We may not hear it much, but it’s important to say that feelings, just like thoughts, can be misleading. Just because you feel something, doesn’t make it true. In many areas of life it’s good to “trust your gut” and “trust your instincts,” but this can be a difficult concept for someone who struggles with OCD. The idea that feelings will guide us doesn’t always make sense.
For example, I may feel “in love,” meaning I have all the butterflies and all the feelings of a brand new relationship. But what happens when I have been in a committed relationship for years and it feels different? The risk we can run is that we may feel like we have now fallen out of love. We may worry that because those early feelings are gone, our love must be gone as well.
The role of shame in OCD
Many individuals with OCD whom I work with identify shame as a huge component of their feelings. Shame is the feeling of guilt turned inward, the idea that one is somehow bad, that their core being is wrong. Often people report feeling like they are not like other people. They describe feeling intense guilt even in the absence of having not done anything wrong. It is as if they themselves have internalized the feeling of wrongness or unworthiness.
When someone has OCD, they are bombarded with intrusive thoughts that go against the very things they care about most. The thoughts cause them to feel like they are the things that their brain tells them they are. If their brain tells them they could murder someone, rather than questioning it, they find meaning in it—after all, it can be very difficult not to take something so important seriously. Rather than responding “well that was an odd thought” or “that doesn’t align with who I am” they accept the things OCD makes them feel as truth: “If I think bad things, then I am also bad.”
These feelings that scary thoughts bring about can convince someone with OCD that they are a monster. The thoughts and feelings build and build and before they know it, they start to equate what they feel with the truth about themselves. Because they feel bad, they must be bad. But this couldn’t be more wrong when struggling with OCD.
Take, for example, the following cases:
Aubrey experiences intrusive images and thoughts about stabbing her husband. She loves her husband deeply, and she is terrified by these thoughts and images, and wishes they would just go away. She avoids her husband as much as possible and refuses to touch knives when he is around. Aubrey feels like a monster. She worries that she could one day “snap” and kill him, even though she has no desire to harm him in any way. Her intrusive thoughts make her worry that somehow “deep down” she must want to harm him. She goes to extreme lengths to avoid any confrontation with him, just to be certain. She often will leave the room if he is in it. She is hyper-aware of everything she feels and thinks when in his presence. At even the slightest sign that she may become upset, she is careful to leave the house. Aubrey would never want to hurt her husband. Yet she has a constant nagging feeling: “But what if I do? What kind of person am I because I have these thoughts?”
Rob enjoys watching crime shows. He has always been intrigued by these types of stories. He reads true crime novels and is fascinated by them. He even used to want to pursue a career as a detective. This all changed when one day he started to have horrifying thoughts about becoming a serial killer. It was as if one day, out of the blue, something in his mind shifted. Suddenly he was terrified of watching shows or reading stories even remotely related to crime or mystery. The idea that he could potentially become a monster haunted him. He wondered if that was why he enjoyed those shows and books all those years. Did that mean something about who he was? Does he relate to the personalities of those killers? Rob couldn’t seem to stop ruminating on these thoughts, and the more he tried to reassure himself that he could never be such a monster, the harder it became to deal with the slightest doubt—after all, he couldn’t know for sure what the future could hold. He gave away all of his books and committed to never watching true crime stories again.
In both cases, these individuals did not enjoy their obsessions. They went to great lengths to avoid anything that triggered these thoughts and feelings. They were not lost in fantasy about doing these things. They despised the thoughts and images. They were tormented by the idea that they could be a monster. That is what OCD is capable of, making you believe that you are a monster. But the truth is that you are most likely an extremely conscientious person who values the very things that OCD latches onto—that’s why it’s so hard for you to accept uncertainty surrounding the thoughts that OCD brings.
Trusting your feelings can feel counterintuitive when you have OCD
When someone has OCD, they encounter doubt in almost anything. They look inward and find more questions than answers. The idea of trusting one’s feelings can be terrifying. This is the very reason that treatment is often so difficult for OCD: most people who have it already know on the one hand that their symptoms may be illogical or even unreasonable. Yet they feel as though their thoughts could pose a real danger or could be true, and they must act based on how they feel in the moment. As a specialist in OCD, I can tell you that these are false alarms. The feelings do feel very real, yet they do not require a response from you. In fact, the more you respond to them, the more anxiety you will experience in the long term.
The people who struggle the most with not responding to these feelings are those who consider their thoughts or feelings to be taboo. These are the thoughts that many consider too difficult to talk about, that have the most difficult feelings attached to them. These are the thoughts that try to convince someone that they must be a monster because the thoughts make them feel so strongly like they are.
How should I respond?
It may seem paradoxical, but the answer to these endless thoughts and feelings is to accept uncertainty about them: maybe they are true and maybe they aren’t. Whether they are or aren’t they have nothing to do with who you are, your values, desires, or intentions. We hear this time and time again in the OCD community. It is important that a person with OCD accept that they will never be able to give “enough” certainty to OCD.
Often, people will say they can accept this uncertainty with most of the things OCD throws at them, but accepting uncertainty about one of OCD’s targets is just “unacceptable” to them. They cannot possibly accept any amount of uncertainty surrounding this thing. For example, the theme of pedophilia OCD (POCD). People with this theme will often say that they would prefer to have any other fears instead. They will say that they could sit with what-ifs and maybes about any other topic. Unfortunately, OCD knows this! That is precisely why these thoughts bother them so much, why they stick so effectively. Whatever someone’s theme of OCD is, it is always something that bothers them greatly and goes against the core of who they are. It will always attack what someone values.
When learning to sit with uncertainty around intrusive thoughts and fears, it is important to recognize that just because something is possible, doesn’t mean it is probable. Is it technically possible that you could wake up one day and choose to do something that opposes your values, even something highly violent or harmful? Yes, it is possible—you could never be 100% certain about anything like that. But it’s highly unlikely, because you have strong values and are always careful to act according to them.
To combat OCD, you must learn to sit with uncertainty about these possibilities and let the anxiety pass on its own. Your brain’s alarm system is going off, so your fears feel very real at the moment. When you don’t engage in compulsions to neutralize these fears, you teach your brain that you are not really in any danger and that you can live and act with confidence in your own values and choices, just as you do in other areas of your life not plagued by OCD. This is what exposure and response prevention (ERP) therapy— the scientifically backed treatment for OCD–helps you learn to do.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
ERP can help you sit with difficult feelings
ERP teaches people with OCD that thoughts, feelings, and urges do not have to have meaning. They can just be background noise. ERP helps people learn to sit in the anxiety and discomfort of these things and see that they can indeed survive them. Most importantly, they learn that they don’t need to do any compulsions to rid themselves of perceived danger or feelings of disgust, and that OCD produces false alarms. They learn that although it may not be comfortable, they can actually tolerate distress caused by OCD. Eventually, the feelings of anxiety do pass. When one continually resists giving into compulsions, their brain actually begins to relearn its responses, realizing that there was no danger in the first place. But it takes consistent practice. Retraining your brain takes time, commitment, and perseverance.
Key takeaways
- OCD distorts thoughts and feelings, making them seem urgent and real, but they often reflect false alarms rather than actual danger or truths.
- Learning to accept uncertainty about intrusive thoughts and resisting compulsions are crucial steps in managing OCD. This can be done with exposure and response prevention therapy (ERP).
