Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Am I just superstitious, or could I have OCD? What the experts say

By Grant Stoddard

Aug 23, 20238 min read minute read

Reviewed byApril Kilduff, MA, LCPC

Do you ever catch yourself knocking on wood, avoiding certain numbers, canceling plans on Friday the 13th, or refusing to step on cracks in the sidewalk, despite being unable to explain how performing these little rituals are keeping you safe? If you have, you’re not alone.  

Superstitions—those age-old beliefs that defy all logic—have woven themselves into the fabric of human behavior for millennia. They’re so deeply ingrained that even the most rational people may feel a pang of worry upon failing to make eye contact while clinking glasses or finding a penny tails-up on the ground. 

But if these seemingly harmless quirks begin to consume your thoughts, dictate your actions, or cause you loads of worry and distress, it’s time to investigate whether something other than urban legends is at play. Specifically, you should look into whether you’re experiencing a distressing yet highly treatable mental health condition called Obsessive-Compulsive Disorder (OCD)

In this article, we’ll look at what superstitions and OCD have in common, what separates them, and how the latter can be treated, often in a matter of a few months.

Superstitions demystified

As mentioned above, superstitions have been with us for a long time. That thing about walking under a ladder being bad luck? It can actually be traced back 5,000 years to ancient Egypt. For the Egyptians, triangular shapes were sacred (picture the Great Pyramids) and to walk through one meant you’d desecrate it. In all likelihood, the superstition traces back even farther than that. 

All superstitions stem from the quintessential human desire to find meaning in random events or gain control over uncertain outcomes. These beliefs often arise from ancient traditions, folklore, and religious practices. They persist in modern times due to cultural transmission and psychological factors such as the human tendency to attribute significance to coincidences and our fear of unknown consequences. 

Superstitions can vary widely: you might dread seeing a black cat crossing the road, but in some countries it’s considered a sign of good luck. The prevalence of superstitions in society demonstrates the widespread, enduring impact of tradition and the shared need for comfort and security in the face of uncertainty. For example, one enduring impact of triskaidekaphobia—a fear of the number 13—is that even today, many tall elevators skip from floor 12 straight to 14. 

Most superstitions are pretty benign. A horseshoe nailed to a door for good luck—open-end up, of course—is also a nice decorative detail. But when an inability to perform a ritual results in paralyzing anxiety, it might be more than superstition. It could be a sign of OCD. 

Do these experiences sound familiar? Learn how you can overcome them.

Here at NOCD, we know how overwhelming OCD symptoms can be—and how hard it is to open up about your experience. You’re not on your own, and you can talk to a specialist who has experience treating OCD.

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OCD explained

OCD is a mental health condition characterized by intrusive, distressing thoughts, images, or urges that one cannot dismiss for the random, meaningless, cognitive glitches they are. These thoughts—known as obsessions—typically take the form of mental images or urges that often oppose one’s most deeply-held values or feel intensely dangerous or threatening. Common themes include harm coming to oneself or others, contamination and illness, one’s own sexuality or identity, and religious practice, among countless others.  

When these obsessions strike, they trigger a flood of distress, shame, worry, or anxiety. Desperately seeking relief from this discomfort, people turn to compulsions—the “C” in OCD—to feel better. These might include seeking reassurance about their doubts from others, checking things over and over, praying excessively, following complicated rituals, researching their fears for hours on end, or avoiding certain situations altogether. Since it’s impossible to feel 100% certain about an obsessive doubt or worry (What if the plane crashes? How can I be sure I remember that night correctly?) people often report a need to do compulsions “just in case” their obsessions pose a legitimate danger.

The problem is that intrusive thoughts, doubts, and uncertainties don’t actually pose a threat. Uncertainty and doubt are present in all areas of life, and intrusive thoughts do not correspond with one’s actual values or identity—often, it’s quite the opposite. So when someone responds to their obsessions by doing compulsions, they inadvertently teach their brain that their obsessions are dangerous and that distress can only be decreased by compulsions, which only increases their fears and worries in the long run.

As you may have already surmised, an association with irrational thoughts and behaviors is one of the main things OCD and superstition have in common. Both involve a heightened sensitivity to perceived threats or uncertainties, leading to repetitive actions as a form of control. 

