Understanding OCD
Obsessive-Compulsive Disorder (OCD) is often misunderstood and misused in our everyday language where it’s reduced to being ‘particular’ or ‘extra tidy.’ In reality, OCD is a complex mental health condition that involves distressing, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that temporarily relieve anxiety but reinforce the cycle over time. Often, despite recognizing “magical thinking” or the ineffectiveness of compulsions, OCD can be very challenging to stop and leaves many feeling stuck. Read on for more insight to what OCD actually is, effective treatment options, and what to look for when seeking support for OCD.
What is OCD?
OCD affects people of all ages and backgrounds. The hallmark of OCD is the obsessive-compulsive cycle:
- Obsession. An unwanted, intrusive thought, image, or urge that feels distressing (e.g., “What if I left the stove on?”).
- Anxiety/Distress. The obsession triggers intense discomfort, doubt, or fear. The body is reading this as real fear and there are marked physical changes.
- Compulsion. The individual engages in a behavior or mental act to reduce distress (e.g., repeatedly checking the stove).
- Temporary Relief. Anxiety lessens briefly, but the brain learns that compulsions are necessary, which strengthens the cycle and keeps OCD symptoms going.
- Repeat. Because the brain hasn’t learned the fear is harmless, it interprets safety as coming from the compulsion itself, reinforcing the cycle.
Over time, this cycle can become exhausting, time-consuming, and disruptive to daily life.
Common Types of Compulsions
While compulsions can take many forms, here are four common categories most fall into:
- Rumination: mentally replaying scenarios, analyzing thoughts, or trying to find certainty.
- Checking: repeatedly verifying that something is safe or complete (locks, appliances, work tasks).
- Avoidance: steering clear of people, places, or objects that might trigger obsessions.
- Reassurance Seeking: asking others to confirm safety, morality, or certainty (“Are you sure I didn’t offend them?”).
These behaviors might offer short-term relief, but they ultimately strengthen OCD’s grip.
Treatment: Breaking the OCD Cycle
Medication and therapy are often recommended, and people may choose one or both depending on their needs and doctor guidance. OCD treatment is hard work AND it’s highly treatable. Read on for therapy suggestions.
Exposure and Response Prevention (ERP)
ERP is a specialized form of Cognitive Behavioral Therapy (CBT) and the gold standard for OCD treatment. In ERP, individuals are gradually exposed to feared thoughts, images, or situations while resisting the urge to perform compulsions. Over time, this retrains the brain to tolerate uncertainty, helping unlearn that a compulsive behavior needs to be engaged in and over time reduces OCD symptoms.
Bilateral Stimulation
Certain bilateral stimulation (such as eye movements, tapping, or sounds alternating left to right) therapies including ART (Accelerated Resolution Therapy) and EMDR (Eye Movement Desensitization and Reprocessing) have also shown promise in helping individuals process distress and work through OCD. These techniques can reduce the intensity of obsessions and related anxiety. If seeking to work through OCD with a form of bilateral stimulation it may be worthwhile to ensure your therapist is educated in effective OCD treatment.
Treatment Caution
OCD is persistent and clever, often finding ways to turn helpful strategies into fuel for compulsions. Many well-meaning talk therapies can mimic or reinforce compulsions, especially mental compulsions like rumination or reassurance seeking. While this may feel nice it may inadvertently feed the OCD cycle rather than disrupt it. If you are unsure about this and how it might play out in your therapy I highly recommend bringing this up with your therapist to explore the best course of action.
Final Thoughts
Living with OCD can feel overwhelming and exhausting, but effective treatment is available. ERP remains the most effective and well-researched approach, and supplemental tools like bilateral stimulation may also be effective when used thoughtfully. With the right help, it is possible to step out of the cycle of obsessions and compulsions and reclaim peace of mind.