OCD Center of Los Angeles California
OCD Center of Los Angeles

OCD and Mental Checking

Monday, December 7th, 2009 Obsessive-Compulsive Disorder (OCD)


If you are faced with the challenge of Pure Obsessional OCD (also known as “Pure O”), then chances are you’ve completed your first round of obsessions and compulsions before you’ve even gotten out of bed each day.  Before you open your eyes, the wheels in your OCD machine start turning, and a sort of science fiction scan of your brain begins searching for evidence of “it”.  Whatever “it” is, “it” is sure to be in there somewhere.

Perhaps it takes a few moments, or maybe it takes no time at all for the OCD search engine to drum up some piece of the broken puzzle.  But inevitably, you find what you are looking for.  The obsession is still there, still unresolved, still malicious and unfair.  The lump in your throat swells and the other physical symptoms of anxiety begin to surface.  Something is wrong and the day has only just begun.

Immediately, your OCD brain begins to engage in a series of mental exercises pitting the unwanted thought against reality, trying to force them to match up or reveal themselves as permanently incongruent.  Someway, somehow, you have to get that sense of closure to indicate that “it” is not you.  Otherwise, you may never get out of bed.

This is “mental checking”, and it is a common feature of Pure Obsessional OCD.  The scan feels like an automatic part of life, no different than the first yawn or stretch.  It happens throughout the day, often without you really being conscious that you are doing it.  When it is not automatic, it presents itself as necessary, like the annoying reminder message for your computer’s antivirus software.  It is important to realize that mental checking is a compulsion.  And despite its automatic presentation, it is subject to the same treatment mechanisms employed when challenging other OCD compulsions with Cognitive Behavioral Therapy (CBT).

In short, mental checking is a behavior.  It is the act of looking for your OCD obsession with the presupposition that you will in some way be able to squash it and get relief.  Furthermore, since we always find what we are looking for when what we are looking for is evidence to justify action, we feel we need to do something about the obsession.  This follow-up compulsion is a form of mental ritual aimed at neutralizing the OCD thought.  It may be playing an event over in your head to make sure it was handled appropriately (also known as retracing), or it may be repeating a series of “good” thoughts to outweigh the so-called “bad” ones.  But the initial behavioral compulsion that puts this OCD cycle into motion is the mental checking, and it is among the more challenging behavioral compulsions to resist because it often appears to precede the unwanted thought.

For people with Pure Obsessional OCD, there are three opportunities to challenge mental checking, listed here in decreasing order of difficulty:

  • preemptive resistance
  • concurrent resistance
  • retrospective resistance

Preemptive resistance may appear impossible until you are well into a course of Cognitive Behavioral Therapy (CBT).  Preemptive resistance requires that you have an awareness of your OCD tendency to check.  If you have developed this awareness, you are more able to see opportunities for mental checking before they Mindfulness Workbook for OCDhappen, and to see them as opportunities to resist checking.  If you have OCD, you may feel an urge to check when you become aware of the absence of your obsession.  Use this urge as evidence that you should re-direct your focus, rather than seeking certainty that the obsession has been dealt with.  In other words, the urge is your clue – it is your signal to resist doing the compulsion.

Somewhat more tangible an objective is concurrent resistance.  If you have already begun mental checking, you are already down the path to digging up an otherwise dormant, unwanted thought.  This is where you can jump in and say, “Wait!  This is mental checking!  This is OCD, and I don’t need to do this!”  At that moment, the challenge you face is to pull yourself back to the present.  What matters now is not whether your obsession has been dealt with.  What matters now is interrupting and stopping the pointless mental compulsion.

Finally, retrospective resistance may at times be the only tool left in your OCD toolbox.  You have already searched for and found the obsession.  You have already tried some compulsive mental exercises in an effort to make the obsession go back to where it came from.  But all is not lost.  You can still use the power of mindfulness and clinical self-observation to fully acknowledge that this was mental checking.  Take this opportunity to remember what it felt like to look for the obsession.  Identify that urge, and acknowledge that it sent you down the path of grappling with the same old OCD junk.  You might be surprised how effective this post-compulsion labeling is in helping you better develop the skills of concurrent and preemptive resistance.

We often find ourselves sending the wrong message to the OCD brain when we engage in compulsions.  We feel fear and engage in a mental (or physical) behavior to flee from that fear.  The brain remembers this as evidence that the behavior saved us from the fear.  But a more effective message to send to our brains is that the behavior is pointless and so is the fear. (For more information on this process, see our previous post on Exposure Therapy for OCD and Anxiety.) So even if OCD may have won a skirmish on the mental field by pushing you into a bout of mental checking, you can still win the battle by reminding yourself that what happened was nothing more than a compulsion.  Next time it won’t be so easy to fool you.

Now get out of bed.

The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) and related anxiety based conditions.  In addition to individual therapy, the center offers six weekly therapy groups, as well as online therapy, telephone therapy, and intensive outpatient treatment.  To contact the OCD Center of Los Angeles, click here.

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58 Comments to OCD and Mental Checking

  1. The information and research here on OCD is of value and appreciated. This was one simple idea on OCD, that for some, might be of help. Art is way of quieting the mind, relieving it of obsessiveness, gaining self-esteem. When you can disappear 3 hours into an artwork, even if it is amateurish, it helps you to refocus and is balancing. For some, it can be an essential self help skill to learn. Turning off the television also is of necessity for some with OCD. TV and movies, can wind one up like a top, bring back memories that are better left dormant, and even the news can have this effect on some. Reading is better for the mind than watching TV or movies (movies, that is entertainment or action movies, as oppossed to documentaries, or educational movies), especially as a way of life, that is daily or weekly.

