What Is OCD?
Obsessive-compulsive disorder (OCD) is a mental health condition that affects how a person thinks, feels, and behaves.
To be diagnosed with OCD, a person must:
OCD isn’t just about being particular or overthinking—it’s a disorder that can make it feel like your brain is constantly working against you.
To be diagnosed with OCD, a person must:
- Experience obsessions, compulsions, or both
- Spend significant time caught up in these obsessions or compulsions, or feel distressed by them
- Have symptoms that are better explained by OCD than another condition
- Not have symptoms caused by substance use or a medical condition
OCD isn’t just about being particular or overthinking—it’s a disorder that can make it feel like your brain is constantly working against you.
What Are Obsessions?
Obsessions are mental experiences that can take the form of thoughts, urges, or images. They are:
- Recurrent – Showing up more than once
- Intrusive – Arriving unexpectedly and feeling unwanted or out of control
- Distressing – Causing anxiety, discomfort, or emotional distress
- Difficult to ignore – Leading to efforts to suppress, neutralize, or get rid of them
Examples of Obsessions
- Fear of harming someone, even though you don’t want to
- An intense need to remember details perfectly or replay past events
What Are Compulsions?
Compulsions are repetitive behaviors or mental rituals performed to reduce distress or prevent a feared outcome—even when it doesn’t logically make sense. They can be:
- Driven by an internal urge or rigid rule set
- Used to relieve distress or avoid a dreaded situation
- Excessive or unnecessary, often continuing well beyond what might be useful
Examples of Compulsions
- Rereading a passage repeatedly until it “feels right”
- Mentally replaying a scenario to make sure nothing was said or done wrong
The Difference Between Generalized Anxiety Disorder (GAD) and OCD
OCD and GAD can look similar because both involve intrusive thoughts filled with fear and worry. But, they are distinct conditions—and a person can have both.
How to Tell the Difference
The biggest distinction? Compulsions. If you’re engaging in repetitive behaviors or mental rituals to relieve distress or prevent a feared outcome, that’s a strong sign of OCD.
But here’s where it gets tricky: Not all compulsions are obvious. Some people with OCD don’t even realize they have compulsions because theirs are completely internal—a form of OCD often called Pure O (Purely Obsessional) OCD.
With Pure O, compulsions don’t involve physical actions like handwashing or checking locks. Instead, they happen in the mind, like:
- Mentally reviewing past events to make sure nothing bad happened
- Repeating words or phrases in your head until it feels "right"
- Analyzing thoughts over and over to make sure they don’t mean something awful about you
- Seeking certainty through rumination, even though certainty never comes
When compulsions aren’t immediately obvious, here are some other ways to distinguish OCD from anxiety:
- OCD tends to focus on specific themes (subtypes), while GAD usually involves a broad range of shifting worries.
- OCD obsessions are often more unrealistic (but not always).
- OCD demands certainty and relief through compulsions (even purely mental ones), while GAD typically involves general excessive worry without rituals to neutralize distress.
If you feel trapped in distressing thoughts and spend a lot of time trying to analyze, neutralize, or "solve" them, it might not just be anxiety—it could be OCD.
Why It Matters to Know the Difference
If you have OCD, treating it like anxiety won’t work.
A therapist treating anxiety with Cognitive Behavioral Therapy (CBT) might use a tool called "Thoughts on Trial," where a person examines the evidence for and against an anxious thought. This works for anxiety because the person can recognize that their fear isn’t grounded in reality.
But for OCD, this strategy backfires.
Instead of reducing anxiety, it fuels the obsession, leading to endless mental debates.
The most effective treatment for OCD involves accepting discomfort and resisting compulsions—an approach that also helps with anxiety.
This is why specialized ERP therapy for OCD is essential, rather than using standard anxiety approaches.
A therapist treating anxiety with Cognitive Behavioral Therapy (CBT) might use a tool called "Thoughts on Trial," where a person examines the evidence for and against an anxious thought. This works for anxiety because the person can recognize that their fear isn’t grounded in reality.
But for OCD, this strategy backfires.
Instead of reducing anxiety, it fuels the obsession, leading to endless mental debates.
The most effective treatment for OCD involves accepting discomfort and resisting compulsions—an approach that also helps with anxiety.
This is why specialized ERP therapy for OCD is essential, rather than using standard anxiety approaches.
You don’t have to stay stuck. Let’s work together to help you reclaim your time, energy, and peace of mind.
How OCD Affects Life
OCD doesn’t just cause anxiety—it can take control of your time, energy, and peace of mind. In fact, OCD was once ranked by the World Health Organization as one of the top 10 most disabling illnesses based on lost income and decreased quality of life (Source).
