Worksheet 1: Your OCD Symptoms

Worksheet 1
THEORETICAL BACKGROUND: What Is OCD?
Your OCD Symptoms

Now list your obsessive thoughts and compulsive actions. Don’t forget to identify possible
avoidance and safety behaviors.
OCD Obsessive Thoughts Compulsive Actions Avoidance and

Safety Behavior
Contamination
Responsibility for
Mistakes or
Disaster

Order and
Symmetry
Hoarding
and
Collecting
Aggressive,
Sexual, Religious
/ Moral Obsessive
Thoughts
Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Worksheet 2a
Pause for a Moment: Letter to Your OCD
“Do I really want to change something and, if yes, what exactly?” Be honest with yourself. What
is troubling about your symptoms? How is OCD harming you? What does OCD take from you?
Are you perhaps indecisive? Are there situations where OCD is helpful for you (“Better to be
safe than sorry”: is it better to accept a compulsion than to be inattentive to your environment?)?
What do you have to give up when you decide to give up your OCD? Are you ready for this?
Why? Grab your pen and write, e.g. a (farewell-)letter to you OCD
(Worksheet 2a (letter) or Worksheet 2b (pro-con list)).

Letter to Your OCD

Worksheet 2b
Pause for a Moment: Letter to Your OCD
Alternatively, write a pro-con list.

Pro-Con list
Pro Con
- -
- -
- -
- -
- -

Worksheet 3
THOUGHT DISTORTION #1: Are Bad Thoughts Abnormal?
Exercise #3: Take a More Lenient Approach
Acceptance: the following things I want to learn to accept on myself and others:
Myself
- Example: Sometimes I let things drop. Sometimes I’m a bit clumsy and that is the way it
is.
Others
- Example: When I’m riding with my bike, pedestrians often block the bicycle lane. I am not
able to change anything about it and getting upset doesn’t help.

Worksheet 4
THOUGHT DISTORTION #1: Are Bad Thoughts Abnormal?
Exercise #5: Acceptance and Appreciation for

Yourself and Others
Praise Yourself
People with OCD often focus on their own mistakes and shortcomings. Change your point of
view: Write down regularly (e.g. every evening) occasions, on which you did something good
for others or yourself.
Date What Did I Do, What What Did I Do, What

Was Good for Myself Was Good for Others
Today? Today?
Example I made myself a really I comforted a friend; I

nice breakfast; I did called my grandma; I
some sports today; I helped my colleague
told my boss, that I with a task
won’t work extra hours
Mon.
Tues.
Wed.
Thurs.
Fri.
Sat.
Sun.

Worksheet 5
THOUGHT DISTORTION #2: Do Bad Thoughts Lead to Bad Deeds?
Exercise #1: Can Thoughts Move Things?
Take a feather or some other very light object, like a piece of paper, and place it on a table in
front of you.
Now try to move this object in a certain direction with your thoughts alone!
Repeat this exercise and make a tally sheet. Check how often it worked √ and how often it didn’t
work x.
√ x
Feather / piece of paper
moved
Exercise #2: Magical Thinking
Many people with OCD know that their thoughts cannot actually influence external things. But
still they continue to have a certain doubt about it.
Try the following:
√ x
Predicting 10 playing
cards precisely
Guessing a number
between 1 and 100
right
Predicting all result of
premier league games
precisely
Remove stain
Own example:
Own example:

Worksheet 6
Exercise #4: Thought-Action Fusion (TAF)
If you have the feeling that your thinking is able to change things, please try the following “easy”
exercises:
Can Thoughts Induce Actions?
Try to cause the following to happen by √ x

just using the power of your mind.
Make an old lady on the street

spontaneously throw away her walking
cane
Make a man tear off his T-shirt
Make the person to whom you are talking

