What is Meta OCD? And, Do I Have It?

When you suffer from obsessive-compulsive disorder (OCD), it can feel impossible to get the intrusive, non-stop thoughts, urges, and mental images out of your mind. It is like there is a runaway train going full speed through your brain – with no “stops” in sight. These intrusive thoughts are obsessions – which often require rituals or routines to stop them. The rituals or routines are called compulsions.

For some, these thoughts and behaviors involve a fear of harming others, but for others, they may involve a fear of germs, bacteria, and becoming “contaminated” by something. Still, other people with OCD may experience upsetting or frightening sexual, violent, or relationship thoughts, which require “avoidance” and/or a constant need for “reassurance” that they are not pedophiles, psychopaths, victims of infidelity or betrayal, or sexual deviants.

Some people with OCD also fear for their safety and/or the safety of friends and loved ones. A fear of having OCD can also be a “type” of OCD. This fear of developing OCD may also include ruminating about how OCD will manifest in your life, how you can ease or stop your fear of getting OCD, and how to treat OCD if you do get it. When you become afraid of getting OCD or you experience non-stop intrusive thoughts about it, it is referred to as “meta OCD.”

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What is Meta OCD?

Meta OCD is a newly discovered “type” of OCD that involves obsessions and compulsions on OCD. What does that mean? It means that a person with meta OCD is “fixated” on possibly living with and being treated for OCD. So, meta OCD is basically the act of “obsessing over obsessing.”

In other words, questioning if you have OCD, fearing that you have OCD, and worrying that you are not receiving the best treatment for it. This “type” of OCD can cause you to question your sanity, health and well-being, and experiences. And, in some cases, it can cause you to fear that you are “going crazy.” It is also common for people with meta OCD to wonder if they are truly experiencing OCD or if it is something else. These individuals typically fear that they are not getting the proper treatment for it if they are indeed suffering from this anxiety condition.

Understand that meta OCD is not an official diagnosis. More specifically, this “type” of OCD is not included in the DSM-5 or recognized by the American Psychological Association (APA). But although meta OCD is not officially recognized in the DSM-5 or by the APA, most mental health providers, researchers, and experts agree that meta OCD is a true form of OCD.

When you have meta OCD, it is easy to get caught up in a non-stop, never-ending OCD cycle or “spiral” that is hard to escape from. Thus, meta OCD is considered a “problem-solving” anxiety condition. People with this “type” of OCD fret over “solving” the mystery of whether or not they have OCD.

Is Meta OCD the Same Thing as Metacognition?

No, but the two terms are interrelated.

Metacognition involves thinking about your thoughts. As such, it is not considered a mental health condition. More specifically, metacognition is an “awareness” of your thoughts and a desire to understand where your thoughts come from and why you think the way you do. When it comes to OCD, metacognition involves focusing on your OCD thoughts – a desire to understand why you keep thinking, worrying about, or obsessing over having OCD. You may worry about or wonder if your intrusive thoughts, images, fears, feelings, doubts, worries, or concerns (obsessions), and/or repetitive behaviors (compulsions) are indicative of OCD.

Where Does Meta OCD Come From?

Dr. John Flavell, an American developmental psychologist, who specializes in child cognitive development, created the term, “metacognition.” And, meta OCD is based on Adrian Wells’ metacognition therapy model. Dr. Adrian Wells is a clinical psychologist and professor of clinical and experimental psychopathology at the University of Manchester, UK, and professor of clinical psychology at the Norwegian University of Science and Technology.

According to Dr. Wells’ metacognition therapy model, meta OCD occurs when intrusive thoughts, urges, fears, feelings, worries, concerns, and/or mental images about having OCD, are combined with metacognitive beliefs. According to Dr. Flavell and Dr. Wells, dysfunctional metacognitive beliefs stem from your “assessment” of the intrusive thoughts. It is this “assessment” that triggers or contributes to your OCD symptoms.

Dysfunctional metacognition thoughts typically revolve around beliefs of when you should engage in or stop rituals and routines (compulsions). It also involves thought/fusion beliefs. What are thought/fusion beliefs? Well, when a person truly believes that something “bad” is bound to happen because he or she thought about it – this is considered a thought/fusion belief.

Thus, Dr. Wells asserts that the best course of treatment for people, who suffer from this OCD or meta OCD, is metacognition therapy (MCT).

Is Meta OCD a “Solving” Condition?

Yes!

According to Stacey Kuhl Wochner, a social worker, meta OCD involves “unrecognized solving rituals” or compulsions designed to “solve” or “fix” a person’s OCD. Because meta OCD involves intrusive thoughts, fears, urges, mental images, etc., about living with OCD – i.e., Is it real? Do I have it? How can I control or stop it? It makes sense that the accompanying ritualistic behaviors could or would somehow “fix” or “solve” this dilemma.

