Search
  • Ali Iverson, Psy.D.

OCD Problematic Thought Patterns

There are 4 key primary thought patterns that keep people stuck in OCD obsessions/unwanted thoughts. They include the following:


1. Over-Importance of Intrusive Thoughts -

Research has shown that most people experience intrusive senseless thoughts (myself included!). These random thoughts can be about anything. Examples:

  1. What if I were to drive into this wall?

  2. What if I harmed [insert person, animal]?

  3. What if I have a serious disease?

  4. What if I am gay/straight and don't know it?

  5. What if there are deadly germs on this handle?

People will develop the most distress about thoughts that are "EgoDystonic" - meaning they are not congruent with who they know themselves to be. Example: I love my dog and have a thought about hurting her. That would be EgoDystonic because it is the opposite of what I know myself to be.


Thoughts and actions are 2 VERY different things. I can hold a ball and have the thought of throwing it through the window and NOT throw it through the window. Thoughts are just neurons firing in the brain and are not true. It is our actions that define who we are.


2. Need to Control Intrusive Thoughts -

The next cognitive pattern that people with OCD get stuck in is trying to suppress and control the thought. The ultimate paradox here is the more we try to control or suppress thoughts (or emotions for that matter!) the worse they become!

Because the thought is perceived to be more important than it actually is (there is generally a fear that it might mean I am a bad person or that it will come true) - there is a strong desire to "get rid" of the thoughts.


Example: What if I told you to spend a minute closing your eyes, and no matter what, don't think of a pink elephant. Most people will struggle with this because the way the mind works is that it amplifies what we try to repress (even though it can appear as thought this is successful temporarily).


Through Cognitive Behavioral Therapy for OCD you will learn how to manage this need to control, and instead learn to distance yourself from the thoughts instead of taking them seriously or engaging with them.


3. Overestimates of Responsibility

There is a tendency of people with OCD to take responsibility for events out of their control (such as believing my partner may get in a car accident on the way home and I must prevent it by performing a ritual such as praying. If I don't pray, it will be my fault when he gets in an accident).


Cognitive Behavioral Therapy helps to train the mind to not accept responsibility for things out of our control and to focus on what we can control. This takes some time, however, because often times people take responsibility for things out of their control because they WANT to feel a sense of control. It sounds counterintuitive, but that is how the mind works. It will create patterns if it needs to in order to manage distress, no matter how illogical they may seem.


4. Intolerance of Uncertainty

This is the most commonly discussed thought pattern associated with OCD and it shows up in numerous ways. Some common ways include uncertainty about the future, uncertainty whether I actually have OCD, uncertainty about whether I could get sick from a door handle, uncertainty about whether a loved one will get in an accident, uncertainty about my sexual orientation, uncertainty about whether I have a disease, and so on.


The compulsions (hand washing, searching google, praying, symmetry, and so on) are typically a way to feel a sense of control of all the uncertainty.


Cognitive Behavioral Therapy/Exposure and Response Prevention therapy train the brain how to tolerate uncertainty, so the compulsions are no longer necessary. As we have discussed previously, compulsions actually make the intolerance of uncertainty worse.




Are you struggling with symptoms of OCD? Contact us to schedule a free, no-obligation, treatment consultation.


20 views0 comments

Recent Posts

See All