Recognizing Neutralization
Neutralizing actions, or compulsions, occur in varying forms and degrees. Some are obvious, others less so, and in some cases they may not be evident at all. They can be identified primarily based on the circumstances that produce them.
The affected person needs to ask the following questions: What is pushing me to perform this action? Is it a response to a trigger that I really observed? Is it based on what I imagine has happened or could happen, even though I didn’t actually see anything?
Neutralization is provoked by obsessive doubts. These doubts are always based on imagined possibilities, not on solid facts observable in the here and now.
Here is an example:
You see an open door, and you close it. This is a normal action: a problem is observed, and you then react based on what you saw.
On your way from your house to your car, you reach for your keys and remember you left them on the kitchen table, so you go back to get them. This is also a normal sequence of actions: going back is not a compulsion because the action was triggered by an actual fact that was true at that particular moment (i.e., not having the keys).
On the other hand:
After leaving the house, the thought occurs that you may not have locked your door properly, and if it’s not properly locked, you could be robbed, and then you will be blamed for it. This is an obsessive doubt.
Indeed, you continue to wonder if you didn’t lock the door properly, despite having no evidence to support this notion and no reason to doubt the action you took. By going back to check the door, you are acting solely to reduce the anxiety or discomfort produced by your obsessive thinking; you are not responding to a real danger. It’s likely that even after you have finished checking the door, you will feel the need to check it again.
Defining Neutralization
We have used the example of locking doors to demonstrate neutralization. However, compulsion/neutralization can take multiple forms, depending on the type of obsessive thinking. Compulsion/neutralization may include any physical or mental action whose purpose is to reduce or prevent anxiety and discomfort incurred by obsessive thinking.
Compulsions Related to Contamination
Thoughts of being dirty or contaminated may lead to cleaning rituals, such as washing hands, objects or floors or cleaning or touching things in a particular manner. Minor cleaning rituals may be performed by rubbing one’s fingers together, holding one’s breath during cleaning, touching objects only with one part of the body or by hiding certain objects/areas from view.
Compulsions Related to Order
These include arranging things, replacing things, being preoccupied by symmetry and feeling uncomfortable if curtains are not pleated right or the edges of objects are not aligned properly. In some cases, there may be a preoccupation with cleanliness, with positioning the edges of objects so that they face a particular way, with making sure that surfaces are flat or with writing in a specific way. There may also be a preoccupation with performing certain tasks perfectly.
The purpose of neutralization may be to take action to stop or prevent the anxiety or discomfort caused by obsessive thinking. Checking, washing, arranging and hoarding are examples of this. Neutralization can also help to prevent the anxiety from returning. For example, wearing rubber gloves to handle the mail is a form of neutralization if it is done to ensure contact leading to anxiety will be avoided. The actions are often minor or hard to notice, such as arranging furniture in order to see something more clearly without having to approach it or positioning objects so that they don’t have to be checked or cleaned. Neutralization may also take a verbal form, such as when words or phrases are repeated in order to reassure oneself or seek reassurance from others.
How Does Neutralization Work?
When neutralization is performed, it is the result of obsessional thinking that makes the affected individual very anxious about the consequences that may occur if neutralizing does not take place. In other words, it is the obsessive thinking, rather than any triggers based in reality, that causes them to perform the neutralization. In effect, they often check things or put them in order despite the evidence presented by their own senses. They may say, for instance, “I know the window is closed, but maybe it’s possible that I didn’t close it properly, so I’ll check it. ” By checking it, they give in to their doubt and imbue the obsessive thinking with power and credibility. This seems to neutralize their anxiety, at least temporarily, and prevents it from growing—or so they believe.
Exercise:
Affected individuals should write down exactly how neutralization affects them by answering the following questions:
After your ritual, do you really feel less anxious?
Have you obtained any new information?
Do you feel more confident after checking or cleaning things?
The answer to all of the above is probably “no” or “not entirely.”
While neutralization may seem to reduce anxiety, this is not always the case. Often, affected people become more anxious than before while checking or cleaning, because it increases their doubt. After checking once, they think of other possibilities that also have to be checked.
The anxiety created by the obsessive idea artificially leads them to a higher level of anxiety than normal. By doing what the obsession dictates, the anxiety is reduced for a short period of time, only to then increase and artificially maintain itself at a higher level. Neutralization never eliminates the anxiety entirely. Usually, affected people do not stop the neutralization ritual because they feel completely reassured but do so for other reasons. For example, they may become tired, they may not have time or they may have other things to do.
Affected individuals should write down on a sheet the reasons why they typically stop their rituals.
How Does Neutralization Maintain Anxiety?
It seems that even though neutralization reduces anxiety at the moment it is used, affected individuals feel better because they have “obeyed” their obsessive idea: that is, they believe the danger has been averted. But as there was no real danger to prevent, they have simply reinforced the obsessive doubt. Doubt stemming from OCD never accomplishes anything useful. As stated before, all neutralization does is maintain a higher than normal level of anxiety and reinforce obsessive doubt.
Even worse, the outcome that affected people fear often actually occurs as a result of neutralization.
Here are some examples :
People who check their door handle several times a day to see if it is working properly risk damaging it so much that it no longer works;
People who wash their hands 50 times a day to be sure that they’re clean risk removing the skin’s protective layer, thereby exposing themselves to infection;
People who perform a superstitious ritual to prevent misfortune risk neglecting real factors that could cause the misfortune to occur.
