by Debra Kissen
power back from intrusive thought OCD

Step 1: See Through OCD’s Scare Tactics

OCD is the fear network of the brain sending a signal that something is wrong and needs to be done about it IMMEDIATELY. OCD only reports on feared consequences that are important to a person. For example, if somebody does not fear spilling water on the floor, OCD will not send the intrusive thought, “Oh no you spilled water. You must clean it up IMMEDIATELY”. On the other hand if someone does care about the safety of her family, OCD might say, “Oh no you left the stove on. You must go back and check IMMEDIATELY or the most important people in your life will die and it will be all your fault.” Similarly, if you care deeply about your family's well-being or your students safety, OCD may inject itself into your awareness with the thought “Oh no. What if I lose control and harm my children or students.”

My clients always ask me what it means about them that they could have such “horrible thoughts”. What I tell them is that somewhere within an obsession is the flip side of a core value. If OCD taunts you with images and thoughts about offending god, then religion must be important to you. If OCD reviews all the ways your family could be hurt, then your family is clearly one of your top priorities.

There is checklist of common intrusive thoughts that I find helpful to share with my patients. There are numerous thoughts on this list regarding losing control and acting out violently or sexually. Several research studies found that when this list is shown to a non-clinical sample of people, approximately 90 percent of those surveyed will agree to having experienced some of the intrusive thoughts.

When the non-clinical sample is asked how bothered they are by experiencing these intrusive thoughts, they are most often only mildly bothered by them. In contrast, when this same list is shown to individuals diagnosed with OCD, a similar percentage of the sample will agree to having experienced these intrusive thoughts but the big difference is how much distress these thoughts evoke for the OCD sample. For those meeting criteria for OCD, there will be a much higher level of emotional distress when these same intrusive thoughts surface.

What keeps OCD alive and well is not the experience of intrusive thoughts but actually one’s reaction to them. The more one dislikes experiencing intrusive thoughts and then tries to repress or fight with these thoughts, the greater the frequency of intrusive thoughts one will experience. The very act of trying to “not have” a bothersome thought guarantees its resurfacing. The only way to know if you are having or not having a thought is to think “Am I think about X” or “I better not think about X” which of course causes one to think about X.

So back to the question of why do those meeting criteria for OCD have such disturbing thoughts? Because they are human and to be human means one will experience freaky, odd thoughts. The human mind is constantly spinning around trying to find interesting problems to solve, in order to keep us alive. We don’t have the speed of the jaguar or the strength of a bear but we do have an all too powerful mind that is very good at planning for future challenges but also for tying itself into a knot. Freedom from OCD is not about stopping the mind from offering up strange and occasionally disturbing thoughts but learning how to recognize spam vs. urgent mail.

I must give a disclaimer here that OCD loves taking anything that is reassuring and turning it into a compulsion. So, if you are reading this blog for the hundredth time and desperately trying to figure out if this sounds like you and if your “awful thoughts” are OCD or if in fact you are an awful person, then STOP reading this blog. As I am sure your experience has shown you obtaining short-term anxiety relief through a compulsion comes at a cost in the form of greater overall anxiety. Instead, strive for long-term freedom from OCD by teaching your mind to not take itself so seriously.

Step 2: Exposure and Response Prevention (ERP)

There is no way past OCD except through it. As described in step one, the more one avoids an intrusive thought, the more one will experience the feared, bothersome, super annoying thought. Therefore, we need to flip the equation on its head and practice bringing on the thought while disengaging from any compulsions that have been utilized to obtain short-term anxiety relief. Common compulsions engaged in, when struggling with intrusive thought OCD are reassurance seeking, information seeking/googling to determine if there is something wrong with self, mental reviewing and avoidance. The best way to organize exposure tasks is by creating an exposure hierarchy that outlines baby steps that you can take to slowly but surely prove to OCD who is in charge (hint…YOU).

Step 3: Get Support

“Support” may sound superfluous but without it your Intrusive Thought OCD fighting plan will most likely be a bust. It is near impossible to do this work alone. It is not that you are not smart enough or determined enough or brave enough to beat OCD. The reason you need external support is because there is nothing more powerful in taking the wind out of OCD’s sails than voicing intrusive thoughts out loud, to a compassionate, informed coach. The same intrusive thoughts that feel so real, all powerful and self-defining when swirling around in your head will disintegrate when said out loud. When your intrusive thoughts are released into the world and your supportive coach looks back at you, and still sees the YOU they believe in and hears your intrusive thought as “blah blah blah” and possibly laughable, your brain will be one step closer to understanding that these thoughts are spam mail and nothing more.