    Hope this idea finds root or acceptance among those working with those with OCD. Thanks.

  2. John Scott on December 8th, 2009
  3. This article is helpful in identifying the steps needed to begin changing behavior. An equally interesting and effective approach, I have found, is outlined in William Glasser’s “choice theory”, where we begin to see our behaviors in a different light (“I choose to do it” over “I have to do it.”) When we begin to make the unintentional more intentional, it changes the way we think about our behavior. I tell OCD people to first think of times when circumstances dictate that they were unable to do the obsessional act they feel compelled to do (this shows them in fact that they don’t have to do it), and then as they become more aware of their behavior to intentionally do the act or thought even if it is not compelling. As our awareness of the thoughts and acts moves towards concurrent and preemtptive, we ask clients to decide whether they want to choose the tendency to check. The goals is not so much to stop the tendency but the change the way we view it. And as that view changes, the tendency, as I have seen it, begins to alter the way that client’s see their obsessions and compulsions–as choices rather than requirements. But it doesn’t work for everyone, so I am thankful to have the above information to help with this often troubling and difficult disorder.

  4. Tom Cannon on December 8th, 2009
  5. Tom,

    Thank you for your insightful comment. I agree with your connecting this approach with Glasser’s “Choice Theory”. There are often overlaps in between various psychological theories.

    From a Cognitive Behavioral Therapy (CBT) perspective, “I choose to do it, but I don’t have to do it” is an example of cognitive restructuring. Our approach melds traditional CBT with mindfulness-based concepts found in Acceptance and Commitment Therapy (ACT) and other “third wave” treatment modalities.

  6. OCD Center of Los Angeles on December 14th, 2009
  7. Cool story, I did not thought this would be so great when I read the link!

  8. amumbancy on December 31st, 2009
  9. I agree with Tom – the concept of choice has helped me quite a bit in battling my OCD and anxiety problems. I fully understand that I can’t control the world but when I emphasize my power over my own choices in life, I feel a little bit better about myself.

  10. Anxious M on January 13th, 2010
  11. It has taken me 20 years to identify that my anxiety is DIRECTLY related to this type of mental behavior. I have a hypochondriacal checking obcession that has made most of my life miserable. The information on this page is dead on and I laughed in relief numerous times while reading because of how well it fits my compulsions. I am SO relieved that there are people that study this. Understanding these mechanisms is just another tool in the arsenal to fight this unfair demon that tortures me.
    Thank you.

  12. Checker on October 31st, 2010
  13. “Checker”, thanks for your comments. I’m happy that the article resonated with you.

    Hypochondriacal checking is quite common and responds well to both traditional Cognitive Behavioral Therapy (CBT) and Mindfulness-Based CBT. With mindfulness, the goal is to accept that you have urges to over-attend to thoughts, feelings, and bodily sensations that you believe are related to illnesses. But remember, just because these thoughts, feelings, sensations, and urges exist does not mean that they are important, or that they need to be acted on. Once you get the hang of thinking this way, it becomes easier to catch yourself earlier in the checking process. Best of luck in your continued treatment.

  14. OCD Center of Los Angeles on November 2nd, 2010
  15. I ran across this when looking or more information on Pure obsessional OCD. It really hit home. My OCD centers on my relationships. I also spend the majority of my day going over and over things in my mind. The hardest part for me are the “what-ifs” that I spend so much time thinking about that I feal have actually happened. I don’t have the funds to get professional help, but was wondering if there are any books that reflect the treatment that is mentioned here. There are not too many resources out there that really understand Pure OCD.

    Thank you for writing this.

  16. Jenna on December 15th, 2010
  17. Hi Jenna, nice to know the article had meaning for you.

    I think a useful rule when living with OCD is to automatically tag any question starting with the words “what” and “if” as an OCD trap that should intentionally go unanswered. The right answer is, “I’ll deal with it somehow.” Everything else is likely to involve the cognitive distortion of catastrophizing.

    I agree there are not many reading materials out there that focus on mental compulsions. The two that come immediately to mind are Imp of the Mind by Baer and Overcoming Obsessive Thoughts by Clark and Purdon. If you are looking for online support with other “pure o” sufferers, you might like to contribute to the following yahoo group: http://health.groups.yahoo.com/group/pure_o_ocd/

  18. OCD Center of Los Angeles on December 16th, 2010
  19. This is such a great article. It is so nice to find this stuff put into words and explained.

    Before I was getting help for my OCD, I used to wake up every morning and check to see if the obsessions were still there. I had no idea that this was a mental compulsion or even that it had a name. Of course, they always were there to some degree or another and the anxiety came with them and set the course of my day.

    Just the other day I experienced the first time that I was able to catch myself doing mental checking. I said to myself “this is mental checking, it is not necessary to continue.” I still felt like I should continue but I decided to act on what I believed to be true (that it was just a useless compulsion) instead of what my feelings were saying. I still felt worn out and frustrated that the OCD had come, but after sharing it with a friend, I realized that I should be proud that I am starting to be able to recognize the compulsions and resist them.

