Our thoughts shape how we experience the world, but sometimes they can trick us into seeing things in a way that feels distorted or overwhelming. This might feel like there’s a “filter” over your thoughts, which is what’s known as a cognitive distortion.
Cognitive distortions are patterns of thinking that can skew how you perceive situations, often making things feel more intense or negative than they really are. Everyone experiences these distortions occasionally— it’s like your brain creates a lens that shifts how you perceive the world around you. For people with obsessive-compulsive disorder (OCD), however, this lens can feel magnified, like it’s stuck in overdrive, turning small worries into overwhelming ones. Cognitive distortions can intensify OCD symptoms, making them even more disruptive to daily life.
The first step towards managing cognitive distortions is truly understanding them. When you can spot them for what they are, you can start to change how much power they have over you. It’s not easy, but it’s absolutely possible—and with the right tools, you can lighten your mental load.
What are cognitive distortions?
Dr. Patrick McGrath, Chief Clinical Officer at NOCD, describes cognitive distortions as “lenses that influence how we perceive the world.” He explains that these distortions don’t necessarily “cause” you to see reality inaccurately, but can filter your perspective, focusing your attention on certain aspects of an experience while ignoring others—like only seeing the negatives in a situation. With time and effort, Dr. McGrath explains, these lenses can be lifted or identified, allowing you to better manage their impact and see your thoughts more clearly.
Common cognitive distortions in OCD
If you have OCD, you know it’s a disorder that thrives on uncertainty. It focuses on intrusive thoughts, images, feelings, or urges that show up as obsessions, pushing you to do anything to escape the distress they bring. The brain’s quick fix? Compulsions—repetitive actions meant to relieve discomfort. While they might help briefly, compulsions don’t address the root problem and keep you stuck in OCD’s cycle.
Cognitive distortions play a big role in this process by making it easier for OCD to latch onto distressing thoughts. Dr. McGrath explains, “OCD thrives on anything that creates doubt or uncertainty, and cognitive distortions are all about viewing things in a way that feels ‘not right.’”
These distorted patterns of thinking fuel obsessions and amplify doubt and anxiety. To better understand how this works, let’s take a look at some of the most common cognitive distortions in OCD, as highlighted by Dr. McGrath.
Intolerance of uncertainty
Intolerance of uncertainty is the inability to cope with doubt or ambiguity. It often shows up as a desperate need to know or be certain about things that are inherently unknowable.
Example: Someone with OCD might obsess about whether they’ll achieve a specific afterlife outcome, feeling a deep need for absolute certainty. As Dr. Patrick McGrath explains, “OCD is the doubting disorder—it says there should be no doubt about anything.”
OCD is the doubting disorder—it says there should be no doubt about anything.
Dr. Patrick McGrath
Overestimation of threat
Overestimation of threat involves exaggerating the likelihood or severity of potential dangers, often imagining worst-case scenarios.
Example: Dr. McGrath highlights, “OCD takes a small possibility and inflates it into a massive certainty.” In the case of this cognitive distortion, a person might hit a pothole and spiral into a belief that they’ve injured someone, imagining catastrophic outcomes like being arrested or ruining their family’s future.
Overestimation of responsibility
Overestimation of responsibility is the belief that one’s actions—or inactions—have far-reaching consequences, even when this is unlikely.
Example: A person might think, “If I don’t perform this ritual, someone will die, and it will be my fault.” Dr. McGrath describes this as seeing oneself as a sort of “butterfly effect” for everything bad in the world.
Thought-action fusion
Thought-action fusion is the belief that thinking about something is as bad as doing it, or that having a thought means you want it to happen.
Example: In this case, someone with OCD might think, “If I imagine harming someone, it means I want to hurt them, and I’m a bad person.” Dr. McGrath explains, “Thinking something doesn’t make it true, but OCD convinces you it does.”
Thinking something doesn’t make it true, but OCD convinces you it does.
Dr. Patrick McGrath
Need to control thoughts
This distortion is the belief that controlling or suppressing intrusive thoughts will prevent bad outcomes.
Example: A person might try to stop thinking “bad” thoughts, believing that failure to control them could lead to disaster. As Dr. McGrath says, “The more you try to control your thoughts, the harder they are to manage.”
The more you try to control your thoughts, the harder they are to manage.
Dr. Patrick McGrath
Intolerance of unwanted emotions
This involves an inability to tolerate feelings like anxiety, guilt, shame, or discomfort, leading to avoidance or compulsions to suppress them.
Example: A person might avoid situations that could possibly trigger guilt, believing they can’t handle the emotion. Dr. McGrath emphasizes that this distortion can focus on many different feelings. “It’s intolerance of any unwanted emotion,” he says.
