Although most individuals experience unwanted and intrusive thoughts, images or urges from time to time (see Strange Thoughts), these thoughts, images or urges can quickly evolve from simple “thought” status into an obsession, due to how the individual responds. When individuals apply meaning and importance to the thoughts they experience, and interpret their thoughts as problematic and significant, it causes these thoughts to increase in frequency, and over to time to become stuck on repeat mode. As a result, simple unwanted thoughts become an obsession. In addition, as these thoughts increase in frequency and intensity, they generate a lot of anxiety. Naturally the person will want to eliminate this anxiety, and soon discovers that by engaging in specific actions their anxiety lowers. However, over time, the individual becomes stuck and dependent on these behaviours, also called compulsions, to cope with their anxiety.
Lets say you have an unpleasant thought, such as, “What if I stab my husband while he is eating his steak!” accompanied by a graphic image which happens to “pop” into your head as you are preparing the meal. If you attach unhelpful meanings to the thought (for example, “having this thought means I’m an evil person who is capable of murdering a loved one”), you will probably feel very anxious as a result. Now, because it is uncomfortable to be anxious, you are likely to find ways to lessen that anxiety. For example, you may repeatedly check to make sure the drawer where you store all the sharp objects (e.g. scissors, knives) is locked and say a prayer to yourself every time you have the “bad” thought. Unfortunately, you find that even though these strategies help you to briefly lessen the anxiety, you need to do them more and more often because your “bad” thought seems to occur even more frequently when you try hard not to have it. You feel trapped because you do not know what else to do but keep using these strategies. The next thing you know, your life is being consumed by the “bad” thought and your constant efforts to control it. This is how the vicious cycle of OCD develops and keeps going: