What is Obsessive-Compulsive Disorder (OCD)?

Obsessions are unwanted, repetitive, and bothersome thoughts, images, or impulses that result in uncomfortable feelings. Compulsions are repetitive behaviors that an individual might engage in in order to decrease obsessions and the subjective experience of distress. When obsessions and compulsions interfere with everyday living, an individual might meet criteria for the diagnosis of OCD.

Common Obsessions:
  • Fear of contamination (due to germs, dirt, chemicals, etc.)
  • Superstitious ideas about numbers or sequences
  • Fear of harming oneself or others
  • Concerns of offending God or doing something immoral
  • Unwanted sexual thoughts or impulses
Common Compulsions:
  • Washing/cleaning
  • Mental compulsions (e.g., counting, reviewing, praying)
  • Checking (that you did not harm anyone or that you did something correctly)
  • Ordering things until they feel "right"
  • Asking others for reassurance

Those who struggle with Obsessive-Compulsive Disorder can get caught up in a seemingly endless cycle of obsessions and compulsions. Obsessions drive compulsive behaviors, which temporarily reduce the suffering associated with the obsessions. But, relief is short-lived, and the cycle continues (and is strengthened) with the repetition of compulsive behaviors.


Cognitive-behavior therapy (CBT) is evidence-based treatment for Obsessive-Compulsive Disorder. That means that this type of therapy has been shown in the research to have positive large-scale outcomes. In fact, only CBT and medication are considered "first line" interventions for OCD. A specific type of CBT, Exposure Plus Response Prevention (ERP) is typically used to treat OCD. With ERP, individuals are discouraged from engaging in compulsive behavior when faced with their obsessions. ERP for OCD  involves exposure (to the obessional content) and response prevention (of the compulsions). With the un-pairing of obsessions and compulsions, and over time, many individuals experience a reduction in frequency and severity of their obsessions (which translates to an even further reduction in compulsive behavior). They learn how to tolerate worrisome thoughts when they occur, thereby preventing compulsive actions from interfering with their functioning. There is also some evidence that suggests that those who suffer from OCD might benefit from Acceptance and Commitment Therapy (ACT), which focuses on accepting and defusing obsessive thoughts, while at the same time, focusing on creating a life worth living.


Several other disorders fall under the Obsessive-Compulsive Disorders umbrella in the DSM-5.  They include Body Dysmorphic Disorder(BDD), Trichotillomania, and Excoriation (Skin-Picking) Disorder, also referred to as Dermatillomania. Each of these disorders involves coping with distress via a repetitive activity/behavior, from appearance checking in BDD, to hair pulling or skin picking in the others. These disorders, too, can be treated with CBT/ERP and, sometimes, with adjunctive medication.

Our counselors are specifically trained in CBT and ERP protocols to address OCD and related conditions. OCD can be a challenging diagnosis, but with the right treatment, it does not have to entail a lifetime of suffering.

Gatewell OCD Therapists: