I've written quite a bit about intrusive thoughts since being here so to save repeating it all again, this might show you my thoughts on it:
http://www.nomorepanic.co.uk/showthread.php?t=184847
I always had OCD traits, but not OCD. They never bothered me. Even when my GAD came at 30, the traits only increased a little but not enough to consider them OCD. When I relapsed I started a new med, Duloxetine, and bang on came full blown OCD. I know others with OCD that prior to a certain med never had it.
The question I find is that whether removing the drug that is obviously "too activating" will cause the OCD to recede back to traits. Or will the anxiety remain at such high levels that the traits have become OCD? Because I wonder whether the activation issue is about increasing anxiety levels far beyond what we felt before, which happened to me the minute I hit the norepinephrine dose of Duloxetine...it was the next morning.
I get what you are saying about compulsions being automatic. I had the same issues. I can't say I fully understand this area, and it seems like it's still emerging, but you might want to have a read about "Tic Related OCD".
There is science developing to show that OCD and Tourettes are found in the same areas of the brain. There are also Tic Related Disorders other than Tourettes, something I wasn't aware of until I started reading about it.
I'm not saying you have Tourettes, you would know this at your age, but what I am questioning is whether what brought on my OCD caused me to have tics. I didn't have them before, so it must have either been the med or the meds impact on my anxiety levels going to a whole new level.
Maybe it is the same for you? I say this because I've seen how you have really been through such a bad time with Cit & Sert over the months and your intrusive thoughts seriously ramped up.
I found my tics went as my overall anxiety levels decreased. This was a long process for me but then I stayed on the med, which can't have helped.