Obsessive compulsive disorder - OCD treatment and therapy from NOCD
OCD subtypes
Harm OCD

Do you have “unacceptable” unwanted thoughts? You are not alone

10 min read
Stacy Quick, LPC

Perhaps one of the least talked about topics surrounding Obsessive-Compulsive Disorder (OCD) is “unacceptable” or taboo thoughts. OCD involves repetitive, unwanted, intrusive thoughts that are hard to control. It also involves compulsions, which can be external or internal. Compulsions are repetitive physical or mental behaviors that a person with OCD uses to neutralize the anxiety and distress caused by intrusive thoughts or in an attempt to prevent something frightening or bad from happening. 

The topics or themes of OCD intrusive thoughts vary from person to person, although most people experience many themes. This can include unwanted thoughts that they may consider “unacceptable,” “forbidden,” or otherwise prohibited by the individual. These types of taboo thoughts often include harmful, violent, aggressive, sexual, or religious thoughts that are in opposition to their value system and morals, and they often bring about intense feelings of discomfort, shame, or guilt. These thoughts are often hard for people to talk about. 

What is defined as “unacceptable” or taboo can be based on many factors, such as where the person comes from, how they were raised, perceived social norms, or their religious beliefs. Regardless of these factors, the thoughts are seen as unacceptable by the person suffering from them. We know that intrusive OCD thoughts are ego-dystonic, meaning that the thoughts go against a person’s nature, which is why they are so anxiety-provoking. The things that the person with OCD gets stuck on are the very things that they find disgusting and horrifying.

I think it is important to dig deeper into this area because it isn’t spoken about as much, even though these types of thoughts are extremely common and don’t mean anything about your character. If you are experiencing unwanted thoughts that are “unacceptable,” know that you’re not alone. Thankfully, today there is far more information available at your fingertips than ever before about taboo thoughts and OCD. You just have to know where to look. 

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Examples of “unacceptable” or taboo intrusive thoughts

OCD themes like POCDSexual Orientation (SO-OCD), Pure O, Harm OCD, Scrupulosity OCD, and others often involve taboo intrusive thoughts that can manifest differently for every person struggling with them. But, at their core they all have a commonality: they cause the person experiencing them to deeply doubt themselves. OCD needs certainty, demanding to know that the thoughts a person is experiencing are not real. OCD looks for their values and then attacks them, causing them to mistrust the very things that they stand for and want in life. It calls into question who they really are and the things they hold most dear. This is why OCD is such a tormenting disorder.

Let’s look at two examples of how taboo intrusive thoughts can affect people with OCD:

Andrea is a new mom to a beautiful baby girl. She has wanted a child her entire life and comes from a large family herself. When she was younger, she was diagnosed with OCD and treated for primarily religious scrupulosity concerns. She worried a lot about going to hell and whether she was sinning. Her symptoms had been mostly under control for many years with an occasional intrusive thought that she easily brushed off. That changed when she brought home her precious new baby.

The shift happened almost overnight. Andrea wasn’t sleeping much and was stressed as she maneuvered her new role as a mother. One day while giving her daughter a bath she had a frightening intrusive thought that she had molested her. She knew that she had no desire to do this, but she just couldn’t shake the feeling that she may have touched her inappropriately. She would never want to hurt her child, and she never experienced sexual arousal from children before. But what if she did? She just couldn’t be “sure.”

For the next week, she remained steadfast in solving this problem. She replayed the bath time over and over in her mind. She started making excuses to not change her baby’s diaper and had her mom come and stay with her to help out. She just wanted her mom there so she wouldn’t be alone with her baby. The shame weighed heavily on her heart: What kind of mother was she? What would other people think if they knew? How could she be a mother with these thoughts? 

Unfortunately, like so many others who have OCD, Andrea was unaware that these terrifying unwanted thoughts were also OCD. Even though she thought she knew what OCD was, and despite having been diagnosed with it in the past, she didn’t know that intrusive thoughts could take on other forms than what she had previously experienced. 

Andrea was suffering in silence. The truth is that she loved this baby more than anything and was highly unlikely to act on any thoughts of harming her child. She was so hyper-aware of her every move, and so careful to not do anything inappropriate, that the last thing she would engage in would be sexually deviant behavior with her child. 

Eventually, Andrea decided to seek the help she desperately needed and began exposure and response prevention (ERP) therapy. She learned that her brain was “getting stuck” on these thoughts. She was able to see the difference between what she thought and how she responded, and that these were not the same. The thoughts did not indicate in any way that she was a dangerous pedophile. She learned to sit in the uncertainty and accept that the thoughts may be there from time to time, but she wouldn’t need to engage them. She wouldn’t even need to solve the “why” of them being there—there was no reason other than she has OCD and sometimes people have unwanted thoughts. With the right tools in place, she went on to enjoy being a mother again. At times when she would have intrusive thoughts, she no longer had to avoid her child or perform compulsions to feel better, and she learned that the distress went away on its own eventually.

