What Is Magical Thinking OCD?

Obsessive-compulsive disorder (OCD) is a mental health condition that involves recurring intrusive and unwanted thoughts (obsessions) and repetitive actions (compulsions). They are performed in an attempt to reduce anxiety caused by the obsessions.

Magical thinking OCD is a form of OCD in which people believe their thoughts, words, or actions could have specific, irrational, real-life consequences. Magical thinking, such as with superstition or in childhood, does occur outside of OCD, but for people with OCD, magical thinking is far more disruptive.

Read on to learn about examples and treatment for magical thinking OCD.

What Is Magical Thinking OCD?

In general, magical thinking involves believing a thought or action has the ability to influence something highly unlikely or unrelated. Superstitions are an example of the broad definition of magical thinking. Stepping on a crack is almost certainly not going to break your mother's back, but still, many people watch where they walk.

Magical thinking OCD is not a clinical diagnosis, but rather a way in which OCD can manifest. It involves faulty thought processes, but to a higher degree than is typical for most people. People with magical thinking OCD experience these intrusive thoughts and the accompanying compulsions in a way that is consuming and disrupts multiple areas of their lives.

People with magical thinking OCD often feel responsible for the well-being of others and worry that their thoughts or actions could cause harm, even if they are unrelated. For example, they may repeat a phrase a certain amount of times to "prevent" a loved one coming into harm, either specifically (like a car accident) or in general. They may realize rationally that they do not have the power to make this happen, but not performing the task will cause anxiety (even severe anxiety).

Superstitions vs. OCD

Even the most superstitious people tend to limit their magical thinking to specific things. Walking under a ladder might cause them distress in the moment, or wearing a lucky shirt when their favorite sports team is playing might make them feel more likely to win, but outside of these situations, the thoughts are not present.

However, people with magical thinking OCD have intrusive thoughts and compulsions that interfere with their everyday lives. The anxiety and fear that comes with magical thinking OCD are usually farther-reaching and more intense than with typical superstitions.

Overlap With Other OCD Subtypes

While magical thinking OCD is its own subtype with distinct characteristics, magical thinking as a concept can occur in other forms of OCD.

For example, someone with contamination OCD may believe they have a communicable disease because they thought about it. A person with relationship OCD may believe their partner is cheating because they imagined them with someone else.

Examples of Magical Thinking

The obsessions and compulsions that characterize magical thinking OCD can be anything, but there are some that are more common.

Common Obsessions

Most obsessions in magical thinking OCD involve anxiety over harm coming to themselves or other people. This harm might be specific, such as failing a test if certain rituals aren't performed, or it may be broader, like a general feeling that something terrible will happen.

Common Compulsions

Compulsions in magical thinking OCD often fall into one (or more) patterns. They include:

• Avoiding certain "bad" numbers, colors, words, etc.
• Repeating "good" words, numbers, or phrases
• Repeating actions (such as turning on a light switch) repeatedly until it feels "right"
• Counting to or beyond specific numbers or performing actions around those numbers (such as eating three slices of apple intentionally, regardless of hunger level)
• Wearing certain clothes or colors
• Repetitive hand movements
• Touching things a certain number of times or in a specific way
• Neutralizing bad thoughts with good thoughts, such as saying "life" if they have said the word "death"
• Arranging objects in a specific way, such as lined up in a row or at right angles
• Moving their body or gesturing in a certain way
• Doing specific things at a certain time or date
• Performing "rituals" where certain actions are repeated
  

Treatment for Magical Thinking OCD

Typical treatment for magical thinking OCD involves behavioral therapy and/or medication. Often both are used together to enhance the effectiveness of both treatments.

Behavioral Therapy

Exposure and response prevention (ERP) is a form of cognitive behavioral therapy that can be used to treat OCD. It is usually performed in an outpatient setting by a mental health professional, such as a psychologist. ERP is often done through individual appointments, but group settings and videoconferencing (teletherapy) may also be options.

In ERP, the person is gradually exposed to their fears, with increasing intensity over time. For a person with magical thinking OCD, this may involve exposure to the intrusive thoughts but resisting the compulsions that the person would typically do to alleviate their anxiety.

Over time, as the person sees that nothing bad happens when they don't perform the compulsion, and their anxiety does decrease even without the compulsive response, they see a reduction in magical thinking.

This type of exposure is only performed with consent and is never sprung on the person unexpectedly.

Medication

Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), can help with symptom relief. These may include:

• Anafranil (clomipramine hydrochloride)
• Prozac (fluoxetine)
• Zoloft (sertraline)
• Luvox (fluvoxamine)
• Paxil (paroxetine)
• Celexa (citalopram)

Higher doses of SSRIs may be needed to treat OCD than are used in treatment for depression. It can take two to three weeks for the medication to start being effective and eight to 12 weeks to see the full effect.

Medication may not be effective enough on its own for everyone, but it can provide symptom relief while behavioral therapy takes place.

Summary

Almost everyone experiences magical thinking from time to time, like in the form of superstitions, without it being disruptive. However, people with magical thinking OCD experience intrusive—and usually more severe—unwanted thoughts. These obsessions, and the compulsions that come with them, interfere with their functioning. For example, they may feel harm will come to themselves or others unless they act on a certain compulsion.

Magical thinking OCD is typically treated with behavioral therapy and/or medication, such as antidepressants.

A Word From Verywell 

If you are experiencing magical thinking symptoms that go beyond benign superstitions, talk to your healthcare provider or mental health professional about magical thinking OCD. OCD can be very disruptive, but effective treatments are available to help.