OCD Thoughts, or Just Thoughts?

Obsessions, in relation to obsessive-compulsive disorder, are defined on the International OCD Foundation website as “thoughts, images or impulses that occur over and over again and feel outside of the person’s control.” Those with OCD are often so tormented by their obsessions that they feel intense fear and anxiety which might even result in panic attacks.

So what exactly are these obsessions? Certainly they must be thoughts so horrible that we shouldn’t even speak of them. To elicit such an intense response from someone, these thoughts must be ones we’d all find shocking and deeply disturbing, right?

Well, no. It turns out the obsessions of those with OCD typically arise from the same types of thoughts most of us routinely have. As a new mom over 30 years ago, I’d have fleeting thoughts of dropping my baby down the stairs, or letting her roll off the changing table. I remember being somewhat puzzled as to why these thoughts popped into my head, because I of course loved my daughter and wanted nothing more than to care for her and keep her safe.

Though I found them disconcerting, I was able to shrug them off and go about my life. I could come up with more of my own examples, but my guess is most of you can likely relate to having these types of thoughts; the kind that just pop into your head, or float by, and make you think, “Where did that come from?” They might be momentarily upsetting because they represent the exact opposite of who you are and what you believe in.

So why do these thoughts affect those with OCD more deeply? Are they just being overly dramatic?

No, that’s not it at all. They affect those with OCD more deeply precisely because they have OCD. Even though those with obsessive-compulsive disorder typically realize their intrusive thoughts don’t make any sense, it doesn’t matter. The obsessions are usually frequent and exceptionally vivid, and can seem very real in the moment. The result is those with untreated OCD get caught up in extreme anxiety that impedes day-to-day functioning.

Does it make sense? Of course not. If it made sense it wouldn’t be OCD. Add some thought-action fusion and a heaping scoop of uncertainty to that intense anxiety, and you will likely end up with someone who is performing compulsions to get a feeling of completeness, reduce anxiety, or make sure everything will be “all right.” The vicious cycle of OCD has begun.

If you have OCD and you’ve been putting off getting help because you’re too afraid or embarrassed to tell a therapist about your obsessions, that’s just not a good excuse. Chances are your therapist, like the rest of us, has had those same thoughts, or similar ones, every now and then. Maybe not as intensely as you’ve had them, but with similar content. Because when you get right down to it, there’s OCD, and there are thoughts, but there are no OCD thoughts.

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