Avoidance works. Until it doesn’t.
If you live with OCD, you already know how convincing avoidance can feel. Don’t touch that doorknob. Don’t say that word. Don’t look at that headline. Don’t drive that route. Don’t sit in that chair. If you avoid the thing that spikes your anxiety, you get relief. Fast.
And that relief is real. Your body settles. Your mind quiets down for a minute. You think, Okay. I handled it.
The problem is what the relief teaches your brain. Avoidance tells your brain: That was dangerous. You survived because you got away. So the next time the trigger shows up, your brain pushes harder. The anxiety hits faster. The list of things you “can’t” do grows. And gradually, almost without noticing, your life starts getting smaller.
This is the part people don’t always say out loud: OCD is not only painful. It’s bossy. It makes rules. It takes time. It steals ease. And it often looks like being responsible, careful, moral, clean, cautious, prepared. Until you’re exhausted.
OCD is not the same as being anxious
Anxiety is a normal human alarm system. It’s supposed to show up sometimes. OCD is different because it gets sticky. It latches onto uncertainty and demands a certain kind of relief.
OCD usually has two parts:
Obsessions: unwanted thoughts, images, urges, or doubts that feel threatening or wrong
Compulsions: things you do to try to neutralize the threat or get certainty
Compulsions can be visible, like washing, checking, or repeating. They can also be mental, like reviewing, praying in a certain way, counting, or trying to “solve” a thought.
Avoidance is often a compulsion too. It’s just quieter.
Not going to the grocery store because you might hit someone with your cart. Avoiding knives because a thought popped in that scared you. Skipping the baby shower because you can’t handle the spike of doubt about contamination. Avoiding your partner because your mind is demanding a feeling of certainty you can’t produce on command.
Avoidance can look like self-control. Sometimes it even looks like maturity.
But the pattern is the same: OCD says, Don’t risk it.
The trap: the more you avoid, the more believable OCD feels
Honestly, avoidance usually makes OCD stronger. Not because you’re doing something wrong but because your brain learns through experience. If you avoid and your anxiety drops, your brain connects the dots and stores the lesson: Avoidance keeps me safe.
That’s why the urge to avoid can feel urgent, even when you logically know the fear is exaggerated or irrational. OCD isn’t interested in logic when it thinks it’s protecting you.
People often come into therapy saying some version of:
I know it doesn’t make sense, but I can’t stop
I’m scared that if I don’t do the ritual, something will happen
I can’t live with the doubt
I’m worried therapy will make it worse
Let’s not sugarcoat that last one. Exposure based treatment can sound terrifying. It involves approaching the very things you’ve been working hard to avoid. So yes, it can feel like the opposite of what you need. But it’s also one of the most researched approaches we have for OCD: Exposure and Response Prevention, often shortened to ERP.
What exposure actually means (and what it doesn’t)
Exposure does not mean flooding you, forcing you, or throwing you into your worst fear on day one. It’s practicing contact with triggers on purpose, in a planned way, while choosing not to do the compulsion that usually follows.
That second part matters. Response prevention is the piece that helps your brain learn something new.
You might feel anxious during exposure. That’s expected. The goal is not to feel calm immediately, it’s to teach your brain that you can handle this feeling and tolerate uncertainty, that you don’t have to obey OCD to be safe.
Over time, many people notice that the anxiety becomes less intense, less sticky, and less controlling. Not always perfectly. Not in a straight line. But enough that life starts opening back up.
Exposure is not about proving that your fear will never happen. It’s about changing your relationship to the fear, and to the need for certainty.
Because certainty is the drug OCD keeps promising you, and it never delivers for long.
A quick example: contamination OCD
Let’s say you touch a public door handle and your mind says, You’re contaminated. You could get sick. You could make someone else sick. You need to wash right now.
Avoidance solution: stop touching public door handles, or carry wipes, or only go places you can control, or use your sleeve, or have someone else open doors for you. Or, or, or…
In the short term anxiety drops, but in the long-term more places feel unsafe. More objects feel risky. Your world narrows.
ERP might look like: touching the door handle and then waiting before washing. Or touching it and washing only once instead of three times. Or touching it and going on with your day, letting the discomfort be there.
This is where people understandably ask: But what if I really do get sick?
We won’t pretend risk is zero (nothing in life is zero risk). ERP is about realistic risk and flexible behavior, not perfect safety.
And it’s done with care. We build a plan and talk through what’s driving the fear. We look at what OCD is demanding, and what it’s costing you.
A different kind of safety
Avoidance feels like safety because it removes anxiety. But anxiety is not the same as danger.
A lot of ERP is learning to tell the difference between, “I feel unsafe” and “I am unsafe” Those two get fused in OCD. Exposure gently, repeatedly, helps un-fuse them. It also helps you practice another skill: letting thoughts be thoughts.
OCD loves to argue. It wants you to debate, analyze, prove, disprove, figure out if you’re a good person, figure out if you’re a bad person, figure out if you’re 100 percent certain. ERP often includes stepping out of the argument. Not because the questions don’t matter but because OCD uses the questions to keep you stuck.
What therapy looks like when it’s collaborative
If you’ve had experiences where therapy felt vague, or overly positive, or like someone was telling you to “just stop thinking about it,” you’re not alone.
Good OCD treatment is practical, specific, and personal because OCD themes can be deeply sensitive.
A collaborative approach might include:
mapping your OCD cycle: triggers, obsessions, compulsions, avoidance, reassurance seeking
identifying what you value and what OCD has been taking from you
building a ladder of exposures, starting with doable steps
practicing exposures in session and between sessions
troubleshooting the sneaky compulsions that show up mid-exposure
making room for setbacks without turning them into proof that you failed
You’re learning a skill set. And yes, it can be uncomfortable. Sometimes you will leave a session feeling stirred up. That does not mean it’s harming you. It might mean you did something brave and new.
We can hold that with you without pretending it’s easy.
If avoidance has been your main tool, start here
You don’t have to jump straight into the hardest thing, but you can start noticing the pattern with a little more honesty. A few questions that can open the door:
What am I not doing because of OCD?
What do I do to feel certain, clean, safe, or reassured?
How long does the relief last?
What has this cost me this month?
If OCD wasn’t in charge, what would I do more of?
Sometimes the first exposure is simply telling the truth about how much you’ve been accommodating OCD. Not to shame yourself. To see it clearly. Because once you see it clearly, you can start making different choices.
Not perfect ones. Not fearless ones. Just choices that give your life more room.