Obsessive thoughts: when your mind will not switch off

What obsessive thoughts are

Can you not stop going over an idea, even though you know it makes no sense? Do you feel trapped in repetitive thoughts that will not let you concentrate or be at peace? Do you need to check things or carry out small rituals to ease the anxiety? If this sounds familiar, it may be what clinical psychology calls obsessive-compulsive disorder (OCD). Only a professional assessment can confirm it.

OCD is not about being tidy or a perfectionist. It is about having intrusive thoughts that cause a lot of distress (obsessions) and that push you to do things to try to feel better (compulsions): checking a thousand times that you locked the door, washing your hands until it hurts, counting in your head, constantly seeking reassurance that everything is fine.

Those actions ease the anxiety for a moment, but they strengthen the cycle and make it harder and harder to break. Compulsions are your mind's attempt to reduce the distress, but they end up becoming a trap.

How to recognise them

• A thought you do not want keeps coming back, even though you know it makes no sense.
• You check many times whether you locked the door, switched something off or did things right.
• You wash your hands or clean far more than you need to, sometimes until it hurts.
• You count in your head, repeat phrases or need to carry out rituals to feel settled.
• You constantly ask others to confirm that everything is fine.
• These thoughts and rituals take up time every day and stop you concentrating.

What helps

Exposure and response prevention (ERP). It means facing the thought or situation you fear without doing the compulsion that usually goes with it. With practice, the brain learns that it does not need to do anything to be safe, and the anxiety comes down. It is like teaching it that it can tolerate uncertainty without rituals. It is part of cognitive behavioural therapy, the recommended psychological treatment for OCD (NICE CG31).

A first exercise. Write down the obsessive thought exactly as it appears and rate your fear from 0 to 10. Try not to do the compulsion for around 5 to 10 minutes and notice how the anxiety changes over time. If it is very hard or the distress does not come down, do not force it on your own: ERP works best guided by a professional, who adjusts it to your pace.

You are not being "obsessive" for fun. Nor overreacting: you are suffering. Naming what is happening, obsessions on one side and compulsions on the other, already helps you see it from the outside.

What therapy does. At We Are Psycho we help you understand what is happening to you, break the cycle and regain your mental freedom, with an exposure plan built with you, step by step.

What it does not do. It does not make you face what scares you most all at once, and it does not promise that the thoughts will disappear completely. It works so that they stop being in charge.

When to ask for help

Almost everyone has an odd thought now and then or checks something twice, and that is not OCD.

It is time to talk to a professional if the thoughts or rituals take up a lot of time every day, if they cause you a lot of distress, if they interfere with your studies, work or relationships, or if you have started avoiding places or situations so they do not come up.

If thoughts of hurting yourself or of not wanting to go on appear, do not wait: call 800 911 2000 (Línea de la Vida). In immediate danger, call 911. We Are Psycho does not provide emergency care.

• 

  Ainhoa Corbera

  Licensed psychologist · Clinical director

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• 

  Jack Díaz Ponce

  Integrative Wellness Psychologist

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• 

  Melanie Olvera Ventura

  Child and adolescent clinical psychologist

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Frequently asked questions

Does being tidy or a perfectionist mean having OCD?

No. Liking things in order or done well is not OCD. We speak of OCD when intrusive thoughts cause a lot of distress and there are compulsions you feel you have to carry out to calm it, even though you do not want to, and all of that takes away your time and peace of mind.

Does having a horrible thought mean I want to act on it?

No. Intrusive thoughts are exactly that: ideas you do not want to have, and they distress you because they go against who you are and what you value. Having them says nothing about your intentions. What keeps them going is the effort to neutralise them, and that is what therapy works on.

How does therapy work at We Are Psycho?

It is online and confidential, with specialised psychological care. You tell us what is going on, we suggest the psychologist who fits you best and you choose. If you have questions about how it works first, we explain it in a free 20-minute call, with no commitment.