    Anyway, thanks for the great article.

  20. Ashley on March 24th, 2011
  21. Thanks for your comment, Ashley. Whenever you start to resist a compulsion, there is going to be some discomfort, a feeling of something left undone or unresolved. Work on using that feeling as something to seek out and own, rather than run from. As your tolerance for uncertainty grows, so too does your freedom from ocd. Keep up the great work!

  22. OCD Center of Los Angeles on April 2nd, 2011
  23. Thank you for the article. I was diagnosed with ocd after about 20 yrs of suffering. I mainly mentally check to make sure someting that I did would not hurt myself or someone else I also worry about sinning and will review things in my mind over and over again some events I have reviewed over and over again for several years in order to try and find certainty that i did not sin or do someting that might cause harm to someone else.

    Your article describes exactly what I do. I wake up in the morning and my brain starts to scan/check for things. I worry that I have done something and might not remember and thus not be able to remedy it. Or will suffer in hell because I overlooked someting that is sinful and will cause me to go to hell.

    I began CBT/ERP therapy three weeks ago and my therapist pointed out that I was mentally checking and that it was a compulsion not necessarily an obsession and since then I have been able to accept the urge to check and not do it. It is amazing how many times the anxiety leaves and rational thinkiong often takes its place without checking.

    I soo apreciate your insight and have made a copy of the article to keep as I feel it describes me perfectly.–Thank You!!

  24. Nic on July 26th, 2011
  25. Nic, thanks for your comments. Your therapist is right. While mental checking may feel uncontrollable at times, it is ultimately a voluntary behavior and something you can develop a greater capacity to resist. Keep up the great work.

  26. OCD Center of Los Angeles on August 3rd, 2011
  27. I appreciate this information. It’s great to know I’m not alone, and I am working to use everything I’ve learned about overcoming Pure O. Once again, thank you.

  28. Amy Ko on March 11th, 2012
  29. Thanks for your comment, Amy! Best of luck in treating your ocd.

  30. OCD Center of Los Angeles on March 24th, 2012
  31. Hi there,
    During my CBT I was taught to accept that just because we have a thought does not mean this thought is infact real or true! I liked this philosophy however couldn’t help and wonder, how do we identity our otherwise rational, logical and ‘real’ thoughts if the meaning of all our thoughts is infact relative or as it seems, debatable.
    I guess my question is most applicable when I read your information on preemptive resistance. How do we know that pursuing our thoughts is futile and that they do not have real significance?

  32. Dominique on February 21st, 2013
  33. Hi Dominique,

    Thank you for your comments.

    I would argue that, ultimately, it is unnecessary to figure out if our thoughts are rational, logical or “real”. When you are hungry or tired, do you spend any time trying to figure out the meaning of those experiences? Of course not. You just accept that you are hungry or tired without analysis.

    Analyzing our thoughts for “significance” is unlikely to result in the sense of certainty you are seeking. As an alternative, I encourage you to accept that you (and me and everyone else) have all sorts of thoughts, and that they don’t really merit analysis. For example, if I have the thought of killing someone who cuts me off in traffic during rush hour, there would be no point in analyzing that thought. My goal would be to continue driving towards my destination, rather than pulling over to the side of the road in order to analyze my thoughts in an effort to determine if I am some sort of crazed killer.

    I don’t know with certainty that I am not a crazed killer, but I am confident that trying to get that certainty would be fruitless. I just have to live with the fact that my brain likes to think, and sometimes it comes up with some less than desirable stuff (especially when someone cuts me off in traffic).

  34. OCD Center of Los Angeles on February 22nd, 2013
  35. Thank you for this article. I found it very helpful. I suffer from mental checking due to OCD. It can be exhausting and overwhelming. Thank you for encouraging me and others who have this problem. We need all the tools we can get to fight our problems.

  36. Rose on February 24th, 2013
  37. Why do OCDers have harm thoughts involving those they love the most? Why are the thoughts about what they hate or fear the most? It’s almost like we are not confident of ourselves to act appropriately…that we lack self-confidence.

  38. linda on February 24th, 2013
  39. Thank you Rose! We’re glad the article was helpful for you.

  40. OCD Center of Los Angeles on February 26th, 2013
  41. Hi Linda,

    Thank you for your comment.

    Yes, it is quite common that harm thoughts are often focused on those for whom we care the most. This makes sense, as it is quite horrifying to most people to think about harming someone they love. That said, plenty of people with harm OCD obsess about harming strangers. The bottom line is that harm thoughts can be focused on anyone.

    I’d like to suggest that trying to figure out why you have specific thoughts, or why some thoughts are about a particular person, is a game you can’t win. Any effort to understand why you have a particular thought is likely to become a compulsion. I think a more effective response is to accept that our brains crank out all sorts of thoughts, including some that are about harm. The goal is to accept the presence of unwanted thoughts, while making no effort to understand them or resolve them or fix them. I know this seems extraordinarily difficult and counter-intuitive to many, but acceptance is the key.

  42. OCD Center of Los Angeles on February 26th, 2013
  43. This article was very good. I’ve read that a key to overcoming OCD is to accept the content of your obsessions as irrelevant. How does one do this? Can you offer any advice or readings on this? I think that is the biggest barrier for me because I have so much shame over my obsessions.

