When Intrusive Thoughts Won't Go Away: Understanding Mental Compulsions and OCD

The thoughts keep coming:

"What if I lose control and hurt someone I love"

"What if I said or did something unforgivable?"

"What if I don't actually love the person I'm with?"

Graphic. Disturbing. Against everything you value. Your stomach drops.

Immediately, you start reviewing: "Why would I think that? What does this mean about me? Have I ever done anything like that before?"

You Google the thought. You check your feelings. You ask someone close to you if you're a good person. Each time, it works—for maybe an hour. Then the thought returns, often stronger than before.

Meanwhile, to everyone else, you look fine. They have no idea you're running a mental marathon, trying desperately to prove you're not the person your thoughts suggest you might be.

If this sounds familiar, you're likely dealing with what's sometimes called "Pure O" or purely obsessional OCD—a pattern where the compulsions happen (almost) entirely in your mind, making them invisible to others and often even to yourself.

Learn more about OCD Treatment—>.

What Makes These Thoughts Different

Everyone has strange or unwanted thoughts occasionally. The difference with this pattern is what happens next.

Most people have an intrusive thought—"What if I swerved into oncoming traffic?"—and dismiss it as mental noise. But with this pattern, that thought feels urgent, meaningful, dangerous. Your mind tells you this requires immediate attention.

What tends to happen:

The thought feels shocking, but also meaningful. Your mind tells you: "This must mean something important about who I really am. Why else would I think this?"

• You feel compelled to figure out what it means—right now

• You start mental rituals: analyzing, reviewing, seeking certainty

• These rituals provide brief relief, then the thought returns

• The cycle repeats, sometimes for hours each day

The thoughts themselves aren't the problem.

It's what you do in response to them that keeps you captured.

The Compulsions You Don't Recognize as Compulsions

The term "Pure O" is somewhat misleading. It suggests purely obsessional—thoughts without compulsions. But that's not entirely accurate.

You have compulsions. They're just invisible.

When mental compulsions start, they feel important, needed, and protective. They're trying to solve the problem.

"If only I can think about this the right way, I can solve this and not worry about it anymore."

This is part of what makes this pattern so exhausting—you're working hard all day, but the work itself is the trap.

Common mental compulsions:

• Mental reviewing: Replaying conversations, events, or past behavior to check if you did something wrong

• Analyzing and debating: Going over the thought repeatedly—"Would I really do that? What kind of person thinks this?"

• Checking feelings: Scanning your body for the "right" feeling—do you still love your partner? Do you feel disgusted enough by the thought?

• Reassurance-seeking: Searching online for answers, asking loved ones if you're a good person, reading forums to see if others have the same thoughts

• Neutralizing: Trying to "cancel out" a bad thought with a good one, or repeating phrases to feel safe

These mental actions feel like they should help. But they're actually feeding the pattern that keeps you stuck.

What the Thoughts Are About

This pattern can attach to almost anything, but it tends to target what matters most to you. The more deeply you care about something—your values, your relationships, your identity—the more material it has to work with.

Some common themes:

Harm Obsessions

"What if I lose control and hurt someone I love?" These thoughts can be graphic and violent, precisely because causing harm is the last thing you would ever want.

Sexual or Taboo Thoughts

Unwanted images or thoughts involving taboo scenarios that violate your deepest values. The shame around these can be crushing.

Relationship Obsessions

"Do I really love my partner? What if I'm with the wrong person? Am I leading them on?" Constantly checking your feelings, comparing your relationship, seeking certainty you can never find.

Sexual Orientation or Identity Questions

Obsessive doubt about sexual orientation or gender identity. The issue isn't the identity itself—it's that you can't stop asking the question.

Religious or Moral Scrupulosity

Religious: "Have I sinned? Am I going to hell? Did I offend God?" Mental checking, repetitive prayer, an unshakeable sense of moral contamination.

Moral/Ethical: "Am I a fundamentally bad person? Did I do enough to help? Am I complicit in harm?" Constant moral self-interrogation, reviewing past actions for ethical failures, needing certainty about your goodness.

The pattern: OCD doesn't waste time on things you don't care about. It targets what's most important to you, then uses your conscientiousness against you.

If you're recognizing yourself in these patterns—and especially if you've tried addressing the symptoms but not what's underneath them—I'd be glad to talk about how we might work together. Contact me to discuss OCD therapy.

Why Smart, Conscientious People Get Trapped

The ironic thing is that this pattern tends to show up in people who are thoughtful, analytical, and deeply responsible. Your capacity for self-reflection—usually a strength—becomes the mechanism that keeps you captured.

Your brain presents a disturbing thought, then says:

"A good person would never think this unless something was deeply wrong. You need to figure this out immediately."

So you do what any reasonable, conscientious person would do: you try to solve the problem. You analyze. You review your past. You seek certainty.

And that's exactly what keeps the cycle going.

The rumination—the mental work that feels like responsible self-examination—is itself a compulsion. It's a defense against something deeper.

Sometimes the compulsive thinking is trying to protect you from core emotions that feel dangerous: rage, grief, vulnerability, shame. Sometimes it developed in a family or environment where it genuinely wasn't safe to make mistakes or let your guard down. The pattern made sense at one point. Now it's keeping you stuck.

The rumination that feels like responsible self-examination is itself a compulsion. It's not solving the problem—it's feeding the pattern that keeps you captured.