In terms of finding a supportive OCD coach, you can contact a therapist that is well trained in CBT for OCD but if this is price prohibitive or if there is not access in your local community to OCD experts, there are other options. You can purchase a CBT for OCD workbook and go chapter by chapter through it with any licensed therapist in your community. You can schedule an appointment with one of ADAA’s OCD specialists who offer tele-mental health services. And it is perfectly acceptable to purchase a CBT for OCD workbook and go through the material together with a friend or family member.

So you now know the three basic steps necessary to kick intrusive thought OCD to the curb. And remember, we are all so much more than our thoughts. Our lives are defined by the actions that we choose to take, not by the electrical storm of thoughts that flicker through our minds.

Dr. Kissen and Dr. Ashley D. Kendall, PhD presented a live webinar on this topic on March 12, 2018 at 1:00 pm ET. 

This webinar shares tips and tools to:

  1. Identify if you may be dealing with harm OCD
  2. Make sense of why harm OCD picks such painful themes and content 
  3. Take the power away from harm OCD 
  4. Re-engage in your life now that you are giving less of your attention and energy to harm OCD

Watch here. 

About the Author

Debra-Kissen_headshot_0 (1)_0.jpgDr. Debra Kissen is the Clinical Director of the Light on Anxiety Treatment Center of Chicago.Dr. Kissen specializes in CBT based treatment to children, adolescents and adults with a focus on anxiety and stress-related disorders, including OCD, PTSD, panic disorder, agoraphobia, social anxiety disorder, generalized anxiety disorder, specific phobias, separation anxiety disorder, compulsive skin picking, trichotillomania and other Body Focused Repetitive Behaviors (BFRBs). Dr. Debra Kissen applies the principles of evidence-based treatments while at the same time treating the whole person, with deep respect for the human spirit and the challenges we all face on our journey through life. Dr. Kissen is a Clinical Fellow at the Anxiety Depression Association of America (ADAA) and is a Co-Chair of ADAA's Public Education Committee.  


Additional Resources

    Upcoming Live Webinars

    Thank you! I feel like you were talking to me personally. I've had OCD for ~10 years and although I'm "coping" (meds & therapist). You express the mental baggage very well and put a light on it that I found very relieving.

    My 13 year old OCD/Extreme Anxiety disorder Son suffers from above after a certain sicko had tried to abduct him.Ever since the trauma of why? and images has led him to scream over thoughts 24/7.His medication is compounded by possibly allergic reaction or Simutaneous Anaphalaxic attacks.So much so when he never reaches a level to get CBT.So six mths later no further on.!This webseminar seems to be perfect in understanding for Us but to Our Boy who needs it most when is he ready ,Please help.

    I am doing my doctorate on trauma and ocd and the use of a trauma-based technique called Somatic Experiencing. It is my clinical experience that when trauma is strongly linked to ocd, one needs more than CBT and ERP. In fact, CBT and ERP can be re-traumatizing in some cases. SE or a carefully implemented body-based trauma approach assists with re-stabilizing the fight or flight response in the body, assists with teaching regulation and establishing a sense of safety through the central nervous system. I think this is critical for trauma-based ocd. Peter Levine is the founder of SE.

    That's quite interesting. I suffer from Pure O and have relapsed after a decade of being relatively symptom free.
    It's now attacking my family with mental imagery of the worst things happening to them either by my hand or someone else's. It's directly linked to abuse I suffered in childhood. ERP was extremely graphic and haunting and long term only made me worse. I'm struggling to cope - please tell me more about Somatic Experiencing and where I can follow up to get help.

    I'm sorry that I have no information about Somatic Experiencing ... but I wanted to send empathy and encouragement in regards to what you are going through.

    I also suffer from Pure O but have been symptom free since 2010. Like a freight train, the thoughts reentered my brain in 2017. I also have the very graphic images of harming people or myself. We only know individually what we are going through and we each suffer in our own way....but I feel that it is so much harder to cope this second round because I thought I had it "beat".

    I describe my current struggle to cope to the people closest to me... "that if I were to be diagnosed with cancer in 2010, I similarly would have been strong and determined to beat it. I would do everything I could to win..... and I did. To have it reemerge 7 years later is devastating. To muster up the will to fight seems so much harder..and then to know that even after I fight it, that it may return later again in my life... is beyond discouraging (I don't even know what the right word is to explain the bottomless pit feeling).

    The way I "got out" the first time was using CBT & medication. It feels cheesy at first.. but by documenting or writing out my feelings each day after my CBT sessions... I was able to see the verrrry slow progress until I was finally out. (I measure my success by the time span in between my scary thoughts). I hope that you are able to get more information on Somatic Experiencing. I know that my paragraph was not very helpful but I just wanted you to know that there are some similar struggles out there and that you aren't entirely alone in your journey to relief. The sooner we reach out for help like this... the sooner we will get better I believe.

