OCD & Intrusive Thoughts
People experiencing Obsessive Compulsive Disorder (OCD), or OCD-type difficulties, can find themselves caught in cycles of unwanted thoughts, anxiety and things they feel driven to do to find relief or certainty.
Making Sense Of OCD And Intrusive Thoughts
These unwanted thoughts, images, urges or doubts are often referred to as obsessions. The things someone feels driven to do in response — to reduce anxiety, prevent something happening or feel more certain — are known as compulsions. Compulsions aren't always obvious to other people. They might involve checking, cleaning, repeating an action or asking for reassurance, but they can also happen entirely in your mind — going back over events, analysing what a thought means, checking how you feel, repeating words or trying to reach complete certainty.
Intrusive thoughts can feel frightening, confusing and sometimes completely at odds with the person you know yourself to be. You may find yourself thinking, “Why would I think that?”, “What if this means something about me?” or repeatedly trying to prove to yourself that something isn't true. OCD can attach itself to the things that matter deeply to us, which can make these thoughts particularly distressing. When you're frightened by your own thoughts, it can also bring feelings of guilt or shame. You might keep what you're experiencing hidden, worry about being judged or begin questioning your character, your relationships or your sense of who you are.
Over time, carrying this privately can affect confidence and self-esteem as well as increasing anxiety. Therapy can provide a confidential, non-judgemental space where these experiences can be spoken about and understood with compassion.
Taking the first step
OCD and intrusive thoughts can sometimes make reaching out particularly difficult. You may have spent a long time keeping certain thoughts to yourself because you're frightened of what another person might think. You don't need to find the perfect words or explain everything at once. We can start with what feels manageable. I offer a free 15–20 minute introductory call where you can tell me a little about what you're experiencing, ask any questions you may have and see whether working together feels like a good fit.
How can therapy help with OCD & Intrusive Thoughts
Therapy can offer a space to begin making sense of what happens when an intrusive thought, image, urge or doubt appears — and why it can become so difficult to let go of. Often, it isn't only the thought itself that causes distress, but the meaning we attach to it and what we then feel we need to do to feel safe or certain. Checking, avoiding, seeking reassurance, mentally reviewing something or carrying out a ritual may bring relief for a while. When the doubt returns, the need to do these things can return too, creating a cycle that can become increasingly difficult to step away from.
Together, we can begin to notice and understand these patterns without judgement. We can explore different ways of responding to intrusive thoughts, gradually reduce behaviours that may be keeping the cycle going and build greater confidence in tolerating uncertainty. There can also be much more happening underneath the surface. Intrusive thoughts can bring shame, guilt, self-doubt and a fear of what your thoughts might say about you. If you've been carrying these experiences privately, therapy can provide space to talk about them with compassion and begin to separate having a thought from what that thought means about who you are.
There isn't an expectation that you simply stop having intrusive thoughts. Trying very hard to get rid of a thought can sometimes give it even more importance. Instead, our work can focus on changing how you understand and respond to these experiences, so that they begin to have less influence over how you feel and live your life.
What we focus on will be shaped around you, your experiences and what feels most important to you.
Frequently Asked Questions About OCD & Intrusive Thoughts Therapy
Intrusive thoughts are unwanted thoughts, images, urges or doubts that many people can experience. Having an intrusive thought doesn't automatically mean that you have OCD. With OCD, intrusive thoughts or doubts can become caught in a cycle where they cause significant distress and lead to compulsions — things you feel you need to do, either physically or mentally, to reduce anxiety or gain certainty.
Having an unwanted thought, image or urge is not the same as choosing an action or wanting something to happen. Intrusive thoughts can feel particularly distressing when their content conflicts strongly with what matters to you. If you're frightened by the meaning you've attached to your thoughts, this is something we can explore without judgement.
No. Although contamination fears and checking are commonly associated with OCD, it can present in many different ways. Compulsions can also happen internally and may be difficult for other people to notice. These might include mentally reviewing something that happened, repeatedly checking your feelings, silently repeating words, analysing whether a thought is true or trying to achieve complete certainty about something.
Reassurance can reduce anxiety temporarily, which understandably makes us want to seek it again when doubt returns. The difficulty is that the relief often doesn't last. Therapy can help you understand this pattern and gradually develop different ways of responding when uncertainty appears.
Yes. When thoughts feel unacceptable or completely different from how you see yourself, it's possible to begin judging yourself simply for having them. Keeping these experiences secret can also contribute to shame, guilt, self-criticism and difficulties with self-esteem. Therapy can offer a space to begin separating the presence of a thought from what you believe that thought says about you.
You remain in control of what you choose to talk about. Building trust is an important part of therapy, particularly when you've been carrying something that feels frightening or shameful. We can work at a pace that allows you to explore what is happening without pressure to share everything immediately.
Not at all. You may recognise some of these experiences in yourself without knowing whether OCD is the right way to describe what you're going through. Therapy can start with simply understanding what has been happening for you. Together, we can explore experiences such as intrusive thoughts, checking, reassurance seeking, avoidance, anxiety, guilt or shame, and begin to make sense of the patterns that may be keeping you feeling stuck. You don't need to arrive with a label or have everything figured out. We can take time to understand what you're experiencing and what feels most important to you.