EFT

This page explains how Emotion Focused Therapy (EFT) helps uncover the root causes that lead to OCD intrusive thoughts.

Understanding the root causes of OCD is the first step toward finding lasting peace. While it’s possible to reduce the anxiety caused by your current thoughts, this is often only a temporary fix. Truly stopping the cycle means looking at why those thoughts appear in the first place. This page explores the mind–body connection through Emotion Focused Therapy, a deeper‑layer approach that looks at how emotional stress and high‑alert states contribute to OCD.

To do this, we will explore the specific underlying issues that trigger OCD thoughts and, more importantly, discuss how to address these root causes at their source.

You can only engage with these root causes if your anxiety levels are low enough to do the deeper work of exploration and healing. When your distress is high, your mind can’t focus on anything beyond the immediate anxiety, which is why I recommend visiting the CBT page first. It focuses on practical techniques to reduce the anxiety triggered by your current thoughts, bringing it down to a more manageable level in the short term.

Once your anxiety has eased enough for deeper work, we can begin looking at what may be driving these thoughts beneath the surface.

These thoughts are often a signal of underlying issues — like stress or trauma. Emotion Focused Therapy helps people explore those underlying issues.

It’s important to note that Emotion Focused Therapy doesn’t claim that stress or trauma cause OCD thoughts — that connection comes from my own model. I use Emotion Focused Therapy simply as the tool for exploring those underlying issues.

When you have OCD, it is natural to feel that the thoughts themselves are the main problem, because they are the source of such intense distress. That pain is very real. However, to find a long-term cure, we have to look at what is powering those thoughts.

When the body is under too much strain, intrusive thoughts can appear as a natural reaction to internal pressure. We have to ask: Why is your internal pressure so high that your mind is producing these thoughts in the first place?

If your body is overwhelmed by underlying stress or trauma, your mind becomes more vulnerable to OCD. The thoughts are the symptoms, but the high-pressure state of your body is the actual root cause.

The underlying issues that prevent the brain from performing its duties can be broadly categorized into two types:

High alert reduces the brain’s repair capacity
Biological issues the brain cannot fix

Below I give specific examples for each of these two categories. There is a good chance you suffer from at least one issue from each category. Please read all of the examples, especially about trauma, even if you think you don’t suffer from it

1. High alert reduces the brain’s repair capacity

A high alert state is simply when the body feels under ongoing pressure and stays slightly tense, even when nothing dangerous is happening. It is usually caused in two main ways: trauma and continuous stress.

Trauma

Trauma is one of the strongest forces that can push the body into a high alert state. When something overwhelming happens — whether in childhood or adulthood — the nervous system shifts into a mode designed to protect you. This shift is automatic. It is not a sign of weakness, and it is not something you choose. It is simply the body doing its best to keep you safe.

Many people assume trauma only refers to extreme events like violence or accidents. But trauma can also come from long term emotional strain, whether in childhood or adulthood. For example, growing up in a home where things felt tense or unpredictable, or where a parent was frequently stressed or unavailable, can place the body under continuous pressure. Similarly, overwhelming experiences later in life — such as a difficult relationship or a sudden loss — can have the same effect. In both cases, the nervous system may adapt by settling into a high alert state, simply because it has been pushed into strong, repeated reactions for so long that the elevated state becomes its new normal.

Living in this elevated state affects how the brain is able to do its normal work.

The brain’s normal work is to keep the body running smoothly — repairing, restoring, and maintaining things in the background.

When the body stays on high alert, the brain has less time for its normal maintenance work. When that maintenance drops by a significant amount, the body is placed under continuous strain. And that strain can make OCD thoughts appear — not because the thoughts themselves are meaningful, but simply as a reaction to the pressure the body is under.

So trauma doesn’t cause OCD directly. Instead, it causes the body to run less smoothly (via a long term high alert state), and that loss of smooth running is what allows OCD thoughts to appear.

Many people don’t realise they’ve been living in a high alert state. Trauma often blends into daily life, especially if it happened gradually or in childhood, and the body adapts quietly in the background. The signs usually become clear only in hindsight — sometimes only after a mental health condition appears — once the nervous system has been under pressure for a long time.

Trauma is a deep and complex topic, and this section can only touch on the basics. If trauma is part of your story, many people find it helpful to explore it with a trained professional who can offer support at a pace that feels safe. Some also find it useful to learn from Dr Gabor Maté, whose books and YouTube videos are widely known for explaining trauma in a clear and accessible way.