Living with OCD can look like:
The reality? OCD is a liar—but when you’re in it, it’s hard to see a way out.
Living with OCD can look like:
- Feeling stuck in a cycle of intrusive thoughts and rituals
- Spending hours each day trying to calm distressing thoughts or urges
- Avoiding certain people, places, or situations to prevent triggers
- Struggling to be present because your mind is always chasing certainty
The reality? OCD is a liar—but when you’re in it, it’s hard to see a way out.
Common Myths
about OCD
Sometimes, OCD can look like it’s only obsessions. That’s often called "Pure O" (Purely Obsessional) OCD—but that name is a bit misleading.
Compulsions are still present; they’re just harder to recognize because they aren’t visible. Instead of outward behaviors like handwashing or checking, compulsions happen entirely in the mind.
Even though these compulsions aren’t visible, they serve the same function as physical compulsions: they temporarily relieve distress but ultimately keep the OCD cycle going.
Most mental health disorders stem from normal human experiences that become extreme enough to impair daily life—OCD is no different.
- Intrusive thoughts: Everyone has them, but people with OCD experience them at an extreme, distressing level that isn’t always grounded in reality.
- Compulsions: Everyone has urges and preferences, but the urges and rituals of OCD feel unbearable.
Having quirks isn’t the same as having OCD. OCD is a debilitating disorder that interferes with life and functioning.
OCD has many different subtypes, including:
And that’s only some of them! A person with OCD may experience one or multiple subtypes, and their obsessions can shift over time.
- Contamination OCD (fear of germs, dirt, or illness)
- Just Right OCD (needing things to feel “perfect”)
- Checking OCD (repeatedly checking locks, appliances, etc.)
- Harm OCD (fear of causing harm to others or oneself)
- Religious Scrupulosity & OCD Therapy (obsessions about morality or sin)
- Relationship OCD (R-OCD) (fixation on doubts about relationships)
- Sexual Orientation OCD (SO-OCD) (intrusive thoughts about one's sexuality)
- Existential OCD (obsessions about what is real and the meaning of life)
- Perinatal/Postpartum OCD (disturbing thoughts related to pregnancy or parenting)
And that’s only some of them! A person with OCD may experience one or multiple subtypes, and their obsessions can shift over time.
“You get to consciously decide what has meaning and what doesn’t.”
— David Foster Wallace
“This is Water”
ACT & ERP Therapy for OCD: How I Can Help
OCD convinces you that if you just do the compulsion one more time, find the right answer, or replay the scenario perfectly in your head, then you’ll finally feel okay.
But that relief never lasts, and the cycle starts all over again.
Therapy helps you step out of that cycle and build true confidence in handling uncertainty, discomfort, and distress.
As a therapist for intrusive thoughts & compulsions, I specialize in Acceptance and Commitment Therapy (ACT) and Exposure and Response Prevention Therapy (ERP)—the most effective approaches for breaking free from OCD’s grip.
But that relief never lasts, and the cycle starts all over again.
Therapy helps you step out of that cycle and build true confidence in handling uncertainty, discomfort, and distress.
As a therapist for intrusive thoughts & compulsions, I specialize in Acceptance and Commitment Therapy (ACT) and Exposure and Response Prevention Therapy (ERP)—the most effective approaches for breaking free from OCD’s grip.
- You’ll learn to step out of OCD’s mental traps. I won’t reassure you or help you "figure it out"—because that’s OCD’s trap. Instead, you’ll develop cognitive defusion skills to recognize obsessive thoughts for what they are: just thoughts, not truths.
- We’ll focus on long-term change—not just quick fixes. Temporary relief from compulsions always comes at a cost: stronger, more demanding OCD. Therapy helps you build true resilience so that your brain stops treating every intrusive thought as an emergency.
- You’ll build confidence in handling uncertainty. Counseling helps you shift from “I need to be sure” to “I can handle not knowing.”
- You’ll learn how to be prepared for setbacks. When OCD tries to creep back in, you’ll know exactly what to do.
- We’ll untangle the self-blame that OCD and stigma have created. Intrusive thoughts are not the same as desires or intentions. I’ll help you separate your true self from the false narratives OCD tries to tell you.
In-Person & Virtual OCD Therapy in South Carolina
I offer in-person and virtual counseling for OCD across South Carolina. Whether you prefer face-to-face sessions or the flexibility of online therapy, you’ll have support to break free from obsessions and compulsions so that you can regain control of your life.
Reach out today to start ACT & ERP therapy for OCD and build the tools you need to manage it with confidence.