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Obsessive Compulsive Disorder (OCD)

What is Obsessive Compulsive Disorder (OCD)?

OCD involves a pattern of unwanted, intrusive thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) that are carried out to reduce anxiety or distress.
 

Obsessions

 

Obsessions are:

  • Recurrent, intrusive thoughts, images, or urges

  • Experienced as distressing, unwanted, or out of character

  • Difficult to dismiss or ignore

 

Common themes include:

  • Fear of harm coming to yourself or others

  • Contamination (e.g. germs, illness)

  • Intrusive thoughts of a violent, sexual, or taboo nature

  • Doubts about safety, responsibility, or “getting it wrong”

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Importantly, these thoughts do not reflect a person’s intentions or character — they are a feature of how the mind can become stuck in a threat-focused loop.

Compulsions

Compulsions are repetitive behaviours or mental acts aimed at reducing distress or preventing a feared outcome. These might include:

  • Checking (e.g. doors, appliances, health concerns)

  • Washing or cleaning

  • Repeating actions or phrases

  • Seeking reassurance

  • Mental rituals (e.g. reviewing, counting, “neutralising” thoughts)

 

While these behaviours may bring short-term relief, they tend to keep the cycle going over time.

 

People experiencing OCD are often very aware that their thoughts or behaviours are excessive or don’t fully make sense, which can add to feelings of frustration, shame, or self-doubt.

How common is OCD?

OCD is more common than many people realise:

  • Around 2–3% of the population experience OCD at some point in their lives

  • Symptoms often begin in late adolescence or early adulthood, though they can start earlier

  • It affects people of all genders and backgrounds

 

(NICE and international clinical research, 2022–2024)

What treatment can we offer?

There are several effective, evidence-based approaches that can support recovery. These focus on breaking the cycle between intrusive thoughts and compulsive responses.

Cognitive Behavioural Therapy (CBT)

CBT supports:

  • Understanding how thoughts, emotions, and behaviours interact

  • Challenging unhelpful beliefs (e.g. over-responsibility, thought–action fusion)

  • Developing more balanced ways of responding to intrusive thoughts

How common is OCD?

OCD is more common than many people realise:

  • Around 2–3% of the population experience OCD at some point in their lives

  • Symptoms often begin in late adolescence or early adulthood, though they can start earlier

  • It affects people of all genders and backgrounds

 

(NICE and international clinical research, 2022–2024)

 

Exposure and Response Prevention (ERP) is the most well-established psychological treatment and is recommended by National Institute for Health and Care Excellence.

 

It involves:

  • Gradually facing feared situations or thoughts (exposure)

  • Learning to resist compulsive behaviours or rituals (response prevention)

  • Allowing anxiety to rise and fall naturally without “neutralising” it

 

Over time, this helps the brain learn that the feared outcomes are unlikely and that anxiety is manageable.

Acceptance and Commitment Therapy (ACT)

ACT can be particularly helpful in OCD by:

  • Changing the relationship with intrusive thoughts (rather than trying to eliminate them)

  • Reducing the struggle and control strategies around thinking

  • Supporting action guided by values, not fear

Compassion-Focused Therapy (CFT)

CFT helps address:

  • Shame and self-criticism often associated with OCD

  • Fear of what thoughts “mean” about you

  • Building a more supportive and understanding inner voice

A compassionate note

OCD can feel confusing and, at times, distressing — especially when thoughts seem at odds with your values. These experiences are far more common than people often realise, and they are treatable. With the right support, it is possible to step out of the cycle of fear and compulsion, and regain a greater sense of freedom and control.

Further support

You may find these trusted resources helpful:

  • NHS – overview of OCD and treatment options

https://www.nhs.uk/mental-health/conditions/obsessive-compulsive-disorder-ocd/

  • OCD UK – specialist support and resources

https://www.ocduk.org/

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