Mental Compulsions: How to Stop The Most Difficult OCD Ritual
Written by: Allyson Inez Ford, MA, LPCC
Mental Compulsions in OCD Recovery
As an OCD therapist and person with lived experience, I can say for (almost) certain that trying to manage mental compulsions is one of the hardest parts of OCD treatment. This is because unlike compulsive behaviors that we can physically choose to engage in or not engage in, many feel like they have less control over their thought processes. After all, isn’t this something we learn early on in OCD treatment- that we can’t control our thoughts?!
The answer is yes and no. It’s true that we can’t control the automatic thoughts that pop into our brain, but we do have agency in what we do with that thought. We also have agency over how much attention we give thoughts. Before we get more into that, let’s review what examples of mental compulsions are. Then we will go over some basics in terms of passive thoughts, active thoughts, attention vs. awareness of thoughts. Finally, we’ll end with tools to disengage from mental compulsions, which is why I am sure you’re all reading this!
Examples of mental Compulsions
Mental compulsions are mental rituals we do in response to intrusive thoughts that temporarily provide a sense of relief. When we engage in mental compulsions, it feels productive, like we are trying to figure out something important. However, when it comes to OCD and mental compulsions we are usually trying to answer something unanswerable. Something that we can’t quite know for 100% certainty (none of us can). OCD sufferers find it really hard to tolerate the uncertainty, so we end up in an endless battle trying to ‘figure it out.’ You may have been operating this way for a while, so it can be hard to identify which thought patterns are compulsions. Below is a list of 7 common mental compulsions- see if you can identify which ones you engage in most!
7 Types of Mental Compulsions:
Self reassurance: this sounds like“I would never do that.” “I am a good person.”
Mental prayers: often needing them to be perfect, to be done in a ritualistic way (certain number of times, certain content or places- the prayer ritual might get longer and longer as OCD makes us think of more things to add)
Conversation review: “Did I really say this or not? What are they thinking? What if they misunderstood me?”
Intentionally thinking good thoughts or images to replace ‘bad’ ones.
Mental lists: often used to make sure memory is intact or to ‘make sure’ or check a compulsion was done correctly.
Repetition of words, images or numbers to prevent something bad from happening.
Ruminating: attempting to answer unanswerable questions, often analyzing the same thing over and over.
*It’s important to note that people without OCD might engage in these thought patterns from time to time, but for the person with OCD, it is repetitive and typically does not relieve anxiety (it might in the very short term, but ends up coming back stronger).
Mental Compulsions & the Obsessive- Compulsive Cycle
Now that you’ve identified your mental compulsions, it’s time to make a plan for how to disengage from them. This is an important part of recovery from OCD, as it is apart of breaking the obsessive compulsive (O-C) cycle. When we break the cycle by stopping the compulsions (even reducing them gradually is great), the intrusive thoughts stop getting reinforced and over time, they don’t bring us so much anxiety. It sounds paradoxical, but when we remove the safety behaviors, our brain habituates to the fear and/or it learns that we can tolerate distress without compulsions. Why would we want to tolerate distress without compulsions? Because the compulsions make the fear stronger. Read more about the O-C cycle in this blog post I wrote.
Attention vs. Awareness
Before we can even begin to disengage from mental compulsions, we need to understand the difference between attention and awareness of thoughts, and active and passive thinking. It turns out, not all thinking is created equal- and how we respond to the thought makes all the difference.
Attention vs. Awareness of thoughts: while we can’t control the automatic thoughts that pop into our brain (awareness), we can control the attention we give the thought. For example: think of something in your environment that you haven’t paid attention to today. Let’s say it’s your ceiling fan. Now that we are talking about it, you’re probably thinking about it more: the color of it, whether or not it’s on or off, how dirty it is, etc. Before we intentionally directed attention towards it, it just existed in your awareness passively. Think of this example like a metaphor for your thoughts. We can practice noticing them (awareness) without intentionally directing attention towards them (attention). Just like we can shift out attention from our ceiling fan back to talking about OCD, we can do the same with intrusive thoughts. Now, at first this will feel really hard. At first it might feel impossible. That’s because your brain is so used to going down the neural pathway of fixating on your intrusive thoughts. However, with lots of practice and patience, we can rewrite this neural pathway. This process is called: attention refocusing training. It is about becoming aware of when we are engaging in a mental compulsion, then intentionally shifting our focus to something that aligns with our values versus giving OCD more airtime. Maybe you’d rather be petting your dog and really focusing on that moment, or playing with your kid, or watching your favorite TV show. Practice this over and over until it becomes second nature.
Active vs. Passive Thoughts
Active versus Passive Thoughts: Similar to the example above, it’s important to note the distinction between active and passive thinking. One requires effort and one does not. Mental compulsions are active thinking, as we are intentionally trying to figure something out. We have control over active thinking. We can shift these per the example above. Passive thoughts, we can’t control, which is why OCD treatment focuses on the response. Another example: think of your weekly grocery list. Maybe there are moments when the thought comes into your mind that you need to add something to the list. That’s a passive thought. You either decide, yes let me add this and think of other things we need to add (active thinking) or you decide it’s not a good time so you’ll come back to it later. You acknowledged the thought, without engaging. That is exactly what we want to do with intrusive thoughts. We don’t want to try to escape it, that just makes it stronger and reinforces the fear. We want to acknowledge and then shift back to the present moment and/or of something we value.
I hope this is starting to make sense! I know it can sound confusing at first. In OCD therapy, we spend a lot of time just learning and noticing about these patterns and then we co-create a plan to help you gradually disengage. My team is very skilled in this and we’d love to support you!
Helpful suggestions:
Know that this is going to take time and a lot of practice. It won’t be perfect. Give yourself grace as you go. We are looking for progress, not perfection.
If you are struggling to build awareness of when you’re engaging in mental compulsions, consider setting random reminders or alarms on your phone throughout the day and notice if you’re engaging in active thinking or passive thinking, and whether or not it falls into one of the 7 types of mental compulsions related to your OCD. Of course, active thinking can be about non-OCD things too and that does not need to be shifted, we NEED active thinking for non-OCD things.
Engage in a daily mindfulness meditation. Even 5-10 minutes of mindfulness a day can help orient your brain to building awareness without judgement. This is exactly what we want to do with our intrusive thoughts! The Leaves on a Stream meditation from ACT therapy is a great one to start with.
Seek help from an OCD therapist, support group and/or psychiatrist. There are many avenues to explore. Sometimes, we need the support of medication for OCD to help us use the coping skills. That has been key to my own recovery. At ED OCD therapy, we can provide you with referrals to trusted providers and you can also check out the IOCDF website for tons of free resources. If you’re interested in starting therapy with us, feel free to reach out for a free 15 minute intro call to see if we are the right fit for you.
OCD recovery is hard work; but I promise that it is worth it in the end. You deserve a life free from obsessive thoughts and compulsions!
Reach out for more information about OCD therapy for CA, WA, UT, FL and MD residents. OCD recovery coaching available worldwide.
