What OCD Actually Is (And What It Isn’t)

Obsessive Compulsive Disorder (OCD) is more common than many people realise, with OCD estimated to affect around 3.6% of Australians (ABS, 2023).

Yet for many people, it takes years before they receive the right support. Research with Australians living with OCD found that, on average, there is a nine-year gap between when symptoms first appear and when people access treatment (Cooper et al., 2022).

Despite this, public understanding of OCD is still limited, with misrepresentation further contributing to stigma, misuse of the term, and delays in diagnosis and treatment.

For many people, the hardest part of OCD isn’t just the symptoms themselves — it’s how long it can take to recognise what’s actually happening.

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What is OCD?

You may have heard someone say they’re “a little bit OCD” because they like things tidy or organised.

In reality, OCD is not about enjoying cleanliness or being highly organised. For many people, OCD is distressing, exhausting, and can significantly impact daily life.

OCD is characterised by two main components:

Obsessions

Obsessions are persistent, unwanted thoughts, urges, or mental images that cause significant anxiety or distress.

These are often called intrusive thoughts.

People with OCD usually recognise that these thoughts may be irrational or excessive, but they still feel overwhelming and difficult to control.

Compulsions

Compulsions are repetitive behaviours or mental acts that a person feels driven to perform in response to the obsession.

The purpose of these behaviours is usually to:

• reduce anxiety

• prevent something bad from happening

• neutralise the intrusive thought

Compulsions may provide temporary relief, but they also reinforce the OCD cycle, causing the distress to return again.

Not all repetitive behaviour is OCD

Repetition itself does not automatically mean something is a compulsion.

For example, repeating actions while learning a skill, practising religion, or following routines can be a normal and meaningful part of life.

What differentiates compulsions is the function and emotional experience behind them.

Someone with OCD may feel driven to perform the behaviour, often against their wishes, in order to reduce distress or prevent a feared outcome.

For example, someone may spend hours washing their hands, not because they enjoy cleanliness, but because they feel overwhelming anxiety if they don’t.

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What Are Intrusive Thoughts?

Intrusive thoughts are unwanted thoughts, images, or ideas that feel disturbing or distressing. It’s important to know that intrusive thoughts are actually very common. Many people experience them occasionally.

What differentiates OCD is that these thoughts:

• occur frequently

• cause significant distress

• lead to compulsive behaviours aimed at reducing anxiety

• interfere with daily functioning

One concept that helps explain this difference is the idea of ego-syntonic vs ego-dystonic experiences.

• Something that is ego-syntonic aligns with a person’s values, beliefs, and identity.

• Something that is ego-dystonic feels inconsistent with who the person is or what they believe.

OCD obsessions are typically ego-dystonic. People with OCD are often deeply distressed by their thoughts and would strongly prefer not to have them.

This is one reason OCD can feel so confusing and frightening.

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Common Types of OCD

OCD can show up in many different ways. Some of the most commonly recognised forms include:

Contamination OCD

This is one of the most commonly recognised types of OCD.

People may experience intense fears about contamination, germs, illness, or environmental toxins. Compulsions often involve excessive washing, cleaning, or avoiding objects or places perceived as contaminated.

Triggers may include:

• body fluids

• germs or disease

• environmental contaminants

• household chemicals

• dirt or perceived uncleanliness

For some people, the distress can lead to hours of washing or cleaning behaviours each day.

Symmetry and “Just Right” OCD

This type of OCD involves a strong need for things to feel even, balanced, or arranged in a specific way.

People may experience distress if objects are not aligned or if actions are not performed in a particular order.

Compulsions can include:

• arranging objects

• repeating actions

• counting

• tapping

• repeating words or phrases

Checking OCD

Checking compulsions often develop from fears that something terrible might happen if something is missed.

Examples include repeatedly checking:

• locks

• appliances

• switches

• whether mistakes were made

• whether loved ones are safe

People may also repeatedly check their own memories or physical sensations to ensure nothing harmful has occurred.

Harm OCD

Harm OCD involves intrusive thoughts about harming oneself or others, often paired with intense fear of losing control.

These thoughts can include disturbing images or fears about violent actions.

Importantly, people with harm OCD are deeply distressed by these thoughts and do not want them to happen.

Taboo or Moral OCD

Sometimes called scrupulosity or taboo OCD, this type involves intrusive thoughts related to:

• religion

• morality

• sexuality

• aggressive thoughts

Because these thoughts often conflict strongly with a person’s values, they can create significant shame and fear.

Many people with this type of OCD believe they are the only person experiencing these thoughts, which can make it even harder to seek help.

Compulsions may include:

• excessive praying

• mental review of past events

• repeating phrases or words mentally

• “cancelling out” thoughts with other thoughts

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How is OCD diagnosed?

As we mentioned earlier, it can take many years for people to receive an OCD diagnosis.

A structured psychological assessment can help identify whether OCD may be part of what someone is experiencing and guide appropriate treatment or support.

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Can you get support for OCD?

Yes.

While OCD can be distressing, effective support and treatment are available. Many people experience significant improvement with the right help.

If you’re wondering whether the thoughts or behaviours you’re experiencing could be related to OCD, speaking with a clinician can be a helpful first step. Our team offers OCD assessments designed to explore intrusive thoughts, compulsions, and related experiences in a supportive and neuro-affirming environment.

Sometimes simply having clarity about what’s happening can make a meaningful difference in knowing what support might help next.

For more information, visit our page on OCD Assessments or contact us today!