    Having a similar experience. after 7 years popped up again. Still on a low grade SSRI for it but suddenly out of nowhere it came back. Had a similar relapse in 2015 but went a way after a week so just waiting now, on day 3. Were you able to get over the return of the OCD? The hardest part for me isnt the thoughts its the somatic anxiety from it such as tense muscles and breathing.

    My son is being treated for various horrendous traumas. Would Se help him ?

    Ashley, I am an LCSW Somatic Experiencing Practitioner (SEP) and found your comments when searching SE and OCD. Yours is the only referencing I found so far. A prospective client contacted me about her obsessive worries about her tinnitus and other physical concerns. I was wondering if SE even at its mildest could be too activating but I have since developed at least a first session strategy and together we will see how things unfold. I appreciate this entire article and everyone’s comments.

    Everything I have red says that ocd is genetic and has nothing to do with trauma . But I felt like it does . Fml I need help lol

    I am suffering with OCD for ten years and this is my eleventh year. I tried meds( which doesn't help me much). So whenever I get these thoughts I usually try to distract myself by watching my favourite tv shows or playing the guitar. Sometimes doing something interesting helps a lot. You should keep a nice conversation with him and try to keep him close don't leave him alone. Invite his friends to spend time with him. This might keep him busy and distracted.
    If he does something like studying or school homework ask him to do it in the same room where his parents are. Keep him away from violent games, pictures. Try not to discomfort him. He might get nightmares too so make a comfort zone for him so he could share about it. I get lots of troubling thoughts when I share about it with my parents I feel better. I wish that your son get better and keep smiling.
    P.S. I m telling this because I have been through worst. And there was no one to help me and I don't want anyone else to go through this.

    I’ve had OCD for about 12 years and it was pretty rough at first, went to therapy and started some medication which eventually lead to some quality years with minor symptoms and issues. However, years later I’m suffering from a pretty rough relapse and need help. I don’t have compulsions but I do have obsessive thoughts which come with anxiety and depression. The longer my struggle goes on, the more and more frustrated and upset I get. I just want to be better and happy again.

    I’ve taken meds and therapy which was helpful. But I finally convinced myself the intrusive thoughts are meaningless and I wouldn’t do what they suggest. I also tell myself I’m a good person and always talk to God as well as read the Bible

    I can totally relate to your post. I too have relapses such as now and also want to be better and happy again. I have so much in life to be thankful for. I know this illness isn’t my fault but I have trouble convincing myself of that. I just want to be normal. Taking meds.

    No one should have to go through such traumas because of some disgusting person.
    Besides therapy, I think it will help him to join a martial arts class to rebuild his confidence and sense of self

    It is amazing to me and so relieving to know that my specific intrusive thoughts are centered around what is actually really important to me. It's so true. Thank you.

    Thank you so so much! I agree as well because sometimes people with ocd think they’re an awful person to have such thoughts” ?

    I just want to say thank you so much for creating this article. I've suffered from OCD and intrusive thoughts for about 4 years now and it has been treacherous!! Due to the nature of the thoughts, there was no way I felt comfortable to share my experience with those around me and walked around with this deep dark "secret" feeling that I was a terrible person. I've done everything from binge eating to abusing alcohol and other substances to help alleviate the agony. Its such a relief to know that I am not a monster and that there is actually a name for this.

    I’m on this site trying to figure out why I’m feeling like I am and having such thoughts like you Meg I couldn’t possibly repeat . I had them when my first child was about 6 months old and managed to shake them off and think of the thoughts as not my own .. now 7 months pregnant with my second the thoughts have come back to haunt me. Again I’ve tried telling myself to stop being so stupid and to get a grip but I feel I’m slowly loosing the ability to manage them on my own. I haven’t really confided in anyone because of the nature of the thoughts and think people would not understand . Thankyou for Sharing your experiences, it makes me feel less of a freak .

    This is exactly what happened to me, my daughter is 4 and I am currently pregnant with my son and an 20 weeks. This all started about 4 weeks ago and it feels like it’s been so long and exhausting, I thought I needed to be locked up and isolated from my daughter in fear of hurting her. 2 weeks after the thoughts started I told my husband and was clearly deeply upset and even he could tell I was not okay. He ended up taking me to my Doctor and she gave me 50mg Sertraline and told me to go to therapy once a week and I have OCD. And two weeks into the meds I definitely tell a huge difference, but it’s like the thoughts are like in the back of my mind if that makes since. Like the thoughts and images only pop through when I’m really tired or feed into them lingering back there. ( mostly when I’m tired, cause who wants to have a war with their own brain when they are exhausted) Iv also recognized that when I do label them as “intrusive thoughts” and an able to just treat it like it’s not important, that guilt sits in. For even thinking about thinking that and then it’s like it festers off of that.