What Actually Helps (And Why It's Counterintuitive)

If you've been dealing with this for any length of time, you've probably tried:

• Reasoning your way out of the thoughts

• Researching to find the one explanation that will finally make sense

• Seeking reassurance from trusted people

• Avoiding triggers

And none of it has worked for more than a few hours.

That's because these strategies ARE the problem.

The Role of Exposure and Response Prevention

Treatment involves learning to do something that will feel completely wrong at first: stop trying to solve the thought.

Exposure and Response Prevention (ERP) helps you:

• Allow the thought to be present without pushing it away or analyzing it

• Resist the mental compulsions (the reviewing, checking, reassurance-seeking)

• Learn through experience that anxiety rises and falls on its own—you don't need to fix it

Over time, your brain learns: "I can have this thought and still be okay. I don't need to spend hours proving I'm not dangerous."

Why Breaking the Compulsion Cycle Isn't Always Enough

ERP is essential. It interrupts the behavioral pattern. But in my experience, that's often not the whole story.

This pattern doesn't develop in a vacuum. For many people, the rumination patterns connect to deeper emotional wounds—experiences of harsh criticism, unpredictability, shame, or trauma—that led to perfectionism, hypervigilance, and chronic self-criticism as ways of trying to stay safe."

This is why additional approaches are often necessary:

• Internal Family Systems (IFS): Often, different parts of you are in conflict. One part desperately seeks certainty. Another part is exhausted from the compulsions. Another carries shame or fear. IFS helps us work with these parts compassionately—understanding what each is trying to protect you from, so they don't have to work so hard.

• EMDR: When specific traumatic experiences or memories fuel the OCD cycle, EMDR can help process and resolve them so they're no longer triggering the same level of distress.

• Experiential Dynamic Therapy: This helps you understand and work through the emotional patterns beneath the OCD—chronic self-criticism, difficulty with anger or vulnerability, unprocessed grief or shame, a nervous system that's been in overdrive for years.

What this means in practice:

Sessions won't just be about resisting compulsions. We'll also make space for understanding why your mind latched onto this pattern, and work with the parts of you that have been holding fear, shame, or hypervigilance for a long time. The goal isn't just symptom relief—it's helping you feel genuinely safer in your own mind and body.

If You're Reading This and Thinking 'That's Me'

You might be wondering: "But what if my thoughts are different? What if I'm the one person who actually is dangerous?"

That question is the OCD.

People who are actually dangerous don't spend hours worrying about whether they're dangerous. They don't feel horrified by their thoughts. They don't desperately seek reassurance that they're good people.

You do all of those things because you care.

And you deserve support that doesn't require you to keep this secret anymore.

Small Steps You Can Take Now

Start noticing the pattern, not just the content

When a thought shows up, notice what you do next. Do you start analyzing? Googling? Seeking reassurance? Just naming the pattern can create a small space.

Try a one-minute pause

Before you Google or seek reassurance, wait one minute. Just notice the urge without acting on it. Not forever—just 60 seconds.

Find a therapist who understands this pattern

Not every therapist is trained in OCD. Some well-meaning therapists can accidentally make this pattern worse by trying to help you "process" or "understand" the thoughts. You want the rumination to end, but you wind up learning to ruminate even better. You need someone who understands that the thoughts aren't the problem—your relationship with them is.

Ready to Work on This?

I work with people experiencing this pattern and other forms of OCD using an integrated approach. We'll use Exposure and Response Prevention (ERP) to interrupt the compulsion cycle, and when it's helpful, we'll also work with Internal Family Systems (IFS), EMDR, and Experiential Dynamic Therapy to address the parts of you in conflict, the emotional wounds, and the nervous system patterns keeping this active.

In our work together, you won't have to convince me you're a good person, and you won't have to keep apologizing for your thoughts. We'll work on both stopping the compulsions and understanding what's underneath them.

Schedule an appointment

I see clients in-person at my McLean office on Chain Bridge Road and virtually throughout Northern Virginia, Maryland, and Washington, DC—including Arlington, Falls Church, Vienna, Tysons, Bethesda, and Georgetown.

Living with OCD: Tips and Strategies for Daily Management

If you follow the Washington Commanders, you might’ve seen kicker Zane Gonzalez’s game-winning playoff field goal last season in the wild card round—and maybe you noticed the routine that went viral afterward. The precise way he tapped his helmet, adjusted his socks, fixed his hair. Over and over, the same sequence, with each kick.

Some people joked about it. Others just chalked it up to athlete superstition. But Gonzalez later shared that his routine wasn’t about luck—it was part of how he manages life with OCD.

That story stayed with me. Because in therapy, I often hear the other side of that routine: the private, internal struggle that rituals like this can represent. For many people living with OCD, the urge to get something “just right” isn’t quirky or amusing—it’s intense, exhausting, and often invisible.

Whether your compulsions are physical or entirely in your head, whether you’ve had a diagnosis for years or are just beginning to wonder—this post is for you. You’re not alone in this, and there are ways to live with OCD that don’t require you to fight so hard every day.

Let’s talk about what it actually looks like—and what might help.

What Makes Daily Life with OCD So Challenging

OCD affects more than your thoughts. It impacts how you move through the world, how you make decisions, and how much energy it takes to get through your day. Some common experiences include:

• Time-consuming rituals: Whether it's handwashing, checking, repeating actions, or seeking reassurance, compulsions can eat up hours of your time.

