“But I Didn’t Even Do Anything!” — Understanding the Sneaky World of Mental Compulsions in OCD

If you've ever heard someone with OCD say, “But I didn’t even do anything, I just thought about it,” you may have witnessed the bewildering reality of mental compulsions, the stealthiest players in the OCD universe.

While traditional OCD tends to get all the press with its handwashing and light-switch flipping, mental compulsions are more like the stealthy ninja of the disorder. They don’t leave soap scum in the sink or slow anyone down leaving the house to triple check the stove is off; instead, they take up space in your brain, quietly, persistently, and exhaustingly.

What Are Mental Compulsions?

To understand mental compulsions, let’s start with an overview of OCD. In Obsessive-Compulsive Disorder, the "O" stands for obsessions: unwanted, intrusive thoughts, images, or urges. The "C" stands for compulsions: things the person does to try to reduce or get rid of the anxiety/dread/icky feelings that comes from those obsessions.

Compulsions are often physical and visible (checking, washing, tapping, retracing steps). But for many people, they happen entirely in the mind. And because they’re invisible, they can be hard to recognize, even for the person experiencing them.

The key difference is this: obsessions are intrusive and unchosen. Mental compulsions, while also thoughts, are intentional responses to try to feel better, safer, or more certain.

Some examples of mental compulsions include:

• Silently repeating a phrase or prayer in your head to “neutralize” a thought

• Replaying conversations to check if you did or said something “wrong”

• Mentally reviewing past events for proof that you’re not a bad person

• Visualizing something “safe” to undo a scary thought

• Reassuring yourself with thoughts like, “I would never act on that!”

  
  

Why They're So Tricky

As Lauren Rosen, LMFT, and Kelly Franke, LMFT, explain in their podcast Purely OCD, mental compulsions are particularly sneaky because they masquerade as problem-solving. But spoiler alert: they're not solving anything.

“Mental compulsions often disguise themselves as genuine attempts to get clarity,” says Rosen. “They feel like they’re helping...until you realize you’ve spent two hours internally debating whether you’re a sociopath because you had one weird intrusive thought.”

Mental compulsions give you momentary relief because it feels like you’ve found, or could find, "the answer" to the question "what if," only to have that answer give rise to yet another "what if," starting the cycle all over again.

Because mental compulsions aren’t visible, sufferers often don’t even realize they’re performing them. Franke adds, “People can go years treating the obsession and not realizing they’ve been feeding the cycle with mental rituals all along.”

It's like trying to quit sugar, but you don’t realize your “healthy” protein bar has 26 grams of it. It’s still a candy bar.

“Pure O” Isn’t Purely Obsessional

Many people use the term “Pure O” (short for “Purely Obsessional OCD”) to describe their experience with mental compulsions. But as the hosts of Purely OCD regularly emphasize, “Pure O” is a bit of a misnomer. While it highlights the internal nature of the distress, it falsely implies there are no compulsions involved.

“There’s no such thing as OCD without compulsions,” Franke clarifies. “It’s just that sometimes the compulsions are all mental—and we need to treat them the same way we treat visible compulsions: with exposure and response prevention.”

So…What Can You Do About It?

The most effective treatment for OCD, whether your compulsions are mental, physical, or both, is Exposure and Response Prevention (ERP). That means gradually confronting your obsessions (exposure), and not performing the compulsion (response prevention). Often, treatment will begin with delaying or reducing a compulsion.

In this case, that might mean not mentally checking, reviewing, or reassuring yourself. No more internal debates or moral courtroom sessions that hijack your lunch break. It’s not easy, and it takes practice. But it’s possible.

Mindfulness-based approaches and ACT (Acceptance and Commitment Therapy) can also be incredibly helpful, particularly in learning how to observe thoughts without buying into them or compulsively pushing them away (check out our blog on using cognitive diffusion).

As Kelly Franke often reminds listeners, “Thoughts are not facts. Thoughts are not threats. And thoughts don’t require answers.”

Final Thought (Not to Be Neutralized)

If you're struggling with mental compulsions, you're not alone and you're not doomed. Just because they’re invisible doesn’t mean they’re invincible. With good treatment, the right support, and maybe a few reminders that you don’t need certainty to move forward, you can learn to live with uncertainty, resist the pull of the mental rituals, and reclaim your mental real estate.

Frankly, your brain has better things to do than debate whether you're a secret monster every time you see a kitchen knife.

Resources:

• Purely OCD Podcast by Lauren Rosen, LMFT, and Kelly Franke, LMFT

• Freedom from Obsessive Compulsive Disorder by Jonathan Grayson, PhD

• Getting Over OCD: A 10-Step Workbook for Taking Back Your Life by Jonathan Abramowitz, PhD

• International OCD Foundation