CivilPsych Services

Individuals, Arkansas and Missouri

OCD

Everyone has odd, ugly or frightening thoughts. What turns one into an obsession is the verdict about it: this thought is dangerous, it means something about me, and I have to do something to cancel it.

Written by Dr. Heath, Ph.D. Neuropsychology, Ph.D. Forensic Psychology. 40+ years of cognitive behavioral work. Reviewed November 2026.

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What's really going on

What people say"My OCD made me do it." The label gets treated as the thing doing the checking, the washing and the counting.
What's usually happeningThink of the road-trip question: did I turn off the coffee pot? An obsession is that kind of open loop, and the ritual closes it for a few minutes. Each time it does, you confirm the verdict that the thought was urgent, and the next loop opens faster. The thought is not the problem. The verdict is.

What you might notice

  • A thought shows up and you are convinced you have to undo it right away.
  • You check, wash, count, repeat or ask for reassurance until it feels right.
  • The rituals take more time each month.
  • You avoid places, objects or people you have tied to the thought.
  • You know it doesn't make sense, and it still feels urgent.

How we work on it

The same method every time: find the thought, test it, practice a better one.

  1. Map the loopThe thought, the verdict you attach to it, the ritual and the relief.
  2. Question the verdictDoes having a thought make it true, likely or a reflection of who you are?
  3. Field-test the verdictCognitive Field Testing: step by step, you meet the thought on purpose, skip the ritual and check what the verdict predicted against what happens. The test is of the verdict, not of your nerve.
  4. Track the timeWe measure the minutes spent on rituals and watch them come down.

Questions

Does having a horrible thought mean I want it to happen?

No. People with these thoughts are usually the ones most bothered by them. The bother is the verdict at work.

Will I have to stop every ritual at once?

No. We start with the easiest one and work up.

Can I keep taking my medication?

Yes. Decisions about medication stay between you and your prescriber. Therapy works alongside it.

Next

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