  44. David on March 25th, 2013
  45. David,

    Acceptance of your unwanted thoughts and feelings is a critical component in effectively managing OCD and anxiety. And this applies not just to the primary thoughts and feelings you experience, but also to the shame you feel related to those thoughts and feelings. In other words, we all need to accept that, while these thoughts and feelings are unpleasant and unwanted, they exist nonetheless, and demanding that they not exist is unlikely to help.

    Mindfulness Based Cognitive Behavioral Therapy is based on the integration of acceptance with traditional CBT, and can help those with OCD become much more accepting of the presence of the mental noise that causes so much of their suffering. I encourage you to read Kimberley Quinlan’s excellent article Mindfulness for OCD and Anxiety, which will give you a good introduction to how you can integrate acceptance into your daily life with these conditions.

  46. OCD Center of Los Angeles on March 30th, 2013
  47. I just recently got diagnosed with Pure O…. I have dealt with Anxiety for about 10years.
    I have problems believing that’s my problem… that’s its really anxiety/Pure O… Something always tells me, that’s not it, its the believing factor that is my problem. I felt so good giving my issue a “name” but now that I have a name for it, I am doubting myself that that’s really what I have… Is this also a symptom of Pure O? Sorry its so hard to explain!
    Thank you!!!!!

  48. Joyce on April 18th, 2013
  49. Hi Joyce,

    Thank you for your comments. You’ve actually done a very good job of explaining yourself!

    Doubt whether one has OCD is extremely common – remember this disorder has historically been called “the doubting disease”. Many people with OCD (especially the Pure O variants of the condition), express grave concern that their obsessive thoughts are actually evidence that they are planning to act on these thoughts. For example, someone with Gay OCD may see their unwanted thoughts about sexual orientation as evidence that they are gay. Likewise, someone with Harm OCD may question whether their unwanted thoughts of hurting someone are evidence that they are a psychopathic killer.

    It is important to remember that everybody has these kinds of thoughts (yes, everybody). Who we are is not determined by whatever random thoughts pop into our minds. A far better barometer of your character, values, goals, and intentions is how you behave. Until such time that you act in a manner that suggest otherwise, it is best to view your thoughts as just that – thoughts. Not evidence, just strange thoughts, not unlike those experienced by everybody else.

  50. OCD Center of Los Angeles on April 20th, 2013
  51. Now my issue is how do I know whats my P-ocd and what just thoughts? I mean, besides the obvious ones!
    I was doing good and now I’m fighting to get back and its really frustrating… One thing sneaks in and I question whether or not its P-ocd and then the Doubting comes in and I mess myself all up!!!!!!
    Any help would be encouraging!
    Much Thanks!

  52. Joyce on May 10th, 2013
  53. Hi there,

    This article, and your responses to the comments, was extremely helpful. I really liked your comment to the “what if” idea – to respond with “I’ll deal with it somehow.”

    I am trying to come up with good, concise responses to various OCD thoughts that pop into my head. When I respond to an unwanted thought, “that’s just my OCD,” sometimes it helps, and other times it just gives me more anxiety that the OCD cycle is about to start all over again (and then it does). Are there any other helpful phrases you can provide to stop the cycle?

    What’s harder to shake off is that sometimes having the harm thoughts make me feel really restless and agitated and aggressive. I try to tell myself it’s just a mood, it will pass, but it’s frustrating because the aggressive feeling I’m experiencing just adds to the “evidence” that I really mean these harm thoughts. Any advice about how to handle it when I am feeling this way?

    This website is great and your helpful responses to the comments are wonderful as well. Thank you for this resource!!!

  54. Veronica on May 11th, 2013
  55. Thankyou so much for this article.

    Knowing that scanning / looking / checking for the obsession is actually a compulsion is really helpful.

    I’ve always wondered and been confused about this. I think it’s what has held me back. I have been able to beat my physical ocd. But my pure o I have not.

    I always thought the scanning, looking, checking at the start was obsessing ! Because it makes me more anxious once I find the scary evidence I am looking for, because then I try to reassure myself about it.

    It goes like this –
    -feeling of anxiety that there’s something wrong & I need to make sure that I haven’t done anything wrong
    -urge to retrace and recall my past,
    -recall my past,
    -find something questionable
    -then try and convince myself it’s not true but it never sticks.

  56. Jane on May 16th, 2013
  57. Hi Joyce – Questioning whether a thought is OCD or “just a thought” is like questioning whether broccoli is a vegetable, or just broccoli. It is a vegetable that happens to be broccoli, and your POCD thoughts are thoughts that just happen to be POCD thoughts. Simply put, all POCD thoughts are just thoughts, and trying to distinguish which thoughts are POCD and which are “just thoughts” is a compulsion that will only lead to more obsessions.

    Rather than trying to solve the unsolvable, I encourage you to accept that you have lots of thoughts, some of which are POCD. And regardless of what type of thought you are having, accept that it exists and don’t try to figure it out. Our brains are superb at coming up with all sorts of wild thoughts, and trying to figure why we have them or what they mean will leave you exhausted.

  58. Tom Corboy, MFT ~ OCD Center of Los Angeles on May 18th, 2013
  59. Hi Veronica,

    Thank you for your comment and for your kind words.

    Frequently, when people have OCD, they begin to obsess not just about the feared thought, but about having OCD itself. This is called “obsessing about obsessing”, and it sounds like this is what is happening for you.

