Understanding OCD: Unraveling the World of Obsessions and Compulsions

Obsessive-Compulsive Disorder (OCD) is a mental health condition that affects millions of people worldwide. It is characterized by a cycle of distressing and intrusive thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) performed to alleviate the anxiety caused by these obsessions. In this blog, we will delve into the intricacies of OCD, exploring what obsessions and compulsions are, how they manifest, and how individuals with OCD can find support and treatment.

The Basics of OCD

  1. Obsessions: The Unwanted Intruders

Obsessions are persistent, unwanted, and distressing thoughts, images, or urges that continuously intrude upon a person’s mind. These thoughts are often irrational, but individuals with OCD cannot simply dismiss them. Common obsessions include fears of contamination, causing harm to others, or a need for symmetry and order. These obsessions can be overwhelming, leading to heightened anxiety and discomfort.

  1. Compulsions: The Ritualistic Response

Compulsions are repetitive behaviors or mental acts that individuals with OCD feel compelled to perform in response to their obsessions. These compulsions are meant to reduce the anxiety associated with the obsessions. For example, someone with contamination obsessions may compulsively wash their hands, while someone with a fear of causing harm might engage in mental rituals, such as counting or reciting phrases.

These obsessions and compulsions can come in many different forms. Today, we will highlight some of the most common types.

Some Obsessions Include:

Cleanliness and Hygiene or fears of contamination. People who struggle with this find themselves obsessing over body fluids (such as urine and feces), household cleaners and the chemicals they use, dirt and environmental contamination (such as mold, asbestos, and radiation), and germs and disease (especially those spread by body fluids and contact with other people). 

Losing Control. People who struggle in this way may find themselves in constant fear of harming themselves or others due to intrusive thoughts. This may look like thoughts of self harm, thoughts of violence toward others, or even verbally attacking others with obscenities. Other patients may struggle with obsessive thoughts about stealing things, or have horrific and violent thoughts for no reason.

Perfectionism. People who struggle in this way often live in fear of forgetting something important, or will hold onto objects because they’re afraid they will eliminate something important by mistake. Common obsessions also include a desire for everything to be even or exact, or an obsession with obtaining and remembering information. 

Unwanted Sexual Thoughts. This may include perverted sexual impulses, obsessions about aggressive sexual behavior, or sexual urges toward children or family members.

Most OCD obsessions are coupled with compulsions. These compulsions often time include:

  • Compulsive hand washing
  • Showering 
  • Cleaning
  • Compulsive straightening of objects, 
  • Door closing and/or locking, 
  • Hoarding of objects, 
  • Repetitive counting 
  • Intrusive thoughts
  • Reassurance Seeking

Another term that is used to refer to compulsive behavioral patterns is a “ritual”.  Since a compulsion is essentially a repetitive ritualistic behavior that is attempting to neutralize the anxiety associated with the obsession, the patterns are often called rituals. This can be one specific compulsive behavior or at times a series of behaviors in a certain order or a certain number of times. 

Some OCD rituals are more subtle and less obvious than others. In fact there are many rituals that are considered “mental rituals” and involve no outward physical behaviors but are all internal thought based patterns. 

Examples of Mental Rituals:

  • A mental review of lists
  • Evaluating the meaning of a thought
  • Trying to suppress or stop unwanted thoughts
  • Thinking special words, sayings, images, or phrases
  • Trying to change a “bad” thought into a “good” thought

“Pure O” OCD

People sometimes refer to a variant of OCD as “Pure O” or “Purely Obsessional” OCD. The purported difference is that in this case it involves only obsessive and intrusive distressing internal thoughts and lacks outward compulsions or compulsive behaviors.  In fact, with Pure O OCD it is not that there are compulsions but that they tend to be more in the arena of the aforementioned mental rituals and are less outwardly or physically external and obvious and at times harder to identify for that reason. 

The Vicious Cycle of OCD

OCD operates in a cyclical pattern. Obsessions trigger anxiety, which drives individuals to perform compulsions. While these compulsions provide temporary relief, the anxiety eventually returns, perpetuating the cycle. This cycle can be incredibly disruptive to daily life, making it difficult to concentrate on work, maintain relationships, or enjoy leisure activities.

Diagnosis and Understanding Triggers

Diagnosing OCD involves a thorough assessment by a mental health professional. Understanding the triggers for an individual’s obsessions and compulsions is a crucial step in managing the disorder. Triggers can vary widely from person to person and may include specific situations, objects, or thoughts.

Treatment Approaches For OCD

OCD is treatable, and approaches have been effective in helping individuals manage their symptoms. This blog won’t go in depth on these areas but next month we will do an in depth look at types of treatment for OCD. This will be the second part of a 2 part series on Understanding & Treating OCD:

  1. Cognitive-Behavioral Therapy (CBT): CBT is a well-established treatment for OCD. It helps individuals identify and challenge irrational beliefs, develop coping strategies, and gradually face their fears through a process known as exposure and response prevention.
  2. Medication: Some individuals with OCD may benefit from medication, typically selective serotonin reuptake inhibitors (SSRIs). These drugs can help alleviate the symptoms of OCD by affecting neurotransmitter levels in the brain.
  3. Support Groups: Support groups provide a sense of community and understanding for individuals with OCD. Sharing experiences and coping strategies with others who have similar challenges can be highly beneficial.

Obsessive-Compulsive Disorder is a complex mental health condition that affects people of all ages and backgrounds. By understanding the nature of obsessions and compulsions, as well as the treatment options available, we can better support individuals living with OCD. Seeking professional help is a crucial step towards managing the disorder, and with the right treatment and support, individuals with OCD can lead fulfilling lives with fewer disruptions from the relentless cycle of obsessions and compulsions. For further information on OCD check out our prior blog  OCD: What it is and what it Isn’t


If you think you may be struggling with OCD, we can help. Call today to schedule your intake appointment with one of our clinicians who treat OCD! We are happy to offer support from our St. Pete, Fl, and Tampa, FL-based practices in other local areas across the state. please contact us to set up a free consultation. We will set up a consult with one of our psychologists who specializes in treating OCD. 

In addition to treating OCD and all kinds of anxiety Disorders, Wellness Psychological Services is proud to offer both in-person and online therapy for the residents of Florida. Our team also offers couples counseling and divorce discernment counseling. We also offer mental health support services including anxiety treatment, trauma therapy, depression counseling, OCD treatment, stress management, and testing and evaluation services for individuals as well! Additionally, we are happy to offer eating disorder treatmentPCIT therapy, DBT, child therapy, therapy for professionals, and health psychology. Feel free to learn more by visiting our blog page or FAQ today!

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