Imagine a man, John, walking in his neighbourhood. He sees a little girl in shorts and the thought "you looked at that girl, you paedophile" pops into his head.
Stunned, he stops and asks himself: why did I have that thought? Does that mean I might do something terrible? Could I be a paedophile and not know it? He engages in a panicked mental debate, growing more anxious as he does so.
Now imagine another man, Bill, walking in his neighbourhood. Like John, he sees a little girl in shorts and the same thought "you looked at that girl, you paedophile" pops into his head. Bill ignores the thought, continues walking and his mind drifts onto other subjects. He quickly forgets he even experienced this intrusive thought.
What's the difference between the two men? John has obsessive-compulsive disorder (OCD); Bill doesn't.
OCD isn't characterised by the presence of intrusive thoughts; it is characterised by how you react to the thoughts. John reacts the way he reacts because he thinks his thoughts are important and require attention; Bill takes no notice of the thoughts because he knows they are not important.
Everyone has experienced intrusive thoughts, but the overwhelming majority take little notice. They see them for what they are – junk thoughts, absurd and unimportant. Consequently, there are no feelings of guilt or anxiety.
In contrast, people with OCD over-attend, over-value, and over-respond to their thoughts. They place too much importance on their thoughts. As a result, they become obsessions.
In other words, there's no difference between the thoughts of a person with OCD and a person without OCD. The difference is in the way people react.
STUDIES
Don't take my word for it – take the word of the multiple researchers who have investigated this question. The first such study was in 1978 and it found 80 per cent of people had experienced unwanted intrusive thoughts, images, or impulses. The content of the intrusive thoughts varied widely, ranging from causing harm to loved ones, engaging in taboo or violent sexual acts, embarrassment, injuries, traumatic images of harming others, and so on.
In a follow-up study in 1984, 88 per cent reported unwanted intrusive thoughts.
A 1993 study co-authored by renowned OCD expert Prof. David Clark found 99 per cent reported at least one type of obsessive intrusive thought, image, or impulse, ranging from choking or stabbing a family member, having sex with an unacceptable person or carrying out a disgusting sex act, hurting or insulting strangers, pushing people in front of a train or car, swerving into traffic, and so on.
In 1998, another Clark study found 84 per cent of college students reported at least one of 20 unwanted intrusive sexual thoughts.
In 2014, in a global survey involving people from 13 countries and six continents, researchers found 94 per cent had experienced at least one type of unwanted, intrusive thought during the last three months.
What about the small number of people who don’t experience intrusive thoughts? OCD expert Prof. Paul Salkovskis once referred to a study he did where 93 per cent said they had experienced unwanted intrusive thoughts. In a follow-up study, his team tried to interview the few people who said they didn’t experience the thoughts, but they didn’t want to speak to the researchers. Salkovskis said he was as convinced as it is possible to be that the real figure is 100 per cent.
As for the unwanted intrusive thoughts themselves, common ones include: while driving, an impulse to run the car off the road; getting a sexually transmitted disease from touching a toilet seat or handle; feeling a sudden impulse to say something rude or insulting to a friend even though you’re not angry at them; an impulse to say something rude or insulting to a stranger; the impulse to swerve a car into oncoming traffic; the thought of having sex in a public place; while driving, the thought of running over pedestrians or animals; when talking to people, having an intrusive thought of them being naked. I could list countless other examples, but hopefully you get the point.
If you have OCD, remember the problem is not your thoughts; it's how you're reacting to them. Stop reacting, and the thoughts will lose their sting.
(First published in Southern Star on 23/5/2024)