The just-right error
This distortion is the belief that things must feel “just right” to be acceptable; anything less is a failure. What is defined as ‘just right’ is different for each individual.
Example: Someone with this distortion might feel the need to adjust an object repeatedly until it feels perfect. Dr. McGrath notes that this distortion isn’t always all encompassing. “It’s okay to not be perfect in some areas, but it convinces you that one specific thing must be flawless.”
Emotional reasoning
Emotional reasoning is the belief that feelings reflect reality, such as thinking something is true just because you feel it.
Example: A person might believe they’ve ruined a party simply because they feel anxious. Dr. McGrath explains they’re thinking through the lens of, “If I feel it, it must be true.”
“The shoulds”
This distortion involves rigid expectations about how things should be, leading to frustration or self-criticism when they’re not met.
Example: Someone with this distortion might believe, “I should always succeed perfectly, or I’m a failure.” Dr. McGrath calls this “the tyranny of ‘the shoulds,’” because a person might receive an A on their test, but since they didn’t get a perfect score they view the grade as a failure and think of themselves as stupid.
Specialness
Specialness is the belief that rules apply differently and exclusively to oneself, leading to heightened self-judgment.
Example: In this case, a person might think, “It’s okay for others to make mistakes, but if I do, it’s unforgivable.” Dr. McGrath notes that with specialness, “It’s the idea that everyone else is fine, but you’re the exception in a negative way.”
Each of these cognitive distortions can occur on their own, or in combinations. Cognitive distortions can occur in a number of mental health conditions, not just OCD. However, if you have been diagnosed with OCD—or you believe you may have OCD—a mental health professional can help you determine which cognitive distortions are affecting you and how to get the help you need.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Seeking help for cognitive distortions
The best way to address cognitive distortions depends on how they show up in your life. For some people, these patterns of thinking exist without being tied to a larger mental health condition. In these cases, working with a therapist is still incredibly helpful. They can guide you through a technique called cognitive restructuring, which focuses on identifying negative thoughts as they arise and reframing them in a way that’s more balanced and realistic. At its core, cognitive restructuring is built on the idea that changing how you interpret a situation can also change how you feel and respond to it.
Exposure and response prevention therapy
If your cognitive distortions feel heightened by OCD or anxiety, therapy may also include exposure and response prevention (ERP), a clinically-proven approach to managing OCD. ERP focuses on helping you face discomfort head-on—a key part of overcoming cognitive distortions. Through this process, your therapist will gradually help you confront your specific triggers in a controlled, step-by-step way, teaching you to sit with the discomfort rather than using compulsions for temporary relief. “To me, ERP really shows people that you can handle whatever your distortion is and that you don’t have to believe it to be true,” explains Dr. McGrath.
Take the cognitive distortion of intolerance of uncertainty as an example. A person might feel they must check the lock on their front door repeatedly to be absolutely certain it’s secure, fearing catastrophic consequences if they don’t. With ERP, a therapist might guide the individual to lock the door once, resist the urge to check it again, and sit with the discomfort of not being 100% certain. Over time, this helps them build tolerance for uncertainty and reduces the compulsion to check. For cognitive distortions, ERP is about feeling okay with the feeling of not knowing something for certain. “It’s learning to live in those situations and live with the uncertainty,” shares Dr. McGrath.
By combining cognitive restructuring with ERP, therapy empowers you to step back from distorted thinking patterns and approach your thoughts with greater clarity and resilience. Over time, you can learn to respond to these patterns in ways that feel less distressing and more freeing.
Bottom line
Living with OCD can make cognitive distortions feel overwhelming, but they don’t have to control your life. These patterns of thinking may add to the uncertainty and discomfort OCD brings, but they’re also something you can work on and manage. The fact that you’re learning about them is already a big step in the right direction.
With the right tools, like ERP and cognitive restructuring, you can start to see your thoughts for what they are—just thoughts. As Dr. McGrath puts it, “You don’t have to believe every distortion to be true—you’re stronger than they make you feel.” It takes time and effort, but little by little, you can learn to handle these thoughts with more ease, feel more in control, and take steps toward living a freer, more peaceful life.
Key takeaways
- Cognitive distortions are normal: Everyone experiences them, but in OCD, they often feel magnified and harder to manage.
- Distortions act as mental “lenses”: They skew how you see things, amplifying doubt and discomfort. OCD thrives on distortions—these thinking patterns fuel obsessions and compulsions, keeping the OCD cycle going.
- Common distortions in OCD include: Intolerance of uncertainty, overestimation of threat, thought-action fusion and “the shoulds.”
- Help is available: With the right tools and support, you can work through cognitive distortions and gain clarity and confidence.Techniques like exposure and response prevention therapy and cognitive restructuring help reframe these thoughts and reduce their impact.