How do I stop reacting to my thoughts? I feel helpless because I have a constant need to reassure myself. . . . I realize that your thoughts can be so overwhelming that you would do anything to stop them. The cycle of obsession-anxiety-reassurance is exhausting and can pull us away from the things we truly care about. Remember though that these thoughts are just your OCD and aren’t a reflection of who you are. But reassurance-seeking is a compulsion, and there are ways to unlearn our compulsive behaviors. One strategy is “doing nothing.” Don’t even take a moment to acknowledge the thought (or feeling or sensation) has occurred, and simply persist through the activity you’re in. Ignoring thoughts is similar to one of the main goals of OCD treatment: becoming able to experience thoughts without reacting to them. But, in and of itself, it’s a very difficult thing to do; and if it comes in the form of avoidance, it might be counterproductive. Similarly, you could take the exposure-based approach of purposely thinking the thought and “welcoming” the thought while resolving not to check. If you’ve worked with an OCD therapist, you might be familiar with the concept of exposure and response prevention (ERP). This means you’re not using any compulsions when you feel anxiety kicking in. Developing strategies for response prevention takes time, and there are no simple answers. Although ERP is the most effective type of therapy for OCD, it can’t work without the response prevention part. If we’re not preventing ourselves from temporarily escaping anxiety, we can’t learn how to do anything else. In general, once they’ve designed some response prevention strategies together, therapists may ask their clients to deliberately intensify their anxiety when they’re in specific situations and it kicks in. Making an exposure out of these difficult situations can help us be more deliberate in our responses and grow from the moment of anxiety, rather than just suffering through it or spending time and energy on compulsions. So, again, working with an OCD therapist is the best way to learn how to create exposures and respond to anxiety without falling back into the same old compulsive cycle.

I’ve been stuck in this cycle for the last month or two and am not sure how to get out of it. Basically, I will work on ignoring the thoughts and not responding or engaging plus limiting/completely eliminating compulsions. After a week or two of constant work, the amount of intrusive thoughts in a day goes down. The anxiety each thought causes also goes down with some, but not all, thoughts passing without notice like they would for a normal person. The thoughts that do stick cause anxiety and make me want to ruminate or do other compulsions but I make sure to limit them. After a bit, I’m in a pretty good head space. This is usually when it goes down hill. I’ll start to question if I even have ocd because some of the thoughts (once again not all) pass without notice. The difficulty resisting compulsions goes down and so does the anxiety, only increasing the questioning. I spend a while questioning if I’ve ever had ocd in the first place and then something sets me off or the questioning itself becomes a trigger and I get stuck back into the same ocd cycle with constant rumination, anxiety, and other compulsions. This lasts for a week or two before I know I need to stop and try and work hard to get back to ignoring the thoughts. And the cycle just restarts over and over again. Does anyone have any tips to stop this from happening? It’s really harming my recovery as every few weeks I dive back into the same negative place I was.

Hi - just for some context, I have OCD and ADHD. I hate bringing this up, but with these diagnoses, when intertwined, there is ALWAYS a thought. I never stop thinking. This is really hard, especially because I feel like I always need to be talking to someone. Whether it’s my friends or family, talking to people brings me down to earth from certain kinds of thought spirals. However, when I’m alone it is the hardest. When my friends don’t reply I have this compulsion to text again or I need to constantly check my notifications so that I have none left to check. But then to them or new people I talk to, this behavior probably comes across as overwhelming or too much. I’m trying to control it and use erp, but also, I have my moments where I’m just vunerable and give into the compulsion. It’s genuinely so embarassing and maybe not as big a deal as I’m making it out to be but, how do I manage? And how do I relax?

The subject of OCD matters to the sufferer because it feels like confirmation that they are fundamentally unlovable and unwanted—as if even existence itself doesn’t want them. They feel like an error, carrying a deep sense of guilt and shame, as if they were inherently wrong. They suffer from low self-esteem and a deep internalized shame, because long ago, they were fragmented and learned a pattern of fundamental distrust—especially self-distrust. But the real trouble doesn’t come from the content of the most vile or taboo thoughts. It comes from the fact that the sufferer lacks self-love. That’s why, when you begin to walk the road to recovery, you’re taught unconditional self-acceptance—because that’s what all sufferers of OCD have in common: if you aren’t 100% sure, if there isn’t absolute certainty, the doubt will continue to attack you and your core values. It will make you doubt everything—even your own aversion to the thoughts. You have to relearn how to trust yourself—not because you accept that you might become a murderer someday—but because you enter a deep state of acceptance about who you truly are. It’s not about becoming a monster at all. It’s about making peace with what lies at the root of the fear. Making peace with the guilt. With the shame. Making peace with yourself and the person you fear you might be. Because that fear is not rooted in reality. It’s not rooted in any true desire to act. It’s rooted in your identity—specifically, in what might threaten it. That’s what confirms the belief that you are fundamentally wrong. And OCD fuels that belief by using intrusive taboo thoughts to attack your very sense of self. But then I wonder: let’s say, for example, someone fears being or becoming a sexually dangerous person—how could that person practice unconditional self-acceptance? I would never accept myself if I were to harm anyone—the thought alone makes me want to cry. I know it’s not about whether or not someone acts on the thought. It’s about the core fear underneath it. So how do you accept yourself when the thoughts—and the feelings around them—feel so completely unacceptable ?