One of the primary symptoms of obsessive-compulsive disorder (OCD) is racing thoughts. Such thoughts are defined as obsessions and lead to compulsive and often inappropriate behaviors. ¹

As such, neutralizing OCD thoughts (or obsessions) is no easy task. Once you find yourself in the OCD cycle, breaking away requires strong mental strength. Still, it is possible.

What Are Intrusive (or Obsessive) Thoughts?

OCD creates uncontrollable, reoccurring thoughts that are known as obsessions. These intrusive thoughts result in compulsive behaviors which are meant to relieve obsessions. ² For example, you may become obsessed with symmetry. By making everything symmetrical in your living environment, you’re attempting to ease obsessive thoughts.

Intrusive thoughts are mental processes interrupting the normal flow of daily thoughts or ideas. These happen deep within the brain (unconsciously), making them difficult to control. ³ Therefore, the key to addressing obsessions is identifying their source and working through them.

What is a Thought-Action Fusion?

Intrusive thoughts are often met with anxiety. You’re likely disturbed by these obsessions and will do anything to relieve them. As a result, you partake in compulsive behaviors that provide you with temporary relief. ⁴

These are known as thought-action fusion. They can lead to many inhibitions in daily life, such as with relationships and responsibilities (i.e. work). However, they can also lead to physiological complications in your nervous, cardiovascular, digestive, immune, and respiratory systems. ⁵

On top of that, intrusive thoughts may be met with paranoia and cause avoidant behavior. ⁶ For example, you may have developed an obsession with motor accidents. As a result, you refuse to travel by car or get near automobiles.

Neutralizing OCD Symptoms and Thoughts

Neutralizing OCD thoughts is easier said than done. Obsessions are powerful and compulsions have become ritualistic. To break down these thought processes and behaviors, you must get to the source of your OCD. And this is a difficult process.

Intrusive Thoughts vs. Self-Identity

Intrusive thoughts can lead you to question your own sanity and moral fiber. ⁷ Especially if these thoughts are disturbing and violent. As a result of this questioning, you may slip down a rabbit hole of “what-if” possibilities. Naturally, this only causes more confusion, worry, and headaches.

You may fear losing your sense of self-control. You may see these obsessions and compulsions as the definition of your self-worth. These inhibitions are when it’s time to neutralize.

A risk capability assessment is one of the first steps you want to take. This can be performed alone or by a mental health professional. It’s meant to remind you that you have control, can rationalize, and hold the ability NOT to act upon your impulses.

If you need assistance in your risk assessment, it can help to talk to others about your OCD. By making others aware of your symptoms, you’re encouraging them to speak out in moments where you do lose control. This can act as a friendly reminder to regain control.

Handling OCD Guilt and Shame

With OCD, you may feel an overwhelming sense of guilt and shame. These negative emotions may come from a diagnosis or from the compulsive behaviors others around you witness. ⁸

Guilt and shame can be just as destructive as obsessions and compulsions. In fact, it may lead to other mental health conditions, such as anxiety and depression. ⁹

This is another reason to be open about your OCD. By identifying your emotions with others, you can develop a support group. If you don’t have someone to talk to, online resources are available. You can learn more at the International OCD Foundation’s Support Groups & Treatment Groups page.

Take Mental Notes

It’s beneficial to document your OCD journey. You can do this by organizing records of symptoms, medication changes, and shifts in compulsions/behaviors. Or, through a personalized journal that’s more introspective about your emotions.

Journaling and documenting any mental illness has proven beneficial. In some cases, it’s led to:

• Creating an atmosphere of being in control
• Neutralizing intrusive thoughts
• Reducing behavioral tics and compulsions

Benefits of OCD Treatment

Since treatment helps you manage OCD symptoms, it can also help neutralize intrusive thoughts. Unfortunately, there is no “one size fits all” tactic. Various treatment paths have worked for different people. As such, you’ll have to experiment before finding your path.

Still, in all OCD cases, there are two standard protocols when it comes to treatment:

Medication

Medication helps to curb symptoms, especially in severe cases. It’s also common, with up to 70% of patients receiving a prescription. These have resulted in a 40 to 60% symptom reduction.

