If you are faced with the challenge of Pure Obsessional OCD (Pure O), then chances are you’ve completed your first round of obsessions and compulsions before you’ve even gotten out of bed each day. Before you open your eyes, the wheels in your OCD machine start turning, and a sort of science fiction scan of your brain begins searching for evidence of “it”. Whatever “it” is, “it” is sure to be in there somewhere.
Perhaps it takes a few moments, or maybe it takes no time at all for the OCD search engine to drum up some piece of the broken puzzle. But inevitably, you find what you are looking for. The obsession is still there, still unresolved, still malicious and unfair. The lump in your throat swells and the other physical symptoms of anxiety begin to surface. Something is wrong and the day has only just begun.
Immediately, your OCD brain begins to engage in a series of mental exercises pitting the unwanted thought against reality, trying to force them to match up or reveal themselves as permanently incongruent. Someway, somehow, you have to get that sense of closure to indicate that “it” is not you. Otherwise, you may never get out of bed.
This is “mental checking”, and it is a common feature of Pure Obsessional OCD. The scan feels like an automatic part of life, no different than the first yawn or stretch. It happens throughout the day, often without you really being conscious that you are doing it. When it is not automatic, it presents itself as necessary, like the annoying reminder message for your computer’s antivirus software. It is important to realize that mental checking is a compulsion. And despite its automatic presentation, it is subject to the same treatment mechanisms employed when challenging other OCD compulsions with Cognitive Behavioral Therapy (CBT).
In short, mental checking is a behavior. It is the act of looking for your OCD obsession with the presupposition that you will in some way be able to squash it and get relief. Furthermore, since we always find what we are looking for when what we are looking for is evidence to justify action, we feel we need to do something about the obsession. This follow-up compulsion is a form of mental ritual aimed at neutralizing the OCD thought. It may be playing an event over in your head to make sure it was handled appropriately (also known as retracing), or it may be repeating a series of “good” thoughts to outweigh the so-called “bad” ones. But the initial behavioral compulsion that puts this OCD cycle into motion is the mental checking, and it is among the more challenging behavioral compulsions to resist because it often appears to precede the unwanted thought.
For people with Pure Obsessional OCD, there are three opportunities to challenge mental checking, listed here in decreasing order of difficulty:
- preemptive resistance
- concurrent resistance
- retrospective resistance
Preemptive resistance may appear impossible until you are well into a course of Cognitive Behavioral Therapy (CBT). Preemptive resistance requires that you have an awareness of your OCD tendency to check. If you have developed this awareness, you are more able to see opportunities for mental checking before they happen, and to see them as opportunities to resist checking. If you have OCD, you may feel an urge to check when you become aware of the absence of your obsession. Use this urge as evidence that you should re-direct your focus, rather than seeking certainty that the obsession has been dealt with. In other words, the urge is your clue – it is your signal to resist doing the compulsion.
Somewhat more tangible an objective is concurrent resistance. If you have already begun mental checking, you are already down the path to digging up an otherwise dormant, unwanted thought. This is where you can jump in and say, “Wait! This is mental checking! This is OCD, and I don’t need to do this!” At that moment, the challenge you face is to pull yourself back to the present. What matters now is not whether your obsession has been dealt with. What matters now is interrupting and stopping the pointless mental compulsion.
Finally, retrospective resistance may at times be the only tool left in your OCD toolbox. You have already searched for and found the obsession. You have already tried some compulsive mental exercises in an effort to make the obsession go back to where it came from. But all is not lost. You can still use the power of mindfulness and clinical self-observation to fully acknowledge that this was mental checking. Take this opportunity to remember what it felt like to look for the obsession. Identify that urge, and acknowledge that it sent you down the path of grappling with the same old OCD junk. You might be surprised how effective this post-compulsion labeling is in helping you better develop the skills of concurrent and preemptive resistance.
We often find ourselves sending the wrong message to the OCD brain when we engage in compulsions. We feel fear and engage in a mental (or physical) behavior to flee from that fear. The brain remembers this as evidence that the behavior saved us from the fear. But a more effective message to send to our brains is that the behavior is pointless and so is the fear. (For more information on this process, see our previous post on Exposure Therapy for OCD and Anxiety.) So even if OCD may have won a skirmish on the mental field by pushing you into a bout of mental checking, you can still win the battle by reminding yourself that what happened was nothing more than a compulsion. Next time it won’t be so easy to fool you.
Now get out of bed.
•The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions. In addition to individual therapy, the center offers six weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment. To contact the OCD Center of Los Angeles, click here.
The information and research here on OCD is of value and appreciated. This was one simple idea on OCD, that for some, might be of help. Art is way of quieting the mind, relieving it of obsessiveness, gaining self-esteem. When you can disappear 3 hours into an artwork, even if it is amateurish, it helps you to refocus and is balancing. For some, it can be an essential self help skill to learn. Turning off the television also is of necessity for some with OCD. TV and movies, can wind one up like a top, bring back memories that are better left dormant, and even the news can have this effect on some. Reading is better for the mind than watching TV or movies (movies, that is entertainment or action movies, as oppossed to documentaries, or educational movies), especially as a way of life, that is daily or weekly.
Hope this idea finds root or acceptance among those working with those with OCD. Thanks.
Thank you for your insightful comment. I agree with your connecting this approach with Glasser’s “Choice Theory”. There are often overlaps in between various psychological theories.
From a Cognitive Behavioral Therapy (CBT) perspective, “I choose to do it, but I don’t have to do it” is an example of cognitive restructuring. Our approach melds traditional CBT with mindfulness-based concepts found in Acceptance and Commitment Therapy (ACT) and other “third wave” treatment modalities.
Cool story, I did not thought this would be so great when I read the link!
I agree with Tom – the concept of choice has helped me quite a bit in battling my OCD and anxiety problems. I fully understand that I can’t control the world but when I emphasize my power over my own choices in life, I feel a little bit better about myself.
It has taken me 20 years to identify that my anxiety is DIRECTLY related to this type of mental behavior. I have a hypochondriacal checking obcession that has made most of my life miserable. The information on this page is dead on and I laughed in relief numerous times while reading because of how well it fits my compulsions. I am SO relieved that there are people that study this. Understanding these mechanisms is just another tool in the arsenal to fight this unfair demon that tortures me.
“Checker”, thanks for your comments. I’m happy that the article resonated with you.
Checking behaviors related to Hypochondria is quite common and responds well to both traditional Cognitive Behavioral Therapy (CBT) and Mindfulness-Based CBT. With mindfulness, the goal is to accept that you have urges to over-attend to thoughts, feelings, and bodily sensations that you believe are related to illnesses. But remember, just because these thoughts, feelings, sensations, and urges exist does not mean that they are important, or that they need to be acted on. Once you get the hang of thinking this way, it becomes easier to catch yourself earlier in the checking process. Best of luck in your continued treatment.
I ran across this when looking or more information on Pure obsessional OCD. It really hit home. My OCD centers on my relationships. I also spend the majority of my day going over and over things in my mind. The hardest part for me are the “what-ifs” that I spend so much time thinking about that I feal have actually happened. I don’t have the funds to get professional help, but was wondering if there are any books that reflect the treatment that is mentioned here. There are not too many resources out there that really understand Pure OCD.
Thank you for writing this.
Hi Jenna, nice to know the article had meaning for you.
I think a useful rule when living with OCD is to automatically tag any question starting with the words “what if…” as an OCD trap that should intentionally go unanswered. The right answer is, “I’ll deal with it somehow.” Everything else is likely to involve the cognitive distortion of catastrophizing.
I agree there are not many reading materials out there that focus on mental compulsions. The two that come immediately to mind are Imp of the Mind by Baer and Overcoming Obsessive Thoughts by Clark and Purdon. You can also read our article on Pure O.
This is such a great article. It is so nice to find this stuff put into words and explained.
Before I was getting help for my OCD, I used to wake up every morning and check to see if the obsessions were still there. I had no idea that this was a mental compulsion or even that it had a name. Of course, they always were there to some degree or another and the anxiety came with them and set the course of my day.
Just the other day I experienced the first time that I was able to catch myself doing mental checking. I said to myself “this is mental checking, it is not necessary to continue.” I still felt like I should continue but I decided to act on what I believed to be true (that it was just a useless compulsion) instead of what my feelings were saying. I still felt worn out and frustrated that the OCD had come, but after sharing it with a friend, I realized that I should be proud that I am starting to be able to recognize the compulsions and resist them.
Anyway, thanks for the great article.
Thanks for your comment, Ashley. Whenever you start to resist a compulsion, there is going to be some discomfort, a feeling of something left undone or unresolved. Work on using that feeling as something to seek out and own, rather than run from. As your tolerance for uncertainty grows, so too does your freedom from ocd. Keep up the great work!
Thank you for the article. I was diagnosed with ocd after about 20 yrs of suffering. I mainly mentally check to make sure someting that I did would not hurt myself or someone else I also worry about sinning and will review things in my mind over and over again some events I have reviewed over and over again for several years in order to try and find certainty that i did not sin or do someting that might cause harm to someone else.
Your article describes exactly what I do. I wake up in the morning and my brain starts to scan/check for things. I worry that I have done something and might not remember and thus not be able to remedy it. Or will suffer in hell because I overlooked someting that is sinful and will cause me to go to hell.
I began CBT/ERP therapy three weeks ago and my therapist pointed out that I was mentally checking and that it was a compulsion not necessarily an obsession and since then I have been able to accept the urge to check and not do it. It is amazing how many times the anxiety leaves and rational thinkiong often takes its place without checking.
I soo apreciate your insight and have made a copy of the article to keep as I feel it describes me perfectly.–Thank You!!
Nic, thanks for your comments. Your therapist is right. While mental checking may feel uncontrollable at times, it is ultimately a voluntary behavior and something you can develop a greater capacity to resist. Keep up the great work.
I appreciate this information. It’s great to know I’m not alone, and I am working to use everything I’ve learned about overcoming Pure O. Once again, thank you.
Thanks for your comment, Amy! Best of luck in treating your ocd.
During my CBT I was taught to accept that just because we have a thought does not mean this thought is infact real or true! I liked this philosophy however couldn’t help and wonder, how do we identity our otherwise rational, logical and ‘real’ thoughts if the meaning of all our thoughts is infact relative or as it seems, debatable.
I guess my question is most applicable when I read your information on preemptive resistance. How do we know that pursuing our thoughts is futile and that they do not have real significance?
Thank you for your comments.
I would argue that, ultimately, it is unnecessary to figure out if our thoughts are rational, logical or “real”. When you are hungry or tired, do you spend any time trying to figure out the meaning of those experiences? Of course not. You just accept that you are hungry or tired without analysis.
Analyzing our thoughts for “significance” is unlikely to result in the sense of certainty you are seeking. As an alternative, I encourage you to accept that you (and me and everyone else) have all sorts of thoughts, and that they don’t really merit analysis. For example, if I have the thought of killing someone who cuts me off in traffic during rush hour, there would be no point in analyzing that thought. My goal would be to continue driving towards my destination, rather than pulling over to the side of the road in order to analyze my thoughts in an effort to determine if I am some sort of crazed killer.
I don’t know with certainty that I am not a crazed killer, but I am confident that trying to get that certainty would be fruitless. I just have to live with the fact that my brain likes to think, and sometimes it comes up with some less than desirable stuff (especially when someone cuts me off in traffic).
I laughed so hard at this response to the comment. It really helped me because of how much I relate to it. Thank you very much.
I am glad that you laughed at the comment. When dealing with OCD, one of the main goals is to stop taking the thoughts so seriously. That often means coming to the realization that the thoughts are ridiculous. Being able to laugh at the crazy nonsense that our brains come up with is far better than getting anxious and depressed about thoughts that are meaningless.
Thank you for this article. I found it very helpful. I suffer from mental checking due to OCD. It can be exhausting and overwhelming. Thank you for encouraging me and others who have this problem. We need all the tools we can get to fight our problems.
Thank you Rose! We’re glad the article was helpful for you.
Why do OCDers have harm thoughts involving those they love the most? Why are the thoughts about what they hate or fear the most? It’s almost like we are not confident of ourselves to act appropriately…that we lack self-confidence.
Thank you for your comment.
