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I can’t get these thoughts out of my head! It could be OCD

Written By Tyler Slay, P-LPC

“I’m so OCD” is a common phrase. Most of us associate obsessive-compulsive disorder with being tidy, Type A, and perfectionistic. That’s a misrepresentation that keeps many people from being able to correctly identify and receive appropriate treatment for OCD. Instead, many people with OCD think they are crazy, immoral, and just aware of things that the average person should pay more attention to. It’s possible that up to 3% of the world’s population struggles with the disorder. That number seems low, but that’s 3% of the world who could be more engaged in their lives rather than struggling with their paralyzing obsessions, fears, doubts, and compulsive behaviors. These are people who are usually deeply caring, vigilant, empathetic, and attuned to others, but their brains are using those positive features in overdrive. They are lost in their thoughts and feelings. We need these people to be free of the control of OCD so they can contribute their gifts to society and experience contentment in their own lives. 

One of my missions in life is to help people identify OCD in themselves so they can get appropriate, potentially life-changing help. Getting the wrong treatment or no treatment at all can be disastrous. I’ve had friends with OCD tell me that they struggled with it so badly that they experienced very little joy or contentment in their lives until they got appropriate treatment for it and started seeing it for what it is - a feature of the brain that does not have to run your life.

Let’s take a brief look at some aspects of how OCD works and one way to approach treatment:


OCD obsessional thinking has two important features that are crucial to understand if we are going to put it in its place. And it can be put in its place! 

1. OCD obsessions only get stuck on questions that are unanswerable. Nobody can fully prove to you that your fears aren’t going to happen or didn’t happen in the past. Nobody can prove that the feeling you’re experiencing won’t last forever. Knowing that your thinking is “illogical” doesn’t fix your anxious feelings.

**Don’t be dismayed if you don’t see your obsession in this list. I can almost guarantee someone else out there is obsessed with the same topic as you! The cruelty of giving someone with OCD an almost guarantee is not lost on me.

Some examples: 

- What if I hit someone with my car?

- What if these unwanted sexual thoughts I’m having mean I am capable of doing something terrible?

- What if the person I’m in a relationship with is not right for me?

- What if I get sick or cause others to get sick?

- What if I can’t control my bodily movements?

- What if I’m going to think about my blinking, swallowing, breathing, etc. forever? 

- What if I didn’t check this important thing and someone gets hurt because of it?

- What if I lose control and hurt someone else or myself?

- What if I’m going to hell because I committed the unforgivable sin?

- Distress because I didn’t feel “just right” after a task. 

- What if everything is an illusion or is fake?

- The need to confess everything to reduce anxiety

- Obsession with any one topic or thought pattern that causes emotional distress and can’t be satisfied with a seemingly logical answer or answers that are generally accepted by people you see as intelligent

2. OCD obsessions typically attack what you care most about. 

If you have kids, your obsessions might be about something bad happening to them or you not loving them enough. You might have intrusive thoughts and visualizations about them getting hurt or even you being the one who hurts them. Those thoughts might lead you to avoid them or continuously tell them how much you love them in order to try to banish the obsessions or reassure yourself that the obsession won’t become a reality. If you’re a Christian or were raised in church, you could be obsessed with not going to hell, not committing the unforgivable sin, not having enough faith, or even wondering if God is real. You might dread going to church because you associate it with the terrible feelings these obsessions gave you when you were a child. If you’re health conscious and more aware of bodily sensations, you might struggle with paying too much attention to certain parts of your body or certain autonomic functions that should happen in the background without your conscious awareness or control. The list goes on and on! 

So, let’s recap and talk about how to approach it:

1. OCD obsessions are about unanswerable and unresolvable questions, doubts, and feelings.

2. The questions, doubts, and feelings attack what you care about the most. 

Only after we really understand these two aspects of OCD can we begin to unwind it and take back the steering wheel of our lives. 

Antidote to #1: Change how you see the problem. OCD is primarily a feature of your brain. Other people are walking around not worrying near as much about the very thing that you’ve devoted countless hours, days, months, and years to trying to figure out or make yourself feel better about. Your history might contribute to your OCD symptoms and thought content, but it likely did not cause the OCD in the first place. You likely would have experienced OCD no matter what. The answer you are seeking is not the issue. You are not the issue. The feeling is not the issue. OCD is the issue. Putting the blame squarely on a feature of your neurology that causes you to think intensely about certain topics or see images that you don’t want to see in your mind’s eye is the first step to not allowing OCD to control you and steal your joy. Naming that helps you get a little distance from it and see it as a movie that is playing in your brain on a repeated loop rather than something you must constantly attend to and figure out. 

Antidote to #2: Engage in what you care about regardless of your obsessions and feelings. OCD asks a disturbing “what if” question (this is the obsession) and then compels you to do a mental or physical action that leads to temporary relief of that question and feeling (this is the compulsion). When you perform your compulsions, the obsessions abate temporarily but ultimately get stronger and gain more control of your life. When you defy your obsessions by taking values-based action rather than fear-based, reassurance-based, feelings-based, or avoidance-based actions, the obsessions slowly begin to take a back seat in your life. Eventually the obsessions become things you simply notice rather than things that cause great anxiety and fear. 

These are the first two major thinking/belief shifts I see in clients who recover. Initial recovery can take place rapidly and the details of recovery are refined with practice in the real world. You can get better!

This is only an introduction, and it should not be used as a substitute for good mental healthcare. If you think this describes you, a friend, or a family member of yours, please reach out to a mental healthcare provider who specializes in OCD and utilizes exposure and response prevention as part of their treatment approach. 


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