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Most people who eventually end up in OCD treatment don't start by Googling: "Do I have OCD?" They start by Googling things like:
And the answer they usually find is: "You're having intrusive thoughts." Technically true. Also, kind of unhelpful — and in some ways, it accidentally points people in exactly the wrong direction. The "Intrusive Thought" Is Not the Problem
Here's something that surprises many people: everyone has unwanted thoughts. Not just anxious people. Not just people with OCD. Everyone. A disturbing idea, image, or doubt can pop into your awareness completely uninvited: What if I swerve my car off the road? What if I said something offensive? What if I don't actually love my partner? These are what clinicians call obsessional doubts. The defining features are that you didn't choose them, and that they are extremely brief. We typically notice something triggering with one of our five senses and don't get a vote on whether the initial thought enters our awareness. But the harder you try to keep one out? The more aggressively your brain sends it back. You're Not Having That "Intrusive Thoughts" All Day Most people who say "I can't stop thinking about this" are not actually having the same unwanted thought fire into their awareness on repeat, all day, against their will. What's actually happening is something more effortful: You are trying to figure it out. This process has a name: rumination. And in OCD, rumination is not the obsession. It's the compulsion. What Is Rumination? Rumination is any mental effort directed at solving, resolving, or neutralizing a distressing uncertainty. It can look like:
And here's the part that makes people want to pull their hair out: even asking yourself "am I ruminating right now?" can become more rumination. Because rumination is simply this: analytical thinking applied to a question that cannot be resolved with certainty. Your brain is doing what brains do — problem-solving. It's just pointed at a problem that doesn't have a solution in this moment. (Important note: many of these problems will be resolved in future -- they simply can't be right now.) Why It Feels Like It's Happening to You "If rumination is something I'm doing, why does it feel totally involuntary?" Because it's happening in response to anxiety — and anxiety makes things feel urgent and automatic. You're not ruminating because you enjoy it. You're doing it because your brain has decided this question is a genuine threat, and that figuring it out will make you safe. Rumination feels like it's helping because it promises relief: just one more pass through this, and I'll finally know. But each pass keeps your attention locked on the threat. Which keeps anxiety running. Which makes the thought feel more dangerous. Which makes you want to analyze it more. The Loop:
Over time, it genuinely feels like "the thought never leaves." But you keep returning to it — not because it won't release you, but because the urge to resolve it is so strong. The thought isn't following you around. You're following it. Why This Matters for Treatment In ERP (Exposure and Response Prevention), the goal is to allow the obsession to be present while refraining from doing the compulsion. But if people don't realize rumination is a compulsion, they assume they're supposed to just sit with the analysis as it runs — which means they keep performing the exact behavior that maintains the anxiety, under the impression they're doing ERP correctly. This is one of the most common reasons people try self-directed ERP (please don't), feel like it isn't working, and give up. A Better Treatment Goal Getting better isn't about eliminating unwanted thoughts — that's not possible. It's not about forcing your mind to move on or arguing yourself out of it. It's about learning not to engage with every question your mind raises. A thought can exist in your awareness without you directing mental effort toward it. And when the effort to figure it out stops? Anxiety tends to come down on its own — not because you solved anything, but because you stopped feeding it. If you're spending hours each day mentally wrestling with questions that never seem to resolve, working with a therapist trained in ERP can help you learn to disengage from compulsive rumination — without suppressing your thoughts or white-knuckling through the anxiety. Christopher Toomer is a Licensed Clinical Social Worker specializing in Exposure and Response Prevention (ERP) and Eye Movement Desensitization and Reprocessing (EMDR) therapy for OCD and anxiety disorders. He provides evidence-based treatment for adults and children 8+ at Indy OCD in Carmel, Indiana. Comments are closed.
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