I think HOCD or ocd in general obsessions often seem so real because we really want to remove the anxiety, and then our brain will try everything it can to get us to agree with the thoughts and our biggest fear of reducing the bad feelings. for example, I have been terrified of having avoidant PD, but after the fear came a desire to get the diagnosis in order to get an answer and calm the anxiety. think ocd in general is so too, that we just want to reduce anxiety and thus our brain will make us agree to take a break