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Backdoor Spikes with OCD and Anxiety

anxiety backdoor spike ocd Oct 11, 2021

Backdoor spikes are a response to your recovery and success. Those who are recovered with anxiety all of a sudden feel a SPIKE of anxiety that came out NO WHERE. It almost sneaks through the back door and says, “hello, is anywhere there….remember me.” “Let me make you doubt yourself, your diagnosis, and all your feelings.” “make you fearful that you’re going to get stuck with all these OCD and anxiety symptoms all over again.”

Introduction: Hi, my name is Nathan Peterson and in this video I want to share with you what a backdoor spike is and what to do with these nasty things. Just when you think you have it all figured out…..uhhhhhh

The “backdoor spike” is a term that is used to describe the overwhelming feelings that individuals with OCD get when they have thoughts that may make them worry that symptoms may come back. 

A backdoor spike often comes about when an individual has been doing well with their treatment plan for a few weeks or months, leading them to believe that they no longer need treatment. This could be related to the person having had some success and believing they are doing well on their own, or it could happen simply because the anxiety-provoking events of their life are naturally subsiding. But then suddenly out of nowhere comes this thought:

“Even though I haven't had any obsessions or compulsive behaviors in weeks, I still may not be able to control them if anything happens to mess up my treatment plan. What would happen if my Dad got sick? Or if my family gets into another car accident? Then these thoughts wouldn't go away and I'd never get better.” (The word “I’ll never get rid of OCD!” is often present here.) This thought can also take the form of an intuition:

Because I have the thought it must be true. It must mean something great and amazing.  It must be my intuition trying to warn me of something.

The individual struggling with a backdoor spike can spend days or even weeks trying to regain control over their thoughts and feelings as they cycle through obsessive questioning of their own sanity. 

Even after many months or years of recovery, some people with OCD may still find themselves struggling with backdoor spikes. For example, a person might not be able to "really" believe that they are not going back into full-blown OCD because of feeling so depressed without their obsessions and compulsions. Or they may feel so much shame about having had OCD in the first place that any thoughts about getting better make them feel like an impostor who doesn't deserve such good fortune.

 When symptoms start to decline. Individuals are feeling really good. I guess what, those darn intrusive thoughts don’t want to stop. So individuals can start questioning. Wait!  I’m still having all these thoughts and I’m not feeling anxious about them. This must mean something. That must mean that I was really a bad person this whole time.  Must mean the things I was thinking about is actually going to happen.


 So with these backdoor spikes what we do about it?  The answer may surprise you. Are you ready?  You do everything you’ve already doing. That’s right!  The treatment that you did which is most likely exposure and response prevention is the treatment that we continually use for backdoor spikes. Because the body and brain all of a sudden come up with a threat, tries to convince you that you’re in danger all over again and most of the time your job is to respond completely different to these threats. If you’re looking around you don’t see immediate danger we choose to leave these threats uncertain.

 Responses like yeah totally I’m going right back into that OCD what a fun ride this is going to be. I sure hope these experiences come back that would be so amazing. It will not feeling anxiety about it probably does mean I like it.  Some may choose to just stick with the uncertainty route which is those maybe maybe not statements.

 Essentially, we are not problem-solving anymore. Not trying to figure out if you’ll have symptoms again or not. Not figure out why you’re not feeling anxiety. We’re not putting any value to this anymore!   

Intuition isn’t a part of this. The brain is really tricky and make someone believe their thoughts are so powerful. Don’t fall for it. 


One thing to know about backdoor spikes is that it may make you believe that this new topic or fear that throws your way is different. It can make you believe that this is so absolutely important. Because all it wants is for you to come back in to the OCD cycle. To reattach.   They think about it, individuals may go weeks or months without anxiety, then all of a sudden comes back. We naturally are going up a lot of meaning to this.

 In here is how we can see the difference between something you need to put value to something you don’t. When anxiety hits, you might look around you, if you don’t see anything happening. The ceiling is falling down, there isn’t a lion running at you, your child’s not about to fall off the counter, It has to be see something you can physically see. Not something you “THINK” is going to happen. 

If there is nothing you can see where you would be in danger, you may choose to treat it as a false alarm and give it NOTHING. Answer a lot of fears with, Yep, maybe maybe not. Or Totally man. 

To reduce the likely hood of a backdoor spike, people do treatment, even when they’re doing well. They do treatment. They continue to face the fears they did in the past. Just to remind them that they are still the boss. 

 If you are wanting to learn treatment for yourself, check out my online self-directed course for OCD. There are 42 videos this thing.  Takes you through everything you need to know about your OCD and how to do treatment.  I’ll leave a link down in the description below. You can even check It out for free. 

 So here’s my question for you,  have you experienced these backdoor spikes?  What did it look like for you?

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