Understanding OCD With Taboo and Repugnant Thoughts
TL; DR
Taboo and repugnant thoughts are a recognized theme of OCD, and having them says nothing about a person's character. Most people experience intrusive thoughts. What sets OCD apart is the spiral of meaning-making, shame, and desperate attempts to push the thoughts away that follows. Ironically, thought suppression makes things worse, not better. The more you try to force a thought out, the louder it gets. The path forward isn't fighting the thoughts or analyzing them, but learning to let them exist without engaging with them, and gradually stripping them of their power. ERP remains the gold standard treatment, and sharing these thoughts with a knowledgeable therapist in OCD therapy is often the first step toward breaking the cycle.
When the Thought Itself Is the Trigger
Obsessive-compulsive disorder (OCD) involves two main parts: unwanted, intrusive thoughts that are difficult to control and cause anxiety or distress (obsessions); and repetitive or ritualistic behaviors or mental acts whose purpose is to decrease anxiety caused by the obsessions or to prevent a feared outcome (compulsions). Some people with OCD, they experience triggers in the environment that bring up intrusive thoughts. For others, like people with the unacceptable/repugnant thoughts theme of OCD, the thoughts themselves truly are the trigger.
What Do the Thoughts Mean?
In the taboo, unacceptable, or repugnant thoughts theme of OCD, unwanted and distressing thoughts or images come into the mind unbidden. Not only are the thoughts themselves by their nature distressing, but people with OCD also tend to become fearful about the meaning of these thoughts. The fact is, most people experience intrusive thoughts of some kind (Radomsky et al., 2013).
However, when people who do not have OCD experience intrusive thoughts, their next thoughts are:
Huh, that was weird
Moving on!
Ok… [directs their attention back to what they are doing]
When people with OCD have an intrusive thought, they invariably think next:
911, emergency! Call the cops, I should be locked up! Straight to jail!
Ok, maybe I’m attempting some humor here… But truly, that is what it sounds like to most people when folks with OCD try to explain how terrible they are for having their intrusive thoughts. Don’t get me wrong, plenty of people do NOT understand OCD and might think that those thoughts are meaningful. But for those of us who know what it means to have intrusive thoughts and what OCD is, the OCD reactions to those thoughts are way out of proportion.
Some ways people with OCD might actually interpret their intrusive thoughts are:
Why did I have that thought? Does it mean something about me? Why would I think that if I wasn’t [fill in the blank with awful thing]?
That was so disturbing. tries to push the thought away. Why won’t it go away? Tries to push it away harder, and the thought only becomes stronger and more specific. Noooooooo
Did I like having that thought? I don’t know where it came from, but I felt something. What if I secretly like it? Who am I?
The Uncertainty Factor
Thoughts are just thoughts. The hard truth is, sometimes thoughts mean something, and sometimes they don’t. Even now, I imagine someone with OCD is reading this and trying to figure out whether their thought was really an intrusive thought or not. One of the biggest questions I get from clients is, “How do I tell if a thought is intrusive or not?” The thing is, there’s no objective measure of this.
An OCD expert can usually assess and tell if an individual has OCD and is experiencing intrusive thoughts, but even that has some amount of uncertainty in it. OCD gets folks desperate to find a definitive answer, but there will always be another what-if question right around the corner. There is no blood test for OCD, so I accept the same risk that my clients at Leap Counseling accept regarding the diagnosis I have provided. I am simply much more willing to accept that level of risk. I accept a much higher level of risk just driving to the grocery store. So do you.
Normalizing Taboo and Repugnant Thoughts
Taboo and repugnant thoughts are difficult because they are so difficult to share with others and can feel alienating. In an effort to normalize the “weirdness” of these thoughts, I have listed several of these thoughts below. I have either personally experienced these or heard about them from someone else:
Graphic images of sexual acts with a child
Spider crawling into one’s… orifices
Sexual thoughts about one’s mom
Thoughts of incest while having sex with a partner
Images of stabbing oneself with a knife in the abdomen
Blasphemous thoughts of having sexual relations with Jesus
Thoughts of jabbing another person’s eyes out
These are just a few examples. And the thoughts or images can get very specific and grotesque. These are not thoughts most people would want to experience.
Taking the Power Away From Taboo Thoughts
Many people with this OCD theme would never dream of sharing their thoughts with someone else, even with a therapist. The very thought of doing so can be terrifying. It can feel like OCD has a gun to the person’s head, threatening that it will all be over for them if they tell another soul. The fear may be coming from a feeling that they are guilty of a terrible crime or are dangerous to others. They are afraid that everyone will reject them and think they are a terrible person for having these thoughts. Or they may be afraid that sharing the thoughts will make them more likely to ‘come true.’
Keeping these thoughts a secret feeds the OCD cycle. It communicates to oneself that the thought IS important - otherwise, it wouldn’t need to be such a big secret. Sharing the thought with someone who understands the person or understands OCD can take the power away from the thought.
As long as the thought is hidden away as a huge secret, it will keep its power over you.
Note that not everyone understands OCD, so it is important to choose someone who is familiar with OCD, like an OCD therapist. Otherwise, their reaction may end up reinforcing the fear. It is best to do this in the context of therapy for OCD.
Why Doesn’t Thought Suppression Work?
