Understanding OCD

Written for Through the Woods Psychology by D. Skretting

Obsessive Compulsive Disorder (OCD) is a mental health condition that is often misunderstood. Many people casually use the term “OCD” to describe being organized, particular, or wanting things done a certain way. OCD, however is much more than a preference for cleanliness or organization. For someone experiencing OCD, unwanted thoughts, fears, and repetitive behaviours can become distressing, time consuming, and disruptive to everyday life.

What is OCD?

OCD generally involves two key experiences: obsessions and compulsions.

Obsessions are recurring, intrusive thoughts, images, urges, or doubts that cause distress (Poli et al., 2022). These thoughts are often unwanted and can feel difficult to control. Examples might include fears about contamination, accidentally harming someone, making a serious mistake, being responsible for something going wrong, or experiencing uncertainty about whether something was done correctly.

Importantly, having an intrusive thought does not mean that you want it to happen or that it reflects who you are. Most people experience unwanted thoughts from time to time. With OCD, however, the thought can become highly significant, leading to attempts to neutralize, prevent, or gain certainty about it.

Compulsions are repetitive behaviours or mental rituals performed in response to anxiety, intrusive thoughts, or a perceived threat. These might include excessive checking, washing, reassurance-seeking, counting, repeating actions, researching, or mentally reviewing an event.

Compulsions can temporarily reduce anxiety, which can make the brain learn that the behaviour was necessary.

Over time, this can create a cycle:

Intrusive thought → Anxiety or uncertainty → Compulsion → Temporary relief → Intrusive thought returns

The more the cycle is reinforced, the more difficult it can become to resist compulsions. Some people experience primarily mental compulsions, such as silently repeating phrases, reviewing memories, analyzing thoughts, seeking internal certainty, or trying to “figure out” whether a thought means something about them. There are also many different themes associated with OCD, including contamination, responsibility, relationships, morality, health, sexuality, harm, religion, and fears about making mistakes. The specific content can vary considerably from person to person.

Can OCD Be Treated?

Yes. OCD is treatable, and people can learn to respond differently to intrusive thoughts and uncertainty.

One of the most established psychological treatments for OCD is Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP), (McGuire et al., 2021). ERP involves gradually and intentionally facing feared thoughts, situations, or sensations while learning to resist compulsive responses. Research supports CBT with ERP as an effective psychological treatment for OCD.

Treatment isn’t about eliminating every unwanted thought. Instead, therapy can help people develop a different relationship with thoughts and uncertainty recognizing that a thought is not necessarily a fact, prediction, intention, or reflection of character. If obsessive thoughts or compulsive behaviours are taking up significant time, interfering with relationships or work, or making everyday life feel increasingly restricted, reaching out to a mental health professional can be an important first step.

You don’t have to navigate the OCD cycle alone. Understanding what is happening is often the beginning of learning how to respond differently.


At Through the Woods Psychology in Calgary, we not only have psychologists and counsellors that can direct bill to most insurance companies, but also counselling therapist interns that can offer low-cost or no-cost therapy to those who are unable to afford sessions or do not have insurance. Sessions are done in person or online.    

Visit our website to learn more or to book your free consultation today. You can also get in touch by email at info@throughthewoods.ca or phone at (403) 984-7922.    

References:
McGuire, J. F., Piacentini, J., Brennan, E. A., Lewin, A. B., Murphy, T. K., Small, B. J., & Storch, E. A. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry, 106, 152223. https://doi.org/10.1016/j.comppsych.2021.152223

Poli, A., Pozza, A., Orrù, G., Conversano, C., Ciacchini, R., Pugi, D., Angelo, N. L., Angeletti, L. L., Miccoli, M., & Gemignani, A. (2022). Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review. Frontiers in Psychiatry, 13, 1063116. https://doi.org/10.3389/fpsyt.2022.1063116