There are a multitude of barriers to accessing mental healthcare. Whether it’s financial, insurance-related, time, or motivation, you may find yourself unable to immediately access treatment for OCD.
If you are experiencing those barriers, or if you just want a supplement to your treatment with some extra “homework,” we have resources for you. Putting your thoughts and experiences down on paper can be valuable for any mental health struggle—especially for highly behavioral conditions like OCD—so we’ve compiled 5 OCD worksheets developed with the help of leading experts in OCD treatment.
These worksheets focus on support systems, mental compulsions, taboo thoughts, relationship OCD: cognitive distortions & compulsions, and identifying your core fear(s).
Each worksheet also has a linked video that will explain and guide you through it. We recommend watching those before you begin, and following along in the worksheet.
Worksheet #1: Support Systems
This worksheet focuses on the importance of having support systems in OCD recovery, as well as the different forms support can take. Dr. Nicholas Farrell, Regional Clinical Director at NOCD, says support systems can be “very important to the recovery journey.”
When you’re facing the challenging but rewarding work of OCD recovery, it’s beneficial to have people in your life to encourage you and hold you accountable. This is true for most challenges in life, and mental health is no exception.
Moreover, it’s important for the people closest to you to understand your condition and treatment. If they don’t have an understanding of how your OCD shows up, and how you can get better, they may be more likely to engage in enabling behaviors that help keep you stuck.
This worksheet will ask you to reflect on the ways you receive emotional, tangible, informational, and social support. If you are lacking support in any of those areas, you can brainstorm ways to seek or ask for support.
There is also a section for you to reflect on the ways your loved ones have provided reassurance to you when you compulsively ask for it. It prompts you to instead reflect on how your loved ones could provide validation without the reassurance.
Follow along with the video guide for our Support Systems worksheet here.
Worksheet #2: Mental Compulsions
This worksheet offers education around mental compulsions, which are any internal actions done to relieve the distress of your intrusive thoughts & triggers.
Dr. Farrell says it’s important for people to know about mental compulsions because, naturally, “they tend to be hidden.” Outside of describing your experience to a mental health professional, you’re really the only one who can identify or notice them.
You will learn about three primary categories of mental compulsions:
- Mental review/rumination
- Thought neutralizing, blocking, or distracting
- Self-reassurance
You will reflect on what mental compulsions you engage in, which thoughts, feelings, and uncertainties you’re trying to avoid by doing them, and how you can prioritize long-term recovery over short-term relief (which is all that compulsions can provide).
Follow along with the video guide for our Mental Compulsions worksheet here.
Worksheet #3: Taboo Thoughts
This worksheet talks about a very common thread among OCD themes and intrusive thoughts: they can be taboo, inappropriate, or deeply uncomfortable in nature.
Some of the more taboo themes include harm OCD, pedophilia OCD, and sexual orientation OCD. While these can feel deeply shameful, Dr. Farrell stresses the “universal nature” of intrusive thoughts.
You might feel like you’re the only one who has ever had these thoughts, but in fact, there are decades of research that point to the contrary. Dr. Farrell likes to show clients this research about the prevalence of all sorts of intrusive thought themes, among those with and without OCD.
You will learn that intrusive thoughts are ego-dystonic, meaning they don’t align with the sufferer’s values, beliefs, or morals. You will then be asked to reflect on how you judge yourself and your intrusive thoughts—how do you label them in your head?
You will be guided in speaking to yourself as you would a friend. Would you tell your friend with these uncontrollable thoughts that they are shameful, disgusting, or bad? It’s highly unlikely that you would. This worksheet will help you practice not speaking to yourself that way, either.
Follow along with the video guide on Taboo Intrusive Thoughts here.
Worksheet #4: Relationship OCD: Cognitive distortions & compulsions
This worksheet focuses first on cognitive distortions that people often engage in when they’re struggling with relationship OCD, though the information can equally be applied to other themes, too.
Cognitive distortions are tricks that OCD plays on us. Dr. Farrell describes them as “thinking errors.” They include:
- All-or-nothing thinking (My relationship has to be perfect otherwise we should break up)
- Catastrophizing (If I can’t be 100% certain about our relationship right now, I’m going to ruin my life in the future)
- Selective abstraction (My partner always gets stains on their clothes—can I live with that forever?)
- Mind reading (Other people probably think we’re bad for each other)
- Hyper-responsibility (If we don’t work out, I could be holding them back from meeting the right person, and it’ll all be my fault)
You’ll reflect on how cognitive distortions show up for you, then learn about common compulsions that people with relationship OCD engage in, such as constant “checking” of your feelings and attraction, “confessing” your intrusive thoughts because you feel so guilty, or seeking reassurance about your relationship (“we’re not going to break up, right?”).
You will then think how you can challenge both your cognitive distortions and compulsions to accept uncertainty and discomfort.
Follow along with the video guide on Cognitive Distortions in Relationship OCD here.
Worksheet #5: Core fears
The goal of this worksheet is to understand any “core fears” that are involved in your obsessions. As such, you will begin by learning more about obsessions—those repetitive, intrusive thoughts that often show up as “what ifs” and threaten our perception of safety.
After you get specific about your obsessions, you will learn more about the many faces of compulsions. Compulsions can show up in a million ways, and be mental (internal) or physical (external), but you will review a list of examples.
Finally, you will walk through the “downward arrow” exercise. You will start with your surface-level obsession (what if I run over someone with my car?) and then answer the question of, “If that came true, then…” until you get to the fundamental fear that causes you such distress. Perhaps the root is that you could be an evil person. Maybe it’s that you don’t have control over your impact on others.
Regardless, identifying your core fear allows you to get more specific about how you can face your fears—and at the end of the worksheet, you’ll brainstorm ways to do just that.
Follow along with the video guide on Core Fears here.
Use the OCD recovery tools at your disposal
Self-reflection and awareness is crucial to OCD recovery, but it can also be draining. Be patient and compassionate with yourself. You don’t have to do these all at once. If it feels overwhelming, you can do just one per day or even one per week, and really sit with each concept. Hopefully, you learn something new about OCD and about your unique experience of it.
If you want to give yourself the best chance at conquering OCD, please know that specialized, evidence-based therapy is available to you. The effectiveness of exposure and response prevention (ERP) therapy has been proven by decades of rigorous research, and it’s more accessible today than ever before.
Here at NOCD, every therapist receives intensive training in ERP, and we accept most major insurance plans to help you get started. If you’re ready to regain control of your life for OCD, I strongly encourage you to learn more about NOCD’s specialized approach to OCD treatment.