• Mental exhaustion: The internal dialogue that OCD creates—What if I missed something? Should I check again? What does it mean that I thought that?—can be relentless.

• Fear of being misunderstood: Many people with OCD hide their compulsions out of shame or fear of judgment, especially when they involve taboo or intrusive thoughts.

• Invisible struggles: Mental compulsions like reviewing conversations, neutralizing thoughts, or counting in your head often go unnoticed by others—making it even harder to explain what you’re going through.

Tips and Strategies for Managing OCD Day-to-Day

There’s no quick fix for OCD, but there are daily practices that can reduce its grip over time. These strategies aren’t about eliminating thoughts—they’re about changing how you relate to them.

1. Structure Your Day Where You Can

OCD thrives on uncertainty and decision overload. Creating predictable routines can help reduce the cognitive load that fuels obsessions. Keep in mind this isn’t about rigidity—it’s about supporting your nervous system and reducing unnecessary stress.

2. Name It: “This Is an OCD Thought”

A key skill in managing OCD is learning to recognize your thoughts as part of the disorder. Labeling a thought as “an OCD thought” creates a bit of space—just enough to make a different choice. The goal isn’t to argue with the thought or prove it wrong, but to notice it and step back.

3. Practice Small Acts of Response Prevention

You don’t have to tackle your biggest compulsion first. Start with something small, like delaying a ritual by 30 seconds or resisting the urge to ask for reassurance once a day. These tiny moments build tolerance and gradually rewire your response to anxiety.

4. Watch Out for Mental Compulsions

Some compulsions happen in your head—like analyzing, mentally checking, or trying to “neutralize” a bad thought. These are just as much a part of OCD as external rituals, and recognizing them is key. When you catch yourself doing a mental compulsion, gently remind yourself that it’s part of the loop, and try returning to the present.

5. Be Kind to Yourself

Living with OCD is exhausting. Progress often isn’t linear. There will be days you feel strong and days when the compulsions win. That doesn’t mean you’ve failed. Practicing self-compassion can prevent the guilt spiral that OCD loves to hijack. A helpful phrase: “I’m working on this—and I don’t have to be perfect.”

6. Track Triggers and Patterns

Keeping a journal can help you spot patterns and identify high-anxiety situations. You might notice certain times of day, stressors, or environments that amplify compulsions. Awareness helps you prepare and respond more skillfully over time.

When to Seek Support

OCD can be deeply isolating—but it doesn’t have to be something you manage alone. If your symptoms are interfering with your daily functioning, relationships, or mental health, working with a therapist who understands OCD can be life-changing.

Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) remain the most well-supported, evidence-based treatments for OCD. They help retrain how you respond to obsessive thoughts by reducing avoidance and breaking the compulsion cycle.

Acceptance and Commitment Therapy (ACT) also plays an important role, especially in helping people move away from fighting thoughts and toward building a life rooted in values—even when anxiety is present. ACT emphasizes willingness and psychological flexibility over symptom control, which many clients find empowering.

Accelerated Experiential Dynamic Psychotherapy (AEDP) is not a first-line treatment for OCD, but it can be a powerful complement—especially for clients whose OCD symptoms are shaped by trauma, shame, or attachment wounds. AEDP helps people access and process emotions that may have been buried under fear, perfectionism, or the urge to control. When OCD is part of a larger emotional survival strategy, AEDP can create a safe space for that deeper healing to begin.

A therapist can help you:

• Build a personalized hierarchy for facing compulsions

• Develop a non-reactive stance toward intrusive thoughts

• Reconnect with emotional resilience through embodied, compassionate exploration

• Stay accountable when avoidance starts to creep back in

OCD is treatable. And therapy can help you not only reduce symptoms—but begin living with more clarity, flexibility, and self-trust.

Final Thoughts

Living with OCD requires resilience, patience, and self-compassion. It’s a daily practice of noticing when the old patterns show up—and choosing, again and again, not to feed them. Some days you’ll feel like you’re making real progress. Other days will feel stuck. That’s part of the process.

Learning to live with OCD isn’t easy—but it is possible. And you don’t have to do it perfectly to make real progress.

Learn more about how OCD therapy can help.

How to Stop OCD Rituals

Obsessive-Compulsive Disorder (OCD) can feel like a relentless cycle of obsessive thoughts followed by compulsive behaviors, or rituals, aimed at reducing the anxiety these thoughts generate. While rituals may provide temporary relief, they ultimately reinforce the cycle, making it harder to break free. Learning how to stop OCD rituals is crucial to regaining control, but long-term relief often involves addressing the deeper emotional issues underlying the disorder. That’s why a combination of response prevention strategies and more in-depth emotional work is key to lasting recovery.

Understanding OCD Rituals

OCD rituals are compulsive behaviors that people perform in response to obsessive thoughts. These behaviors can be mental (such as repeating specific thoughts) or physical (such as checking or cleaning). While they provide short-term relief from anxiety, they often make the compulsive cycle worse over time. For many people, these rituals are not just habits—they often serve as defenses against difficult emotions like anger, sadness or fear. While rituals offer short-term relief, they ultimately maintain the cycle of OCD by reinforcing the belief that the ritual is necessary to prevent a feared outcome.

Strategies to Stop OCD Rituals

1. Exposure and Response Prevention (ERP)

   ERP, a type of Cognitive Behavioral Therapy (CBT), involves gradually exposing yourself to the triggers that provoke your obsessions while preventing the compulsive behavior that follows. This technique reduces the anxiety associated with the obsession and helps break the cycle of rituals over time.

2. Mindfulness and Acceptance

   Mindfulness teaches you to observe your thoughts and feelings without immediately reacting to them. This can help you sit with the discomfort of obsessive thoughts and reduce the urge to perform rituals. Over time, this practice allows you to experience difficult emotions without automatically turning to compulsions for relief.

3. Delay and Disrupt the Ritual

   By delaying or disrupting a ritual, you can weaken the connection between your obsessions and the compulsions that follow. Start by postponing the ritual for a few minutes and gradually increase the delay over time. This creates space to reflect on what you're feeling and break the automatic response cycle.

4. Cognitive Restructuring

   Cognitive restructuring is another component of CBT that helps you challenge the irrational beliefs and distortions behind your OCD. By identifying the flawed logic in your thinking, you can start to question the validity of your obsessions. For example, if your OCD makes you believe that leaving the house without checking the door multiple times will lead to a break-in, cognitive restructuring will help you recognize that checking once is enough and that repeatedly checking doesn’t provide additional security.

5. Practice Self-Compassion

   OCD can be exhausting, and it’s easy to get frustrated with yourself for performing rituals. Practicing self-compassion is key. Understand that breaking the cycle of OCD takes time, and setbacks are normal. Acknowledge your progress and treat yourself with kindness throughout the process.

The Importance of Addressing Emotional Roots

While the above strategies are important for disrupting OCD rituals, it’s also critical to address the emotional roots that contribute to OCD. For many individuals, OCD rituals serve as a way to avoid or distract from uncomfortable emotions. Often, these emotions are repressed so effectively that the person is unaware of them. Over time, the rituals become habitual and seem disconnected from any emotional experiences. However, the core emotional challenges remain intact, driving the compulsions beneath the surface.

Get Professional Help for Long-Term Healing

This is where professional help becomes invaluable. While short-term coping strategies can help manage symptoms, working with a therapist allows you to dive deeper into the underlying emotional issues that fuel your OCD. By addressing repressed emotions—whether it's sadness, guilt, anger, or even joy — you can achieve long-term healing rather than just symptom management. Therapists trained in modalities like Exposure and Response Prevention (ERP), as well as deeper emotional work such as psychodynamic or experiential therapies, can guide you through this process.

Through therapy, you can gain awareness of the emotions that trigger your compulsions, allowing you to work through them rather than continue to avoid them. This dual approach—stopping the rituals and addressing the emotional drivers—creates a comprehensive plan for overcoming OCD and achieving long-term relief.

Learn more about how OCD Treatment can help you manage obsessive thoughts and break the cycle of compulsive behavior.

OCD and Perfectionism: Understanding the Connection

Obsessive-Compulsive Disorder (OCD) and perfectionism often go hand in hand, creating a cycle that can be challenging to break. While perfectionism alone can be a trait many strive for, when intertwined with OCD, it can lead to significant distress and impairment. In this post, we’ll delve into the relationship between OCD and perfectionism, explore the underlying mechanisms, and discuss effective strategies for managing these conditions.

What is OCD?

OCD is a mental health disorder characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that individuals feel driven to perform. These compulsions are often performed to alleviate the distress caused by the obsessions, but they provide only temporary relief and can interfere significantly with daily life.

Understanding Perfectionism

Perfectionism involves striving for flawlessness, setting excessively high standards, and being overly critical of oneself. While it can motivate individuals to achieve their best, extreme perfectionism can lead to anxiety, stress, and a fear of failure. When perfectionism becomes maladaptive, it can severely impact one’s mental health and overall well-being.

The Link Between OCD and Perfectionism

1. Cognitive Rigidity: Both OCD and perfectionism involve a rigid cognitive style. Individuals may hold inflexible beliefs about the necessity of perfection and the catastrophic consequences of mistakes.

2. Fear of Failure: A common thread in both conditions is an intense fear of failure or making mistakes. This fear drives obsessive thoughts and compulsive behaviors in OCD and perpetuates the relentless pursuit of perfection in perfectionism.

3. Need for Control: The need to control one's environment and outcomes is prevalent in both OCD and perfectionism. This need for control can manifest in excessive checking, organizing, and correcting behaviors.

4. Intolerance of Uncertainty: Both conditions are marked by a low tolerance for uncertainty. This intolerance fuels the compulsive behaviors in OCD and the constant striving for certainty and control in perfectionism.

The Impact on Daily Life

The combination of OCD and perfectionism can create a debilitating cycle. Individuals may spend excessive time on tasks, repeatedly checking and correcting to ensure perfection. This can lead to procrastination, missed deadlines, and significant distress. Social relationships can also be affected, as the fear of judgment and failure may lead to avoidance of social situations or overly controlling behaviors.

Pathways to Recovery

The good news is that there are effective strategies and therapies to manage OCD and perfectionism:

1. Cognitive-Behavioral Therapy (CBT): CBT helps individuals identify and challenge maladaptive thoughts and beliefs related to perfectionism and OCD. Techniques such as cognitive restructuring and exposure and response prevention (ERP) are particularly effective.

2. Exposure and Response Prevention (ERP): ERP, a specific type of CBT, involves gradually exposing individuals to feared situations or thoughts without allowing them to engage in compulsive behaviors. This helps reduce the anxiety associated with obsessions and diminishes the compulsions over time.

3. Internal Family Systems (IFS): IFS therapy helps individuals understand and harmonize the different "parts" of themselves, particularly those affected by OCD and perfectionism, fostering internal healing and integration.

4. Experiential Psychodynamic Therapies: Approaches like ISTDP (Intensive Short-Term Dynamic Psychotherapy) and AEDP (Accelerated Experiential Dynamic Psychotherapy) focus on exploring and processing underlying emotional conflicts. These therapies help individuals access and process emotions that drive perfectionistic and obsessive behaviors, leading to deeper healing.

5. Mindfulness and Acceptance: Mindfulness practices can help individuals become more aware of their thoughts and feelings without judgment. Acceptance and Commitment Therapy (ACT) teaches individuals to accept their thoughts and feelings rather than trying to control them, reducing the power of obsessive thoughts and the need for perfection.

6. Self-Compassion: Developing self-compassion involves treating oneself with kindness and understanding in the face of mistakes and imperfections. This can reduce the harsh self-criticism that fuels perfectionism and OCD.

7. Setting Realistic Goals: Learning to set realistic and achievable goals can help break the cycle of perfectionism. It involves recognizing that perfection is an unrealistic standard and that making mistakes is a natural part of the learning process.

Moving Forward

Understanding the connection between OCD and perfectionism is the first step towards managing these conditions effectively. By recognizing the patterns and mechanisms that link them, individuals can begin to break free from the cycle of obsessive thoughts and compulsive behaviors. With the right support and therapeutic strategies, it’s possible to reduce the impact of OCD and perfectionism on daily life, leading to greater peace of mind and overall well-being.

If you or someone you know is struggling with OCD and perfectionism, seeking help from a mental health professional can provide the necessary tools and support to navigate these challenges. Remember, recovery is a journey, and taking the first step towards understanding and addressing these issues can lead to profound and positive changes in your life.

Learn more about treatment options for OCD here.

What is the Correlation Between OCD & Depression?

One of the more daunting and under-discussed aspects of mental health is co-morbidity. It’s quite common for more than one disorder to be present in a person, but it’s not always easy to identify. This reality can make it challenging to properly diagnose and design treatment priorities. For example, it’s not unusual for obsessive-compulsive disorder (OCD) to be associated with depressive disorders. 

As many as half the people with OCD will also be diagnosed with depression. Thus, it makes sense to explore the correlation between these two conditions. With that in mind, let’s take a closer look at the basics.

OCD & Depression: What Comes First?

The answer is not crystal clear, but empirically, the vast majority of instances involve OCD arising before depression. Considering the distress OCD causes daily, this trend is not a surprise. Yes, depression can potentially come first and rarely do the two disorders emerge simultaneously. But, for the purposes of this conversation, the evidence currently points toward depression as part of obsessive-compulsive disorder.

Does This Mean OCD Causes Depression?

Sometimes, yes. OCD symptoms present a relentless challenge. Obsessive, intrusive thoughts cause anxiety, guilt, and shame. Compulsive actions negatively impact all aspects of your life. Living with this is enough to bring anyone to a depressive state.

Meanwhile, however, a clear cause of OCD has not yet been identified. As of now, the following factors are being explored:

• Specific issues within the brain

• Genetics and family history 

• Childhood trauma

• Streptococcal infection

Correlation Between Obsessions, Compulsions, and Symptoms 

Obsessions

The O in OCD is used to describe those unwanted thoughts that kick the cycle into effect. These disturbing intrusions can completely shift a person’s self-perception. Over time, this process lands the person with OCD on the road to depression. How much fear, anxiety, and rumination can they take? This highlights why treatment is critical. When someone with OCD has confidence that they can manage their obsessions, they are less likely to experience despair. 

Compulsions

Compulsions are the rituals people with OCD perform in the name of easing anxiety. They know the actions are not logical, but if they can prevent the intrusive thoughts for a while, that’s all the logic they need.  

The act of performing compulsions is energy-intensive and time-consuming. Compulsions are typically obvious, too. Hence, depression enters the picture when you calculate how much this disorder hampers daily functioning and brings on negative attention. 

OCD and Depression: Overlapping Symptoms

• Both disorders are associated with negative self-beliefs

• You’ll notice that your thought patterns can exacerbate symptoms 

• OCD and depression both decrease one’s daily functioning, relationships and interactions, and general mood

• Both have similar treatment plans that may include therapy, medication, mindfulness, and physical activity like yoga

OCD and Depression: Crucial Differences 

Of course, each case can be incredibly unique, but general trends exist. For example, OCD has hallmark signs like repetitive thoughts, behaviors, and tic disorders. None of these are associated with depression. 

Self-Help Tips For People With OCD and Depression

• Address the OCD symptoms before taking on the depression. This typically improves the co-existing depression.

• Physical activity has been found to ease symptoms for both disorders. 

• Do not self-isolate. It’s tempting to withdraw, but you need human connection and love now more than ever. 