Superstitions arise from a belief that specific actions can influence future events, even though no logical connection exists. Similarly, people with OCD experience intrusive thoughts or obsessions that evoke anxiety, which they try to alleviate through repetitive, ritualistic behaviors. Often, this involves the very same magical thinking that’s responsible for superstitions. In fact, common superstitions can become OCD compulsions in some cases—the distinction is all about how people use these behaviors and the ways they impact their lives. 

OCD and superstition: differentiating between the two

While superstitions and Obsessive-Compulsive Disorder (OCD) do share some surface similarities, it is crucial to distinguish between the two phenomena. 

Superstitions are cultural beliefs and practices aimed at finding meaning in random events or gaining control over uncertain outcomes. These beliefs are often rooted in tradition, folklore, or religious practices, and while they may influence people’s behavior, they do not typically lead to distress or impairment.

On the other hand, OCD is a clinical mental disorder characterized by distressing and intrusive thoughts, images, or urges known as obsessions. These obsessions trigger intense anxiety and are often followed by repetitive behaviors or mental acts called compulsions. The primary purpose of these compulsions is to reduce the distress caused by the obsessions or to prevent perceived negative outcomes. Unlike superstitions, OCD profoundly impacts a person’s daily life, causing significant impairment in various areas, such as work, relationships, and overall functioning.

To differentiate between occasional superstitions and OCD, it is essential to consider the severity, frequency, and impact of the thoughts and behaviors. Occasional superstitions are generally harmless and may not interfere significantly with a person’s life. In contrast, OCD-related compulsions become excessive and time-consuming and interfere with a person’s ability to engage in regular activities. Indeed, this degree of impairment is one of the condition’s main diagnostic criteria. 

“Your average Joe who likes to wear his team’s jersey on game day, is likely going to have a level of insight where he knows that what he’s wearing has no bearing on his team winning,” says Aaron Hensley MSW, LCSW, a therapist at NOCD. “By that same token, if that jersey somehow got thrown away, it’s not going to impair his day to day function. The same can’t be said of a person with OCD who’s experiencing obsessions. They’re going to be dealing with some intense anxiety and a vicious cycle of compulsions that could literally become debilitating.” 

Hensley adds that people with OCD often feel urgently compelled to perform their rituals, even when they recognize their irrationality. The inability to resist these compulsions in light of this irrationality leads to feelings of shame, guilt, and frustration, further perpetuating the cycle of OCD.

But here’s the biggest difference. Superstition, given its relative harmlessness, needn’t be treated. OCD, on the other hand, should absolutely be addressed with specialty care, given the damage it can cause in people’s lives and its tendency to get worse when left untreated. 

Luckily, a highly effective, evidence-based treatment for OCD exists and is more accessible than ever. It’s called exposure and response prevention therapy (ERP)

Exposure and response prevention therapy (ERP) 

Exposure and Response Prevention therapy (ERP) is the leading form of therapy used to treat OCD. During ERP, people with OCD work closely with a specialty-trained therapist to confront distressing thoughts and situations while resisting the urge to perform their usual compulsions. ERP has proven highly effective, reducing obsessions and compulsions in around two thirds of people with OCD, often within a few months.

The core component of ERP involves gradual, intentional exposure to situations, thoughts, images, sensations, or objects that trigger your OCD-related anxiety. This can be challenging at first, but it provides opportunities for your brain to learn that you can tolerate uncertainty, doubt, and other uncomfortable feelings, without engaging in compulsions for a false sense of safety or certainty. Doing this will break the cycle of distress and compulsion, allowing your brain to rewire its response patterns by allowing the anxiety and distress to naturally dissipate, which will always happen because all emotions are temporary states.

ERP often includes homework assignments to practice outside of therapy sessions. These assignments reinforce what you’ve learned and help apply these new skills to real-life situations. You and your therapist will regularly review your progress toward the goals you initially set. This evaluation helps make adjustments to your treatment plan when needed, since every OCD treatment journey is unique to the individual.

ERP is a long-term strategy that treats your symptom’s root cause—the vicious cycle of obsessions, distress, and compulsions. Once you’ve made significant progress, the focus shifts to maintaining gains and preventing relapses. Your therapist will equip you with coping strategies to use beyond the formal treatment period.

Start getting better today

Every one of the over 300 therapists in the NOCD Therapy network specializes in OCD and receives ERP-specific training. If you think you might have OCD and want to learn how you can learn to conquer OCD long-term with the help of a trained specialist, I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.

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