OCD sucks because it's a very complicated condition that most people misconstrue due to popular depictions. Take the show "Monk" for example, people see it as if it was something beneficial, that makes a person more meticulous, etc. However what that show cannot display is the type of anxiety that plays out in the mind of someone with OCD that makes them do all that stuff. I will put it to you like this... If you've ever seen Monk, and know how he likes to keep all of the things in his apartment a certain way, in a certain order, etc. you might think that's because he just pays super close attention to detail, and in fact the show revolves around him being a phenomenal detective because of that attention to detail--so it's seen as some kind of advantage whereas his suffering is left hopelessly unexplained. If Monke were a real person, he believes that if he leaves a coffee mug in the wrong place, he'll knock it over, step on a shard of glass, get an infection, not be able to complete his work, and basically indirectly attribute it to some sort of doomsday scenario so that the mug being in the right place becomes the most important thing in the world, and he cannot find relief from this anxiety until it is in its proper place. Now imagine you did the same thing, but with every single little thing that you deal with in your daily life--every object you come in contact with, every decision you must make, etc.
Compulsive acts are like a tip of the iceberg when it comes to OCD. You obsess about everything, you compulsively do maybe one or two things. The long and short of it is that engaging in the compulsive behavior releases serotonin, convincing you that this action will make you feel better--because it does. But then because of the ongoing imbalance, when you begin to feel anxiety again, you will again turn to the compulsive behavior to find relief. Of course it's not readily identified like that, and that's why it's so confusing. You start looking at a scratch on your knife and you think, "Wow that bugs me. Why does that bug me so much? I gotta get rid of that," without realizing that it wasn't really the scratch on the knife at all that made you feel that way, and that your mind is basically working overtime to convince you that it needs your attention, that you need to fix it, because doing so will regulate that serotonin. In a simpler way to put it, your mind convinces you that it is imperative to do this action to be happy, but logically you cannot understand why that's the case and that's where the struggle begins--and that's why it's so often that people use lofty or just plain faulty logic to justify why they do such things, usually reflecting the urgency that they feel in their own mind. "If I don't wash my hands, I'll infect someone, they'll get the flu and die and I will be a murderer." Meanwhile the brain just wants you to wash your hand to boost your serotonin levels.
And then sometimes it's not even a conscious decision to begin engaging in the compulsive act... Yeah OCD is some complicated stuff. I honestly think that medication is more essential to treating it than any behavior/cognitive therapy can be because of the complexity of it. At least, it makes understanding it easier because it kind of "takes you out of it" and lets you observe from a 3rd person's perspective. Then later on it's more easy to make behavior adjustments with your new found understanding.
Anyway, not to drole on or offer unsolicited advice... I just use to have very severe OCD. I would do things like, leave in the morning to work or school, and then convince myself I left a lamp on and that it would burn the house down if I didn't go back to turn it off. And then on the second departure from home, I would do it again... Sometimes doing this all morning until I missed whatever I was heading to. Yeah it was seriously that bad. Now days it's not that I don't have unreasonable anxiety and fears like that, I'm just more practiced at deciding "Yeah that probably won't happen," and continuing on my normal day. It's uncomfortable but it sure beats going back and forth to turn your lamp off... If I hadn't gotten on medication and into therapy at the time I did, I have to say I would probably be a much less functioning person. It's not easy to make those decisions, but the more you able you are to overcome the obsession/anxiety side the more able you will be in avoiding the compulsive behavior. The sad part is you don't really get any relief, because the root problem ( the imbalance ) still exists--but usually the benefits of not engaging in the compulsion are enough of a reward themselves.
