Live AMA: Dealing with challenging intrusive thoughts

This is such a hard feeling, because panic can make your thoughts feel so real in the moment. OCD and panic both have a way of making you feel like “this has to mean something” or “I need to figure this out right now.” And when your anxiety spikes, it can suddenly feel like your thoughts are reality instead of just thoughts. That’s one of the hardest parts of OCD and panic. Just because something feels convincing doesn’t mean it’s true.

@Anonymous I second this question 🙋

@anonymous and @torylynn84 I third this question! This is the nature of much of my intrusive thoughts. The Mama guilt and regret thoughts are especially brutal as I watch my two oldest boys (25 and 17) struggle in life (one an addict, the other with OCD, both with repeated severe trauma). Not all is due to mistakes made by me, but it often feels that way. I also watch my young sons (10 and 8) suffer and my mind’s wheels turn from the moment I wake up to question past and present decisions in terms of impact on my precious boys. It paralyzes my decision making because I’m afraid I’ll never get it right and they’ll be hurt still more. (ie. What if I choose an incompetent therapist for my son again who does more harm than good? Etc…)

This is such a thoughtful question, and honestly I think a lot of people with OCD struggle with this. OCD has a way of making people feel like they need complete certainty about who they are and what they value. But ERP therapy isn’t about giving up on your values or never understanding yourself. If anything, it’s about learning to put your values over your fear. OCD wants you stuck in your head trying to feel certain. But a lot of the time, our values are reflected more in how we live, the choices we make, and the way we consistently show up over time. A lot of people find that the less they argue with OCD about who they are, the more grounded they start to feel in themselves naturally.

@Anonymous this is very relatable. I had never had an intense fear of dying until someone was telling me about their intense fear of dying. and at first I was like, yeah it’s something that I never really think about and i’m actually fine with death. but after they started making me think about, I can’t stop being terrified of it.

This is actually a really common OCD experience. Anything can trigger OCD and give it a new angle to latch onto. Reading about a new subtype online can suddenly turn into “wait… what if this applies to me too?” And then OCD starts doing what it does best, analyzing, checking feelings, replaying thoughts, trying to get certainty. The hard part is that we can’t avoid every trigger that might show up. In fact, trying to avoid them will just fuel the OCD cycle even more, because OCD will always find something new to question. A lot of this comes back to learning that if something actually needs to be dealt with, we’ll handle it when we get there, instead of trying to solve every possibility ahead of time.

OCD doesn’t always show up as “what if” thoughts. Sometimes they sound like statements, accusations, memories, urges, or things that feel very direct and convincing. I think a lot of people expect intrusive thoughts to sound uncertain, but OCD can sound extremely confident. What usually matters more isn’t the wording of the thought, but the fear, urgency, and compulsive loop around it

@Anonymous I feel you

@Anonymous I understand you completely! And then i feel guilty that they aren’t causing me the same amount of anxiety or distress as they did before so it MUST mean that I secretly enjoy it…..the rumination is evidence that it is clearly not enjoyable if im trying to convince myself out of a thought spiral. So exhausting. I see you and understand you!!

This is such a painful part of OCD, because it can make you feel completely trapped in your own mind. When memories feel unclear, exaggerated, or incomplete, OCD tends to latch onto that uncertainty and treat it like something dangerous that has to be figured out. And the more your mind tries to replay it, analyze it, or “make sure” of what happened, the deeper that spiral can become. What makes it especially hard is that memories are naturally imperfect to begin with, but OCD has a really hard time tolerating that. So it can turn normal uncertainty around memory into something that feels incredibly urgent and consuming.

False memory OCD can feel so exhausting because it convinces you that if you just think about it a little longer, replay it one more time, or find the “right” feeling, you’ll finally get certainty. But the loop usually keeps going because OCD keeps moving the target. What stands out to me with this subtype is how strong the pull is to mentally review and figure it out, even when it’s already taken so much time and energy. And a lot of the work ends up being around learning that uncertainty around memories is actually part of being human, even though OCD treats it like something dangerous. The less attention and importance the loop gets over time, the less consuming it tends to become.

First, I just want to say it really sounds like you’ve fought hard to get parts of your life back, and the fact that the nightmares have already lessened in frequency and intensity says a lot about the work you’ve done. Harm OCD can feel especially disturbing because it targets the people you care about most, and when it shows up in dreams it can feel even more unsettling and harder to separate from reality. What stands out to me is how OCD can start attaching meaning to the dreams themselves, almost like they need to be analyzed, feared, or taken as evidence of something. And that fear of going back to sleep makes so much sense when the experience feels that intense. But the fact that things have already shifted with therapy and ERP is important too. Even if it still shows up sometimes, that doesn’t erase the progress you’ve made.

This is such a hard intersection with OCD, because healthcare already carries real responsibility, which can make it really hard to recognize where appropriate care ends and compulsive checking begins. It sounds like OCD is really attaching itself to the fear of making a mistake and the responsibility that comes with patient care. And that can make the checking feel not just justified, but necessary. I think this is also why OCD in these settings can feel especially exhausting. That line can feel really blurry, and the urge to feel certain can become really intense. No matter how hard OCD tries to convince us otherwise, the relief from checking usually doesn’t last very long, so the urge to go back and check again keeps getting reinforced.

When OCD gets wrapped around things like death, existence, or reality, it can start to feel like your mind is constantly pulling you away from the present moment and into trying to figure something out that has no clear answer. OCD creates this really intense sense of urgency around the thoughts, like you have to engage with them or figure them out right now in order to feel okay again. OCD rarely wants us present. It wants us in our heads, analyzing, questioning, spiraling, and trying to get certainty. And it makes sense that when one theme gets loud, it can start pulling older themes back in too. That’s such a common OCD pattern. Remember, no matter how OCD decides to show up, the treatment remains the same.

@Napa Kiwi It should be coming up live through the NOCD app shortly

@Chente_g Where in the app do I go?

@Napa Kiwi It’ll automatically send you a notification when it starts , not sure why it hasn’t already

@Chente_g Thanks, I'm having a Senior sort of brain today.