The most common OCD medication is serotonin reuptake inhibitors (SRIs), a type of antidepressant. ¹⁰

Talk Therapy

Cognitive behavioral therapy (CBT) has also proven helpful. Through it, you’ll discuss the obsessions or compulsions that concern you. You’ll then use this understanding to make a positive change in your OCD cycle. ¹¹

On top of CBT, you may be recommended exposure and response prevention (ERP). Here, you’ll be required to expose yourself to the thoughts, images, objects, and situations that make you anxious. From your reactions, a psychologist will help you develop ways to address, cope, and eventually change those compulsions. ¹²

References

¹ Brock H, Hany M. Obsessive-Compulsive Disorder. 2023 May 29. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 31985955.

² Starcevic V, Berle D, Brakoulias V, Sammut P, Moses K, Milicevic D, Hannan A. Functions of compulsions in obsessive-compulsive disorder. Aust N Z J Psychiatry. 2011 Jun;45(6):449-57. doi: 10.3109/00048674.2011.567243. Epub 2011 Apr 21. PMID: 21510720.

³ Holland MT, Trapp NT, McCormick LM, Jareczek FJ, Zanaty M, Close LN, Beeghly J, Greenlee JDW. Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Long Term Naturalistic Follow Up Study in a Single Institution. Front Psychiatry. 2020 Feb 28;11:55. doi: 10.3389/fpsyt.2020.00055. PMID: 32184741; PMCID: PMC7058594.

⁴ Figee M, Pattij T, Willuhn I, Luigjes J, van den Brink W, Goudriaan A, Potenza MN, Robbins TW, Denys D. Compulsivity in obsessive-compulsive disorder and addictions. Eur Neuropsychopharmacol. 2016 May;26(5):856-68. doi: 10.1016/j.euroneuro.2015.12.003. Epub 2015 Dec 11. PMID: 26774279.

⁵ Härter MC, Conway KP, Merikangas KR. Associations between anxiety disorders and physical illness. Eur Arch Psychiatry Clin Neurosci. 2003 Dec;253(6):313-20. doi: 10.1007/s00406-003-0449-y. PMID: 14714121.

⁶ Moutoussis M, El-Deredy W, Bentall RP. An empirical study of defensive avoidance in paranoia. Behav Cogn Psychother. 2015 Mar;43(2):182-99. doi: 10.1017/S1352465813000805. Epub 2013 Sep 27. PMID: 24073930.

⁷ Raveendranathan D, Shiva L, Sharma E, Venkatasubramanian G, Rao MG, Varambally S, Gangadhar BN. Obsessive compulsive disorder masquerading as psychosis. Indian J Psychol Med. 2012 Apr;34(2):179-80. doi: 10.4103/0253-7176.101800. PMID: 23162197; PMCID: PMC3498784.

⁸ Mavrogiorgou P, Becker S, Juckel G. Guilt and Shame in Patients with Obsessive-Compulsive Disorders. Psychopathology. 2024 Apr 24:1-11. doi: 10.1159/000537996. Epub ahead of print. PMID: 38657572.

⁹ Hellberg SN, Abramowitz JS, Ojalehto HJ, Butcher MW, Buchholz JL, Riemann BC. Co-occurring depression and obsessive-compulsive disorder: A dimensional network approach. J Affect Disord. 2022 Nov 15;317:417-426. doi: 10.1016/j.jad.2022.08.101. Epub 2022 Aug 30. PMID: 36055534.

¹⁰ Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M. Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Curr Neuropharmacol. 2019;17(8):710-736. doi: 10.2174/1570159X16666180813155017. PMID: 30101713; PMCID: PMC7059159.

¹¹ Gragnani A, Zaccari V, Femia G, Pellegrini V, Tenore K, Fadda S, Luppino OI, Basile B, Cosentino T, Perdighe C, Romano G, Saliani AM, Mancini F. Cognitive-Behavioral Treatment of Obsessive-Compulsive Disorder: The Results of a Naturalistic Outcomes Study. J Clin Med. 2022 May 13;11(10):2762. doi: 10.3390/jcm11102762. PMID: 35628888; PMCID: PMC9145175.

¹² Law C, Boisseau CL. Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives. Psychol Res Behav Manag. 2019 Dec 24;12:1167-1174. doi: 10.2147/PRBM.S211117. PMID: 31920413; PMCID: PMC6935308.