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Saying “thank u, next” to Intrusive Thoughts

When Ariana Grande released possibly the greatest music video of 2018, did she know that she was also providing the perfect line for dismissing intrusive thoughts? I like to think that she did...

People with Obsessive-Compulsive Disorder (OCD) experience highly distressing intrusive thoughts, which they respond to through behaviors called “compulsions.” For example, people with OCD might have worries that their parent is going to die if they don’t perform a certain ritual or that they have hit someone with their car without realizing it or that they are going to contract a deadly disease. Of course those fears would freak anyone out! The problem is, because these fears are not current reality, people with OCD end up spending a ton of their time and energy engaging in compulsions that are not actually protecting them in any way. Unfortunately, avoiding all cracks cannot guarantee that you will not break your mother’s back.

What’s the difference between someone with OCD and someone without it? One simple difference is the response to intrusive thoughts. Actually, everyone has intrusive thoughts, and the thoughts/urges/images of people with OCD are not any weirder or scarier or more unusual than those who do not have OCD.

Let’s say you were holding a friend’s baby and you had the thought, “What if I drop this baby?”. Someone without OCD might think, “Nah, unlikely” and keep holding the baby. Someone with OCD might perceive this intrusive thought as much more important and relevant to the current situation. They might think...

“How could I have such a thought right now?! What does this say about me? Am I about to drop the baby?”

They might respond by handing the baby off to someone else and continuing to worry about their ‘true’ feelings toward babies.

What we’ve learned about OCD is that a thought is just a thought; random thoughts do not necessarily reveal our moral character or our future actions (Abramowitz, 2018).

In evidence-based OCD treatment, we are trying to help people to get less involved in their thoughts. While we cannot stop intrusive thoughts from coming in, we can decrease our engagement with them (AKA compulsions). Our goal is for someone with OCD to notice their intrusive/obsessive thought, not engage in a compulsion related to it, and then continue engaging in a values-based behavior. Here’s an example:

Pre-OCD Treatment

Intrusive Thought/Obsession: I might have cancer

Action/Response/Compulsion: *Spends hours Googling cancer symptoms and checking their body for ‘signs’ of cancer*

Post-OCD Treatment

Intrusive Thought/Obsession: I might have cancer

Compulsion: None!

Action/Response: *Continues Googling “What kind of cat would I be?”*

Someone struggling with OCD likely is experiencing MANY obsessive/intrusive thoughts and most of them are super distressing. Here’s an example of someone trying to get ready in the morning while experiencing a bunch of intrusive/obsessive thoughts:

*Eating breakfast* “What if I never find love?”

*Brushing their teeth* “Did I leave the stove on downstairs?”

*Putting on makeup* “What if we’re all living in the Matrix?”

*Getting dressed* “My heart just skipped a beat. Am I having a heart attack?”

Now here is where Ariana Grande’s lyric comes in: Instead of trying to answer those questions (which would be a compulsion), we would want this person to just keep doing their morning routine as best as possible, trying to focus on the present moment. So, instead of compulsions, their response to these many “important” life questions could be...

“What if I never find love?” --> “thank u, next”

“Did I leave the stove on downstairs?” --> “thank u, next”

“What if we’re all living in the Matrix?” --> “thank u, next”

“Am I having a heart attack?” --> “thank u, next”

Fighting OCD takes a lot of courage, effort, and cute tricks like this. I hope this tactic will be helpful for someone who hasn’t yet found their trick to help them more easily move away from compulsive engagement with their intrusive thoughts.

If you try this out, please comment your feedback below!

If you’d like to learn more about OCD, click here.

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