The Self-Compassion Workbook for OCD by Kimberley Quinlan looks at how to use self-compassion in conjunction with exposure and response prevention (ERP) to manage OCD. The foreword is written by Jon Hershfield, co-author of The Mindfulness Workbook for OCD, which I’ve previously reviewed. Like that book’s use of mindfulness, this book uses self-compassion as a way to augment ERP, which is the gold standard for OCD, rather than replace it; the author refers to this as self-compassionate ERP (SC-ERP). This isn’t a book that tells you to just be nicer to yourself and your OCD will go away.
The author is very realistic in her approach to self-compassion. At the beginning of the book, she explains that it’s not “flowers and unicorns,” nor is it about giving yourself compliments while you run away from your fears. It’s about being kind to yourself as you make space for discomfort; it’s “warm, yet fierce.” The author also addresses roadblocks to self-compassion that people with OCD commonly experience, as well as how to handle them.
Case studies are presented early on and then used throughout the book to illustrate different concepts and exercises. I thought these were really well constructed; they were realistic, and I think they’re likely to help the book to feel more personally relevant for readers.
The background info presented about OCD included a longer list of OCD subtypes than the lists I’ve come across before, with examples like postpartum, emotional contamination, sensorimotor, hyper-responsibility, and obsessing about obsessing. The book also outlines compulsions that are often associated with each obsession type. There’s also an explanation of how the brain works in relation to OCD symptoms, which I think is always useful information to include.
The author writes that clients always want to know how to stop the obsessions from happening, and she explains why it doesn’t work that way. Trying to suppress thoughts only makes them dance around in your head even more. You may have heard me mention the “don’t think about a white bear” exercise that gets those bears doing the lambada in your head; her equivalent example is don’t think about a green apple.
In general, the book includes a lot of very reasonable explanations for what the author is saying, plus plenty of reinforcement that self-compassion isn’t about weakness. For example, when going through the steps of the OCD cycle, obsessions -> anxiety -> compulsions -> temporary relief, she explains how self-criticism feeds into the entire cycle, and self-compassion can change that. Her approach to breaking the OCD cycle involves “fierce self-compassion and badassery.”
I liked the suggestion that instead of always aiming for an A+, life gets better when you drop your expectations down to a B-. It’s not about aiming for mediocrity, but rather dropping the expectations that fuel self-criticism.
Mindfulness is incorporated as a way of acknowledging that you’re in pain but not judging it or coming up with stories about it. Another important concept is compassionate responsibility, which involves putting yourself first and being unconditionally there for yourself. There are also a variety of foundational self-compassion exercises offered that you can use as you begin to work on ERP.
Part two of the book gets into ERP, emphasizing the importance of accepting uncertainty and feeling uncomfortable. This section begins with a chapter on identifying obsessions and compulsions and then creating an ERP Challenge List to work on. There are several chapters devoted to working on exposures, including flooding, imaginal exposures, interoceptive exposure (i.e. exposure to bodily sensations) and creative ways of getting creative and playful with exposures.
Part three of the book is on recovery and beyond, and addresses issues like continuing ERP through recovery, acknowledging the trauma that OCD can inflict, and facing grief over what’s lost to OCD.
I thought this book was great. I’m not a flowers and unicorns kind of person, and this is not a flowers and unicorns kind of book. You don’t have to be into meditation or affirmations or things like that that you might associate with self-compassion. I think this would be a great choice for anyone dealing with OCD.
The Self-Compassion Workbook for OCD is available on Amazon (affiliate link).
I received a reviewer copy from the publisher through Netgalley.