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Key points
- The thoughts that get stuck in one's head are those that most frighten or offend them.
- Unwanted intrusive thoughts and obsessional doubts are reinforced by one's efforts to get rid of them.
- Reducing bewilderment around obsessions is a huge step in recovering from obsessive intrusive thoughts.
We know that seeking insight into either the meaning of the content or the “root causes” of OCD can lead a person down a rabbit hole. An important principle of effective treatment is to target the factors which maintain the symptoms. We have discussed many of these in previous posts: paradoxical effort, sticky mind, entanglement with content, anxiety sensitivity, and a range of avoidance behaviors.
Still, there is an understandable and sometimes urgent desire to figure out why these thoughts and doubts have become so disturbing and why now they emerge. This post aims to dispel the bewilderment that accompanies the onset of obsessions developing from an initial unwanted intrusive thought or doubt.
There is a widely held myth that unwanted intrusive thoughts are somehow random. This is a bewildering idea because it suggests that there can be an event without a cause. While it is simply unknown what causes any passing thought, it is definitely not random as to why any particular thought becomes stuck and why it turns into an obsessional narrative replete with worries about what could possibly happen or might have happened.
When doubt suddenly appears where none existed before, it is not random. It is your relationship with these thoughts, images, and sensations that determine whether they become repetitive and disturbing.
Unwanted Thoughts Are Not "Wishes"
Here is the answer to “Why is this particular thought stuck?” or “Why have I started doubting something I never even thought about before?” Repetitive, disturbing, obsessional doubts and worries are the ones you struggle with, debate yourself over, try to justify and then reassure, and, most importantly, try to get rid of. This is the fuel that feeds them. So, it follows that the thoughts that get stuck are the ones that you are most offended by, scared of, or freaked out by. They are the thoughts that are the opposite of you—your values, your true self, and what matters to you.
So, it is conscientious people that suddenly are stuck on a thought that they might have made a mistake, it is gentle people who are most appalled by violent thoughts, and it is people of faith who have repetitive blasphemous ideas or worries about offending God. It is thoughtful people who get stuck worrying about doing something wrong, impulsive, or immoral.
Unwanted intrusive thoughts and obsessional doubts are the very opposite of wishes. And they are reinforced by the fight you put up to get rid of them. They mean the opposite of what they seem to mean.
Research suggests that we may unconsciously scan ourselves for thoughts, feelings, and images that we have strong reactions to. We may be sensitized to certain themes because of real things that happened earlier in life, such as something you did not notice, a mistake you made, something said to you or about you, or about the way people “should” be. Or perhaps you witnessed something and promised yourself you would not do or feel or think a certain way. This has set you up to be sensitive to any hint of a particular unacceptable feeling or doubt. Or it may be that holding yourself to perfectionistic standards leaves no room for thoughts that are contrary to your values or even the remote possibility of losing control.
On the other hand, while it is certainly true that stuck obsessional thoughts are not random, it does not follow that their content is deeply meaningful or important. Unfortunately, misunderstandings of OCD symptoms have led down terrible paths: obsessional doubts about sexuality, suicide, or harming others are not signs of hidden impulses, wishes, or desires.
Obsessional doubts about relationships are not red flags. Worries about safety or failure or illness are not predictions. Bizarre thoughts are not a sign of oncoming psychosis. Just because some thought gets stuck does not make it a message, a warning, or a signal.
Information About OCD Helps Reduce Resistance
When you figure out that your obsessional doubts and intrusive thoughts are not dangerous or true, that in fact they are not at all a reflection of a perverse or angry or unconscious wish or urge, or a signal that you are prone to negligence, irresponsibility or impulsivity, the need to struggle against them starts to dissipate. You can back away from the constant vigilance to ward them off.
And you can let go of the terrible story you imagined when you treated these thoughts as signifying something unwanted lurking inside you. You can begin to see the absurdity of considering extremely remote possibilities as likely. You can let go of the narrative you created in which you must take preventive action, so you are not responsible for some imagined adverse event. You do not have to stay hijacked by your own imagination about what could or might happen.
If you realize there is something you cannot know for sure but have no real evidence—just your own doubting—you can leave it alone. You can go back to treating yourself as trustworthy and the world as safe enough to proceed. Avoiding and checking and seeking reassurance just does not seem so necessary.
This is why we advocate for information about how OCD works; how it tricks you. And how you get entangled with it. And how the story you build in your imagination about remote possibilities can seem so logical when you are absorbed in it.
Reducing Bewilderment Makes Exposure More Effective
It is important to experience some reduction in bewilderment about the questions that naturally arise when you find yourself unable to do things you used to do without hesitation or find yourself believing thoughts that you “know” do not make sense, and or are preoccupied with topics that seem absurd even to you. It helps to know what has happened.
Research has shown that compulsions and avoidance reinforce the stickiness and distress that comes with obsessional doubts and unwanted intrusive thoughts. It is indeed important to stop avoiding. But if you bravely engage in exposure while still in a state of bewilderment, the benefits of exposure may be less resilient. It is also much more difficult to make your way through exposures or to try to tolerate distress when you are bewildered. As long as you remain bewildered, wondering, “Why this issue?” you will not have the trust in yourself that you deserve.
How about the other bewildering question of, “Why now?” It is likely you have been born with two “tendencies”—one we call sticky mind, and the other the tendency to fear the sensations and thoughts that come with anxiety or disgust or other emotions. Then, some additional stressor suddenly or gradually builds until your OCD shows up.
It could just be developmental—puberty or menopause, for example. It could be excitement or anxiety about a change—school, a job, a move, or a relationship. It could be a loss. It could be something stressful that happens to you or to someone you know, or just in the media. It could be a conflict of any kind—or too much alcohol or a harmless but scary medication reaction. It is also possible that you have always been “like this” as far back as you can remember.
Knowing what kicked off the cycle can reduce bewilderment. It is not out of the blue. There is a reason. However, the way forward is not to focus on what started the sensitization but on the factors that keep the symptoms front and center and exacerbate and maintain the distress. In fact, often the particular focus of obsessional doubting has little or nothing to do with the sensitizing stressor.
If you are no longer bewildered about how OCD leads you astray, you may find yourself naturally abandoning the internal arguing, the checking and reassuring, the avoiding, the stories of remotely possible disasters that you are responsible for. And you will start trying out the things you had started avoiding.
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