Coping with Intrusive Thoughts and Compulsive Behaviors: A Guide

Obsessive thoughts and behaviors?

Hello, doctor.
I often have intrusive thoughts, such as cursing deities or having disrespectful images of them when I enter a temple.
I also frequently experience similar disrespectful thoughts and images regarding the deceased, often involving profanity or sexual content, but I don't genuinely wish to disrespect anyone.
Sometimes, when I'm walking and these thoughts or images arise, I feel compelled to retrace my steps.
When I'm writing and they occur, I erase and rewrite.
When I turn the lights on and off, if these thoughts come up, I feel the need to switch them back on again.
I believe that if I redo an action once, it can somehow cancel out these disrespectful thoughts.
If I don't do this, I become very anxious, fearing that I might face retribution or something bad happening.
This situation is quite distressing and has made me hesitant to go out, causing me to fall behind in my studies.
I hope you can offer me some advice on how to cope when these chaotic thoughts arise.
Thank you.

Niming, 10~19 year old female. Ask Date: 2016/08/25

Dr. Ding Shuyan reply Psychiatry

Hello, my patient has the same concerns as you, but I want to assure you that the things they worry about have never happened.
However, the anxiety can indeed be quite overwhelming.
The quickest solution to your issue is to see a doctor and consider medication; you might want to discuss this with your parents.
These so-called obsessive thoughts will come and go.
As for how you handle them, I suggest you treat them like watching a movie.
Each time they come and go is like the end of a film; when the lights come on, we rush to get up and leave our seats, following everyone out of the theater, deciding whether to go home or do something else.
The plot of the movie or the emotional ups and downs at that moment are essentially not worth worrying about! You can redirect your attention and not dwell on where these thoughts come from, or blame yourself for having these unwanted thoughts, or worry about not performing certain rituals to counteract them, fearing punishment or misfortune.
Just notice when these obsessive thoughts return; don’t fight them, but don’t follow them either.
It’s like passing by a stranger on the street; you don’t have any good or bad feelings towards them, nor do you need to forget about them.
Just keep walking your path and continue doing what you need to do.
Also, try not to spend too much time alone in deep thought, as this can give obsessive thoughts a chance to grow.
Wishing you all the best, Dr.
Ding Shuo-Yan.

Reply Date: 2016/08/25

More Info

Coping with intrusive thoughts and compulsive behaviors can be a challenging journey, especially when these thoughts lead to significant anxiety and compulsive actions that interfere with daily life. It’s important to understand that what you are experiencing is a common symptom of Obsessive-Compulsive Disorder (OCD), which is characterized by unwanted, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce the distress caused by these thoughts.

Firstly, it’s crucial to recognize that intrusive thoughts do not define who you are. They are simply thoughts that arise involuntarily and do not reflect your true intentions or desires. Many individuals with OCD experience similar thoughts, including those that may seem blasphemous or disrespectful. The key is to understand that having these thoughts does not mean you will act on them or that they reflect your values or beliefs.

Here are several strategies that may help you cope with intrusive thoughts and compulsive behaviors:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for OCD. CBT, particularly a subtype called Exposure and Response Prevention (ERP), involves gradually exposing yourself to the thoughts or situations that trigger your anxiety while refraining from performing the compulsive behaviors. Over time, this can help reduce the anxiety associated with the intrusive thoughts.

2. Mindfulness and Acceptance: Practicing mindfulness can help you observe your thoughts without judgment. Instead of trying to suppress or fight against the intrusive thoughts, acknowledge their presence and allow them to pass without engaging with them. Techniques such as deep breathing, meditation, or grounding exercises can help you stay present and reduce anxiety.

3. Challenge Your Thoughts: When intrusive thoughts arise, try to challenge them. Ask yourself questions like, “What evidence do I have that this thought is true?” or “What would I say to a friend who had this thought?” This can help you gain perspective and reduce the power these thoughts have over you.

4. Limit Compulsions: While it may feel necessary to perform compulsive behaviors to alleviate anxiety, this can reinforce the cycle of OCD. Gradually try to limit these behaviors. For instance, if you feel the urge to redo an action, set a timer for a few minutes and allow yourself to sit with the discomfort before acting on the urge.

5. Journaling: Writing down your thoughts can provide an outlet for your feelings and help you process them. It can also help you identify patterns in your thoughts and behaviors, which can be useful in therapy.

6. Seek Professional Help: If you haven’t already, consider reaching out to a mental health professional who specializes in OCD. They can provide tailored strategies and support to help you navigate your experiences.

7. Medication: In some cases, medication such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to help manage symptoms of OCD. Discuss this option with your healthcare provider if you feel it might be beneficial.

8. Support Groups: Connecting with others who experience similar challenges can provide comfort and understanding. Support groups can be a safe space to share experiences and coping strategies.

Remember, recovery from OCD is a process that takes time and patience. It’s important to be kind to yourself and recognize that setbacks may occur. By implementing these strategies and seeking support, you can work towards reducing the impact of intrusive thoughts and compulsive behaviors on your life.

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