spontaneously say the word
“downstream”
Make your counterpart get the giggles
Make the subway move backwards
Own example:
Own example:
One goal of the exercise is to show that your thoughts are not as powerful as you may think.
Another is that it involves shifting the focus of your worry without simultaneously suppressing
obsessive thoughts or avoiding the situation. As we have seen, both suppression and avoidance
just reinforce the problem.
Flukes are possible in some exercises; therefore, you should make a tally sheet. If a prediction is
correct look at the cases in which you have been wrong before.
Worksheet 7
Can Thoughts Change Objects?
Try to change the following objects by just √ x

using the power of your mind
Change the color of a car
Cause a statue to lose one arm
Turn water into cola
Make a traffic signal change to blue
Increase the size of a fire hydrant
Reconstruct a broken bottle out of its

shards.
Turn a pizza into a hamburger
Let a soccer ball shrink to the size of a

tennis ball
Own example:
Own example:

Worksheet 8
Can Thoughts Influence Results?
Try to make the following events happen √ x

by just using the power of your mind
Activate a car alarm
Make the second hand of a clock stop
Turn on a fan
Open a window
Make a flying bird land in a certain place
Unplug the iron
Close a tap
Own example:
Own example:

Worksheet 9
THOUGHT DISTORTION #3: Must Thoughts Completely Obey My Will?
Exercise #4: Delight in Your Thoughts
My Complaisant Companion
Example: Comic figure, fantasy figure (good fairy, guardian angel, ...), film figure (e.g. Professor
Dumbledore from „Harry Potter“), famous person, ...
Name of my companion:
Looks / voice:
Fictive walk on the beach...
What he/she said:
What were helpful words or sentences:
What do I want to remember:

Worksheet 10
THOUGHT DISTORTION #4: Is the World a Dangerous Place?
Exercise #1: Get Informed!
What adverse events are you especially afraid of, and which ones do you think are especially probable? Write these down and get
informed. Look up answers in reputable and objective sources—and not ones that cater to gloom and doom.
Obsessive How high do I How high is the Other consequences /

fear think is the probability according calming facts as a
probability for to my research? result from my
the event? research
Adverse Getting cancer A lot of people The majority of people Improvement in

event die from cancer, doesn’t get cancer. prevention, early
so it has to be diagnosis and treatment
very probable to helped that the
get it. probability to die from
Example
cancer decreased for

decades. From 1980 to
now the mortality has
decreased by more than
20 percent.
Worst Die from cancer Cancer is nearly More than half of all
Consequence always fatal. cancer patient can expect
permanent cure.

Worksheet 10
Adverse
event
Worst
Consequence
Source: http://www.krebsinformationsdienst.de

Worksheet 11
Exercise #2: Calculating Chains of Probability
Identify the factors that must line up perfectly for a feared event to occur. Each factor has a
specific estimated probability of 0.01 (= 1%) to 0.5 (= 50%) to 1 (= 100%). Factors have to be
multiplied by each other. Each additional factor considerably reduces the probability of the
occurrence as a whole (read more about this in section “False Calculation of Probability”
Thought Distortion #4: Is the World a Dangerous Place?).
Example: Probability of a burglary resulting from an unlocked door: Factor 1: The door is not
locked (0.4) x factor 2: A burglar is close to my apartment (0.3) x factor 3: …exactly on the day
when the burglar is close to my apartment, I forgot to lock the door (0.5) x factor 4: The burglar
chooses my apartment, from all the possible other apartments (0.3.) x factor 5: The burglar
doesn’t get disturbed by anybody and can complete the burglary unnoticed (0.7). Even with high
estimated single probabilities the probability for the feared occurrence is 0.4 x 0.3 x 0.5 x 0.3 x
0.7 = 0.0126. This is a probability of 1,26%.
Feared Occurrence: Respective Probability (from

0.01 (=1%) to 1 (=100%)
Factor 1:
____ % = ____
Factor 2:
____ % = ____
Factor 3:
____ % = ____
Factor 4:
____ % = ____
Factor 5:
____ % = ____
Factor 6:
____ % = ____
The product results from a multiplication (x) of the numbers listed above:
0.__ x 0.__ x 0.__ x 0.__ x 0.___ = 0.__ This is a probability of ___%.
(0.5 e.g. are 50%).

