Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Overcoming “realistic” fears in OCD

6 min read
Stacy Quick, LPC

“But this is different! This could actually happen!”

I can’t even attempt to tell you how many times people have told me this in therapy. OCD is always telling people that this one fear is somehow different from the rest. Many times people have told me that they aren’t sure it is even OCD because it could actually happen or be true. It is a realistic fear.

The truth is, most fears are related one way or another to the worst things that have happened at some point to someone, and that is what makes them so terrifying. Horrifying things are possible. But OCD twists this into a belief that these things should be feared, and that the mere possibility of something happening makes our fears not only rational, but necessary. But that’s not the case—let’s talk about why.

It could happen, and that is what makes it so scary

When I was very little I can remember visiting a relative’s home. Playing in the background was a show called “Unsolved Mysteries.” At my own home, we did not watch much television, and when we did, it was mostly cartoons. That day, the show sounded scary—even the voice of the person narrating it had a creepy tone to it. I tried repeatedly to ignore it. But like many things, the more I tried no to listen the more I was drawn in, and the more curiosity overcame me. 

Bits and pieces of the show came hurtling through my ears. It was a story of a little girl, who was about my age at that time. She had come up missing. Since the show was called “Unsolved Mysteries,” I knew she was still missing. The thought of this haunted me. That night and several more afterwards I couldn’t sleep. I couldn’t shake the troubling feelings that this gave me. The idea that someone my age was out there without family or help weighed so heavily on my little heart. 

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It didn’t take long for my thoughts to become obsessions. Plagued by “what ifs,” I spiraled down an anxiety-ridden path. The very idea that someone may have hurt a child was shocking to me at that time. I was around 7 at that time, so it hadn’t really sunk in that there was such evil or danger in the world. Even more frightening, though, was the idea that this danger could conceivably strike anyone at any time. 

My experience is all too familiar for people suffering from OCD—the possibility of something happening that is out of our control can lead to endless thought cycles. The imagination can run wild. Most people, who do not suffer from OCD are able to see these types of stories for what they are: rare, unlikely situations that are sad and difficult to understand. They are able to move fairly quickly past them and continue to live their lives with little to no impact. They can recognize that the event that has occurred doesn’t directly impact their safety. They do not have an immediate sense of imminent danger. People without OCD can accept that bad things happen in the world, that some things are out of their control, and that they do not need to necessarily do anything to alleviate the negative feelings that this causes.  

An inflated sense of responsibility

Imagine the story was reversed. Let’s imagine that instead of a television show on crime and violence, I had been a 7-year-old girl who overheard an inspirational story. Perhaps this story focused on a child who was born in extreme poverty, but then everything changed when her family hit the lottery. Suppose that this show focused not on the impoverished life she had led, but rather on how a windfall financial situation led to wonderful opportunities for her. 

What makes this story one that OCD is less likely to latch on to? Why wouldn’t this story keep me up for nights on end in spirals of mixed anxiety and yearning, questioning if this could happen to me or my loved ones? How come I wouldn’t feel the urgent need to do something in order to have this experience in my life?

A big part of this difference is because people with OCD have a faulty alarm system in their brain. It goes off at the mere mention of something that goes against their values or their true desires. Once this is triggered, they go into survival mode. So, in the TV show, the missing girl who may have been a victim of a horrific crime that goes against my values, and I now feel the need to protect myself and others from this becoming a reality in my life or theirs. 

That’s where compulsions come in. OCD has convinced me that I can keep myself and others safe from all manner of harm. Naturally, since keeping people from harm is so important to me, OCD convinces me that if I can act to protect others, then I must. It’s given me a sense of over-responsibility—if something bad happens, I could have done something about it. It will be my fault. This sense of control leads me in an impossible pursuit, because my actions will never be enough to satisfy OCD. Bad things happen to us and the people we love, and it’s not our fault. 

These experiences are often highly excessive and bring about a great deal of distress. Many times there is no logical connection between an intrusive fear and the behavior we feel obligated to complete “just in case.” Other times, there is a kind of logic behind the thoughts and actions. For example, avoiding talking to strangers to avoid getting kidnapped does, in a way, make sense. But OCD takes this to the extreme—if you don’t do everything, OCD says, it will all be your fault when something goes wrong. For example, a child with OCD may decide that any teacher who is not their own is now a stranger. When approached by a teacher in their school, they may run away or ignore them, fearful of being kidnapped. It becomes an obsession that gets in the way of their ability to learn and socialize at school. 

The benefits of ERP treatment for overcoming OCD’s tricks

Exposure and response prevention (ERP) is the gold standard for OCD treatment—and it can be used to target even the most “realistic” fears that are interfering with your life. ERP helps you to see that fears may feel very real, especially in the moment, but that you don’t need to be ruled by them, as OCD would like you to believe. 

ERP helps you learn to sit in the anxiety and discomfort of your obsessions—even when they feel realistic—and see that you can indeed survive them, without doing any compulsions to rid yourself of this perceived danger. You can learn that although it may be uncomfortable, you can actually tolerate the distress that the thoughts cause. Eventually, the feelings of anxiety do pass. When you don’t give in and do a ritual or a compulsion your brain actually relearns that there was no danger in the first place. It takes consistent practice. Retraining your brain takes time, commitment, and perseverance.  

Effective, specialized OCD therapy is here

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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. You can book a free 15-minute call with our team to get matched with one and get started with OCD treatment.

NOCD Therapists specialize in treating 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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