In general, when people perform neutralization, they interrupt the normal progress of events. In so doing, they alter the flow and may suffer negative consequences as a result.
What Is Mental Neutralization?
Mental neutralization is a special category and is a means of reacting to recurrent disturbing thoughts whose implications or consequences do not have an immediate effect on the surrounding environment. Thoughts such as “God is dead” or “my wife will die someday” do not lead to external neutralizing actions, but their import is nevertheless very disturbing. This leads to the adoption of mental strategies whose goal is to reduce their impact. Mental neutralization has the same effect as overt neutralization: that is, it serves to temporarily reduce anxiety and discomfort but does not generate any useful sensations, benefits or information, and it is entirely driven by obsessive thinking related to the danger evoked by the disruptive thoughts.
Mental neutralization strategies include:
Trying to inhibit the disruptive thought; modifying the thought; replacing the thought with other words or images; changing the order of certain words; counting in one’s mind; distracting oneself; trying not to think of anything; telling oneself a story; giving oneself orders or instructions so as to adapt to the thought; performing magic rituals to drive out the thought; and performing mental rituals.
Mental neutralization strategies may be carried out even if external rituals have already been performed. Mental rituals and external rituals may also be conducted at the same time and in response to the same obsession.
Here is an example:
- After resisting the impulse to physically check your door, you nevertheless recreate the act of closing the door in your mind or repeat a reassuring phrase to yourself.
In addition, mental neutralization strategies of which affected people are unaware may jeopardize the progress they have made in terms of addressing overt neutralization. They may, for example, say to themselves, “This particular exposure doesn’t count because my therapist asked me to do it.” They may also perform a mental ritual to reduce their anxiety during incidences of exposure, such as distracting themselves or repeating a reassuring phrase.
What is avoidance?
Obsessions can also lead to avoidance. In the case of avoidance, affected individuals simply avoid a situation or an object that is liable to provoke obsessive thinking and in turn generate anxiety. Rather than taking direct action based on their surroundings, they avoid neutralizing actions, either by avoiding the situation or the action that leads to obsession.
Examples:
Delegating to someone else, making decisions that exclude an action from one’s routine, performing only part of an action and not using a device in a certain way are all avoidance reactions. Avoidance may also be more subtle, such as changing the route one takes to work, using certain devices only at specific times or places, completing only part of a task or making a detour while carrying out a task.
Mental avoidance:
This involves trying not to think about certain things. It differs from mental neutralization, which consists of modifying or inhibiting thoughts. When affected individuals ask someone to perform an action instead of them, it means they are completely avoiding the cause of anxiety. Not driving, not cooking and not talking about certain subjects due to fear of the obsessive thoughts and doubts they provoke are all avoidance strategies. The goal of avoidance is to partially or entirely prevent anxiety from arising. Avoidance can become such a routine activity that affected people no longer realize that they are staying away from certain people or situations. It is thus important that they question themselves to determine which of their habits are designed to avoid dealing with anxiety.
Accommodation
This occurs when affected individuals or their families change their daily habits or rearrange their family life in order to accommodate OCD. This is more intrusive than avoidance and may, for example, take the form of moving to another home, not buying certain types of furniture or delegating certain tasks to someone else. Accommodation often includes a change in social habits in order to adapt to OCD, such as deciding not to invite certain people to one’s home or to not visit certain places.
What Does OCD Feel Like?
Since the doubt associated with OCD is based on possibilities and not on realities, one possibility may sometimes lead to another and then another, resulting in a never-ending chain of possibilities. The more affected people consider the situation, the more they increase the level of discomfort caused by their obsessive thoughts. Many people recognize OCD precisely because of this sense of escalating discomfort; they can distinguish it because it is unlike any other type of unpleasant feeling. This level of discomfort seems to include feelings of powerlessness, guilt and even the sense of being overcome by a catastrophic event. Some people call this feeling the “ball” or the “knot.” Do you recognize it? Do you have a special name for it?
Coping and Adaptation Strategies
There are strategies that affected people may have developed themselves in order to resolve the anxiety caused by OCD or related stress. These coping or adaptation strategies may include distracting oneself, relaxation exercises, sports, keeping busy, talking to friends, etc. They are neither a means of avoiding the problem nor of yielding to the obsessive idea and neutralization. Rather, they are independent methods that have been adopted to deal with OCD.
Many people believe that their responses to obsession are coping strategies when they are actually avoidance or neutralization behaviour. This behaviour prevents them from facing the obsessive idea of danger. In therapy, affected individuals will use strategies that resemble coping strategies, but they are taught for the purpose of helping them to become accustomed to their anxiety rather than following, encouraging or avoiding the obsessive idea.
Only by confronting their obsession will affected individuals realize that it is without foundation.
Conclusion
We have listed the principal means of identifying neutralization via its behavioural, intellectual and emotional components. Here is a review of the signs that distinguish neutralization from other activities:
- Neutralization is a mental or overt action triggered by doubt of an obsessive nature rather than by concrete evidence, and its purpose is to reduce the anxiety caused by the obsessive idea.
- Neutralization may reassure one temporarily, but it offers no positive information or feelings.
- Neutralization reinforces one’s sense of doubt or lack of confidence and maintains one’s level of anxiety.
- Neutralization is always preceded by and accompanied by a particular feeling that has been defined as aggressive and inducing tension, discomfort or anxiety.