When OCD looks like competence
Updated: 7 days ago
If you're the one everyone rings when the plans fall apart, the friend with spare plasters, a phone charger and a packet of biscuits somewhere at the bottom of her bag, and people often say "I don't know how you do it", this one's for you.
I'm Charlotte, an OCD specialist therapist in the UK, and one of the things nobody tells you about OCD is that it can look a lot like being very good at life. It can hide inside good grades, a clean kitchen and being a reliable friend, and because everything looks fine from the outside, it can go unnoticed for years, sometimes even by the person living with it.
First, what's normal
Lots of people take pride in their work, like a tidy home, double-check an important email, or feel a pull to get things right. Being organised, careful and conscientious is a lovely thing to be, and none of it on its own is OCD.
So when might it be OCD?
OCD is a cycle of obsessions (thoughts, images, urges or doubts that keep coming back, feel unwanted and cause real distress) and compulsions (things you do, out loud or in your head, to make the distress settle or to feel sure).
Clinicians usually start thinking about OCD when that cycle causes real distress, takes up a lot of time, often more than an hour a day, or gets in the way of daily life. Only a qualified professional can say whether it's OCD, so if anything here sounds familiar, it's worth asking rather than guessing.
How OCD can hide behind doing well
The extra effort looks like dedication. Re-reading a piece of work until it feels "right", staying late to check it one more time, or redoing something that was already fine can look like a strong work ethic, when underneath it there may be a doubt that won't settle until it feels certain.
The tidy home has a cost. A spotless kitchen can be a pleasure, and for some people it's also the place where hours quietly go, because the cleaning has to be done a certain way or until it feels finished.
Being reliable can come from fear. Never missing a message, always being the one who remembers, or feeling responsible for everyone's safety can come from care, and it can also come from a worry that something bad will happen, and it'll be your fault, if you let go of it.
Most of it happens in your head. Many compulsions are quiet: reviewing, replaying, checking how you feel, or going over a conversation to make sure you didn't upset anyone. Nobody can see those, so nobody thinks to ask.
OCD is often under-recognised, and on average people can wait many years between their first symptoms and getting the right help.
Why "but I'm coping" can keep you stuck
When you're holding a job, a home and a family together, it can feel as though you don't have the right to ask for help, because surely help is for people who are struggling more than you. So the effort carries on quietly, and the cost shows up in other places: exhaustion, a short fuse at the end of the day, no time that's really yours, or a sense that you're always a step away from something going wrong.
Coping and struggling can happen at the same time, and you don't need to be falling apart to deserve support.
My own OCD has been loudest at times of stress, change and insecurity, which are often exactly the times we push hardest to keep everything looking fine.
OCD grief
Something I see a lot in people who are diagnosed later in life, or who start to wonder about OCD after years of "that's just how I am", is grief. Grief for the time the loop took, for the evenings spent checking or reviewing, and sometimes for the version of you who might have had a bit more room to breathe.
OCD grief is very real, and it deserves gentleness. It often sits alongside relief, because finally there's a name for what's been happening, and with a name comes a way to work with it.
What helps
OCD is treatable and recovery is possible. The treatment NICE recommends first is CBT with exposure and response prevention (ERP), where we work together, at your pace, to gently face the doubt while you practise not doing the compulsion, including the quiet ones in your head. Other approaches like I-CBT and ACT can help alongside it.
Please take this post as an invitation, in case you needed permission to look a bit closer and ask for an actual assessment, rather than a checklist to diagnose yourself from.
If you'd like to understand your own loop a little better first, my free guide Is this OCD? walks through the loop, the compulsions people often miss, and where to go next.
Quick answers
Tap a question to open it.
How do I know if what I'm experiencing is OCD?
OCD usually involves unwanted thoughts, images or doubts that feel distressing, and things you do to try to feel better or more certain, such as checking, avoiding, seeking reassurance or going over things in your mind. Only an assessment can tell you whether it is OCD, and you don't need a diagnosis to get in touch.
Can OCD be cured?
OCD is treatable and recovery is possible. There isn't a guaranteed cure, and I'd never promise one. With the right therapy, many people find OCD takes up far less of their life, and they know what to do when it flares up.
Do I need a diagnosis or a GP referral?
No. You can contact me directly.
How much does private OCD therapy cost?
Sessions are 50 minutes and cost £120, or £660 for a block of six (£110 per session). A free 15 to 20 minute consultation by phone or video is available if you'd like one first.
When you're ready
I work with adults online across the UK, and I'm a BABCP accredited CBT therapist with 12 years in NHS and community mental health services. You don't need to have it all figured out before you get in touch.
For bite-sized OCD support most days, come and find me on Instagram at @the_floral_therapist.
Charlotte
If you feel unsafe, or worried you might act on a thought, call 999 or go to A&E, call NHS 111 and choose the mental health option, or call Samaritans free, any time, on 116 123.
This post is educational and isn't a replacement for therapy. Please speak to an OCD specialist or contact your GP for further support.
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