Understanding magical thinking OCD

 You’ve probably heard someone say to “knock on wood” as a way of preventing something bad from happening. Different types of superstition and ritual are common across cultures. For the most part, they offer a helpful way to gain a sense of peace and control in a chaotic world. 

For people living with a presentation of OCD symptoms called magical thinking OCD, superstition and ritual can actually cause harm. Magical thinking OCD causes frequent intrusive thoughts, called obsessions, that can lead people to believe that they can prevent harm to themselves or others using their thoughts. This mistaken belief causes them to engage in unhelpful behaviors, called compulsions, in an attempt to prevent that harm from happening. Left untreated, what results is a continued cycle of obsessions and compulsions that can significantly impact a person’s quality of life.

What is magical thinking OCD?

You cannot be officially diagnosed with magical thinking OCD because it is an unofficial OCD subtype. However, many people use this term to describe the experience of someone whose OCD symptoms revolve around a false belief that their thoughts have the power to shape real-world outcomes.

All people living with OCD have unwanted, intrusive thoughts called obsessions. They respond to these thoughts with ritualistic behaviors, called compulsions, in an attempt to lessen their anxiety. So for example, in some common forms of OCD, a person’s obsessions might revolve around symmetry. They believe that something bad will happen if objects aren’t organized in a certain way. These thoughts occur frequently and are distressing enough to impact their daily life and mental health. In turn, they engage in compulsions, like frequent reorganizing, in an attempt to make their intrusive thoughts go away.

People living with magical thinking OCD experience obsessions and compulsions related to what seem like superstitions. But these superstitions go beyond having a lucky number or knocking on wood. A person with magical thinking OCD believes that their thoughts have the power to shape unrelated outcomes. This results in heightened stress and anxiety due to a fear that if they don’t engage in a specific thought or behavior, something harmful will happen to them or someone else. 

Common symptoms of magical thinking OCD

Every person living with magical thinking OCD will have their own unique experience of the condition. But some common examples of the ways it manifests include:

Typical intrusive thoughts in magical thinking OCD

• If I wear this dress that I wore to a funeral, someone else will die.
• If I don’t lock my car door 10 times, someone will break in.
• If I don’t wake up when the clock displays an even number, my day is doomed.
• If I hear or read a racial slur, I’ll become a racist myself.
• If I don’t text my son a certain number of times while he’s at work, he’ll get into an accident on the drive home.
• If I picture my friend getting injured on their hiking trip, it will definitely happen.
• If I don’t say enough prayers, someone close to me will get cancer.

Common compulsions related to these intrusive thoughts

• Avoiding “dangerous” actions like wearing certain clothes or using “unlucky” numbers
• Repeating thoughts or behaviors a specific number of times to keep something bad from happening
• Refusing to take action or do certain things unless there’s a “sign” that it’s safe 
• Doing actions multiple times (like touching a doorknob or lock) to prevent harm
• Constantly counteracting negative thoughts with positive thoughts or prayers in ways that impact your ability to function
• Seeking frequent reassurance from others or feeling the need to constantly confess unwanted thoughts or behaviors
• Organizing physical objects in a very particular way to feel safe

Effects of magical thinking OCD

Living with untreated magical thinking OCD can have a significant impact on a person’s mental health and their ability to function. Without the right support, all presentations of OCD can lead to:

• Social isolation and relationship challenges
• A loss of interest in the things you used to enjoy
• Chronic fear and anxiety
• Trouble with focus and concentration
• Issues with performance at work or school
• Heightened risk for developing another mental health condition like major depression
• Unhealthy substance use as an attempt to self-medicate
• Self-harm and suicidality (in severe cases)

What causes magical thinking OCD?

There isn’t a single underlying cause of magical thinking OCD. But researchers have discovered some factors that may make you more likely to experience clinical OCD, including:

• Genetics: Having a family history of OCD or other mental health conditions
• Environment: Living through trauma or other major transitions that significantly affect your life
• Biology: Having certain abnormalities in the area of the brain that are responsible for regulating serotonin 
• Personality: Being a person who is naturally meticulous and feels responsible for others (in ways that are unhelpful)
• Mental health: Living with chronic anxiety or another co-occurring mental health condition like depression

How is magical thinking OCD treated?

Although magical thinking OCD is not an official subtype, it’s typically treated the same way as other forms of OCD. The following approaches are frequently used to help people who have been diagnosed with clinical OCD:

• Self-care: Most people living with OCD need professional help to manage their symptoms. But creating a self-care routine can also support your mental health and well-being throughout your treatment journey. This can look different for everyone. But be sure to take care of your physical health and make time for stress-reducing activities that rejuvenate you.
• Cognitive-behavioral therapy (CBT): CBT is a form of talk therapy that helps people identify and challenge intrusive, magical thoughts. In doing so, they replace unwanted thoughts and behavioral patterns with healthier responses.
• Exposure and response prevention (ERP): ERP is a subtype of CBT that involves a safe, gradual exposure to triggers under the supervision of a therapist. This approach can help participants begin to accept a perceived loss of control around their ability to shape real-life outcomes with their thoughts and behaviors. 
• Medication: Some medications, like selective serotonin reuptake inhibitors (SSRIs), can be effective in reducing OCD symptoms. Talk to your doctor or psychiatrist to see if a prescription medication is right for your treatment plan.

Find the right therapist for you with Rula

It seems like human beings have always believed in some form of magic, superstition, or ritual. These traditions span across history and cultures and offer a path toward peace and understanding in an uncertain world. But people living with magical thinking OCD believe that their thoughts can shape real-world outcomes in tangible ways. This leads to a distressing cycle of fear and anxiety that can take a toll on their mental health. So if you or someone in your life is living with magical thinking OCD, know that you’re not alone. 

At Rula, we’re here to make it easier to find a therapist who takes your insurance. In less than 30 seconds, we can match you with a therapist who specializes in your unique needs and is available to meet as soon as this week. And if medication ends up being a part of your OCD treatment plan, we can connect you with a psychiatrist in our network too. 

Find a therapist with Rula