Obsessive Compulsive Disorder (OCD) is a debilitating psychological condition which is characterised by the sufferer experiencing distress and difficulties in normal functioning caused by intrusive thoughts and compulsive behaviours. Typically we would treat OCD using Cognitive Behavioural Therapy (CBT), with emphasis on Exposure with Response Prevention (ERP). However, we also know that changes in the way we think about intrusions in OCD can play a big part in effective treatment.
You may also have heard them referred to as “thought traps”.
The “C” in Cognitive Behavioural Therapy stands for “Cognitive”. Cognition refers to any mental event or process that occurs in a given problem. One of the basic assumptions in CBT is that changes in how we think about our experiences can maintain a given problem. OCD is no different.
Our brains are highly complex, evolved processing machines. Whilst we would all like to think that we always have clear, rational thoughts, our thinking can all be subject to distortions, biases and misinterpretations which can lead to the development and maintenance of unnecessary or unwanted emotional experiences.
It’s not our fault that we have thinking errors – this isn’t about an individual having “faulty thinking”. We are all prone to thinking errors and cognitive distortions. They are actually built into us.
What we can do however, is make ourselves aware of the types of thinking errors and cognitive distortions that can present themselves. We can learn them, label them and detach from them to ease our emotional distress.
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Before you carry on reading, take a look at Catastrophising and Emotional Reasoning from our thought traps post. These are also very common ways of thinking in OCD. Can you recognise any of the others?
This is when the OCD sufferer has the belief that just thinking a thought leads them to carrying out a particular action, or is the same as doing the action. So, just as the name suggests, “Thought” and “Action” are mentally fused together. For example, Someone may have an intrusive thought about a loved one being in a car accident. They believe that this thought alone makes the accident more likely, or even causes it, to happen. This may lead to rituals aimed at preventing the feared outcome or neutralizing unwanted thoughts.
‘Moral’ thought-action fusion refers to the belief that having an ‘unacceptable’ or ‘disturbing’ thought is the same as performing the action. For example, someone might feel as guilty for having lustful thoughts as if they had committed adultery.
The belief that having a thought can cause an event or means that the event has happened. Having the intrusive thought that I’ve driven over someone in my car is an example of this. This can lead to rumination, checking and doubt rituals.
The belief that an object carries thoughts, feelings or personal characteristics. For example, in Hoarding OCD, the sufferer may not want to part with a particular item because it embodies the feelings and thoughts of a loved one with whom it is loosely associated with.
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