So initially, our focus for the month at NextTherapist was on disordered eating. While that remains an important topic, something unexpected happened this week. Many of the therapists who joined the platform—and whom we interviewed—shared that a significant part of their clinical work involves treating obsessive‑compulsive disorder (OCD).
That shift felt important.
Because despite being one of the most common mental health conditions—often cited as the fourth most commonly diagnosed mental health disorder—OCD remains one of the least understood and most misrepresented.
When a Diagnosis Offends
In my own clinical work, I’ve had sessions where I carefully and gently suggested that a client’s symptoms may be consistent with OCD. More than once, this has been met with offense. In one case, I even lost a client because of it.
That reaction tells us something important: OCD isn’t just misunderstood—it’s stigmatized.
Almost weekly, I hear someone casually say, “I’m so OCD about this.” It’s usually said with a smile, often as a subtle self‑compliment.
“I’m so OCD about keeping my house clean.”
What they’re really communicating is that they have high standards, strong work ethic, or attention to detail.
As someone who was diagnosed with OCD at 17, I can tell you plainly: it is not something I would ever brag about.
Living With the Label
Twenty years ago, OCD was far less understood than it is today. When I was diagnosed with anxiety and OCD, I felt far more comfortable telling people I had anxiety. Saying I had OCD felt shameful—loaded with judgment and misunderstanding.
OCD carries a strange irony:
It’s used casually in everyday language as a compliment, yet it carries deep stigma for those who actually live with it.
That contradiction alone makes it worth talking about.
What OCD Is Not
OCD is not simply perfectionism.
It’s not just being organized, detail‑oriented, or clean.
Those traits are more accurately associated with obsessive‑compulsive personality traits or obsessive‑compulsive personality disorder (OCPD)—which is entirely different from OCD.
So what is OCD?
What OCD Actually Looks Like
When people think of OCD, they often picture excessive handwashing or fears of contamination. While this is one presentation, it accounts for only about 25–30% of people with OCD.
The majority of OCD presentations look very different.
For me—and for many clients I see—it showed up as something far less talked about:
Intrusive fears of harming someone
I know. That sounds alarming.
If someone doesn’t want to hurt anyone, why would they have thoughts about doing so? And doesn’t having those thoughts mean they want to?
This is where OCD is often deeply misunderstood.
In OCD, intrusive thoughts are:
- Unwanted
- Ego‑dystonic (they go against a person’s values)
- Highly distressing
One of the clearest ways clinicians differentiate between someone who genuinely wants to harm others and someone experiencing OCD is how distressing the thoughts are.
My therapist once said something that stayed with me:
“If you were truly a serial killer, you’d be out there being a serial killer.”
The thoughts weren’t desire.
They were fear.
And the fear itself was the disorder.
Why This Conversation Matters
When OCD is reduced to a punchline or personality quirk, people who are struggling:
- Delay seeking help
- Feel ashamed of their symptoms
- Worry about being misunderstood—or judged
And unfortunately, many therapists receive little specialized training in OCD, which can make finding the right support even harder.
That’s why we care so deeply about elevating conversations like this.
Why Finding the Right OCD Therapist Matters
One of the reasons OCD is so important to diagnose and treat accurately is that it is one of the few mental health disorders where the wrong treatment approach can actually make symptoms worse.
OCD is frequently misdiagnosed as generalized anxiety disorder or depression. While these conditions can co‑occur, treating OCD as if it were only anxiety or depression can unintentionally reinforce obsessions and compulsions rather than reduce them.
When therapy focuses primarily on reassurance, thought‑challenging, or avoidance reduction without directly addressing compulsive behaviors, it can strengthen the OCD cycle. What feels supportive in the moment can actually increase long‑term distress.
This is why specialized, evidence‑based treatment approaches such as exposure and response prevention and other OCD‑informed therapies are so critical.
Research consistently shows that the average person with OCD waits nearly seven years before working with a therapist who can adequately treat their diagnosis. That represents years of unnecessary suffering, not because OCD is untreatable, but because it is so often misunderstood.
Finding the Right Help
OCD is highly treatable—especially when addressed with evidence‑based approaches like Exposure and Response Prevention (ERP) and other specialized OCD‑informed therapies.
But treatment starts with being seen accurately.
At NextTherapist, we’re intentional about highlighting clinicians who are trained and experienced in treating OCD—not just anxiety in general.
If you or someone you love is struggling with intrusive thoughts, compulsions, or fears that don’t align with who you are, you’re not broken—and you’re not alone.
Explore OCD‑informed therapists on NextTherapist and find care that fits who you are—not the stereotypes.
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If this post resonated with you, we encourage you to share it. The more accurately we talk about OCD, the less power stigma holds.
