Psychoanalysis

A modern explanation of the root causes of OCD

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 Psychoanalysis, a therapy that helps us understand the deeper patterns behind OCD. I’ll be using its modern form — Psychodynamic Therapy — to show how long term relief becomes possible.

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. Psychodynamic Therapy — the modern form of Psychoanalysis — recognises that if the body is under strain or unable to function properly, it can lead to malfunctioning thoughts in the mind. Understanding this link between the body and the mind is the very basis of this approach.

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.

In the psychoanalytic perspective, an intrusive thought acts as a 'release valve' for a body that is under too much strain. 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 'fertile ground' for OCD. The thoughts are the symptoms, but the high-pressure state of your body is the actual root cause.

When the body is in this high-pressure state, the brain’s priorities shift. Instead of focusing exclusively on the physical actions required to keep the body running smoothly, it also has to share its attention by responding to the OCD thoughts. Because the brain's attention is now split, it can no longer perform its essential maintenance tasks effectively.

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

1. Issues that are too complex for the brain to fix by itself
2. Stress hinders brain’s repair of the body

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. Issues that are too complex for the brain to fix by itself

(a) Thyroid Gland Issue

(b) Trauma

(c) Genetics

(a) Thyroid Gland Issue

When you get OCD the first thing your doctor will do is test if you have a thyroid gland issue. The thyroid gland produces hormones that help regulate the body's metabolism. If it stops working properly, it can cause OCD (and other mental illnesses)

(b) Trauma

If you ask OCD sufferers if they have suffered trauma in their lives, most will say no. This is because they think trauma only refers to major things such as the experiencing of violence or being involved in a car crash.

However, if a person experiences minor trauma that occurs over a long time period, it can add up to major trauma. For example, if both parents work long hours and are unable to spend much time with their child, over time that child will feel traumatised, as they are missing out on care from their parents.

In the body there is a metaphorical bucket where all the trauma a person suffers is stored. If this bucket gets too full the subconscious mind needs to raise an alarm. It can do this by generating OCD thoughts

Trauma is such a deep topic, it’s not possible to cover it adequately in a website about OCD. Its likely everyone has some trauma, even if you think you don’t. The only issue is, is your trauma bucket full or not. Once again, I recommend seeing a therapist/psychologist about this, as people cannot solve it themselves

If you want to start looking into trauma without the aid of a therapist/psychologist, then any book or YouTube video by Dr Gabor Mate would be a good start. He is a world-renowned expert in trauma

(c) Genetics

Some people think if their parents have OCD, they will get it too. Over the last 30 years or so, a new field of science has emerged that disputes this claim. That field is called epigenetics, which is concerned with how cells control gene activity. The key thing for OCD is that if a child only suffers minimal stress in their lives, they may never end up inheriting OCD. The OCD gene is only switched on when the cells cannot function properly, and the main reason for this poor functioning is stress

Epigenetics is a fascinating area, and if you want a good introduction to the subject, you should get a book from the epigenesist Dr Bruce H Lipton, called ‘The Wisdom of your cells’. It is aimed at the general reader, so you don’t have to be a scientific expert to understand it

As a side note, some people erroneously think that if they and their siblings have OCD, then it must be genetic. This is not true in all cases, as OCD can be learnt. For example, if the mother of the siblings is scared of contamination, she can drum this contamination fear into her kids. Technically this is called conditioning

If you are sure that your OCD is genetically inherited, then it’s unlikely you will fully recover from OCD (i.e. you will get OCD thoughts for the rest of your life). However, by using Exposure and Response Prevention (i.e. the 'B' part of CBT therapy), you can reduce the impact the OCD thoughts have on you, and possibly still enjoy a good quality of life

Keep yourself updated about the latest findings in epigenetics, in the future they may find a way to switch off the OCD gene

2. Stress hinders brain’s repair of the body

On a daily basis the brain performs a large number of tasks, including replacing dying cells with new ones. These tasks are easy for the brain. However, it stops doing these tasks when it has to generate the stress response. Now, if the stress response is activated only occasionally, the brain can make up for any task that is missed by doing overtime. But, if the stress response is being generated regularly, then it cannot perform all the needed tasks. Therefore, in this situation, the body is not getting what it needs, and so the subconscious mind raises the alarm by producing OCD thoughts

What kind of things cause stress? Some are obvious, such as losing a job, but for some of the causes, it’s not obvious, because the source of the stress sits in the subconscious mind, which we don't have direct access to

The following are common reasons why the stress response is being generated regularly

a) Irrational Self-Beliefs (self-Esteem)

b) Irrational Beliefs about the world

c) Stress that is real

a) Irrational Self-Beliefs (self-Esteem)

Everyone has beliefs about themselves. For example, whether they think they are a kind person or if they think are intelligent. What is not well known is that a person can hold two contradictory self-beliefs about the same thing!! How can this be? Well, remember self-beliefs are just thoughts that have become entrenched. And as we know, thoughts come from two different parts of the mind – conscious and subconscious.

