Belief Systems in OCD

How is it that different people can attribute different meaning to their unwanted intrusions?

Our underlying belief systems can play a big part.

A belief system is a network of ideas that help our brain to interpret the world, ourselves and others: they help us to make sense, or make meaning, from our experience.

Belief systems are a normal brain process. Ideally, they are stable with some flexibility to adapt to different situations.

For instance, someone could hold a strong belief in doing no harm to all living things, while also allowing flexibility to recognise that killing a mosquito can be helpful.

This is not helpful as the rules are applied to situations where it not warranted.

The belief systems in OCD
tend to be overly rigid.

Beliefs Associated with OCD

The beliefs below have been associated with OCD:

Intolerance of uncertainty e.g., “I need to know that everything is ok”
Perfectionism e.g., “I need to balance out the bad with good until just right”
Thoughts are important, e.g., “this thought means something!”
Heightened responsibility e.g., “It’s all on me to stop this from happening”
Overestimation of threat e.g., “I won’t be able to cope”
Thoughts must be controlled, e.g., “I need to stop thinking this”
“Bad” thoughts are as bad as “bad” actions, e.g., “I’m bad for even thinking this”
Having a “bad” thoughts makes that “bad” thing more likely to happen, e.g., “this is a sign that something bad is going to happen if I don’t do something”

People who do not have OCD may also hold similar belief systems, but they are likely to be more flexible.

Why is this important?

The symptoms of OCD are just the surface level of what is happening.

Two people with OCD can present with symptoms that look nothing like one another. For instance, someone who presents with compulsive washing symptoms might seem quite different from someone who presents with "pure O".

However, if we go a little deeper, we are likely to see that both people have similar underlying belief systems. For instance, both may hold rigid beliefs of intolerance of uncertainty:

Compulsive Washing e.g., "I need to know that everything is clean"

Pure O e.g., "I need to be sure that I have covered everything"

This is important because it gives us another target for change in treatment.

CBT for OCD is important for not only addressing the symptoms, but the underlying beliefs that contribute to the cycle of OCD.

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