The individual has intrusive thoughts. Obsessions are developed.
Germs are disgusting. They are deadly, are contagious and definitely will infect people including me and cause negative side effects and sickness!
The individual believes than an intrusive thought reveals something meaningful (eg: they interpret the thought as a warning sign that a negative event will come true).
Uh oh, this must be a warning. If I touch something, there must be bacteria on it. Bacteria is deadly! If I get germs on my hands, I will die!
Distress is developed as a result of interpretation from these intrusive thoughts.
Oh no! I touched the table, others may have touched it before, so there's bacteria on it. If I don't do anything to stop this, I'll die in 5 minutes!
For example, this girl has distress associated with obsessive and irrational fears of contamination.
Compulsions are developed as an attempt on neutralizing these obsessions.
Ah, much better. Now I must make sure to keep washing my hands every time I touch something with germs, so my hands can always be clean!
This girl spent a long while to wash her hands, and frequently does it as well to prevent germs.
This girl is performing excessive and repetitive washing of her hands to relieve her obsessive fears of contamination.
Someone with OCD may become “stuck” on that thought and be intensely afraid that they might lose control and act on it. Or worse, they believe that having the thought is just as bad as doing it. This is called thought-action fusion [TAF].
What if I don't wash my hands and contaminate my daughter? I don't want to hurt my daughter... I don't want her to die!
For example, a patient with OCD experienced intrusive images of her daughter being diseased after having close contact with her.
These images were so terrifying to the patient that she would no longer allow herself any physical contact with her daughter.