Written by Colter Bloxom, LPC
Colter is a licensed psychotherapist and the owner and founder of Thrive Therapy. He specializes in the treatment of anxiety, OCD, anxiety, identity issues, and more.

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Rumination, or going over a thought over and over again, is familiar to anyone who has experienced anxiety. But people with obsessive-compulsive disorder (OCD) go through something that can be much more intense than rumination: the OCD cycle.

Getting stuck in the OCD cycle is one of the hardest parts of living with OCD and why this disorder can become so debilitating. But there is a way out. Here, I’ll go over how to get out of an OCD loop, including the types of treatment that could help.

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What is the OCD cycle?

The OCD cycle, also known as an OCD loop or OCD spiral, is a big part of what makes OCD so hard to cope with. Most people who live with an anxiety disorder know what it feels like to have spiraling thoughts. For people with OCD, this cycle becomes worse because of the addition of compulsions, which are one of the core symptoms of OCD.

Brain imaging and brain scan technology have found that OCD patients literally get stuck in a loop 'of wrongness' that causes them to repeat the same thoughts and behaviors over, and over, and over again.

Begins with an obsession

An OCD loop starts with an obsession – an intrusive thought that brings with it a great deal of fear, shame, guilt, or disgust. There are many different types of intrusive thoughts, but they all tend to revolve around topics that you find the most horrifying. 

Obsessions and intrusive thoughts aren’t the lighthearted, funny thing that they’re made out to be in the media – which you already know very well if you live with OCD. They’re very upsetting, and can include fears like “What if I’m actually a pedophile in disguise?” “What if I don’t really love my partner?” and “Did I run someone over on my commute and block it from memory?”

Obsession leads to unbearable distress

Whatever the obsession is, it causes unbearable anxiety and distress. Most people have intrusive thoughts now and again, but if you live with OCD, you can’t get it out of your mind. These thoughts torture you for hours, days, or weeks – you can’t stop going over the fear in your mind, agonizing about whether or not it could come true.

Distress makes you do compulsions

Along with obsessive, the second key component of OCD is compulsions. Compulsions are any behavior that you do repetitively to try to get rid of the anxiety and horror that obsessions bring. The media often portrays compulsions as counting or checking behaviors, but any behavior – even mental ones – can become compulsive.

For example, if you have the obsession: “Did I run someone over on my commute and block it from memory?” you may mentally review your memories over and over again to try to “remember” whether you ran someone over. You might check the news repeatedly for stories of hit-and-runs, or even retrace your steps to check for evidence of your “crime.” These compulsions can take up hours of your day, which is how OCD can become so debilitating.

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Compulsions bring temporary relief, feeding back into obsessions

If compulsions didn’t work at all, then you might not get caught in an OCD loop. The problem is that they are effective – temporarily. For a few moments after you do the compulsion, you may feel some relief, only to find that the anxiety returns viciously shortly after.

This reinforces the (false) idea that obsessions need to be taken seriously and acted upon. By repeating these patterns, you inadvertently teach your brain that the obsessive thoughts do present a real threat, and that compulsions can, albeit temporarily, prevent your fears from coming true. 

This brings you back to square one – obsessions – and you get trapped deeper and deeper into the OCD cycle. Each stage reinforces the last, and you end up dedicating your life to trying to avoid and placate obsessions.

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OCD thought loop examples

To illustrate, let’s talk about a (fictional) client in Thrive Therapy’s OCD treatment program, Jess. Jess lives with contamination OCD, which drives them to constantly fear that the food they’re eating hasn’t been disinfected enough and will cause them and their family members to get sick. 

One day, as Jess is eating a home-cooked dinner with their family, they have the thought: “What if I didn’t cook the chicken well enough, and we all get sick with salmonella poisoning?” Jess tries to push this fear away, but it’s persistent. The thought fills Jess with intense fear and guilt. 

Eventually, Jess cuts their chicken breast into smaller and smaller pieces, checking for any sign of pink. When they don’t see any pink, they feel relieved for a few minutes – but the obsession just returns: “What if my piece was the only one that was cooked?” They ask their family members to cut their pieces up, as well. Long after dinner, Jess stays up looking on the internet for early signs of salmonella poisoning. The next morning, they ask their family members over and over again for reassurance that they’re not feeling sick.

Jess is stuck in a loop. Because they gave in to their compulsions, they inadvertently gave credence to their obsessive thoughts and taught their brain that they were actually in danger. Their compulsions helped temporarily, but obsessions only came back stronger with, “What if?”

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How to break the OCD cycle

If you’re trapped in thought loops like this, you might feel that OCD is ruining your life. This cycle is why OCD can become so debilitating for so many people. You feel like you have no choice but to perform compulsions, so you spend more and more of your time doing them – only for obsessions to keep coming back.

But in reality, you do have a choice. And research shows the only way to stop the OCD cycle is to resist the urge to do compulsions. By resisting, you rewire your brain and teach yourself that you are able to tolerate obsessions without doing anything to avoid them or push them away. After all, at the end of the day, they’re just thoughts.

The most effective treatment method for OCD, a type of cognitive behavioral therapy called exposure and response prevention (ERP), focuses on helping you do just this. It can be hard to prevent obsessions altogether – and, like I mentioned earlier, most people have intrusive thoughts sometimes. What you can do is change the way you react to these thoughts.

Here are some ERP and acceptance-based strategies you can try to break the OCD cycle:

• Response prevention: The most important strategy is to resist the urge to do compulsions. Your obsessions may tell you that you must repeat a certain behavior or ritual to protect yourself or make the uncomfortable feelings go away. Resist the urge – this can be much easier to do with the support of a qualified OCD therapist.
  
  
• Delayed response: If you absolutely can’t resist the urge to do compulsions, then try at least to delay them. Can you wait half an hour before giving in to the urge? 10 minutes? 30 seconds? The longer you can resist, the more you train your brain to get out of the OCD thought loop.
  
  
• Non-engagement: Simply go about your day as if you weren’t having the thought. Try not to engage with it in any way. Think to yourself: “If I wasn’t having this obsession, what would I be doing right now?” Do that instead of your compulsions.
  
  
• Acceptance: Think about how you’d react if I’d told you: “Whatever you do, don’t think about a red bus.” If you’re like most people, the first thing you imagined when you read that was a red bus! By trying so hard to avoid your thoughts, you may accidentally be paying it more attention. So rather than avoidance, try practicing acceptance. Simply allow the thoughts to be there, without pushing it away.

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OCD treatment and IOP in Phoenix, AZ

Getting out of an OCD cycle can feel impossibly challenging. But many people with OCD have learned to resist the urge to perform compulsions, stop OCD thought loops in their tracks, and live a fulfilling and happy life.

Learning to manage OCD symptoms requires OCD treatment. If your OCD symptoms are severe, you could benefit from more intensive treatment. Thrive Therapy’s mental health IOP (intensive outpatient program) in Phoenix, AZ is specifically designed to help people who live with OCD and other mental health conditions like anxiety, depression, and PTSD. We meet 9 hours a week for 12 weeks, which provides you with an intensive treatment option that still fits into your busy schedule.

Are you ready to weaken the power that OCD holds over your life? Get in touch with us today to ask how we can help.