OCD & Scrupulosity | Christian Psychologist

Psychology for Obsessive Compulsive Disorder

Are you feeling overwhelmed by intrusive thoughts, driven to repeat certain actions, or constantly seeking reassurance? Support is available to help you understand and manage the challenges of Obsessive-Compulsive Disorder (OCD). Therapy can assist you in making sense of your experiences, reduce the distress caused by obsessions and compulsions, and help you reclaim a sense of calm, confidence, and control in your daily life.

"With patience and support, the grip of OCD can be loosened, revealing a life of balance".

Information about OCD

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is a condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) that individuals feel driven to perform. These symptoms can interfere with daily life, making it difficult to focus, relax, or engage in activities. Common obsessions include fears of contamination, harm, or making a mistake, while compulsions might involve excessive cleaning, checking, or seeking reassurance.

OCD can arise from a combination of genetic, neurological, and environmental factors. Stressful life events or changes can trigger or exacerbate symptoms. Understanding the specific causes and symptoms of OCD is crucial for effective treatment, which is where "formulation" becomes important. Formulation involves creating a personalised understanding of an individual’s experiences and symptoms, helping to tailor the most effective treatment plan.

What is the best Treatment for Obsessive Compulsive Disorder?

Understanding the specific causes and symptoms of OCD is crucial for effective treatment, which is where "formulation" becomes important. Formulation involves creating a personalised understanding of an individual’s experiences and symptoms, helping to tailor the most effective treatment plan.

Obsessive-Compulsive Disorder (OCD) can feel overwhelming, but with the right support and evidence-based treatment, many people experience significant relief from symptoms and improved quality of life. Treatment is most effective when it is tailored to the individual, taking into account the nature of their obsessions and compulsions, as well as underlying cognitive and emotional patterns. Below are three approaches commonly used in treating OCD.

Exposure and Response Prevention (ERP)

ERP is considered the gold-standard psychological treatment for OCD. It is a structured form of cognitive behavioural therapy (CBT) that helps individuals gradually face their fears (exposure) without engaging in compulsive behaviours (response prevention).

During ERP, clients work collaboratively with a psychologist to identify situations, thoughts, or images that trigger anxiety and compulsions. Through carefully planned exposures, clients learn to tolerate discomfort and uncertainty, gradually reducing the urge to perform compulsions and weakening the obsessive-compulsive cycle over time.

ERP helps the brain learn that feared outcomes are unlikely or manageable and that distress can reduce naturally without relying on rituals.

Inference-Based Cognitive Behaviour Therapy (I-CBT)

Inference-Based CBT offers an alternative approach that is especially helpful for individuals with OCD who struggle with intrusive thoughts that feel deeply believable, even when irrational.

Rather than focusing on the content of obsessions or external triggers, I-CBT explores the reasoning process behind the obsession. It addresses how the individual came to infer that something dangerous or morally wrong could happen — despite a lack of real evidence.

The goal is to challenge the faulty reasoning that fuels obsessive doubt and to help clients reconnect with their sense of reality and personal values. I-CBT can be particularly effective for people who feel their obsessions stem from internal doubt or imagination rather than real-world events.

Schema Therapy

For some individuals, underlying emotional patterns or early life experiences can make OCD symptoms more persistent or distressing. Schema Therapy helps explore and address deeper emotional themes (or “schemas”) that may contribute to obsessive-compulsive thinking and behaviours.

Common schemas that may underlie OCD include an excessive need for control, high standards, or fears of failure or punishment. Schema Therapy helps individuals identify these core patterns and develop healthier ways of understanding themselves, their emotions, and their relationships.

This approach can be particularly valuable when OCD coexists with other difficulties such as perfectionism, low self-worth, or long-standing relational struggles.

What are the Symptoms of OCD?

Obsessive-Compulsive Disorder (OCD) involves a pattern of distressing thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that a person feels driven to perform. These symptoms can take many forms and often cause significant distress, even when the individual recognizes that their fears or rituals may not make logical sense.

Obsessions

Obsessions are intrusive, unwanted thoughts, images, or urges that cause anxiety or discomfort. They often feel distressingly “out of character” and may be difficult to control or ignore. Common obsessions include:

Contamination fears (e.g., fear of germs, illness, or toxic substances)
Fear of harm (e.g., worry about causing harm to oneself or others)
Religious or moral scrupulosity (e.g., fears of being sinful or blasphemous)
Sexual or violent intrusive thoughts (e.g., unwanted taboo thoughts that go against personal values)
Need for symmetry or exactness
Fear of making a mistake or being responsible for something bad happening

These thoughts are not simply worries or preferences—they are often disturbing, persistent, and feel out of the person’s control.

Compulsions

Compulsions are actions (either physical or mental) that a person feels compelled to perform in response to an obsession, often to reduce anxiety or prevent a feared outcome. While these actions might provide temporary relief, they tend to reinforce the OCD cycle over time.

Common physical compulsions include:

Repeated handwashing or cleaning
Checking (e.g., locks, appliances, or health symptoms)
Arranging or ordering items until they “feel right”
Repeating certain actions or numbers
Seeking reassurance from others

Mental Compulsions

Not all compulsions are visible. Many people with OCD engage in mental compulsions—repetitive thoughts or internal rituals that are used to neutralize or counteract the distress caused by obsessions. These may include:

Repeating phrases or prayers silently
Mentally “undoing” or cancelling bad thoughts
Reassuring oneself mentally (“I would never do that”)
Counting or reviewing events in one’s mind
Trying to mentally “prove” something didn’t happen

Mental compulsions can be just as time-consuming and distressing as physical rituals and often go unnoticed by others.

Impact on Daily Life

OCD can vary in intensity. For some, it may feel like a constant background noise; for others, it can interfere significantly with relationships, work, or day-to-day functioning. People with OCD often feel shame or confusion about their symptoms, but it’s important to know that OCD is a treatable condition. With the right support, individuals can learn to manage symptoms and reclaim a sense of calm and control.

Help is Available

Kylie, a Registered Psychologist and experienced counsellor, uses a combination of inference-based Cognitive Behavioural Therapy (CBT), Exposure and Response Prevention (ERP), and Schema Therapy to address OCD and scrupulosity. CBT helps clients identify and change the thought patterns that contribute to OCD, while ERP involves gradually facing fears without resorting to compulsive behaviours. Schema Therapy addresses the underlying beliefs that may fuel OCD symptoms.

There is hope for those struggling with OCD and scrupulosity. With the right support and treatment, it is possible to manage symptoms and regain control over your life. Therapy can provide the tools and strategies needed to effectively manage OCD and improve your well-being. Kylie invites you to book a session to discover how her tailored therapeutic approach can support you in overcoming OCD and living a more balanced life.