What Is OCD?
Spotlight by Dr. Hyejin Jin
Obsessive-Compulsive Disorder (OCD) is a condition that causes unwanted, intrusive thoughts and repetitive behaviors that can feel impossible to stop. Many people think of OCD as being “neat” or “organized,” but OCD is not a personality trait. OCD is a mental health condition that can deeply impact daily life. It affects about 2–3% of the population, which means millions of people experience it at some point in their lives. It also affects people of all genders, ages, backgrounds, and personality types. OCD is not caused by weakness, choice, or upbringing. It is a neurobiological condition influenced by genetics, thought patterns, and environmental stress.
The good news is: OCD is treatable, and people can learn to live full, meaningful, and value-centered lives through effective therapy.
Understanding OCD: A Therapist’s Insight
OCD has two key components: Obsessions and Compulsions.
What are obsessions?
Obsessions are intrusive thoughts, images, or urges that feel disturbing, uncomfortable, or “wrong” that cause the individual significant psychological and emotional distress.
Common themes of obsessions include:
Fear of contamination
Fear of causing harm to others
Fear that something bad will happen if something is not done exactly right
Disturbing thoughts, images, or ideas that are sexual, violent, or religious in nature
Fear of being sinful, immoral, or spiritually “wrong”
Fear of being in the “wrong” relationship or not being a “good enough” partner
Needing things to be symmetrical or “just right”
People with OCD do not want these thoughts. In fact, they often feel distressed specifically because the thoughts contradict who they are.
What are compulsions?
Compulsions are behaviors—either physical or mental—performed to relieve anxiety or prevent something bad from happening. Often, the individual feels a strong urge to engage in compulsions even if they do not want to, or rationally know that it does not “make sense” to engage in them. Compulsions can lead to the development of rigid rituals and routines that can take significant time and energy for the individual to complete them.
Examples include:
Rewashing or rechecking
Repeating actions until they feel correct
Asking for reassurance
Avoiding certain people or places
Mental rituals (counting, reviewing memories, repeating phrases)
The relief that compulsions provide is temporary. Over time, they make OCD stronger.
Whether the fear is about germs, morality, safety, identity, or relationships, the pattern is the same:
Intrusion → Anxiety → Compulsion → Temporary Relief → Cycle Strengthens
An evidence-based treatment called Exposure Response Prevention (ERP) breaks that cycle.
The Most Effective Treatment: ERP
Exposure and Response Prevention (ERP) is the gold-standard treatment for OCD.
ERP helps people:
Face the intrusive thoughts or triggers (Exposure). There are two types of exposures that are conducted in ERP:
Imaginal Exposure. Client intentionally imagines or vividly describes a feared situation, thought, or outcome rather than confronting it in real life. It’s used when the feared scenario cannot be safely or practically recreated (e.g., starting a house fire, harming someone, contracting a fatal illness) or when the fear is primarily mental or obsessional.
Example: “What if I didn’t turn off the stove and my house burns down?”
In-Vivo Exposure. Client directly confronts feared situations, objects, or cues in real life, rather than in imagination. It’s the behavioral component of ERP, where clients systematically face the actual triggers that provoke obsessional anxiety — while refraining from performing safety behaviors or rituals (the “response prevention” part).
Example: The client turns off the stove once, resists rechecking it, and leaves home for 30 minutes. They practice tolerating the uncertainty that it might still be on.
Refrain from performing compulsions (Response Prevention)
This process teaches the brain:
Anxiety naturally rises and falls on its own, even if we do not engage in the compulsion
Thoughts do not require action
Uncertainty can be tolerated, thus decreasing the likelihood for the individual to engage in the compulsion to lower their distress
Life can become bigger than OCD’s demands.
What ERP Looks Like in Practice: A Case Example
A client has an obsession that they will accidentally leave their oven, stove, and/or sink on before they leave their home. They are fearful that they will cause irreparable damage to their apartment and cause significant harm to their neighbors in the building (i.e., obsession). As a result, the client repeatedly checks the knobs on their oven, stove, kitchen sink, and bathroom sinks before leaving their apartment. Their checking routine can take more than 30 minutes at a time because they are unsure if they really saw that the knobs were turned to “off” and doubt that they actually turned everything off. In addition, they take hundreds of pictures of their appliances and sinks in the “off” position to make sure they really remembered to turn everything off before leaving their home. The client also sends some of these pictures to their closest friend before leaving their home to receive reassurance that they are safe to leave (i.e., compulsions in the form of checking, repeating actions, seeking assurance).
Exposure Hierarchy
The client begins ERP with a trained therapist. After an intake session, they first create an Exposure Hierarchy. This is a personalized list of situations, objects, or activities that cause obsessional thoughts and compulsive behaviors. They collaboratively create a list of anxiety-inducing triggers (e.g., watching a scene in a TV show or movie where a house burns down due to a negligent mistake, or leaving the home without checking any of their appliances or sinks).
After they create the Exposure Hierarchy, they identify and rank each specific item on the hierarchy on a scale (e.g., 0 to 10, 0 to 100) based on the level of distress they cause. The client and therapist also make a list of compulsions they have engaged in in the past. Additionally, any other compulsions they might see themselves engaging in if they were to be exposed to the items on the Exposure Hierarchy.
