Disgust-Based OCD: When There's No Obvious Core Fear

It's not always fear driving OCD; sometimes it's disgust. In this episode, Jess and Laura unpack disgust-based OCD: what makes it different from anxiety-based presentations, why there's often no obvious "core fear" to find, and how disgust sensitivity and propensity shape the way it shows up. 

They cover mental contamination, self-regulation, shame beliefs (including LGBTQ+-specific shame), and why some safety seeking behaviours might need to stay for now. 

Expect personal anecdotes, an apocalypse tangent, and a full toolkit of practical experiments, from metacognitive imagery work to ACT and CFT-informed approaches, for building tolerance to the intolerable. 

Plus: Listener Question, a Weekly Win, and an Exposure Lab challenge.

Podcast by:

Laura Mole, Adv. Dip, MBACP OCD specialist therapist

and

Jessica Hayes, Msc PGDip, BABCP Accred OCD and perinatal specialist therapist

Edited by Christian Nickson

Time Stamps:

01:00 Overview

02:00 Why disgust-based OCD

03:05 Brain Spam

08:40 What is disgust?

11:55 Personal disgust examples

17:40 Disgust reacts differently to anxiety

19:00 Expectations for treatment

19:45 No core fear

26:00 Disgust sensitivity and disgust propensity

27:30 Self-regulation's role

31:55 How therapy can look

36:00 People can be disgusting

36:50 Shame beliefs and origins

39:05 Metacognitive therapy imagery descripting

41:50 Disgust associations

45:15 Allowing safety behaviours

46:20 A focus on values

49:55 Apocalypse tangent

53:44 Acceptance and Commitment Therapy (ACT) and Compassion Focused Therapy (CFT) approaches

55:20 Laura's summary of disgust approaches

58:00 Disgust aims and reminders

1:01:15 Listener Question

1:03:50 Weekly Win

1:05:27 Exposure Lab

1:10:00 Goodbyes

Disgust Behavioural Experiments:

**1. "Opposite action" for disgust**

Pick something mildly disgusting (not your worst trigger). Physically approach it, let yourself really look at it rather than looking away, and notice the urge to tense up or recoil- then deliberately soften your shoulders/hands. The exercise is about closing the gap between "disgusted" and "recoiling," not making the disgust disappear.

**2. The reappraisal game**

Take a disgust-trigger object and describe it out loud using only neutral, clinical, or absurdly technical language-no evaluative words allowed. E.g. a used tissue becomes "cellulose fibres holding condensed nasal secretions." This is changing the *meaning* attached to a stimulus rather than the stimulus itself.

**3. Rewrite the ending**

Take a recurring "gross" intrusive image and, eyes closed, deliberately continue the scene past where it normally stops- give it a different, even ridiculous ending. This is a small version of imagery rescripting, which works by changing the affective meaning of the image rather than trying to suppress or avoid it.

**4. Pairing test**

Since disgust is often *learned* through association rather than reasoned belief, try repeatedly pairing a low-stakes disgust trigger with something genuinely pleasant (a favourite song, a square of chocolate) over several short exposures, and notice whether the association shifts.

Resources:

Disgust Scale-revised: Disgust Scale, DS-R 

Feelings Wheel: Feelings Wheel | Worksheet | Therapist Aid 

Get in Touch:

Got intrusive thoughts to share or questions for us:

Email us at [email protected]

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Content Warnings:

We do reference some thoughts that people may find distressing so please listen with caution if this is you, and take a break if you need to. 

Disclaimer:

This podcast provides educational content only and is not a substitute for professional mental health support, please contact a mental health professional for advice and support.