Obsessive-compulsive disorder (OCD): when your mind cannot stop, even though you want it to
Some people have thoughts that come back again and again, however hard they try to get rid of them. They do things over and over, checking, counting, cleaning, arranging, going over things, because if they do not, something very bad might happen, or because the discomfort they feel if they do not becomes unbearable. They know perfectly well that what they are doing is excessive and makes no sense, but they cannot stop. They spend hours trapped in rituals that steal their time, their energy and their ability to be present in their own lives. And sometimes they have not told anyone, because they feel that if they explained it they would seem mad, and because they have lived like this for so long that they no longer know whether there is another way to function.
OCD is not about being tidy or a perfectionist. It is a real disorder, with real suffering, in which the mind gets caught in a cycle of obsessions and compulsions that is very hard to escape without help. With the right approach, that cycle can be interrupted.
What OCD is
Obsessive-compulsive disorder is characterised by obsessions, compulsions, or both, which take up significant time, cause intense distress and interfere with daily functioning.
Obsessions are recurrent, intrusive thoughts, images or urges that the person experiences as disturbing and unwanted. They are not ordinary worries about real problems: they are thoughts that break in uninvited, cause intense anxiety or distress, and that the person tries to ignore, suppress or neutralise.
Compulsions are repetitive behaviours or mental acts that the person feels driven to perform in response to an obsession or according to very rigid rules. The aim is to reduce distress or prevent something feared, but the relief they bring is always temporary. The compulsion does not resolve the obsession: it feeds it.
The most common types of OCD
OCD can show up in very different ways. Some of the most common are:
Contamination and cleaning OCD: fear of being contaminated by germs, dirt, toxic substances or illness, leading to extensive washing, cleaning or avoidance rituals. It is not an obsession with order: it is a real fear that something bad will happen if things are not cleaned enough.
Checking OCD: persistent doubt about whether something has been done, whether the light is off, the gas is off or the door is locked, leading to repeated checking even though the person knows they have already done it. Checking brings momentary relief but does not remove the doubt.
Symmetry and order OCD: an intense need for things to be perfectly arranged, symmetrical or in a particular position. If they are not, a feeling of discomfort appears that is very hard to tolerate.
Intrusive thoughts OCD: disturbing thoughts about harming yourself or others, doing something inappropriate, blasphemy, or sexual or violent content that causes horror and shame. It is important to stress that having these thoughts does not mean wanting to act on them. What characterises OCD is precisely that these thoughts are ego-dystonic: completely opposed to the person’s values and wishes.
Hoarding: extreme difficulty getting rid of objects, regardless of their real value, for fear of needing them in the future or making a mistake by throwing them away.
Moral or religious OCD (scrupulosity): intense, persistent worry about having done something morally wrong, having sinned or not being good enough. A guilt that does not go away even after confessing, praying or analysing the situation exhaustively.
Relationship OCD: obsessive doubt about whether you truly love your partner or whether the relationship is the right one, leading to a compulsive search for certainty that never arrives. The suffering is enormous and does not reflect the person’s real feelings.
The OCD cycle and why it is so hard to break
OCD always works in the same way, whatever its specific content:
The obsessive thought appears. Intrusive, disturbing, unwanted. It creates discomfort, anxiety or a sense of urgency that is very hard to tolerate.
The person performs the compulsion to reduce that discomfort. They check, clean, pray, go over things mentally, seek reassurance, avoid. The discomfort decreases. Briefly.
The thought returns. More strongly. Because the compulsion has taught the brain that the thought is dangerous and must be neutralised. The more you try to get rid of the thought, the more present it becomes. The more you perform the compulsion, the more necessary it feels.
Breaking the cycle does not come from more willpower or from trying harder to suppress the thoughts. That makes the cycle worse. What works is changing your relationship with the obsessive thought: no longer treating it as a threat that has to be neutralised.
What lies behind OCD, from an emotional perspective
OCD has a clear neurobiological basis, involving specific brain circuits related to threat detection and safety responses. But the emotional dimension is just as important.
OCD almost always settles in the areas that matter most to the person. Obsessions about contaminating a loved one appear in those who love most. Obsessions about causing harm appear in those most horrified by the idea of doing so. Moral obsessions appear in those who care most about being a good person. The intensity of the obsession is inversely proportional to the desire to act on it.
From an emotional perspective, OCD can also be understood as a way in which the emotional system tries to manage underlying anxiety or an intolerance of uncertainty that has found no other channel. Compulsions are attempts to obtain certainty in a world that cannot offer it. And the cycle continues precisely because the certainty sought is never enough.
How it affects daily life
Stolen time: rituals and compulsions can take up hours each day, taking time away from work, relationships, rest and enjoyment. Some people spend most of their day managing OCD without anyone around them knowing.
Progressive avoidance: the person increasingly avoids situations, objects or contexts that might trigger obsessions, which gradually narrows life and increases isolation.
Impact on relationships: compulsions can involve the people around you, who are recruited to give reassurance, take part in rituals or avoid doing things that might trigger an episode. This creates tension, exhaustion and resentment, even where there is a great deal of love.
Shame and secrecy: many people with OCD go years without telling anyone because they feel their thoughts are unacceptable or will make them seem dangerous or mad. That silence increases suffering and delays seeking help.
How we work with obsessive-compulsive disorder (OCD) at Tierra de Crecimiento
At Tierra de Crecimiento Psicología we work with OCD in its two fundamental dimensions: the obsessive-compulsive cycle that maintains it and the emotional root that sustains it.
Working on the cycle involves learning to relate to obsessive thoughts differently: not trying to eliminate or neutralise them, but developing the ability to tolerate them without acting on them. This gradually reduces their intensity and power, because the brain learns that the thought is not dangerous and does not need neutralising.
Working on the emotional root involves exploring what is sustaining the underlying anxiety and what intolerance of uncertainty is feeding the cycle, and how to develop emotional resources to stay with what cannot be controlled without needing compulsions to provide a certainty that is never enough.
The process takes courage: facing discomfort without performing the compulsion is uncomfortable at first. But it is precisely that tolerated discomfort that allows the cycle to be interrupted. And when it is interrupted, life regains the space OCD had taken.
The work takes place in individual sessions, in person in Madrid or online. When OCD is very intense or comes with significant depression, therapy can be complemented by a medical assessment that considers medication, always as an additional tool alongside the emotional work, never as a substitute.
If OCD is stealing your time, energy and quality of life, we can help. Contact us for an initial, no-commitment consultation.
Do you recognise yourself in what you have read about OCD?
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