It’s Just an Obsessional Doubt

Exposure therapy isn’t the only proven treatment for OCD. Inference-Based Cognitive Therapy (IBCT) helps individuals place their obsessions in the proper context. People with OCD tend to overvalue their obsessive doubts.

Consider a man with harm-related OCD who has the intrusive thought, “What if I pushed my friend down the stairs?” He ruminates: “Does this mean I want to do it? Can I trust myself? Am I dangerous?”

In IBCT, we move the spotlight from the doubt itself to the broader picture—the information he’s overlooking. He forgets that he has never been violent, that the thought horrifies him, and that he has no criminal history.

Everyone experiences the occasional strange or disturbing thought. The key difference is that people without OCD quickly dismiss these mental blips as insignificant, whereas those with OCD interpret them as meaningful and threatening.