What is OCD?
The truth about intrusive thoughts and OCD
The truth about intrusive thoughts is that everyone has them.
Yes, everyone.
Your brain is constantly generating thoughts, images, memories, predictions, and possibilities. Some of them are helpful. Some are random. Some are uncomfortable. Having an unwanted thought does not mean something is wrong with you. It does not mean you secretly want it, that it says something about your character, or that it is a sign of who you really are.
The problem with OCD is not the intrusive thought itself.
The problem is the conclusion OCD convinces you to make about that thought.
Someone without OCD may have the thought, “What if I accidentally hurt someone?” and their brain moves on.
Someone with OCD may have the same thought and think:
“Why did I think that?”
“What does it mean about me?”
“Does having this thought mean I am capable of doing it?”
“What if this thought is warning me about something?”
The thought becomes evidence.
OCD takes a normal human experience—the ability to imagine possibilities—and treats it as proof of danger, responsibility, or uncertainty.
The problem with OCD is that it treats imagination as if it were relevant to reality.
A thought is not the same thing as an observation.
An observation is something you are directly experiencing through your senses. You can see it, hear it, touch it, or gather evidence about it.
Imagination is your brain creating a possibility. It can be creative, protective, and useful—but it is not the same thing as reality.
For example, looking at a doorknob and noticing “there is a doorknob there” is an observation.
Thinking, “What if someone touched this and left harmful germs behind that I cannot see, and what if I get sick?” is imagination.
The problem is not that your brain created the possibility. That is what brains do.
The problem is when OCD says, “Because I can imagine it, I need to treat it like it is happening.”
Normally, our brain uses a process that says: things are okay unless evidence tells us otherwise. We use our senses, our experiences, and common sense to make reasonable decisions.
Why are you not worried the chair you are sitting in right now is about to break?
Because you are trusting the evidence around you. You see the chair. You have experience sitting in chairs. Nothing is telling you there is a problem.
OCD reverses this process. It starts out with a feared conclusion and then seeks out the evidence that supports the conclusion.
If you want to learn more about OCD and how to catch this unhelpful thinking process in the moment, ask me about ICBT. I am one of few therapist trained in ICBT, an evidence-based alternative approach to ERP.
Inference-Based Cognitive Behavioral Therapy (ICBT) helps you recognize when OCD has pulled you away from what is actually happening and into a story your mind has created. The goal is not to argue with every thought or prove yourself safe—it is to rebuild trust in your own ability to observe reality, make decisions, and move forward without getting pulled into endless doubt.