There is also an important piece of good news. You don’t necessarily need to resolve the past trauma if it’s not affecting your current life directly, such as through flashbacks or ongoing reminders. However, it can still affect you indirectly, because the high alert state you’re in now may have been created by that trauma. In that situation, it can be helpful to work with an Emotion Focused therapist, because they can help you come out of that high‑alert state. The aim isn’t to process the trauma; it’s to ease the patterns that keep the body tense.

Continuous Stress

Continuous stress is another strong force that can push the body into a high alert state. When stress builds up day after day — whether from work, relationships, health worries, or simply having too much to manage — the nervous system shifts into a mode designed to protect you. This shift is automatic. It is not a sign of weakness, and it is not something you choose. It is simply the body doing its best to keep you safe.

Continuous stress can come from long term pressure that builds gradually over time. For example, working in a demanding job with little rest or managing ongoing responsibilities without enough support can place the body under continuous pressure. In both cases, the nervous system may adapt by settling into a high alert state, simply because it has been pushed into strong, repeated reactions for so long that the elevated state becomes its new normal.

Living in this elevated state affects how the brain is able to do its normal work.

The brain’s normal work is to keep the body running smoothly — repairing, restoring, and maintaining things in the background.

When the body stays on high alert because of continuous stress, the brain has less time for its normal maintenance work. When that maintenance drops by a significant amount, the body is placed under continuous strain. And that strain can make OCD thoughts appear — not because the thoughts themselves are meaningful, but simply as a reaction to the pressure the body is under.

So continuous stress doesn’t cause OCD directly. Instead, it causes the body to run less smoothly (via a long term high alert state), and that loss of smooth running is what allows OCD thoughts to appear.

Many people don’t realise they’ve been living in a high alert state. Continuous stress often blends into daily life, especially when it builds gradually, and the body adapts quietly in the background. The signs usually become clear only in hindsight — sometimes only after a mental health condition appears — once the nervous system has been under pressure for a long time.

Continuous stress is a broad topic, and what we’ve covered so far is only the foundation. To understand how long term pressure shapes the body and mind, it helps to look at the different sources of stress that can quietly build over time. Some pressures are obvious, while others operate in the background without our awareness. The next sections explore these sources in a clear and gentle way, so you can recognise the patterns that may have shaped your own stress levels.

a) Irrational Self-Beliefs (self-Esteem)

b) Irrational Beliefs about the world

c) Stress that is real

a) Irrational Self-Beliefs (self-Esteem)

Everyone carries certain beliefs about themselves — ideas about whether they are a good person or whether they are capable. What many people don’t realise is that it’s possible to hold two contradictory beliefs about yourself at the same time. This can feel confusing, but it’s actually very common.

The reason is that our thoughts come from two different parts of the mind. One is the conscious, rational part that looks at evidence and forms deliberate judgments. The other is the subconscious, a less reflective part of the mind that forms beliefs early in life and tends to hold onto them.

The conscious mind can hold a clear, evidence based belief about your abilities. For example, it may recognise that you are good at your job because you meet deadlines, solve problems well, or receive positive feedback in your reviews. This part of the mind looks at what is actually happening and forms a rational conclusion.

The subconscious mind can hold a completely different belief about the very same thing. If someone formed a general belief in childhood that they were incompetent or likely to fail, the subconscious may carry that belief forward into adulthood. So when that person goes to work, the subconscious automatically assumes they must be bad at their job, even when the evidence says otherwise.

This means the brain can receive two opposing messages at the same time — one from the conscious mind and one from the subconscious. The conscious mind says, “I’m doing well,” while the subconscious quietly insists, “I’m not good enough.

When this happens, the brain has to decide which message to follow. And in almost all situations, the brain trusts the subconscious, because this part of the mind is responsible for keeping the body running.

Therefore, generally speaking, it is your subconscious mind that controls your emotions.

Once the subconscious forms a self belief, it starts filtering the world through that belief. It pays attention to anything that seems to confirm it and quietly ignores anything that contradicts it. So if a person’s boss praises them for doing excellent work, the subconscious dismisses it. But if they make a small mistake — like a typo in an email — the subconscious immediately says, “See? This proves you’re not good at your job.

That interpretation then triggers an emotional reaction. The subconscious generates feelings such as stress, embarrassment, or shame, and the person suddenly feels bad.

Over time, repeated bursts of stress or embarrassment train the brain to stay on alert for the ‘danger’ of being exposed as incompetent. This creates a state of ongoing anxiety at work. And when someone is anxious for long periods, the brain shifts resources away from important maintenance tasks — like repairing cells — because it thinks survival is the priority.

