The Sidestep Meets the Step Forward
Beyond the Stereotypes: What Therapists Want You to Know About OCD
By Davina Morris, LMSW | July 14, 2026
As a therapist, there are a few areas and topics that I avoided– purposely. I can give broad textbook definitions of these areas as I was trained, but, truthfully, staying away from digging deep was the plan. My internal dialog was, “Nope, that area is not for me,” so it seemed that some topics were too much for me. I felt like I wouldn’t be able to handle it and thought to pass them off to a more “professional” professional. That was the plan. Let me tell you how that has all changed.
Honestly, it was people’s trust in the therapeutic process and rapport that changed things for me as a therapist. It was my supervisor’s experienced ear and sharing assessments that sparked my interest in learning what I didn’t want to know before. It was people I sat with honest, worried, stressed, sincere people that shared something was off for them and they couldn’t place it. It was the tone in people’s voices as they shared more of their thoughts that had never been vocalized. It was also, truthfully, the wealth of free, easily accessible information in this area that made me feel the struggle is real.
That’s why I started to learn more about one of the areas I was hesitant to learn about: Obsessive Compulsive Behavior (OCD). I haven’t run across the type we see on TV, with the excessive handwashing, or people saying their space has to be neat and in order because they are “so OCD.” We rarely expand on those concepts – that handwashing can be linked to the feeling that everything a sink touches is contaminated, so they wash their hands to the point of removing their skin, or that they make everyone in their home change their clothes every time they come in. There is also the person who is “so OCD” that they must have everything “just right,” develop an all-or-nothing perspective, and give up on goals because, if what they do is not perfect, they become intensely distressed. So yes, those forms of OCD have a certain place and should not be put down in any way. However, it may help more if we begin to take another step to be more inclusive with all the ways OCD can show up.
OCD tells the person it is attached to that there is this huge fear, leading to a misunderstanding of that fear, anxiety, or discomfort, then a safety behavior or compulsion (internal or external), relief after the safety behavior, and then it starts all over again. OCD behaviors or compulsions can range from “Checking” to “Pure O.” Checking, the most common compulsion, is about reassurance seeking, for example, checking if the door is locked or if the stove is turned off to the point of always being late. Pure O is when a person has obsessions with mental compulsions. An example could be someone who has to think negatively or something positive won’t happen, and vice versa, if they think something positive, something negative will happen, so they feel like thinking about every negative thought is the only way to go. There are so many more things to include perinatal, scrupulosity, harm, relationship, and sexual orientation, all of which are just a snapshot of the different subtypes. Most OCD thoughts are ego-dystonic, meaning their thoughts go against anything a person would typically do or go against their own values. What I have learned about OCD is that it’s highly under diagnosed, so it is not often treated. Meaning people are doing this alone. I have also learned that Exposure Response Prevention (ERP) is the best course of action to help with OCD, along with medication, but there is constant and new research with more methods. OCD cannot be stopped by exploring its pathology, or how I interpret it; it does not care about an origin story or the arc of where the obsessive compulsions started. Well, it does care because if time is spent on finding the origin, then OCD lives to lurk another day. Past training stated, “work on the OCD, not backwards but forwards.” This did not make sense to me, but I trust the leaders in this area. They were directly saying work on the compulsions, or they will not be defeated. Rest assured, there is a reason. Trust the experts every time, with a critical mind.
There is much more I want to learn in this area: terminology, recommended readings, holistic approaches, and cultural perspectives. This is an area that will be a part of me moving forward.
May my internal “I don’t want to know,” current learning, and reflections spark something in all of us so those with OCD, diagnosed or not, no longer go through these difficult thoughts alone.
