OCD Formulation diagram outlining the cycle of triggers, intrusive thoughts, compulsions, and cognitive processes.

This worksheet is a tool to help you understand how Obsessive Compulsive Disorder (OCD) works for you personally. It shows how one thing leads to another in a cycle. Since this is a personal formulation, there is no single "correct" answer like in math. Instead, you need to fill in the boxes with your own experiences.

Here is a step-by-step guide on what to write in each section, using a common example of germs and cleanliness to show you how it works. You should replace this example with your own specific thoughts and actions.

Step 1: Triggers

What goes here: These are the specific situations, places, or things that start the worry.
* *Example:* Touching a doorknob in a public place.

Step 2: Intrusive thoughts, images, urges, or doubts

What goes here: This is the sudden thought or feeling that pops into your head after the trigger. It usually feels unwanted.
* *Example:* "That doorknob was covered in dangerous bacteria. I am now contaminated."

Step 3: Meaning of intrusive thoughts... (Center Circle)

What goes here: This is the most important part. Why does that thought scare you? What do you think will happen if you don't fix it?
* *Question to ask yourself:* "What does it say about me if I have this thought?" or "Why is it bad?"
* *Example:* "If I am contaminated, I will get sick and die, or I will make my family sick. It means I am irresponsible."

Step 4: The Reaction Circles (The bottom half)

These circles show what you do because of that scary meaning. They often make the OCD stronger.

A. Compulsions (Left Circle)
* What goes here: The physical actions you do to fix the problem or lower the anxiety.
* *Example:* Washing hands repeatedly until they hurt, or using hand sanitizer 5 times in a row.

B. Avoidance and safety behaviours (Bottom Left Circle)
* What goes here: Things you stop doing or special rules you follow to stay "safe."
* *Example:* Using your elbow to open doors, avoiding public bathrooms entirely, or carrying wipes everywhere.

C. Attentional and reasoning bias (Right Circle)
* What goes here: How your brain tricks you. Do you notice only the bad stuff? Do you assume the worst?
* *Example:* Noticing every tiny speck of dirt but ignoring that the floor looks clean. Assuming that if you feel anxious, something bad must be happening.

D. Emotions and bodily sensations (Bottom Right Circle - partially cut off)
* What goes here: How you feel physically and emotionally.
* *Example:* Feeling panic, a racing heart, sweaty palms, or a feeling of dread.

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Final Answer:

To complete this task, you must fill in the blank shapes with your personal experiences. Below is a completed example based on a common "Contamination" theme to show you exactly what to write in each box:

1. Triggers:
> Touching a shopping cart handle.

2. Intrusive thoughts, images, urges, or doubts:
> "My hands are now covered in germs from everyone else who touched this."

3. Meaning of intrusive thoughts (Center):
> "If I don't clean this off immediately, I will catch a serious illness. Having these thoughts means I am weak and can't handle normal life."

4. Compulsions:
> Washing hands with hot water and soap for 5 minutes straight; scrubbing until skin is red.

5. Avoidance and safety behaviours:
> Refusing to go grocery shopping alone; wearing gloves when outside; not touching my face until I get home.

6. Attentional and reasoning bias:
> Focusing only on people who look sick; assuming that "visible dirt" equals "deadly virus"; believing that feeling anxious means I am definitely in danger.

7. Emotions and bodily sensations:
> High anxiety, nausea, tightness in chest, urge to cry.