Yes, it is quite common that harm thoughts are often focused on those for whom we care the most. This makes sense, as it is quite horrifying to most people to think about harming someone they love. That said, plenty of people with harm OCD obsess about harming strangers. The bottom line is that harm thoughts can be focused on anyone.
I’d like to suggest that trying to figure out why you have specific thoughts, or why some thoughts are about a particular person, is a game you can’t win. Any effort to understand why you have a particular thought is likely to become a compulsion. I think a more effective response is to accept that our brains crank out all sorts of thoughts, including some that are about harm. The goal is to accept the presence of unwanted thoughts, while making no effort to understand them or resolve them or fix them. I know this seems extraordinarily difficult and counter-intuitive to many, but acceptance is the key.
This article was very good. I’ve read that a key to overcoming OCD is to accept the content of your obsessions as irrelevant. How does one do this? Can you offer any advice or readings on this? I think that is the biggest barrier for me because I have so much shame over my obsessions.
Acceptance of your unwanted thoughts and feelings is a critical component in effectively managing OCD and anxiety. And this applies not just to the primary thoughts and feelings you experience, but also to the shame you feel related to those thoughts and feelings. In other words, we all need to accept that, while these thoughts and feelings are unpleasant and unwanted, they exist nonetheless, and demanding that they not exist is unlikely to help.
Mindfulness Based Cognitive Behavioral Therapy is based on the integration of acceptance with traditional CBT, and can help those with OCD become much more accepting of the presence of the mental noise that causes so much of their suffering. I encourage you to read Kimberley Quinlan’s excellent article Mindfulness for OCD and Anxiety, which will give you a good introduction to how you can integrate acceptance into your daily life with these conditions.
I just recently got diagnosed with Pure O…. I have dealt with Anxiety for about 10years.
I have problems believing that’s my problem… that’s its really anxiety/Pure O… Something always tells me, that’s not it, its the believing factor that is my problem. I felt so good giving my issue a “name” but now that I have a name for it, I am doubting myself that that’s really what I have… Is this also a symptom of Pure O? Sorry its so hard to explain!
Thank you for your comments. You’ve actually done a very good job of explaining yourself!
Doubt whether one has OCD is extremely common – remember this disorder has historically been called “the doubting disease”. Many people with OCD (especially the Pure O variants of the condition), express grave concern that their obsessive thoughts are actually evidence that they are planning to act on these thoughts. For example, someone with Gay OCD may see their unwanted thoughts about sexual orientation as evidence that they are gay. Likewise, someone with Harm OCD may question whether their unwanted thoughts of hurting someone are evidence that they are a psychopathic killer.
It is important to remember that everybody has these kinds of thoughts (yes, everybody). Who we are is not determined by whatever random thoughts pop into our minds. A far better barometer of your character, values, goals, and intentions is how you behave. Until such time that you act in a manner that suggest otherwise, it is best to view your thoughts as just that – thoughts. Not evidence, just strange thoughts, not unlike those experienced by everybody else.
Now my issue is how do I know whats my P-ocd and what just thoughts? I mean, besides the obvious ones!
I was doing good and now I’m fighting to get back and its really frustrating… One thing sneaks in and I question whether or not its P-ocd and then the Doubting comes in and I mess myself all up!!!!!!
Any help would be encouraging!
Hi Joyce – Questioning whether a thought is OCD or “just a thought” is like questioning whether broccoli is a vegetable, or just broccoli. It is a vegetable that happens to be broccoli, and your POCD thoughts are thoughts that just happen to be POCD thoughts. Simply put, all POCD thoughts are just thoughts, and trying to distinguish which thoughts are POCD and which are “just thoughts” is a compulsion that will only lead to more obsessions.
Rather than trying to solve the unsolvable, I encourage you to accept that you have lots of thoughts, some of which are POCD. And regardless of what type of thought you are having, accept that it exists and don’t try to figure it out. Our brains are superb at coming up with all sorts of wild thoughts, and trying to figure why we have them or what they mean will leave you exhausted.
This article, and your responses to the comments, was extremely helpful. I really liked your comment to the “what if” idea – to respond with “I’ll deal with it somehow.”
I am trying to come up with good, concise responses to various OCD thoughts that pop into my head. When I respond to an unwanted thought, “that’s just my OCD,” sometimes it helps, and other times it just gives me more anxiety that the OCD cycle is about to start all over again (and then it does). Are there any other helpful phrases you can provide to stop the cycle?
What’s harder to shake off is that sometimes having the harm thoughts make me feel really restless and agitated and aggressive. I try to tell myself it’s just a mood, it will pass, but it’s frustrating because the aggressive feeling I’m experiencing just adds to the “evidence” that I really mean these harm thoughts. Any advice about how to handle it when I am feeling this way?
This website is great and your helpful responses to the comments are wonderful as well. Thank you for this resource!!!
Thank you for your comment and for your kind words.
Frequently, when people have OCD, they begin to obsess not just about the feared thought, but about having OCD itself. This is called “obsessing about obsessing”, and it sounds like this is what is happening for you.
You mention that there are times when you have unwanted harm thoughts, and then begin obsessing about the possibility that the OCD is about to rear its head. This is obsessing about obsessing. Fortunately, the best response to this type of OCD is the same as any other type of OCD. When you find yourself worrying that an OCD episode is going flare up, just remind yourself that “that’s just my OCD, and I’ll deal with it somehow”. Simply put, worrying about OCD spiking is no different than worrying about any other unwanted thought. Accept it, label it for what it is, and get on with your day.
As for feeling “restless, agitated and aggressive”, these are just feelings, not evidence that you are a violent person. At some time or another, everybody has these types of thoughts and feelings, so if they are evidence of our true character and intent, then the entire planet is populated my murderous thugs. The best response for these and any other unwanted feelings is the same as for unwanted thoughts – “that’s just an unwanted feeling, and I’ll deal with it somehow”.
Thankyou so much for this article.
Knowing that scanning / looking / checking for the obsession is actually a compulsion is really helpful.
I’ve always wondered and been confused about this. I think it’s what has held me back. I have been able to beat my physical ocd. But my pure o I have not.
I always thought the scanning, looking, checking at the start was obsessing ! Because it makes me more anxious once I find the scary evidence I am looking for, because then I try to reassure myself about it.
It goes like this –
-feeling of anxiety that there’s something wrong & I need to make sure that I haven’t done anything wrong
-urge to retrace and recall my past,
-recall my past,
-find something questionable
-then try and convince myself it’s not true but it never sticks.
Your comments point to the problem of distinguishing “Pure O” from “OCD”. Pure O is really not so pure, as everybody with Pure O responds to their obsessions with compulsions – it’s just that the compulsions are a little less obvious. Scanning, checking, or looking at one’s obsessions is really no different than scanning, checking, or looking at a door lock or stove knob. And trying to get reassurance about a thought is no different than trying to get reassurance that the front door is locked or that you have washed your hands enough. It all just seems different because it is only going on in your head.
I encourage to try something different. When you have unwanted thoughts, experiment with not trying to convince yourself of anything – not trying to prove that something is true or not true. Just accept that your brain is yet again exhibiting just how creative it is. Think of your unwanted thoughts as stories you brain comes up with. It loves to come up with stories, but they are just fictions that you needn’t buy into.
I would say I have and deal with pretty much everything described in this article along with the ocdla piece on “memory hoarding” as well, constantly analyzing my thoughts,scanning/checking, hoarding the idea of doing things, retracing and replaying almost everything ranging from simple interactions to even just moments that have past where I think I had a thought or feeling that was significant,exc. Basically it feels like my entire mental processing system and way my mind works is through all of these neurotic ‘modes’ I am constantly “resetting” or trying to get my mind back to a natural state through these compulsions but of course this is no solution. For quite sometime now, usually multiple times a day I attempt to just give it all up and I promise myself I will just accept all the uneasiness and anxiety that comes from not giving into the obsessions and that if I successfully do this long enough I will beat it and my mind can enter a natural state. My question, and probably a stupid one since I’m writing this in the first place, is if this “simple” strategy of just stopping cold turkey and accepting everything that comes with it can actually work or if ocd is so powerful that it really isn’t a rational way to go about trying to beat this versus actual therapy.
It sounds like you are doing quite a few mental compulsions (analyzing, checking, retracing, replaying, memory hoarding, etc.) in an effort to “control” your thinking, and get back to what you describe as your “natural state”. But humans cannot control their thinking. Our brains think whatever they want to think. That is our natural state.
Accepting all of your unwanted OCD thoughts and feelings is a great step in the right direction, but it is not as “simple” as you might hope. OCD thoughts and feelings will continue to appear, and you will quite naturally want to get rid of the discomfort you experience in their presence. Your job is to accept these thoughts and feelings, and to face them directly. This is the Exposure and Response Prevention (ERP) part of therapy, and it is as important as the “acceptance “ part.
Ultimately, you would benefit from moving away from a position of trying to “beat” or “control” your thoughts and feelings, and towards a position of accepting and challenging them. Structured CBT with a therapist who specializes in treating OCD is the best way to accomplish this for most people, but you can certainly apply these principles on you own.
I am questioning life at the moment. And it is very painfull and scary. I can not get these philosophical questions out of my head. Is erverybody real or are they a figment of imagination? is the most scary question i am dealing with now. It is called solipsism.
Have you seen this before? Can you give me some advice?
I was diagnosed with Ocd when I was 22 years old.
The symptoms you describe sound very much like what we call “Existential OCD”, which I have also seen described as Solipsism OCD. People with this variant of OCD obsess about whether they are “real”, or others are “real”, or if reality is “real”. Common concerns are “what if this is all a dream” or “how do I know if any of what I experience is actually “real”?
I think the problem with calling it Solipsism OCD is that it gives these thoughts the veneer of legitimacy – like they are somehow a function of authentic philosophical inquiry. But they are actually just one more manifestation of OCD’s ability to lead people to doubt just about anything – even doubting whether or not they actually exist! This isn’t philosophical inquiry – it’s OCD.
I cannot provide you with any reassurance that other people are “real” because this question is unanswerable. My belief in the value of empirical data (i.e., my five senses) leads me to “believe” that others (including you) are “real”, but I do not “know” anything. I don’t “know” if others are “real”, or even if I am “real”. For all I “know”, I am not “real”, and I am the figment of someone else’s imagination!
The real problem here is that your attempts to get some sense of certainty on the issue of “realness” are compulsions. Every time you try to answer questions about reality or existence, you dig the hole deeper. Simply put, there is no answer that will provide you with absolute certainty, because absolute certainty doesn’t exist.
The good news is that these types of questions do not need answering. We can choose to live with unanswered questions roaming around inside our minds. Your goal is to accept that you have these questions, and to make no effort to answer them. While this may at first seem excruciating, you will over time learn that you can, in fact, live without certainty. These are questions that you cannot answer and that don’t need an answer.
Thanks for this. It is such a relief. I spent hours online looking for answers……. Arguments against solipsism and rationalizing why I am real and others are. So the trick is realizing I don’t have to answer this but rather just live with uncertainty?
Yes, the best option is to realize and accept that you do not need an answer to whether or not certain things or people are “real”, and to instead live with uncertainty. I have no idea if I am real, or if you or anyone else is real. Nor do I need to know.
Tom- I have conquered this ocd thought but it’s back. I have tried to face the fear but that leads me to more panic right now. I can’t quit thinking “I can’t accept the thought as OCD” if I’m not real. Then I panic about going insane and ending up in a mad house. It’s driving me mad. Any advice ?
My answer to your prior query from 2015 stands (see above), As I noted then:
“The best option is to realize and accept that you do not need an answer to whether or not certain things or people are ‘real’, and to instead live with uncertainty. I have no idea if I am real, or if you or anyone else is real. Nor do I need to know.”
As for your comment “I can’t accept the thought as OCD if I’m not real”, I say only this: Nonsense! Your ability or willingness to accept anything is unrelated to whether or not you are “real”.
You say you want my advise, so here it is: stop wasting your time and energy trying to figure out if you are real. Simply put, your “real”-ness or “not real”-ness is unimportant. It is just an unimportant thought that your brain produces. I also encourage you to read our article “OCD is Fake News”, which addresses how to respond to these unimportant thoughts.
Quite frankly, that has got to be the BEST answer I have ever seen in my life! I’ve been through intense therapy for OCD including CBT and ERP. The fact that you didn’t offer reassurance but left a lot of uncertainty was brilliant. So well said!
