OCD
5 Roadblocks to Acceptance in the Treatment of OCD
Misconceptions about mindfulness could be getting in the way of your OCD recovery.
Updated September 3, 2025 Reviewed by Ekua Hagan
Mindfulness skills training can be a helpful component of Obsessive-Compulsive Disorder (OCD) treatment, as it entails observing thoughts, feelings, sensations, images, and urges without judgment and without resistance, something often difficult for those with OCD who spend a lot of time and energy judging and resisting intrusive and unwanted thoughts and images.
OCD involves the presence of repetitive, unwanted and disturbing (to the sufferer) intrusive thoughts, images, and "urges" that are distressing to the person experiencing them. Such obsessions can be taboo in nature: violent obsessions (ex. "stab them" popping into a person's mind repeatedly), sexual obsessions (ex. am I attracted to children?), blasphemous obsessions (ex. "fuck god" popping into a person's mind over and over again). Obsessions are ego-dystonic: opposite to a person's values, desires, beliefs, and self-concept. As such, it makes sense that the sufferer would want to make the thoughts and feelings go away. However, resistance to the thoughts and feelings is the fuel that feeds the OCD fire.
When we resist thoughts and feelings, we signal to our brain that these thoughts and feelings are dangerous and meaningful when—in reality—they are the exact opposite: harmless and unimportant. Naturally, the brain produces more of these false alarms because it is ultimately trying to keep you safe, though it is malfunctioning greatly while doing so.
The opposite of resistance is acceptance aka allowance aka mindful detachment, concepts that can feel frightening for people with OCD, largely because of myths and misconceptions about mindfulness skills. As an OCD specialist, I work through this misconceptions with clients and have done so below. If this is you, have compassion for yourself. Mindfulness is tricky for many people, whether you have OCD or not.
Misconception #1: Acceptance means that I am accepting the thoughts as truths.
Mindfulness is accepting the presence of thoughts and feelings. It is not accepting them as truths and then living your life according to them. Mindfulness is letting the thoughts and feelings be there without fusing with them.
A mindful response is, “I am having the thought that I could be a pedophile (or whatever it is that your OCD comes up with). Alright, I’ll accept its presence. The thought is allowed to be here while I move about my day.”
A mindfulness response is not saying, “I am a pedophile. I’ll accept this as a truth.”
Misconception #2: It is irresponsible to accept the presence of anxiety without reacting to it.
When we feel anxious, our body may naturally go into a fight-flight-or-freeze response to try to protect us. This is helpful when we are faced with an actual threat but when it comes to OCD, the brain is malfunctioning. The filtration system is off and thoughts are flagged as dangerous when there is no danger present. Therefore, you feel anxiety without the presence of a threat. This is referred to as a false-alarm feeling.
The work here is to trust the process and acknowledge that you are experiencing false-alarm feelings. It seems counterintuitive to not react to anxiety, but it’s counterproductive to react to anxiety when danger is not present. The reaction (compulsion) signals to the brain that the obsessions are dangerous and reinforces them. This perpetuates the obsessive-compulsive cycle.
Feeling anxious does not automatically mean that you are in danger.
Misconception #3: Allowing a thought to be there will make it come true.
This is the cognitive distortion referred to as thought-action fusion at play. It is very common amongst those living with OCD. The sufferer may believe that thinking a thought makes it more likely that the thought will come true. A common example is someone thinking that if they have the thought about stabbing someone, it increases the likelihood that they will actually stab someone.
Magical thinking, another cognitive distortion in which a person believes that their thoughts or behaviors will make something happen when those thoughts are behaviors are not connected realistically to the feared outcome, is at play. Thoughts are not actions. You can think a thought one million times without it being true, coming true, or meaning something about you. An example I often give clients is as follows: Look at that lamp and try to make it move with your thoughts. Can they do it? Nope!
Usually, thought-action-fusion is pervasive with unwanted thoughts and is focused heavily on negative outcomes. When I ask a client if they can make something positive happen with their thoughts, they are likely to say no.
Thought-action fusion is irrational, as is OCD.
Misconception #4: I don’t like the thoughts/feelings and I do not want them to exist. I’m not accepting their presence.
We are often not in control of our thoughts and feelings. For example, we can't tell our brain and body to stop feeling anxious and magically feel no anxiety. We can't tell our brain to never think something again and the thought disappears forever. On the contrary, thought suppression often backfires, leading to an increase of the very thoughts you tell your brain it cannot think.
To say that we do not want the thoughts, images, feelings, and/or any physical sensations that happen to us is to say that we have a choice that we do not. When something arises out of our control and already exists, we have two choices: acceptance or resistance. It is uncomfortable to accept the presence of unwanted thoughts and feelings. It is more uncomfortable, in the long run, to resist them.
Please note: this does not apply to mental compulsions and other thought process that are active. This is referring to automatic thoughts that arise without a person's control.
Misconception #5: These are “bad” thoughts and I’m a bad person for letting them be there.
Those with OCD often feel immense of guilt and shame for having intrusive thoughts. They may think they’ve done a bad thing by having a thought (irrational and unfounded guilt) or are a defective person for having the thought (irrational and unfounded shame). Having a mental health condition does not make you defective or bad, and there are not good or bad thoughts or feelings. There merely are thoughts and feelings. What makes them “good” or “bad” in our minds is the meaning we assign to them. A thought is a string of words inside of our head. Those words are then a string of letters. The letters are not good or bad. They are letters.
Thoughts and feelings are out of our control most of the time and that does not make us bad. That makes us human. When we can see thoughts and feelings as what they are, simply thoughts and feelings, it becomes easier to accept their presence without compulsive engagement and without resistance. It becomes easier to let them be as we turn our attention to what is more meaningful in the present moment.
