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Center for Anxiety & Chronic Worry

937 Tahoe Blvd., Ste. 210; Incline Village, Nevada 89451  

PHONE: 775.831.2436

Copyright (c) 2016-2017  Behavior Therapy & Family Counseling Clinic

All rights reserved    Barry C. Barmann, Ph.D.    Mary B. Barmann, MFT


Obsessions (intrusive thoughts), are unwanted, unacceptable and repetitive thoughts, images, or impulses that are associated with subjective resistance, are difficult to control, and generally produce a great deal of anxiety, guilt, or disgust even though the person having such intrusive thoughts may recognize their senselessness. The content of these thoughts or images generally revolves around themes concerning dirt and contamination (disease), aggression, doubt, sexual acts, orderliness, symmetry, precision, harm involving self, loved ones, or strangers, making mistakes (perfectionistic), or blasphemy; all of which are entirely at variance with the individual’s view of him/herself, values and usual manner of behaving. Which is why obsessions are referred to as Ego-dystonic in nature; that is, they are not at all consistent with that individual's personality.  Note that obsessions are not limited by simply thoughts. They also include sudden visual images or urges may seem to “come out of the blue”, that is, with no clear “trigger”. Although there are oftentimes very specific environmental triggers concerning an obsession (e.g., seeing what is believed to be a contaminated object), obsessions can also frequently occur as the result of a neurological "false alarm", in which the brain's Orbital-Frontal Cortex inadvertently sends a message to the Caudate Neucleus (via the Thalamus), indicating  that "danger is present", when in fact, no real danger exists. View the VIDEO below, for a visual representation of this process. This sense of potential imminent harm leads to feelings of anxious arousal, thus prompting the individual to seek safety by performing behaviors of a ritualistic nature. The video clip seen below, provides depiction of this neurological overactive feedback loop between these three brain structures. Due to the extensive variety of obsessional themes, the content of the obsessive thought is very idiosyncratic in nature, hence the are more than 34,000 different forms of obsessions discussed within the OCD literature. However, the four most common categories of obsessions typically include the following:

  • Aggression/Harm
  • Contamination
  • Sensory, or a need to feel "just right"
  • Symmetry/Exactness
  • Scrupulosity


For more information on Obsessive-Compulsive Disorder and Obsessions, please

visit the following 2 excellent web sites:

Obsessive-Compulsive Foundation

Anxiety & Depression Assocation of America

OCD Fast Facts

What are Compulsions

Links to OCD Resources

How Obsessions are triggered has been debated in the literature for many years.

However, it is clear that intrusive thoughts are triggered by both internal, as well as

external environmental stimuli (e.g., a public telephone may elicit thoughts of

contamination).  These unwanted thoughts intrude into conscious

awareness against the persons will. In addition, obsessional content is also

unacceptable to the person, in large part because of the negative emotions (e.g.,

anxiety) associated with its occurrence. Keep in mind that most people experience

disturbing intrusive thoughts from time to time, yet these ideas are easily dismissed

as trivial in nature.  However, those individuals with OCD tend to place a great deal

of over importance on mental intrusions, thus eliciting a sense of extreme emotional

distress. These feelings then tend to lead to a very strong need to “neutralize” or

“undo” these particular thoughts,  images or urges, by engaging in a repetitive,

seemingly senseless, behavioral or covert (mental) set of rituals, also referred to as

compulsions. Individuals with OCD believe that these rituals serve the

purpose of temporally lessening this sense of emotional discomfort, as well as

helping to prevent the occurrence of harm to self or others, due to a sense of over

responsibility concerning the content of their mental intrusions.

In addition to environmental events, Obsessions are also triggered by

an overactive feedback loop between the brain's Orbital Frontal Cortex, Caudate

Neucleus, and the Thalamus, resulting in a neurological "False Alarm", thus

causing a feeling of anxious arousal, and the need to perform specific rituals. The

neuroanatomy of this over-active feedback loop within the brain is seen in the video

clip below:


Center for Anxiety & Chronic Worry

937 Tahoe Blvd; Ste. #210;  Incline Village (Lake Tahoe), Nevada 89451  

Phone: 775.831.2436

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