The bottom line, however, involves finding a mental health professional with whom you have a good rapport. As daunting as the OCD-depression is, it can be managed, and you can reclaim so much more control over your life. The key is to be consistent and compliant with the treatment plan. If you or someone you know is struggling with these co-existing conditions, let’s talk soon.

Learn more about OCD Treatment.

The Overlap of OCD & Autism

Understanding the intricate relationship between obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) is crucial for accurate diagnosis and effective treatment. These two conditions, while distinct, often intertwine in complex ways, posing challenges for individuals and clinicians alike.

The overlap of symptoms between OCD and autism can lead to misdiagnosis. When they co-exist, it’s not uncommon to have one of the conditions go undiagnosed. With all that in mind, one must understand both the similarities and the differences. 

The Overlap of OCD & Autism

Generally speaking, three primary categories of overlap can cause confusion:

Intrusive Thoughts/Obsessions

Intrusive thoughts are the norm for people with OCD. But it’s lesser known that obsessions are not uncommon with anyone dealing with ASD. With OCD, they may manifest as, for example:

• Fear of embarrassing oneself by what they say or do

• Unwelcome thoughts that are distressing, violent, or inappropriate

• Rumination related to harmful events happening to someone they love (including themselves)

Autism notoriously leads to obsessions. Someone with ASD may focus on a specific topic or interest. While the causes are very different, an outsider may just see obsessions and not be able to discern the origin. Once again, this can complicate diagnosis. 

Stimming

Self-stimulating behaviors or stimming are almost always associated with autism. Rocking oneself, repetitive actions, and finger or foot tapping are common examples. Therefore, if someone with OCD engages in very repetitive behavior, it can be mistaken as ASD. Once again, the underlying purpose of the action (in this case, stimming) is very different. That said, without an assessment, it can be very tough to discern which disorder is present.

Social Interactions 

As you might imagine, someone with either ASD or OCD can struggle in social settings. People don’t understand the obsessions or repetitive actions. The person with ASD or OCD can tell that they’re being judged, but this typically just adds to the anxiety — and thus, the behaviors. Yet again, others are unsure what’s happening and why.

Unless and until observation and evaluation have been performed, the presence of a mental health disorder can be missed or misdiagnosed. Then, of course, there is the fact stated up top: 25 percent of kids between the ages of 4 and 17 with OCD have been diagnosed with ASD.

When OCD & ASD Are Co-Morbid 

Obsessive-compulsive disorder is often tough to diagnose. Its symptoms overlap with many other conditions. When an autistic person has OCD, things get even trickier. For this reason, certain tools and measures have been designed to help ease the confusion. The process is comprehensive and involves practitioners from multiple disciplines. That said, a lot hinges on the experience and knowledge of the clinicians. 

Another crucial factor is the potential that someone with ASD will have issues with communication. Of course, each case is unique, but it’s not unusual for an autistic individual to struggle with articulating what they are feeling. This can obscure OCD symptoms and leave them unaddressed.

What Are Your Options?

If you or someone you know might be dealing with the overlap of ASD and OCD, you’re not alone. This means there are clinicians out there with the skills and experience to screen for both disorders effectively. Obtaining such information is the critical first step toward addressing and managing the intertwined symptoms.

Don’t struggle in silence or try to self-diagnose. I invite you to contact me today to learn more about the steps available to you.

Learn more about OCD Treatment.

Harm OCD: Causes, Symptoms, and Treatment

Most folks would rather not admit it, but intrusive thoughts are a common part of life. They’re uncomfortable and can be quite disturbing at times. But, for most people, they’re fleeting and can be easily dismissed. This is not the case for anyone with a sub-type of obsessive-compulsive disorder (OCD) called harm OCD.

For them, unwanted thoughts about harming oneself or others are frequent and powerful. They are the obsessions in obsessive-compulsive disorder and can create a desire to perform compulsive rituals to ward them off. Compulsions may temporarily relieve anxiety, but they return as soon as the obsession does. The harm OCD cycle must be addressed.

What Causes Harm OCD?

As is the case with any type of OCD, no specific cause has been identified. Research continues, but, in the meantime, close observation has revealed some of the factors that could be associated with harm OCD, e.g.:

• Family history and learned behaviors 

• Preexisting mental health issues

• Brain chemistry

• Traumatic life events

Common Harm OCD Symptoms

Of course, there are intrusive thoughts and mental images of violence that trigger an intense fear that the person having such thoughts will carry them out. This includes a general dread that they will commit harmful acts by accident and remain unaware of them. Someone with harm OCD harbors a deep concern that they are violent people and just hiding their true nature. 

As mentioned above, obsessive thoughts of harm launch a cycle of compulsions in the name of reducing anxiety. Such rituals may involve:

• Self-interrogation with the intent to discover if they are truly capable of such horrific behavior

• Asking others for reassurance

• Hiding items that could be used to hurt themselves or others

• Avoiding exposure to news stories or violent content 

• A fixation on spiritual practices or items that they feel can prevent them from losing control 

• Engaging in dedicated research to learn more about people who have committed heinous crimes

• Fastidiously reviewing and replaying all their actions to make sure they did not contribute to the harm of anyone they encountered 

Needless to say, harm OCD can seriously hamper one’s daily functioning. Thus, they must get the help they need and deserve.

