Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Why am I always repeating words in my head? Advice from a therapist

By Jessica Migala

Nov 30, 20238 min read minute read

Reviewed byApril Kilduff, MA, LCPC

Some of us just love words. Some of us use mantras to help us start the day off well. Or we might repeat a word like “strong” to finish the final mile of a tough run. Or maybe there’s a turn of phrase that tickles your brain. Or a line in a song that just won’t leave your head.

All of these are pleasant experiences with words. For some people, though, they may find that a disturbing word or thought pops into their head and won’t leave, causing them to doubt themselves as a person. 

If you find that you’ve got words on repeat in your head, here’s what may be going on, plus how to know if you should seek help—and what type of help to look for.

Why am I always repeating words in my head?

He’s just a poor boy from a poor family….

Good times never seemed so good….

We will, we will rock you…

Sometimes, repeating words in your head is just an “earworm,” says April Kilduff, MA, LCPC, LMHC, Clinical Trainer at NOCD. (An earworm is a catchy part of a song that gets stuck in your head. Think Journey’s “Don’t Stop Believin’,” Lady Gaga’s “Bad Romance,” or NSYNC’s “Bye Bye Bye.”) These types of earworms happen to most of us and usually go away once you stop paying attention to the lyrics running in your head.

This can also be indicative of echolalia, which is defined as a “meaningless repetition of words or phrases heard by someone,” according to StatPearls. It comes from the Greek words echo (to repeat) and lalia (speech). It’s common in the language development of toddlers.

But persistent word repetition can show up in childhood or adulthood, too. “When I’ve talked to people who repeat words over and over in their head, it can be because they like the sound of the word, and they find something pleasant and soothing about it,” says Kilduff. “A word pops into your head because of something someone else said or it was on a movie or TV show and it goes on a mental loop,” she says. 

Echolalia is also a facet of many different mental health conditions, most commonly in neurodivergent populations—such as autism, where three in four children have echolalia, per StatPearls. In addition, you may also see it as part of dementia, schizophrenia, in the aftermath of a stroke, among other scenarios.

It becomes a problem when a word or phrase gets stuck in your head that you don’t want to be there, Kilduff says, and now it causes enough distress and takes up a significant amount of your time that it becomes difficult to focus or go about your day or hinders your ability to function. Basically, when it’s associated with distress, frustration, and/or impairment, then that’s a problem.

What is OCD?

Repeating words in your head is not an uncommon feature of obsessive-compulsive disorder, or OCD, and it can become intensely distressing or bothersome.

OCD is a chronic mental health disorder that features obsessions and compulsions. Obsessions are intrusive thoughts, images, sensations, or urges that cause significant distress, while compulsions are the behaviors—both mental and physical—that are done to neutralize that distress or keep something bad from happening. 

We can help you tackle your intrusive thoughts, no matter what they are

Find an OCD specialist

The disorder can manifest in so many ways, one of which is through the repetition of certain words. You may repeat words that relate to the content of your intrusive thoughts, such as “harm,” “murder,” “pedophile,” “dirty,” or “dying.” In general, OCD might intrude with any word that’s negative or worrisome, from embarrassing phrases to racial slurs.

“Certain trigger words can get stuck in your head and continue to show up that cause a lot of distress and impairment,” says Kilduff. This is often related to a larger subtype or core obsession in OCD, such as having unwanted thoughts about developing schizophrenia or becoming psychotic.

So, what’s going on? “There can be a word that pops into your head and suddenly, OCD comes in and says wait a minute…why are you thinking this? What does this mean when the word gets stuck in your head or keeps popping in as an intrusive thought?” explains Kilduff. It’s important to remember that everyone experiences intrusive thoughts from time to time, but while someone without OCD might not enjoy certain words entering their mind, they can brush them off and move on. If you have OCD, however, your OCD will slither in and tell you that the presence of that intrusive thought means something about you or what you’re capable of. As a result, you may develop lasting, intense worries: a fear of schizophrenia in Health Concern OCD, a fear that you are a pedophile in Pedophilic OCD, or a fear that you could murder someone in Harm OCD

One common compulsion when you’re trying to counteract an unwanted word is thought neutralization. “Someone takes an unwanted thought, image, or word and tries to cancel it out or neutralize it by then having a good or desirable thought, image, or word,” explains Kilduff. For example, if the word “schizophrenia” pops up, a thought-neutralizing compulsion could be “healthy” or “non-psychotic,” they say. Full phrases—everything will be okay or I’d never hurt my cat—might also be used as a way to feel better about disturbing intrusive thoughts.

