OCD is caused by the strategies people use when they experience intrusive thoughts and the beliefs they have that intrusive thoughts are important and harmful.
OCD is driven by metacognitions about the importance of thoughts (obsessions):
“Thinking something makes it so”
Because of the importance assigned to obsessional thoughts, OCD patients activate the CAS (the cognitive attentional syndrome) in response to them. The CAS in OCD consists of:
Rumination as a way to detect and prevent threats
Worrying about the consequences of obsessional thoughts
Monitoring for unwanted thoughts, feelings, and “threats” in the environment
Suppressing unwanted thoughts
Neutralizing thoughts
Performing rituals (compulsions) mentally and physically
MCT focuses on changing the relationship with intrusive thoughts and help patients relate to them differently so that they no longer view their intrusive thoughts as important.
Helpful posts about OCD
Thoughts never come true – Why MCT is the right treatment for OCD