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OCD Therapy, Obsessive Compulsive Disorder

Therapy and OCD: How Does It Work?

You’ve probably heard people joke that they keep their home clean because they’re “so OCD.” But Obsessive Compulsive Disorder is much more complex and difficult than a simple preference for tidiness. If a spotless house were the primary symptom of OCD, few people would seek treatment.

However, the disorder is usually very painful and destructive. It causes anxiety from obsessive thoughts, which often leads to compulsive actions. These repetitive behaviours often feel inescapable, and they can seep into every part of a person’s life. 

People with OCD often feel isolated and hopeless because of their condition, but they don’t have to suffer alone. There is therapy available for OCD, and a calmer, happier life awaits on the other side. 

What do obsessions and compulsions look like?

Not all people with OCD experience both obsessions and compulsions, but they usually do come together. Here’s a quick rundown of each of these symptoms.


According to the National Institute of Mental Health, obsessions are recurring thoughts, urges, or mental images that cause anxiety or fear. These thoughts might include:

  • worries about being contaminated by things like germs, dirt, or chemicals
  • thoughts about things that are against their moral code, such as violence or sexual imagery
  • unreasonable fears about danger from things like accidents, fires, or attacks
  • anxiety about objects being placed in a certain order

These obsessions are often called intrusive thoughts, because they seem to simply happen, regardless of the situation. They pop up over and over, and no amount of arguing or evidence will make them go away. People with OCD recognize that these thoughts are irrational, but that doesn’t stop these ideas from returning or get rid of the anxiety they cause. 


The intrusive thoughts can lead to compulsive behaviours. These actions feel uncontrollable, even when people become desperate to stop. They’re an attempt to ease the anxiety caused by obsessive thoughts, but they only provide momentary relief. Here are some examples of compulsive actions:

  • a fear of contamination may cause obsessively cleaning or avoiding touching certain items
  • fears about safety can lead to repetitive checks to be sure the stove is turned off or the door is locked, even moments after it was last checked
  • people sometimes engage in extensive, repetitive rituals, such as counting objects, repeating phrases, or arranging items, because they fear they are in danger if they don’t complete them
  • intrusive thoughts about violence or sexual behaviour can drive people to elaborate religious rituals seeking forgiveness

These actions don’t help people get rid of their anxiety, but they usually do provide a tiny moment of relief. This fleeting feeling reinforces the behaviour, even when people know it’s irrational and even harmful.

It’s important to note that not all people with OCD have compulsive behaviours. It’s possible for people to only experience intrusive thoughts without the accompanying actions. This doesn’t make it any less difficult. If someone’s day is consumed by intrusive thoughts about germs, it can cause overwhelming, painful anxiety, even if they don’t wash their hands until they’re raw. 

How OCD is diagnosed

Many people have habits or rituals that bring them comfort, even when they know they’re not rational. But people with OCD aren’t just being careful or indulging a superstition. The hallmark of this disorder is that even though they realize that what they’re thinking or doing is irrational, they still can’t control it. 

People with OCD generally lose an hour or more each day to their intrusive thoughts or compulsions. The obsessions cause problems in many parts of their lives, such as work, relationships, or enjoyable activities. Their repetitive thoughts and behaviours don’t feel good or make them happy, but they feel unable to stop. 

Sometimes people with OCD also have a tic disorder. This can be a motor tic, which causes short, repetitive movements, such as blinking, head jerking, shoulder movements, or grimacing. It can also be expressed as vocal tics, such as sniffing or grunting.

OCD is diagnosed when someone describes experiencing these symptoms to a mental health care professional. People with this disorder often feel deep shame about it, so this step can be hard. But getting a diagnosis enables them to get treatment. And with treatment comes hope.  

Effective treatment for OCD

One of the frustrating things about OCD is that sufferers know that their thoughts and actions are irrational, but they still can’t control them. It’s very hard to change your behaviour when your brain is blaring an alarm that you’re in danger. But it’s not impossible, and a therapist can help. 

The Anxiety and Depression Association of America explains that  CBT Therapy can help people with OCD retrain their brains to cope with their symptoms. With CBT, people learn to choose healthy, rational responses to the thoughts that create anxiety. They build habits that bring them relief, freeing them from the self-feeding cycle of anxiety and compulsion. 

One powerful tool used in CBT is exposure and response prevention (ERP). This is a process that gradually introduces patients to situations that trigger their obsessive thoughts. This deliberate exposure enables them to confront their responses slowly, in a controlled manner, with the support of their therapist. With practice, over time, patients learn to react in healthier, constructive ways. 

Another therapy that has been found to be effective for OCD is Dialectical Behaviour Therapy (DBT).  DBT is a form of CBT therapy that focuses on accepting and understanding emotions.  DBT helps clients develop skills to manage and regulate emotions to develop a healthier mental health state. 

It’s very important to know that although this therapy can be challenging, it is never forced upon a patient. They progress at their own pace. After all, the goal of treatment is for the patients to reclaim their sense of control in dealing with their thoughts and actions. With deliberate practice, the skills they practice in a safe setting can be applied to their lives. They learn to manage their brain’s alarms and live the life they long for. 

If you are struggling with OCD and want help to overcome the painful effects it has on you, please contact us today. Our compassionate, experienced therapists are here to help you gain the skills you need to reclaim your life. 

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