Meta OCD can also include seeking treatment for OCD, however, when the treatment does not produce the desired results quick enough, it can cause you to question if you really have OCD and/or if the OCD treatment you are receiving for it is right for you. Fearing that you have OCD or that your OCD treatment will be or is unsuccessful, combined with an intense, non-stop need to “solve” or “fix” this problem can unintentionally worsen your OCD symptoms (i.e., intrusive thoughts about OCD and ritualistic behaviors, like “avoidance” or “reassurance”).

What Causes Meta OCD?

The exact cause(s) of OCD and meta OCD are currently unknown, however, researchers suggest that genes (hereditary), brain chemistry and/or structure changes, and childhood trauma (child abuse, neglect, domestic violence, abandonment, etc.) may play a role in the development and severity of all forms of OCD. In some cases, although rare, children may develop OCD or meta OCD after contracting strep throat or another streptococcal infection (i.e., PANDAS). Still, in most cases, meta OCD appears after a general OCD diagnosis, and once OCD treatment has begun.

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What Are the Symptoms of Meta OCD?

Well, as with general OCD, meta OCD involves two main symptoms – obsessions and/or compulsions.

Common meta OCD obsessions and compulsions are listed below:

Meta OCD Obsessions

  • Constantly and obsessively wondering if you truly have OCD
  • Fearing that this obsession will never end
  • Questioning if you are receiving the best course of treatment for your “type” of OCD
  • Worrying that you may not be engaging in the therapy process the right way
  • Wondering if you are lying to or being “fake” with yourself and others about your OCD

Meta OCD Compulsions

  • Continuously scheduling therapy appointments
  • Taking numerous online quizzes, surveys, and/or questionnaires about OCD
  • Stockpiling brochures, pamphlets, apps articles, books, etc., on OCD
  • Constantly seeking “reassurance” from friends and family that you do not have OCD
  • “Avoiding” performing specific actions or engaging in certain behaviors for fear that they are indicative of OCD

How is Meta OCD Typically Treated?

Meta OCD is a fairly new concept that is not well-established or studied. Therefore, there is no universal way to treat this form of OCD. As a result, addressing meta OCD can be tricky. Why? Because some OCD treatments could potentially increase your “fixation” on OCD, leading to it becoming an OCD compulsion.

Listed below are convention OCD and meta OCD treatments:

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is the most common OCD treatment, and because meta OCD is a form of general OCD, this approach works well for both versions of OCD. The purpose of CBT is to help you change how you think (i.e., stop thinking about OCD) with the hope that it will also help you stop your meta OCD compulsions. The theory is that if you can stop thinking about having OCD and/or the treatment process, you will be less likely to perform compulsive behaviors (rituals and routines) to stop it.

Exposure and Response Prevention (ERP) Therapy

Like other forms of OCD, exposure and response prevention (ERP) therapy has shown tremendous success in the treatment of meta OCD. ERP therapy is the “gold standard” OCD and meta OCD treatment. The best way to manage your meta OCD symptoms is to work with a trained exposure and response prevention (ERP) therapist.

Although meta OCD may prove to be more challenging to treat, the same treatment protocols used for general OCD apply to meta OCD. During meta OCD treatment, OCD sufferers are encouraged to embrace the uncertainty, confront their fears and doubts, and reclaim their lives.

ERP therapy is a type of cognitive-behavioral therapy (CBT) that is designed to gradually “expose” a person to situations, thoughts, feelings, and/or images that could be triggering their obsessive thoughts and/or compulsive behaviors.

Thus, ERP therapy helps you confront your OCD triggers in a controlled, safe environment – without engaging in rituals, routines, ruminations, or compulsive behaviors. Gradually, with repeated exposure to your fears, your stress, anxiety, and OCD symptoms will cease, and your need to complete certain actions will also decline.

With the use of ERP tools and techniques, you will learn how to stop the intrusive thoughts about OCD and/or the tedious behaviors preventing you from living a happy and productive life. Stopping the compulsions (i.e., avoidance, reassurance, searching, etc.) helps your brain understand that there is no danger present.

By sitting with your stress, anxiety, and discomfort – instead of trying to “escape it,” you are essentially learning that there is nothing to worry about – and nothing bad is going to happen. Thus, ERP therapy teaches you how to “allow” the intrusive thoughts, fears, doubts, feelings, mental images, and/or urges about OCD.

Will it be uncomfortable? Absolutely. But you will survive and emerge better than before. Your meta OCD symptoms will lessen and eventually disappear altogether – without any response (behavior or action) from you. If by chance, your thoughts, feelings, fears, doubts, etc., return, you will be better equipped to deal with them.

