How OCD Counseling Helps Manage Intrusive Thoughts

If you have OCD, or suspect you have OCD, you are probably familiar with intrusive thoughts, or even intrusive images, sensations, or worries that seem to pop into your mind out of nowhere and begin a spiral. So many of the clients with OCD I work with come into therapy hoping to “stop” the thoughts or “make them go away.” My clients are often surprised to learn that making intrusive thoughts or images go away is not actually the primary goal of OCD therapy! I remember being surprised too. Those intrusive sensations, images, or thoughts (or obsessions as they’re known in OCD) are so unpleasant, scary, disgusting, or distressing, why wouldn’t the main goal be to make them go away?

If you ask someone with OCD if they have tried to make the obsessions go away on their own, every person will tell you YES. They’ve tried, sometimes for years, to make them stop, but they haven’t. Why is this?

OCD is a cycle, and it is fueled by compulsions, which are things we do to try and neutralize the obsession and the distress it creates. Therefore, the more we fight against the obsessions by telling ourselves they aren’t true, checking to see if a feared outcome happened, or organizing things just right, we are actually increasing the power of OCD.

Source: IOCDF (iocdf.org)

So what is the solution to managing obsessions and intrusive thoughts? It’s actually changing our relationship to the obsessions.

The main evidence based therapeutic approach to treating OCD is Exposure and Response Prevention, or ERP. ERP focuses on exposing yourself to the obsessions of OCD in a safe, guided, and gradual way, without using compulsions or safety behaviors. Your brain and your body learnt to tolerate the discomfort of the obsessions, therefore teaching yourself that they are not actually dangerous. Acceptance and Commitment Therapy (ACT) is another cognitive-behavioral-based approach I like to use that focuses on mindfulness of your current state and taking action steps that are important to you, even when things are hard or OCD is loud. Both ERP and ACT focus on our relationship to our thoughts, rather than stopping the thoughts or trying to make them go away on their own.

If you’re dealing with OCD or anxiety, working with a therapist trained in evidence-based approaches is so important. The team at Simplify has counselors trained in these methods who want to come alongside you in learning to change your relationship with your intrusive thoughts so that you can live a life full of meaning and purpose, even when challenges arise. Reach out to us today to get started!