As Andrea learned, in OCD treatment, OCD specialists don’t want to reassure people about their fears. What I mean by this is that we don’t want to ensure them that they will never do something. This is because we know that this temporary reassurance will not last. It may help at the moment to reduce panicked feelings, but ultimately you cannot give OCD “enough” reassurance. It will always want more. At the same time, early in treatment, I think it is important that people with OCD understand what OCD truly looks like and how it works. It’s important to know that OCD latches onto the very things that go against their values. Knowing these things will help them to recognize the symptoms early on and treat them effectively. Then, we work on other strategies together to cope with the distress OCD causes, without providing reassurance or engaging in other safety-seeking behaviors.

Brian had intrusive thoughts his whole life, for as long as he could remember. He always felt he was “off” but managed to get by and never felt he needed help. He had not even heard of OCD and didn’t know what he was experiencing had a name. He worried that he may have seemed weird to others, so he often avoided socializing. It wasn’t until he learned about a notorious serial killer that he started having what he would say were the absolute worst fears he ever experienced. 

Shortly after watching a documentary about this serial killer who was an antisocial person, Brian started to think he himself could become a serial killer. He started to think that maybe he enjoyed hearing about and learning about murderers. He reviewed what the documentary said about the personality traits of the serial killer over and over again, trying to determine if he was like this serial killer or not. He had become obsessed with Googling things like “signs of a sociopath” and “how do you know if you would kill someone?” He felt sick to his stomach every day. He knew he hated these thoughts and would never want to hurt someone, but he couldn’t shake the what-ifs. He needed to know for sure that it would never happen. 

Brian remembered the show had talked about certain behaviors that the serial killer experienced when he was a child, one of which was bed wetting. Brian had wet the bed until he was a teenager. Now he was convinced he was destined to be a killer. He was constantly filled with anxiety and could barely eat or sleep. Out of desperation and fear, he finally called his doctor. 

Thankfully, Brian’s doctor knew that he was likely experiencing OCD. His doctor referred him to a therapist who specialized in OCD and ERP, and now, he is on the road to recovery. The OCD specialist understood that was Brian was experiencing was OCD and was not judgemental about his thoughts. Now, Brian is learning to live the life he wants to live regardless of the thoughts in his head. He is starting to recognize that he doesn’t need to do anything to get rid of the thoughts. The thoughts are not dangerous or indicative of who he is. They are just thoughts.

Having self-compassion

It is crucial that a person with OCD has self-compassion. Anyone, with or without OCD, should practice this skill. This means giving yourself grace and being kind to yourself, even when you experience hardships or when things happen that cause you to question your adequacy. It is allowing for error and accepting that you are human and have flaws. It is loving and caring for yourself despite all the difficult things you face day to day. 

When you have OCD, it is important to recognize that you are not what you think, and thinking something doesn’t equal doing something. Having self-compassion as a person with OCD means loving yourself enough to take care of yourself. It is fighting against the guilt and shame that often accompany taboo thoughts. It is having perseverance and a dedication to living life based on your values and your terms. It is not allowing OCD to steal your joy. It is taking back control of your life. Self-compassion allows you to see that you are not alone, there are people who understand your experiences. There is help and there is hope. 

Getting help from a specialist who understands your thoughts

No matter how “unacceptable” the thoughts that you’re struggling with are, a therapist who is specialty-trained in ERP will not judge you for them, as they deeply understand OCD and all OCD subtypes, including the ones that are more taboo. Through ERP, they can teach you that these intrusive thoughts, feelings, urges, or images do not have to have meaning at all. They can just be background noise, and they don’t have to take up more space in your life. 

ERP helps people with OCD to sit in the anxiety and discomfort of these thoughts and see that they can indeed survive them—and most importantly, they don’t need to do any compulsions to rid themselves of anxiety, distress, or any perceived danger. You can learn that although it may not be comfortable, you can tolerate the distress that even the most taboo thoughts cause. Eventually, the feelings of anxiety do pass. When you don’t give in to rituals or compulsions, your brain relearns that there was no danger in the first place, thus correcting the faulty alarm we have in our brains. But retraining your brain takes time, commitment, and perseverance. This is why it’s critical to work with a qualified, licensed OCD specialist who can help build a personalized treatment plan specifically for your needs, goals, and progress.

If you’re struggling with OCD and want to take the power away from your intrusive thoughts, NOCD can help. Our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs – and that means the best care for our members. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

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NOCD Therapists specialize in treating Harm OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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