Several research studies have shown that holding certain beliefs about our thinking (called metacognitive beliefs) may lead us to worry about our thoughts in an obsessive spiral.
These include believing that our thoughts are important to monitor and control (‘thought control beliefs’), that thinking about ‘bad’ things can cause them to happen (‘thought likelihood fusion beliefs’), or that having intrusive thoughts about doing something ‘bad’ is the same as acting immorally (‘thought moral fusion beliefs’).
When we hold these beliefs, we are more likely to interpret our anxious intrusive thoughts as being dangerous and important to pay attention to, and to try to stop or suppress them in a way that actually has the opposite effect.
We tend to be the most bothered by, and try to get rid of, the intrusive thoughts that are against our values and who we are as a person. This means that our attempts to avoid the very thoughts that make us anxious can set up a vicious cycle that keeps distress going over time.
For example, imagine a very gentle person who has an unwanted and senseless intrusive thought about stabbing their partner, who they love dearly. This thought is likely to be disturbing and uncomfortable to have. The person may find the intrusive thought truly terrifying and difficult to let go of, especially if they believe that “I’m a bad person for thinking this” or “thinking this thought means I may lose control and actually stab my partner”.
Hiding all the knives in the house, leaving the kitchen when their partner is there, and trying instead to focus on positive thoughts about their wedding day may provide short-term relief from the anxiety the intrusive thoughts cause. However, these physical and mental coping strategies are compulsive attempts at thought suppression, and typically will increase the thoughts and the anxiety linked with them over time.
This vicious cycle of intrusive thoughts (obsessions) and distress, leading to physical or mental compulsions and relief, then more obsessions and compulsions in the future, explains how normal intrusive thoughts may turn into OCD.