Thank you to my colleague Amanda Petrik-Gardner for permission to use her infographic!

Identifying when OCD is pulling you in:

Many people find it helpful to label their OCD thoughts as external to them, such as calling the thoughts “the voice of OCD”. This helps us to separate what our logical minds or inner intuition knows from the imaginary-based fearful or obsessive thoughts that OCD pulls us into. 

For example, instead of getting all caught up in an OCD bubble, we can learn to separate and label OCD thoughts by telling ourselves things like:

  • OCD wants me to believe I need to ask for reassurance from people
  • OCD is telling me I need to keep checking the doors are locked
  • OCD is telling me I need to keep questioning and analyzing my decisions 
  • OCD wants me to believe I’m a bad person and unworthy of love 

Often the hardest part of observing our OCD thoughts instead of letting them take us over is learning to recognize the “voice of OCD” for what it is, since OCD can be so convincing and compelling.

In ICBT (Inference based cognitive therapy) one thing we work on is learning to recognize when we are going into our “OCD bubble”. The “OCD bubble” starts with a thought or fear that arises in the imagination and that then triggers us into building a story that feels very believable. OCD does this by using real facts, events, or associations that give the story seeming plausibility, but that is actually about weaving them into a narrative that takes facts and ideas out of context or uses them in ways that aren’t relevant right now. 

These stories that OCD creates are often so compelling that we don’t stop to question whether we’re in the “OCD bubble” vs. constructively problem solving or strategizing about a real threat. 

For example, OCD may tell us we should return an outfit we just bought  (which fit well, was well-priced, and we loved while in the store) since: it can only be returned within 7 days of purchase; we once bought an outfit in the past and then wished we could return it but it was too late; and sometimes a person buys something but then finds something later they like better. OCD makes it sound very reasonable and compelling to go back and return the outfit, even though in the here and now, looking at the facts, there’s no real good reason to return it; we liked it, it fit, the price was good. 

Going back and identifying the sequence that starts the “OCD bubble” (the theme is usually different for each of us) and evaluating whether the “story” began with something based on our senses (ie a reality based doubt that is relevant right now), or a realistic cue of danger, vs. a scenario that started in the imagination based on hypothetical what if scenarios, or irrelevant doubts, is an important step in disrupting the need to use compulsions to deal with the fears that OCD tells us to worry about. 

Another big piece of OCD treatment, at least in the ICBT model, is learning to trust our senses and our perceptions. OCD tells us things like: “check again”, “get more reassurance”, “ruminate and overanalyze”, “worry about doing something out of character”, etc. Learning to ask ourselves questions that counter the voice of OCD such as “Am I really the type of person who hurts other people? Do I want to hurt other people?”; “Am I the kind of person who usually forgets things?”; “Is my relationship actually ok by objective standards”, etc helps us recognize that the answer is often very different from what OCD would want us to believe! We are often not the self that OCD tells us we should worry we are. 

Sometimes OCD is also a learned trauma response, either because it initially gave us a sense of control in the face of trauma we experienced (this may have been a helpful survival technique that was needed when we were younger and were helpless in a traumatic situation), or as an attempt to counter-identify with someone we didn’t want to be like. Someone who wasn’t loved may worry they don’t really love their partner or family members; someone who was blamed for someone else’s irresponsibility may worry they’re not being responsible enough. In these situations we develop fears based on our past traumas, but the fears themselves are not really realistic to who we are as people. 

Learning to distinguish normal doubts or worries from obsessional (OCD-based) concerns is possible, and in cases of appropriate anxiety, doubt, or worry, we can usually find ways to resolve the relevant problem or to recognize that the problem is out of our control and focus elsewhere. OCD on the other hand pulls us further into more anxiety, more doubt, compulsions that don’t work, and imaginary scenarios that aren’t resolvable. Identifying the “bubble” for what is is is often the first step in disrupting OCD’s control over our minds and lives.