Worksheet 12
Exercise #4: Gathering Corrective

Experiences…Confrontation Therapy
Create your own “fear ladder”! Use the example in this chapter ( Thought Distortion #4: Is
the World a Dangerous Place?) as an orientation.
Difficulty Situation/ Exercise
1. (low)
2.
3.
4.
5.
6.
7.
8.
9.
10. (high)

Worksheet 13
THOUGHT DISTORTION #5: Must Bad Thoughts Be Suppressed?
Exercise #2: Alternative Approach for Dealing

with Negative Thoughts
Take an observational and distanced attitude toward your thoughts. Some people with OCD are
helped when they connect their obsessive thoughts to an image or a scene and weaken them by
directing these ideas with their mind.
Try to visualize the following scene for at least 1-2 minutes.
Scene Example:
Imagine that you are observing a violent storm from a safe shelter, and you can see that the first
breaks in the storm are already evident on the horizon. Hang your obsessive thoughts on the
blackest part of the passing cloud front. Now let the storm rage (e.g., lightning splits a tree; a
tornado demolishes a house). Slowly, the storm will start to let up and reveal better weather
ahead.
My personal scene:

Worksheet 14
THOUGHT DISTORTION #6: Is Danger Necessarily Present When
Feelings Alarm Me?
Exercise #2: The Influence of External Factors

on Thinking and Feeling
How do the factors below influence your well-being and your emotional world?
Try to write down the influence of each factor accurately.
Factor Influence: This tends to make me

aggressive, fearful, cheerful, sad,
nervous, relaxed…
Example: Alcohol
“Small amounts of alcohol loosen my
tongue and help me relax. But when I have
too much to drink, I quickly feel personally
insulted by other people.”
Stress
Boredom
Lack of Exercise
Drugs
Weather, light
Medication
Lack of sleep
Other:

Worksheet 15
THOUGHT DISTORTION #6: Is Danger Necessarily Present When
Feelings Alarm Me?
Exercise #3: Making a Mountain Mountain

Range out of a Molehill
Only for the courageous! OCD is a master of exaggeration and leads people to believe that
improbable or even impossible scenarios could actually occur. When your OCD has for the
umpteenth time made a mountain out of a molehill, take it to the next level and make a mountain
range out of it. Escalate the scenario until it becomes grotesque, and embellish it as much as
possible! This frequently diminishes the fear instead of increasing it. This “reverse psychology”
is also called paradox intervention.
Obsessive thought: Your house burns down because of a defective stove.

Conscious exaggeration: Because of the current drought, a firestorm
spreads across the continent. Within a few days, the entire sky turns black.
Life on Earth becomes almost impossible due to the lack of sunshine. Even
though the trial against you is eventually dismissed, religious fanatics accuse
you of being one of the Seven Horsemen of the Apocalypse. Satanists
worship at the altar of the scorched remains of your stove.
My obsessive thought/s:
Conscious exaggeration:

Worksheet 16
THOUGHT DISTORTION #8: Am I Responsible for Everything?
Exercise #1: Not Judging with Double

Standards
People with OCD, often without knowing it, make judgments based on a double standard:
They apply a higher moral yardstick to themselves than to others on the basis of their upbringing.
Consider whether this applies to you. Imagine the following mishaps, answer the questions and
then write down your answer in the table:

Example:
“Mishap”: Pickpockets stole my wallet
What I would say to myself / think Terrible. I’m such a fool, this is
about myself: typical for me.
What I would say to a good friend: This can happen to everyone, it’s not
that bad.
Own example:
“Mishap”:
What I would say to myself / think

about myself:
What I would say to a good friend:
Think about how hard and unsympathetic you would be or perhaps already have been with
yourself in such situations. But if it was a friend you would probably sincerely comfort him or
her and provide some good reasons why his mishap was minor, normal, and forgivable.
For any actual or presumed wrong behavior in the future, tell yourself what you would say to a
good friend in a comparable situation.

