OCPD individuals genuinely value cleanliness and perfectionism (ego-syntonic). In contrast, those with OCD often hate their compulsions, performing them only to alleviate anxiety from irrational, intrusive thoughts (ego-dystonic). The act itself provides no pleasure.

Repeatedly venting to friends or family creates a negative feedback loop that damages relationships. Unlike a therapist who pushes for solutions, friends often act as enablers, which hinders actual progress and leads to social exhaustion.

By preventing the compulsive response (e.g., not checking), Exposure and Response Prevention (ERP) forces the individual to sit with their anxiety. They learn firsthand that the anxiety will eventually fade on its own, a process called extinction decay, which breaks the reinforcement cycle.

Known as the "doubting disease," OCD's checking compulsions create a vicious cycle. Research shows that repeatedly performing an action, like checking a lock, actually makes a person less confident in their memory of having done it, which in turn fuels the urge to check again.

Individuals who believe they only have obsessions ("Pure O") often engage in hidden mental compulsions. These can include mentally replaying events or arguing with thoughts, which serve the same anxiety-reducing function as physical compulsions.

"Thought-Action Fusion" is the belief that having a thought is as morally wrong or as likely to cause an outcome as performing the action. This cognitive distortion makes normal intrusive thoughts feel dangerous, predisposing individuals to OCD.

A person with OCD can be consumed by a specific irrational fear, only for it to be suddenly replaced by a new, equally intense obsession. In hindsight, the previous obsession often seems illogical, yet the new one feels just as compelling.

When a person acts on an intrusive thought (e.g., stepping away from a platform edge), they inadvertently validate its importance. This provides temporary relief but strengthens the thought's power, creating a feedback loop where obsession and compulsion reinforce each other.

The diagnostic threshold for OCD, measured by tests like the Yale-Brown Scale, involves spending hours each day on obsessions and compulsions. This clinical severity is often misunderstood by the general public who use the term casually for minor quirks.