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Obsessive Thoughts in OCD
Obsessive thoughts, or obsessions, are ideas that persist in the mind despite repeated attempts to stop thinking of them. They might be thoughts, images, or behavioral impulses, and they often induce a feeling of anxiety. Someone with OCD can have these thoughts at any time, regardless of what he or she is doing. Obsessive thoughts might include:
- Fear of dirt, contamination, or infection, such as a fear of touching surfaces or objects due to the possibility of contamination.
- Thoughts of getting sick and/or dying. These might be thoughts of the person with OCD, or someone close to the person.
- The desire to have the surroundings tidier, more organized, or more symmetrical. This tends to include intense feelings of distress and anxiety when objects and surroundings aren’t orderly.
- Violent or aggressive behavioral impulses, such as images of hurting someone or behaving aggressively.
- Sexual thoughts or imagery. This might include sexual thoughts about another person, or replaying of pornographic images in the mind.
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Compulsive Behavior as a Coping Mechanism
In OCD, a compulsion is any behavior that the person feels compelled to perform repeatedly. The compulsive behavior, often referred to as performing rituals, is a way of coping with the anxiety caused by obsessive thoughts, and the type of behavior an individual has tends to depend on the nature of the thoughts.
- Someone with a fear of dirt or contamination often feels compelled to wash his or her hands or shower repeatedly. Compulsive cleaning might also occur.
- A desire for organization might manifest as constant checking, counting, or moving of objects, for example to make the items on a desk symmetrical in terms of location and number.
- If someone has repeated thoughts of hurting someone, he or she might feel the need to continually make sure the person is unharmed.
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How do you know if it’s OCD?
Most people have things they are particularly fussy about, such as having clean floors, or being punctual, or being overly concerned about personal hygiene. This is not at all the same thing as OCD.
Someone with OCD doesn’t perform rituals such as washing or cleaning because they want to: they do it because they have to. There is a huge difference between wanting to be clean, and washing your hands until they are raw, swollen, and painful. Someone with OCD might spend hours a day performing rituals, and feel distressed about the obsessive thoughts that prompt the behavior, but still cannot stop either the thoughts or the behavior.
It’s time to see a doctor when the thoughts or behavior start affecting quality of life, or when performing rituals starts taking up a significant amount of time, interfering with daily life.
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American Academy of Family Physicians: Obsessive-Compulsive Disorder: What It Is and How to Treat It
International OCD Foundation: Obsessions and Compulsions
National Institute of Mental Health: When Unwanted Thoughts Take Over: Obsessive-Compulsive Disorder
Penn State Milton S. Hershey Medical Center College of Medicine: Obsessive-Compulsive Disorder (OCD)
Smith, M., Jaffe-Gill, E., and Segal, J., for HelpGuide: Obsessive-Compulsive Disorder (OCD) Symptoms and Treatment of Compulsive Behavior and Obsessive Thoughts.