3 Common OCD Distortions and How They Maintain OCD
Black and White Thinking
This type of thinking evolves from a desire for certainty. It hinges on the belief that perfection is possible and there is a single ‘right’ decision. This type of rigid thinking can lead to a lot of angst because you may spend a considerable amount of time questioning what decision to make, and when you finally make a choice, you are often filled with unending doubt that you selected the ‘wrong’ choice. This may lead you to ask for reassurance from others, which ultimately only serves to reinforce anxious thoughts in the long term. In treatment, you are guided to move towards ‘gray’ thinking, not allowing black and white thinking to make rules for your actions. In addition, you learn to accept your thoughts and what it would be like to live in a world where they may be true.
Mind reading is a tricky distortion because it's rooted in one’s desire for connection, that is innate and natural. Our brain scans people’s expressions, postures, and tone during social interactions to determine whether you are safe and meeting social norms. Unfortunately, when one suffers from mind reading in OCD, their brain has a “negative tilt” that predisposes them to predict that someone is thinking poorly of them. Then, their brain may create connections between certain social signals and danger, leading to increased anxiety, rumination, and ritualizing. For example, one young woman had the intrusive thought that her husband does not truly love her. She had no evidence for this and was frequently reminded by her partner of how much he loved her. However, when she was having a conversation with him and he broke eye contact during her story, she experienced intrusive thoughts that he must find her boring and that he regrets marrying her. This resulted in an increase in anxiety and asking repeatedly whether he was happy in the marriage. The compulsive reassurance seeking often lead to the young woman starting an argument and questioning her husband’s love. A way to address this distortion is by noticing one’s triggers and generating other possible interpretations. It’s adaptive to think of both “good” and “bad” possibilities of what others may be thinking, so that you can learn to live with the uncertainty of not knowing what others think. In this example, the young woman could choose to accept that she will never know if her husband truly loves her, but she can choose to stay with him and enjoy the time they do have together. Either way, life continues and it’s your choice to accept the discomfort of not knowing what someone truly thinks to overcome the trap of mind reading.
Thought- Action Fusion
This distortion over emphasizes the importance of thoughts and links thoughts to being equivalent to action. For example, you may have an “awful thought” of harming someone and then spend hours ruminating over why you had that thought and if it means that you’re a bad person. Often people believe the goal of treatment is to stop having these thoughts and to rationalize why you’re a good person who would never do something so awful. However, the goal of addressing this distortion is to know that your thoughts mean nothing of importance. Every thought has a dynamic origin that has multiple emotions and meanings—not one single meaning. The goal of overcoming this distortion is to accept ALL possible meanings and move forward without attaching labels to yourself. As harsh as it may initially sound, accept your judgement and learn to live with possibly being a “bad” person for having “bad” thoughts. This way, your unwholesome thoughts are less likely to create a strong response for you and thereby lose significance, decreasing the frequency of them, or at least your reactions to them.