Why OCD Goes After What You Love Most
The new parent who adores their baby. The person who would never cheat. The kindest person in the room. These are often the exact people who come into my office terrified of their own minds. That is not a coincidence. It is how OCD works.
What is an intrusive OCD thought?
An intrusive OCD thought is an involuntary, repetitive, and distressing thought, image, or urge. These thoughts are what clinicians call ego dystonic, meaning they conflict with a person's core values, beliefs, or desires. In other words, the thought feels completely foreign to who you are, and that is a big part of why it is so upsetting.
Common themes include fears of contamination, causing accidental or intentional harm, taboo or forbidden thoughts (sexual, religious, or aggressive), and a need for symmetry or exactness (International OCD Foundation, n.d.).
The OCD Loop
Everyone has strange or unwanted thoughts from time to time. The difference with OCD is what happens next. OCD related intrusive thoughts trigger significant anxiety or doubt, which drives compulsive behaviors or mental rituals meant to neutralize the perceived threat or distress.
In the moment, these compulsions may bring some relief. But the intrusive thoughts usually come back stronger and louder, and the person gets stuck in what I call the OCD Loop: thought, anxiety, compulsion, brief relief, and then the thought again, often with more intensity than before.
What these thoughts can look like
I often work with individuals who have dark, scary OCD thoughts. These can include unwanted sexual thoughts about children, fears of cheating on a partner, constant questioning of whether they truly love their partner, or the fear that they hit and killed someone while driving past them.
Notice what these have in common. The loving parent gets thoughts about harming or violating their child. The committed partner gets thoughts about betrayal. The careful driver gets thoughts about killing a pedestrian. OCD tends to attack the very things a person values most.
Why OCD targets what you care about most
Your brain does not treat every thought equally. If a random thought pops up about something you do not care about, it barely registers. You might think "that was weird" and move on without a second thought. But when a thought touches something you deeply value, like your child's safety, your relationship, your faith, or your sense of yourself as a good person, your brain's alarm system goes off. The stakes feel enormous, so the thought feels enormous too.
Psychologist Stanley Rachman found that intrusive thoughts turn into obsessions when a person interprets them as significant, as if the thought reveals something important about who they are or what they might do. People with strong moral standards and a heightened sense of responsibility are especially likely to interpret their thoughts this way (Rachman, 1997). In other words, the caring is part of what fuels the fear. OCD does not need to invent something scary. It simply finds what matters most to you and asks, "But what if?"
Once that alarm goes off, the brain starts scanning for the thought, checking whether it is still there, and trying hard to push it away. Unfortunately, that backfires. Research on thought suppression shows that trying not to think about something tends to make it show up even more (Wegner et al., 1987). So the harder you fight a thought about something you love, the louder it gets, and the more it seems like it must mean something.
This is why the thought is not a clue about some hidden desire. It is a reflection of what you would hate to lose, and OCD knows exactly where to aim.
A thought is not a fact about youHaving an unwanted thought does not, by itself, make it true. It is not a fact about you or your character, and it does not mean you intend to act on it.
At the same time, it is important to be accurate here. Frightening, unwanted thoughts can be part of OCD, but the fact that a thought feels disturbing does not prove that it is OCD. A clinician looks at the broader pattern, including how often the thoughts occur, how much distress or disruption they cause, and whether the person feels driven to do something about them. Those compulsions can include checking, avoiding, mentally reviewing, confessing, and repeatedly asking for reassurance.
OCD can also make people overanalyze what a thought means and search endlessly for certainty that they would never act on it. That search for certainty is part of the loop, not the way out of it.
How OCD is treated
Exposure and Response Prevention, or ERP, is an evidence based therapy commonly used to treat OCD (International OCD Foundation, n.d.). In ERP, clients gradually face the thoughts and situations that trigger their anxiety while practicing not doing the compulsion. Over time, the brain learns that the thought is just a thought, and the alarm system begins to quiet down.
Medication can also be part of treatment. Selective serotonin reuptake inhibitors, or SSRIs, are the most common medications used for OCD, though only about 40 to 60 percent of people with OCD benefit from first line SSRI treatment (Korn, 2016). This is something to explore with your prescriber.
An integrative lens: your body matters too
From an integrative perspective, OCD symptoms often get worse when we are under stress. Sleep deprivation, dehydration, hunger, illness, and inactivity can all turn up the volume on intrusive thoughts. Taking care of your body will not cure OCD, but it can make the work of treatment feel more manageable.
Hormones can play a role as well. For some women, OCD symptoms increase during the premenstrual phase, pregnancy, the postpartum period, or perimenopause, and higher estrogen levels have been linked to worsening symptoms (Rapkin et al., 2002, as cited in Korn, 2016).
There is also some research looking at nutrition and OCD. Vitamin B12 levels are often low in people with OCD (Greenblatt, 2013, as cited in Korn, 2016), and melatonin, the hormone that helps regulate sleep, has been found to be reduced (Monteleone et al., 1995, as cited in Korn, 2016). This is psychoeducation, not a treatment recommendation. If any of this resonates, it is worth a conversation with your physician, prescriber, or a registered dietitian, who can check levels and help you decide what makes sense for you.
You are not your thoughts
OCD is also rarely alone. Many people with OCD also experience depression, anxiety, ADHD, eating disorders, or related conditions such as body dysmorphic disorder, trichotillomania, skin picking, or tic disorders (Korn, 2016). If that is you, it does not mean you are too complicated to help. It means you deserve care that looks at the whole picture.
If you are living with scary intrusive thoughts, please hear this: having a thought is not the same as wanting it, believing it, or acting on it. You deserve support from someone who understands OCD and will not flinch when you tell them what your brain says.
Ready to get unstuck?
At Claimed Counseling, Ashley Franklin, LICSW, CIMHP, specializes in treating OCD and has been providing Exposure and Response Prevention since 2013. As a licensed therapist and certified integrative mental health professional, she combines ERP with a whole person approach that looks at your nervous system, sleep, stress, and body, not just your thoughts.
You do not have to explain your worst thoughts perfectly, and you do not have to be sure it is OCD before reaching out. That is what we figure out together.
Book a free 15 minute consultation to see if we are a good fit:
Claimed Counseling offers telehealth sessions for adults living in Massachusetts. Insurance and rates vary by clinician, and we are happy to walk you through your options during your consultation.
This post is for educational purposes only and is not a substitute for professional diagnosis or treatment. If you are in crisis, call or text 988 or go to your nearest emergency room.
References
International OCD Foundation. (n.d.). What is OCD? https://iocdf.org/about-ocd/
Korn, L. (2016). Nutrition essentials for mental health: A complete guide to the food mood connection.
W. W. Norton. Monteleone, P., Catapano, F., Tortorella, A., Di Martino, S., and Maj, M. (1995). Plasma melatonin and cortisol circadian patterns in patients with obsessive compulsive disorder before and after fluoxetine treatment. Psychoneuroendocrinology, 20(7), 763 to 770.
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35(9), 793 to 802.
Rapkin, A. J., Mikacich, J. A., Moatakef Imani, B., and Rasgon, N. (2002). The clinical nature and formal diagnosis of premenstrual, postpartum, and perimenopausal affective disorders. Current Psychiatry Reports, 4(6), 419 to 428.
Wegner, D. M., Schneider, D. J., Carter, S. R., and White, T. L. (1987). Paradoxical effects of thought suppression. Journal of Personality and Social Psychology, 53(1), 5 to 13.
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