OCD Series: Obsessive Bad Thoughts
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As a therapist who specializes in OCD therapy, I’ve worked with many clients who feel tormented by intrusive, disturbing thoughts. These thoughts often center around violence, harm, or taboo topics—leaving individuals feeling frightened, ashamed, and convinced something is terribly wrong with them. This OCD subtype, sometimes called “Obsessive Bad Thoughts” or “intrusive thoughts OCD,” is more common than most people realize. In this post, I’ll help demystify this experience, explore how it functions, and explain how therapy for OCD can help you find relief.
What Are Obsessive Bad Thoughts?
This subtype of OCD is defined by unwanted, intrusive thoughts that feel distressing and inconsistent with your values. Examples may include violent images, sexual thoughts about inappropriate individuals, or fears of acting immorally or criminally. What makes these thoughts so painful is that they often contradict the person’s identity and sense of self.
The book The Imp of the Mind by Dr. Lee Baer is a powerful resource for understanding this experience. He explains that many people—whether they have OCD or not—experience random, upsetting thoughts. What sets OCD apart is the emotional intensity and compulsive response that follows. People with OCD interpret these thoughts as dangerous or significant, and they go to great lengths to neutralize, suppress, or avoid them.
Common Obsessions and Compulsions
Here’s what Obsessive Bad Thoughts OCD can look like:
Obsessions:
Thoughts of harming someone (e.g., stabbing a loved one, pushing someone off a ledge)
Sexual thoughts about children, family members, or religious figures
Blasphemous or morally repugnant thoughts
Fears that having these thoughts means you’re dangerous, immoral, or "bad"
Compulsions:
Mentally reviewing or “checking” to confirm you didn’t act on a thought
Seeking reassurance from others ("I would never do that, right?")
Avoiding people, places, or objects that might trigger the thoughts
Praying, counting, or performing rituals to "cancel out" the thought
These thoughts feel incredibly real, and the distress they cause can lead to deep isolation, anxiety, and depression. Yet, the presence of these thoughts does not reflect the person’s true desires or character—in fact, it’s often the opposite. People with this form of OCD tend to be highly conscientious and morally sensitive.
The Challenges of Obsessive Bad Thoughts
One of the cruelest aspects of this OCD subtype is the shame that surrounds it. Many clients have never shared these thoughts with anyone—not even a therapist—for fear of being judged or misunderstood. The secrecy reinforces the suffering.
It’s important to understand that thoughts are not actions, and having a thought—even a disturbing one—does not mean you’ll act on it. The Imp of the Mind emphasizes this point and invites readers to stop judging themselves for thoughts they cannot control.
More than 1 in 100 people have experienced OCD in the past year, per NIH.
How I Treat Obsessive Bad Thoughts OCD
There are highly effective approaches to treating this form of OCD. Here’s how I typically support clients:
Exposure and Response Prevention (ERP): With ERP, we gently expose you to feared thoughts (e.g., writing down the intrusive thought without doing a ritual) while helping you resist the urge to neutralize or avoid it. Over time, your distress decreases, and the thought loses power.
Cognitive Restructuring: We’ll explore how you interpret your thoughts and work to challenge distorted beliefs like “having a thought means I want it” or “if I think it, it will happen.”
Mindfulness and Acceptance-Based Strategies: Rather than fighting or judging your thoughts, you’ll learn to observe them with curiosity and let them pass without engaging.
Medication: In some cases, SSRIs can help reduce the frequency and intensity of intrusive thoughts, especially when symptoms are severe.
Moving Forward
If you’re living with Obsessive Bad Thoughts, please know: you are not your thoughts. You are not alone. There is hope, and there are tools that can help you step out of fear and into peace.
Additional Support: Finding a Therapist in Philadelphia
At Philadelphia Talk Therapy, I offer specialized OCD treatment for people experiencing distressing intrusive thoughts. If this post resonates with your experience, please know that help is available—and healing is possible. Reach out today to begin your journey.
Matt Sosnowsky, LCSW, MSW, MAPP is the founder and director of Philadelphia Talk Therapy. For over a decade, Mr. Sosnowsky has provided psychotherapy services in agency and private practice settings, helping individuals overcome mental health challenges, manage life transitions, and find passion & meaning in life.
Want to learn more about Philadelphia Talk Therapy and how we can help you understand and treat Symmetry OCD? Get in touch today.
