OCD is a complex illness with many causes, including biological, psychological and social factors. A psychological process that may help cause and maintain OCD symptoms is thought-action fusion. Let’s explore the relationship between thought-action fusion and OCD symptoms.
What Is Thought-Action Fusion?
Thought-action fusion is when you believe that simply thinking about an action is equivalent to actually carrying out that action. For example, if a disturbing thought, like harming a loved one, pops into your mind, you might believe it’s as bad as the action itself.
Thought-action fusion can also lead people to believe that thinking about an unwanted event makes it more likely that the event will happen. For instance, you might think that by imagining a loved one dying in a car crash, it somehow increases the chances that this will actually happen.
Symptoms
The extent to which someone with OCD experiences thought-action fusion can predict the severity of their symptoms. Some experts suggest that thought-action fusion might contribute to OCD symptoms. This process may be linked to another psychological process called thought suppression.
Although almost everyone experiences strange or shocking thoughts occasionally, if you have OCD, you might try to suppress these “dangerous” thoughts. Unfortunately, this often makes them return even stronger, creating a cycle of thought suppression and distressing thoughts.
Thought-action fusion might encourage thought suppression by making you believe your thoughts are “dangerous.” For instance, if you think that having a thought about harming someone is the same as doing it, this can understandably feel threatening.
In this way, thought-action fusion and thought suppression may work hand-in-hand to create distressing obsessions. And in turn, such obsessions can lead to debilitating compulsions, which are used as an attempt to neutralize or undo the feared outcome or thought.
Treatment
Addressing thought-action fusion is an important part of many cognitive-behavioral treatments for OCD. Although the imagined link between thoughts and actions is almost always illogical, if you have OCD it can sometimes be difficult to have insight into the irrationality of these thoughts. Therapy often involves challenging this perceived connection through experimentation or observation.
For example, if you are afraid that thinking about a bomb going off in your workplace makes it more likely that this will happen, you could intentionally think about this and then see if this feared outcome comes true or not. Although initially distressing, these types of experiments can help challenge beliefs about the link between thoughts and actions as well as make thought suppression less likely; indeed, if your thoughts are not actually dangerous, why push them away?
Behaviorally-oriented therapies such as acceptance and commitment therapy (ACT) also work to build flexibility in thinking rather than trying to eliminate distressing thoughts like obsessions using a variety of mindfulness techniques, metaphors, and life enhancement exercises. ACT teaches clients to be less invested in their thoughts, which helps to avoid the tendency to label thoughts as dangerous.
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Berle, D., & Starcevic, V. “Thought-action Fusion: Review of the Literature and Future Directions”. Clinical Psychology Review 2005 25: 263-284.
Einstein, D.A., & Menzies, R.G. “The Presence of Magical Thinking in Obsessive Compulsive Disorder”. Behaviour Research and Therapy 2004 42: 539-549.
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