Understanding OCD: Beyond Cleaning and Checking
When most people think of obsessive-compulsive disorder (OCD), they picture constant handwashing or checking the stove. But OCD is far more complex—and far more misunderstood—than a few visible rituals.
How OCD Is Diagnosed—In Everyday Language
OCD isn’t just about liking things neat or double-checking a lock. Mental health professionals look for two key ingredients:
Obsessions – Intrusive, unwanted thoughts, images, or urges that create anxiety or distress. They show up even when you don’t want them and feel hard to ignore.
Compulsions – Actions or mental rituals you feel driven to do to quiet the anxiety or “neutralize” the thought. This can be washing, checking, counting, repeating phrases, or even replaying memories.
For an OCD diagnosis, these cycles typically:
Take up a lot of time each day (often more than an hour),
Cause significant distress, and
Interfere with daily life—work, relationships, or simply enjoying your day.
You don’t need to check every box perfectly; everyone’s experience is unique. But if these patterns feel familiar, you’re not alone—and help is available.
Compulsions: Throwing Water on a Grease Fire
Compulsions feel like they bring safety. They often carry their own logic: water puts out fires—so I’ll throw it on the stove.
But with OCD, every time you “throw water,” you’re really feeding the flames. Each compulsion temporarily lowers anxiety while actually reinforcing the obsession and amplifying the sense of threat. Over time, compulsions are food for OCD: the more you engage, the more you fear the obsession.
Why Obsessions Stick
Obsessions latch onto what you value—family, safety, morality. That’s why they feel so invasive. The cycle strengthens because your brain starts to fear not just the thought, but the distress attached to the thought.
Exposure Therapy Works—Here’s Why
Exposure and Response Prevention (ERP) is the gold-standard treatment for OCD. It can feel counterintuitive at first: you deliberately face triggers without performing the compulsion.
Think of sitting through turbulence on a plane. Your brain only learns you can tolerate distress when you actually stay in it. ERP helps your nervous system discover that anxiety naturally peaks and subsides—even when you don’t do the ritual. Over time, this experiential learning rewires your brain’s threat system and reduces the power of obsessions.
Why Benzodiazepines Aren’t Daily OCD Tools
Benzodiazepines (like Xanax or Ativan) have their place—such as a surgery or an occasional flight when the goal is to enhance functioning. Used sparingly, they can be appropriate.
But for daily OCD management, they’re not recommended. Here’s why:
Blunts ERP Learning: By numbing anxiety, benzos prevent your nervous system from fully experiencing and mastering the distress ERP relies on.
Tolerance Risk: Regular use builds tolerance, meaning you’ll need more over time to get the same effect, which can lead to dependence.
For long-term relief and real brain change, the experiential learning of ERP is far more effective than ongoing benzodiazepine use.
The Brain’s Survival Wiring
Our brains are built for efficiency and survival. The amygdala—our fear center—sits deep in the brain with lightning-fast connections to the autonomic nervous system. Fear signals reach your body faster than your prefrontal cortex can reason.
That’s why you can’t “think” yourself out of fear. Imagine walking in the woods: you see a line on the ground, and you jump before realizing it’s a stick, not a snake. Your amygdala triggered a survival response before logic had a chance.
When Survival Becomes Overdrive
This hardwiring is adaptive in a dangerous environment, but modern life doesn’t require such constant vigilance. OCD hijacks the system, leading to threat misappraisal, intolerance of doubt, and overchecking.
Checking the door once makes sense. Checking it twenty times trains your brain to believe that replaying the memory prevents a break-in. The only way to break that false link is to stop checking—even when it feels uncomfortable.
Nature, Nurture, and Temperament
Why do some brains ramp up to “level 11”? Often it’s a mix of temperament and experience: an anxious, emotionally attuned, and perceptive child who felt over-responsible may discover that rituals offer a sense of control. Over time, those coping patterns become habits the brain defaults to under stress.
The Takeaway: OCD Doesn’t Resolve on Its Own
OCD isn’t about cleanliness or quirky habits. It’s a disorder of attention and threat processing—one that will not simply fade with time. Left untreated, symptoms often grow stronger and more intrusive.
The good news is that specialized therapy works. Exposure and Response Prevention teaches your brain, experientially, that you can handle the feelings you fear—and lasting change follows.
Ready to Begin?
If you or someone you love is struggling with OCD, you don’t have to face it alone. At Cope & Calm Counseling, we specialize in anxiety and OCD treatment and provide compassionate, evidence-based care—both in-person and virtual—for clients throughout Connecticut, including Greenwich, Ridgefield, Brookfield, and New Fairfield.