Thank you so much for your kind words. I am glad that they resonated with you.
Thanks so much for this article!
I’ve noticed lately that when I respond to an obsessive thought with “I don’t need to analyze this thought” or “I’ll deal with that if it happens,” I actually feel relief instead of anxiety, I think because in a way those responses are serving as a sort of reassurance. My mind seems to translate these responses into the idea that if I don’t have to engage with the the thoughts, they must not be important. Logically I know this is the goal, but I’m also wondering if it undermines exposure, in a way. Should I be using a different response?
I think that responding to obsessions with “I don’t need to analyze this thought” or “I’ll deal with that if it happens” is right on target. This sort of relabeling technique is similar to Jeffrey Schwartz’ “four steps” as described in his book Brain Lock, and can be very effective in helping people to have a more objective and realistic view of their unwanted thoughts. You may also want to read our article on Mindfulness Based CBT for OCD and Anxiety. That said, two additional points are worth making.
First, it would be counterproductive if you used these phrases compulsively. In other words, remind yourself “I don’t need to analyze this thought” or “I’ll deal with that if it happens” one time only. We have seen clients who turn this relabeling into a compulsion – i.e., saying phrases similar to the two you mention hundreds or even thousands of times a day. The goal is to remind yourself once, and then get on with things in a non-compulsive manner.
Second, and related to #1 above, many people use relabeling with the hope that in doing so, their obsessions and anxiety will decrease. But that is just a way of trying to control your thinking, which again, is a compulsion. Your goal should not be to reduce anxiety, but to accept it as fact of life. If you are using your relabeling phrases with the agenda of “relief”, then you are likely using these phrases as compulsions.
All of the above noted, if you are not using these phrases compulsively, and you anxiety just happens to go down, that’s great. Don’t look a gift horse in the mouth!
Hi, Thank you for this article.
I’ve been suffering from negative thoughts for AT LEAST 8 years (since 13 y.o) but I’m not sure if this is OCD. When a negative thought hits me I become anxious and I fight it. The more I fight the more I obsess with it (which I know is counterproductive).
I have bad thoughts about myself and I imagine myself in millions of negative situations and I try to put a “NO” or “STOP” sign in front of the image (that appears on my mind). If “NO” and “STOP” don’t feel right I try to cross the image out (mentally). (The same thing goes for negative words). I do this all day, almost 24 hours a day and it’s mentally exhausting. It doesn’t allow me to concentrate on other things of real life and it gives me headache. Lately, “NO” “STOP” and crossing out don’t work anymore because it takes me minutes to visualize them in my mind. My mind is SO TIRED that I don’t have energy for that. So I just leave the thought ALONE and say “f*ck it..whatever…” That’s when the thought goes away naturally.
BUT, when I forget about the obsessive thought during the day and when things are okay, for a second I think “Wait…is the thought still there? I just want to make sure I’ve forgotten it……….Oh God..it’s still there…” Then the fight begins. It’s funny because when I want to make sure the thought is gone, I realize I’m thinking about the thought itself. I also have lots of “What if”s on my mind.
Something else I started doing lately is questioning my own thoughts. Whenever I think about something (non OCD-related) I ask myself “Is this a normal thought? Would anyone else think like me in this moment? Am I normal?”
Sometimes, when I don’t want to dwell on thoughts and when the thought begins I tell myself “The thought is about to begin. Don’t dwell on it. Don’t lose the sense of reality. Not now.” And I go back to my daily schedule. When several days are okay I still go back to maing sure the thought is not there…but unfortunately the cycle begins.
Thank you for your comments.
While I cannot provide a diagnosis via blog, the symptoms you describe are consistent with those of OCD. In fact, they are text book examples of OCD symptoms. Many people think OCD must include obvious compulsions, but for many people, their compulsions fly under the radar. Generally speaking there are four main ways in which one can do compulsions:
~obvious overt physical compulsions (i.e., handwashing)
~avoidant compulsions (i.e, not doing something because of your obsession)
~reassurance seeking (asking people for reassurance or looking things up online)
~mental compulsions (employing mental strategies such as mentally reviewing situations, events and thoughts in an effort to reduce anxiety)
Virtually everything you mention in your comment falls into the latter and less obvious-to-the-naked-eye category of “mental compulsion”, for example:
~ Putting a mental “NO” or “STOP” sign in your mind to counteract an unwanted thought
~ Mentally crossing out unwanted images or words
~ Mentally checking to see if the unwnated thought or image is still in your mind
~ Questioning the normalcy of your thoughts
~ Telling yourself “The thought is about to begin, don’t dwell on it”
The good news is that you have already discovered the key. As you noted, when you “just leave the thought ALONE and say “f*ck it..whatever…” That’s when the thought goes away naturally.”
Exactly – leave the thought alone and it will leave you alone. You gain nothing (except exhaustion and more OCD) when you resist unwanted thoughts. They are in your head whether you like it or not. The best approach is to peacefully co-exist with them, as open warfare is doomed to failure.
A good way of accomplishing this is to take a “mindful” approach to your unwanted thoughts. I encourage you to read our article titled Mindfulness for OCD and Anxiety. You can also read our webpage Mindfulness Based CBT for OCD and Anxiety.
Hallo!!! Great article!!! I would like to ask you something. Is it a common ocd obsession when I think that I put a glass to my fathers food and some day he will die, because the glass will go to his heart?? And then, it will be my fault. Something tells me like… I did it for real and then regret it!!! I mentally check about that but I m so uncertain. I m afraid I may caused harm to my dad and that I had the intention to harm him. Please help me!
Thoughts that one has accidentally (or purposely) hurt someone, are endemic to OCD, and are often described as “Harm OCD”. I encourage you to read our four-part series on Harm OCD.
God bless you, this is reassuring. I’ve been silently suffering with pure o like thoughts that I find hard to even confront myself, let alone admit to others. It’s a nightmare. Sometimes thoughts of something I did in my past would pop up and I end up overanalyzing it to justify that I’m not that way even if it might have looked that way. Then the need to recite something to “chase” those thoughts away begins. Sometimes that fails and I think, “NO. I know I’m not that way. I refuse to accept that.” or something along those lines as my line of defense. If successful, I can get on with what I’m doing. If not, I end up in a puddle of tears trying to lather, rinse, and repeat until I get the desired effect. I haven’t been officially diagnosed or anything, but this seems to be the closest thing to explain the symptoms I’ve been having.
It is quite natural for humans to have memories of things they did in the past. But analyzing these memories in an attempt to prove your character will not work. Likewise, reciting specific phrases in an effort to prove that you are “not that way” will not help matters. These are two examples of compulsions, and while they may provide short term relief, the thoughts will return (as you have already discovered).
A far better solution would be seeking out a treatment provider who specializes in Cognitive Behavioral Therapy (CBT). This is the therapeutic approach that has has consistently been found by researchers to be the most effective treatment for OCD. If you would like to discuss treatment at our center, we can be contacted via our website at https://ocdla.com/. Take care.
I suffer from intrusive thoughts and while I thought I didn’t have any mental rituals, I now know that I do some mental checking and avoiding.
I have two questions:
1) after mental checking for and finding the thought, the thought will circulate over and over in my head for a long time. Is this considered an obsession, or rumination (a compulsion)?
2) sometimes I have the thought that I want to do what is on my thoughts, even though I clearly don’t. Is this some sort of testing ritual? Or just more obsessive thought?
All of this sounds like obsessions to me.
A good rule of thumb is that conscious, volitional efforts to analyze your thoughts are compulsions, while thoughts that keep coming up on their own, with no effort or direction from you, are obsessions. Either way, analyzing whether your thoughts are obsessions or compulsions is unnecessary, and has the potential to become an obsession in it’s own right. Instead, accept that the unwanted thoughts are present and do nothing about them. Just peacefully co-exist with them and do what you would normally do if they weren’t present.
What about unwanted physical sensations? Does that also pertain to pure ocd? Can that make checking worse?
Unwanted sensations are the same as unwanted thoughts or feelings – they are obsessions. Accept them and let them exist.
After many years of having obsessions and compulsion, NONE of the things I have EVER worried about happening have ever happened. However, each time I have a major spike my brain says, “This may be the one time it is real and I should worry.” How do you approach larger spikes versus the smaller value spikes? Make sense?
Yes, this makes total sense in the world of OCD. So the next time you have an obsession, stop and remind yourself that none of the things you have ever worried about happening have ever happened. It doesn’t matter whether the spike is “low” value or “high” value, the goal is the same – to accept the presence of the uncomfortable thought without doing any compulsions (including mental compulsions).
Hello, this has helped me a lot greatly. Thank you for this amazing post. I honestly think I can self-diganosis myself with OCD, but I’m not quite sure… Here’s my story and it would be great to hear back from you! It started about 4 months ago, for 2 months I had HOCD, I constantly thought myself to death. That has passed only be replaced by TOCD thoughts (which stands for transgender OCD) I’m scared that I’ll be transgender. I had these thoughts before with HOCD about 2 months ago and once I stopped “caring,” and “answering my thoughts,” it kind of went away, but HOCD came back with a punch. Now, great news, my HOCD is gone but TOCD is here with revenge. I’ve been dealing with 24/7 constant intrusive thoughts. The moment I wake up, “What if I was trans?” to the moment I sleep, “What happen if I was trans?” I don’t even know what my real thoughts and what my OCD thoughts are. Question I have for you, I know people have POCD, HOCD, and stuff like that, but is TOCD real too?
It is fairly common for those with a history of HOCD to experience obsessions related to other sexual behaviors they don’t want, such as incest, besiality, pedophilia…and being trans. What you report here is not even remotely unusual.
Hello, thank you so much for all of the support and answers you have provided for all of us! So, I have been going through month long episodes of existential ocd, constantly questioning my very exisistence and that of others. This in turn leads to depression. My question is , have you ever dealt with these issues and if so what therapy seems to be the most affective therapy? I’m currently seeing a phsycologist that has never encountered these thoughts with ocd. Thank you for any hep!
The most effective treatment for Existential OCD is the same as for all other sub-types of OCD – namely Cognitive Behavioral Therapy (CBT) with a strong focus on Exposure and Response Prevention (ERP). Additionally, a mindfulness component is especially helpful for the more Pure O types of OCD such as Existential OCD.
That said, there is nothing unusual about Existential OCD – it is a fairly common subtype of OCD, and a therapist who specializes in treating OCD would be very familiar with this. If your current psychologist has never encountered this variant of OCD, then there is a good chance that he/she knows very little about OCD and its treatment.
Would you have a doctor who has never set a broken bone treat you for a broken arm? Of course not. I encourage to find a therapist who has treated this before.
Thank you for the information Tom. Looks like I will be searching for a more compatible therapist.
I wish you a happy New Year and again a big THANK YOU for helping me cope with OCD. I’ve probably read most of your articles and to a certain extent adopted that way of thinking and even those methods that you’ve introduced in the blog. It has helped me a ton in my battle with the disease but nonetheless I pretty often,like most of your patients,I suppose, come to the conclusion that there’s probably something that I’m doing wrong. I have those periods when OCD kicks in in its full glory and makes a total mess out of me leaving me thinking that I’m completely mad. Right now,I’m in this kind of a period(it’s been almost two months now). I have OCD “episodes” almost all day and the worst part is that they’re morphing. It’s not only harm OCD or existential OCD..it’s everything that you can think of. Common sense tells me that this is more than normal for someone who suffers from the disorder but frankly I keep wondering why I haven’t made any progress yet? Moreover,it discourages me and makes my life seem pointless. Why isn’t there a big breakthrough? I’ve been aware of my state for a year now and I’ve had my good and my bad moments but why do I always end up being on the brink of a nervous breakdown with severe chest pain and a head bursting from inside out? Am I not being patient enough? What can I do? I know that you’ll probably advise me to start seeing a therapist or get myself a proper therapy but that’s just out of the question since my country has little history in treating OCD I guess,or because it might be expensive or time consuming(as it should be) and I just have so much to do. I’d like to help myself because I’m the only therapist I can afford at this stage. I constantly search for a proof that I’m still sane and I can’t help hoping that a just a little bit of progress will provide an answer. Can you provide me with an answer? Thank you in advance.
A few thoughts on your post:
1) It is not unusual for those with OCD to have symptoms of multiple variants of OCD.
