Living with OCD: Understanding the Difference Between Obsessions and Compulsions
When you have Obsessive-Compulsive Disorder (OCD), it often feels like your own mind is working against you. Unwanted thoughts or images pop up out of nowhere. No matter how hard you try to push them away, they keep returning. To ease the anxiety they cause, you might start repeating certain actions or mental rituals, but the relief is usually short-lived. Understanding this cycle is the first step toward breaking free from it.
What Are Obsessions?
Obsessions are intrusive thoughts, fears, or mental images that cause distress. They aren't just worries or preferences; they feel unwanted and often focus on issues that conflict with your values or sense of self.
Some common examples include:
Fear of contamination or illness
Worries about harming yourself or others
Doubts about whether you locked the door or turned off the stove
Unwanted sexual or religious thoughts
A need for things to feel “just right” or symmetrical
These thoughts can feel disturbing or even shameful. That's why many people with OCD try to suppress them or seek reassurance. Sadly, the more you fight an obsession, the stronger it tends to grow.
What Are Compulsions?
Compulsions are the actions or mental rituals you perform to ease the anxiety caused by obsessions. At first, they may appear to give you control, but they actually reinforce the cycle of OCD.
Compulsions can include:
Excessive cleaning or hand washing
Repeatedly checking locks, appliances, or emails
Counting, praying, or repeating phrases in your mind
Arranging or touching objects in a specific order
Seeking reassurance from others (“Are you sure I didn’t offend them?”)
While doing a compulsion may provide temporary relief, it teaches your brain that you can only manage anxiety by giving in to these rituals. Over time, this keeps the cycle going and can worsen symptoms.
How Obsessions and Compulsions Work Together
Think of OCD as a loop:
1. A distressing thought (obsession) appears.
2. Anxiety builds in response.
3. A behavior or ritual (compulsion) is performed to ease the discomfort.
4. Temporary relief is felt until the next obsession starts the cycle again.
The goal of therapy is to help you step out of this loop by learning to tolerate uncertainty and discomfort without relying on compulsions.
How Therapy Helps
At ThriveWell Psychotherapy, we use effective treatments like Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) to help you break free from this pattern. ERP helps you face your fears in a safe, structured way while resisting the urge to perform compulsions. Over time, your brain learns that anxiety will fade on its own and that you are stronger than intrusive thoughts.
With support, many people with OCD experience significant improvements in daily functioning, confidence, and peace of mind.
You’re Not Alone
If you see yourself in this cycle of obsessions and compulsions, know that help is available and that OCD is very treatable. With the right tools and guidance, you can quiet the noise in your mind and start living with more freedom and control.
At ThriveWell Psychotherapy in Manhattan, our experienced clinicians provide compassionate, personalized care for OCD and anxiety-related conditions. Whether you prefer in-person or virtual therapy, we’re here to help you take the first step toward lasting change.