OCD & Compulsions

Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition characterised by intrusive, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) performed to alleviate the distress caused by these thoughts. OCD affects approximately 2-3% of the population worldwide, and India is no exception. Despite its prevalence, OCD remains widely misunderstood, often trivialised as mere perfectionism or cleanliness preference.

The reality of living with OCD is far from the casual way the term is used in everyday conversation. OCD is a debilitating condition that can consume hours of a person's day, significantly impair functioning, and cause immense psychological suffering. The obsessions experienced by individuals with OCD are not simply worries about real-life problems; they are intrusive, irrational thoughts that the person recognises as excessive but cannot control.

Common obsession themes include contamination fears, harm-related thoughts, religious or moral scrupulosity, symmetry and ordering, and unwanted sexual or violent thoughts. Compulsions — the behaviours performed to reduce the anxiety caused by obsessions — can include excessive handwashing, checking, counting, arranging, mental reviewing, reassurance-seeking, and avoidance of triggering situations.

OCD operates through a self-reinforcing cycle. An intrusive thought triggers intense anxiety or distress. The individual performs a compulsion to reduce this distress. The temporary relief reinforces both the perceived threat of the obsession and the necessity of the compulsion. Over time, the cycle intensifies, requiring more elaborate rituals and consuming increasing amounts of time and energy.

The impact on daily life is profound. Many individuals with OCD spend several hours per day engaged in compulsive behaviours or trapped in obsessive thought loops. Work and academic performance suffer. Relationships are strained as loved ones are pulled into accommodation patterns — participating in rituals, providing reassurance, or modifying their behaviour to avoid triggering the person's obsessions.

Social isolation is common, as individuals with OCD may avoid situations, places, or people associated with their obsessions. The shame and embarrassment surrounding the nature of certain obsessions — particularly those involving taboo themes — prevent many people from disclosing their experiences, even to close family members.

Physical health can also be affected. Excessive handwashing can cause dermatitis. Checking behaviours may disrupt sleep. The chronic stress of living with OCD takes a toll on the immune system and overall well-being. Many individuals develop comorbid depression or other anxiety disorders as a consequence of untreated OCD.

Exposure and Response Prevention (ERP) is the gold standard psychological treatment for OCD. This specialised form of Cognitive Behavioural Therapy (CBT) involves gradually exposing the individual to situations that trigger their obsessions while helping them resist performing compulsive behaviours. Through repeated exposure without ritual completion, the brain learns that the feared outcomes do not occur and that anxiety naturally diminishes over time — a process called habituation.

ERP is conducted systematically, beginning with less anxiety-provoking exposures and gradually progressing to more challenging ones. The therapist works collaboratively with the individual to create a hierarchy of feared situations and develop strategies for managing the discomfort that arises during exposures.

Research demonstrates that ERP is effective for approximately 60-80% of individuals with OCD who complete treatment. Many experience a significant reduction in symptoms, with improvements maintained long after therapy ends.

For individuals with severe OCD or those who have not responded adequately to therapy alone, medication — typically selective serotonin reuptake inhibitors (SSRIs) — may be recommended as a complement to ERP. The combination of ERP and medication often produces the best outcomes for severe presentations.

It is crucial to find a therapist who is specifically trained in ERP for OCD. General therapy approaches that focus primarily on understanding the meaning of obsessions or relaxation techniques are not effective for OCD and may actually reinforce the disorder. Our directory helps you identify psychologists with specific expertise in evidence-based OCD treatment.

Recovery from OCD is a journey, not a destination. While treatment can dramatically reduce symptoms and restore functioning, most individuals benefit from ongoing practice of the skills learned in therapy. The goal is not to eliminate all intrusive thoughts — everyone has them — but to change your relationship with these thoughts so they no longer control your behaviour.

Support from family and friends plays an important role in OCD recovery. Understanding that OCD is a neurobiological condition, not a character flaw, helps loved ones provide appropriate support without inadvertently reinforcing compulsive patterns. Many therapists include family psychoeducation as part of their treatment approach.

Self-help resources, support groups, and online communities can provide additional support alongside professional treatment. However, these should complement, not replace, evidence-based therapy with a qualified professional.

Finding the right OCD specialist is crucial for successful treatment. Look for psychologists who explicitly mention ERP training and experience in treating OCD. Our directory features verified professionals across India who specialise in obsessive-compulsive disorders and use evidence-based treatment approaches to help individuals break free from the OCD cycle and reclaim their lives.