OCD, Magical Thinking, and Thought / Action Fusion

Dr Burns,

Have you ever come across a form of anxiety where people think they have done something just because they had the thought of doing it? For example, I had a friend working in an analytical laboratory, and he was testing tablets which had to be tested in a certain order. He was worried about mixing up two of them and therefore believed he had done this. As a result, he had to get new tablets from the batch and repeat the test causing a great deal of anxiety.

What is the distortion here?



Thank you Shane,

The name of the distortion is Emotional Reasoning, as in “I am so incredibly anxious right now that the danger must be real!” In other words, you reason from your emotions, thinking they reflect reality. Anxious individuals nearly always assume that their anxiety means that the danger is real.

Depressed individuals also do this. They think, “I feel hopeless, so I must BE hopeless.” Or, “I feel like a loser, so I must really be worthless.”

Emotional Reasoning is misleading because our emotions result from our thoughts—and not from what is actually happening. And if your thoughts are distorted, your feelings will not reflect reality any better than the curved mirrors in amusement parks that make your image look weird.

Other distortions in this case include Fortune Telling—telling yourself something awful is about to happen when there is no evidence. All anxiety results from this distortion. For example, if you have a fear of flying, you are probably telling yourself that if you get on a plane, there’s a good chance it will run into turbulence and crash.

The problem you described in your friend is common in individuals struggling with Obsessive Compulsive disorder (OCD)—the obsession is the thought that something awful is about to happen, and the compulsion is the ritual or habit you engage in to try to undo the danger. A common example is people who drop a letter in the mail box, and then they check over and over to make sure the letter has actually dropped into the mail box.

This belief something awful might happen just because you are thinking about it is also called Thought / Action Fusion by some experts. In other words, you believe that just because you are thinking something, it will happen. This explains the resistance that many anxious individuals have to using Exposure, which is crucial to effect treatment. They think if they allow themselves to think of something awful, and become anxious, something awful will happen. This is, of course, superstitious nonsense, but humans, for some reason, have a strong urge to be superstitious and to believe in things that cannot possibly be true!

You can also think of this Magical Thinking—you believe that if you are thinking about some awful outcome, and feeling extremely worried, then the thing you fear might really happen. Magical Thinking is very common in all forms of anxiety. For example, you may tell yourself that if you worry enough about an upcoming test, you’ll work hard and get a good grade. You may also tell yourself that if you were cured of your performance anxiety, then your performance in school would deteriorate. That is another one of the biggest reasons that anxious individuals so often resist treatment. On the one hand, they are suffering, but at the same time, they are convinced that the anxiety is protecting them from something awful.

Hope this helps!



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