”. This is especially true when it comes to anxiety provoking situations. And in case of any doubt, travelling with OCD is exactly that. My bet is that you are going travelling because in some way, it helps you connect with the person you want to be, and the life you want to live. Whether it be about experiencing different cultures, connection, adventure, novelty or exploration. Being clear on your driver can be massively helpful.
On a more practical note, is there anything that you can you bring with you which can help your nervous system settle or increase feelings of safety? Perhaps a comfort item or something that reminds you of a person that you are close to. Another way to do this is to have photos on your phone which connect you to times when you have felt safe, soothed and connected. Or you can use visualisation or imagery to connect to a memory. This can help manage your level of threat in the body and mind. Remember, this is not to be a compulsive act to get rid of distress. Rather, a tool to help your body feel soothed, in the presence of OCD.
A new relationship to thinking
Our minds have a mind of their own. It’s true, every day the mind is constantly throwing out all sorts of thoughts and stories. Your mind creates a lot of noise. It’s how the mind works. If you go on holiday and take your mind, which I guess you will, then it will be no different. wants attention and it wants you to engage. Often the hope is that you will find the magic answer to rid yourself of these unwanted thoughts and experiences. However, I encourage you to come back to the idea that rather than getting rid of, we change the way we relate to, and how we respond to, OCD. After all, I assume you’ve tried various ways to get rid of OCD with little effect?
One way to do this is to name your OCD story. Now, this might sound a bit strange but bear with me. If you labelled your OCD, what would it be? The harm story? The humiliation story? The doubt story? Similarly, you can create a character out of your OCD. What would it look like if your OCD was an animal, cartoon or film character?
You are not your thoughts and your thoughts are not you. Yep, read that one again. Your inner experiences whether it be thoughts, sensations or urges are not a reflection of your identity or inner most desires. So hold your mind lightly, become a witness to your thoughts, sensations, urges rather than identifying with them. It’s like you are taking a helicopter perspective, looking down at what is happening in your mind rather than being caught up in the action. You might find it quite fascinating, or even amusing how weird some of the stuff that our brains comes up with. The job is to notice the thought and detach from meaning from it. There’s OCD doing its thing again…Thanks Mind… Here’s the harm story.
Believe it or not, there is research based on how these strategies can be helpful. Just to be clear, the job here is not to stop the thought. It is never to stop the thoughts. If any therapist has told you this, well, then you should leave.
Ruling thoughts
When it comes to OCD what’s on the surface does not tell the full story. What is the core fear? I am a bad person, I am responsible, I am mad. These, combined with ruling thoughts get us hooked. The rules we hold about our thoughts lead us to compulsions. Compulsions are behaviours, either inside our mind or physical, that we do to respond to intrusions. What are the rules you hold about your thoughts. Some common examples below:
- I can’t handle it/ I can’t cope with it
- I need to know for sure
- I have to respond to every thought
- Because I think it, I have to do it
- If I have this thought, I am a bad person
- If I think a lot about this thought, it means it is important,
- I have to respond to every thought that pops into my mind
- Not responding to thoughts is causing harm to others.
- Not doing anything about the thought, is the same as causing it
- I think, therefore I am
- They feel scary, therefore it is scary
- I am responsible
The golden rule here is that thoughts and behaviour and different. So, although your OCD may tell you the above rules. I can wholeheartedly confirm that none of them are based on truth or wisdom of how our minds work. Try your best to catch your ruling thoughts and ask how do I want to respond to these?
Values-based Exposure and Response Prevention (ERP)
OCD is a great trickster. Because of the rules, it can make you believe that you have no choice other than to check, count or wash one more time. This is the fuel of OCD. I need to call OCD out though as this is not true. It may feel like you don’t have a choice but the reality is that thoughts and behaviour while connected, are completely separate. You can have a thought or a feeling and do something different. You can take action that leads you toward your values and the person you want to be instead of away. Release from OCD lies in our actions and how we respond.
Values-based Exposure and Response Prevention (ERP) is a common way to treat OCD. It involves two steps: exposing to situations that trigger our obsessions AND resisting our usual responses i.e. compulsions. These practices should continue when you are on holiday. You may need to make some adjustments or think out of the box when not in your familiar surroundings. One thing is for sure though, if you are able to carry out ERP while on holiday, you are likely to get some relief. Watch out for the sneaky mental compulsions that are not always visible.
Consider how your wise self can make decisions around what you do. OCD will shout from the rooftops and dictate what you do or don’t do. This just adds to the problem. Even if you don’t feel like it, take action in line with your values. The more we learn to resist our compulsions, the quieter OCD will get and eventually, we will starve it of its power.
Tips for value based exposures:
- Use your values (refer to preparation) to guide your ERP
- Push the boundaries without overwhelming yourself
- Planned and spontaneous practices
- Variety of settings
- Variety of exposures (real life/ imaginal e.g. recordings)
- If scripts or recordings replay multiple times, several times a day
- Have response prevention message at the ready (Maybe I will get HIV, maybe I will not. It is possible. I am safe in the uncertainty)
- Detach from thoughts (I notice I am having the thought that I am a paedophile)
- Track your progress
- Watch out for sneaky mental compulsions
Support
OCD can lead you to withdraw and disconnect from people around you. Or, it can lead you to stay close repeatedly seeking reassurance from people close to you– do you think I could be a paedophile? Did I make the right decision? Am I a bad person? Instinctively, people close want to help and reassure you. However, this adds fuel to the fire. The relief will be temporary at best, and it will leave the OCD insatiable needing more. If you can, stay connected and I encourage to be open about your struggle and ask them to refrain from providing reassurance. Chances are, you are not the only one who struggles in this way. They can also help keep you on track with your ERP practices.
Compassion
Let’s be clear, travelling with OCD is no mean feat. It takes courage. From my experience of working with clients, the inner critic is not far away. So, often working with OCD involves working with the inner critic and the accompanying judgements and criticisms it emits. If you have OCD while on holiday, then know it is not a reflection of any failure on your part. It is absolutely not of your choosing. In fact, going on holiday with OCD should be commended as what it takes to keep your head above water, is pretty impressive. Can you acknowledge what it takes? How would you treat a friend who was struggling in the way that you are? Go easy on the goals you set yourself, and the ERP practices you set. You are not expected to do it all perfectly.
Conclusion
OCD flares for many when on holiday. There are a lot of understandable reasons it does this. There are ways to soften the burden of OCD while on holiday including preparing and engaging with your values, learning to hold your mind lightly and witness the OCD chatter rather than get caught in it. What’s more continuing values based practices, utilising support and compassion all can help.
If you found this guide helpful, check out How to spot unhelpful thoughts when travelling