    You mention that there are times when you have an unwanted thought, and then begin obsessing about the possibility that the OCD is about to rear its head. This is obsessing about obsessing. Fortunately, the best response to this type of OCD is the same as any other type of OCD. When you find yourself worrying that an OCD episode is going flare up, just remind yourself that “that’s just my OCD, and I’ll deal with it somehow”. Simply put, worrying about OCD spiking is no different than worrying about any other unwanted thought. Accept it, label it for what it is, and get on with your day.

    As for feeling “restless, agitated and aggressive”, these are just feelings, not evidence that you are a violent person. At some time or another, everybody has these types of thoughts and feelings, so if they are evidence of our true character and intent, then the entire planet is populated my murderous thugs. The best response for these and any other unwanted feelings is the same as for unwanted thoughts – “that’s just an unwanted feeling, and I’ll deal with it somehow”.

  60. Tom Corboy, MFT ~ OCD Center of Los Angeles on May 18th, 2013
  61. Hi Jane,

    Your comments point to the problem of distinguishing “Pure O” from “OCD”. Pure O is really not so pure, as everybody with Pure O responds to their obsessions with compulsions – it’s just that the compulsions are a little less obvious. Scanning, checking, or looking at one’s obsessions is really no different than scanning, checking, or looking at a door lock or stove knob. And trying to get reassurance about a thought is no different than trying to get reassurance that the front door is locked or that you have washed your hands enough. It all just seems different because it is only going on in your head.

    I encourage to try something different. When you have unwanted thoughts, experiment with not trying to convince yourself of anything – not trying to prove that something is true or not true. Just accept that your brain is yet again exhibiting just how creative it is. Think of your unwanted thoughts as stories you brain comes up with. It loves to come up with stories, but they are just fictions that you needn’t buy into.

  62. Tom Corboy, MFT ~ OCD Center of Los Angeles on May 18th, 2013
  63. I would say I have and deal with pretty much everything described in this article along with the ocdla piece on “memory hoarding” as well, constantly analyzing my thoughts,scanning/checking, hoarding the idea of doing things, retracing and replaying almost everything ranging from simple interactions to even just moments that have past where I think I had a thought or feeling that was significant,exc. Basically it feels like my entire mental processing system and way my mind works is through all of these neurotic ‘modes’ I am constantly “resetting” or trying to get my mind back to a natural state through these compulsions but of course this is no solution. For quite sometime now, usually multiple times a day I attempt to just give it all up and I promise myself I will just accept all the uneasiness and anxiety that comes from not giving into the obsessions and that if I successfully do this long enough I will beat it and my mind can enter a natural state. My question, and probably a stupid one since I’m writing this in the first place, is if this “simple” strategy of just stopping cold turkey and accepting everything that comes with it can actually work or if ocd is so powerful that it really isn’t a rational way to go about trying to beat this versus actual therapy.

  64. Brett on June 3rd, 2013
  65. Hi Brett,

    It sounds like you are doing quite a few mental compulsions (analyzing, checking, retracing, replaying, memory hoarding, etc.) in an effort to “control” your thinking, and get back to what you describe as your “natural state”. But humans cannot control their thinking. Our brains think whatever they want to think. That is our natural state.

    Accepting all of your unwanted OCD thoughts and feelings is a great step in the right direction, but it is not as “simple” as you might hope. OCD thoughts and feelings will continue to appear, and you will quite naturally want to get rid of the discomfort you experience in their presence. Your job is to accept these thoughts and feelings, and to face them directly. This is the Exposure and Response Prevention (ERP) part of therapy, and it is as important as the “acceptance “ part.

    Ultimately, you would benefit from moving away from a position of trying to “beat” or “control” your thoughts and feelings, and towards a position of accepting and challenging them. Structured CBT with a therapist who specializes in treating OCD is the best way to accomplish this for most people, but you can certainly apply these principles on you own.

  66. Tom Corboy, MFT ~ OCD Center of Los Angeles on June 4th, 2013
  67. Dear Tom,

    I am questioning life at the moment. And it is very painfull and scary. I can not get these philosophical questions out of my head. Is erverybody real or are they a figment of imagination? is the most scary question i am dealing with now. It is called solipsism.
    Have you seen this before? Can you give me some advice?
    I was diagnosed with Ocd when I was 22 years old.

  68. Erik on June 17th, 2013
  69. Hi Erik,

    The symptoms you describe sound very much like what we call “Existential OCD”, which I have also seen described as Solipsism OCD. People with this variant of OCD obsess about whether they are “real”, or others are “real”, or if reality is “real”. Common concerns are “what if this is all a dream” or “how do I know if any of what I experience is actually “real”?

    I think the problem with calling it Solipsism OCD is that it gives these thoughts the veneer of legitimacy – like they are somehow a function of authentic philosophical inquiry. But they are actually just one more manifestation of OCD’s ability to lead people to doubt just about anything – even doubting whether or not they actually exist! This isn’t philosophical inquiry – it’s OCD.

    I cannot provide you with any reassurance that other people are “real” because this question is unanswerable. My belief in the value of empirical data (i.e., my five senses) leads me to “believe” that others (including you) are “real”, but I do not “know” anything. I don’t “know” if others are “real”, or even if I am “real”. For all I “know”, I am not “real”, and I am the figment of someone else’s imagination!

