Cognitive Distortions in OCD: What You Should Know

Do you have thoughts that keep coming back? Do you often find yourself confirming, repeating or doing things repeatedly to reduce anxiety? If the answer is yes then most probably, you have heard of Obsessive Compulsive Disorder (OCD).

Here, OCD is usually driven by cognitive distortions. Thinking patterns of this kind are typically misleading and obscure which adversely affect our mental health. Although they happen to everyone once in a while. For people with OCD, these distorted thought loops become stuck causing more anxiety and an urge to do compulsions. To manage OCD, one should understand those distortions and get assistance from a mental health counselor.

Cognitive Distortions: Understanding Biased Thoughts

Cognitive distortions also called distorted thinking or cognitive biases refers to deviations from rational and logical thinking patterns. These mistakes taint our perception, interpretation and judgment of information leading us into wrong conclusions and decision making processes. Such distorted thinking can affect our mental well-being immensely contributing to conditions like depression and anxiety.

Types Of Cognitive Distortions:

  • Polarized Thinking (Black-and-White Thinking): This distortion involves seeing situations as all good or all bad, with no middle ground. For instance believing that one is either a complete success or a total failure.
  • Overgeneralization: Overgeneralizing happens when we apply one negative event in all similar situations. For example, assuming that failing in a job interview means that you will never succeed at any interview.
  • Catastrophizing: Catastrophizing entails exaggerating the importance of negative events expecting the worst possible outcome ever. For instance believing that minor mistakes will ruin your entire career.

Impact on OCD:

While everyone experiences cognitive distortions occasionally, they become difficult in conditions like obsessive-compulsive disorder (OCD). In OCD, these distorted thoughts cause obsessions that are persistent and distressing and result in compulsive behaviors such as hand washing constantly done by an individual with contamination obsessions due to distorted beliefs about germs and cleanliness.

Uncertainty in OCD

  • Feeding the Cycle of OCD: Uncertainty is a major factor in sustaining the continuous loop of obsessions and compulsions that characterize OCD. They always remain doubtful about their actions and results, leading to repeated behaviors seeking for certainty.
  • Symptom Maintenance: These irrational thoughts often originate from an unknown danger, creating a state of panic and reinforcing obsessive-compulsive behavior. Breaking this cycle involves challenging these ambiguities through Cognitive-Behavioral Therapy (CBT), Exposure-Response Prevention (ERP) techniques and Acceptance and Commitment Therapy (ACT).

Changing Thought Patterns

In addressing cognitive distortions, the first step is to identify them. This is where Cognitive-Behavioral Therapy (CBT) comes in handy by helping people in questioning these distorted ideas and replacing them with more grounded and specific ones. Herein, individuals can improve their mental health and mitigate the negative effects of faulty thinking on their lives.

Common Cognitive Distortions in OCD

Black and White Thinking (All-or-Nothing Thinking)

All-or-nothing thinking is a mental process that refuses to accept the middle position when interpreting events as either all good or all bad. This may strengthen compulsions and worsen anxiety in some cases of obsessive-compulsive disorder.


When an individual feels dirty in his/her mind as a result of intrusive thoughts or associations. This entails unwanted and fearful ideas entering your head.

Overestimation of Threat

Uncertainty about the severity or likelihood of threats causes individuals to exaggerate dangers in certain settings, resulting in increased anxiety and compulsiveness intended to prevent perceived harm.

Thought-Action Fusion

Indecision regarding whether thinking something is as bad as doing it leads to thought-action fusion, where individuals equate their intrusive thoughts with actual harmful actions. This blurring fuels anxiety and compulsion.

How Cognitive Distortions Affect OCD?

Fueling the OCD Cycle:

The vicious cycle of obsessions and compulsions in OCD is greatly maintained by cognitive distortions. This is how:

  • Obsessions: Intrusive, distressing thoughts, images, or urges.
  • Compulsions: Repetitive behaviors or mental acts aimed at reducing anxiety caused by obsessions.


