More on OCD
Obsessive–compulsive disorder does not have a single cause. Instead, it usually develops from a combination of factors. Some people may be more biologically sensitive to anxiety and intrusive thoughts because of differences in brain chemistry, stress response systems, or family history. Early experiences also play a role; for example, growing up in environments where safety, responsibility, or certainty felt especially important, or where mistakes were heavily criticised, can increase vulnerability by teaching the mind to focus on preventing harm or “getting it right.” OCD can also emerge or worsen during times of high stress, loss, or change, with traumatic or overwhelming experiences reinforcing a sense of danger and keeping the mind on constant alert for threat.
Why does OCD continue?
OCD is maintained by a cycle. Intrusive thoughts or fears trigger anxiety, guilt, or disgust. To reduce this discomfort, a person may carry out compulsions such as checking, washing, reassurance-seeking, or mental reviewing. These compulsions bring short-term relief, but they also teach the brain that the thought or situation really was dangerous. This keeps the cycle going and often makes the intrusive thoughts stronger over time. Self-blame, shame, and rigid beliefs such as “I must control every thought” or “having the thought means I’m a bad person” can make the cycle even harder to break.
How does treatment help?
Therapy helps by targeting the processes that keep OCD alive. The gold-standard approach is Cognitive Behavioural Therapy (CBT) with Exposure and Response Prevention (ERP). In ERP, clients gradually face feared thoughts, images, or situations while resisting compulsions. Over time, the brain learns that anxiety reduces naturally without rituals and that intrusive thoughts do not need to be acted upon. Research consistently shows ERP to be the most effective treatment for OCD, with around 70% of people experiencing significant improvement.
Why seek treatment?
Without treatment, OCD can become more entrenched over time, narrowing daily life and increasing distress. With the right support, recovery is possible. Therapy does not mean eliminating all intrusive thoughts (everyone has them), but it helps change the relationship to those thoughts, loosen the grip of compulsions, and reclaim the freedom to live in line with your values.
Many of the clients I work with describe shame as one of the biggest barriers to starting therapy. I want to reassure you that in our work together, you will be met with acceptance, understanding, and support. Therapy offers a safe space to explore these feelings and learn evidence-based ways to gently dissolve shame, so you can begin to break free from the barriers that have been holding you back.
