Understanding (OCD): Breaking the Cycle of Obsessions and Compulsions

Have you ever found yourself caught in a cycle of thoughts that simply won't let go?

You tell yourself not to think about it, yet the thought keeps returning. You try to reassure yourself that everything is okay, but the doubt lingers. Perhaps you check the door one more time, wash your hands again, replay a conversation over and over, or seek reassurance from someone you trust. For a brief moment, the anxiety settles… until the next intrusive thought appears.

Living with Obsessive-Compulsive Disorder (OCD) can feel exhausting and incredibly isolating.

Many people living with OCD recognise that their fears are driven by anxiety, yet the anxiety feels so real that ignoring it can seem impossible. The urge to perform a compulsion is an attempt to find relief from overwhelming uncertainty and distress.

For more than 500,000 Australians, this is part of everyday life.

What Is Obsessive-Compulsive Disorder (OCD)?

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterised by recurring obsessions and compulsions that can become difficult to break without support.

Everyone experiences intrusive thoughts from time to time. Most people are able to let these thoughts come and go without attaching much meaning to them. For someone living with OCD, these thoughts can create intense anxiety, self-doubt, and a powerful urge to do something to make the anxiety go away.

Obsessions may focus on contamination, causing harm, checking, religion, relationships, health, or the need for things to feel "just right." Although the content varies, they often create the same overwhelming sense that something needs to be resolved immediately.

The OCD Cycle

Why Does OCD Feel So Difficult to Break?

If you've ever wondered, "Why can't I just stop?", you're not alone. OCD is maintained by a cycle that becomes stronger each time anxiety is relieved through a compulsion.

Intrusive thought → Anxiety or uncertainty → Compulsion → Temporary relief → OCD cycle becomes stronger

When an intrusive thought appears, anxiety rises. Performing a compulsion often brings temporary relief from the anxiety. Although this relief feels helpful, it unintentionally teaches the brain that the compulsion kept you safe.

The next time the thought returns, the urge to perform the compulsion often feels even stronger.

Over time, this cycle can become automatic, making OCD increasingly difficult to break.

Why Intrusive Thoughts Can Feel So Real

If you live with OCD, intrusive thoughts can feel incredibly real. They can leave you questioning yourself, your intentions, or whether something bad might happen if you don't act.

Intrusive thoughts are a recognised symptom of OCD and are not a reflection of your character, values, or intentions.

It's important to remember that intrusive thoughts are not the same as compulsions. Intrusive thoughts are the unwanted thoughts, images, or urges that create anxiety. Compulsions are the behaviours or mental rituals performed in an attempt to reduce anxiety or create a sense of certainty.

While some compulsions are visible, such as checking or washing, many happen entirely in the mind. You might replay conversations, mentally review events, silently count, repeat phrases, seek reassurance, or try to "cancel out" unwanted thoughts.

Although these mental compulsions may bring temporary relief, they also keep the OCD cycle going.

Why Uncertainty Feels So Uncomfortable

At its core, OCD is often driven by an overwhelming need for certainty. Although obsessions may focus on different things, there is often a powerful need to know with absolute certainty that everything is okay. The challenge is that life rarely provides absolute certainty.

Learning to tolerate uncertainty, rather than trying to eliminate it, is one of the key goals of evidence-based therapy for OCD.

Evidence-Based Therapy for OCD

Living with OCD can feel exhausting. You may have spent months or even years trying to push the thoughts away, make sense of them, or find certainty, only to find yourself caught in the same cycle.

Therapy offers a different approach. Rather than trying to prove the thoughts right or wrong, the focus is on helping you gradually step out of the cycle that keeps OCD going. As you become less reliant on compulsions to relieve anxiety, the cycle begins to loosen its grip, allowing you to spend less time managing OCD and more time living the life you want to live.

Cognitive Behavioural Therapy (CBT), including Exposure and Response Prevention (ERP), is considered the first-line psychological treatment for OCD. ERP involves gradually facing situations or thoughts that trigger anxiety while resisting the urge to perform compulsions. Over time, this helps reduce reliance on compulsions and builds confidence in tolerating uncertainty.

When to Seek Help

Living with OCD can be incredibly isolating. Many people hide their symptoms because they worry they will be misunderstood or judged.

You do not have to manage OCD on your own.

With evidence-based support, many people begin to feel less controlled by OCD and more able to reconnect with the people, activities, and experiences that matter most to them.

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Vanessa Allen is an Accredited Mental Health Social Worker, psychotherapist and clinical supervisor with over 18 years experience. She is a Credentialed Eating Disorder Clinician (ANZAED), EMDR therapist and RO-DBT practitioner, and founder of Evolving Minds Counselling and Psychology in the Sutherland Shire.