  • Obsession: They are afraid that they may become contaminated (e.g., through a doorknob).
  • Catastrophic Thought: “In case I do not wash my hands properly enough, I will catch a fatal disease.”
  • Compulsion: They wash their hands excessively to prevent what they believe will happen.
  • Temporary Relief: For some time, the anxiety decreases.
  • Reinforcement: Handwashing seems to assist in stopping bad things from happening to them again.
  • Cycle Repeats: The obsession comes back, leading to more compulsions.

Challenging Cognitive Distortions

Cognitive Behavioral Therapy (CBT) is a composite therapeutic approach dealing with the interconnectedness of thoughts, feelings, and actions. Cognitive Behavioral Therapy aims to alleviate negative emotions while promoting overall well-being by making changes in these areas. For OCD, Cognitive Behavioral Therapy is extremely useful. 

Acceptance and Commitment Therapy ACT

Moreover, ACT can play a significant role in helping people with OCD by accepting their thoughts and feelings as they are without having to change them. Instead of struggling against their obsessions, patients concentrate on their values and implement actions that align with these values; this helps to reduce the impact or influence of obsessions and compulsions. That is why ACT is used to develop psychological flexibility, which allows one to engage in satisfying activities despite the presence of OCD signs and symptoms.

Exposure & Response Prevention Therapy (ERP)

This technique provides the foundation for Cognitive Behavioral Therapy for OCD. In Exposure & Response Prevention Therapy, patients are deliberately exposed to disturbing obsessional thoughts without performing any compulsory rituals. By this means they automatically break the link between obsession and compulsion that was established by doing it. The target here is to confront anxiety until it goes away directly in such a way that desensitization will occur. It has two components:

  • In vivo exposure: Over an extended period of time facing fearful stimuli in real life situations repeatedly.
  • Imaginal exposure: Describing things or events which one fears and what would happen if they did.

Cognitive Restructuring

This portion of CBT involves identifying and challenging irrational beliefs. Questioning distorted ways of thinking associated with OCD can change behavior patterns on which these reactions are based, thereby reducing distress levels.

Deep Breathing and Progressive Muscle Relaxation:

These exercises can be done during mental health therapy sessions to manage anxiety and promote relaxation.

Benefits of Cognitive Behavioral Therapy for OCD

  • Within weeks after starting Cognitive Behavioral Therapy treatment for OCD, most people report improved condition.
  • The number of sessions per week could vary depending on how severe one’s symptoms are but usually last about six months.
  • Optimal results rely heavily on active participation outside therapy sessions.

Identifying and Challenging Distorted Thinking Patterns

  • Reality Testing: In Cognitive Behavioral Therapy individuals are encouraged to analyze their own thoughts critically which checks with reality on any evidence basis rather than using irrational fears?
  • Socratic Questioning: OCD therapists in NYC use probing questions so as to facilitate clients who are exploring the validity and accuracy of their beliefs.

Developing Balanced Thoughts

  • From: “If I don’t wash my hands perfectly, disaster will strike.”
  • To: “I can wash my hands thoroughly without obsessing over it.”


All in all, cognitive distortions have a significant impact on OCD, particularly by feeding the cycle of obsessions and compulsions. Step one to manage your suffering from OCD accurately, noticing these distorted thought patterns. Keep in mind that Cognitive Behavioral Therapy (CBT) can enable you to challenge such distortions while developing healthier thinking habits.

If you feel like seeking assistance from an OCD specialist in NYC who uses Cognitive Behavioral Therapy, please go ahead. With OCD, there is life beyond limitations, there is hope for fulfillment again.

It is actually important to find a therapist for anxiety in New York since it can be a good approach to deal with issues related to mental health. In case you want efficient New York psychotherapy services, contact Gita Sawhney who will compassionately and professionally support you through your mental health journey.


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