Understanding OCD and what helps

Written By Addy Dunkley-Smith

Many people use the phrase “I’m so OCD” to describe being neat or organised, but Obsessive-Compulsive Disorder is a very specific clinical condition. It’s also commonly confused with Generalised Anxiety Disorder (GAD), because both involve worry and distress. The difference lies in the structure of the anxiety and the behaviours that follow.

How OCD Presents

OCD is made up of two parts:

  • Obsessions: intrusive, unwanted thoughts, images or urges that spark intense anxiety or disgust.

  • Compulsions: the repetitive behaviours or mental actions a person feels driven to perform to reduce the distress or prevent something bad from happening.

Obsessions usually feel “ego-dystonic,” meaning they don’t align with the person’s values and are deeply upsetting. Compulsions can take many shapes: checking, cleaning, reassurance seeking, mental reviewing, repeating phrases, counting, or avoiding entire situations altogether.

How is this Different to Anxiety?

Normative anxiety is our everyday internal alarm system doing its job readying us for a challenge. People feel it when they’re running late, meeting someone new, giving a presentation, or dealing with uncertainty. The thoughts are usually in proportion to the situation, even if a bit uncomfortable (very few people enjoy the feelings of anxiety). It rises, it falls, and it doesn’t dictate behaviour in a rigid way.

OCD is a whole different creature. The anxiety is fuelled by intrusive, unwanted thoughts or images that feel out of character, disproportionate, or flat-out illogical. Unable to trust the fear or discomfort will pass, the person feels compelled to perform certain rituals to relieve the fear or prevent something imagined from happening. These rituals become repetitive and rule-bound, pulling life into narrow, exhausting loops rather than the flexible ebb and flow of normal anxiety.

What about an Anxiety Disorder?

Generalised Anxiety Disorder (or GAD which is when worry becomes chronic and hard to control) is characterised by persistent, excessive worry about everyday life areas like work, finances, relationships, or health. The thoughts are usually about real-life topics, just taken to extreme levels. Individuals with GAD ruminate, predict worst-case scenarios, and feel chronic restlessness or tension, but they don’t perform compulsions in the same structured, ritualistic way seen in OCD.

  • OCD: “What if this terrible thing happens because of me?” → compulsion.

  • GAD: “What if things go wrong?” → worry spiral.

Understanding this difference matters because the treatment approaches differ. If you are still unsure, you’re not alone! This is why it is important to speak to a mental health professional who has experience with OCD.

How Exposure and Response Prevention (ERP) Works

ERP is the gold-standard, evidence-based treatment for OCD.
It involves two core components:

  1. Exposure
    Gradually facing the thoughts, images, or situations that trigger obsessive fears. These exposures are always collaborative, structured, and tailored to your specific concerns.

  2. Response Prevention
    Reducing or stopping the compulsions that temporarily relieve the distress. Over time, anxiety decreases naturally, even without performing the compulsion. This teaches the brain a new pattern: “I can tolerate uncertainty, and nothing bad happens!”

ERP supports people to reclaim their time, reduce fear, and live a life guided by values rather than compulsive patterns.

If You’re Considering Treatment

I offer ERP as a treatment for OCD. If you believe OCD is impacting you or a loved one, reaching out is a strong first step toward recovery and reclaiming your life.

Resources:

Addy Dunkley-Smith
Next

How to Find a Psychologist in Melbourne for Stress, Overwhelm, and Burnout