The Obsessive Compulsive Cognitions Working Group (OCCWG; Steketee et al., 2003)identified six key types of appraisals and beliefs that play a crucial role in the development and maintenance of OCD.
These factors can interact with each other and with other biological, psychological, and environmental influences to contribute to the development and maintenance of OCD symptoms.
Understanding these underlying causes can help informtreatment approachesand support individuals in managing their symptoms.
1. Inflated Responsibility
People with OCD often have an overvalued sense of responsibility for preventing harm to themselves or others. They may believe thatfailing to prevent harmis morally equivalent to causing harm directly.
This belief can lead to excessive guilt and an overwhelming need to take action to prevent negative outcomes, even when the likelihood of such outcomes is low, or the individual’s ability to prevent them is limited.
People with inflated responsibility may worry that their actions or inactions could lead to harm, such as a fire, burglary, or injury to others.
They may repeatchecking behaviors to prevent these perceived negative outcomes, such as ensuring that appliances are turned off, doors are locked, or loved ones are safe.
HarmOCD SimplyPsych
2. Overimportance of Thoughts
Individuals with OCD tend to overestimate the importance and meaning of theirintrusive thoughts.
They may believe that having a thought increases the likelihood of the event occurring in reality (thought-action fusion) or that having amorally repugnant thoughtis equivalent to committing a morally repugnant deed (moral thought-action fusion).
These beliefs can cause significant distress and lead to attempts to suppress or neutralize the thoughts through compulsions.
Compulsions
ocd cycle
Avoidance
People with OCD often try to avoid things that might trigger their obsessive thoughts. They do this for a few reasons:
For example, someone with OCD might avoid certain places (like hospitals or public bathrooms), objects (like knives), situations (like being alone with a child), or people (like those who are sick).
If they can’t avoid these things entirely, they might try to avoid direct contact, like wearing gloves or using their sleeve to open a door.
People with OCD related to disturbing thoughts (like harming others) might also avoid talking about their thoughts. They worry that revealing the thoughts could make them happen, or they feel ashamed and scared of the consequences (like having their child taken away).
While it’s understandable that people want to avoid things that make them anxious, avoiding doesn’t help in the long run.
It stops them from learning that their fears won’t necessarily come true and that they can handle the distress. Avoidance also takes up a lot of time and energy, making OCD an even bigger problem in their lives.
3. Mental Control of Thoughts
People with OCD often overvalue the importance of exerting complete control over their intrusive thoughts, images, or impulses.
They may believe that complete mental control is both possible and desirable and that any failure to control their thoughts is a sign of weakness or moral failing.
This can lead to excessive attempts to monitor and control their thoughts, paradoxically increasing the frequency and intensity of the intrusive thoughts.
Thought Suppression
People with OCD often try to push away or ignore their obsessive thoughts. They do this for a few main reasons:
Researchers think that trying not to think about something actually makes you think about it more. It’s called the “white bear effect” – if I tell you “don’t think about a white bear,” it’s hard not to picture one.
But for people with OCD, studies don’t really show that pushing away thoughts makes them happen more often.
So while trying to control or get rid of obsessive thoughts fully might not always work, it’s not necessarily true that it always backfires and makes the thoughts more frequent or intense.
The effects can vary from person to person and situation to situation.
4. Overestimation of Threat
Individuals with OCD tend to overestimate the severity and likelihood of negative events occurring.
They may believe that the world is a dangerous place and that bad things are more likely to happen to them than others.
This heightened perception of threat can fuel anxiety and drive compulsive behaviors aimed at reducing the perceived risk.
Hypervigilance
People with OCD often overestimate the likelihood and severity of potential threats, which leads tohypervigilance, a heightened state of alertness and sensitivity to triggers related to their obsessive concerns. This hypervigilance can manifest in several ways:
Although hypervigilance is understandable, it is ultimately unhelpful because it ensures that even minor threat indications are noticed, possibly at the expense of important safety information.
Monitoring bodily sensations can lead to misattribution of normal physiological changes, while attempting to prove that harm has not occurred is futile, as the absence of evidence is not evidence of absence.
Furthermore, repeatedly monitoring oneself can undermine confidence in one’s own sensory experiences.
Hypervigilance and avoidance are important markers of OCD severity and treatment progress, even though they are not always included in symptom measures.
5. Intolerance of Uncertainty
People with OCD often havedifficulty tolerating uncertaintyand may believe that they must be absolutely sure of something to avoid making mistakes.
They feel a strong need to consider all possible outcomes of a situation, leading to excessive doubting, checking, and seeking reassurance.
Theinability to tolerate uncertaintycan maintain the cycle of obsessions and compulsions.
This might include worrying about a future event, thinking of all the worst-case scenarios, replaying a past scenario, predicting how something will play out, or planning something to every last detail.
Compulsive rituals, avoidance behaviors, and safety behaviors in OCD can be understood as ways for individuals to seek certainty when faced with uncertainty.
6. Perfectionism
Individuals with OCD may believe that there is a perfect solution to problems and that even minor errors will have serious consequences.
They may tend to believe that they must be perfect at everything to be a worthwhile person.
Orderliness Symmetry OCD
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
