OCD and Thought-Action Fusion


by master isolated images  freedigitalphotos.net

by master isolated images freedigitalphotos.net


This week I’m sharing a post from June 2012….

As I’ve mentioned before, and most of us already know, our minds have minds of their own. All kinds of thoughts run through them on a daily basis: some happy, some distressing, some weird, some comical. So many thoughts over which we have no control. Some hang around longer than we’d like, while others are fleeting. Most of us filter out the thoughts that are necessary and important at any given time, and pay little to no attention to the rest. But for those with obsessive-compulsive disorder, it is rarely this simple.

OCD is complicated, and many different elements may contribute to the development of the disorder. One of these factors is a process known as thought-action fusion. This is when a person believes that thinking bad or distressing thoughts is just as terrible as performing the action associated with the thought. So say a thought pops into your head that involves physically hurting somebody you care about. Those who deal with thought-action fusion believe that thinking this thought is just as horrible as following through with it. Imagine how terrifying this can be (not to mention what it can do to one’s self-esteem).

Additionally, thought-action fusion can also include the belief that thinking these terrible thoughts can somehow make them come true. So if you believe that thinking about harming a loved one can actually cause this harm to happen, what would you do? Most of us would try as hard as we could not to think this awful thought. And, given that our minds have minds of their own, the more we try not to think of something, the more we can’t stop thinking about it. It’s not hard to see how this process is conducive to the development of obsessions.

Even though I don’t have OCD, I can sometimes personally relate to different aspects of the disorder, to a point. In terms of thought-action fusion, I realize that I have, on occasion, been superstitious about thinking certain negative thoughts. Stop thinking that; it might come true. I don’t really believe my thoughts can control what happens, yet I find myself trying to stop these thoughts anyway. It’s no different from feeling you might “jinx” something by thinking or talking about it.

Once again we see that the thoughts and behaviors of those with OCD are often no different from those who do not have the disorder. It is the severity that sets them apart. For those who suffer from thought-action fusion that feeds their obsessive-compulsive disorder, cognitive behavioral therapy with a competent therapist can help. And once this cognitive distortion is conquered, there will be a little less fuel to feed the fire of OCD.

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14 Responses to OCD and Thought-Action Fusion

  1. There’s a famous Yiddish saying, “Tracht gut, unt Zein gut.” Think good, and it will be good. I love that, and I sure hope it works for some people! I do believe that thoughts have far-reaching influence. How many times have you thought about someone, only to have them call you moments later? Happens to me all the time. So although I don’t think I suffer with thought-action fusion (whew! at least one symptom I don’t have :-D), I do think that there is some thought-action connection that Western minds don’t necessarily subscribe to. What is prayer, if not concentrated thought? What about the cause>>effect premise of Buddhist meditation? I’ve seen more than one OCD’er go off the deep end into prayer and spirituality because a) they believed that they’d better do it or else something bad would happen, or b) if they didn’t do it everything they had would disappear. Oy.

    • Thanks for your comment, Laura, and I think you bring up some great points. I agree with you about how our Western minds “think” and also believe there are connections we don’t fully understand. I think in relation to OCD, it’s all about the degree or severity of thought-action connection, and also how much it affects our lives. For example, I will often send positive, healing thoughts to a friend who is ill…..it takes a few minutes out of my time, and who knows? It might help. On the other end of the spectrum might be someone who needs to pray for ten hours a day because they fear their loved one will die if they don’t. Thanks again for sharing…you’ve given me a lot to think about!

      • Interesting that you mention religion. I got involved with Orthodox Judaism, which has prayers from the moment you wake up until you go to sleep. It triggered my OCD so intensely that I was in a constant state of anxiety about whether I had forgotten something, whether I was doing something wrong..in the middle of this I became seriously ill and oh boy, I was flat on the floor being to know what I had done wrong and how to fix it. The compulsions and anxiety became so bad that I just had to STOP observing at all! I feel much better now, only occasional feelings of guilt for not doing what I’m “supposed” to do…I’m sure you hear this a lot from people obsessed by religious observance.

    • Absolutely, Laura. Scrupulosity is a common type of OCD and I wrote a post on it a while back:
      https://ocdtalk.wordpress.com/2014/06/01/ocd-and-scrupulosity/. As we all know, OCD often latches on to what is most important to us. I’m glad you were able to stop…you knew what you had to do and had the strength to do it!

  2. myocdvoice says:

    I’m so glad you wrote this. I’ve done this so many times but never heard this term for it before. You learn something new everyday!

    (I more often fall into the category where you fear thinking it will make it come true, or at least I did when I was younger since intrusive thoughts are less of my OCD’s focus right now.)

    Have a good one! 🙂

    • Thanks for sharing, myocdvoice. My guess is many people think this way without realizing there is a name for it. But I think just pointing out what thought-action fusion is can be really helpful. I know it was for my son!

  3. Faith says:

    I’m so glad I found your blog. I’m 17 & I also correctly diagnosed myself as having ocd with the help of the Internet a couple of years ago. I went to a counselor sporadically who used talk therapy, but I stopped going about a year ago. I am trying to find a new therapist to go to, but I am really unsure of what credentials to look for. Do I look for a psychologist, counselor, psychiatrist, or what? I’ve been in pretty low points before with my ocd, but I am presently at one of my lowest. I feel like some of my friends & especially my family don’t want to deal with me anymore. I try to avoid my family as much as possible because I know I won’t be able to control my compulsions when I’m around them & they’ll just get angry at me.

    • Hi Faith, I’m so glad you commented and I’m so sorry you have been having such a tough time with your OCD. The really positive thing here is you want help, and OCD is treatable! In my experience, typically clinical psychologists will treat OCD – but not all of them.You need someone who has had experience and success using exposure and response prevention (ERP) therapy. That being said, there are certainly other health care providers who might be capable as well. Sometimes one of the hardest things about OCD is finding the right treatment! If you are in the US, I’d suggest checking out the IOCDF (link on my Resources sidebar). You can also call them and get help starting your search. Your family needs to be educated as to what OCD really is, as well, so that they can hopefully be a source of support to you, in the right ways. Good luck as you move forward….there is so much hope for your recovery. Please keep in touch!

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