Obsessional Thinking and Anxiety

Jerry Kennard Health Pro
  • It's not uncommon for people to get muddled over the difference between obsessions and compulsions, so I'll begin this Sharepost by highlighting the differences. Obsessions are thought processes whereas compulsions are actions. In obsessive compulsive disorders (OCD) you won't be surprised to learn these two processes are intimately linked. But focusing on obsessions it becomes clear some fairly common features emerge.


    The first of these features, or characteristics, is that the thoughts themselves are unpleasant and unwelcome. Another feature is the repetitive nature of the thoughts. When it comes to thought content we know these are frequently repelent to the person. Common themes include harm being inflicted on other people, often close to them, sex, contamination from bacteria and viruses and bad language. Obessive thoughts may also include the fear of making mistakes or behaving in some inappropriate way. Some of the better known obsessions, in part because the obsession frequently translates into a compulsion, include concerns over security (locked doors, gas turned off, light switches) and the need for exactness and arranging things in order or sequence.

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    Obessional thinking is a personal battle. The person understands the lack of logic behind their thinking and they understand that their thought processes are of their own design, but they feel it is out of their control. Obsessional thinking tends to defy rational thought processes and anxiety increases as a result.


    Thought-action fusion is the term usually applied to a particular feature of obessive thinking. Here, the person establishes a belief that the more they think about something the greater the chances are that it will actually happen. For example, the more often a person thinks of themselves being involved in a car accident the more likely it is this will happen. This form of thinking is not so far removed from what is termed 'magical thinking', that is, a belief that certain actions will have (often negative) consequences. Superstitions are an everyday example. Many otherwise perfectly normal people will not walk under a ladder, or will feel upset if they spill milk or crack a mirror. Spells and other mystical activities are a step up from this and appear to have a profound effect on susceptible individuals. Repeatedly thinking that something will happen sets up an internal conflict between the thoughts themselves and attempts to suppress them. This is one of the root causes of anxiety.


    Maybe three percent of the population is affected by OCD at some point in their lives.This makes the condition a significant mental health problem. There are varying interpretations over the nature of obsessional thoughts. Some experts point out the degree of symptom overlap between schizotypal traits and OCD. Psychologists Lee, Cougle and Telch (2003) say that despite evidence suggesting that OCD and schizophrenia are distinguishable, there is a line of research suggesting a possible linkage between OCD and schizo-typy. About half of OCD patients exhibit mild to severe levels of schizotypal traits, which has led to the speculation that there may exist a schizotypy subtype of OCD.


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    Cognitive psychologists say the thought processes of people with OCD are the same as for those without. The difference, they suggest, seems to rest on the significance of these thoughts to the person who has them and the fact that attempts to deny or stop thoughts invariably have the opposite effect.


    One interesting feature is the way in which many people with OCD appear to have an exaggerated sense of responsibility for their actions. Most people are able to distinguish between the significance of thoughts and part of the treatment for people with OCD is to learn or re-learn this process. Selective serotonin reuptake inhibitors (SSRI's) appear to have a positive effect in some cases, particularly those with an associated depression which is common in OCD. In such cases the most positive outcomes appears to be from a combined medical and psychological treatment package.



    Han-Joo Lee, Jesse R. Cougle, Michael J. Telch (2005) Thought-action fusion and its relationship to schizotypy and OCD symptoms. Behaviour Research and Therapy 43. 29-41.


Published On: November 09, 2011