How To Stop OCD ‘What If’ Intrusive Thoughts

If you have OCD, ‘what if’ thoughts are a source of great torment and pain for sufferers.

Have you ever had a thought stuck in your head that gets stuck in a loop, going around and around… until it feels like you have no ability to think about anything else?

They seemingly come from nowhere and are often taboo, strange, downright bizarre, or disturbing in nature.

Almost everyone experiences these thoughts from time to time.

But for those with OCD, these thoughts cause such all-consuming uncertainty and dread, sufferers feel compelled to try and resolve them so they can feel in control once again.

While there are many types of intrusive thoughts, the ‘what if’ thoughts wreak havoc and do an excellent job of playing on our doubts.

For those with obsessive-compulsive disorder (also aptly named the doubting disorder), the ‘what if’ question always sways toward your least wanted outcome or convinces them of an unwanted desire that feels dreadful.

Fortunately, there are ways to manage these ‘what if’ thoughts so they do not rob you of the ability to live a joyful and fulfilling life.

What is OCD? A Recap

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterized by recurring, unwanted thoughts, images, urges, feelings, or sensations (obsessions) and repetitive behaviors or mental acts (compulsions) that individuals feel driven to perform to relieve the uncertainty and anxiety triggered by those obsessions.

Many clients who come to us say that they feel trapped inside their own mind, unable to escape the fear narrative.

For those with this condition, it can feel dangerous to let those obsessions go unexplored.

The potential consequence of what could happen if the fear became reality, is just too much to bear.

This is why they find themselves stuck in the OCD loop.

Those compulsive behaviors are done to regain a sense of certainty and offer momentary relief.

Yet, in performing those compulsive rituals, they inadvertently strengthen OCD’s grip and keep the cycle in motion.

The OCD cycle can become all-consuming, affecting various aspects of a person’s life. They may spend significant amounts of time and energy engaged in compulsions, experiencing increased stress and interference with daily activities. 

OCD is more common than people realize with up to 2% of the world’s population experiencing OCD in their lifetime. And, as an immensely isolating and lonely disorder, it can give sufferers great strength knowing that they are not alone in this.

Intrusive thoughts in OCD

Many people who struggle with OCD, believe that this disorder is a ‘thinking problem’.

Clients will often ask how they can stop their ‘what if’ thoughts.

The truth is, OCD is also a feeling problem. 

It’s understandable to think that if the thoughts went away, we’d be able to find joy, happiness, and hope. But there are two main things to consider here:

1. We cannot stop any thought, including intrusive thoughts, so trying to do so is futile.
2. If you had a thought without any accompanying negative emotion, you would likely carry on as usual and consider it ‘just a bit weird’

The greatest deception of OCD is that it does an incredible job of convincing you that these thoughts need to be resolved.

Any feelings of doubt naturally compel us to explore, consider, and find clarity.

After all, that feeling of doubt creeps upon us when we’re faced with the unknown (a.k.a – uncertainty), and our brains don’t manage well with this.

Those ‘what if’ thoughts are sneaky whispers of doubt that can grow and become pretty loud.

The tricky thing here is to recognize that in asking the question ‘what if’ we’re asking an unanswerable question. If we 100% knew the answer, we wouldn’t have to consider all of the various possible outcomes.

But life is full of possible outcomes, good and bad.

In OCD, those ‘what if’ thoughts always gear toward the negative and conjure up a feeling of risk and perceived danger.

What distinguishes these intrusive thoughts in OCD is the significant distress they cause. People with OCD often attach excessive importance and significance to these thoughts, interpreting them as indicating a genuine threat or potential harm. 

The more they try to suppress or control these thoughts, the more persistent and intense they become, leading to a cycle of obsessions and compulsions.

It’s important to note that having intrusive thoughts alone does not indicate OCD. Intrusive thoughts are a common human experience, and many people without OCD occasionally have fleeting intrusive thoughts. However, in OCD, these thoughts become pervasive, and intrusive, and result in significant distress and disruption in daily life.

OCD ‘what if’ thoughts vs. Non-OCD related ‘what if’ thoughts

If everyone experiences ‘what if’ thoughts, how can we determine if they’re a ‘normal’ thought or an OCD thought?

OCD “what if” thoughts are characterized by their repetitive, distressing, and often illogical nature.

They lead to excessive uncertainty and anxiety, which cannot be left unexplored. In contrast, non-OCD “what if” thoughts are fleeting thoughts that do not cause significant distress or interfere with daily functioning.

This is why intrusive thoughts within OCD fall under the category of obsessions.

Because they are relentless and persistent and can leave the sufferer feeling like a prisoner to their thoughts.

