What is thought suppression, and why does it make OCD worse?

When people begin therapy for OCD, they often ask, “How can I stop having these horrible thoughts?” It’s only natural; obsessions can be horrifying and uncomfortable, filling people with doubt about who they are and what they’re capable of. In response, they’ll do anything they can to stop their thoughts or avoid them entirely—this is called thought suppression, and it’s actually a compulsion that makes OCD worse over time. 

When we discuss intrusive thoughts that are experienced with OCD, the term ‘thoughts’ encapsulates feelings, images, and urges as well. This is important to remember. Thoughts are experienced in these different forms: words, sentences, questions, images, and urges are all experiences that we refer to as intrusive thoughts in OCD. 

No one likes to feel anxious

Intrusive and unwanted thoughts are a hallmark symptom of OCD. It makes sense then, that people with OCD would want to neutralize the feelings associated with them—in OCD, intrusive thoughts become obsessions when they trigger intense feelings of anxiety or distress. And like any other unpleasant feelings, people with OCD work to avoid this strong discomfort.

Why is this not a good thing to do when you have OCD? The answer lies in the way OCD works. It begins with an intrusive thought, image, urge, or feeling. This is upsetting or distressing, and the person wants to get rid of these negative feelings. However, the more the person tries to push the thoughts away, the more they come back. It’s virtually impossible to not think about something when your attention is drawn to it, so in avoiding these thoughts and feelings, one trains their brain that the thoughts and feelings pose a real danger, which is not the case. 

Suppressing uncomfortable thoughts also takes energy. It is an active process. It may not feel like one, but it actually is. You need to remain vigilant to hold the thoughts at bay. This can deplete your energy and wear you down, especially when done repeatedly and for long periods of time. What happens when you are depleted and stressed? You become more prone to intrusive, anxiety-provoking, unwanted thoughts. 

The other problem that arises is that you have inadvertently told your brain that these thoughts are actually important, or indicative of real danger. The problem is that intrusive thoughts are merely thoughts, and pose no threat or danger whatsoever. It was a false alarm. The more you respond to these false alarms, the more they continue to go off. 

What should I do instead?

The best way to respond to intrusive experiences like these is to allow them to exist, sit with the discomfort they cause, and proceed with your life as they fade on their own. The core of this is accepting uncertainty—OCD demands 100% certainty about your thoughts, doubts, and fears, telling you that anything less cannot be tolerated. This is what lies beneath so many compulsions that only make OCD worse. By allowing thoughts to exist, accepting uncertainty about your fears, and living your life despite passing discomfort, you engage in response prevention, the key to taking the power away from OCD over time.

Notice your thoughts, images, urges, or feelings when they occur. Just notice them. Simply put, recognize that they are there as you continue living. Remind yourself: I will remain mindful of the moment that I am in. I will not get caught up in trying to discern the meaning behind this thought. I will continue on, tolerate this anxiety, and it will fade on its own. The next time it occurs, I’ll be even more prepared to pay it no mind.

Remember that when you experience OCD, the thoughts are ego-dystonic. This means that they go against what you value and what aligns with your character and goals. That is why they bother you so much. It is also important to recognize that just because you think something, it is not the same as doing something—this belief is a thought distortion known as thought-action fusion.

Remain non-judgemental

Learning to accept your intrusive thoughts without judgment is crucially important when you have OCD. Too often, those with OCD internalize their thoughts or try to make sense of why they had the thoughts in the first place. The truth is that everyone has similar thoughts, but they do not give them meaning or try to internalize them to mean something that they don’t. 

It is also pivotal that you give yourself compassion. You don’t need to avoid the thoughts, because that is all they are, and they don’t mean anything about you as a person. It is only through fear and shame that you give them any importance at all. People who experience OCD can tend to be self-critical, often punishing themselves for their thoughts. Engaging in thought suppression only further intensifies the feelings of guilt and self-distrust that those with OCD often experience.

Treat yourself how you would others

We are often our worst critics—especially people with OCD. We tend to judge ourselves far more critically than we would someone else. Self-compassion helps us to take a step back and show ourselves kindness. I love the phrase “be gentle on yourself.” It reminds me to remember that I’m doing the best that I can. 

You can tolerate the feelings that the thoughts bring with them. You don’t need to be perfect at this, but you are capable. It is possible to live a life towards your values. You don’t need to suppress the thoughts. They can exist and you don’t need to do anything with them. 

ERP can help teach you not to rely on thought suppression

By using exposure and response prevention (ERP) therapy, specialty-trained, qualified, and licensed OCD specialists can work alongside you and teach you how to disengage from intrusive thoughts, feelings, urges, or images, and live life without being ruled by compulsions and fear. They can assist you in recognizing thought suppression and help guide you to be mindful and non-judgmental towards yourself and your unwanted thoughts. They will come up with reasonable and creative ways for you to gradually face the fears that are holding you back from living the life that you want to live. 

If you have any questions about starting ERP therapy or need more information about the treatment, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.