Obsessions are unwanted, unacceptable intrusive 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 obsessions may recognize their senselessness. The content of obsessions 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. 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 at the top of this page, provides a visual representation 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:

One of the most obvious characteristics of obsessions is their intrusive quality.

Although obsessions are most often triggered by external stimuli (e.g., touching a

public telephone may elicit thoughts of contamination), they 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 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.For more information on

Obsessive-Compulsive Disorder and Obsessions, please visit the Obsessive-Compulsive

Foundation and the  Anxiety & Depression Assocation of America web sites.

OCD Fast Facts

What are Compulsions

Links to OCD Resources

OBSESSIONS are caused 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.

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


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