OCD: How much of what I see on TikTok is true?!
Written by Christina Jackson, MA
OCD (Obsessive-Compulsive Disorder) is so much more than organizing your cookie jar for likes. Yes, you may have seen this on TikTok, where the lady beautifully stacks all of her cookies inside of the glass cookie jar. She then talks about how people say she is ‘OCD’ for stacking her cookies in a strategic pattern. But OCD is way more than excessively organizing or doing something for show.
What you see on TikTok
Maybe you have heard other things on TikTok or other social media outlets. Like the trend, “I’m so OCD” just because I have a neat desk. But nope again. This is not the proper use of the diagnosis Obsessive-Compulsive Disorder. OCD is not a personality quirk or an organizational preference. It is much deeper than that.
People have created endless content on TikTok that is quick and flashy to grab your attention. How about the clip where a person dyes their hair and blames it on a compulsive thought. Surely, that has to be true! But that’s more of an impulsive decision than an intrusive thought as associated with OCD.
Well, you may say, at least the advice on TikTok is reliable. Hmmm…is it though? Telling people phrases like, “You’re overreacting” and “You need to relax” have made their way through these platforms, but they are not helpful because they can increase shame or negative self-talk.
Another really common phrase is “Stop thinking about it.”
Advice that helps… or not
Let’s think about “Stop thinking about it.” Aside from being invalidating and unhelpful, it generally makes it worse. Why? Because if I say don’t think about pink elephants dancing in tutus, that’s all you are thinking about now. Ha! That visual will be stuck in your head for the rest of this blog.
Research shows that the more we tell ourselves not to think of something the more we think of it. This is because our brains are excellent at diverting attention. This design functions as a safety feature to help keep us alive. It is amazing at finding danger, then focusing on it. Yet, the same function can over function and create a neurobiological loop where suppressing thoughts actually makes them stickier. With OCD, the thoughts are more severe than pink elephants in tutus (you’re welcome!). Therefore, telling someone to “Stop thinking about it” is not a useful method.
So, what does work? ERP (Exposure & Response Prevention) is the leading evidence-based intervention currently being used. It is a behavioral therapy, not a talk therapy (psychotherapy). Merely talking about their fears or compulsions does not make the person feel safer. Nor does it cause the intrusive thoughts to go away. Similar to the “just stop thinking about it” method, just talking about it does not make it go away. Instead, ERP helps interrupt the neurobiological loop, which can reorient the brain to focus on something else and help the body to feel less distress.
Time to get nerdy and break down these terms to make it make sense. What is this neurobiological loop we keep referencing? Essentially, neurobiological refers to the interaction between your mind (or psyche, which does the thinking) and your brain (the mass in your head, or physical hardware). Loop means it has created a cycle, or circle, that is ongoing. For example, a person has a thought that flags danger, the brain diverts attention to keep the person safe from the danger, then an idea emerges about what will keep them safe and a compulsion is born. A compulsion is an action or thought that is performed to relieve the feelings of distress. Some common loops revolve around fears while driving. For example, a person may be afraid that they will hit a pedestrian, so the brain hyper focuses on this outcome, and a strategy is put into place to prevent it, like not exceeding a certain speed or only using a particular route. The loop gains momentum because even if their mind can logically reason that they did not hit a pedestrian, their brain believes the compulsion prevented the catastrophe and begins to organize around this idea. Through neuroplasticity (which is the shaping and reshaping of the brain), components of the brain begin malfunctioning to signal danger where there is no danger or intensifying the danger level. However, in a non-OCD brain, these components are functioning in a typical manner, which allows the person to dismiss the danger warning and move on to the next thought.
Therefore, it is not helpful to tell someone to “Stop thinking about it” because their brain is functioning in a different manner. This is also why ERP is so effective for OCD, because it interrupts the loop, or cycle, and begins to help the brain reorient (via neuroplasticity) or reshape to lessen the danger signals to a more moderate level.
About those intrusive thoughts
Next, intrusive thoughts. Let’s talk about it! (Are the elephants still dancing?) What are they? Don’t we all have them? What’s the big deal? Much of the information on TikTok tends to minimize or inflate mental health concepts. So, here’s the tea on intrusive thoughts in relation to OCD.
Intrusive thoughts are intruders, like a burglar in your home. They are uninvited and unwanted. Furthermore, they are distressing to the person with OCD because they are ego‐dystonic, which means the thought goes against the person’s core values and their belief about themself. For example, in the driving scenario, a person believes they are a kind person who does not harm others. But then the constant thought chatter (a non-stop dialogue of doubt and doom) begins telling them they may have hit someone, and they are a horrible person that harms people, etc. An OCD mind is constantly being bombarded with a flood of doubt about who they really are and doom (that they might be harmed or harm others). In summary, intrusive thoughts for a person with OCD are extremely distressing and cause physical stress due to the frequency (an ongoing dialogue) and the content (the thoughts are ego-dystonic or violate their core values and beliefs). These elevated levels of constant distress are also why people perform the compulsion because they are looking for relief. However, performing the compulsion inadvertently feeds the cycle and reinforces the doubt and insecurity, fear, or shame.
ERP, on the other hand ‘breaks the rule’ by not performing the compulsion, which interrupts the cycle and causes the brain to reexamine the set pattern. A simple response like “Maybe?” is used in ERP. Saying “Maybe” instead of performing the compulsion causes the brain to stutter, so to speak. It creates a hiccup in the pattern. For example, when a person with OCD has to drive and their thought chatter about hitting a pedestrian starts, they can simply reply, “Maybe.” “I don’t know. Maybe I will, maybe I won’t. Either way, I’m going to drive and not perform the compulsion to relieve the distress. I’m just going to drive.” This new thought causes the brain to put less emphasis on the original concern. Remember, it all started with a legitimate safety concern, but then the person’s thoughts and brain gained momentum as the neurobiological loop was reinforced. Therefore, informing the brain that the concern is no longer that important will help the brain stop the hyper focus of attention on that concern. Granted, the brain will search for the next safety concern, but with regular practice, a person with OCD can experience more peace by using ERP to retrain their brain to be less hypervigilant.
Managing OCD
Likewise, it is common to practice distress tolerance exercises to help withstand the urge to perform the compulsion. DBT (Dialectical Behavioral Therapy) commonly uses these exercises. They include deep breathing exercises, somatic shifts to divert attention like touching something cold, muscle relaxation exercises, and ACCEPTS (Activities, Contributing, Comparisons, Emotions, Pushing Away, Thoughts, Sensations). These are all ways to temporarily divert the attention while resisting the urge. Combining ERP and DBT has shown to help people manage their compulsions and retrain their brain.
If some of these things resonate with you and you think you may have OCD, please see a qualified professional for more information and a formal evaluation, which may or may not lead to a diagnosis. Remember that Psychiatrists, Psychologists, and therapists are qualified professionals. TikTok and other social media outlets that have not met you personally are not qualified to diagnose or treat you.
Maybe you are reading this and you have already seen a professional and you know you have OCD. Keep up the good work of seeking help and implementing your interventions! Retraining the brain is ongoing hard work. Give yourself credit for the hard work you do every day to show up for life! (Confetti & applause moment!) Celebrate your small wins to build more and bigger wins!
Or you may be reading this because you have a loved one suffering with OCD. Maybe this will help you understand what it is like to be in their skin and develop a better understanding of what is and is not effective when speaking with them.
…and why are you still thinking about dancing elephants?!
Christina Jackson helps children, teens, and adults heal from trauma, navigate grief, and manage anxiety. She has therapy appointments available in Murfreesboro and through telehealth.