The conscious mind can have one self-belief, for example, they are good at their job. The conscious mind will form this self-belief by looking at the evidence e.g. they regularly meet their deadlines, and they get good marks at their year-end review.

The subconscious mind can think that the same person is bad at their job. The subconscious can form a general self-belief during early childhood that they are incompetent at most things. So, when they are older and have to go to work, the subconscious assumes that they must be bad at their job.

So the brain is getting contradictory messages from the two-parts of the mind. How does it decide which one is true?

The brain trusts the subconscious, as it is the subconscious that keeps the body running.

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

Once the subconscious forms a self-belief, it only looks for things that confirm that self-belief, and completely ignores evidence that contradicts it. So, if the boss of the person praised that person for doing a really good job on a task, the subconscious mind would ignore that. If on the other hand, the person made a slight mistake, perhaps misspelling a word in an email, the subconscious would say ‘see, I told you you were crap at your job’.

The subconscious would then also generate a negative emotion, perhaps stress, or embarrassment, which would make the person feel bad.

And after a while of feeling stressed or embarrassed, that person’s brain will be acclimatised to looking out for the ‘danger’ of being discovered that they did a bad job, and so they will be regularly/continuously anxious at work. This is very bad for the functioning of the body, as when a person is anxious, the brain stops doing important things like replacing dying cells.

In the world of Cognitive Therapy (i.e. the 'C' part of CBT), these self-beliefs are sometimes called ‘core beliefs’.

Before an individual can fix these irrational self-beliefs, they first have to establish what they are

It is difficult for a person to know what they are, as the self-beliefs sit in the subconscious mind, which the person cannot directly ask or interrogate. Due to this difficulty, I highly recommend seeing a therapist/psychologist about this. These therapists/psychologists know which questions to ask that will pull out these irrational self-beliefs.

If you are unable to see a therapist/psychologist about this, then you could try to figure out your irrational self-beliefs by using the following method:

a) write down each of the below irrational self-beliefs on a piece of paper (or computer)

• I am not good enough
• I am a disappointment
• I am incompetent
• I don’t belong
• I am a failure (will fail)
• I have to be perfect

b) think of situations in your life that caused you emotional distress and write them down on the paper

c) for each situation, think about why you got the emotional distress. Typically, there is a top-level reason e.g. to avoid being criticised. But this top-level reason is not enough, you need to keep drilling down until you get to the underlying self-belief. For example, if you are too caring, ask yourself why. The answer could be because you need validation from other people. Then continue this line of questioning by asking yourself ‘why do I need validation from other people’. The answer to this question might be because you have the irrational self-belief that ‘I am not good enough’

Essentially, keep asking the ‘why’ question until you get to one of the irrational self-beliefs

Once you have figured out what your irrational self-beliefs are, you can then start to figure out how to correct them

Correcting these self-beliefs takes time, possibly years. There are two things that you need to do. The first is to start challenging these self-beliefs. Cognitive therapy can help with this. The second thing is to change your behaviour, and behavioural therapy helps with this. I have already explained how cognitive therapy and behaviour therapy works in the page on CBT, but if you need more information, then please search on the internet, as what works for one person may not work for another

For an alternative to standard cognitive and behavioural therapies, search for the online resources of Peter Crone, who is known as the mind architect. There is an excellent video on YouTube where he talks about how the mind works and how to change its workings (see below YouTube link)

b) Irrational Beliefs about the world

In our subconscious, we hold beliefs about how the world should work. For example, if you treat someone nicely, they should treat you nicely. Unfortunately, the world does not always work like that. Your conscious knows this, but that’s almost irrelevant, as it’s our subconscious that controls our emotions, and so you will get still get the emotional hit despite knowing that its irrational. So, we need to change the beliefs in our subconscious, which can be achieved by doing CBT therapy

Below are some common irrational beliefs about the world that our subconscious holds:

• Unsafe
• Unfair
• Nice

Unsafe

If someone was murdered in the area you live, you may think it’s better to never go out alone, in case you are also murdered. This can lead to the irrational belief that your area is overly dangerous, and so each time you leave your home, you get stressed. If you need to leave your home on a regular basis (e.g. to go to work), this will create lots of stress for you

You can reduce or eliminate this stress if you never leave your home, but other stress will replace it, such as missed opportunities to see friends/family, or perhaps missing out on a better job because it requires you to leave your home

Unfair

If you are able to meet your basic needs, but are unable to buy the finer things in life, you may think the world is unfair. But do you actually need the finer things in life? Also, worrying about it regularly is only going to raise your stress levels