Worksheet 17
THOUGHT DISTORTION #8: Am I Responsible for Everything?
Exercise #2: Putting the Cart Before the Horse
Break down your own negative experiences. Divide the pieces of the pie below: Allocate the size
according to how important circumstances, other people, or yourself were in the development of
certain (most feared) occurrences. Begin with the circumstances and other people. There are slots
for up to three people and three circumstances. Identify as many factors as possible. Then first
write down your own influence. You will see that your own influence will be relatively small
through this type of approach.
Your situation:

Factor Influence
Circumstance 1
Circumstance 2
Circumstance 3
Person 1
Person 2
Person 3
Yourself

Worksheet 18
THOUGHT DISTORTION #9: Good Is Not Good Enough
Exercise #1: Nobody Is Perfect
1. Pay Attention to Apparently Perfect People
Name a really perfect person. Every person has faults.
Do you think the world doesn’t forgive faults? Turn on the TV! You will see that even the
presenters on the daily news and stars lisp, muddle their lines or maybe don’t fulfill the ideal of
beauty, but still are popular and “good at business”.
Person Faults and flaws
Angela Merkel Example: Lisps,…
The Pope
Wayne Rooney
Own example:
Own example:
Own example:
Own example:

Worksheet 19
THOUGHT DISTORTION #9: Good Is Not Good Enough
Exercise #2: Nobody Is Perfect
2. Make Conscious Errors
What Specific Fears Do You Have? (e.g., that people will laugh loudly at you in public)
Write down an example of your own in the table.
Error Most Feared Actual Consequence?

Consequence?
Tying your tie the Everyone notices the None of the male
wrong way error. They laugh at colleagues noticed. An
you loudly and the boss older female colleague
insults you (“What’s shakes her head,
your problem? My 8- smiles indulgently, and
year-old daughter points out the mistake.
could do a better job.”) Then she says, “Don’t
worry, my husband
does the same thing”
Mixed up facts of a They now think I’m a Nobody noticed except

story liar and not trustworthy for myself

Worksheet 20
THOUGHT DISTORTION #10: Can I Achieve the Ultimate Truth?
Exercise #1: Can Truth Be Achieved…and Is It

Always Worth Striving for?
Make a list of up to five incidents where it would have been unfortunate if you had already
known the outcome.
Incident Example: Surprise party
Write down up to three issues for which no ultimate truth exists because they depend on taste,
depend on the definition, can change, depend on culture,… .
1. 2. 3.
Depend on taste
Depend on the
definition
Can change
Depend on
culture

Worksheet 21
THOUGHT DISTORTION #11: Does Brooding Help to Solve Problems?
Exercise #1: Stop Sign
A method for interrupting brooding consists of saying “stop” loudly or quietly. As soon as
brooding thoughts come up say “stop” or another word. Support this with inner images or a
bodily reaction. If possible, do something else (alternative behavior). Many roads lead to Rome.
Experiment with this method and figure out what helps you the most.
Set Stop Signs

How? Personal realization Used? How
successful was it?
1. Brooding with My stop-word: Example: Yes, often
interrupting loudly used, most of the time
(e.g. saying “stop”) it was helpful
2. Supporting inner My image:
image
(e.g. imagining a
stop sign)
3. Supporting bodily My bodily reaction:
reaction
(e.g. making a fist
with your hand)
4. Alternative My alternative
behavior behavior:
(e.g. movement
exercise)
Change the way of thinking:

How? Used? How successful was it?
Imagine a “bang”
Slowing down central words
Hopping in your thoughts
“Nonsense questions”

Worksheet 22 (Information Sheet)
THOUGHT DISTORTION #12: OCD Is a Brain Disorder – So Does That
Mean I Can’t Do Anything to Change It?
OCD and the Brain
Almost every week new findings are published in scientific journals about brain changes in OCD.
The correlations between some peculiarities in the brain and OCD have been a source of relief to
some patients (“it’s not me—it’s my OCD”) while others become resigned out of a misperception
that OCD involves irreparable dysfunction—just like a defective car.
This assumption is based on a wrong idea about the way our brain works. Here is a short
summary of the most important facts:

