Obessions and compulsions
People often use the term “OCD” casually, usually to describe someone who likes things neat, organised, or symmetrical. But Obsessive–Compulsive Disorder, or OCD, is very different from simply being particular. It can be distressing, exhausting, and take up a lot of time and mental energy.
In OCD, people experience two main things: obsessions and compulsions.
Obsessions
Obsessions are unwanted, intrusive thoughts, images, or urges that trigger anxiety, distress, or discomfort. These thoughts are not something a person wants or agrees with, which is often what makes them so unsettling.
Common themes can include:
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Contamination, such as fears about germs, illness, or dirt.
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Harm, such as fears about accidentally harming yourself or someone else.
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Responsibility, such as worrying that something bad will happen because of something you did or failed to do.
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Order or symmetry, where things need to feel “just right”.
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Taboo thoughts, such as sexual, religious, or aggressive thoughts that feel completely out of character.
These thoughts can feel shocking or confusing, and many people worry that having them says something about who they are. In reality, intrusive thoughts are something most people experience from time to time. With OCD, the thoughts tend to get stuck and trigger a strong sense of responsibility or danger.
Compulsions
Compulsions are actions that someone feels driven to perform in response to an obsession. The aim is usually to reduce anxiety or prevent something bad from happening.
Compulsions can include visible behaviours, such as:
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Washing hands
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Checking locks, appliances, or messages
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Arranging or repeating actions until things feel right
They can also be internal or mental rituals, such as:
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Repeating phrases in your head
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Counting
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Mentally reviewing events
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Trying to cancel out or “neutralise” a thought with another thought
These behaviours can bring short-term relief. The difficulty is that the brain then learns that the only way to feel safe is to perform the ritual, which keeps the cycle going.
OCD becomes a problem when obsessions and compulsions begin to take up a lot of time, cause significant distress, or interfere with work, study, relationships, or daily life.
OCD is a recognised mental health condition. It is not a personality quirk and it is not simply about cleanliness or organisation.
In therapy, we work on understanding how the cycle of obsessions and compulsions is operating in your life. The focus is on learning different ways to respond to intrusive thoughts, gradually reducing compulsive behaviours, and getting back the time and energy that OCD has been taking up.