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  • Jaime Castillo, LCSW

What we Have Been Getting Wrong about OCD - 5 Common Misconceptions


Obsessive Compulsive Disorder (OCD) is a debilitating condition that is widely misunderstood. People with OCD are often represented as being overly concerned with germs or hyper-particular about orderliness or symmetry. Many people living with the condition go years without adequate diagnosis and treatment because what they're experiencing doesn't line up with their preconceived ideas about what it means to be "OCD." Once a diagnosis of OCD is made and treatment begins, many people with OCD face a lot of stigma surrounding their symptoms due to lack of understanding from others as well as internalized shame. The more we understand about OCD, the better we can recognize it and support those living with it. Below are the top 5 common misconceptions about OCD that are important to debunk.


1. OCD is only about being overly organized, clean or particular.


The obsessions experienced by someone with OCD are, by definition, intrusive,

unwanted and disturbing. Obsessions are ego dystonic, meaning they go against a

person’s most important values. OCD attacks what is most important to the person, and

therefore causes a great deal of distress. People with OCD will usually go to great

lengths to disprove or neutralize an obsession, which sometimes means ritualizing or

performing compulsions for hours on end. There is nothing glamorous about it.


2. People with OCD have different kinds of thoughts than people without OCD.


People without OCD have intrusive and disturbing thoughts just like people with OCD

do. For example, people without OCD might have the experience of looking down from

a tall bridge and thinking, “What if I jumped?” or holding a newborn baby and thinking,

“What if I drop it?” These are the same kinds of thoughts that someone with OCD might

have. The difference is that OCD latches on to these thoughts, “flags” them as being

very important, and often convinces you that having the thought is just as bad as

completing the action. It then convinces you that there is no room for uncertainty, and

you need to go to great lengths to prevent any further harm.


3. Compulsions are always behaviors you can see like handwashing and checking locks.


Compulsions are mental or behavioral acts that are performed to reduce the anxiety

caused by the obsession. While many compulsions, like handwashing and checking, can

be seen from the outside, some people experience only mental compulsions. Mental

compulsions include counting, praying, mental reviewing, reassuring yourself or saying

something silently to neutralize the obsession, like “STOP!” These can be harder to

detect than behavioral compulsions, but can cause just as much impairment.


4. You need to know what caused your OCD in order to heal from it.


Most people who have OCD want to know what caused them to develop the condition.

There are different theories about why and how OCD develops, and we don’t yet have a

clear answer. However, it is likely that OCD is caused by a combination of genetic and

environmental factors. Fortunately, despite not having an exact cause of OCD

pinpointed, we do have a very clear understanding of how to treat it effectively, without

ever needing to know why it developed. Knowing what caused your OCD is not a

prerequisite to healing from it.


5. Any form of therapy will be helpful in treating OCD.


When seeking professional help, it is very important to find a therapist who specializes

in treating OCD. This is because some traditional forms of therapy, like talk therapy, may

encourage you to talk about your obsessions in a way that actually reinforces them and

gives them more power. Similarly, if a therapist is not properly trained to detect

compulsions associated with OCD, they may inadvertently reinforce mental compulsions

and, over time, cause symptoms to worsen. Living with OCD is hard enough and the

treatment it requires to overcome it is no walk in the park either. Finding the right

therapist can ensure you don’t waste time, money and energy on something not likely

to help. A list of specialists can be found at iocdf.org.

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