What Are Ego-Dystonic Thoughts in OCD
Published July 25th, 2024
5 min read
Thoughts that are ego-dystonic go against our values and beliefs, causing anxiety, fear, and stress.
Written by Simon Spichak
We can’t control the thoughts that pop up in our heads throughout the day. These thoughts can be ego-dystonic, meaning they go against our personal beliefs and values. Ego-dystonic thoughts can lead to rumination in obsessive-compulsive disorder (OCD).
Ego-dystonic thoughts in OCD
Have you ever had a strange thought pop into your head, like, “What if I hurt someone that I love?” While many people can ignore these fleeting thoughts and go about their day, in OCD, these thoughts can become repetitive or intrusive, leading to distress.
Some other examples of ego-dystonic thoughts revolve around:
Infidelity or cheating.
Hurting yourself or others physically or emotionally.
Breaking tenets of your religion.
In harm OCD, people may have a belief that having these kinds of thoughts is just as bad as intrusive or disturbing behaviours. The thoughts are obsessions, which lead to anxiety, fear, and distress. People with OCD may have compulsions to address these thoughts.
Sometimes, people ruminate on these thoughts or try to argue with them, but these strategies only make things worse, causing these thoughts to pop up again and again.
Treating ego-dystonic thoughts
Therapists treat ego-dystonic thoughts through exposure and response prevention (ERP), a first-line therapy for OCD. ERP is a modified form of cognitive behavioural therapy (CBT) that helps you confront fears, intrusive thoughts, and obsessions in a healthy way while also helping you learn to resist compulsions, and helping you avoid engaging with ego-dystonic thoughts.
Getting started with ERP
The first step of ERP involves learning about the types of thoughts you’re having and how you respond to them. For example, some people with ego-dystonic thoughts may spend hours going over their thoughts to convince themselves that they wouldn’t actually do certain behaviours that hurt themselves or loved ones as the thoughts imply.
During the session, the therapist will acknowledge your beliefs and the risks associated with these thoughts. They will work with you to understand that the risks might be exaggerated and do not require compulsions to prevent bad things from happening.
Exposure and response prevention
Next, your therapist will expose you to the thoughts that cause you to fear and anxiety to help you learn that nothing bad will happen if you learn to ignore these thoughts and have them pass you by.
This part of the therapy will desensitize you to the thoughts so they don’t stick around in your brain. If there is an annoying constant sound at work – like construction nearby – you might eventually become used to it and start to ignore it. Similarly, ERP will help you get desensitized to the noisiness of ego-dystonic thoughts.
It can take 12 to 16 sessions to complete this treatment.
How Resolvve can help
Resolvve has a library of free resources about OCD which may be helpful for your mental health journey:
We also offer affordable, low-cost therapy with practitioners who have extensive experience treating clients with OCD using ERP. When you’re ready to take the next step, you can book a free consultation.
Please note that this post is written for educational purposes; it is not therapy. If you need to talk to a professional, please book a consultation with a psychotherapist through Resolvve.
