The Flame Within

OCD: One of the Most Misunderstood Mental Health Disorders

Obsessive Compulsive Disorder is one of the most misunderstood and misdiagnosed mental health conditions.

Many people think OCD is about being neat, organized, or liking things a certain way. It is not.

OCD begins with intrusive thoughts.
Unwanted. Distressing. Repetitive.
Often completely opposite of the person’s values.

These thoughts create intense anxiety or distress.

To reduce that anxiety, a person engages in compulsions. These are behaviors or mental acts meant to bring relief. This might look like checking, reassurance seeking, mental reviewing, confessing, avoiding, repeating, or ritualizing.

The compulsion brings temporary comfort.

But then something happens.

The intrusive thought comes back stronger.

And the cycle tightens.

OCD is a spiral.
Intrusive thought leads to anxiety.
Anxiety leads to compulsion.
Compulsion brings temporary relief.
Relief reinforces the intrusive thought.
The intrusive thought returns stronger.

Over time, the brain learns the wrong lesson. It learns that the compulsion is what keeps you safe.

But in reality, the compulsion is what keeps OCD alive.

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Why OCD Is Often Misdiagnosed

OCD is one of the diagnoses that is frequently missed or misunderstood. Research shows it can take up to 14 years for someone to receive an accurate OCD diagnosis.

Why?

Because it often looks like generalized anxiety.
Or perfectionism.
Or even depression.

But anxiety treatment alone does not treat OCD.

OCD requires a very specific and unique therapeutic approach.

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What Actually Treats OCD

The gold standard treatment is Exposure and Response Prevention, also known as ERP. This is a specialized form of cognitive behavioral therapy.

ERP teaches the brain something new.

You can have the intrusive thought and not respond with the compulsion.

This feels overwhelming at first. Sometimes incredibly uncomfortable. That is why many individuals also benefit from medication alongside therapy.

But healing begins when the pattern is recognized.

OCD requires:
Pattern recognition.
Intentional response.
Refusing the compulsion.
Building healthier habits over time.

When someone learns to identify the OCD pattern and respond strategically instead of reactively, change begins.

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The Pickleball Analogy

In my office, with clients, I often explain OCD like pickleball.

Good pickleball players understand that once the ball goes over the net, there is a pattern. The ball will return. Skilled players begin to anticipate where it will land. They do not panic when it comes back. They prepare. They position themselves strategically.

In the same way, OCD has a predictable pattern.

Intrusive thoughts will come.

But when you recognize the pattern, you can anticipate it.
You can prepare your response.
You can choose not to swing the same way every time.

Instead of reacting with a compulsion, you respond with strategy.

Over time, the brain learns a new pattern.

And healing begins.

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A Christian Perspective

Intrusive thoughts can feel spiritual, shameful, or deeply personal, especially for believers.

But Scripture reminds us:

“For God has not given us a spirit of fear, but of power, love, and a sound mind.”
2 Timothy 1:7

OCD is not a lack of faith.
It is not a moral failure.
It is not spiritual weakness.

It is a neurological and psychological pattern that can be treated.

“We take captive every thought to make it obedient to Christ.”
2 Corinthians 10:5

Taking thoughts captive does not mean fighting them with fear or rituals. It means recognizing them for what they are and choosing a wise, grounded response instead of reacting out of panic.

God designed the brain with neuroplasticity, the ability to change. Through intentional practice, therapy, and sometimes medication, those patterns can be rewired.

“He restores my soul.”
Psalm 23:3

Restoration is possible.

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OCD Requires a Specialist

One of the most important things to understand about OCD is this.

It requires treatment from a therapist who is specifically trained in treating OCD.

Not all therapists are trained in Exposure and Response Prevention. Traditional talk therapy can unintentionally reinforce compulsions by providing reassurance or analyzing intrusive thoughts in ways that strengthen the cycle.

OCD treatment is highly specialized.

Working with an OCD specialist ensures that therapy is structured correctly, exposures are done safely and gradually, and compulsions are addressed in a strategic and evidence based way.

If someone has been in therapy for years and still feels trapped in the same intrusive thought and compulsion cycle, it may not mean they are resistant to treatment. It may mean they need a clinician trained specifically in OCD treatment.

The right modality matters.

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Reflection

If you struggle with intrusive thoughts:

Can you identify your OCD pattern.
What compulsion do you use to try to feel better.
What would it look like to pause instead of react.
How might trusting the process feel different than trying to eliminate the thought.

If you love someone with OCD:

Do you recognize when reassurance may be feeding the cycle.
How can you support treatment instead of strengthening compulsions.

OCD thrives in secrecy and shame.
Healing begins with understanding and strategy.

Like pickleball, once you recognize the pattern, you can prepare your response.

And over time, the spiral loosens its grip.

Blessings, Crystal

© 2026 Crystal Ridlon, LPC
Victorious Living Counseling
All rights reserved.