The thoughts feel inescapable. They're in your mind and body, but you feel like you can't control them. You know they're not rational, but you feel compelled to let them direct your behavior. They demand that you do something to make them go away—often a compulsive behavior.
The Relationship Between Thoughts and Urges
Jon Hershfield's text, Harm OCD, indicates, “people with harm OCD often describe their intrusive thoughts as 'urges' because it's difficult to find another word for the marriage of an intrusive thought and a sensation in the body that seems to indicated an imminent action.
It seems to come out of nowhere — a strange, disturbing thought or a troubling image that pops into your mind. It might be violent or sexual, or a recurring fear that you'll do something inappropriate or embarrassing. Whatever the content, it's often unsettling and may bring on feelings of worry or shame.
These symptoms can cause distress and lead to behaviors that interfere with day-to-day activities. People with OCD may feel the urge to check things repeatedly or perform routines for more than an hour each day as a way of achieving temporary relief from anxiety.
People might compulsively bring their attention to their breathing, heart rate, swallowing, blinking, or other typically automatic or subconscious bodily processes. Just as intrusive thoughts become more distressing when you pay attention or engage with them, the same can be said for these physical symptoms.
That's not the way OCD works. In fact, ignoring symptoms, telling yourself that you're not really that bad and you can manage the disorder by trying self-help for OCD will only exacerbate the situation. OCD generally tends to worsen over time without treatment.
However, this patient had a difficult time believing that. He would say, “But I feel this urge. It's physical!” I explained that sometimes OCD gives false physical urges, as well as false thoughts.
Try to resist the urge to push the intrusive thoughts away. Suppression might feel like a logical solution, but it can actually intensify, rather than lessen, the obsessiveness and distress you experience around them. Your thoughts are real, but make it your goal to acknowledge them without identifying with them.
The nature of intrusive thoughts can make them feel real
When you experience these obsessions and your brain triggers the fight, flight, and freeze response (the anxious response), you experience a dump of hormones in the body such as adrenaline and cortisol that signals that you need to ACT NOW.
Unfortunately, OCD doesn't just go away. There is no “cure” for the condition. Thoughts are intrusive by nature, and it's not possible to eliminate them entirely. However, people with OCD can learn to acknowledge their obsessions and find relief without acting on their compulsions.
Get plenty of exercise
Exercise is an effective way of fighting OCD stress and anxiety. It helps to refocus your mind when intrusive thoughts and compulsions arise. Experts recommend 30 minutes of aerobic exercise per day, but it doesn't have to happen all at once.
Some people with OCD may start to experience physical sensations that aren't actually there. For example, someone with contamination OCD could start having the physical sensation that their hands are dirty. They might be able to “feel” dirt and grime on their hands, even though they can't see it.
Exposure therapy has been shown to be effective for reducing symptoms in about 75% of patients with compulsive staring. This type of therapy should be done under supervision from a qualified mental health professional, who has specialty experience in treating OCD with exposure and response prevention.
The more you attempt to either push away or to "understand" the thought, the "stickier" the thought becomes. When the thought feels uncontrollable and "sticky" and the efforts to get rid of it don't bring a lasting relief, this may be a sign that your OCD got you on the hook again.
Obsessive, difficult-to-control thoughts are also a defining characteristic of OCD. These impulsive thoughts blow everyday worries out of proportion because they are often highly unrealistic and can take on qualities of magical thinking.
They're usually harmless. But if you obsess about them so much that it interrupts your day-to-day life, this can be a sign of an underlying mental health problem. Intrusive thoughts can be a symptom of anxiety, depression, or obsessive-compulsive disorder (OCD).
The most common trick is OCD trying to convince you that “this time it is not OCD.” It is important to educate patients how to spot the difference and it's helpful to emphasize that OCD tends to feel like an emergency and needs to be attended to immediately.
For most of us, these thoughts seem “messed up” or funny, because they're so out of place. But for someone with OCD, these disturbing thoughts might feel like real possibilities — even if that person knows their thoughts are probably irrational.
Like a schoolyard bully, OCD demands attention. If you try to ignore it, it will get louder and more irritating. It is known for being manipulative and cunning. It tries to tell you how to live your life.
The bulk of the problems occurring within your OCD come from you. The main reason that compulsions seem so hard to stop is because you have rehearsed them so often that they have become very automatic habits that are easy to do without thinking.
Around 6% to 24% of people with OCD are likely to experience some form of sexual obsession. This doesn't even include people who remain unwilling to confess their forbidden thoughts.
Anxiety and arousal
This attention and the anxiety you are feeling may actually increase blood flow and physical arousal. This can make you feel as if you are aroused by the intrusive thoughts when in fact the opposite is true. Many people with this type of OCD call this 'groinal response'.