Harm OCD Treatment 

This is no “cure” for any form of OCD. However, proven treatment options are available. The most prominent is Exposure and Ritual Prevention (ERP). Working with an experienced therapist, the person with harm OCD agrees to be exposed to a trigger. The plan is to reduce the compulsive response to obsessive thoughts progressively. Here is a basic description of the process:

• The first step involves a short pause. When triggered to activate a ritual, the person commits to not take any action for a predetermined amount of time. This slowly builds confidence that they are not out of control.

• During the next exposure, you add to the delay by performing the compulsion in slow motion. You may still get the anxiety relief you seek, but again, you are reclaiming more control over the cycle.

• Typically, compulsive rituals will have several parts. Hence, the client will choose one component to omit. To review, they’ve resisted taking immediate action, slowed down the pace, and now altered the cycle by removing a step.

• By repeating and adding to the steps above, the person can reach a point where they can get triggered without responding. Yes, the intrusive thoughts arrive, but they no longer feel helpless in the face of them.

ERP can retrain the brain to recognize that there are big differences between thoughts and actions. Someone with harm OCD feels less trapped by the cycle and can function more healthily. 

Learn more about OCD Treatment.

What Is Relationship OCD?

As the name implies, obsessive-compulsive disorder (OCD) involves obsessions (e.g., intrusive thoughts) and compulsions (rituals designed to ease the anxiety caused by obsessions).In a recent post, I discussed that OCD is chronic, with symptoms coming and going throughout somebody’s life. It does not have a cure, but there are approaches that can manage it.

OCD has several subtypes, for example, relationship OCD (R-OCD). As you might imagine, this variation is marked by severe anxiety within the realm of one’s relationship. This anxiety centers around self-doubt and typically triggers the obsession-compulsion cycle. Let’s explore some of the signs and symptoms of R-OCD. 

R-OCD Behaviors 

Everyone has dating quirks and concerns. But R-OCD is much more than that. It can even manifest before a relationship starts, e.g., people who refuse to date because they don’t think anyone is a good match. That said, R-OCD behaviors are more common and identifiable within the context of an existing relationship.

Here are a few of the fixations you might see in someone with R-OCD:

• Needing to know if there is something wrong with their partner constantly.

• Precisely how much their partner loves them or is attracted to them.

• Being reassured that a break-up is not imminent.

• Comparing their relationship to other couples.

Despite such anxious concerns, they may feel incapable of initiating a conversation about them. Hence, the anxiety creates obsessions and compulsions which dominate their life.

Common R-OCD Obsessions

The behavior list above is a good place to start. People with R-OCD may feel obsessed with the “knowledge” that their relationship is doomed. They may obsess over a strange look their partner gave them. Or, they may obsess over the occasional disagreement and feel as if it means their relationship is doomed to end.

These types of obsessions can become all-consuming and cause someone to develop compulsive responses in the hope of experiencing at least some temporary relief. 

Common R-OCD Compulsions

To ease some of the distress they feel, people with R-OCD may spend a lot of time scrolling. For example, they might type something like this into the nearest search engine, “Signs of a cheating partner.” Compulsions can provide a respite from intrusive thoughts, and they can take the form of:

• Comparing: Social media makes examining a wide range of carefully curated couple’s photos and videos possible. Do they look happy? How long have they been together? Do both partners participate equally in the online interactions? These relentless observations can be used to “prove” whatever feels more calming.

• Clinginess: As touched on above, the need for reassurance can become suffocating.

• Making Lists: Depending on which obsession is loudest at the moment, someone with R-OCD can compile a list to silence it or reinforce it. With enough ink and lines on the paper, convincing ourselves about anything is entirely too easy.

But How Do We Really Know If It’s Relationship OCD?

Everyone doubts or compares themselves to other people or situations. However, maybe you have read through the post and are wondering if this also applies to you.

What makes R-OCD different is the intense amount of time it takes up. Daily functioning takes a back seat. Someone will allocate major chunks of their day — often every day — to obsessing over their relationship. In cases of R-OCD, this is a pattern that is often repeated in every single relationship someone has been in.

If the information above resonated with you, the wisest move is to speak with a professional. I encourage you to reach out for more information about OCD treatment.

Signs of OCD in Adults

This post is not about someone who places their books in size order on a shelf. It’s also not about that person you know who practices good hygiene. Obsessive-compulsive disorder (OCD) is not what pop culture tells us it is. You see, there’s nothing unusual about feeling anxiety and getting uncomfortable about it. Such feelings come and go in everyone’s life. 

With OCD, however, feelings like this are chronic and can feel relentless. They manifest in unusual ways that often serve to heighten anxiety. Your everyday life — relationships, work, school, etc. — is impacted, and you need relief. Fortunately, with proper treatment, OCD can be managed.

The Basics of OCD

It’s a disorder characterized by intrusive thoughts that cause anxiety. In the name of reducing that anxiety, a person with OCD will experience obsessions and address them with compulsions. This cycle offers temporary relief, but soon enough, the intrusive thoughts return.

During this cycle, you may encounter some of the signs that have become shorthand for OCD, e.g., counting, washing, and more. Left unchecked, the OCD cycle can hamper anyone’s ability to function daily. 

