Are OCD intrusive thoughts real?

[Answered on Quora.com by Karl Martin]

They are the opposite of who you really are. What is happening is the fear center of your brain, the amygdala, is malfunctioning or misfiring, sending you an anxiety spike by mistakenly warning you that you are in danger of the thought. When anxiety happens, your brain then tries to solve the question of this thought. You tell yourself, "Wait a minute, that’s not me, that’s bullshit". Your brain will then again test you with the thought. Because the amygdala is primal and cannot be reasoned with, it fires another anxiety spike, perhaps bigger than the first one, warning you that you are in danger of the thought. It gets stronger because you flagged it as important by reacting to it. Trying to solve the thought starts to create a loop where you get the thought as a test. You then repel from the thought. Your amygdala responds because you have shown it that it is correct for sending you the anxiety, by your actions of avoiding and questioning the thought, as well as your severe non-acceptance of this thought. Since the amygdala is a non-reasoning part of the brain and only learns from your actions, its response just gets stronger. It’s really just acting as your best friend, warning you of the danger you are in because of the thought that you keep showing it through your actions of avoidance and disdain is so very important to you. Basically it’s your actions of avoidance that are the food the amygdala needs to show it that it is correct to keep warning you. The constant anxiety makes you doubt yourself and think that it’s real and you are what these thoughts are telling you. You're not. This comfort and truth won’t really help you, however. In a twist of cruelty, reassurances that you get from yourself or others only feed the disorder by reinforcing to the amygdala that it is indeed right to warn you every time you have the thoughts. Through the proper therapy, you will learn to teach the amygdala that you are not afraid of these thoughts, and in fact welcome them from your actions of accepting them and running toward them using exposures to teach your amygdala that you are perfectly okay with having them. After a while, the amygdala learns that you are not afraid of the thoughts, and it stops sending you all this discomfort. The thoughts then lose their power, and since they are not important to you anymore, they stop bothering you.