Fear and anxiety are emotions that can provide us with data about the external world and alert us to threats that require our attention, keeping us safe. They can be thought of as our brain’s “alarm system” or threat detection capability.
The Faulty “Alarm System”
In OCD, our brain’s “alarm system” is faulty, sending up alarms that don’t match the external world. Rather than helping us attune to necessary information in our environment, obsessions paralyze us with a level of intense fear, anxiety, or intrusive, disturbing thoughts that often don’t match up with our experience.
Obsessions aren’t responses to fearful stimuli in our environment, but intrusive, persistent thoughts or images that the brain treats as a high-priority threat. These thoughts can be incredibly distressing and make us feel compelled to “neutralize” or eliminate these thoughts through compulsive behaviors.
Some Helpful Examples
To appreciate how this works, consider the following sequence of events featuring threat detection working as intended:
A car veers in my direction (fearful stimulus) → I panic (emotion) → I jump out of the way (congruent action) → after reaching safety, the panic abates shortly thereafter (the emotion dissipates naturally).
In OCD, however, our threat detection picks up on hypotheticals or “what-ifs?” that don’t match the information our environment is sending us.
For example:
A car approaches me from the opposite direction in the opposing lane (neutral stimulus) → I am struck by an intrusive thought: “What if I veered into them, causing a crash?” (hypothetical reality) → My brain treats this imagined reality as genuinely dangerous (a concept known as “inferential confusion”) → I panic (emotion) → I pull over to prevent myself from causing harm (incongruent action/compulsive response to manage the imagined threat) → I start to feel better (negative reinforcement).
The OCD “Loop”
Unfortunately, with OCD, this process results in negative reinforcement, which creates a “loop” or vicious cycle. Since I was able to “fix” the thought by neutralizing the perceived threat, I feel relief in the short term. Unfortunately, in the long term, I also end up learning a few things that strengthen my dependence on these neutralizing behaviors and “rituals.”
- I must protect myself from my thoughts.
- I must eliminate fearful thoughts and feelings to feel safe.
- My actions prevent feared outcomes.
Over time, as we feed our doubts and fears—and as our reliance on compulsive behaviors deepens—our fundamental sense of trust and confidence in ourselves and our senses erodes. As the association between our obsessions and compensatory behaviors becomes more tightly intertwined, it can feel nearly impossible to break the loop.
Therapy for OCD
This is where exposure and response prevention therapy (ERP) comes into the picture. ERP disrupts this chain of events by targeting the “inferential confusion” that occurs in OCD, and empowers individuals to gradually overcome their fears and core doubt through exposure to fearful stimuli without relying on compulsive behaviors that feed the loop.
If you know or suspect you are dealing with OCD, consider finding a therapist who is trained to diagnose and treat OCD using gold standard psychotherapies like ERP, ACT, and I-CBT. The International OCD Foundation’s (IOCDF) website has a directory of therapists who are trained in modalities for OCD, and also contains incredible educational materials for individuals with OCD and their families alike.
This blog contains the views of Alex Thomson and is intended as educational content. It is not a replacement for therapy or formalized diagnostic assessment. Read full Disclaimer.
Alex Thomson is a licensed associate professional counselor in the state of Georgia and a certified trauma professional. He provides counseling services through Exhale Counseling Services in Acworth.
