Untangling OCD: What Are Obsessions, Compulsions, and How Can Therapy Help?
Intrusive Thoughts Don’t Define You
OCD can make you feel trapped in your own mind—but healing is possible. Learn what OCD is (and isn’t), and how therapy can help you get unstuck.
By Nutbrown Counselling
Obsessive-Compulsive Disorder (OCD) is often misunderstood—and misrepresented. It’s not about being extra clean or quirky about how you arrange your bookshelf. OCD is a serious mental health condition that can feel exhausting, confusing, and even frightening to live with.
This blog explores what OCD really is, the difference between intrusive thoughts and compulsions, and how therapy can help you (or someone you love) find relief and clarity.
What Is OCD?
OCD is a mental health condition characterized by two key elements:
Obsessions – unwanted, distressing thoughts, images, or urges that keep intruding into your mind
Compulsions – behaviours or mental acts done to reduce the anxiety caused by obsessions
These cycles can be incredibly distressing—and they’re not a choice.
OCD affects about 1–2% of the population, and it can show up at any age. It’s not caused by weakness or personality traits, and it’s not something you can “just stop thinking about.”
What Are Obsessions?
Obsessions are intrusive, unwanted thoughts, images, or urges that feel disturbing or distressing. They often go against a person’s values or sense of self, which is why they can feel so alarming.
Common obsessions include:
Fear of harming others (even accidentally)
Contamination fears (germs, illness, bodily fluids)
Sexual or violent intrusive thoughts
Religious or moral fears (e.g. fear of blasphemy)
“Just right” feelings or fear of things being uneven or out of order
Many people with OCD feel shame or fear about these thoughts—but it’s important to know that having a thought is not the same as acting on it.
Intrusive thoughts are normal, even in people without OCD. But in OCD, the brain gets “stuck” on those thoughts, creating a cycle of anxiety and rumination.
What Are Compulsions?
Compulsions (sometimes called rituals) are repetitive behaviours or mental actions that someone feels driven to do to reduce the anxiety caused by obsessions.
Compulsions can be:
Physical actions: handwashing, checking locks, organizing, tapping
Mental rituals: praying, repeating phrases, counting, mental reviewing
Avoidance: staying away from people, places, or objects that trigger anxiety
While compulsions might feel like they offer temporary relief, they actually reinforce the obsessive cycle over time. The more you perform them, the more your brain links anxiety relief to the compulsion, keeping the loop going.
What OCD Is Not
OCD is not:
A personality quirk or preference for cleanliness
The same as perfectionism or being detail-oriented
A joke or punchline (e.g. “I’m so OCD about my email inbox!”)
People with OCD often feel intense shame, guilt, or isolation. Minimizing or stereotyping the condition makes it harder for folks to reach out for help.
How Can Therapy Help?
Therapy is one of the most effective tools for managing OCD. The most evidence-based treatment is Exposure and Response Prevention (ERP)—a type of therapy that gently helps people confront their fears without engaging in compulsions.
Other therapy supports may include:
CBT (Cognitive Behavioural Therapy): Helps reframe unhelpful thoughts and beliefs
Psychoeducation: Understanding how OCD works helps reduce shame and fear
Mindfulness and distress tolerance: Learning to sit with discomfort without reacting
Values work: Reconnecting with who you are outside of OCD’s grip
Therapy doesn’t mean your thoughts disappear overnight. But it does mean you’ll gain more choice, more awareness, and more capacity to respond instead of react.
You Are Not Your Thoughts
OCD can be cruel. It can make you doubt yourself, fear your own mind, and feel like you're always one step away from disaster. But recovery is possible—and you don’t have to face it alone.
At Nutbrown Counselling, we offer compassionate, evidence-informed support for clients struggling with intrusive thoughts, compulsions, and anxiety. If OCD has been taking up too much space in your life, therapy can help you find your way back to yourself.
Warmly,
Nutbrown Counselling
In-person & virtual counselling in Kelowna, BC
🌐 www.nutbrowncounselling.com
📅 Book a Session
Legal Disclaimer
This blog is for informational purposes only and does not replace professional mental health or medical advice. If you are struggling with OCD or other mental health concerns, please consult with a licensed healthcare provider.
References
Abramowitz, J. S., McKay, D., & Taylor, S. (2008). Clinical handbook of obsessive-compulsive disorder and related problems. Johns Hopkins University Press.
International OCD Foundation. (n.d.). What is OCD? https://iocdf.org/about-ocd/
Stein, D. J., Costa, D. L. C., Lochner, C., Miguel, E. C., Reddy, Y. J., Shavitt, R. G., ... & Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature Reviews Disease Primers, 5(1), 1-21. https://doi.org/10.1038/s41572-019-0095-5
Taylor, S., Abramowitz, J. S., & McKay, D. (2012). Cognitive-behavioral models of OCD. In G. Steketee (Ed.), The Oxford Handbook of Obsessive Compulsive and Spectrum Disorders (pp. 109–131). Oxford University Press.