Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Why OCD feels so real

5 min read
Stacy Quick, LPC

A question that often arises over the course of OCD treatment is “but why does it feel so real?”

This happens with every single theme that OCD can latch on to. Even when you recognize and have insight into your condition, it can still have a strong pull, and the “what-ifs” can be overpowering. The reason behind this is that there is technically a possibility that some feared outcome could happen, even if it’s a one-in-a-trillion chance. That doesn’t mean it’s probable, but OCD can take hold of the slightest uncertainty.

The illusion of certainty

Individuals who suffer from OCD get caught up in the need for certainty—but it is an illusion. We want to know for sure that whatever we are having intrusive thoughts about will never happen, or is completely false. We want to know without a shadow of a doubt that what we fear has no meaning. Here lies the dilemma: it is impossible to know absolutely for certain, or enough to ever satisfy OCD. The bar is too high. The stakes are too high. OCD attacks the very things that we value and care the most about. It attacks the core of our identities. That’s what makes it so compelling. 

People who do not live with OCD can have the very same thoughts, images, and urges, and yet they are mostly unphased by them. They do not attribute meaning to them. In fact, if you asked someone without the disorder whether they experienced these same thoughts, they might say they don’t. That’s because when working properly, our brains are designed to weed out unhelpful, unneeded information. When your brain filters out unnecessary and faulty information, it can determine what actually needs your attention. People who do not have OCD are able to filter those thoughts out and pay so little attention to them that they may not even register. Even when they notice an intrusive thought, they can very readily dismiss it as “silly” or “weird.” They may think to themselves that it came out of nowhere and shrug it off, having enough confidence that it didn’t mean anything. 

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Unfortunately for those of us who suffer from OCD, this process isn’t working correctly. When we have a thought, image, or urge that goes against our values we stop and pay attention. Our brains turn on us. We are filled with fear and intense anxiety and we want to know why the thought was there in the first place. Our brains scream at us that something is wrong. The parts of our mind that are helpful to alert us to real danger and protect us have failed us. Our alarm system malfunctions. We get stuck on these thoughts and attribute meaning to them. And thus begins the very slippery slope that is OCD.

Anxiety is not “bad”

When you have OCD, you are often trying to get rid of anxiety. But anxiety is not a bad emotion. It may feel unpleasant, but it serves a very important purpose. We need anxiety. It helps us to survive. Think back to when you were a child—how did you learn what was dangerous versus what was safe? Anxiety likely played a pivotal role in this development. When you touched a hot surface you would feel pain, which would teach you not to touch the hot surface again. This lesson helped you to survive many other dangers that occur. This learning helped you to be cautious around fires, thus preventing disaster. Anxiety is present to protect and guide us when working effectively. 

Anxiety feels intense. Your brain is trying to get your attention. It is screaming at you to do something, to fight, flee, or freeze. This is a good thing when there is a real danger present. However, this is not useful when you have OCD and are experiencing intrusive thoughts. Your mind is sending you signals that you need to do something, even though there is no real risk. It is yelling at you that you need to take action. This is why OCD feels so real. There is a very real process taking place in your brain. The problem is that it is a faulty alarm; there is no actual danger. When you have OCD, you are left feeling all of the signals that there is imminent danger, but there isn’t. 

ERP teaches you to retrain your brain

Retraining your brain to know that there is no real danger is possible with exposure and response prevention (ERP) therapy, the gold standard treatment for OCD. ERP teaches a person with OCD that thoughts, feelings, and urges do not have to have meaning. They can just be background noise. ERP helps people with OCD to sit in the anxiety and discomfort of these things and see that they can survive them and most importantly, that they don’t need to do any compulsions to rid themselves of this perceived danger. It is a false alarm. There is no real danger. 

Through ERP, they learn that although anxiety may not be comfortable, they can tolerate the distress. Eventually, the feelings of anxiety do pass, and you don’t have to do anything to make this happen. When we don’t give in and do a ritual or a compulsion, our brains learn that there was no danger in the first place, correcting the faulty alarm over time. But it takes consistent practice. Retraining your brain takes time, commitment, and perseverance.  

Find a therapist who can help you manage your OCD

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The best way to practice ERP and manage intrusive thoughts is to work with a therapist specialty-trained in ERP. At NOCD, our therapists specialize in OCD and ERP, and they will provide you with a personalized treatment plan designed to best meet your unique needs. Your therapist will teach you the skills needed to begin your OCD recovery journey and will support you every step of the way. They will guide you in taking small steps to reach your goals.

Our team of therapists at NOCD is passionate about the treatment of this debilitating disorder and is trained by world-renowned experts. To learn more about working with a NOCD therapist, schedule a free call with our care team.

Stacy Quick, LPC

Stacy Quick LPC, is a therapist at NOCD, specializing in the treatment of OCD. She has been working in the mental health field for nearly 20 years. Her goal is to help members achieve skills to help them live a more fulfilling life without letting OCD be in control. Ms. Quick uses ERP and her lived experiences to help her members understand it is possible to live a life in recovery. She is a mother of 3 children, 2 of whom are also diagnosed with OCD. Ms. Quick is also a writer and content creator. Learn more about Stacy Quick on Instagram: @stacyquick.undone

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Licensed Therapist, MA

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.

Madina Alam

Madina Alam

Licensed Therapist, LCMHC

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.

Tamara Harrison

Tamara Harrison

Licensed Therapist, MA

I have personally struggled with OCD and know what it's like to feel controlled by intrusive thoughts and compulsions, and to also overcome it using the proper therapy. I’ve been a licensed therapist since 2017. I have an M.A. in Clinical Mental Health Counseling, and practice Exposure and Response Prevention (ERP) therapy. I know by experience how effective ERP is in treating OCD symptoms.

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