2) It is also quite common that these OCD symptoms frequently “morph” from one to another and back again.
3) Expecting “a big breakthrough” is not a reasonable expectation, especially if you are not in treatment. Your awareness that you have these issues is not enough to combat them.
4) Your progress is slow precisely because you are not in structured Cognitive Behavioral Therapy (CBT) for your OCD, which scores of research studies have found to be the most effective treatment for OCD.
5) Searching for proof that you are sane is a hopeless quest. For what it’s worth, I cannot guarantee that I am sane either. But neither you nor I nor anyone else actually needs to know if they are sane. We all just need to accept that our brains come up with strange unwanted thoughts that do not merit any attention whatsoever, and to then get on with the business of living, despite the presence of these thoughts.
II have been reading all the comments and replies and this site has been so beneficial too me, thank you!
Thanks Sue – we’re happy to hear that the articles have helped. Take care.
Reading this article and everyone’s comments has greatly helped. I’m not sure what I have been experiencing all of these years is OCD or hypochondria but my mind is always constantly wondering, worrying, doubting, and mental rituals just to get through the day. I’m so scared of having a disease or virus, and this consumes my everyday. A lot of self checking and mental thoughts. I am sinking fast.. I just keep avoiding seeking help. Do you know of anyone good in Dallas, TX specializing in OCD/Hypochondria ?
Thanks for your comment.
The line between OCD and Hypochondria is at times very grey. It is probably best to view Hypochondria as essentially being a type of OCD in which the person’s obsessions are about their health. In any case, a therapist who specializes in treating OCD with CBT should be able to help you with any health-related obsessions you have. I encourage you to visit the website of the International OCD Foundation at http://www.iocdf.org, as they have an online database of therapists who specialize in treating OCD.
Hello, ive been suffering from an intrusive bad memory for 2 years. I recently read the happiness trap by russ harris and its been helpful. however, im currently confused with how to handle one particular issue and it is causing me some anxiety.
with the intrusive memory, what I do is I allow it to enter my mind without resisting. Ive already accepted what happened so any thoughts that enter my mind are not that painful anymore. and any painful feelings that stem from that, I just accept.
however, there are times when there are no intrusive memories, but then i suddently get anxious as if id forgotten how to cope with the memory. then a thought comes up that i should think or picture the intrusive memory in my mind. thinking about the memory then gives me relief bec i realize i can still handle it properly. im guessing this is mental checking?
my question is, should i treat that as the intrusive bad memory itself somehow sneaking up on me and just allow it to come and go in my head? or should i treat it as a mental checking compulsion to THINK about the bad memory and to not give in to the compulsion?
its really hard not to think about the memory once that starts.
Yes, when you consciously choose to think about the memory in order to check that you are still able to handle it, that is a compulsion.
You also asked:
“…should i treat that as the intrusive bad memory itself somehow sneaking up on me and just allow it to come and go in my head? or should i treat it as a mental checking compulsion to THINK about the bad memory and to not give in to the compulsion?”
The answer is that memories occur spontaneously, and when you force yourself to experience a memory to check it, that is not really a spontaneous memory – it is a compulsion. You should not consciously bring up the memory for any reason. When it naturally appears, let it exist and get on with your day, but do not purposely bring it up for the purpose of checking.
I was diagnosed with obsessional thinking 2.5 years ago,a few months after the birth of my daughter.
It all started with a dream and snowballed from there. I was fine one minute and a depressed anxious mess the next.
i am on board with an ocd specialist but im not getting anywhere.
i tried some exposure on my own which has turned out disastrous leaving me feeling like i wanted to act on my thoughts. Im feeling emense guilt and cant get the experience out of my mind.
I felt like my hands were going to move on there own and the feelings i felt felt like an urge to act on the thoughts. Im a mess.
is this part of ocd. My therapist has been away for 6 weeks and i cant speak to him for another week. I have this horrible feeling i am a terrible person. Its awlful.
I thank you in advance if you reply.
I cannot really assess your situation, as you have not mentioned what the specific thoughts are that are upsetting you. That said, everything that you have written sounds like typical OCD.
It sounds like you have a therapist who specializes in treating OCD, and I encourage you to address these issues (including your attempts at exposure) with him.
Thank you for replying.
There sexual in nature and now its too the point that my mind tells me that i really am a sicko and that i do want to do it even though i really do not. It makes me so depressed.
Can ocd do this? Make you think you do want yo do these terrible things.
My body feels horrible. I just want to love and give my baby girl the world but i cant. I cant take meds so i feel like nothing is going to help me. Its feels to ingrained. I feel like a walking monster. 🙁
Having unwanted thoughts of a sexual nature that you find uncomfortable does not make you a “monster” – it makes you someone with OCD. I reiterate that you should discuss your thoughts and your concerns about them with your therapist, who you noted is an OCD specialist. If therapy continues to provide you with no results, there is a good chance that your therapist is not really a specialist (anyone can say they are an OCD specialist). If at any point you would like to discuss the possibility of treatment at our center, feel free to contact us via the contact page on our website at https://ocdla.com/.
OCDLA — I’ve found your site and book amazingly helpful. Thanks. I do have a question about meditation. I’ve been using it as a way to escape “anxiety attacks” associated with my OCD thoughts. If I get too revved up, I put in some ear phones, do about thirty minutes of meditation (trying to think of nothing but not excluding bad thoughts — just accepting them and letting them pass through). My question is whether or not this meditation is a bad thing? For me, it seems to reset my brain and allow me to get back on an even playing field. I chill out and can see things clearly and calmly. That said — is it something I shouldn’t be doing? It gets me out of my anxiety, but I hope it’s not an avoidance thing that is making the problem/OCD/focus worse in the long run?
Your help and thoughts are appreciated.
As you have discovered, meditation can be very helpful. And it sounds like you are using meditation effectively and reasonably. That said, I want to caution you against becoming too reliant on mediation as a quick fix to, as you put it, “escape anxiety attacks”. The ultimate goal of meditation should be to become more psychologically flexible when facing the numerous vicissitudes of life, including those which bring unwanted anxiety. Research has found that the key component in effectively managing unwanted thoughts in OCD is a type of Cognitive Behavioral Therapy (CBT) known as Exposure and Response Prevention (ERP), which focuses on facing your anxiety head-on rather than trying to escape it.
I was hoping you could assist me with my current situation. I am experiencing anxiety and stress from my “just right” OCD. Recently, someone sent me a text that triggered a negative thought. The only way to counter this thought was to do a compulsion and prompt him to resend me another text with a word that I viewed would counter the original text. However, this did not work out and essentially created a failed compulsion. Now the obsession has shifted from the original obsession to the fact that I failed the compulsion. There will be a few more opportunities to complete the compulsion, but again my mind has set scenarios where it will have to be just right. Please assist if you can.
Thanks for commenting.
The solution to your problem is to stop trying to counter your obsession with compulsions. When you request that your friend re-send an email with a word that you hope will counter your OCD, you are doing a compulsion. As you noted this “did not work out”…and it will never work out in the long-term. Sure, sometimes this sort of action will provide short-term relief, but in the long-term, compulsions will simply prolong and worsen your OCD. Ultimately, all compulsions are “failed compulsions”.
A better solution is to seek treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for OCD.
Thank you so much for this article. It really does a thorough job of explaining this incredibly tricky concept. I was hoping you could shed some light about urges to say intrusive thoughts out loud. For instance, lately I have been dreading going to staff meetings because I am so afraid that I will say something inappropriate or hurtful about one of my coworkers or tell the boss things they have told me in confidence. I know that we are supposed to frame these things in a “so what” fashion where we think about the worst possible thing that could happen in order to desensitize us from that fear. My issue is that I just can’t say “so what” to the repercussion of me losing my job that I really love. Anyway, I am confused as to whether this urge is part of the “O” or the “C”. Are these urges compulsions that I am trying to do in order to make my anxiety go away? Whenever I think about it that way it scares me because people with OCD act on their compulsions so I think that means I am going to do it. When I am having these urges it feels like I am going to die if I do not act on them and it’s so distressing.
Thank you so much for all of your insight.
The fear of saying things that would be hurtful to others is a very common symptom of OCD, and is generally conceptualized as a variant of Harm OCD.
Obsessions in OCD can usually be seen as “what if..” statements, and the core obsession in this type of OCD is “what if I say something horrible and unacceptable”. There is not a significant difference between this “what if…” thought and the thought “what if I say something that was told me in confidence, thus violating that person’s trust”. In both cases, the fear is causing harm by saying something.
Note that I have not mentioned the word “compulsion” in my explanation. That is because these thoughts are obsessions. A compulsion would be any action you take (including an internal mental action) that is done in an effort to reduce the anxiety you experience when you have these unwanted thoughts. You have presented no evidence that you are actually going to say hurtful things, only that you fear saying hurtful things.
And yes, you could live with the repercussions of losing your job. People live with far worse things every day – their children die of cancer, terrorists blow up their parents, planes crash killing their spouses, etc. All of these things are truly horrible, yet people survive their losses and get on with their lives. I am quite confident you would survive saying something harmful and getting fired.
My main issue when I try to accept unwanted feelings and not engage in my retracing compulsion is that my mind then tells me ‘this is not OCD, this is something you should be retracing, because it might mean that you did something bad, and that you in fact are a bad person.” This makes it particularly hard to resist seeking reassurance from someone else to confirm that I am not a bad person.
My question is, how do you deal with the uncertainty that maybe it is not actually an OCD thought but a real concern that you should be turning your mind to, and you avoiding retracing it just further proves that you are a bad person for wanting to avoid feeling guilty/ashamed?
Of course you have these doubts – sowing doubt about one’s thoughts is exactly what OCD does.
The best way to deal with your uncertainty is to accept it, and to accept the discomfort it causes. Certainty is an illusion – it doesn’t really exist, and pursuing it will cause you misery.
As you have seen, seeking reassurance has not provided you anything resembling long-term certainty. A better option is to accept reality as it is, rather than as we would like it to be, and that means accepting the presence of feelings of uncertainty.
Hello, I have been experiencing unwanted sentences or images in my head which bring me much anxiety. I realize i keep reacting to them by repeating the sentence or picturing the images and focusing on them very hard while looking at how I feel. Im not sure why I do this but I think i try to do it until I feel “right”. Is this a compulsion?
Also, I recently feel the need to classify whether my actions are compulsions or not. Answering these questions reduces the anxiety but it comes back again. How do I deal with this?
This certainly sounds like OCD. You are experiencing unwanted, anxiety-provoking thoughts (i.e., obsessions), and you are attempting to alleviate your discomfort with mental behaviors (i.e., compulsions).
As to how you should deal with this, I encourage you to seek help with a therapist who specializes in the treatment of OCD.
This has truly been an incredibly insightful article, in fact everything I have read on this site has been some of the most enlightening information on how to actually deal with pure-O. For so long I have been confused as to how any kind of mindfulness or CBT can help me, because I believed I had no compulsions. But you actually explain how to identify mental compulsions which so few sites do, and it is as though someone has finally flipped on the lights in a dark room. I realize that I really do have compulsions.
But I do have one question. How do you advise dealing with OCD when your obsessions actually end up really happening frequently? For instance, I have had an obsession about seeing animals get hit, and would tell myself if I saw a dove get hit right in front of me it meant the “thing that makes animals get hit” did it because of me. Well…turns out the million to one chance happened, and a dove did get hit in front of me, but only got grazed by the car and flew away. I also had obsessions about other animals and they were hit too. Its really scary, and all started because I had a thought about a rabbit while walking, then saw a rabbit had been hit .
Thank you for your comment. It’s really wonderful to hear that our article has helped you to better understand mental compulsions in Pure O.
Things that we think sometimes do actually happen. For example, if I have a thought about having breakfast, that thought would turn out to be accurate on occasion (every day actually). But just because someone has a thought about something occurring does not mean that the person’s thought caused that thing to occur. Simply put, we are not that powerful – we cannot make bad things happen just by thinking them.
I encourage you to read our article OCD and Thought-Action Fusion to get a better idea of how people with OCD often make the mistake of believing that their thoughts are directly involved in bad things occurring.
