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 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 think 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 who know 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 this: 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 a single 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.
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