Before someone can change these subconscious self beliefs, they first need to understand what those beliefs actually are.

This can be difficult, because subconscious beliefs sit outside of everyday awareness. You can’t simply ask your subconscious what it believes. For this reason, many people find it helpful to work with a therapist or psychologist who knows how to ask the kinds of questions that bring these hidden beliefs to the surface.

If seeing a therapist isn’t possible, you can still try to uncover these subconscious beliefs yourself by using the following method:

a) Start by writing down the common subconscious self beliefs

Write each of the following on a piece of paper or on your computer:

I am not good enough
I am a disappointment
I am incompetent
I don’t belong
I am a failure
I have to be perfect

These are some of the most common subconscious beliefs people carry from childhood.

b) Write down situations that caused you emotional distress

Think of moments in your life when you felt stressed, embarrassed, ashamed, rejected, or anxious. Write each situation underneath the list.

c) For each situation, gently explore why it caused distress

Most situations have a surface level reason (for example, wanting to avoid criticism). But the deeper reason usually connects to a subconscious self belief.

To uncover it, keep asking yourself “why?” in a calm, curious way.

For example:

“Why did I feel upset?” → “Because I wanted validation.”
“Why did I need validation?” → “Because I’m afraid I’m not good enough.”

Keep following this chain until you reach one of the self beliefs on your list.

There is no rush. This is a gentle process of discovery, not interrogation.

d) Once you identify your subconscious self beliefs, you can begin to change them

Correcting subconscious beliefs takes time — often months or years — because they were formed early in life and have been reinforced through repeated emotional experiences.

There are two parts to the process:

Seeing the belief clearly and recognising when it appears

The first step is simply knowing what the belief is. Without that clarity, the emotional reaction feels mysterious — as if it comes out of nowhere. Once you can name the belief, the reaction becomes understandable rather than confusing. Recognising the belief doesn’t stop the emotional reaction, but it does show you the pattern — when it appears and how it tends to unfold.
Having new emotional experiences that contradict the belief

Subconscious beliefs don’t change through logic or willpower. They shift when you repeatedly have experiences that don’t match the old belief — moments where you feel safe, capable, valued, or understood. Over time, these experiences create a different emotional reality, and the old belief gradually loses its power.

If you want a fuller explanation of these two steps, an Emotion Focused therapist can walk you through how subconscious beliefs form and how they change over time.

a) Irrational Beliefs about the world

Just as people can carry subconscious beliefs about themselves, they can also carry subconscious beliefs about the world. These beliefs act like a hidden rulebook — ideas about fairness, predictability, and how people ought to behave.

These beliefs shape how safe or unsafe the world feels. When the world doesn’t match the rulebook — when people behave unpredictably, unfairly, or simply differently from what you expect — the emotional system reacts. The reaction can feel sudden and disproportionate, even if you logically know the situation isn’t dangerous.

Below are some common subconscious beliefs about the world that people often carry without realising it:

The world is unsafe
The world is unfair
People should be kind or considerate

1. The world is unsafe

If someone is harmed in your neighbourhood, your emotional system may start treating the whole area as dangerous. Even if the actual risk is low, the subconscious generalises the threat, and everyday activities — like leaving the house — can trigger stress. The stress isn’t coming from the situation itself, but from the underlying belief that danger is everywhere.

2. The world is unfair

If you can meet your basic needs but can’t afford the things you want, the emotional system may interpret this as evidence that life is unfair. The belief isn’t really about the objects — it’s about what they represent. Replaying this belief repeatedly creates ongoing frustration and stress.

3. People should be kind or considerate

If you expect people to behave in a certain way — for example, to let you merge in traffic — you may feel irritated or stressed when they don’t. The stress comes from the gap between the internal rule (“people should be considerate”) and the reality that people behave differently. The emotional system reacts to the broken expectation, not to the event itself.

There are many other subconscious beliefs about the world, and most people don’t realise they hold them. These beliefs often sit beneath awareness, shaping emotional reactions in ways that feel automatic and puzzling.

Changing these world beliefs follows the same process as changing subconscious beliefs about yourself. Once you can see the belief clearly and then have new emotional experiences, the emotional reactions soften. The mechanism is the same — the emotional system updates when reality repeatedly contradicts the old expectation.