    The real problem here is that your attempts to get some sense of certainty on the issue of “realness” are compulsions. Every time you try to answer questions about reality or existence, you dig the hole deeper. Simply put, there is no answer that will provide you with absolute certainty, because absolute certainty doesn’t exist.

    The good news is that these types of questions do not need answering. We can choose to live with unanswered questions roaming around inside our minds. Your goal is to accept that you have these questions, and to make no effort to answer them. While this may at first seem excruciating, you will over time learn that you can, in fact, live without certainty. These are questions that you cannot answer and that don’t need an answer.

  70. Tom Corboy, MFT ~ OCD Center of Los Angeles on June 18th, 2013
  71. Thanks so much for this article!

    I’ve noticed lately that when I respond to an obsessive thought with “I don’t need to analyze this thought” or “I’ll deal with that if it happens,” I actually feel relief instead of anxiety, I think because in a way those responses are serving as a sort of reassurance. My mind seems to translate these responses into the idea that if I don’t have to engage with the the thoughts, they must not be important. Logically I know this is the goal, but I’m also wondering if it undermines exposure, in a way. Should I be using a different response?

  72. Rachel on June 25th, 2013
  73. Hi Rachel,

    I think that responding to obsessions with “I don’t need to analyze this thought” or “I’ll deal with that if it happens” is right on target. This sort of relabeling technique is similar to Jeffrey Schwartz’ “four steps” as described in his book Brain Lock, and can be very effective in helping people to have a more objective and realistic view of their unwanted thoughts. That said, two additional points are worth making.

    First, it would be counterproductive if you used these phrases compulsively. In other words, remind yourself “I don’t need to analyze this thought” or “I’ll deal with that if it happens” one time only. We have seen clients who turn this relabeling into a compulsion – i.e., saying phrases similar to the two you mention hundreds or even thousands of times a day. The goal is to remind yourself once, and then get on with things in a non-compulsive manner.

    Second, and related to #1 above, many people use relabeling with the hope that in doing so, their obsessions and anxiety will decrease. But that is just a way of trying to control your thinking, which again, is a compulsion. Your goal should not be to reduce anxiety, but to accept it as fact of life. If you are using your relabeling phrases with the agenda of “relief”, then you are likely using these phrases as compulsions.

    All of the above noted, if you are not using these phrases compulsively, and you anxiety just happens to go down, that’s great. Don’t look a gift horse in the mouth!

  74. Tom Corboy, MFT ~ OCD Center of Los Angeles on June 26th, 2013
  75. Hi, Thank you for this article.
    I’ve been suffering from negative thoughts for AT LEAST 8 years (since 13 y.o) but I’m not sure if this is OCD. When a negative thought hits me I become anxious and I fight it. The more I fight the more I obsess with it (which I know is counterproductive).
    I have bad thoughts about myself and I imagine myself in millions of negative situations and I try to put a “NO” or “STOP” sign in front of the image (that appears on my mind). If “NO” and “STOP” don’t feel right I try to cross the image out (mentally). (The same thing goes for negative words). I do this all day, almost 24 hours a day and it’s mentally exhausting. It doesn’t allow me to concentrate on other things of real life and it gives me headache. Lately, “NO” “STOP” and crossing out don’t work anymore because it takes me minutes to visualize them in my mind. My mind is SO TIRED that I don’t have energy for that. So I just leave the thought ALONE and say “f*ck it..whatever…” That’s when the thought goes away naturally.
    BUT, when I forget about the obsessive thought during the day and when things are okay, for a second I think “Wait…is the thought still there? I just want to make sure I’ve forgotten it……….Oh God..it’s still there…” Then the fight begins. It’s funny because when I want to make sure the thought is gone, I realize I’m thinking about the thought itself. I also have lots of “What if”s on my mind.
    Something else I started doing lately is questioning my own thoughts. Whenever I think about something (non OCD-related) I ask myself “Is this a normal thought? Would anyone else think like me in this moment? Am I normal?”

    Sometimes, when I don’t want to dwell on thoughts and when the thought begins I tell myself “The thought is about to begin. Don’t dwell on it. Don’t lose the sense of reality. Not now.” And I go back to my daily schedule. When several days are okay I still go back to maing sure the thought is not there…but unfortunately the cycle begins.

  76. E. on September 27th, 2013
  77. Hi E.,

    Thank you for your comments.

    While I cannot provide a diagnosis via blog, the symptoms you describe are consistent with those of OCD. In fact, they are text book examples of OCD. Many people think OCD must include obvious compulsions, but for many people, their compulsions fly under the radar. Generally speaking there are four main ways in which one can do compulsions:

      ~obvious overt physical compulsions (i.e., handwashing)
      ~avoidant compulsions (i.e, not doing something because of your obsession)
      ~reassurance seeking (asking people for reassurance or looking things up online)
      ~mental compulsions (employing mental strategies such as mentally reviewing situations, events and thoughts in an effort to reduce anxiety)

    Virtually everything you mention in your comment falls into the latter and less obvious-to-the-naked-eye category of “mental compulsion”, for example:

      ~ Putting a mental “NO” or “STOP” sign in your mind to counteract an unwanted thought
      ~ Mentally crossing out unwanted images or words
      ~ Mentally checking to see if the unwnated thought or image is still in your mind
      ~ Questioning the normalcy of your thoughts
      ~ Telling yourself “The thought is about to begin, don’t dwell on it”

    The good news is that you have already discovered the key. As you noted, when you “just leave the thought ALONE and say “f*ck it..whatever…” That’s when the thought goes away naturally.”

