Written by Shireen Ali, Clinical Psychology Registrar
One of the most confusing and distressing parts of OCD is that it often seems to target the things that you care about most.
If you have OCD and you’re a loving parent, you may have intrusive thoughts about harming your child. Similarly, someone with OCD who deeply values their relationship may become consumed by thoughts and doubts about whether you truly love your partner. If someone has OCD and their faith is really important to them, they experience blasphemous thoughts. If being a good person matters a lot to someone with OCD then their mind may latch onto fears about being selfish, cruel, or dangerous.
This can feel terrifying for people with OCD because the thoughts seem so real but are completely opposite to your values. As a result, many people begin to wonder, What if this means something? What if I secretly want this? What if I’m not the person I thought I was?
This is exactly where OCD takes control.
OCD Is More Than It Seems
OCD is often misunderstood as only being about cleanliness, order, or repeated checking. However, at its core, OCD is about doubt, uncertainty, and threat.
It can help to think of OCD as a beast that is constantly looking for what feels the most important and meaningful things in your life. When the beast identifies that area or subject that you care about the most, it attaches itself to those topics. This is what makes the “risk” feel real.
The OCD beast does this because that is how it can grab someone’s attention. If someone did not care about the thing that were obsessing about, the thoughts wouldn’t feel distressing in the first place.
The distress that people feel in response to intrusive thoughts related to OCD is because the subject matter is important to them.
Intrusive Thoughts Are Not Intentions
Everyone in the world has strange, unwanted thoughts from time to time. The difference is, someone with OCD may unconsciously attach meaning to those thoughts . While someone without OCD might think, That was weird, and move on. Someone with OCD might think, Why did I have that thought? Does it mean something about me? What if I act on it? What if I can’t be trusted?
The thought becomes sticky because it feels important or it feels like a threat.
The brain starts treating thoughts like immediate threats that need to be solved. This is what actually creates the OCD cycle in the first place. It’s a cycle where meaning is attached to an intrusive thought which leads to heightened anxiety. This then leads to compulsions like reassurance seeking, checking behaviours, analysing and avoiding which only provides people with temporary relief. The brain learns that the thought is dangerous and we need compulsions to alleviate the threat, so the thought comes back stronger and we engage in the compulsions again.
The Trap of Compulsions Like Reassurance
When OCD targets what matters most, we will engage in behaviours that provide us with a sense of short term relief. Behaviours like reassurance can feel impossible to resist. People may find themselves asking questions like:
- “Do you think I would ever do that?”
- “What if I’m in the wrong relationship?”
- “What if I don’t actually love my baby?”
- “What if I’m secretly a bad person?”
The problem here is that reassurance never lasts. You might feel better for a few minutes, maybe even hours, but eventually the doubt returns. OCD always finds another “what if.”
This is because OCD does care about logic or reason. Instead, it wants certainty, and certainty is something no one can fully have. Trying to reach 100% certainty is like trying to fill a bucket with a hole in the bottom. No matter how much reassurance you pour in, it never stays, and there is always another “what if” to ask.
Why It Feels So Real
People with OCD often say, “But it feels so real.” That makes sense. Of course it feels real.
OCD creates intense feelings of fear, guilt, disgust, and urgency. It can feel like the anxiety itself is proof that something is wrong.
But feelings are not facts.
Feeling anxious about something does not actually mean you are dangerous.
Feeling uncertain does not mean there actually is an immediate problem to solve.
If a fire alarm goes off in your apartment, it’s understandable to think that something is wrong. However, when we know that the fire alarm itself is faulty, going ahead with the constant checks of every room, or calling for reassurance, or avoiding the apartment altogether may instead keep the fear going. Alternatively, we can learn to recognise that the alarm is sending a false signal and practice responding differently, even while the uncertainty and discomfort are still present.
So Treatment Means Doing the Opposite
Most people respond to OCD by trying harder to prove they are safe, good, or certain. But true healing often means doing the opposite.
It means allowing uncertainty instead of solving it. It means noticing the intrusive thought without engaging with it. It means trying to resist compulsions, even when anxiety rises. It means accepting that discomfort can be present without needing immediate relief.
This is the foundation of Exposure and Response Prevention (ERP), one of the most effective treatments for OCD.
ERP does not ask you to like the thought or agree with it. It teaches you to stop treating the thought as meaningful or dangerous. Over time, the brain learns that the thought is just a thought.
Final Thoughts
OCD attacks what matters most because that is where fear feels strongest.
OCD can target love, morality, faith, safety, identity, or responsibility. It tries to tell people that the very things they value most are at risk and convinces them that certainty is the only way to stay safe. But certainty is not the answer.
Learning to tolerate uncertainty, step back from intrusive thoughts, and stop feeding compulsions is what begins to loosen OCD’s grip.
If OCD is making you doubt yourself or your values, it might be worth reaching out for support. Working with a clinician who understands OCD is important especially because OCD is often misunderstood. With the right support, people can learn to manage their OCD differently.
References
Abramowitz, J. S., McKay, D., & Storch, E. A. (Eds.). (2017). The Wiley handbook of obsessive compulsive disorders (Vol. 1). Malden: John Wiley & Sons.
Foa, E. B., Yadin, E., & Lichner, T. K. (2012). Exposure and response (ritual) prevention for obsessive-compulsive disorder: Therapist guide. Oxford University Press.
Starcevic, V., Berle, D., Brakoulias, V., Sammut, P., Moses, K., Milicevic, D., & Hannan, A. (2011). Functions of compulsions in obsessive–compulsive disorder. Australian & New Zealand Journal of Psychiatry, 45(6), 449-457.