Starting with the least distressing item on the Exposure Hierarchy, the client is exposed to that situation without engaging in their usual compulsive response (e.g., watching a scene in a movie where someone leaves the kitchen while there is a lasagna cooking in the oven without asking themselves, “did I turn off my oven before I came to this therapy session?)
The client’s level of distress is periodically monitored throughout the exposure exercise. Once the client feels less distress when doing the exposure and/or they feel as though they can tolerate the distress, they move onto the next item on the Exposure Hierarchy. This process is repeated until they have been exposed to all items on the hierarchy.
ERP is collaborative, paced, and structured so that exposure work feels challenging but doable—not overwhelming.
Other Interventions that Support OCD Treatment
While ERP is the foundation, other therapy models help strengthen long-term change.
Cognitive Behavioral Therapy (CBT)
Helps challenge beliefs that maintain the OCD cycle (e.g., “What if I missed something?” or “I must have 100% certainty”).
Acceptance and Commitment Therapy (ACT)
Helps develop the willingness to experience discomfort while living in alignment with personal values rather than engaging in avoidance
Dialectical Behavior Therapy (DBT) Skills
Mindfulness, distress tolerance, and emotion regulation skills build resilience during ERP work, especially if emotions feel intense
Medication
Some people benefit from Selective Serotonin Reuptake Inhibitors (SSRIs) or clomipramine alongside therapy. Medication can reduce symptom intensity enough to make ERP more accessible. Many people do ERP with or without medication—both approaches are valid and individualized.
Addressing Interfering Factors in Treatment
Even when someone is ready to work on OCD, certain patterns can get in the way. Common barriers include:
Intolerance of distress. Believing anxiety must be eliminated rather than tolerated.
Family accommodation. When loved ones participate in reassurance or avoidance unintentionally reinforcing OCD.
Perfectionism about doing ERP “correctly”. Turning treatment itself into a ritual.
Co-occurring conditions. Such as depression or ADHD, which may require tailored pacing.
The belief that intrusive thoughts mean something about one’s character. Psychoeducation helps correct this.
Working through these factors is part of the therapeutic process—not signs of failure.
Prognosis and Long-Term Outlook
Many people experience significant symptom reduction with ERP. Some reach full remission; others learn to manage symptoms in ways that allow them to live full, meaningful lives.
What supports progress:
Consistency with ERP
Willingness to face uncertainty
Reducing family/system reassurance patterns
Learning to tolerate discomfort without ritualizing
Relapses can happen during stressful periods, but the skills learned in ERP make it possible to regain control.
The goal is not to eliminate intrusive thoughts entirely (everyone has them!)—the goal is to change how you respond to them.
If You’re Struggling, You’re Not Alone
OCD can feel isolating, confusing, frightening, and most importantly, exhausting. But you are not your thoughts, and this disorder is treatable. Recovery is real, and it is possible.
If you’re interested in learning more about therapy for OCD at Manas Cor, I offer Exposure Response Prevention treatment tailored to your needs.
You can schedule a consultation or ask questions by sending me an email at hjin@manascorpsych.com
I would be honored to support you in the process of reclaiming your life from OCD.
Discover What Life Can Feel Like When OCD No Longer Leads the Way
Living with OCD can feel like a never-ending cycle of fear, doubt, and exhaustion. You might find yourself spending hours caught in repetitive thoughts or rituals, knowing they don’t make sense, but feeling powerless to stop.
Individual therapy for OCD offers a space to slow down, understand what’s happening in your mind and body, and begin taking small, intentional steps toward freedom. Through Exposure Response Prevention (ERP) and other evidence-based approaches at Manas Cor, you can learn to face uncertainty, tolerate discomfort, and begin trusting yourself again
Schedule a consultation today if you’re ready to take that next step.
Begin working with an individual therapist in Washington, DC who specializes in OCD.
Together, you’ll map out a plan that supports both understanding and lasting change, so you can begin living a life that feels fuller, calmer, and truly your own.
Other Mental Health Services We Offer in DC
In addition to individual therapy, we also provide psychological testing and assessment, and group therapy for adolescents and adults. Whether you're navigating anxiety, depression, life transitions, relationship challenges, or the lingering effects of past experiences, therapy offers a supportive space to process, reflect, and grow, both one-on-one and in community with others.
About the Author
Dr. Hyejin Jin is a licensed psychologist and cognitive behavioral therapist with extensive experience treating Obsessive-Compulsive Disorder (OCD), mood and anxiety disorders, trauma, and body-focused repetitive behaviors. With a background from the University of Southern Mississippi and the University of Washington, Dr. Jin integrates evidence-based approaches like CBT, ERP, and DBT to help clients build resilience and create meaningful change.
For nearly a decade, she has also taught DBT skills in both individual and group settings and is passionate about providing gender-affirming, inclusive care for LGBTIQA+ individuals. Dr. Jin is conversationally fluent in Korean and values creating a therapeutic space that is culturally sensitive, compassionate, and collaborative.
Outside of Manas Cor Psych, she enjoys cooking, watching sitcoms, and spending time with her dog.
