Obsessive-compulsive disorder (OCD) involves obsessions, which are unwanted, distressing thoughts, images or urges, and compulsions, which are repetitive actions or mental rituals done to reduce the distress. Compulsions bring short-term relief but keep the cycle going. OCD is treatable, especially with CBT using exposure and response prevention (ERP), sometimes with medication.
Obsessions
Intrusive, unwanted thoughts that cause anxiety, such as:
- fear of contamination or illness,
- fear of causing harm,
- needing things to feel "just right",
- unwanted religious, moral or taboo thoughts,
- doubts about whether something was done correctly.
Having intrusive thoughts is common. In OCD, the thoughts are frequent, distressing and hard to dismiss.
Compulsions
Actions or mental rituals to reduce anxiety:
- excessive washing or cleaning,
- checking locks, appliances or messages,
- repeating, counting or arranging,
- seeking reassurance,
- repeating prayers or phrases to "undo" a thought.
The OCD cycle
Obsession, then anxiety, then compulsion, then brief relief, then the obsession returns stronger. Compulsions teach the brain that the thought was dangerous and needed neutralising.
Misconceptions
- "Everyone is a bit OCD." Liking things tidy is not OCD; OCD is distressing and time-consuming.
- OCD is not just about cleanliness.
- Intrusive thoughts do not mean a person wants to act on them.
Religious OCD
Some people experience obsessive doubts about religious practice, such as repeated worry about whether prayers or ablutions were done correctly. Therapists can work respectfully with religious values, sometimes alongside trusted religious guidance.
Treatment
- CBT with exposure and response prevention (ERP): gradually facing feared thoughts or situations without performing compulsions, so anxiety reduces naturally. See what is CBT.
- Medication: certain medications can help; discuss with a psychiatrist.
Our therapists provide evidence-based treatment for OCD online.
Frequently asked questions
Can OCD be cured?
Many people improve greatly with treatment, and some become symptom-free. Ongoing skills help prevent relapse.
Should family members help with compulsions?
Joining in compulsions or giving constant reassurance can maintain OCD. Therapists can guide families on supportive responses.
Can children have OCD?
Yes, and early treatment is effective.