Signs of OCD in Adults

Before we get to the outward signs — the compulsions — it’s helpful to offer a brief description of the obsessions that get things started. Even if they realize that their intrusive thoughts are irrational, someone with OCD still has the understandable need to resolve them. Some of the most common OCD obsessions involve: 

• Fear of contamination — by other people or inanimate objects 

• A desire for everything in their vicinity to be symmetrical and orderly 

• Concern that they will suddenly harm someone, someone will harm them, or some random harm will come to anyone

• Worrying that they have not completed a task, e.g., turning off an appliance or locking a door

• Fear of misplacing something important or minor 

• Disturbing thoughts related to religion or sex

• In some cases, the intrusive thought can be patently meaningless yet still anxiety-inducing 

Next come the signs and symptoms. When an adult with OCD performs compulsions, they are most often noticeable by others.

Compulsions

The anxiety caused by OCD obsessions can be overwhelming. They leave the person to conjure up anything to relieve the tension. Thus, the compulsions they perform are personal, and they feel necessary. However, if compulsions offer fleeting relief, they can result in days filled with repetitive rituals. Here are some OCD compulsion examples: 

• Cleaning: Hand-washing is most commonly associated with OCD, but this compulsion can also manifest in toothbrushing or taking many showers. In addition, it can involve cleaning objects instead of yourself. 

• Checking: What they check often includes locks and appliances. Also, it could mean relentlessly checking to be sure you brought whatever items were required for your destination. 

• Arranging: You need items in your line of sight to be laid out in a particular way. 

• Counting: These are compulsions related to numbers. 

• Avoidance: Sometimes, it can be a person or place that feels like it’s the source of distress.

• Approval: A person with OCD may need and seek reassurance regularly. 

In other words, when looking for signs of OCD in adults, it typically comes down to identifying compulsions in action. However, this isn’t a green light to make assumptions or accusations. As you can certainly imagine, this cycle is unpleasant. No one wants to be there. They feel shame about it. 

Hence, if you or someone you know is displaying behaviors like those listed above, it makes sense to reach out for help. An experienced mental health professional can help guide you in your quest to help a friend or loved one.

Learn more about OCD Treatment.

6 OCD Symptoms in Adults

Obsessive-compulsive disorder (OCD) is a frequently misunderstood condition. People casually associate OCD with anyone who is orderly or organized. But what we’re really talking about here is a diagnosable mental health condition that can severely hamper a person’s daily functioning. As the name implies, this is due to a cycle of obsessions and compulsions. 

OCD is chronic and has no known cure, but it can be managed. Symptoms may come and go throughout a person’s lifetime. With proper treatment, obsessive-compulsive disorder can be less disruptive to your life. But a big first step is understanding and recognizing OCD symptoms as they typically present in adults. 

OCD Obsessions and Compulsions

Obsessions

We all get intrusive thoughts at times. With OCD, such thoughts and images cause extreme anxiety. They feel out of control even if they are demonstrably irrational. We’ll flesh out specifics below, but some common obsessions center on germs, self-harm, sex, perfectionism, symmetry, and reassurance.

Compulsions 

To soothe the anxiety caused by obsessions, someone with OCD engages in ritualistic, repetitive actions they believe will prevent the feared outcomes from occurring. Typically, the relief is short-lived, and the cycle returns. Some of the most common compulsion categories are:

• Counting 

• Arranging

• Cleaning (yourself or objects)

• Checking

• Hoarding 

• Seeking reassurance

• Repeating certain words

All of the above blends into the following six symptoms:

6 OCD Symptoms in Adults

1. Severe Discomfort With Asymmetry 

Symmetry can be defined widely — from lining things up to brushing an equal number of times on each side of the mouth — but in all its guises, it can be present as an OCD compulsion. This is not to say being organized is a red flag. But if it becomes something you need to do, it may warrant closer examination. 

2. Fearing a Particular Disease 

The last three or four years have made this behavior more common. However, its potential connection to OCD lies in how far you consistently go to avoid catching a disease. A compulsion preoccupies people with OCD to the point of palpably altering their daily lives. 

3. Thoughts of Self-Harm and/or Harming Others 

It can be uncomfortable, but anyone can have such thoughts in moments of anger or frustration. They’re rare and almost always easy to control. Someone with OCD, on the other hand, is driven to profound fear by anything like this. 

4. Seeking Reassurance 

Yet again, on its face, this is not problematic. When associated with OCD, seeking reassurance becomes more assertive, ongoing, and desperate. You regularly ask questions like, “Do you love me?” Compulsions like this have the potential to sabotage a relationship, friendship, or job.

5. Double-Checking 

Did you lock the door? Was the stove turned off? Is a friend or family member in danger? OCD double-checking can turn any situation into a pressure cooker. You may leave an important situation to drive home and make certain the front door is locked.

6. OCD Symptoms at Home and Work

This last category highlights how adult OCD can present differently depending on the situation. For example, at home, you may:

• Avoid contact with family members (including intimacy with a spouse) for fear of contamination 

• Hold onto objects that have long outlived their usefulness

• Worry that your family or roommates don’t like you

At work, watch for: 

• A precisely organized desk or workspace

• Long, frequent visits to the bathroom to wash your hands

• Intense anxiety when work plans or deadlines change without warning

It’s Not About Self-Diagnosis

The information offered here is designed to create awareness, not fear. If you find yourself resonating with much of it, it could be a good idea to connect with a professional to schedule a free consultation. 

Learn more about OCD Treatment…