What is meta OCD? (aka ocd about your ocd)
Meta OCD: Understanding OCD About Your OCD
What is OCD?
Let’s first discuss what the OCD cycle looks like. OCD has two main components: obsessions and compulsions. Obsessions are unwanted, distressing thoughts, images, urges, sensations, or commands that pop into your mind (unfortunately, you don’t have control over them). These thoughts cause discomfort (anxiety, guilt, shame, etc.), and in an effort to ease that discomfort, someone engages in a compulsion, which is a mental or physical behavior. While compulsions provide short-term relief, they only reinforce the obsessions and keep someone stuck in the OCD cycle.
The OCD cycle:
Obsession → Anxiety → Compulsion → Temporary Relief → Stronger Obsession
What is Meta OCD?
Meta OCD is a common OCD subtype within the umbrella of obsessive-compulsive disorder. A subtype is a specific theme that someone’s OCD becomes focused on, often involving obsessions and intrusive thoughts around one particular topic. One lesser-known subtype is Meta OCD.
Meta OCD consists of obsessive or intrusive thoughts about OCD itself, especially questions about the diagnosis, treatment, or whether the experience “really” is OCD. In simple terms, Meta OCD feels like having OCD about your OCD.
Meta OCD Symptoms & Intrusive Thoughts
People struggling with Meta OCD may experience persistent doubts, worries, fears, or intrusive thoughts such as:
“What if I don’t actually have OCD?”
“How do I know if it’s actually OCD?”
“What if I’m lying about or faking my symptoms?”
“Am I doing treatment correctly?”
“What if my intrusive thoughts aren’t upsetting me enough?”
“What if my OCD gets worse?”
Like all OCD subtypes, the exact content and intensity of these obsessions can vary from person to person. OCD is extremely creative—if you can imagine it, OCD can latch onto it.
Meta OCD Compulsions & Behaviors
Compulsions in Meta OCD may include:
Seeking reassurance from a therapist, loved ones, or online that your experience is “normal” or truly OCD
Ruminating, or thinking about your diagnosis and symptoms repeatedly to try and figure out an answer
Mentally reviewing symptoms to “prove” it’s OCD
Googling or researching OCD subtypes and symptoms repeatedly
Checking body sensations or emotional reactions to intrusive thoughts to ensure you feel distressed “enough”
Trying to block, neutralize, or “fix” thoughts
As with obsessions, compulsions vary depending on a person’s unique OCD cycle. While they may feel helpful in the moment, they only provide short-term relief and actually fuel the obsessive thoughts, keeping you stuck in the OCD cycle.
Why Meta OCD Feels So Convincing
OCD is tricky and manipulative. Because Meta OCD latches onto your mental health, the urge to “figure it out” can feel urgent and convincing. OCD craves certainty, but we live in a world where certainty doesn’t exist. Even after receiving a formal OCD diagnosis from a trained professional, that may not be enough certainty for your OCD.
Treatment for Meta OCD (ERP, CBT, and ACT)
The gold standard treatment for OCD is Exposure and Response Prevention (ERP) and, in some cases, medication. ERP therapy involves gradually exposing someone to things that trigger their obsessive thoughts or avoidance behaviors, while resisting the urge to perform compulsions. ERP works best under the guidance of a trained professional who understands the nuances of OCD.
Other helpful approaches include:
Acceptance and Commitment Therapy (ACT)
Cognitive Behavioral Therapy (CBT)
Inference-Based Cognitive Therapy (IBCT)
An important part of treatment (including treatment for Meta OCD) is learning to accept uncertainty. For Meta OCD, this may mean finding acceptance of uncertainty around:
Your diagnosis
Whether treatment is being done “correctly”
How distressed you feel by your thoughts
What your thoughts or feelings truly mean
Treatment for Meta OCD may involve allowing thoughts like, “What if this isn’t OCD?” or “What if I’m doing treatment wrong?” to exist without analyzing, checking, or seeking reassurance.
You Are Not Alone
If you are struggling with Meta OCD, know that you are not alone. One of the most common questions I get when diagnosing someone with OCD is, “Are you sure it’s OCD?” While I understand the desire for certainty, I don’t have the 100% certainty that OCD demands.
Here’s what I can say: doubting the doubting disorder is very on brand for OCD.
If this blog post resonates with you, working with a therapist who specializes in OCD treatment and ERP therapy can be an important next step. If you are located in California or Michigan and need a therapist specializing in OCD or high anxiety, you can complete an inquiry form to complete a free 15-minute consult call with one of our therapists.
