Intrusive Thoughts: Is It OCD or Something Else?

Q: Intrusive Thoughts: Is It OCD or Something Else?

Hello： Sometimes people make inner vows that reflect their determination at that moment. <br>However, circumstances can change over time, and our mindset and resolve can also evolve, which does not imply that we were lying or insincere at that time. <br>The occurrence of good or

Not sure if it's obsessive-compulsive disorder (OCD)?

Hello, doctor.
I turned 18 this year.
For the past few years, I've often had intrusive thoughts, but it seems that in the past, these thoughts would change quickly.
However, for the past three years, these thoughts linger for a long time.
I often find myself making vows to the universe or some higher power, saying that if I don't do something, something bad will happen (for example, if I don't say a certain phrase in front of the class ten times, specific negative events will occur).
I dwell on these thoughts for a long time, and during this process, I start to think that if I do something else, it means I disagree with my initial vow (for instance, if I ask the teacher to go to the restroom during class, it means I disagree with my vow to say that phrase ten times in front of the class).
However, whether it's the initial vow or the subsequent action that would indicate disagreement, it's usually something I don't want to do.
So sometimes I avoid doing it, but then I worry about not doing it, which has made me unhappy over the years.
(It can also be the opposite; for example, if I don't drink a beverage today, it means I disagree with my initial vow, even though I really want to drink it.)
Finally, doctor, I have a few questions.
The first question is: if I have made a vow to the universe (like the one about saying a phrase in front of the class ten times) but don't follow through, what will happen? The second question is: if I later think that doing something else means I disagree with my initial vow, but I don't do it (like asking the teacher to go to the restroom during class), does that mean I agree with my initial vow? The third question is: because I keep thinking about these things, I feel like I might as well say that I disagree with all of them, or I might say that if I really do the vowed action, then the bad thing will happen (for example, I might say: "Universe, if I really say that phrase in front of the class ten times, then that bad thing will happen").
Or when I think that doing something else means I disagree with the vow, I might say that if I do that thing, it means I agree (for example, I might say: "Universe, if I ask the teacher to go to the restroom during class, it means I agree with my initial vow").
However, sometimes when I say these things, I get confused and end up not knowing what I'm really trying to express, which makes me afraid that what I say doesn't match my true intentions (for instance, if I meant to say: "Universe, if I really say that phrase in front of the class ten times, then that bad thing will happen," but I accidentally say: "Universe, if I really do not say that phrase in front of the class ten times, then that bad thing will happen," or "Universe, if I do not ask the teacher to go to the restroom during class, it means I agree with my initial vow").
If I really say it wrong, what should I do? What will happen if I don't follow through?
The fourth question is: I feel like, okay! If doing something means I disagree with my initial vow, then I might as well do it! I think this way or say: "If I do this, it means I disagree with my initial vow." But in the end, due to laziness or other reasons, I might not do it.
However, I have said it out loud; if I don't do it, does that mean I agree with the vow?
Lastly, if I seriously think or say to the universe that not doing something will lead to a certain outcome, does that mean that not doing it will indeed lead to that outcome? Doctor, I'm sorry for the lengthy message.
I truly apologize.

123, 10~19 year old female. Ask Date: 2016/07/03

Dr. Liang Sunyuan reply Psychiatry

Hello: Sometimes people make inner vows that reflect their determination at that moment.
However, circumstances can change over time, and our mindset and resolve can also evolve, which does not imply that we were lying or insincere at that time.
The occurrence of good or bad events is not related to the repetition of such rituals; disasters will not occur simply because a ritual was not completed.
Bad things happen for their own reasons, but they should not be associated with rituals.
However, individuals with anxiety disorders and obsessive-compulsive disorder often feel anxious when rituals are not completed and may feel a strong urge to finish them, which can consume a lot of time and mental energy.
If this becomes a significant concern, it is advisable to seek medical assistance.
Wishing you well.

Reply Date: 2016/07/03

More Info

Understanding intrusive thoughts can be quite complex, especially when they involve compulsive behaviors or beliefs that are tied to specific outcomes. Based on your description, it sounds like you may be experiencing symptoms that are consistent with Obsessive-Compulsive Disorder (OCD), but it’s important to clarify a few things.

What Are Intrusive Thoughts?
Intrusive thoughts are unwanted thoughts that can cause significant anxiety or distress. They often involve fears of harm, doubts about one's actions, or compulsive beliefs that certain actions must be taken to prevent negative outcomes. In your case, the thoughts about making promises to the universe or feeling compelled to perform certain actions to avoid bad outcomes are indicative of this pattern.

Addressing Your Concerns
1. Consequences of Not Following Through on Promises: You mentioned feeling anxious about not fulfilling promises made to the universe. It’s crucial to understand that these thoughts, while distressing, do not have real power over your reality. Not following through on these promises will not cause the feared outcomes to happen. This is a common cognitive distortion in OCD, where individuals believe that their thoughts or actions can directly influence reality.

2. Confusion About Actions and Agreements: The confusion you feel regarding whether doing or not doing something signifies agreement or disagreement with your initial promise is also a hallmark of OCD. This cycle of doubt can lead to compulsive behaviors aimed at reducing anxiety. It’s essential to recognize that these thoughts are not reflective of reality; they are symptoms of anxiety that can be managed.

3. Fear of Miscommunication: Your concern about saying the wrong thing and what that might mean is another common issue in OCD. The fear that a misstatement could lead to negative consequences is a form of magical thinking. It’s important to remind yourself that your words do not hold the power to dictate reality in the way you fear.

4. Procrastination and Compulsion: The struggle between wanting to act on your thoughts and procrastination can create a cycle of guilt and anxiety. It’s important to understand that not acting on compulsive thoughts is a step towards breaking the cycle of OCD. Engaging in activities that you enjoy or that are meaningful to you can help redirect your focus away from these intrusive thoughts.

5. Seriousness of Your Thoughts: When you express serious intentions to the universe about consequences for not acting, it reflects a deep-seated fear that is often associated with OCD. It’s vital to challenge these thoughts and recognize that they are not based on reality. Seeking professional help can provide you with strategies to manage these thoughts effectively.

Recommendations
- Seek Professional Help: It would be beneficial to consult with a mental health professional who specializes in OCD or anxiety disorders. Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), is an effective treatment for OCD.

- Practice Mindfulness: Mindfulness techniques can help you observe your thoughts without judgment and reduce the power they hold over you. Learning to accept intrusive thoughts as just thoughts can lessen their impact.

- Journaling: Writing down your thoughts can help you process them and see patterns. It can also provide a sense of relief and clarity.

- Support Groups: Connecting with others who experience similar thoughts can help you feel less isolated and provide additional coping strategies.

In summary, while your experiences with intrusive thoughts can be distressing, they are manageable with the right support and strategies. Remember, you are not alone in this, and help is available.

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