Thought-action-fusion is a common cognitive distortion associated with OCD. It’s where a person believes that having a thought is equivalent to performing an action, or that thinking something makes it more likely to happen.
It is a very important distortion to be aware of if you’re suffering from OCD as when you’re in fight or flight mode – talked about in my previous post – anything can feel possible.
Remember when we are suffering from OCD we are highly likely to be in the fight or flight (sympathetic) part of our nervous system. When in fight or flight our ability to think rationally goes out of the window and so things that we know to be impossible, when in our rational minds, can feel possible!
When struggling and ruminating on an OCD obsession the brain and body are suffering with high stress (fight or flight), when in this state our memory becomes selective and fragmented. Our attention narrows (tunnel vision) and our hippocampus (memory organiser) works less efficiently.
The result of this is that we can get gaps in our memory, Out-of-order recall and confusion about timelines. In addition to this the brain searches for danger-related memories, and the Safe or neutral memories are harder to access.
It’s important to note that a Strong memory ≠ accurate memory. Stress increases confidence in memory and emotional intensity but decreases, detail accuracy, context and perspective!
All this results in intrusive memories feeling more real because they’re emotionally tagged
- “What if” thoughts feel urgent due to amygdala activation
- Memory distrust develops (“What if I forgot something important?”)
This fuels checking, reassurance, and rumination.
For me this was one of the most enlightening distortions to learn about. Following my nervous breakdown, I was constantly in my sympathetic nervous system and so I had a few events when an intrusive thought occurred, and I couldn’t remember clearly/rationalise it/work it out, this caused me unbelievable distress.
Thought-action-fusion can make you feel like a thought is real and because of your mental state your inability to rationalise that distortion feeds the uncertainty. We need to recognise this pattern when it happens for what it is and reduce the impact by:
- Not trying to ‘figure it out’ while anxious – this includes during the night, no analysis between 11pm and 5am remember!
- Remembering that you’re in fight-or-flight, you’ll be thinking in extremes and this is not evidence.
- Find ways to reset and come back into the parasympathetic nervous system (rest and digest).
I really love Byron Katies method for this where we say:
Is it true?
Is it 100% true?
If the answer to the second question is no – which it will be because the stress is based on doubt and uncertainty, then ‘you have to let it go’.
Why would you torture yourself over anything less than 100% certainty?
Fear lives in the vague after all and it’s my guess, it’s just a thought (obsession), attached to a feeling of uncertainty, that you’re basing your rumination on, not facts.
Your brain is probably desperately trying to work out whether there is something genuine to be concerned about, you should take this as your sign that there isn’t!
I really hope this helps, OCD recovery isn’t easy and sometimes thought-action-fusion can get worse when we are in recovery and start to let our guard down, but know and trust who you are and as always,
Stay Strong xxx