The brain is the record of its use
- When we are happy or sad this automatically leads to a change of the current blood flow
in the brain. Long-term influences lead to stronger changes. These processes are usually
changeable and reversible.
- The brain changes which can be found by patients with OCD are minor and aren’t clearly
speaking for irreversible defects.
- It isn’t clear whether the found changes can be evoked by the symptoms (as a
consequence not as a reason) or if they have already been there before!
- Our thinking changes our brain. This has been shown often, e.g. an OCD therapy changes
the brain in a similar way as medication.
Genetics
- The genes have an influence on our personality but this doesn’t put the final nail in the
coffin. It channels possibilities which can be changed into other directions or stay mute by
external influences or experiences.
Neuropsychology
- It is controversial, if people with OCD have other so-called neuropsychological

impairments (problems of the higher mental functions, e.g. attention deficits and
forgetfulness) in addition to the thought distortions mentioned here.
- Studies which show impairments in people with OCD compared with a control group
often have methodological problems. Furthermore group differences cannot be
generalized on the individual case!
- Also colleagues, who think that people with OCD have certain neuropsychological
conspicuities must admit that these are rather small.

Worksheet 23
THOUGHT DISTORTION #13: Am I a Failure?
Exercise #1: Reduce Exaggerated

Generalizations
Individuals with depression tend to make exaggerated generalizations. They are apt to think
things like:” Once a loser, always a loser.” Instead of seeing things as “black and white,” try to
find more positive and constructive explanations for misfortunes and other negative events.
Try to be as specific as possible: Avoid generalizations that include words such as always or
never as well as imprecise and offensive terms such as stupid or fool. Now write down your own
examples in the table below and work through them in the same manner as the first example.

Event Exaggerated Constructive
Generalization Evaluation
You can’t get your “I’m fat and ugly.” “I might have gained a
pants to close. bit of weight, but that
does not mean I’m
ugly?”

Worksheet 24
Exercise #2: Be Aware of Your Strengths
Instead of concentrating on your perceived weaknesses and shortcomings, you should remind
yourself of your strengths and talents.
We all have abilities, which are not shared by everyone and which we can be proud of. These do
not necessarily have to be rare talents, world records, or ground breaking inventions.

Procedure Examples My Strengths
1.Think about your - I am technically

own strengths talented.
What am I good at? - I have an infectious

What have I received smile.
compliments for in the
past? - I am a good listener.
2. Imagine specific - I helped a friend paint

situations her apartment. I was a
great help to her,
When and where? What without me she
have I done and who wouldn’t have
has provided feedback? managed.
- My colleague told me
yesterday that –no
matter how bad his
mood is – he is always
charmed by my smile.

Worksheet 25
Exercise #4: Dealing with Positive and Negative

Feedback
During childhood, many people learned to give more weight to criticism than to appreciation.
This may also become a depressive thought trap! Try to find more positive/constructive
evaluations for your own negative and positive events. Enter a particular situation in pairs: once
with a good and once more with a bad outcome.
Event Depressive evaluation More

positive/constructive
evaluation
You pass a test “The questions were “Great. I’m really proud
really easy, everyone of myself and will
could answer them.” reward myself today.”
You fail a test “What a humiliation. “It’s upsetting, but I

I’m such an idiot.” can repeat the test. I
will talk with someone
who passed the test
and figure out how they
studied for it.”

Worksheet 26
Exercise #6: Be Grateful
For the following exercise we ask you to think about the things you are grateful for. Also if
you’re not feeling good at the moment there will be something in your life which you are grateful
for, also if the mental fight against the symptoms is blocking it.
For what am I grateful?
- Example: I’m grateful that I have a park so close to my apartment in case I need fresh air or
just want to stretch my legs.
- Example: Although my best friend and I fight once in a while, and this is exhausting, most of the
time we get along great together.

