How much of these thoughts are thoughts and how much of them are things you think you might act on? Is there any part of you that worries that you would act out on the thoughts?
I have intrusive violent thoughts, I recently admitted to my T that my biggest worry is that I like the thoughts and that I would not be able to stop if I started. She did the usual questions, do I think I would ever act on them, do I worry I would act on them, am I safe... stuff. And her response to everything was thoughts are thoughts, feelings are feelings, and we are humans with feelings and that have thoughts. We talked about this just on Mon and Wen of this wee - so very recently.

Are your thoughts & urges accompanied by hallucinations encouraging or ordering you to act out on the thoughts or urges?

How has your T been in terms of being receptive to more challenging topics? What is your feel of him?

Have you had other obsessions and moved on from them or is has this been your one and only obsessive topic?