OCD Intruisive Thought Reassurance
This audio discusses the intrusive thoughts that occur with a certain obsessional type Obsessive-Compulsive Disorder in which the individual is anxious or fearful due to experiencing unacceptable thoughts, images, or impulses. The purpose of this audio is to help the person with OCD understand that having such thoughts is normal and that worrying about the thoughts creates the obsessional process.
Although this audio may provide reassurance for the individual who has such thoughts, it is meant to be a step in the treatment process and not relied upon solely for reassurance. The individual with OCD should try to make this a way of thinking so they can learn to dismiss the thoughts as other people do.
TRANSCRIPT
This audio is for people who have been diagnosed with Obsessive Compulsive Disorder (OCD) and are distressed by disturbing thoughts, images, or impulses. This audio may not apply to other types of disorders so it is important to have a diagnosis by a mental health professional who has expertise with OCD.
The purpose of this audio is to provide an understanding of the obsessional, intrusive thoughts that occur with OCD. In particular, this audio is focused on a type of OCD that involves having unacceptable thoughts, images and impulses. Many times these thoughts can be disturbing and the person with OCD believes that there is something wrong with him or her due to having such thoughts or they fear that they will do something wrong because of the thoughts.
Although this audio provides reassurance about the thoughts, it is not meant to be used as an exclusive method for dealing with these thoughts. It is meant to be a step in the process of helping you to challenge the thoughts and recognize that they are meaningless rather than letting the thoughts control your life.
First, the definition of obsessions are intrusive thoughts, images, or impulses that are unwanted and disturbing to the individual. Even though the specific obsessions may seem odd or even impossible, what distinguishes obsessions from delusions is that the person with OCD recognizes the thoughts, images, or impulses as unreasonable or illogical. Yet, they feel anxiety caused by the possibility of the thoughts being true and experience a strong drive to eliminate the thoughts and images.
Intrusive thoughts can occur in many ways. I will describe some of the common ones although this list isn’t exhaustive. Just because the thoughts you have are not included does not mean that your thoughts are not obsessive thoughts.
In this audio I am just discussing the type of obsessions that involve thoughts or images that are disturbing to the individual. For instance, a person might have thoughts about abusing a child. Or, they might have thoughts about committing suicide. Or, they might have thoughts about hurting someone else. Or, they could have an image of killing someone. Or, they might have thoughts about being crazy and losing control. They might have thoughts that are considered blasphemous according to their religious beliefs. They might have sexual images that are disturbing to them. The thoughts and images themselves can take many different forms. However, what the thoughts or images have in common is they are unacceptable and disturbing to the individual.
What is important to recognize about these thoughts and images is they are not unusual or abnormal no matter how odd or crazy they may seem. What I mean by this is that we all have strange or odd thoughts and images come into our minds all the time. In this world we are bombarded by thoughts and images from other people, TV, newspapers, movies, the internet, social media, books, magazines, music, etc. We cannot avoid disturbing or distressing information coming into our brains from these sources.
Our brains are constantly processing all this information we receive. In addition, our brains try to organize and make sense of information. Sometimes our brains try to organize unconnected information. And this is where problems can occur for people with OCD. Most people, when their brain puts 2 and 2 together to equal 5, they shake their head, say to themselves “That doesn’t make sense” and ignore their brain’s conclusion. However, people with OCD will try to make sense of the information, thought, or image. They might think “There must be a reason why I am thinking this. Maybe it is what I really believe or want to do.”
For example, a person is driving and they have a sudden image of turning right in front of a diesel truck bearing down on them. The average person will shrug that thought away knowing that it is just some weird thought out of nowhere that is meaningless. However, the person with OCD might think “Why did I have that thought? Maybe I really have a death wish. I must want to commit suicide. There is something wrong with me because I had this thought.”
Many people with OCD believe that the only people who have thoughts of suicide are depressed people who are suicidal. They believe that only people who are potential killers would have thoughts or images of killing someone. They believe that only pedophiles have sexual thoughts about children.
This is not at all true. Most of us are likely to have such thoughts at times. However, the difference between the fleeting thought or the intrusive thought and an intentional thought is that people who intend to hurt themselves or someone else develop plans based on the thoughts. In other words, the thoughts also involve a desire and plan to carry out the impulse. People who have OCD do not have a plan or desire to carry out the impulse. In fact, the opposite is true. They are fearful of the thought, image, or impulse and do NOT want it to occur. This fear is the source of their anxiety and distress.
I realize that it seems that other people are not having these types of thoughts or images. There are a couple of reasons for this. The first is that people often don’t talk about odd thoughts. The most likely explanation, however, is that most people are not even aware that they these thoughts occur. You might ask “How is that possible?” To understand how it is possible, it is necessary to understand the nature of memory. We have three types of storage for memory. The first type is sensory memory which is incoming information that is processed by the brain and then released almost immediately unless it is something necessary for us to know. For instance, the brain is constantly processing temperature and as long as the body is in a normal range, the information is released. However, if the body is getting too hot, the brain draws our attention to it by sending the information to short-term storage. Information is in short-term storage only long enough for us to act on it—about 15 seconds. So, if the body is too hot, we remove our coat. But then the memory is gone. If someone asks us a couple hours later “Were you too hot earlier?” we are unlikely to remember. Only when information goes into long-term storage are we likely to remember it later. But for information to be sent to long-term storage, it must be repeated or emphasized. For instance, if we said to someone nearby when we removed our coat “Wow! It is sure hot!” then that information is more likely to go into long-term storage.
