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OCD and Dealing with Intrusive Thoughts

written by: Dr. Kristie Leong • edited by: Paul Arnold • updated: 9/23/2010

People with OCD frequently experience obsessive-compulsive disorder intrusive thoughts. Find out what causes these sometimes disabling thoughts and how they can be treated.

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    The Phenomenon of Obsessive-Compulsive Disorder Intrusive Thoughts

    People suffering with the disorder OCD often experience the phenomenon of intrusive thoughts. These consist of “inappropriate” or anxiety-provoking thoughts that seemingly randomly enter their mind and cause distress. Obsessive-compulsive disorder intrusive thoughts can take a variety of forms. Some may be violent, religious, or sexual in nature, and the person may fear acting upon these unsettling messages. Needless to say, this can arouse a great deal of fear and uncertainty in a person with OCD.

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    Obsessive-Compulsive Disorder Intrusive Thoughts Affect Normal People Too

    Intrusive thoughts aren’t unique to obsessive-compulsive disorder, normal people have them too, but in healthy people the thoughts are usually a short-lived annoyance, while in people with OCD they cause great deal of discomfort and anxiety. Instead of dismissing an intrusive thought as a normal person would, a person with OCD exaggerates the importance of the idea, causing it to take on greater significance in their mind. They may become obsessively focused on the intrusive thought and believe they’re in danger of acting on it. This causes them to channel their energy towards repressing the thoughts and performing rituals to keep them at bay, which only makes the situation worse.

    If a person experiencing obsessive-compulsive disorder intrusive thoughts was able to let the thought go, as most people would, it would break the cycle of obsession and anxiety. Because of their disorder they cling to them, creating further fear and anxiety. They may use rituals such as hand-washing or other actions to reduce their disabling fear. It’s a vicious cycle of intrusive thought, anxiety, obsession, and ritualistic behavior that’s difficult to break.

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    Helping People with Obsessive-Compulsive Disorder Intrusive Thoughts

    Is there a way to break the cycle of disordered thinking? According to cognitive theory, people with OCD attach false ideas to their intrusive thoughts based on their previous life experiences. They interpret these thoughts as “bad” and see themselves as powerless to stop them. Even more anxiety-provoking is the belief that they might act on them. Some counselors use cognitive therapy to help people with OCD change their interpretation of these thoughts and the way they construe them. In a sense, this neutralizes them, so they no longer hold power over them.

    Cognitive therapy for obsessive-compulsive disorder intrusive thoughts may be used alone or in combination with behavioral therapy. Behavioral therapy, or exposure therapy, involves gradually exposing the person to objects or situations that bring on the intrusive thoughts - until they no longer fear acting on them and feel less compelled to perform their protective rituals. This is done in a graded fashion with the constant support of a therapist. Many OCD sufferers experience improvement with this approach, although it may take several months to see progress, and it may not completely eliminate all of the obsessive-compulsive disorder intrusive thoughts. Rather, it makes them easier to deal with.

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    Medications Also Help Obsessive-Compulsive Disorder Intrusive Thoughts

    Antidepressants may be helpful for people with severe intrusive thoughts – but medications alone are usually not enough by themselves. A combination of medications, when appropriate, and cognitive or behavior therapy offers the best chance for reducing the frequency and severity of the disabling thoughts that keep an OCD sufferer a prisoner in their own mind.

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    References

    Psychother Psychosom. 2001;70:288-297.

    Medscape CME. “A Highlight of New Research on the Treatment of Obsessive-Compulsive Disorder”

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    Sample contents.