OCD and Thought-Action Fusion

As many of us already know, our minds have minds of their own. All kinds of thoughts run through them on a daily basis: some happy, some distressing, some weird, some comical — so many thoughts over which we have no control. Some hang around longer than we’d like, while others are fleeting.

Most of us filter out the thoughts that are necessary and important at any given time, and pay little to no attention to the rest. But for others, including those with obsessive-compulsive disorder, it is rarely this simple.

OCD is complicated, and there are many components that commonly occur as part of the disorder. One of these factors is a cognitive distortion known as thought-action fusion. This is when a person believes that thinking bad or distressing thoughts is just as terrible as performing the action associated with the thought.

Say a thought pops into your head that involves physically hurting somebody you care about. Most of us would think, “How strange. Where did that come from?” And then we’d go on with our lives. But not those who deal with thought-action fusion. Because they believe that thinking this thought is just as awful as following through with it, they can’t just let it go. Imagine how terrifying this must be! And it certainly doesn’t do much for one’s self-esteem; many of those with OCD feel they must be horrible people for thinking such thoughts.

Additionally, thought-action fusion can also include the belief that thinking these terrible thoughts can somehow make them come true. So if you believed that thinking about harming a loved one can actually cause this harm to happen, what would you do? Most of us would try as hard as we could not to think this awful thought. And, given that our minds have minds of their own, the more we try not to think of something, the more we can’t stop thinking about it. It’s not hard to see how this process might be conducive to the development of obsessions.

Even though I don’t have obsessive-compulsive disorder, I can sometimes personally relate to different aspects of the disorder, to a point. In terms of thought-action fusion, I realize that I have, on occasion, been superstitious about thinking certain negative thoughts. Stop thinking that; it might come true. I don’t really believe my thoughts can control what happens, yet I find myself trying to stop these thoughts anyway. It’s no different from feeling you might jinx something by thinking or talking about it.

Once again we see that the thoughts and behaviors of those with OCD are often no different from those who do not have the disorder. It is the severity that sets them apart. For those who suffer from thought-action fusion that feeds their obsessive-compulsive disorder, cognitive-behavioral therapy with a competent therapist can help. And once this cognitive distortion is conquered, there will be a little less fuel to feed the fire of OCD.

Man with difficult thoughts photo available from Shutterstock