    Exactly – leave the thought alone and it will leave you alone. You gain nothing (except exhaustion and more OCD) when you resist unwanted thoughts. They are in your head whether you like it or not. The best approach is to peacefully co-exist with them, as open warfare is doomed to failure.

    A good way of accomplishing this is to take a “mindful” approach to your unwanted thoughts. I encourage you to read our article titled Mindfulness for OCD and Anxiety. You can also read our webpage about Mindfulness Based Cognitive Behavioral Therapy for OCD and Anxiety.

  78. Tom Corboy, MFT ~ OCD Center of Los Angeles on September 30th, 2013
  79. Hallo!!! Great article!!! I would like to ask you something. Is it a common ocd obsession when I think that I put a glass to my fathers food and some day he will die, because the glass will go to his heart?? And then, it will be my fault. Something tells me like… I did it for real and then regret it!!! I mentally check about that but I m so uncertain. I m afraid I may caused harm to my dad and that I had the intention to harm him. Please help me!

  80. Maris on March 18th, 2014
  81. Hi Maris,

    Thoughts that one has accidentally (or purposely) hurt someone, are endemic to OCD, and are often described as “Harm OCD”. I encourage you to read our four-part series on Harm OCD starting at http://www.ocdla.com/blog/harm-ocd-1-1488 .

  82. Tom Corboy, MFT ~ OCD Center of Los Angeles on March 31st, 2014
  83. God bless you, this is reassuring. I’ve been silently suffering with pure o like thoughts that I find hard to even confront myself, let alone admit to others. It’s a nightmare. Sometimes thoughts of something I did in my past would pop up and I end up overanalyzing it to justify that I’m not that way even if it might have looked that way. Then the need to recite something to “chase” those thoughts away begins. Sometimes that fails and I think, “NO. I know I’m not that way. I refuse to accept that.” or something along those lines as my line of defense. If successful, I can get on with what I’m doing. If not, I end up in a puddle of tears trying to lather, rinse, and repeat until I get the desired effect. I haven’t been officially diagnosed or anything, but this seems to be the closest thing to explain the symptoms I’ve been having.

  84. Anonymous on May 19th, 2014
  85. I suffer from intrusive thoughts and while I thought I didn’t have any mental rituals, I now know that I do some mental checking and avoiding.

    I have two questions:
    1) after mental checking for and finding the thought, the thought will circulate over and over in my head for a long time. Is this considered an obsession, or rumination (a compulsion)?

    2) sometimes I have the thought that I want to do what is on my thoughts, even though I clearly don’t. Is this some sort of testing ritual? Or just more obsessive thought?


  86. Chris on May 21st, 2014
  87. Hi Anonymous,

    It is quite natural for humans to have memories of things they did in the past. But analyzing these memories in an attempt to prove your character will not work. Likewise, reciting specific phrases in an effort to prove that you are “not that way” will not help matters. These are two examples of compulsions, and while they may provide short term relief, the thoughts will return (as you have already discovered).

    A far better solution would be seeking out a treatment provider who specializes in Cognitive Behavioral Therapy (CBT). This is the therapeutic approach that has has consistently been found by researchers to be the most effective treatment for OCD. If you would like to discuss treatment at our center, we can be contacted via our website at http://www.ocdla.com. Take care.

  88. Tom Corboy, MFT ~ OCD Center of Los Angeles on June 2nd, 2014
  89. Hi Chris,

    All of this sounds like obsessions to me.

    A good rule of thumb is that conscious, volitional efforts to analyze your thoughts are compulsions, while thoughts that keep coming up on their own, with no effort or direction from you, are obsessions. Either way, analyzing whether your thoughts are obsessions or compulsions is unnecessary, and has the potential to become an obsession in it’s own right. Instead, accept that the unwanted thoughts are present and do nothing about them. Just peacefully co-exist with them and do what you would normally do if they weren’t present.

  90. Tom Corboy, MFT ~ OCD Center of Los Angeles on June 2nd, 2014
  91. What about unwanted physical sensations? Does that also pertain to pure ocd? Can that make checking worse?

  92. Anonymous on September 3rd, 2014
  93. Anonymous,

    Unwanted sensations are the same as unwanted thoughts or feelings – they are obsessions. Accept them and let them exist.

  94. Tom Corboy, MFT ~ OCD Center of Los Angeles on October 15th, 2014
  95. Hi,

    After many years of having obsessions and compulsion, NONE of the things I have EVER worried about happening have ever happened. However, each time I have a major spike my brain says, “This may be the one time it is real and I should worry.” How do you approach larger spikes versus the smaller value spikes? Make sense?

  96. Alex on October 25th, 2014
  97. Hi Alex,

    Yes, this makes total sense in the world of OCD. So the next time you have an obsession, stop and remind yourself that none of the things you have ever worried about happening have ever happened. It doesn’t matter whether the spike is “low” value or “high” value, the goal is the same – to accept the presence of the uncomfortable thought without doing any compulsions (including mental compulsions).