The reaction to these repugnant thoughts is then to push them away (especially if you have OCD) or suppress them. Unfortunately, we know that thought suppression does not work for OCD (Williams et al. 2022). We cannot control what thoughts pop into our heads. We can only control what we do with them once they are there. When we try to control them, it ends up making things worse.
Try this activity:
For about 3 minutes, tally how many times you think of a pink elephant (without intentionally trying to think about it, but also without trying to suppress or control the thought).
Now, for 3 minutes, try NOT to think of a pink elephant. Tally every time you do think of a pink elephant.
On average, most people will think about the pink elephant more when they actively try NOT to think about it. This is referred to as the paradox of thought control. When we intentionally try NOT to think about something, we will often think about it more. To heal from this theme of OCD, it is necessary to stop trying to push away the thoughts. Recent research has shown that, initially, this may increase the occurrence of the intrusive thought, but it will allow your mind to realize that the thought is no longer important, and the frequency starts to decrease (as long as other compulsions don’t take the place of thought suppression; Swisher & Newman, 2026).
Letting The Thoughts Be There
If we are not supposed to push the thoughts away, then what do we do instead? The short answer is, do nothing. Allow the thoughts to be there without interacting with them. Don’t push them away, but don’t pull them in to examine them either. It’s a skill, and it’s not easy, but it gets easier the more it is practiced.
There are different strategies out there that can help with this. One is to practice mindfulness of current thoughts. For example, the Leaves on a Stream exercise is a meditation meant to practice observing one’s thoughts without doing anything with them. It’s a great way to practice just noticing thoughts, but we can’t be meditating all the time. Other strategies include nonengagement responses. Whenever someone has a distressing thought, it can be helpful to only respond with:
Thanks, mind!
Maybe that thought means something, maybe not
That thought makes me feel anxious
These strategies help to notice the thought and then move forward with the thought. It’s important to allow the thought to continue to be there or dissipate on its own. It’s like keeping a trinket with you, carrying it along as you go about your day.
Ultimately, this is about retraining your mind to stop seeing these thoughts as important and to challenge your fears. Exposure and response prevention is the gold standard treatment for OCD, including OCD with taboo and repugnant thoughts. It’s a huge leap of faith, but it’s the first step to taking back your life from OCD.
You Are Not Your Thoughts, And Online OCD Therapy in Wauwatosa Can Help You Believe That
If taboo or repugnant thoughts have left you feeling ashamed, isolated, and afraid of your own mind, you are not alone, and you are not a bad person. OCD therapy can help you stop giving those thoughts the power they don't deserve, so you can start living without the weight of shame and secrecy holding you back.
Leap Counseling and Consultation is a Wisconsin-based solo therapy practice led by Dr. Johanna Wood, who specializes in OCD and anxiety disorders, including the taboo and repugnant thoughts theme of OCD. Dr. Wood provides a judgment-free space where clients can finally say the unsayable and receive personalized, evidence-based treatment that helps them strip intrusive thoughts of their power and reclaim their lives. Taking that first step is simpler than OCD wants you to believe:
Reach out to schedule a free 15-minute consultation
Work one-on-one with an experienced OCD therapist in Wauwatosa who understands taboo and repugnant OCD
Begin learning to let thoughts exist without meaning, and stop letting shame run the show
Other Services Dr. Wood Provides Online in Wauwatosa, WI, & All PSYPACT States
Carrying taboo and repugnant thoughts in secret is exhausting, but OCD therapy can finally give you a place to set that weight down. With the right support, many people find that once they stop fighting their intrusive thoughts and start relating to them differently, the shame lifts, the thoughts lose their grip, and life starts to feel livable again.
Taboo and repugnant OCD is one of many themes and conditions I work with at my Wisconsin-based online therapy practice. If there are other concerns you've been carrying alongside your OCD, whether related to anxiety or something else entirely, those are worth addressing too, and there's room for that in treatment. Beyond OCD, I provide therapy for a range of anxiety disorders, including Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Social Anxiety Disorder, and Phobias.
As a licensed psychologist in Wisconsin and all PSYPACT states, I'm able to work with clients online across many locations. You don't have to keep living in fear of your own mind. Browse my mental health blog to learn more about taboo OCD and anxiety treatment, and reach out whenever you feel ready to take that first step.
About the Author
Dr. Johanna Wood is one of the few OCD therapists who can sit with a client's most unspeakable thoughts and respond not with alarm, but with genuine understanding. Having personally experienced intrusive thoughts and the anxiety spiral of relationship OCD, she knows firsthand what it's like to have a thought that feels too disturbing, too shameful, or too frightening to say out loud. Her own ERP treatment taught her that the only way to take power away from those thoughts is to stop hiding from them: a "leap of faith" she now helps her clients take in a space that is completely free of judgment.
That lived experience sits alongside an extensive clinical background. Dr. Wood is a Wisconsin-based clinical psychologist specializing in evidence-based OCD treatment, including ERP. She earned her PhD in Clinical Psychology from Northern Illinois University and completed her doctoral internship at Rogers Behavioral Health in the OCD and Anxiety Adult Residential Program, one of the most intensive OCD treatment settings in the country, where she later supervised clinical staff.
Dr. Wood is licensed in Wisconsin, holds PSYPACT authorization, and is an active member of the International OCD Foundation, contributing to national education efforts on scrupulosity OCD. Her practice is built on the belief that no thought is too taboo to bring into the therapy room, and that bringing it there is often where healing begins.