Finally, word repetition can also arise out of another OCD theme, called Magical Thinking OCD. This can occur when a word or phrase is used due to superstition that it holds a certain power to influence things that happen. In many instances, a word or phrase could be used to prevent bad things from happening. 

Other times, the word or phrase may feel as if it holds powers that cause bad things to happen. Kilduff recalls a member who was afraid of having a cancer relapse. Whenever the word “cancer” popped into her mind, she’d stop what she was doing. Because if she were to continue to shop or clean her home after thinking “cancer” or “the c-word,” she worried that it might cause her cancer to relapse. This member had to use a lot of thought neutralization to counteract that word—but her fears always returned, again, and again. 

Get your life back from OCD

How can I get help?

If you have OCD that’s driving intrusive thoughts centered around words and phrases, the best treatment for any type of OCD is called exposure and response prevention treatment, or ERP.

ERP is known as the gold-standard treatment for all subtypes of OCD. During ERP, you will work with your therapist to identify triggers for your obsessions. For example, perhaps that’s seeing a specific word that you find distressing, like “knives,” which then gets stuck in a loop in your mind. Your therapist would then use that exposure and you would commit to not performing a compulsion, like thought neutralization—instead, you’ll learn that you’re able to simply sit with the discomfort you feel, and it’ll go away on its own. 

This allows you to face your fears head-on. You’re intentionally confronting what you fear and allowing all those uncomfortable feelings to wash over you without doing anything about them. By not performing a compulsion, you will learn that you are resilient. You can live with the anxiety of your obsessions. 

Here are a few different therapy exercises that may be used when you’re treating word repetition in OCD, says Kilduff:

  • Reading: Read articles or stories with the intrusive word or phrase in them. 
  • Watching: Watch TV or movies that use the word. For example, if your exposure is to the word “schizophrenia,” you might watch part of a documentary about the mental health condition. 
  • Speaking: You might say the word out loud in a session or find ways to use it in everyday conversation. 
  • Writing: You might write part of the feared word, then progress to the full word, writing it over and over again.

Resisting mental compulsions has its challenges. “Any time the word pops into a member’s head, we teach them to resist, delay, or mess up the related compulsion somehow,” says Kilduff. “One of the things that is important to understand about mental compulsions is that our brains need something to chew on—you can’t just tell yourself not to think that word. Because when you try to avoid that word, it just grows stronger. 

“Instead, we give members a counterstatement,” Kilduff explains. “For example, if a thought neutralization word for ‘cancer’ is ‘never,’ then we’d change that to ‘maybe.’ That allows you to mentally exist in that space of uncertainty and learn that you can tolerate the feelings that arise from that uncertainty.”

OCD treatment you can afford

Use your insurance to work with a NOCD specialist.

You can learn to conquer OCD

If you notice that you are repeating words or phrases in your head to cancel out disturbing thoughts, NOCD can help. Get connected with one of our many licensed therapists who are specially trained in treating OCD with ERP therapy. 

NOCD’s research has shown that ERP can be used for all subtypes of OCD. What’s more, research also shows that virtual ERP therapy works just as well as in-person treatment to reduce OCD symptoms

With NOCD Therapy, you can do face-to-face live video sessions where you’ll learn the tools to stop engaging in word repetition and thought neutralization in a safe space. Between-session resources are also available when you need extra support. I encourage you to learn more about NOCD’s accessible, evidence-based approach to OCD treatment and get on the road to recovery today.

We specialize in treating OCD

Reach out to us. We're here to help.