Understanding OCD
What is the FIRST thing that comes to mind when you hear the term OCD? For many, it’s a mental image of someone cleaning every nook and cranny of their house, or arranging items in a very organized and orderly fashion. Maybe you’ve even heard someone say “I’m so OCD” when referring to their love of tidiness. But Obsessive Compulsive Disorder (OCD) is far more than a personality quirk - it’s a misunderstood and often debilitating mental health condition affecting millions of people worldwide.
In this blog post, we’ll break down what OCD really is, clear up some of the most common misconceptions, explore how it actually shows up in people diagnosed with the condition, and how it can be treated. Whether you’re newly diagnosed, supporting a loved one, or just looking to better understand mental health, you’ll come away with a deeper understanding of OCD.
Misconceptions About OCD
When people think about OCD, they often imagine someone who washes their hands repeatedly or lines up their books by size or color. While those can be behaviors associated with OCD, they don’t define the condition. In fact, one of the most common myths about OCD is that it’s simply about being clean, organized, or perfectionistic.
In reality, OCD is a disorder driven by intrusive thoughts (obsessions) and the urge to neutralize the anxiety caused by those thoughts through compulsions—either mental or physical actions. These thoughts are unwanted, distressing, and completely out of line with a person’s values or intentions. For example, a new parent might have intrusive thoughts about harming their baby, even though they are deeply loving and protective. The anxiety triggered by these thoughts can be overwhelming, leading them to avoid certain activities or engage in rituals to prevent their catastrophic fear from coming true. It is worth driving this point home: OCD is an ego-dystonic condition, meaning the obsessions and compulsions are NOT in alignment with one’s values, self-concept, and desires. The new parent having intrusive thoughts about harming their baby would NEVER WANT to harm their baby and are actually experiencing immense fear at the thought - fear so strong that it drives them to engage in the compulsions even if there is a part of them that knows they would never harm their baby.
People struggling with OCD often feel ashamed, isolated, and confused. Most people with OCD believe their obsessions are likely untrue, but that logic alone cannot stop the cycle. OCD is driven by fear. When OCD is left untreated, it can significantly interfere with a person’s ability to function, form relationships, or feel safe in their own mind.
What OCD Really Looks Like
From a clinical standpoint, OCD is a misfire in the brain’s threat detection system. I like to call them “brain hiccups.” The person experiences something that triggers their obsession, and the brain misinterprets that event as danger or a threat, setting off an alarm. Unfortunately, for those with OCD, their brain signals the “danger” alarm a lot, even if the person understands logically that there is a very small chance of something bad actually happening. Because the fear associated with the obsession is so strong, the person with OCD feels compelled to perform some sort of action—whether external (like checking or washing) or internal (like repeating a phrase or mentally reviewing a situation)—to make the anxiety go away or to prevent the feared outcome from coming true.
There’s a catch, though: those compulsions only provide temporary relief from the anxiety. Over time, they reinforce the belief that the thought had meaning and the situation was actually dangerous.
trigger → obsession → anxiety → compulsion/avoidance → temporary anxiety reduction → reinforced OCD cycle
Continuing in the OCD cycle leads to more frequent and time-consuming compulsions that drive the intensity of the obsessions by treating the intrusive thoughts as meaningful and grounded in reality.
As a therapist specializing in OCD, I’ve worked with clients whose symptoms are invisible to those around them. They may look calm on the outside, but internally, they’re battling an exhausting loop of doubt, fear, and reassurance-seeking. Many clients feel like their thoughts mean something terrible about who they are—but the truth is, intrusive thoughts are not dangerous, and they are not a reflection of character. You are not your OCD.
If you’re wanting to learn more about OCD, or find additional resources, I highly recommend visiting the International OCD Foundation’s page.
How OCD Is Treated Effectively
If you’re living with OCD, it can feel like your mind is running the show. The good news? There are proven treatments that work. The most effective treatment, considered to be the gold-standard treatment for OCD, is Exposure and Response Prevention (ERP). ERP is all about exposing you to situations that trigger their obsessional fears and anxiety and preventing the compulsive behaviors that typically follow. ERP essentially throws a wrench in the OCD cycle and introduces new learning. Over time, clients are habituated to their obsessions, they experience less anxiety overall, their fears are disconfirmed, and they are able to tolerate uncertainty much better.
So, what does ERP look like in practice, you might ask? Here’s a couple examples:
Contamination fears: touching multiple public doorknobs and not immediately washing your hands afterwards.
Harm obsessions: having a knife sit on the end table during the therapy session.
If these examples sound scary to you, you’re not alone. ERP is specifically tailored to each individual and their specific obsessions and fears: we start with exposures that produce a manageable level of anxiety with the goal of working our way up the hierarchy we’ve created. ERP is not about exposing you to harm or danger - it’s about helping your brain learn that it can tolerate anxiety/uncertainty/discomfort without needing to act on it. This process slowly rewires the brain’s fear response and builds resilience to uncertainty. I love this treatment because it truly is about taking baby steps towards healing and the results are maintained over time.
If this sounds like your experience, know this: you are not alone, and it’s not your fault. OCD is treatable, and with the right support, you can live a life that isn’t ruled by fear.
If you're ready to explore treatment options like ERP, or just want to learn more about how OCD shows up and how to manage it, I’d love to help. Check out my services page to learn more about the therapy options I offer.
Reach out to schedule a consultation.
Let’s work together to help you move beyond OCD—and toward the life you want to live.
