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Aurora Counseling Associates

In plain terms

OCD (Obsessive-Compulsive Disorder)

Obsessive-compulsive disorder (OCD) is a condition where unwanted, intrusive thoughts, called obsessions, drive repeated behaviors or mental rituals, called compulsions, done to ease the distress those thoughts cause. The relief is brief, so the cycle repeats. OCD responds well to a specific form of therapy called exposure and response prevention.

How OCD works

OCD runs on a loop. An intrusive thought or image arrives, it spikes anxiety, guilt, or disgust, and a behavior or mental act brings the feeling down. Because that relief is real but short-lived, the brain learns the ritual is what keeps you safe, and the loop tightens. Common themes include contamination, harm, symmetry, and taboo thoughts, but OCD can attach to almost anything a person cares about.

How it is treated

The front-line treatment is exposure and response prevention (ERP), a structured form of CBT where you approach what you fear in small, planned steps without doing the ritual, until your nervous system learns the feared outcome does not come. Skills from DBT can steady the distress along the way, and for some people medication alongside therapy works better than either alone. OCD often overlaps with anxiety, and many people see meaningful change without the condition ever fully disappearing.

This page is part of our therapy glossary.

Where we work with this

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Questions

Common questions

Is OCD just about being neat or organized?
No. Tidiness is a small and often misleading part of it. OCD is about intrusive thoughts and the rituals done to relieve them, and those rituals are frequently invisible, like counting, checking, or mentally reviewing.
What is ERP?
Exposure and response prevention is the most effective therapy for OCD. You face a feared situation in gradual steps while resisting the compulsion, so the anxiety rises and then falls on its own and the brain relearns that the ritual is not needed.
Can OCD be treated with telehealth?
Yes. ERP works well by secure video, and for some people practicing in their own environment, where the triggers actually live, makes the work more effective.

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References and further reading

OCD responds well to specialised care, and related concerns are covered by our therapy for anxiety and trauma therapy. To learn more about OCD, see the International OCD Foundation and the National Institute of Mental Health.