More Exercises to Increase Self-Esteem
• Each evening, write down a few positive things that you have done (up to 5). Then, go
through these things in your mind. Scientific studies have shown that things that we learn or
think about just before falling asleep are memorized better.
• Tell yourself in front of the mirror, “I like myself!” or “I like you!” At first, you may feel a
bit silly doing this, but try it anyway!
• Accept compliments and write them down. Try to remember situations, in which you felt
really good—try to remember these with all your senses, perhaps with the help of photos,
souvenirs, or other keepsakes.
• Do things you really enjoy like going to the movies or a café or watching an old movie on
TV—ideally with others.
• Work out for at least 20 minutes—but don’t overexert yourself. If possible try endurance
training, for example, a long walk or jogging.
• Listen to whatever music elevates your mood. – no matter whether this is hard rock, jazz,
pop, or folk music…
“SB 096” by L. Marie
(8/10/2015)

THOUGHT DISTORTION #14: Does This Mean That I Won’t Get Better
and Might Even End Up Insane?
OCD ≠ Psychosis
Is OCD like a psychosis? No!

The most important differences between OCD and schizophrenia/psychosis/delusion are listed in
the table:

Aspects OCD Schizophrenia/psychosis/ delusion
Degree of Strong doubts, insight into Strong conviction, no or inadequate

conviction disorder at least partially insight into disorder
present
Content Concern is mostly related to Conviction that enemies intend us
the idea that something bad harm. Themes mostly relate to
could happen to others or to persecution and spying.
oneself by coincidence or
inattention such as causing a
fire by forgetting to turn off
the stove. Themes often
involve taboo topics like dirt,
sexuality, or aggression
Course Frequently chronic if untreated Episodic, often with intermittent
symptom-free periods
Boundaries with Uncertainty whether one’s Conviction that other persons are
the outside thoughts may prompt thoughts inserting thoughts into one’s mind or
world or actions in others (direction are prompting actions with their
of concern: from self toward thoughts (direction of concern:
others: thought-action fusion, opposite than in OCD)
see Thought Distortion #2:
Do Bad Thoughts Lead to Bad
Deeds?)
Drug therapy Mostly antidepressants (High-dose) antipsychotics

Worksheet 1: Your OCD Symptoms

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Worksheet 1

THEORETICAL BACKGROUND: What Is OCD?

Your OCD Symptoms

OCD Obsessive Thoughts Compulsive Actions Avoidance and

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Pause for a Moment: Letter to Your OCD

Pause for a Moment: Letter to Your OCD

Alternatively, write a pro-con list.

Exercise #3: Take a More Lenient Approach

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Exercise #5: Acceptance and Appreciation for

Date What Did I Do, What What Did I Do, What

Example I made myself a really I comforted a friend; I

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Exercise #1: Can Thoughts Move Things?

Exercise #2: Magical Thinking

Try the following:

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Exercise #4: Thought-Action Fusion (TAF)

Can Thoughts Induce Actions?

Try to cause the following to happen by √ x

Make an old lady on the street

Make a man tear off his T-shirt

Make the person to whom you are talking

Make your counterpart get the giggles

Make the subway move backwards

Exercise #4: Thought-Action Fusion (TAF)

Can Thoughts Change Objects?

Try to change the following objects by just √ x

Change the color of a car

Cause a statue to lose one arm

Turn water into cola

Make a traffic signal change to blue

Increase the size of a fire hydrant

Reconstruct a broken bottle out of its

Turn a pizza into a hamburger

Let a soccer ball shrink to the size of a

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Exercise #4: Thought-Action Fusion (TAF)

Can Thoughts Influence Results?

Try to make the following events happen √ x

Activate a car alarm

Make the second hand of a clock stop

Make a flying bird land in a certain place

Unplug the iron

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Exercise #4: Delight in Your Thoughts

Fictive walk on the beach...

What he/she said:

What were helpful words or sentences:

What do I want to remember:

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Exercise #1: Get Informed!

Obsessive How high do I How high is the Other consequences /

Adverse Getting cancer A lot of people The majority of people Improvement in

cancer decreased for

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps

Moritz S, Hauschildt M (2016) Detecting and Defusing Thought Traps