    Just curious, has it gotten better for you?

    Hello, I feel your pain and tiredness, I also have harm OCD and it was like opening a pandora box that no matter how you tried to close it, you can’t. It feels like living in a nightmare but as years passed by I get to learn how to cope with it. Therapy helped a lot for me to understand that all my thoughts are normal that brain are producing, the difference is that my brain can’t filter it. To a normal person these thoughts can easily discarded as silly or not important but with OCD this are serious thoughts brought by fear. I agree with the article above if you fear it the more it will become sticky. Avoidance would only make it stay longer. Exposure will lessen it. Thoughts has no emotions. They are just product of brain, when we learn to let it pass without judging it, it makes it easier. When a harmful thought pop up in your brain, if you can, just consider it as watching a movie, don’t react, try to breath in and out and relax. Wait for it to disappear, believe me they will. Be strong, my prayers are with you.

    Just reading your comments have made me feel better! I first experienced this when my son was 6 months old and attributed it to stress, post partum hormones and a rough breakup with his father. Now 4 years later this has resurfaced and hit me in the face! It is debilitating and as a single parent, very scary. I just want to sleep all day so I don't have terrible, intrusive thoughts and I am brought to tears by trying to fend them off. I have started on the track of determining if this is just OCD or OCD brought on by my Mirena, thyroid, endocrine system. Thank you for your suggestions above on how to manage.

    I’ve been having really bad intrusive thoughts lately! This is the first time experiencing them and it is very scary to me. I am always so scared I am going to hurt someone, I always want to sleep as well because it clears my mind.

    Kay thank you...I'm trying to be strong. I'm VERY overwhelmed by a VERY stupid/thought/behavior that came out-of-the blue 2 weeks ago that has consumed me with anxiety and now depression. I have dealt with this on/off most of my adult life. It's exhausting and no one seems to understand how this takes control and spirals me into thinking I'm worthless. I'm embarrassed and wish I was "normal", even though "at times" I feel I have it all going for me.

    You sound just like me, I also am consumed by a very stupid/thought/behavior that has consumed me with anxiety and depression. Looking into Ocd specific medication. What has worked for you.

    After reading this and seeing your response it’s made me feel a whole lot better I’ve always had anxiety but I’ve learned to cope with it no matter how hard it gets and now I have these instructive thoughts wich are disgusting and horrible and it takes a while to go away After I’ve thought of them but after reading what you said it’s made me feel relieved because now I know others out there have horrible thoughts/imagesout of the blue .

    Thank you, Kay, for sharing that advice. It really helped me feel better today. I hope you're still doing well. ~Kristin

    I know exactly how you feel about the guilt. i have those thoughts lingering in the background and even when they dont bother me i still have this massive guilt. i know i am not a monster but i cant get rid of the guilt, its tearing me up inside. really trying to hard to compartmentalise but its getting harder and harder

    Your not alone Meg, I’m currently battling it but it’s really reassuring to read professionals who highlight to us that we’re NOT a threat. Mindfulness is really helping me cope.

    I have really scary ocd thoughts and I thought something was wrong with me. I read this article and it really helped me to understand ocd a lot better. Thanks

    This was very helpful and enlightening to the kind of intrusive thoughts I am having. I have an appointment with a professional and will bring up this! I don't feel so scared anymore.

    "Our lives are defined by the actions that we choose to take, not by the electrical storm of thoughts that flicker through our minds."

    Thank you so much for this. Coming from a professional, it's even more powerful Thank you. I'm going to take your suggestion to buy a book to start a self-therapy since I don't have money for a therapist.

    As I am lying in my bed, it is 23:35,can't sleep because I have way too many thoughts in my head. But this description and advice about ocd brought some peace.

    When I read about intrusive thoughts it sounds like me but I don't have any typical OCD symptoms. I don't need to obsessivly do anything... i dont have compulsions ir anything I just have awful thoughts constantly. I do have tourettes syndrom which is commonly paired with OCD. I know that I am a good person who has always wanted to help people but sometimes the thoughts take over. Could this still be OCD?!

    Hi, I have that same problem, but I believe that it's OCD because I've always had intrusive thoughts with no compulsions and as I am getting older, my life is getting very complicated (stressed life due to University and bullies) and some compulsions are now kicking in.

    I believe the thoughts alone are a symptom. The thoughts their self are obsessive and compulsive. I'm just now finding out intrusive thoughts even being a thing. I am 31 and have been tortured by my thoughts just about my whole life. Good luck!