Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Magical contamination

Sep 9, 20225 minute read

Obsessive-Compulsive Disorder (OCD) is a disorder that consists of obsessions and compulsions. An obsession is an unwanted, intrusive thought, image, feeling, urge, or sensation that causes a significant amount of distress. Intrusive thoughts are like false alarms in your brain. They set off the “danger signal” even when there is no real danger. 

Compulsions are either overt (outward/physical) or covert (mental) behaviors that one does in response to an obsession that one feels they have to perform in order for them to feel safe, to keep others safe, or to reduce their distress. This often results in a reduction in anxiety, shame, fear, doubt, or disgust. Responding with compulsions reduces these feelings, but it teaches the brain that those false alarms are real and need to be taken seriously. By practicing non-engagement, or response prevention, the brain can be taught that those false alarms are just that: false. 

Magical Thinking OCD involves fears about someone potentially harming others, harming themselves, or harm coming to those they love or care about by external sources if they do not perform a specific pattern of behavior or mental compulsion demanded by their OCD. This becomes a common way of thinking no matter how irrational the obsession appears to themselves or others. These compulsions tend to provide effective short-term relief and a sense of safety and control, but they make OCD worse long-term.

Magical thinking OCD – Common obsessions

  • Fear that if they don’t think or say a certain phrase, something bad will happen.
  • Fear that if they don’t do something a specific way, something bad will happen. 
  • Fear that failing to do things in a certain way will cause something bad to happen. 
  • Fear that one ought to think positive thoughts and avoid negative thoughts, or something bad will happen. 
  • Fear that thoughts alone can control outcomes in life
  • Fear that others might know their thoughts, even without verbalizing them

Common triggers

People with Magical Thinking may be triggered by situations that have previously resulted in a bad outcome and want to prevent that outcome or anything like that from happening again. Sometimes, with OCD, an intrusive and unwanted thought, image, or urge itself can be the trigger.

Triggers common for people with magical thinking fears include:

  • Going through a stressful or difficult life event
  • When a friend or loved one is leaving for travel
  • Performing the same activity they were doing when they learned about something bad
  • Learning of stories that involve “bad luck”
  • Intrusive thoughts themselves

How can I tell if it’s magical thinking fears as part of OCD, and not anxiety?

Generally, if you have OCD, you will experience unwanted and persistent thoughts, images, urges, or sensations that cause a significant amount of distress, occupying at least 1 hour per day on average. You will also perform compulsions or safety behaviors to help you feel better. OCD will also affect functioning in at least one life area such as relationships, work, school, home responsibilities, and social life. 

Additionally, obsessions in OCD are ego-dystonic, which means that the intrusive thoughts or urges caused by OCD do not represent your actual values, identity, desires, or beliefs. Anxiety, on the other hand, is ego-syntonic, which means the source or topic of anxiety accurately represents your values and beliefs. An individual will typically choose to focus on the source of anxiety in order to decrease the anxiety. An obsession in OCD, however, will simply happen to you without any intention to bring it about; usually by a trigger.

Common compulsions

A compulsion is something done in response to obsessions in an attempt to reduce anxiety or distress. Compulsions prevent OCD from learning that there is no real danger that comes from obsessions. Each time someone performs a compulsion, that reinforces that there is something to fear. 

When people with Magical Thinking OCD experience intrusive thoughts, images, feelings, or urges that cause distress, they may feel like they have to perform specific behaviors or mental acts to reduce anxiety, distress, or avoid a feared outcome. However, the compulsive behaviors are not realistically connected to what they are trying to prevent. 

Compulsions performed mentally or physically by people with magical contamination fears include:

  • Following specific routines or rituals, such as having to do most things a certain number of times to feel okay
  • Saying a certain phrase when saying goodbye to someone to prevent anything terrible from happening to them 
  • Avoiding cracks on the sidewalk when walking 
  • Avoiding bad words, numbers, or phrases
  • Praying a specific prayer 
  • Counting steps before and after going through a doorway 
  • Turning a light switch on and off a certain number of times or something bad will happen
  • “Thought Neutralization,” which is the mental process of trying to replace a “bad” thought or image with a “good” one

How to treat magical thinking OCD

Magical Thinking OCD can be debilitating for people who struggle with it, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with a licensed mental health professional who has specialty training in OCD, you can get on the path to recovery.

ERP exposes individuals to their unwanted intrusive thoughts, urges, or images, or the situations that trigger their obsessions and cause distress. The goal of Exposure and Response Prevention is to teach them to resist performing a mental compulsion, overt compulsion, or ritual, and instead create a new relationship with their anxiety or fear. The individual will gradually be exposed to their triggers, slowly, one step at a time, until they work all the way up to conquer exposures that create the most distress. 

The pace at which you move will be determined by you and your treatment provider. This requires a great deal of practice, but will typically provide gradual relief if you are consistently practicing exercises as discussed in therapy. It doesn’t happen overnight, but it is worth it, and you can get better.  

If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

We look forward to working with you.

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