Great article. I have suffered from OCD since I were a kid and have been through all of it’s “types”. The most difficult to deal with were the mental compulsions. I remember I once thought that the movie “The Lord of Flies” would give me “bad luck”. I knew this was absurd but felt I had to keep proving to myself that it would not cause me bad luck. I would only feel comfortable after solving this question. Then I would forget some of the answers or think of new “variables” I didn’t consider. This only stoped when I found a new subject. After hearing about a man who beat his son because he damaged his car, I started questioning if I was giving more value to my books (I’m a collector) than to my family, for I wouldn’t forgive myself if this was true, and even stopped reading (better safe than sorry). Needless to say, this didn’t do any help.
Thanks for the article and sorry for the long post, but since I rarely found mention to obsessions similar to mines, I decided to write them, in case someone like me reads this page.
A few thoughts…
“Bad luck” as a controllable condition does not exist (nor does “good luck”). Luck is by definition out of your control. If you (or anyone else) had control of your luck, then it would no longer be luck.
OCD will always look for new “variables”. This is especially true when one learns to effectively manage their response to any specific obsession.
Not collecting or reading books is an avoidant compulsion that will only lead your brain to look for new variables upon which to obsess. And as you learned, avoidance doesn’t work.
I m 26 with a long history of health related OCD that flares up in difficult times of change in my life or basically whenever I am really stressed out.The thing is that I moved on from the HIV and MS phobias to mental illnesses and specifically paranoia at this point in time.Recently my OCD has been so bad that I am actually considering I am becoming paranoid.I am checking in myself and others if a specific behavior could be paranoid in the smallest amount and if it can (which it usually does) then it is like huge red lights screaming “PARANOIA” light up in my mind making me believe that I am on the onset of paranoia and that I will suddenly stop eating food from other people and think that everyone is talking about me etc. This is getting quite out of hand, my “rational” mind is only a whisper at times and this makes me even more scared.Also it is as if every little doubt I have regarding someone’s behavior, if deemed as slightly misunderstanding by any possible person in the world, means that I am completely paranoid.I ve spoken to two psychiatrists and they both told me i’ve got OCD but for some reason my mind keeps spitting out scenarios and “evidence” that I m paranoid. HELP!
The fear of having a severe mental illness is a common obsession in OCD. Checking yourself and others for signs of paranoia is a compulsion that is only making this obsession worse for you. Likewise, avoiding food given to you by others sounds like a typical avoidant compulsion. I encourage you to seek treatment with a therapist who specializes in the treatment of OCD using Cognitive Behavioral Therapy (CBT).
I’ve had sensorimotor ocd and i really got better with ERP. But now i’m obsessing about my OCD. I keep wandering if what I think is a rumination or just my regular thoughts and if things i like to do are compulsions. I’m supposed to avoid compulsions and ruminations but I cannot tell which is which. I feel like I’m trapped.
It can be very difficult for people with OCD to determine which thoughts are obsessions, and which are “regular thoughts”. And even the act of trying to figure out the difference can become a compulsion in itself. I encourage you to consult with a therapist who specializes in treating OCD, as they will be able to help you more effectively address this conundrum.
I’m at the age of 30 I’m a male and it has been a real struggle for me with my battle with OCD Checking. I am constantly checking to make sure that I have locked the front door in the house as well as all the light switches before I leave the house even though I know they are switched off. Its been a constant battle and I really cant live like this. It is also effecting me at work as well and I really need to get some help with this. Does anyone know if CBT really works? Thank you so much.
The symptoms you describe are extremely common symptoms of OCD, and are very treatable. There are literally scores of studies that have repeatedly and consistently found that CBT with an emphasis on a specific technique called Exposure and Response Prevention (ERP) is the most effective treatment for OCD.
I am wondering if mental checking can become a problem even after having had some success with ERP? I have ROCD and felt like I had some initial success with ERP and was feeling better because of it, but then experienced what felt like regression, things like experiencing anxiety ‘spikes’ around my wife again. The psychologist I work with has not really given me a satisfactory explanation of what is going on, but this article made me think that some of my behaviors were subtle ways of mental checking, e.g., when I think an obsessive thought is emerging, I tell myself to ‘do nothing’ so I won’t fall into compulsions, but I think I may be sort of monitoring myself and my anxiety level to gauge the effectiveness of this strategy. Can something like this interfere with successful ERP?
There is no expiration date on OCD. Just because you have had some success during your treatment does not mean that you will never again experience symptoms. The “regression” you describe is quite common. In fact, for most people, symptoms wax and wane over time. Furthermore, the “monitoring of your anxiety is a mental compulsion that will only make things worse. Anxiety doesn’t need to be monitored or evaluated – it needs to be experienced as a part of normal life.
I’m a 15 year old girl who has been recently diagnosed with the health anxiety type of pure o, and i’ve gotten help for it. It’s pretty much gone now. However, what my therapist doesn’t know is that I also have two other obsessions. One is the fear of getting schizophrenia (I guess that’s still my health anxiety lingering around) and these really strange existential thoughts. The existential thoughts stemmed from the schizo fears because I thought “If schizophrenic people have hallucinations, how can I tell whether or not everyone around me is actually a figment of my imagination?” I haven’t been able to let go of this one thought for 6 months, but I’m too scared to tell my therapist because she might think I’m crazy. I think I’ve gone insane because I just can’t stop thinking about it. Even when I stop thinking about it, I notice that I stopped thinking about it and think about it even more. When I go onto forums, everyone just talks about HOCD or POCD, so I feel alone. No one else has really had this obsession. Please help? I just want to go back to normal.
You are correct – obsessions about Schizophrenia are really no different that fears about any other health issue. Think of your Schizophrenia fears as a manifestation of Health Anxiety, with the focus being specifically on mental health. BTW, some people also refer to these specific fears as “Schiz OCD”.
That said, it sounds like your Existential OCD obsessions are also a function of your Health Anxiety, as evidenced by your report that these obsessions directly stem from your fears of Schizophrenia.
The bottom line is that neither I nor anyone else can provide you with proof that your life experience is not merely a figment of someone else’s imagination. Likewise, I have no way of being certain that my own life is not merely a figment of your imagination. There is no way to get certainty on this matter, and you do not need certainty.
Instead, what you need to do is to accept that your brain can think up anything it wants, including the idea that you don’t even exist and that you are just a figment of someone else’s imagination. Accept your brain’s creativity without assuming that it means anything important. And stop going on OCD discussion boards, as doing so is clearly a compulsion for you ( and many others unfortunately).
I just realized that I am doing lot of mental checking to handle obsessions that may arise in future. For an year almost, I am not able to figure out meaning of obsessions. For example, my obsessions are “Will I get it ?”, “I may get them”, “If you see, you will get it”, “If I go there, I will get them”. I am spending almost an year to figure out what “it, they, them” means in these thoughts but not able to figure out. All these thoughts are accompanied by anxiety spikes. Please suggest me what kind of OCD is this, do these obsessions (it, they, them) have any meaning ?
Human brains generate a lot of thoughts, many of which are completely unimportant. I see no reason why you should try to figure out what these thoughts mean. And if you have been unable to figure them out after a year of trying, I doubt I would be able to figure them out after reading a one paragraph blog comment. My suggestion is that you stop analyzing your thoughts, and allow them to exist without trying to figure out what they mean.
For the longest time I didn’t realize that I had some deep mental compulsions. I thought it was just pure O. Now that I know, I am trying to not do the mental checking no matter how hard it is! Mornings are hardest.. Because I want to see if my obsession is still there! It’s a work in progress!!!
It is not an “either/or” situation – mental compulsions are a symptom of Pure O. In fact, mental compulsions are the single most defining characteristic of Pure O. I encourage you to read the section of our website about Pure O at https://ocdla.com/obsessionalocd/.
Thanks for all of the great advice on this site!
I think I have some form of ‘pure O.’
My main problem now is that, in addition to ‘standard’ harm thoughts, is that I am a pretty excessive daydreamer and generally my fantasies involve people I know and care about… They are generally everyday situations, but sometimes the fantasties include episodes I feel are inappropriate (not sexual, or even romantic…just weird or making me question my values). I used to feel that my mind was my own private space and anything that happened in there didn’t really matter (i was only distressed by POCD because I thought it meant I was ‘like’ that), but because these thoughts seem self-generated, even if I reject them immediately, I feel guilty and it bothers me that my mind may not stand up to account by my nearest and dearest, especially those I have ‘sinned’ against in my thoughts….I’m really struggling to work out whether some thoughts are self-generated or unwanted or some sort of hybrid!
Something I can manage it and sometimes I feel very guilty and that I should limit my involvement with the concerned people, which I don’t want to do, because we have great relationships…
Yes, your mind is your own private space. But that has nothing to do with OCD. Your private space, just like everybody else’s private space, has some unexpected thoughts that you would prefer not exist. But limiting your time with others and trying to ascertain whether your thoughts are “self-generated” are not only pointless, but counter-productive. In short, avoidance and analysis are compulsions that will make your OCD worse, not better.
Your mind does not need “stand up to account” by others. They have no vote on what your brain comes up with. Besides, I assure you they all have some unwanted thoughts of their own.
I have been diagnosed with OCD and I feel like I am stuck in my mind CONSTANTLY regardless of how I am feeling. Analyzing every thought, feeling and action of myself and others. Is this part of OCD as well? It’s hard to make decisions. It’s like no matter what I’m doing, I’m constantly aware of my thinking and feelings. It’s driving me insane!! What can be done about this? Thanks for any help or insight you can give me!
Analyzing one’s thoughts, feelings, etc. is a very common compulsion for many people with OCD. I encourage you to seek treatment with a therapist who specializes in Cognitive Behavioral Therapy (CBT) for OCD.
Very very useful article. What I gather from it is that doing mental checking like “is obsession still there?” is a compulsion which needs to be resisted, correct? In my situation when I obsess and feel anxious than I start to ruminate and would relate places or someone I see on the road with obsession I am having. For example as I obsess and fear drugs I would sometimes mentally relate someone who is behaving weirdly on the road with drugs. Seeing this person quickly triggers the obsession in my mind. Is this some form of mental checking?? Is this a way to reduce anxiety/uncertainty and hence a compulsion?? Please let me know.
Yes, this sounds like mental checking. Your goal is to allow whatever unwanted thoughts about drugs pop into your mind to exist, without trying to resist them or figure them out. Ultimately, it doesn’t matter if an unwanted thought is “still there”.
Lately I’ve been struggling, once again, the thought that I have killed someone at a place where I’ve been. I do a lot of mental checking such as going though the chronology of events to ensure that I did not do anything.
My question is: are these thoughts common in the realm of OCD and how can I practise acceptance of the thoughts. It seems so incredibly tough. Currently I am trying to peacefully co-exist with the thlights, but of course it’s much easier said than done. I am about to begin a new round of therapy with my therapist who is trained in CBT and ERP.
Any advice and support from you would be greatly appreciated!
A few thoughts…
1) Yes, a fear of having killed someone is a common fear in Harm OCD.
2) One doesn’t really practice acceptance – one either accepts or does not accept. It is a shift in consciousness more than an exercise. Your job is to accept the presence of unwanted thoughts without responding to them with compulsive analysis or behaviors (that’s the part that takes practice).
3) My advice is to commit to your treatment with your therapist.
I feel as though I have an unusual type of OCD. It may fall under the sensorimotor OCD, but it is to do with hyper awareness of my mind. It is as though I go into my mind, and can’t get out of it. For example, I will be having a conversation with someone, but simultaneously aware that I am “in my head” and not just running on regular, auto-pilot. It is very distressing. When I eventually get out of my head, I will suddenly realize I am functioning “normally” and then suddenly get back into my head again. It’s as though I have a hyper awareness of myself and I can’t let it go. So now, I repeatedly become aware of my own mind; it’s an awareness rather than thoughts with content which is what makes me think it may fall somewhere in the sensorimotor category. That and the fact that the central fear is that I cannot stop focusing on something which is essentially just a normal process, and which most people are completely unaware of.
How would you characterize this type of OCD and what kind of therapy would help? I recently bought your book “The Mindfulness Workbook for OCD” but I can’t find the category I fall under (hyper awareness is closest).
Don’t get too caught up in knowing the “right” category or term for your OCD – it’s all OCD, and these words are just slang terms that help identify specific subsets of symptoms.