If you want a fuller explanation of how these world beliefs form and how they can change, an Emotion Focused therapist can help you explore how these beliefs formed and how they affect your emotional reactions.

c) Stress that is real

For the previous two sections (i.e. irrational self beliefs and irrational beliefs about the world), it’s not the situation itself that creates the anxiety or stress — it’s the subconscious belief about the situation that generates the emotional reaction.

But life can bring situations where the stress comes from the situation itself, not from a belief about it. For example, if a parent develops dementia or cancer, the emotional system reacts because the situation is genuinely difficult.

Therefore, I call this type of stress ‘real’, because the situation itself is difficult, and the emotional reaction makes sense in light of what is happening.

Below are some further examples of situations that can cause real stress:

Serious Illness — a major health condition can create ongoing stress and uncertainty
Financial Difficulties — money pressures can create ongoing worry and a sense of instability
Working Long Hours — extended workloads can gradually drain energy and increase stress
Relationship Issues — difficulties in relationships can create ongoing stress
Grief — major losses or expected losses can place significant strain on the system
Racism — experiencing discrimination can create significant and ongoing stress
Modern technology — constant stimulation can increase stress, and social media comparisons can make people feel less satisfied, for example when others appear happier or more successful even if that isn’t really the case
Neurodivergence — differences in attention and sensory processing can create ongoing stress, especially when everyday environments aren’t set up in ways that feel comfortable or supportive

All of these pressures can add up over time, and when they do, the body starts to struggle.

When stress builds beyond what the body can comfortably handle, the brain has less capacity to carry out its normal maintenance work. When this happens, intrusive thoughts can appear as a signal that the system is under strain and not getting what it needs to function smoothly.

Real stress is not possible to get rid of completely, as the situation that causes it is outside of your control (e.g. if your parent has dementia, it is not something you can change).

So, the focus becomes finding ways to reduce the stress where you can. Helpful approaches might include:

Mindfulness — simple practices that help reduce internal pressure and create a bit more calm (I’ve written a separate page on this)
Medication — for some people, medication can help reduce overall stress levels (I’ve also written a separate page on this)
Religious or spiritual grounding — for those who believe, many traditions offer ways of making sense of difficult situations, such as the idea that the soul continues beyond this life.

We have now reached the end of the high‑alert section. The next section looks at a different source of internal pressure: biological issues the brain cannot fix by itself.

2. Biological issues the brain cannot fix

(a) Thyroid Gland Issue

(b) Genetics

(a) Thyroid Gland Issue

Doctors often check the thyroid when someone develops mental‑health symptoms for the first time, because thyroid hormones play a major role in regulating energy, mood, and overall stability in the body. When the thyroid is underactive or overactive, it can create physical changes that sometimes resemble mental‑health difficulties — such as anxiety or low mood. In these cases, the symptoms are linked to a hormone imbalance, and medical treatment is needed to address the underlying issue.

(b) Genetics

Many people worry that if a parent has OCD, they are destined to develop it too. Current research suggests the picture is more complex, and genes are only one part of the story. A newer field called epigenetics explores how life experiences can influence the way genes are expressed. This means that even if someone has a genetic vulnerability, it does not automatically mean they will develop OCD — certain environmental factors, such as prolonged stress, can play a role in switching that vulnerability on.

Epigenetics is a fascinating area, and if you’re interested in an accessible introduction, Dr Bruce H. Lipton’s book The Wisdom of Your Cells offers a reader‑friendly overview of how gene activity can be shaped by the environment.

It’s also worth remembering that OCD‑like patterns can be learned within families. For example, if a parent is very fearful of contamination, children may absorb these fears through observation and repetition — a process known as conditioning. In these situations, the behaviour is influenced by the environment rather than genetics.

If you believe your OCD has a strong genetic component, it doesn’t mean improvement is out of reach. Many people find that structured therapies — such as Exposure and Response Prevention (the behavioural part of CBT) — can reduce the impact of symptoms and help them maintain a good quality of life.

As research in epigenetics continues to grow, we may learn even more about how genes and environment interact, and how these insights could support future approaches to treatment.

Bringing It All Together: A Final Reflection

Understanding the root causes of your OCD is an act of profound self‑compassion. By exploring how a body under pressure can create a mind in distress, you shift from simply managing symptoms to healing the conditions that give rise to them. Recognising that intrusive thoughts often appear when internal pressure builds changes the entire perspective: the thoughts are not the enemy, but symptoms of a system under strain. With this deeper understanding, you gain a clearer roadmap for lasting change — one where the internal pressure gradually eases and your mind can return to its natural state of balance.

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