Examples of ‘what if’ thoughts within OCD subtypes

Here are specific examples of “what if” thoughts that are commonly associated with different subtypes of Obsessive-Compulsive Disorder (OCD):

1. Contamination OCD:

   – “What if I touch a contaminated surface and get seriously ill?”

   – “What if I accidentally ingest something toxic and harm myself?”

   – “What if I am carrying germs and infect others?”

2. Checking OCD:

   – “What if I left the stove on and my house catches fire?”

   – “What if I didn’t lock the door properly and someone breaks in?”

   – “What if I didn’t turn off an electrical appliance, and it causes harm?”

3. Harm OCD:

   – “What if I impulsively harm my loved ones or strangers?”

   – “What if I lose control and commit a violent act?”

   – “What if I am responsible for causing harm to others without realizing it?”

4. Sexual Orientation OCD (SO-OCD):

   – “What if I’m actually gay, even though I’ve always identified as straight?” (or vice versa).

   – “What if my lack of attraction to a specific gender means I’m not who I thought I was?”

   – “What if my thoughts or doubts about my sexual orientation define my true identity?”

5. Relationship OCD (ROCD):

   – “What if I’m with the wrong partner and I’m missing out on true love?”

   – “What if my doubts about my feelings mean I don’t really love my partner?”

   – “What if I’m not attracted to my partner anymore, and it’s a sign of a failing relationship?”

The context of the thought depends on an individual theme and OCD presentation, and they can vary greatly from one subtype to another.

One thing is for certain, they are emotionally exhausting and can greatly limit one’s experiences of life.

How to know if it’s an OCD ‘what if’ thought or a ‘normal’ thought

It’s important to note here that a thought is just a thought.

Within OCD and outside of OCD, intrusive thoughts occur, and it’s incredibly common to have ‘what if’ thoughts. With any circumstance, our brains are always going to wonder what MIGHT happen one way or the other.

In reality, these are all ‘normal’ thoughts.

But it’s how we experience them that helps us distinguish whether or not we may be caught in the OCD cycle.

Here are a few factors to consider:

1. Frequency: OCD thoughts typically occur frequently and persistently. They can feel like a broken record player that’s impossible to turn off. Non-OCD thoughts, on the other hand, are generally more fleeting and do not cause such significant distress or preoccupation.

2. Uncertainty and Anxiety: OCD thoughts lead to intense distress, anxiety, and discomfort. They can provoke a sense of urgency or fear that we feel compelled to solve. Non-OCD thoughts, although they may sometimes be worrisome, typically do not evoke the same level of distress.

3. Impact on Daily Life: If your thoughts significantly interfere with your daily functioning, relationships, or overall well-being, it may be indicative of OCD. For instance, if you find yourself spending excessive amounts of time and energy engaging in rituals or avoiding certain situations due to your thoughts, it could suggest OCD.

4. Persistence and Resistance: OCD thoughts tend to be persistent and resistant to rational arguments or reassurance. Even when you recognize that the thoughts are irrational, you may still find it challenging to simply let them be. Normal thoughts, on the other hand, are more easily dismissed or reasoned with.

5. Compulsive behaviors: If you feel compelled to engage in physical or mental compulsions that offer temporary relief from the discomfort of those obsessions, this may be a sign that you’re stuck in an OCD loop.

It’s important to understand that only a qualified mental health professional can provide a definitive diagnosis. 

If you have concerns about your thoughts and their impact on your well-being, it’s advisable to consult with a qualified mental health professional experienced in assessing and treating OCD. They can help evaluate your symptoms, provide an accurate diagnosis, and guide you toward appropriate treatment options.

Can you stop intrusive ‘what if’ thoughts?

It is common for those with OCD to want to know how they can stop these ‘what if’ intrusive thoughts, but this is not the goal of effective OCD recovery.

The goal is to be able to identify those thoughts, accept them, allow them, and then continue with your day as you would choose to if they never occurred.

Intrusive thoughts cannot be stopped, but we can change our relationship and response to them so they no longer dictate how we live our lives.

Why do ‘what if’ intrusive thoughts become sticky

“What if” intrusive thoughts can become “sticky” or persistent for several reasons:

1. Anxiety Sensitization: When you experience anxiety in response to a particular thought or situation, your brain can become sensitized to it. This means that the more you try to avoid or suppress the thought, the more it becomes ingrained in your mind, leading to its persistence.

2. Attention Bias: The brain has a natural tendency to pay more attention to potential threats or negative information. In the case of OCD, “what if” thoughts are often perceived as threats, causing your brain to fixate on them and make them appear more significant as a problem that needs to be solved.

3. Safety Behaviors and Reassurance-Seeking: Engaging in safety behaviors or seeking reassurance in response to intrusive thoughts can inadvertently strengthen their hold. These behaviors provide temporary relief from anxiety, which reinforces the belief that the thoughts are indeed dangerous, leading to a continuation of the obsession-compulsion cycle.