That said, everything you write sounds like Hyperawareness OCD, which is really just another term for Sensorimotor OCD. Think of it this way – you are are over-attending to a mental process (thinking), while most people conceptualize sensorimotor OCD as over-attending to physical processes (blinking, swallowing, etc.). There is no significant difference – in both cases, the sufferer is over-attending to processes that do not merit such a degree of attention.
Hi! I woke up and did immediatly scan for sensations and trying to think about and “solve” my one problem that I’ve been obsessed about the last six months. I’ve just started ERP and I heven’t yet come to understand how to manage my thoughts, well, the response prevention bit. I’m not diagnosed with Pure O but with BDD but I can relate much more to the problems that are described with Pure OCD. The thing is that I made a cosmetical treatment and after having read about damage it can do (on web forums, this is not admitted by the medical community) I could see and feel changes in my own face. Friends and family don’t agree with me and the confusion and fear have lead me into a spiral of obsessions. What arises most anxiety is not what I feel I look like now (though I don’t like it and feel angry about the “harm made”) but the unceartainty, I feel obsessed with solving this problem.I have lots of doubt, is this not a natural reaction after being harmed? Shouldn’t I be allowed to try to prove my experience right? Or is this some bizarre (EXTREMLY real) mixture of BDD and Pure O?
BDD is very much like OCD, and is in fact considered an Obsessive Compulsive Spectrum Disorder. In BDD, the “obsession” is about an alleged flaw in one’s appearance. I encourage you to read our page on BDD.
Is it possible for these thoughts to sometimes engender feelings? Because I’m sure I remember having HOCD and POCD at a certain point in time and I didn’t just have thoughts but also feelings of this being true as well. Currently struggling with trans OCD or TOCD which is also fairly common, and I feel as though it “feels” right a lot of the time, as before with HOCD at times it felt like I was gay and when I would ask myself or imagine myself having gay sex etc. it would sort of feel right. The same with the TOCD, if I imagine it sometimes it feels right if I imagine myself being a woman etc. and I even sometimes like the idea. I remember the same thing when I had HOCD many years back. Does this sound normal or is it possible not OCD but legitimate feelings?
A few thoughts…
1) Trying to parse the difference between “thoughts” and “feelings” is a compulsion that will make OCD worse.
2) Ditto for analyzing whether a thought or feeling “feels right”.
3) There is no significant difference between Trans OCD and HOCD -they’re both just different flavors of the same obsession (“What if my sexuality is different than I want it to be”).
4) Everything you write sounds like OCD.
Thanks for the article. I feel like my OCD has morphed into something odd. Every few seconds I “check in” to see if I’m still anxious, or I check in to see I’m still checking in. There isn’t a thought that goes along with this, it’s like I obsessively have to check in with my mind. But I don’t know what I’m looking for! It’s very distressing cause it isn’t a thought, it’s like a mental check in with my mind. I acknowledge that I’m doing and try not to be bothered by it, but it happens every 5 seconds.
I’m so distressed. Is this a mental compulsion? Am I reaponding correctly?
Yes, this is a mental compulsion. The best response is to note the desire to check for anxiety, and to then choose not to check. Anxiety doesn’t deserve so much of your attention. If you are anxious, so be it.
My 13 year old daughter suffered from OCD when she was 9 (bad thoughts that she would try to wash away). By the time she was 11 it was mostly gone but it has now returned in a much more severe manner, appearing much like Pure O. She initially had clear, complete thoughts being fired at her which scared her but now she says her brain is just a constant rumble of random words and she’s having trouble keeping her thoughts straight. She is starting to have trouble functioning and is showing signs of depression (she’s a straight A student with a good group of friends, involved in outside activities). She is currently seeing a therapist who is using ACT. She has only been to 4 session but I’m wondering if she needs to be in a more intensive program since she seems to be slipping fast despite treatment? Hard to watch as a parent as I feel helpless and am scared that I’m losing her to this illness. I also don’t know how to handle the “mental checks” because she doesn’t even understand what’s going on.
ACT is a type of Cognitive Behavioral Therapy (CBT) that can be very helpful for those with OCD. It is what is sometime a “third wave” variant of CBT, or a “Mindfulness Based CBT” approach.
That said, I believe ACT should be employed to augment Exposure and Response Prevention (ERP), not instead of ERP. If the therapist treating your daughter is using ACT exclusively, I encourage you to ask why they are not using ERP, which virtually every OCD expert on the planet would tell you is the evidence-based treatment of choice for OCD. And if you believe your daughter needs a more intense approach to treatment, then by all means do research on intensive treatment for OCD.
As someone who has suffered from OCD for 10 years I found this article extremely helpful, and found myself nodding in agreement at almost every sentence. At 23 I believe I have developed a good understanding of OCD having been to about half a dozen therapists in my life, but I still struggle. Even now I have somehow found myself in another extremely difficult cycle of obessional thoughts, obessively worrying over whether I did something or not that has almost pushed me too far. However I believe things will get better and I believe this article will be a big help. Thank you 🙂
Thank you for your comment. It’s great to hear that you found our article to be helpful. Take care.
This all started 3 months ago when I was studying for my exams(anxious mind), I was reading an article about suicide and got entangled in this suicide thought which came out of nowhere. I got so caught up with it I couldn’t let it go. I mean life was happening quite nicely, where did this thought come from?
After being anxious all the time and having few anxiety attacks after a week I started to research and found out about Pure O. I haven’t told anyone about this yet. 1st month was very hard then I started practicing mindfulness meditation before going to bed which helps me go to sleep. Now after 3 months I’m obsessing quite less than before and starting to recognize it was just a thought (that’s what you’re supposed to do right?) but the problem is reality seems to be weird now. Everything that I used to before seems quite weird and unusual. After getting this derealized feeling my anxiety rises up again and makes this checking and obsession come back again. This derealized feeling is killing me. Am I not on the right direction?
A few thougts…
1) Yes, it is a good strategy to recognize that thoughts are just thoughts, and to not take thoughts so seriously.
2) Feelings of derealization should be treated the same. Don’t give them power by over-valuing them as “important”. They are just feelings. It really doesn’t matter if your experience of reality is different than it used to be.
3) If you find it difficult to move to a place of acceptance of whatever thoughts and feelings you are experiencing, I encourage you to seek treatment with a therapist who specializes in treating OCD.
I found this article last night , and while I was reading it, I too talking out loud and laughing/agreeing with it because of how spot on it was. I first want to say thank you so much for contributing your time and expertise to this subject. Because of people like you, people like me ( and everyone on this thread), find hope and inspiration knowing that recovery is possible, and that this condition can be managed. So I thank you. So as I said I read this article last night ( and lately my OCD has been getting so bad I just feel like the walls are closing in around me ). Last night gave me the insight that I do not HAVE to check, and that it is a CHOICE. I check 100’s of times during the day and I have felt like it is automatic…But last night I dug deep and really thought about it and realized I don’t HAVE to do it.I may not have a choice about the content coming into my head, but I can choose NOT to check My question is; what is the best way to differentiate between Checking and Obsessions? As I feel like they appear as extremely similar sometimes..
You are exactly right when you say “I may not have a choice about the content coming into my head, but I can choose NOT to check”. And understanding this difference is the key to understanding the difference between obsessions and checking.
An obsession is something that pops into your mind with no effort on your part at all. On the other hand, checking is, as you noted, a “choice”. It is a behavior, albeit a mental behavior in your case.
In other words, any analysis of an obsessive thought is a checking compulsion. Just let the unwanted thought exist as if it were not important…because it really is not important – it’s just a thought.
Hello. First off I would like to thank you for quite literally saving my life. Four years back I was contemplating suicide, but your article transformed the way I deal with my problem. But now I find myself spiralling back and whoever wrote this piece seems to be about the only person on the planet who maybe understands what Im going through. It started when during one of my first sexual experiences I lost my erection. This evolved into a life-swallowing obsession with my ability to get and maintain an erection. What makes my problem unique and seemingly unsolvable is that my fears and obsessions do in fact cause me to have difficulty maintaining an erection. Whenever I do (whether with someone or alone) I cannot stop myself from focusing on it and obsessing over how it could go away any minute, which of course distracts my mind from the experience and in many cases causes me to lose my erection, practically realizing my fear and in turn leading me to spend my days and nights engaging in mental checking. Any suggestions on how to get out of this hell? You saved me once, maybe you can do so again.
You are spending WAY TOO MUCH TIME thinking about your penis. Erections are kind of like sleep in that the more time you spend worrying about them, the more likely you are to interfere with what is normally an automatic process.
Based on what you write, there is nothing physiologically wrong with your penis. The only issue appears to be your over-focusing on it, and over-valuing its erections. If you accept your penis as it is without assigning so much value to it and to erections, you will likely discover that it works just fine. It is your over-attention and over-valuing that is causing the problem.
And btw, if you doubt that you are over-valuing erections, just look at how you describe your issue as being “life-swallowing”, as if you erections are the most important thing in the world.
Love your article! Very helpful! I have Pure O and have two questions:
1.) Can OCD cause you to yell out the words you are most afraid of in anger? I have become so afraid of my thoughts and angry with them that I just yell out the very words that I was afraid of saying in the first place.
2.) Is it normal to be so afraid of a thought that you pretend to do or say the things you are most afraid of in order to search for a feeling that you would never really do what you fear?2
Yes and yes. People with OCD often test themselves by saying or doing certain things in an effort to see how it makes them feel. This is a compulsion that will only make your OCD worse.
Great article! I have Pure O and have hit the backdoor spike. However the Mental Checking is still there every 5 seconds- I have it bad, which I don’t understand why I even do since I have very little to zero anxiety. For CBT, my therapist said to allow the checking happen as much as it wants and eventually it will go away. Is that good advice or should I be always trying to resit checking- even though it seems so automatic- I can’t even tell the diference between the obsession and the mental checking.
Any help would be great! Thanks!
A few thoughts…
1) You say you have “little to no anxiety”, yet you are reading blog articles about OCD and writing a comment on this blog about OCD. That suggests that you are anxious about these thoughts. If you were not anxious about them, you wouldn’t be reading this blog or writing in for advice about how to better manage your OCD.
2) Your current therapist likely knows nothing about OCD. The very idea that he would say that you should allow yourself to do compulsive checking behaviors suggests he is clueless. If doing compulsive checks eventually led to OCD going away, nobody would have OCD. The exact OPPOSITE is true – compulsive checking worsens OCD! The goal is to accept and allow for the obsessions (i.e., the thoughts, feelings, etc.), not the compulsions (the behaviors, including mental behaviors such as mental checking).
3) You say you want my help so here is my suggestion – find a new therapist.
Thanks so much for your responses. My checking is almost second by second- what would be a suggestion for stopping the checking so often since it feels so automatic?
My best suggestion is that you discuss these issues with your treatment provider.
Thanks Tom for your replies. Another question that came up that I wanted to ask is that when dealing with the checking, is it always the same obsession or does checking create new obsessions. For example if someone is suffering religious OCD and they have been checking for a long time, and they start trying to stop checking, can a whole host of new blasphemies spring up left and right.
Such like instead of a particular phrase or dead obsession, it is checking with new words and phrases that spring to mind.
OCD is like ice cream. Chocolate, vanilla and strawberry are all different flavors, but they are all ice cream, and the process of making each is the same. Likewise, all of these thoughts about different words and phrases may seem different, but they are all OCD. There is nothing special about the new words or phrases – they are just different flavors of the same thing.
I seem to be dealing with a weird and distressing obsession. Whenever I do something that I enjoy or has meaning to it I get thoughts which get rid of its meaning. For example if I’m being intimate with my partner I think ‘we’re just 2 animals spending time together it’s all scientific and our love doesn’t matter’ or if I am doing art I think ‘I’m just putting chemicals on a piece of paper it’s silly and has no meaning’ it’s really distressing because it takes the meaning out of actions that I used to Be so passionate about and leaves me feeling crap. How do I deal with thoughts like this because in a way, I guess they are true and that’s what really gets me.
Humans can obsess about ANYTHING. Furthermore, ANYTHING can be viewed through more than one lens. For example, following your lead, I could look at my phone and think “It’s not a means of communication – it’s just a box with a bunch of circuits and solder and plastic”. Or I could think about the smell of coffee and think “That so called ‘smell’ is just my brain interpreting molecules in the atmosphere and attaching a label to them”. The best thing to do is to accept that your brain is creating these useless re-interpretations, and that they are not important.