Acceptance and Commitment Therapy (ACT)

Another OCD treatment used to address meta OCD is acceptance and commitment therapy (ACT). Contrary to popular belief, the goal of ACT is to improve your quality of life – not eliminate all of your OCD symptoms (i.e., a fear of getting OCD). During ACT therapy, OCD sufferers are taught how to identify, acknowledge, and accept or “embrace “their intrusive thoughts about OCD – instead of ignoring, dismissing, or “fixing” them. Acceptance and commitment therapists encourage people with OCD to think about their thoughts – but from an “outsider” or “witness” perspective.

Metacognitive Therapy (MCT)

Metacognitive therapy (MCT) is another effective meta OCD treatment. The goal of MCT is to help OCD sufferers become more “aware” of their metacognitive processes. This OCD therapy also teaches these individuals how to “tweak” or alter their higher-order metacognitions, like the importance or “value” placed on their thoughts and beliefs about having OCD and getting the right treatment for it.

Inference-Based Therapy (IBT)

Based on the belief that OCD symptoms stem from illogical thoughts, ambiguous doubts, and/or irrational fears, inference-based therapy (IBT) seeks to help OCD sufferers change or “tweak” their thoughts process, so they no longer fear having OCD and/or getting treatment for it.

Antidepressants

In some cases, especially when therapy has been unsuccessful alone, a psychologist may refer a person with meta OCD to a psychiatrist, who specializes in treating people with this form of OCD with medications. If a psychiatrist feels like anxiety or depression is fueling your fear of developing OCD and/or receiving treatment for it, he or she will likely prescribe a selective-serotonin reuptake inhibitor (SSRI).

Common SSRI antidepressants are Luvox, Zoloft, Paxil, and Prozac. Keep in mind, however, that there are limited studies on meta OCD – and which treatment(s) are the most effective and beneficial for this form of OCD. Still, researchers suggest that the best treatment for all forms of OCD is a combination of psychotherapy and medications.

What Is It Like to Live with Meta OCD?

Listed below are examples of what it is like to live with meta OCD:

Dakota

“I have been having trouble with thinking I do not have OCD. You could ask me straight up and I would say yes confidently, but in my head, it is like…do you? My mind keeps telling me, ‘You know you are just faking it for attention just to make it look like you have OCD. You have been faking it your entire life and people know that you are lying.’ It is honestly more aggravating than anything.

Living with meta OCD can be rough, but my therapist told me to use humor when it comes to realizing just how ridiculous some things are. This has helped a lot. Like last year, I swore up and down that I was going to die from a heart attack. No doubt in my mind. I was like, ‘I only have five-years max.’ This is it. Heart disease is how I am going to die. I started having a panic attack and had no idea what to do, so I got a chest X-ray and EKG reading, and everything was perfect, thank God.

But at the moment, I was like, ‘No, you are wrong. You suck at your job, and should be ashamed of yourself.’ I did not say that, but that is what I was thinking at the time. I knew how ridiculous it sounded because a lot of doctors take their jobs really seriously. I knew that my doctor knew what he was doing, but I was still unsure if I had OCD or if something else was happening to me. It is ridiculous and hilarious now that I think about it. But, although you are confused and uncertain right now, do not give up. Find any light you can and get a death grip on it.”

Amber

“I’ve been doing ERP therapy for a while, and it has definitely helped me not get as panicky in real life. Though, I find that when my fears are presented to me in an inorganic way, during the ERP therapy, I am not super anxious – just somewhat uncomfortable or uneasy. I worry that because I am more afraid of my intrusive thoughts in real life than I am in ERP therapy, it will all come rushing back once therapy is over.

I act like I hate ERP therapy, but if I am honest with myself, I actually enjoy the exposure exercises. However, my OCD is still making me question if I have been lying about having OCD this whole time (as an excuse), or if I have just been an awful person this whole time. Ugh, I hate this. Can anyone else relate to the whole ‘maybe I don’t have OCD and I am just a terrible person’ thoughts?”

Are There Any Self-Help Tools, Natural Remedies, and/or Lifestyle Changes I Can Use to Treat My Meta OCD Symptoms?

Absolutely!

There are numerous self-help tools, natural remedies, and/or lifestyle changes that can reduce or eliminate your meta OCD symptoms.

These resources include following a healthy diet, getting plenty of exercises, getting proper sleep, refraining from caffeine, alcohol, and illegal drugs, trying CBD, researching meta OCD, reading books about OCD and meta OCD, practicing mindfulness, downloading OCD recovery apps, adding vitamins, nutrients, and/or herbs to your daily routine, attending hypnotherapy/hypnosis sessions, going to regular support group meetings, investing in online OCD treatment programs, like Impulse Therapy. Impulse Therapy is an OCD recovery course that helps you wrangle your OCD and meta OCD symptoms back under control – so you can have the life you want and deserve.

References

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Author

DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

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