What does this have to do with people having strange thoughts or images but not even being aware of the thoughts? For most people, the thoughts and images are dismissed from short-term storage as being just an odd, meaningless, or random thought and so the thoughts are never retained in long-term storage. What that means is that if you asked someone “Do you ever have disturbing violent thoughts?” they will most likely say “no” because they have no long-term memory of the thoughts.
A good example of this is I was once explaining the concept of violent, intrusive thoughts as being normal to a client who had OCD and her husband. I turned to the husband and asked “Haven’t you had weird or violent thoughts at times?” His response was “No, I’ve never had thoughts like that.” However, a month later he returned and told me “You know, when you asked me if I ever had violent thoughts, I wasn’t aware of having any. But because you asked me, I’ve paid more attention to my thoughts and I realized that I do have strange and violent thoughts. I’ve just always ignored them before!”
This is an example of the normal process of these types of thoughts. Most people have them. But they shrug them off very quickly which causes them to not have a memory of them. However, people with OCD believe that the thoughts are abnormal so that when they have these thoughts they think something is wrong with them. What occurs, then, is because they are worried about the thoughts, they have more of the thoughts. If I told you having thoughts about pink elephants is a sign of serious disturbance, you might find yourself having more and more thoughts about pink elephants. The more you became concerned about the thoughts and tried to suppress them, the more you would have the thoughts.
The problem, then, with OCD is not the fact that you have strange, violent, sexual, or blasphemous thoughts, images or impulses, it is that these thoughts cause you distress which causes an increase in the thoughts. Frequently, people with OCD believe that even if the thoughts are normal, it is not normal to have them all the time and they conclude this must mean that there is something seriously wrong other than the OCD. Although it is true that it is not normal for the thoughts to occur all the time, it is still only a sign of the OCD and nothing more serious.
The problem in this thinking is what we refer to as “emotional reasoning,” an irrational thinking style that can contribute to many common problems. Emotional reasoning is the belief that “if I feel something, it must be true.” However, feelings can be inaccurate. Feelings must be processed to determine accuracy, not just be accepted as accurate. For people with OCD, it is common to feel guilty due to having what they believe are unacceptable thoughts. This feeling of guilt confirms in their mind that they have done something wrong. In other words, they believe “If I feel bad or guilty, I must have done something wrong.”
However, such a belief is not always true and can be the distorted perception of emotional reasoning. Just because someone feels guilty doesn’t mean they have done something wrong. This is especially true of OCD because people with OCD often have an over-developed sense of morality and responsibility which causes them to feel guilty about even innocuous behaviors. Therefore, it is important that a person with OCD evaluate an emotion such as guilt for accuracy based on evidence.
Hopefully, by now, you are understanding how these thoughts and images and feelings occur and you are recognizing that you are not seriously disturbed because you have such thoughts. However, that doesn’t mean that the OCD will just go away and that these thoughts won’t bother you. As with any type of cognitive therapy, repetition is the key. You may need to listen to this audio again and again and tell yourself these ideas over and over until you believe them more strongly.
Specifically, what should you tell yourself? Thoughts are not bad. Feelings are not bad. Thoughts are not reality. Feelings are not reality. Thoughts and feelings do not make you bad or good. Thoughts are just thoughts. Feelings are just feelings. You use thoughts and feelings to determine reality but they need to be assessed for accuracy. Just because you think or feel something does not make it true. You need to determine whether it is true based on evidence.
People have all kinds of thoughts and feelings. Evidence of this comes from novels, television, and movies. How could any of these things have been created if someone didn’t think of them? It is normal to have all sorts of thoughts, images, feelings, and even impulses. Just because a person thinks something doesn’t mean they will act on it.
When you worry about the meaning of having strange thoughts you create more memories of the thoughts and increase the number of connections in your brain for these thoughts. That is why the more you obsess about them the easier they come to mind. Once you have created these pathways it is necessary to create competing pathways that can become stronger. The way to do this is through repetition. By listening to this audio repeatedly and then telling yourself the relevant information again and again you can create a competing pathway in your brain that eventually can become stronger than your obsession.
But as I said, repetition is the key. You can’t expect to tell yourself something new a few times and expect that you will start thinking that way. How many times have you repeated your obsessional thoughts? Most likely, thousands and thousands of times. You can’t change any established pattern by just challenging it a few times. You must again and again tell yourself the reasons why your intrusive thoughts are meaningless rather than giving them meaning.
Thoughts are just thoughts. Feelings are just feelings. Thoughts are not bad. They do not make you bad. Feelings are not bad. They do not make you bad. Thoughts are not reality. Feelings are not reality. You use thoughts and feelings to determine reality but they need to be assessed for accuracy. Just because you think or feel something does not make it true. You need to determine whether it is true based on evidence.
Use the information in this audio again and again. You may not feel it right now, but your intellectual self can judge it’s accuracy. Eventually, as you keep repeating this information, you will feel it more and more.