As for “meaning”, the best quote I know of is this:
“Meaning is not discovered. It is not something lying around on life’s road waiting to be tripped over. One makes meaning.” In other words, there is no objective “meaning” to anything, and the only meaning that matters is the one we each create regarding the people and things in our lives.
Thank you so much for everything you do through this website. I have Pure O and see a therapist that doesn’t specialize in OCD but helps me a little. Her strategy is “see thoughts as thoughts and not engage with them, just let them be”. She doesn’t assign exposure exercises, just tells me to desist from compulsive thinking when the thoughts do pop up.
My Pure O is mostly along existentialist and religious lines. I have been trying to do deliberate exposure to thoughts on purpose to help myself, but I’m not sure that I’m doing them right.
1. Should I set specific times to think about the obsession (expose myself) in order to resist the compulsion? I have been randomly saying throughout the day: “ok, I’m now allowing the thought to come to my head but then I won’t engage in it”. After reading what you wrote, I began to think this is actually “mental checking” and perhaps “digging the obsession”, instead of exposure b/c it’s unplanned.
2. My anxiety goes down, not up, when I resist the compulsion. This makes me feel I’m not doing it “real/scary enough” and that I won’t get long term results.
3. How about doing just what my therapist says (just resisting the compulsion when O pops up spontaneously w/o deliberate…
Your therapist is half-way there. Yes, you should view OCD thoughts as being just thoughts, and you should not engage with them. However, scores of research studies have consistently found that Exposure and Response Prevention (ERP) is the key component to successful treatment for OCD. So I encourage you to continue viewing OCD thoughts as just being unimportant thoughts that do not require or deserve your engagement, AND I encourage you to do ERP. Along those lines, here are the answers to your questions
1) Yes, set specific times. Do as much exposure as possible every day. And don’t forget the “response prevention” part. That means not saying”…I won’t engage” in the thoughts. Just purposely place the unwanted thought into your moind, while making no effort to soften the blow. For example, you could do something which your OCD tells you not to do for fear the action will result in you going to hell. Then say to yourself “something along the lines of “I am going to go to hell because of what i just did”, but don’t then say “But I’m not going to engage with that thought”, Just do the action, have the thought, and let it sit there unopposed.
2) Maybe you are not experiencing anxiety because the exposure is not “real/scary enough”. Or maybe the exposure is working, and your anxiety is decreasing as a result. There is no way for me to know based on the little information I have. The bottom line is this: make your exposures as uncomfortable as possible. If a particular exposure becomes less scary over time, that is probably due to the ERP. Then double down by making the exposure scarier.
3) No, as noted above, your therapist is only half-way there. In other words, she is wrong. Do ERP.
Thank you very much, Tom.
Thank you for all the help on this site.
Two quick questions:
1. I started doing ERP for Pure O on my own. I write my scary thoughts/scenarios on my phone and read them throughout the day without doing mental compulsions. My qn is: when the anxiety arises, do I sit mindfully with those feelings until they come down like some therapists say or once the anxiety is induced, I move on to what I would like to do despite the anxiety?
2. The point of ERP is not to seek certainty and allow for the uncertainty to remain for things that the brain is scared of. So when the qn pops in my head, “will erp help, am I going to get better?”, I’ve been saying: “don’t know, who knows”. My question is, does it mean I cannot have a positive outlook at all? Such as trusting myself that I can get over this and I have the strength? I feel like I’m afraid to empower myself with a positive attitude just to leave room for uncertainty.
Regarding question #1, I encourage you to do both. Sit with the anxiety, but don’t sit there all day! The ultimate goal is to live your life as if the unwanted OCD thoughts and feelings were not a factor, and that means getting on with your life. So sit with the feelings, mindfully acknowledging their existence, without capitulating to them by doing compulsive behaviors, and then get on with your day.
As for question #2, you don’t need a positive attitude. I would argue that questioning your mindset about your “attitude” is a waste of time. Live your life as you want to live it, regardless of whatever pops into your mind. Actions matter – thoughts do not.
I wake up every morning, mentally checking for my ‘stuck song syndrome’, and if there isn’t a song already in my head, I put one there. If the song goes during the day because I am distracted I will at some point mentally check for it, and if a song is not there, I will often put one there – just to torture myself. I do have pure ”o” OCD, and in the past if the pure o was images and not songs, my mind was CONSTANTLY checking to see if the thought was there ready to scare me. If I can get past the hideous mental checking (which feels like an obsession of it’s own but is a HUGE compulsion) I think that the songs will back away. Do you agree.
Thank you kindly,
It doesn’t really matter if the focus of your obsessionally is a song or an image or…anything. It’s all OCD. And purposely checking for a song in your head, and/or purposely putting a song in your head, are compulsions that will make your OCD worse, not better.
The good news is that you appear to recognize this, and to see that the mental checking is a compulsion that is making things worse for you. And while I agree that doing this compulsion is making your obsessions worse, I want to caution against assuming that there is a guarantee that the songs will “back away” if you stop doing compulsions. I think you should stop the compulsions while at the same time accepting the possibility that unwanted songs may continue to appear in your mind. Your best response is to accept the possibility of the unwanted songs being present, without doing any compulsions in an effort to deal with them. When you accept the songs, their presence will be unimportant.
I am so glad this thread is still actively – thank you for all your help!
I have a question I hope you will answer.
I have scrupulosity and my intrusive thought is that I am not “allowed” to think the thought: “I promise God to take the bus today” (this is an ongoing theme; making promises to God).
I have had these intrusive thoughts a long time and I am starting to learn that they are just thoughts.
I’m used to getting these pop-up thoughts but yesterday I suddenly felt like I wanted to think the thought on purpose eventhough it’s the one thought in the world I DON’T want to think of and I thought of it like five times but each time I ended the sentence with the thought “no” to like show my brain I didn’t mean it.
Now I feel like I have made a promise to God that was on purpose because I thought it on purpose and it didn’t just pop-up as I believe intrusive thoughts do so I don’t believe I can label this as intrusive when I thought of it myself?
Can you help me understand why I thought it on purpose and/or is it an intrusive thought?
Thank you so so much!!
You did not think this thought on purpose. Everybody has what you describe as “pop-up thoughts”. In fact, I would argue that the great majority of thoughts that humans have are pop-up thoughts, i.e., thoughts which just appear unbidden in our consciousness.
Trying to control what pop into your mind is a recipe for misery. Ditto for analyzing your thoughts in an attempt to understand why they are present in your mind. No matter the content, allow your thoughts to exist without analysis, for they really are just thoughts.
I think my main problem is “obsessing about obsessing”. I don’t have any specific fears or scary thoughts (I.e religion, harm, sexuality, etc.) but I fear getting caught in a thought loop and the resulting sense of panic. For instance, i will be going about my day and all of the sudden i have a thought about getting caught in a thought loop. From that point, i just keep trying to refocus my attention and not engage with the thought, but i usually end up worrying and having rapid thoughts. With that in mind, I have 2 questions.
1) do you have any ideas on how I could successfully do ERP session? I’m having trouble figuring out how to do it since there is not a specific thought I can hold onto to intentionally elicit the feared response.
2) Many times throughout the day, it like my mind is reminding me of anxiety or urging me to think about it, although I haven’t quite formulated an actual thought yet. Is this a compulsion that should be resisted and treated as a reminder to refocus my attention?
Thanks so much, Tom!
1) Actually, you do have a specific thought to hold onto. That thought is: “OMG, what if I get stuck in a thought loop”. That said, you should be doing ERP with a therapist who specializes in treating OCD. Unless you have specific training and experience with ERP, attempting this on your own is not likely to produce results.
2) I reiterate, you HAVE formulated the fearful thought, which is noted in #1 above. Also, when your mind presents you with anxiety-provoking thoughts, that is an obsession, not a compulsion. The compulsion is your effort to resist the anxiety by refocusing your attention.
Please don’t view the following sentence as rudeness on my part. The fact that you cannot discern the difference between an obsession and a compulsion reinforces what I stated above that you should not be attempting ERP on your own. I encourage you to seek treatment with a professional therapist who specializes in treating OCD.
I am 53 and have been dealing with OCD since a teenager. I have been successful in being able to keep it at bay by accepting whatever thought I had, just complete acceptance and they would eventually fade. About once or twice a year I would get a more severe bout that would last a week or two but I would manage it. Lately, due to severe stress, for the last year or so I have not been able to shake my OCD. I have always dealt with harm OCD mostly but a had a few different themes. However, now it seems my brain has created an OCD where I worry about my emotions. I check them and worry what if I lose my sense of humor, what if I lose the ability to be happy? Immediately when I start feeling happy now I analyze it. I ask myself – what is happiness anyway? Normally, I could be in the moment now I am hyper aware of myself and the moment I start feeling happy I get a sinking feeling because I’ve conditioned myself. My quandary is ERP for harm OCD is straightforward and helps, but would ERP work the same way for fear of losing the ability to be happy? It seems to me, like with a fear of insomnia, which I also get, it’s not as straight forward.
Obsessing about things such as happiness, insomnia, and one’s sense of humor is no different than obsessing about possibly causing harm to someone. Ditto for compulsively over-analyzing and over-reacting to these types of unwanted thoughts.
Likewise, ERP would be pretty much the same. I encourage you to seek treatment with a therapist who specializes in treating OCD with ERP.
Hi I have a quick question.. When I am at work or with people the obsessing reduces which is great. On my own I get stuck in the twisty ocd traps.
I have a question regarding mental reviewing and ocd scripting. I have been scripting my worse fears and reading them. I am concerned this is actually a compulsion ie thinking the thought on purpose to lose fear of it, I am trying to bring the anxiety on. I have stopped obvious compulsions but I definitely check in with my obsessive thoughts to see if they still bother me.. I then try to bring the anxiety on when this occurs without neutralising ie. Yes you really are a monster etc etc is this a good idea, it’s bringing more anxiety on which I thought was a good things but I am concerned it is coming under the umbrella of mental reviewing.. Ocd is a tricky beast but I am not giving up. How do you tackle erp with this..
It sounds like you are doing imaginal exposure scripts, and doing so on your own, rather than under the guidance and supervision of a therapist. To be blunt, that is a mistake, and I strongly encourage you to find a therapist who specializes in treating OCD. Simply put, you do not have the training to properly implement treatment for your OCD. I also encourage you to read our article about imaginal exposure at https://ocdla.com/imaginal-exposure-ocd-anxiety-4847.
Lately I’m obsessed with the idea of doing mental reviews of my past to find evidence on if I really am a monster or a bad person. I think so hard on certain memories that I feel like I find what I am looking for (even though I don’t want to find anything) then the thoughts of this memory is very distorted… I can’t see the full memory, just small details.. I can’t tell if it is an actual memory or if it is something my head is making up? False memories? Is it something I’ve read about, seen on tv, news article.. I can’t be sure.. but it feels so real and my head tells me “ I’m onto something, keep thinking, keep digging” I want to stop doing these mental reviews of my past (I am going far back as kindergarten- I am 30 yrs old now)
I haven’t “found” anything.. but my ocd tells me it’s real and I’m close to finding something, It’s extremely distressing.
My ? is now that I found “something” that feels real and feels like I need to put the puzzle pieces together.. but most of the details are missing.. how do I accept this unwanted thought of “there might be something there” and not feel the need to check. It makes be feel like I can’t carry on w my day until I figure…
Analyzing your thoughts and memories in an effort to find some alleged hidden past event that will provide evidence that you are a bad person sounds like a classic compulsion to me. I encourage you to stop this behavior (yes, mental review is a behavior) immediately.
You do not need to “put the puzzle pieces together”. On the contrary, you would be far better off if you stopped reviewing your thoughts and memories, and stopped trying to figure out if you are secretly a bad person. If you are unable to do this alone, I encourage you to seek treatment with a therapist who specializes in treating OCD.
I suffer from intrusive thoughts in regards to having an inappropriate relationship (having an affair, beginning an inappropriate relationship with someone under age, etc). I am happily married with three wonderful kids and I can’t imagine the shame and hurt I would bring to my family and friends if I acted on something like this.
Regarding ERP, my issue is that if I find someone attractive my mind automatically goes to some scary places and I get to a point where that person is all I think about. The best thing for me to do is to avoid them and after time the thoughts will go away but that is not always possible – wife’s sister, daughter’s friend, family friend, etc. As soon as the thoughts dissipate, once I see that person again the thoughts return.
