OCD: Thought Compulsions

By Brian Robinson.


In most cases, OCD involves both intrusive thoughts and physical compulsions or rituals. The thoughts draw the sufferers attention to something that has to be done, and the sufferer is then compelled to carry out the ritual.

Another way to put this, is to say that the thoughts draw the sufferers attention to something bad that might happen. And then the sufferer is then compelled to do the ritual in order to prevent the bad event from taking place. In other words, at the heart of OCD, lies the idea of prevention. And in essence, the OCD mind believes that certain actions hold the potential to avoid bad things. It is first and foremost a preventative and action based disorder. And if we are to outwit the OCD mind, it is worth remembering this.

However, some sufferers tell us there are no compulsions and this may be true in a small number of cases. What is more likely, is that the compulsions take the form of thought rituals. For example, the sufferer may be compelled to recite a series of prayers in their head. And this may be seen as a help to stop a bad thing from happening. Or, the sufferer may believe they have already done something wrong. And so they have to recount events in their mind to make sure that is not the case.

This last example highlights another characteristic of OCD which can be quite prevalent and that is uncertainty. Uncertainty does not sit well with the OCD mind and sometimes this can lead to the sufferer seeking constant reassurances. Seeking these reassurances is not a good strategy. It is better to accept that uncertainty will always feature in life and remember that is not necessarily a bad thing.

People react to OCD differently and how we react can be important. For example, it’s easy to see OCD as a cursed condition that ruins our lives because that’s often what it is. However, to say that’s all OCD is, and to hold that view at the forefront of our thinking, can in itself feed into the condition. Consider this: as mentioned above, at the heart of OCD is the idea of preventing bad things and the protection of the sufferer and others. OCD can be seen as a seriously misguided friend who is simply trying to help. OCD as a misunderstanding may be infuriating, but it can also be seen as a caring disorder. There is no suggestion here that we should be relaxed and welcoming in our disposition towards OCD. But there is scope to see the condition in a different light and that may be of some help.

What have I done?

Another example of a thought compulsion is where the person believes they may have hurt someone, perhaps even run them over with their car. That is the intrusive thought: and the compulsion is to go over events in your mind to see if that may have happened.

Or, it may be that the person believes they have been unfaithful to their partner: and again, the compulsion is to go over all interactions with members of the opposite sex to see if anything untoward may have happened. These concerns also cast OCD in a more caring light, and indeed, they have much to say about the caring nature of the sufferer.

It is fairly safe to say that OCD has to be tackled on two fronts. We have to try and make some headway with the thoughts, cognitions. And we have to try and turn the clock back on the compulsions or behaviours. And in many cases, perhaps most cases, this means the involvement of a Cognitive Behavioural Therapist. Unfortunately, therapists are not always readily available and so self-help may be the only option.

If we take the example of the person who believes they have been unfaithful, we should first of all be clear about what that means. For most of us, that would mean sex or kissing with another person, but for the OCD sufferer, an innocent hug with a friend may not be seen as entirely innocent. Underpinning this suspicion, is probably the fundamental truth that even though we may be involved in a relationship, we may still see others as being attractive. That is not a form of unfaithfulness: that is just a fact of human nature.

Even though our rational mind may know we haven’t been unfaithful, we cannot simply tell our selves we are just being silly and stop worrying. Pure dialogue will not convince the OCD mind. Our OCD mind is more likely to evolve through experience and input in the form of images. For example, when we are compelled to go through past events, it may help to delay that by looking at pictures of when you were together with your partner and demonstrating faithfulness. That will tend to calm the OCD mind in a way that dialogue cannot.

Pictures can hold the potential to outwit the OCD mind

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