Self-care for OCD: managing intrusive thoughts and compulsions

Effective strategies for coping with OCD symptoms and where to access support.

Living with obsessive compulsive disorder (OCD) can be incredibly challenging, both for the people who are directly affected and their loved ones. However, there are effective ways to limit the impact on your day-to-day life.

This article offers expert-led self-care strategies to help effectively manage OCD symptoms, including obsessions and compulsions.

Managing intrusive thoughts

Intrusive thoughts are a common and often distressing symptom of OCD, but learning how to manage them can significantly improve your quality of life.

Consider these two strategies when looking to manage intrusive thoughts.

Accept intrusive thoughts

It's important to understand that everyone has intrusive thoughts, but for people with OCD, these thoughts can become overwhelming. These could relate to anything, but commonly people will experience intrusive thoughts around self-doubt, acts of violence or aggression, germs or contamination or obsessing over saying or doing the wrong thing public.

Rather than trying to push them away, which often makes them more persistent, try to accept their presence. Acknowledge that these thoughts are a part of your condition, they don’t reflect your true intentions or desires, and you don’t need to avoid them. By accepting their existence without judgement, you can reduce the anxiety they cause.

To help you do this, you could try:

A grounding technique – this could be an object you keep with you, or a phrase you say to yourself, that removes you from this thought and reminds you to keep it in perspective. This could be a fidget toy, stone or other anything you have to hand - as long as it fits in your pocket.

Avoid attaching meaning to them

Intrusive thoughts can feel distressing, but it's crucial not to attach significance to them. These thoughts don’t define you or your character. Remind yourself that they are just thoughts, not facts or predictions. Practising this mental separation can help you reduce the power and influence that these intrusive thoughts can have over your emotions and behaviour.

To help you do this, you could try:

Playing around with the thought – some people find that making a joke of the intrusive thought, by exaggerating or making fun of it, helps to lessen the power it has in your mind.

Managing OCD compulsions

Using these strategies, it’s also possible to lessen the impact of your OCD compulsions on your day-to-day life.

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Pinpoint your compulsions

The first step in managing OCD compulsions is to clearly identify them. Compulsions are repetitive behaviours or mental acts that you feel driven to perform in response to an obsession.

Take some time to reflect on your actions and recognise which ones are compulsive. This can be a challenge at times, but start by thinking about:

Whether you feel an intense urge to perform this behaviour to alleviate anxiety or prevent something bad from happening
If this behaviour follows a specific, rigid pattern
If it consumes a significant amount of time, interfering with daily activities
Once you do it, it brings comfort in the immediate-term but then you feel the need to do it again

These are indicators that might suggest this behaviour is a compulsion. Keeping a journal can be helpful, noting when and why you engage in these behaviours. Understanding your specific compulsions is essential for developing strategies to manage them effectively.

“After brushing her teeth, she turns off the cold water tap so hard that it's at risk of breaking. She then turns both taps in the 'off' direction just to make sure and follows this by placing her hands under both taps to feel there is no water running and repeats the words “check, check, check”. Mary stares at the taps intensely to be sure the water is definitely switched off.”
Read more about a typical day in the life of someone living with OCD.

Curb or reduce compulsions

Once you've identified your compulsions, there are things you can put in place to gradually work at curbing, delaying or reducing them.
Here are some strategies to try. If you’re able to, discuss and practise with a trained mental health professional at first:

Do something to distract yourself from the compulsion
Resist the compulsion and sit with it. Start from a position of acceptance rather than shutting yourself away
Set a timer and resist for as long as you can. Try to beat your time
Make a list of compulsions, and challenge yourself to resist the ones you find the easiest to deal with first
Challenge everyday compulsions first, especially if you don’t associate them with anxiety or stress
Chip away at a compulsion by doing a lesser version of it each time. For example, if you wash your hands compulsively, do it for gradually less time

Throughout, remind yourself:

To make notes of your success, or keep a journal that tracks how you’re doing
To practise. Some of these will make you feel uncomfortable at first, but it will get easier in time
To try and avoid replacing a compulsion with something else – this isn’t a long-term strategy
Why you’re doing this, and by engaging in your compulsions, your OCD will get stronger
To trust in the process. With planning and practice, you have the power to overcome these compulsions

Coping mechanisms for OCD

Accompany these specific techniques with other general good habits for managing the anxiety and stress that’s associated with your OCD.

Use visualisation: imagine a peaceful scene or a calming place whenever you feel overwhelmed by obsessive thoughts or compulsive urges. This mental escape can help reduce anxiety and give you a sense of control
Make lifestyle changes: incorporate regular exercise, a balanced diet, and sufficient sleep into your routine. These changes can improve your overall wellbeing and resilience, making it easier for you to manage your OCD symptoms
Distract yourself: engage in activities that capture your attention and interest, such as reading, hobbies or spending time with loved ones. Distracting yourself can help break the cycle of obsessive thoughts and compulsive behaviours
Engage in compassionate self-talk: practise positive affirmations or just speaking kindly to yourself, especially when OCD symptoms arise. Remind yourself that you are not your thoughts and that it's OK to get help and take things one step at a time
Take breaks online: limit your screen time and take regular breaks from social media and other online activities. Excessive screen time can increase anxiety and compulsive behaviours, so stepping away can be beneficial
Talk to someone: share your feelings and experiences with a trusted friend, family member or therapist. Talking about your struggles can provide relief, offer new perspectives, and remind you that you’re not alone in this journey

Support for OCD

As with any mental health problem, knowing you’re not in it alone can be incredibly empowering. Here are some options to consider, to help you get the right support for your OCD.

Peer support

Connecting with other people who have OCD can be incredibly reassuring and empowering. Peer support groups, both in-person and online, provide a safe space to share experiences, offer advice, and gain insights from people who truly understand what you're going through.

In the UK, try OCD-UK and OCD Action for charity-based support for OCD.

Treatment for OCD

If your OCD is severely affecting your ability to live your life the way you want to, and self-help strategies aren’t improving the situation, reaching out private treatment for OCD is an option you should consider. Many therapies, such as cognitive behavioural therapy (CBT), exposure and response prevention (ERP) and eye movement desensitisation and reprocessing (EMDR), are effective for treating OCD.

At Priory, our experienced mental health professionals tailor treatment plans to each person’s needs, providing comprehensive care and support. Don’t hesitate to reach out to us to discuss your options and take the first step towards recovery.

Blog clinically reviewed by Dr William Shanahan, Medical Director (Private) and Clinical Director of Addictions (BAO, BCh, DCH, D'OBS, FRCPsych, MB), Priory Hospital Roehampton