Magical Thinking OCD

Obsessive-compulsive disorder (or OCD) is a mental health disorder that mainly focuses on unwanted and intrusive thought content. Despite arousing extremely unpleasant feelings within the patient, causing many of them to seek treatment, its tenacity can often be traced back to the patient’s reliance on seemingly superstitious rituals. Referred to as “magical thinking OCD,” this form of OCD combines several hard-to-shake inclinations and symptoms. Read on to find out more about this condition.

Obsessive-Compulsive Disorder: Definition

Originally believed to be an anxiety-centric mental health disorder, these days an ongoing debate is taking place, with recent studies citing distress as the source of this condition. And yet, whether it is derived from a sense of impending danger (like anxiety) or a persistent feeling of unease (like distress), experts agree that OCD mainly manifests through three aspects: obsessions, compulsions, and level of insight.

Obsessions are defined as recurrent thought content (or theme) that is highly unpleasant to the individual experiencing it. The four most common OCD themes are:

• Contamination. Pervasive thoughts on the need to constantly clean one’s body, for fear of disease or infection.
• Catastrophizing. The constant contemplation of a terrible incident befalling the individual themselves, or a loved one.
• “Just Right” Thinking. Unpleasant preoccupation with perceived untidiness, a pressing desire to count, or a nagging self-doubt that pushes the individual to check and recheck that a certain action had indeed been carried out.
  Taboo Thoughts. Returning again and again to thoughts of sacrilegious or socially unacceptable content and imagery, individuals with this type of OCD feel a great deal of guilt over the perceived immorality they relate to their condition.

Compulsions are oftentimes the reaction to said obsessions, carried out in an effort to calm them down. OCD-related compulsion types are numerous and include repeatedly turning the light switch on and off, washing one’s hands, silently repeating a particular sentence, and more.

The individual’s level of insight attests to their ability to recognize that the false belief driving their OCD is indeed not true. A good level of insight allows the patient to come to terms with their condition, a poor level of insight views their false beliefs as most likely true, and an absent level of insight causes them to fully believe their false beliefs.

Magical Thinking OCD: Definition

Magical thinking OCD (sometimes referred to as mtOCD), appears to walk the line between high insight that acknowledges the irrationality of the patient’s beliefs, and absent insight that transgresses into psychotic delusions. Patients with mtOCD will act out a chosen compulsive behavior (and sometimes conjure up a certain thought) as a way to rid themselves of their obsessive thinking.

Since initially this technique is able to effectively assuage their obsessive content, they begin to believe, or at least to consider whether they have the ability to “cure” themselves of OCD. Examples for magical thinking OCD can be found among all four common obsession themes:

• Contamination: Believing that excessive hand washing (or really any repeated response) can ward off any type of ailment.
• Catastrophizing: Taking a certain route to work in an effort to safeguard one’s family against being involved in a car accident.
• “Just Right” Thinking: Arranging the teacups in the kitchen cabinet according to a specific order, at the off chance that it may prevent the distress one feels when their cups are in relative disarray.
• Taboo Thoughts: Touching their right shoulder as a way to “wipe their mind” of the profane images of someone they know, which sometimes appear in their imagination.

Performing such rituals is thought to shield the individual from the bombardment of obsessive thoughts, and as such, is perceived as a “magical” amulet against their condition. The problem here is that such performative reactions do not have the power to free them of their obsessions, at least not for long.

For while magical OCD-related compulsions initially tend to decrease the individual’s distress or anxiety, eventually they cease to work. By the time this happens, the newly acquired compulsions will have already been incorporated into the individual’s OCD, causing them to be carried out every time a magical OCD-related obsession arises.

The Prevalence of Magical Thinking

Magical thinking OCD, by definition, goes against basic logic. Why would a generally rational individual believe that, say, throwing a pinch of spilled salt over one’s shoulder can protect from bad luck, as cannot walking under a ladder? If these examples seem a bit more acceptable, it is because they are considered superstitions (regarding the salt), or stem from religious practices (regarding the ladder).

Magical thinking is in fact quite common in everyday life and does not have to impinge on one’s well-being. It is only when it does conflict with the individual’s daily functioning in a significant way that magical thinking can become a burden, and part of a mental health condition such as OCD, schizophrenia or general anxiety disorder (GAD).

This, in part, is what makes magical thinking so pervasive: not only does it appear in various cultures and religions, but it also helps group members feel a sense of belonging, by performing shared rituals. Magical thinking can also receive a good deal of “support” from accepted traditions, which have historically repeated a certain, ritualistic action.

Such traditions can be a cherished piece of communal history, and do not necessarily develop into a cause for concern. The problem only arises when such practices interfere with an individual’s ability to enjoy life, to a degree that constitutes a mental health disorder.

Magical Thinking During Childhood and Beyond

Though the idea of having the power to the minutiae of one’s life, may be a sign of mental health concern in adulthood, it is considered a normative and standard part of a child’s development. As such, children routinely experience magical thinking, believing they are able to change a traffic light from red to green with their mind, or change their parent’s stance about having a snack before dinner by twitching the tip of their nose.

Such beliefs tend to solidify by confusing correlation with causation: a child whose father had once agreed to their eating a freshly baked cookie as a special treat prior to supper, might have noticed they had inadvertently twitched their nose at the very moment their father had said yes. This led them to thinking such an action will always bring about a cookie, when in fact it was merely a coincidence.

Magical thinking OCD can work similarly in adulthood. A grown woman who noticed that her OCD-related anxiety lessened, and her obsessions went away when she tapped the light switch with her index finger, could develop magical thinking OCD as a result. Depending on her level of insight, she may feel there is no harm in continuing this ritual, find it to likely help her ward off her OCD, or emphatically believe it has the power to cure her condition.

Treating Magical Thinking OCD

Treatment for magical thinking OCD is akin to treating other forms of this disorder, in that it is expected to respond well to options known for their safety and efficacy.

The FDA has recognized a number of treatments found to effectively treat OCD while only causing a tolerable level of side effects, if any. Among them are:

• Selective Serotonin Reuptake Inhibitors. SSRIs for short, this family of medications prolongs the activation of the neurotransmitter serotonin. Known for their ability to act as a mood regulator, SSRIs have been shown to be particularly effective when treating OCD.
• Cognitive-Behavioral Therapy. Shortened to CBT, this form of goal-oriented psychotherapy examines the thoughts, feelings, physical sensations and behaviors the patient has learned to associate with their condition. By bringing them to light and helping the patient withstand exposure to triggering stimuli, CBT can assist them in their ability to refrain from OCD-related behaviors outside their therapy sessions, as well.
• Deep Transcranial Magnetic Stimulation. Also known as Deep TMS™, this medical device treatment relies on electromagnetic fields to safely regulate the neural activity of brain structures found to be associated with the appearance of OCD. The treatment process is non-invasive and does not require the use of anesthesia. Repeated sessions of Deep TMS have been shown to significantly alleviate the symptoms of this condition, thereby improving the patient’s quality.