OCD Therapy
Intrusive Thoughts, ERP & OCD Treatment FAQ
Have questions about OCD, intrusive thoughts, compulsions, reassurance-seeking, or ERP? Learn about OCD symptoms and evidence-based OCD therapy.
What is OCD?
Obsessive-compulsive disorder (OCD) is a mental health condition characterized by unwanted, intrusive thoughts, images, urges, or fears (obsessions) and repetitive behaviors or mental acts (compulsions). OCD can be extremely distressing and can interfere with relationships, work, school, and everyday life.
OCD can take many different forms. It isn't simply being organized, perfectionistic, or concerned about cleanliness. People with OCD may experience symptoms involving contamination, harm, relationships, morality, religion, sexuality, health, responsibility, or uncertainty.
The good news is that effective treatments are available, including evidence-based psychotherapy such as Exposure and Response Prevention (ERP).
Do I have OCD, or am I just overthinking?
Everyone overthinks or worries from time to time. OCD tends to involve a more persistent cycle of intrusive thoughts, anxiety or uncertainty, and attempts to obtain relief through compulsions, avoidance, checking, reassurance, or mental rituals.
For example, someone might have a thought such as, "What if I made a terrible mistake?" A person with OCD may repeatedly review what happened, ask others for reassurance, search online for answers, or mentally analyze the situation in an attempt to become completely certain.
Only a qualified mental health professional can determine whether your symptoms meet the criteria for OCD. You don't need to diagnose yourself before reaching out for help.
Why do I have intrusive thoughts?
Intrusive thoughts are a common human experience. The problem in OCD is often not the existence of a thought itself, but the significance OCD assigns to it.
A person may become caught in questions such as:
"Why did I think that?"
"What does this say about me?"
"What if it means something?"
"What if I can't trust myself?"
"What if this thought comes true?"
Trying to completely eliminate, analyze, or neutralize intrusive thoughts can become part of the OCD cycle. OCD treatment focuses on changing your relationship with these thoughts rather than trying to guarantee that unwanted thoughts will never occur.
Does having an intrusive thought mean I will act on it?
Not necessarily. Unwanted intrusive thoughts can involve things that a person finds frightening, offensive, or inconsistent with their values.
For people with OCD, the thought itself can become the source of intense fear and uncertainty. A person may then begin checking their feelings, intentions, memories, or reactions to determine what the thought "really means."
Therapy can help you recognize when this process has become part of an OCD cycle and learn healthier ways of responding to intrusive thoughts.
Why do OCD thoughts feel so real?
OCD can make uncertainty feel urgent and important. When a thought triggers anxiety, your brain may treat the thought as something that requires immediate investigation or resolution.
This can lead to repeated checking, analyzing, reassurance-seeking, or avoidance. These strategies may provide temporary relief, but they can also keep the OCD cycle going.
OCD therapy focuses on learning that you can experience uncertainty and uncomfortable thoughts without needing to resolve them completely.
Can OCD cause relationship doubts?
Yes. OCD can involve persistent doubts about relationships, attraction, compatibility, or whether you truly love your partner. This is sometimes referred to as relationship OCD (ROCD).
A person may repeatedly analyze their feelings, compare their relationship to others, ask their partner for reassurance, test their attraction, or search for certainty about whether the relationship is "right."
The issue isn't simply having questions about a relationship. OCD can turn normal uncertainty into an ongoing cycle of checking and analysis.
Can OCD make me question my identity, sexuality, or values?
Yes. OCD can target areas that are particularly meaningful to you, including identity, sexuality, morality, religion, relationships, and personal values.
The person may repeatedly ask themselves questions such as, "What if I'm actually different from who I thought I was?" or "What if this thought means something about me?"
The resulting checking, testing, comparing, and reassurance-seeking can become compulsions that maintain the cycle.
Why does OCD make me need certainty?
OCD often creates an intense demand for certainty. You may feel that you cannot move forward until you know for sure that something is safe, correct, morally acceptable, or true.
Unfortunately, many of life's questions cannot be answered with 100% certainty.
OCD therapy can help you learn to tolerate uncertainty rather than repeatedly trying to eliminate it through checking, reassurance, avoidance, or mental analysis.
Should I see a therapist for OCD?
Consider talking with a therapist if intrusive thoughts, compulsions, avoidance, reassurance-seeking, or anxiety are interfering with your daily life. You don't need to wait until your symptoms become severe.
It is important to work with a therapist who has specific training and experience treating OCD, particularly with evidence-based approaches such as ERP.
A New Narrative Counseling can match you with an OCD-informed therapist who can help you understand what you're experiencing, assess whether OCD may be involved, and discuss appropriate treatment options.