Nice

Some drivers behave in a nice way when they drive their cars. For example, if they are driving in the main road, and there is a car in the side road, a nice driver would let that car in the side road come in (to the main road). But not all drivers are nice, and it is quite possible for the driver in the side road to have to wait ages before they are let into the main road. This can cause that driver frustration and annoyance. Once again, if the brain is generating needless negative emotions, then it has less time to fix issues in the body. The individual needs to change that belief

There are many more irrational beliefs about the world, most people don’t realise they have them. That’s why it’s good to see a therapist/psychologist about this issue

A final note on irrational beliefs about how the world should work, is that they are examples of cognitive dissonance i.e. one part of our mind (subconscious) holds an irrational belief but the other part (conscious) holds the opposite belief. This also applies to irrational self-beliefs mentioned earlier.

c) Stress that is real

For the previous two examples (i.e. Irrational Self-Beliefs and Irrational Beliefs about the world) it’s not the situation that causes the anxiety/stress, it’s the individual’s belief about the situation that causes the actual anxiety/stress

But life can throw up situations where it’s not the person’s belief that is causing the issue, it’s the actual situation. For example, if you have a parent that has dementia or cancer, you are going to experience stress.

Therefore, I call this type of stress ‘real’, as the situation is a bad one, and so it is appropriate to get stressed

Below are some further examples of situations that cause real stress

1. Serious Illness
2. Financial Difficulties
3. Working Long Hours
4. Relationship Issues
5. Grief (anticipatory or actual)
6. Racism

If you experience too much stress, the brain is less able to perform its function of keeping the body running efficiently. When this occurs, the subconscious can generate OCD thoughts, to alert the conscious mind that the body is not getting what it needs

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, you cannot fix that)

So, all you can do is find ways to reduce the stress. This could include things like:

1. Mindfulness (which I have written a page on)
2. Medication (see your doctor)
3. For people who believe in religion, remind yourself of the parts that deal with difficult situations e.g. in most religions, when someone dies, its only their body that dies, their soul is still alive, and perhaps it has gone to heaven

The next two topics on this page are the impact of modern technology, and separately, neurodivergent people

I wasn't sure if I should include these topics, as they are both just variations of stress. But modern technology has permeated almost every aspect of our lives, so I feel it would be helpful if I mentioned some of the negative aspects of it

Also, increases in medical knowledge have led to the discovery that there are a lot more neurodivergent people than we originally thought. It has been estimated that up to 20% of the UK population are neurodivergent. Added to this is the fact that neurodivergent people are particularly prone to anxiety issues, so it would be remiss of me to not mention something about neurodivergent people

Modern Technology

1. Mobile Phones
2. Computers/Laptops

1. Mobile Phones

• If people are constantly on the phone, it means the brain has less time to perform its duties of keep the body running smoothly
• The constant stream of notifications and updates can create a sense of urgency and a fear of missing out, leading to increased anxiety and stress
• Social media - It can contribute to feelings of inadequacy and low self-esteem. The tendency to compare oneself with others and the desire for validation through likes and comments can lead to a distorted self-image and feelings of worthlessness
• Mobile phones can cause sleep issues, in that at night time, your body will start winding down, but if you get a message on your phone from work, then your body’s routine is disrupted

2. Computers/Laptops

Advances in computing have made working from home a lot more common these days. This presents the following problems:

• People tend to work longer hours when working from home, which causes more stress
• Possibility of the need to work harder during working hours. That is, when you are in the office, sometimes an issue you face is solved by simply overhearing a conversation that your work colleagues are having. When you work from home you don’t get that benefit
• Social Isolation - Extroverts in particular may find it difficult to work from home, as they need stimulation from other people to be happy. Even some introverts prefer to have some social contact during the week
• If an individual has to work from home on a day when the kids are also at home, it creates additional stress, as they have two conflicting demands
• Even after people have switched off their computer/laptop off at the end of the working day, there is always the risk that they can get a call from their employer asking them to log on again, which creates extra stress

Neurodivergence

Neurodivergent people have brains that work differently from the average or “neurotypical” person. The way they learn, communicate and perceive their environment differs from the average person. Examples of neurodiverse conditions are autism and ADHD

So, how does a neurodivergent condition prevent the brain from ensuring the body works efficiently? Basically, they get additional stress compared to a neurotypical person. The additional stress includes feeling overly uncomfortable in social situations, or uncomfortable in sensory environments (e.g. when there are loud noises). They also prone to suffer more self-esteem issues, because the world is not always understanding of neurodivergent people

If you want learn more about the link between the body and the mind, two prominent modern day psychoanalysts/psychodynamic analysts are Jonathan Shedler and Farhad Dalal.

I just want to add a caveat before I finish this page. This is that no one can definitively say what the cause of OCD is for any individual. But I would be very surprised if some of the issues mentioned above aren’t the reason why you got OCD in the first place

The next page is on Mindfulness - please click the below button