OCD subtypes
Magical Thinking OCD

What Are Magical Thinking OCD Exposures? Explanation and Examples

4 min read
Keara Valentine
By Keara Valentine

Have you ever knocked on wood for good luck? Or worn your favorite color for a little fortune on a job interview? It’s common to engage in superstitions from time to time, even if you don’t fully believe in them. However, when you have magical thinking obsessive-compulsive disorder (OCD), knocking on wood might feel like more than a fun way to prevent something unlucky — it seems like an essential action you must complete to avoid terrible consequences. 

People with magical thinking OCD experience frequent intrusive thoughts, images or urges around superstition, colors and numbers. They may worry they’ll potentially harm themselves or others through negative thoughts, fearing that what’s in their head may influence reality. It’s stressful and frightening to think you could be liable for hurting a loved one just because the wrong image popped into your head. So, in response, people use compulsions to find relief from their distress. That might mean counting to 100 each time they make a phone call, making sure to follow each negative thought with five positive thoughts, or fixating on a specific sound or phrase. 

People with magical thinking OCD are driven by a need to know with 100% certainty that something bad won’t happen. Even if you logically understand that your fear and this ritual are not connected, the hypothetical scenarios feel so frightening, you’d rather do whatever feels necessary to prevent them. A person might think, “Counting to 100 probably won’t prevent bad luck, but I’ll do it anyway to be on the safe side. Why take any chances?”

“Counting to 100 probably won’t prevent bad luck, but I’ll do it anyway to be on the safe side. Why take any chances?”

How is magical thinking OCD treated?

If you’re struggling with magical thinking OCD, the path to recovery might feel impossible to navigate. The fears driving someone with magical thinking OCD aren’t usually based in logic, and they can’t be overcome with rationalizations. This can become a problem in treatment when people are misdiagnosed. A therapist who is unfamiliar with OCD may be tempted to reassure their patient that whatever the person is afraid of will not happen. Unfortunately, this serves as a compulsion and only strengthens the OCD cycle long-term.

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Fortunately, there is treatment available specifically for OCD. Exposure and response prevention (ERP) therapy is considered the gold standard for OCD treatment, and studies show that 80% of patients respond positively to it. ERP specifically targets your obsessions and compulsions by intentionally exposing yourself to the source of your obsessions and refraining from your compulsions. If you’re convinced you need to count to 100 to prevent bad luck, during therapy you might work on testing the predictions you fear the most.

What are magical thinking OCD exposures?

Exposures for magical thinking OCD will depend on what sources trigger your obsessions and compulsions. Let’s say when you watch a movie, you have to pinch your left thumb each time someone says a name on the screen. You’re convinced something bad will happen if you don’t perform this ritual. You may not be exactly sure what would happen, but you definitely don’t want to find out. This ritual makes paying attention to a movie difficult, and your partner can tell your mind is elsewhere, but you don’t see any alternatives. 

You’ll be intentionally exposing yourself to the source of your obsessions — and that’s the first step.

Together with your therapist, you might watch a movie and hear someone say another person’s name. By doing this, you’ll be intentionally exposing yourself to the source of your obsessions.

Below are some possible exposures for people with magical thinking OCD.

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Examples of magical thinking OCD exposures

  • Looking at a color or number you’re convinced will bring bad luck 
  • Repeating a word or phrase you find unlucky
  • Going to a location you’re superstitious about
  • Speaking to someone you think will bring bad luck 
  • Performing an action you’re convinced will make loved ones unlucky
  • Refraining from asking a friend or loved one for reassurance 
  • Refraining from counting to a certain number in your head 

Exposure is the first step in ERP therapy. The next step is to prevent yourself from responding with your established compulsion.

What is response prevention?

In the example where you’re watching a movie, the goal will be to hear someone say a name and not pinch your thumb. This might be difficult at first. If you’re convinced something bad will happen when you don’t perform a specific ritual, it can feel scary to prevent yourself from doing it. You might think, “Why would I take the risk of something bad happening?” Or, “Maybe treatment isn’t for me. Maybe I can live with this type of OCD. It’s honestly not that bad.” You might even think, “Maybe my therapist is wrong and I don’t have OCD after all. What if she misleads me and I end up being responsible for something bad happening?” 

“Maybe my therapist is wrong and I don’t have OCD after all. What if she misleads me and I end up being responsible for something bad happening?” 

Response prevention is what allows you to familiarize yourself with a new idea about your obsessions. Instead of feeling forced to respond with a compulsion, you realize that your worst fears don’t materialize when you don’t pinch your thumb, and your anxiety will likely decrease. Over time, it may become easier to refrain from this compulsion, and eventually, you may feel you won’t need to do it at all. 

Magical thinking OCD treatment

If you think you have magical thinking OCD and want to learn more, a therapist who specializes in OCD will be able to make an accurate diagnosis. If you’re interested in treatment for OCD, you can schedule a free call with the NOCD clinical team. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how important ERP therapy is. 

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Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

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NOCD Therapists specialize in treating Magical Thinking OCD

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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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