What is Obsessive Compulsive Disorder (OCD)?

People with OCD experience recurrent unwanted and distressing thoughts, images, or urges know as obsessions. These can often cause the sufferer significant anxiety. This in turn leads to compulsive behaviours (repetitive physical or mental actions) designed to try and reduce their anxiety. Common types or themes of obsessions and compulsions include the following:

Types\themes of obsessions and associated compulsions –

Doubt\intolerance of uncertainty:

The focus of these obsession are often around whether you have done something or not. For example feeling uncertain about whether you switched off appliances at home before leaving. The associated compulsions would be around excessive checking behaviours such as repeatedly check to make sure appliances are switched off or doors are locked.


These obsession are often around doing things to an exact standard, needing to have objects placed in a certain order or position or tasks or events to be completed in a set way. The associated compulsions would often might include arranging items in specific ways, or having to perform daily task in a certain way e.g. putting closes on in a certain order.


People with these obsessions often fear something bad happening unless they take certain actions. Examples might include fears about contamination from germs, harm coming to others or offending others. These types of obsessions can lead to compulsions such as excessive washing/cleaning, mental rituals and/or seeking excessive reassurance from others.

What keeps OCD going?

Research has shown that everyone experiences obsessions or unwanted thoughts. However, people who suffer with OCD tend to attach unhelpful significant and meaning to their obsessions.

Take the example of someone who is having obsessive thoughts about harming others. Someone suffering with OCD might see the occurrence of these thoughts as a sign that they are likely to act on them, as oppose to just seeing them as unwanted thoughts and letting them go. This then leads to the unhelpful strategies for controlling obsessions which we referred to as compulsions.

These compulsions serve to reduce distress or anxiety in the short-term but their overall affect is to strengthening belief in the meaning of the obsession i.e. I am likely to harm someone. People with OCD can then get into debilitating cycle of increased obsessions and compulsions which can have a significant impact on their day-to-day lives.

In addition to the above general stressful events and uncertainty often has the effect of increasing difficulties with OCD. Research also shows that the development of OCD is often related to stressful events or uncertainty in the suffers early life e.g. loss of a parent or excessive pressure to conform to certain rules or standards.

How can CBT help?

CBT for Obsessive compulsive disorder tends to focus on the following areas:

  • Recognising and understanding the cycle of  unhelpful cognitive and behavioural responses to obsessions described above
  • Identifying and challenging unhelpful meanings attached to obsessions
  • Dropping unhelpful compulsions associated with obsessions through a process known as “Exposure Response Prevention”
  • Developing more helpful strategies for dealing with stress and uncertainty
  • Focusing on understanding how the individual’s difficulties with OCD have developed and challenging unhelpful beliefs and rules which may have resulted from difficult past experiences.

Further information links



CBT Therapist Manchester