OCD: More Than What You See
When we think about obsessive-compulsive disorder (OCD), we might picture someone repeatedly washing their hands, checking locks or needing everything in a particular order. But for many people living with OCD, some of the most exhausting experiences are the ones nobody else can see. The constant questioning. The need for reassurance. The fear of having done something wrong. The uncomfortable thoughts that seem to arrive without warning.
When your mind questions what matters most
Most of us experience unwanted or intrusive thoughts from time to time. For someone living with OCD, these thoughts, images or urges can become persistent, distressing and difficult to disengage from. OCD can sometimes centre around the things someone values most. A loving parent might experience frightening thoughts about harming their child. Someone who deeply values their relationships may repeatedly question whether they've upset someone or done something wrong. These thoughts can feel completely at odds with who someone is, leaving them struggling to understand why they're experiencing them.
Could It Be OCD?
Intrusive thoughts can be difficult to talk about, especially when you don’t understand why you’re having them. If something in this article feels familiar, you’re not alone, and you don’t have to navigate these feelings on your own. You don’t need to have all the answers or know exactly what you’re experiencing to reach out. Taking that first step can help you better understand your thoughts and explore the support available to you.
When your own thoughts frighten you
One of the most distressing aspects of OCD can be the relationship someone develops with their own thoughts. Intrusive thoughts can feel frightening, disturbing or even repulsive, particularly when their content conflicts with someone's values or sense of who they are. Someone may begin questioning themselves:
Why would I think something like that?
What does this say about me?
The distress can extend beyond anxiety. Feelings of disgust, guilt and shame may emerge, leaving someone frightened not only by the thoughts themselves but by what they fear those thoughts might mean. For some, the possibility of being misunderstood or judged can make speaking openly feel almost impossible. They may worry that saying their thoughts aloud will change how others see them, leading them to keep their experiences hidden, sometimes even from those closest to them. Research has identified an association between OCD and shame (Laving et al., 2023), while NICE guidance recognises that people experiencing OCD may find discussing their symptoms particularly difficult.
The exhausting search for certainty
OCD isn't always something we can see. Someone may appear calm while internally replaying conversations, questioning memories or mentally checking whether something terrible might happen. To ease the distress, they may seek reassurance, avoid certain situations or carry out mental or physical rituals. These responses can provide temporary relief, but the uncertainty often returns. And so the cycle continues. It's not simply a matter of choosing to stop worrying. For someone experiencing OCD, the need to feel certain can become overwhelming.
Understanding OCD and finding support
OCD is not a personality quirk or simply a preference for tidiness. It is a mental health condition that can significantly affect someone's emotional wellbeing, relationships and everyday life. The encouraging message is that OCD is treatable. Evidence-based psychological treatment, particularly cognitive behavioural therapy (CBT) incorporating exposure and response prevention (ERP), can help people respond differently to intrusive thoughts and reduce compulsive behaviours. During OCD Awareness Week, we have an opportunity to challenge misconceptions and develop a greater understanding of experiences that often remain hidden.
Because behind the behaviours we might notice, there may be someone quietly struggling with fear, uncertainty and exhaustion.
Understanding begins with looking beyond what we can see.
And sometimes, a little more compassion and a little less judgement can make a meaningful difference.
The following sources informed this article:
1. Laving et al. (2023)
The association between OCD and shame: A systematic review and meta-analysis. British Journal of Clinical Psychology.
Read the peer-reviewed research
2. National Institute for Health and Care Excellence (NICE)
Obsessive-compulsive disorder and body dysmorphic disorder: Treatment (CG31).
3. NHS
Obsessive-compulsive disorder (OCD): Symptoms.
Further Support
OCD-UK is a UK charity offering information, resources and support for people affected by OCD and their families.
You can also explore the OCD and Intrusive Thoughts area of support at The Belonging Therapy.