  98. Tom Corboy, MFT ~ OCD Center of Los Angeles on October 27th, 2014
  99. Hello, this has helped me a lot greatly. Thank you for this amazing post. I honestly think I can self-diganosis myself with OCD, but I’m not quite sure… Here’s my story and it would be great to hear back from you! It started about 4 months ago, for 2 months I had HOCD, I constantly thought myself to death. That has passed only be replaced by TOCD thoughts (which stands for transgender OCD) I’m scared that I’ll be transgender. I had these thoughts before with HOCD about 2 months ago and once I stopped “caring,” and “answering my thoughts,” it kind of went away, but HOCD came back with a punch. Now, great news, my HOCD is gone but TOCD is here with revenge. I’ve been dealing with 24/7 constant intrusive thoughts. The moment I wake up, “What if I was trans?” to the moment I sleep, “What happen if I was trans?” I don’t even know what my real thoughts and what my OCD thoughts are. Question I have for you, I know people have POCD, HOCD, and stuff like that, but is TOCD real too?

  100. Christine on November 4th, 2014
  101. Hi Christine,

    It is fairly common for those with a history of HOCD to experience obsessions related to other sexual behaviors they don’t want, such as incest, besiality, pedophilia…and being trans. What you report here is not even remotely unusual.

  102. Tom Corboy, MFT ~ OCD Center of Los Angeles on November 10th, 2014
  103. Hello, thank you so much for all of the support and answers you have provided for all of us! So, I have been going through month long episodes of existential ocd, constantly questioning my very exisistence and that of others. This in turn leads to depression. My question is , have you ever dealt with these issues and if so what therapy seems to be the most affective therapy? I’m currently seeing a phsycologist that has never encountered these thoughts with ocd. Thank you for any hep!

  104. Tyler on November 16th, 2014
  105. Hi Tyler,

    The most effective treatment for Existential OCD is the same as for all other sub-types of OCD – namely Cognitive Behavioral Therapy (CBT) with a strong focus on Exposure and Response Prevention (ERP). Additionally, a mindfulness component is especially helpful for the more obsessional variants of OCD such as Existential OCD.

    That said, there is nothing unusual about Existential OCD – it is a fairly common subtype of OCD, and a therapist who specializes in treating OCD would be very familiar with this. If your current psychologist has never encountered this variant of OCD, then there is a good chance that he/she knows very little about OCD and its treatment.

    Would you have a doctor who has never set a broken bone treat you for a broken arm? Of course not. I encourage to find a therapist who has treated this before.

  106. Tom Corboy, MFT ~ OCD Center of Los Angeles on November 16th, 2014
  107. Thank you for the information Tom. Looks like I will be searching for a more compatible therapist.


  108. Tyler on November 16th, 2014
  109. I wish you a happy New Year and again a big THANK YOU for helping me cope with OCD. I’ve probably read most of your articles and to a certain extent adopted that way of thinking and even those methods that you’ve introduced in the blog. It has helped me a ton in my battle with the disease but nonetheless I pretty often,like most of your patients,I suppose, come to the conclusion that there’s probably something that I’m doing wrong. I have those periods when OCD kicks in in its full glory and makes a total mess out of me leaving me thinking that I’m completely mad. Right now,I’m in this kind of a period(it’s been almost two months now). I have OCD “episodes” almost all day and the worst part is that they’re morphing. It’s not only harm OCD or existential OCD..it’s everything that you can think of. Common sense tells me that this is more than normal for someone who suffers from the disorder but frankly I keep wondering why I haven’t made any progress yet? Moreover,it discourages me and makes my life seem pointless. Why isn’t there a big breakthrough? I’ve been aware of my state for a year now and I’ve had my good and my bad moments but why do I always end up being on the brink of a nervous breakdown with severe chest pain and a head bursting from inside out? Am I not being patient enough? What can I do? I know that you’ll probably advise me to start seeing a therapist or get myself a proper therapy but that’s just out of the question since my country has little history in treating OCD I guess,or because it might be expensive or time consuming(as it should be) and I just have so much to do. I’d like to help myself because I’m the only therapist I can afford at this stage. I constantly search for a proof that I’m still sane and I can’t help hoping that a just a little bit of progress will provide an answer. Can you provide me with an answer? Thank you in advance.

  110. V. on December 28th, 2014
  111. Hi V.,

    A few thoughts on your post:

    1) It is not unusual for those with OCD to have symptoms of multiple variants of OCD.

    2) It is also quite common that these symptoms frequently “morph” from one to another and back again.

    3) Expecting “a big breakthrough” is not a reasonable expectation, especially if you are not in treatment. Your awareness that you have these issues is not enough to combat them.

    4) Your progress is slow precisely because you are not in structured Cognitive Behavioral Therapy (CBT) for your OCD, which scores of research studies have found to be the most effective treatment for OCD.

    5) Searching for proof that you are sane is a hopeless quest. For what it’s worth, I cannot guarantee that I am sane either. But neither you nor I nor anyone else actually needs to know if they are sane. We all just need to accept that our brains come up with unwanted thoughts that do not merit any attention whatsoever, and to then get on with the business of living, despite the presence of these thoughts.

  112. Tom Corboy, MFT ~ OCD Center of Los Angeles on February 12th, 2015
  113. II have been reading all the comments and replies and this site has been so beneficial too me, thank you!

  114. Sue on March 25th, 2015
  115. Thanks Sue – we’re happy to hear that the articles have helped. Take care.

  116. Tom Corboy, MFT ~ OCD Center of Los Angeles on April 14th, 2015

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