4. Emotional Significance: The emotional weight attached to intrusive thoughts can make them stickier. They often provoke intense fear, guilt, or discomfort, leading your brain to perceive them as significant and requiring attention.

5. Perseveration: OCD is characterized by repetitive thinking patterns. The more you ruminate on a “what if” thought, analyze it, or try to find a solution, the more it becomes stuck in your mind. This perseveration contributes to the stickiness of the thoughts.

Strategies for unsticking sticky what-if thoughts

While it can be challenging, it is possible to manage and reduce the impact of “what if” intrusive thoughts associated with OCD. 

Here are some strategies that may help:

1. Recognize and Accept: Acknowledge that these thoughts are a symptom of OCD and not a reflection of your true self or intentions. Acceptance can help decrease distress and reduce the urge to engage in compulsive behaviors.

2. Mindfulness and Meditation: Practice mindfulness techniques to observe your thoughts without judgment. Cultivating mindfulness can help create distance between yourself and the intrusive thoughts, reducing their impact on your emotions and behavior.

3. Exposure and Response Prevention (ERP): Work with a mental health professional trained in ERP, a form of cognitive-behavioral therapy specific to OCD. ERP involves gradually exposing yourself to your intrusive thoughts, feelings, sensations, and urges without engaging in compulsive behaviors. Over time, this can help reduce the power and frequency of intrusive thoughts.

4. Self-Care and Stress Reduction: Engage in activities that promote relaxation and well-being. This can include regular exercise, getting enough sleep, practicing stress-management techniques, and engaging in hobbies or activities that bring you joy.

Remember, overcoming intrusive thoughts takes time and persistence. 

It’s important to be patient and compassionate with yourself and seek professional help if needed. With appropriate treatment and strategies, you can learn to cope with and reduce the impact of “what if” intrusive thoughts.

Best Treatment

The best treatment for intrusive thoughts, particularly when associated with Obsessive-Compulsive Disorder (OCD), is a combination of proven methodologies that have yielded incredible results.

These typically include:

1. Cognitive-Behavioral Therapy (CBT): CBT, alongside a type of CBT called Exposure and Response Prevention (ERP), is considered the gold standard treatment for OCD. ERP involves gradually exposing oneself to the thoughts, situations, or triggers that provoke intrusive thoughts while resisting the urge to engage in compulsive behaviors or rituals. Over time, this helps to reduce the anxiety and distress associated with the thoughts and weaken their grip.

2. Acceptance and Commitment Therapy (ACT): ACT focuses on accepting the presence of intrusive thoughts without trying to eliminate them. It aims to help individuals clarify their values and commit to taking actions that align with those values rather than being controlled by their thoughts. ACT can help manage the distress caused by intrusive thoughts and reduce their impact on daily life.

3. Mindfulness: Mindfulness-based approaches, such as Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT), can help individuals develop skills to observe their thoughts without judgment and cultivate a more accepting and non-reactive stance towards them. Mindfulness techniques can be beneficial in reducing the distress and emotional impact of intrusive thoughts.

4. Medication: In some cases, medication, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed to help manage the symptoms of OCD, including intrusive thoughts. Medication can work in conjunction with therapy to reduce the severity of the thoughts and associated anxiety. Medication should ONLY be prescribed by a qualified mental health professional following an effective diagnosis.

It’s important to consult with a mental health professional, ideally one with experience in treating OCD, to determine the most suitable treatment approach for your specific needs. 

They can conduct a thorough evaluation and create an individualized treatment plan tailored to your circumstances.

1:1 Private Therapy

If you suspect that you might be struggling with intrusive thoughts within the context of OCD, we encourage you to seek support from a highly trained clinician.

Our team of OCD specialists is trained to the highest standards and takes an open, highly compassionate, and non-judgemental approach.

While we understand that it can feel scary to begin the recovery conversation, our clients often tell us that they are so glad they had the courage to take the first step.

With every day that passes, OCD only grows in strength.

Today could be the first day toward a life where you no longer let intrusive thoughts ruin your life, and instead, you live the life you truly deserve to live – no longer trapped inside your mind.

If you’re based in California or Arizona, please submit an initial intake form here.

We’d be honored to support you in your recovery journey.

Online self-paced program

We understand that private therapy is not accessible to every, which is why top OCD specialist, Kimberley Quinlan, has created ERP SCHOOL.

ERP SCHOOL is a self-paced program giving you all the tools and techniques you need to take your life back from OCD. It shares with you the exact same methodologies that we offer our private clients, and it will show you how to apply them to your own specific obsessions and compulsions.

Click here to learn more about ERP SCHOOL.