With ERP I find that this just makes the thoughts and feelings worse. Every time I see certain individuals the thoughts and feelings grasp a hold of me and fill me with anxiety – I question myself – how could I feel this way about this person? Would I really act on the obsession? I find myself struggling with the guilt of these thoughts and feelings.
Any suggestions? Perhaps I haven’t given ERP a fair shot…
It sounds to me like you are doing ERP by yourself, which is a terrible idea. Unless you happen to be therapist trained in ERP, you have absolutely no idea what you are doing. So my first and only advice is to find a therapist who is actually trained and experienced in conducting ERP.
I have this recurrent thought of why does it matter. When I see or hear something good the thought comes. I’ve also started checking for that thought to see if it’s still there, which then brings on the thought of course. But the thing is the checking itself gives me anxiety….like omg I’m doing it again. I’m gonna be stuck checking for this forever. Same with random songs and melodies. So then should I be checking in order to get rid of my fear of the checking? Thank you.
No, you should not check for certain thoughts in an effort to challenge your fear of checking. Instead, you should accept that your brain produces all sorts of unimportant thoughts, including the thought “why does it matter” (or any variant of that thought, such as “nothing matters”), and you should make no effort to control or eliminate that thought. It is just a thought, and checking for it accomplishes nothing other than to worsen your OCD.
Hearing these questions and your feedback brings so much relief. You are amazing and are helping so many people.
I think I’m taking the right steps in my struggle to manage my OCD but I still find myself avoiding certain situations that spike my anxiety and thoughts. When I challenge myself to not avoid these situations and I actually confront my worries I find that it’s extremely uncomfortable and I ruminate over these thoughts for hours following the incident. I get this pit in my stomach and think to myself, “How can I possibly be thinking these thoughts?” and “Why do I feel this way?” I reason that if I avoid I’m safe and if I don’t avoid any number of things can happen (I can act impulsively, I can develop stronger feelings, etc)
Is the idea to simply sit with this anxiety and not analyze it? Simply let the thoughts and feelings be there as uncomfortable as it may be with the idea that over time it gets easier and easier?
When that rush of emotion comes when NOT avoiding, what’s the best way to handle this?
Thanks again as always. We all appreciate you and the work your staff does.
You ask “Is the idea to simply sit with this anxiety and not analyze it?”, to which I say YES!!!
As you have seen, attempting to avoid these unwanted, anxiety-producing thoughts may work in the short-term, but in the long-term, you remain a prisoner of the avoidance.
The only real freedom you will find is by letting yourself be in the presence of your discomfort.
So glad to read your insight into OCD. After 18 healthy years, mine is back. I’m getting a handle on dismissing the minor thoughts, but having a hard time with one more troubling one. Is there any circumstance where retracing my steps is helpful? From what I’m reading I should resist the temptation to “fix” my intrusive thoughts.
Trying to “fix” unwanted thoughts by retracing your steps is a classic OCD compulsion, and will only make things worse for you.
Tom- your dedication to helping people deal with this means the world.
I am currently feeling extreme HOCD – it’s been kicking holes in a wall over the years and has now blown right through. It is compounded by the fact I experienced sexual abuse as a child/in uni which has lead to guilt/shame/fear towards men. I relate those experiences to my feelings about my sexuality and get more confused & distressed. My mind has been on a constant loop of checking and pulling up random memories to ‘prove’ something, it is exhausting.
This website is a fantastic resource. I have officially taken a leap into the unknown & am actively searching out a therapist for the first time.
Thanks for all you do!
Thank you so much for your kind words. It is truly gratifying to hear that our website and articles have been helpful to you.
Hi I’m a girl. 1 yearago a thought came into my head and it was “what if your trans”. Before this thought I loved being a girl. It scared me like no other thought, I obsess over it 24/7. It gave me so much anxiety but felt so real. It made me think I was trans. I felt SO disconnected from myself, it was scary. this went on for months. it went away and I think HOCD happened for a bit. same anxiety. now TOCD is back. My questions: 1. can OCD make you feel so disconnected to yourself/the person you were before the thoughts started?
2. does my story sound like ocd
3. can TOCD make me feel wrong being a girl? I used to LOVE being a girl and now I don’t because my thoughts are telling me i’m not being my “true self”
4.) best treatment?
To answer your questions…
4) Cognitive Behavioral Therapy (CBT) with a focus on a specific CBT technique called Exposure and Response Prevention (ERP).
Hi I’m Male , I never feel aroused by men and never feel aroused by thoughts of acting sexual with men or by gay porn, I do feel aroused by women, however to prove it I force myself to masturbate to gay thoughts , I don’t feel aroused and the only erection I feel is the one from the physical stimulation. Then I think about women and get myself aroused and then switch back to gay thoughts to see can I get off to them.I find If I get tense I can feel the orgasm coming and can get off. What does this mean do I have to go off and say I’m gay and sleep with guys or is the ejacultion response proof I’m gay but I just feel this response doesn’t fit with who I am.
Your ejaculation when masturbating is not proof you are gay – it is proof that your reproductive system is operating properly. When men masturbate, they eventually ejaculate. You could masturbate while thinking of mashed potatoes or while looking at a picture of a telephone and you would still eventually ejaculate.
I encourage you to read our series of five articles about HOCD starting at https://ocdla.com/hocd-30-things-you-need-to-know-5522/.
Dear Tom, Hope you are fine, i have persistently suffered from thoughts/images/sensations about oral sex with my 8 the old m these are causing me so much depression shame and guilt, Much off the time is just an anxious feeling with no graphic image, but I’m aware of it all day. The checking destroys me as i try to imagine the thought to see if i feel any pleasure. There is no sexual arousal but some anxiety but sometimes i feel like like the sucking sensation which means i am a sick paedophile and makes me so depressed. I just wish these horrible thoughts would one day disappear and i could enjoy like with my beautiful child. I also spend hours trying to find out how these thoughts started . Thanks for your time.
As you note, checking and trying to figure out how the thoughts started has not worked. That is because those behaviors never work – they always lead to more OCD and more misery.
As uncomfortable as it may be, the goal is to allow the thoughts to exist without doing anything about them. The less you respond to them, the less they will be an issue, as you will be starving the OCD of the responses that feed it.
Thank you for this article. I’ve had OCD basically as long as I can remember and it’s gone up and down in severity over the years. It seems like the few times it’s really spiked have been at strange times in my life. The first one being when I moved as a child, and recently during the COVID pandemic while I’ve been more isolated from social interactions and spending more time alone.
For something that can seem so strange to an outsiders point of view (and even mine, because deep down I do believe that I know how ridiculous my compulsions are), it’s great to have what I go through so accurately described so I know that this is a known disorder and I’m not alone.
Thank you for commenting. It’s great other that our article helps you feel less alone in dealing with your OCD.
It feels like I am constantly checking my mental state to see if I am anxious or if I have brain fog. In response to acknowledging that I am anxious and have brain fog, I try to find ways to get rid of it (eg. finding a sentence that I believe will make me feel more present and then repeating that sentence). Do you believe this is OCD?
While I cannot provide a diagnosis via this forum, I can say that the symptoms you describe are consistent with OCD. I encourage you to seek an assessment with a therapist who specializes in treating OCD.
Hello, I was diagnosed with OCD nearly 20 years ago. It started out with hand washing, etc. For several years now, I have had incredible doubt about everything I do which causes lots of fear and anxiety. I thought I locked my car one time, but it was unlocked when I got back. I used my remote to test my locks which worked. I then got it my car, set my keys down, and drove off. Then I thought, “maybe the keys were in the car the whole time? What if someone made copies of keys?” This was false because I was outside the car with the remote. That wasn’t good enough, I replayed the event over and over to “solve” what “really” happened. It caused massive anxiety and fear. This is a repetitive story with “something” new all the time.
Living in fear,
The mistake you made was that you “replayed the event over and over to “solve” what “really” happened”. And as you note, the replaying of the thought “caused massive anxiety and fear”. And as you further note, this ends up being “a repetitive story with “something” new all the time.” That is how OCD works. The more compulsions you do, the worse the OCD gets.
So your goal is actually quite simple – let the thoughts exist, but do nothing about them. Having doubts will not cause nearly as much discomfort as your OCD is already causing.
One day I had the thought “what makes it wrong to be a pedophile?”, and I made the mistake of trying to figure it out. Hundreds of hours of rumination and checking later, I still get stuck on this thought.
Over time my mental checking has left me numb to this thought. I want to be like everyone else and find these acts wrong and not doubt it. I’m worried not having strong feelings in response to this thought makes me a monster.
Does my doubt indicate psychopathy, or just more OCD?
Nothing you write suggests that you are a psychopath, and everything you write suggests you have OCD. Everybody (including people without OCD) has all sorts of unwanted thoughts. The problem is that, when you had an unwanted thought, you made the mistake of trying figure it out. And As you learned, no matter how much time and energy you devoted to figuring it out, you never succeeded in doing so.
Your goal should not be “to be like everyone else and find these acts wrong”. Your goal should be to accept the existence of whatever unwanted thoughts appear in your mind, without taking them seriously, and without responding to them with compulsive attempts to figure them out.
Hi and thanks for this info… its very helpful. I do not have a history of OCD and have had occasions of mild anxiety. However, I had a number of severe panic attacks earlier this year, which for the most part I’ve gotten under control. But now I have anxiety nearly all day which I am constantly thinking about, whether its trying to accept it or figure out the solution. I suspect this is pure O. Any thoughts on how to treat? ERP? thank you!!
I cannot provide you with a diagnosis on the basis of a short comment on a blog. That said, the symptoms you report suggests the possibility of Pure O. I encourage you to read our article on Pure O at https://ocdla.com/pure-o-101-6880. I also encourage you to seek a formal assessment with a therapist who specializes in treating OCD.
My current theme is viewing certain artistic drawings or photos on line and later I will try to remember exactly certain details of the picture for example “ what color was this, what were there arms like” or some other inane detail. The obsession is “what if this question no matter how unimportant, is with me forever and I can’t stop thinking about it and i can’t move on until I check it”. Then I will compulsively revisit the picture or mentally review it until it feels right, only to find relief for an hour before another picture I saw on my way to relieve that question starts the cycle over again.
This all sounds like a variant of OCD that is colloquially known as “memory hoarding”. I encourage you to read our article on the topic at https://ocdla.com/memory-hoarding-obsessive-compulsive-disorder-ocd-1964.
As for the best approach, I encourage you to seek treatment with a therapist who specializes in the treatment of OCD using Cognitive Behavioral Therapy (CBT) focused an a specific CBT technique called Exposure and Response Prevention (ERP).
Hello there! Thank you for this article. For the past few weeks I have been dealing with obsessing over some past memories, which after some research I found that it is a form of ocd called real event ocd. . This week felt much better than the last but I don’t know if I am recovering or unconsciously performing mental compulsions. I do not have any physical compulsions.
I have observed that when an intrusive memory pops up, my brain automatically moves to thinking about something other than the intrusive memory and I don’t even realize it. Is this a compulsion?
You note that “my brain automatically moves to thinking about something other than the intrusive memory and I don’t even realize it”.
If you are genuinely doing this shift unconsciously, then it may not be a compulsion. That said, it sounds like it distresses you, and at some point you recognize that you have been making this shift. I encourage you to seek treatment with a therapist who specializes in treating OCD, as they can help you determine if you have OCD, and what course of treatment would be appropriate depending on whether you have OCD or not.
Hey there! Thanks for this article. The last sentence hit me so bad ? I was lying in bed reading this and it was morning. I always notice when I am mentally checking or when the urge is coming. Mostly when I am realizing that I am totally present or in a joyful situation. And after noticing this I feel so bad about myself that I am just not able to not do it/ not did it right or even started it. “It is a compulsion and you can stop it so stop it” and then I focus so much on not doing it/ not thinking about it, that another kind of obsessing taking place I think ? it is confusing now. it’s like I am checking if I am checking or testing if I can really resist..
Can there be an exposure to the fear of doing compulsions?
Checking to see if you are checking is still checking. And focusing on “not thinking about it” is a compulsion that will make things worse.
As for exposures that address “the fear of doing compulsions”, I encourage you to seek treatment with a therapist who specializes in treating OCD.