Everyone is not ‘a little bit OCD’: Understanding OCD beyond the stereotypes

When people say, “I’m so OCD,” they are usually referring to liking things neat or organized. While preferences for order can be part of anyone’s personality, this phrase not only misses the mark, it encourages potentially harmful stereotyping of a very real problem.

Licensed marriage and family therapist Kenneth Phelps, PhD, broke down the assumptions about this poorly understood condition, including what it means to have OCD, how it’s treated and more.

What is OCD?

“Obsessive-compulsive disorder, or OCD, is not being a tidy person or liking things neat or organized,” said Dr. Phelps. “OCD is a clinical condition that can consume hours of a person’s day, strain relationships and create significant distress.”

When OCD is treated like just being detail-oriented or liking structure or routine, it can blur important distinctions and make it harder for those truly struggling with OCD to recognize the need for help.

How does OCD affect daily life?

“At its core, OCD is driven by a cycle of obsessions and compulsions,” said Dr. Phelps. “Obsessions are intrusive, unwanted thoughts, images or urges. We’re not talking about seeing a messy table and feeling a need to clean up. Obsessions trigger anxiety, fear or disgust in the person experiencing them.”

Compulsions, on the other hand, are behaviors or mental acts that the person with OCD feels compelled to perform to reduce their distress or keep something bad from happening.

“Any relief they receive from following these compulsions is temporary,” said Dr. Phelps. “Over time, the brain learns that the compulsions ‘work.’ This, unfortunately, only strengthens the cycle and makes the intrusive, obsessive thoughts even more persistent.”

Most people with OCD recognize that these fears are irrational or that their compulsive behaviors cannot actually affect events, but they’re still pulled into the cycle. This can lead to losing their job when they aren’t able to get to work on time due to being stuck in a cycle of compulsive behavior or feeling they can’t maintain their relationships with loved ones.

Isn’t OCD just washing your hands too much or something?

“Obsessive-compulsive disorder shows up in countless ways,” said Dr. Phelps. “While some people may experience that drive to clean their environment or themselves repeatedly, that’s just one example. Others may feel compelled to avoid objects that their intrusive thoughts have declared ‘unclean,’ or struggle with fears of accidentally causing injury. This could lead to repeated checking of doors or appliances or being unable to leave their house until they feel the compulsion has been satisfied.”

Individuals with OCD could also struggle with intrusive thoughts that are sexual, violent or blasphemous, leading them to follow mental ‘rituals’ like suppressing their own thoughts, repeating phrases, praying excessively or seeking reassurance repeatedly from those around them.

“Keep in mind that these thoughts are not in any way welcome,” said Dr. Phelps. “These unwanted thoughts can make someone with OCD feel like they have to follow their rituals to try and ‘be good’ or that if they don’t perform their rituals, they’ll end up committing terrible crimes or causing harm against their own will.”

These concerns focus on religious or moral themes, with compulsions like repeated confessing or a strong need for certainty about being “good.”

What are other ways that OCD can show up in daily life?

“OCD may also show up as a persistent sense that something is not quite right, leading to arranging, counting or repeating actions until the feeling settles,” said Dr. Phelps. “In tic-related presentations, a rising sensory urge or internal tension may prompt behaviors such as tapping, touching or evening up, sometimes overlapping with conditions like Tourette Syndrome.”

The common thread is that the thoughts are unwanted and inconsistent with the person’s values, and the behaviors don’t feel intentional. People with OCD are not making a casual choice to have these thoughts or follow these compulsions. They feel forced or driven to them.

Is OCD treatable?

“OCD is highly treatable, which is one of the most encouraging aspects about it,” said Dr. Phelps. “The gold standard therapy is Exposure and Response Prevention (ERP), a structured approach that helps individuals gradually face the situations they fear while resisting the urge to perform compulsions.”

Diagnosis and treatment planning are often supported by tools like the Yale-Brown Obsessive Compulsive Scale, which helps guide care and track progress over time. For example, someone with contamination fears might touch a doorknob and delay washing, while someone with harm-related OCD might practice tolerating uncertainty without checking. Over time, this retrains the brain to learn that anxiety can rise and fall without the need for compulsions.

Many clinicians also use Acceptance and Commitment Therapy (ACT), which helps individuals change their relationship to intrusive thoughts by focusing on values and willingness rather than control. Families also play an important role by learning to reduce accommodation, such as no longer providing reassurance or participating in rituals. Instead, they are asked to support the affected person’s use of treatment skills. For moderate to severe OCD, Selective Serotonin Reuptake Inhibitors (SSRIs) are often recommended, typically at higher doses, to reduce symptom intensity and support engagement in therapy.

Seeking treatment for OCD can make all the difference

“If you or a loved one may be struggling with OCD, seeking care from a provider trained in evidence-based treatment is essential,” said Dr. Phelps. “OCD can feel isolating, but with the right support, individuals can regain time, freedom and a sense of control in their lives.”

For additional support and education, consider connecting with OCD South Carolina or OCD Tennessee, valuable local resources for community and advocacy. The International OCD Foundation (IOCDF) also offers a wealth of information, treatment resources and a robust YouTube channel featuring expert-led talks.