Why Do People Get Stuck in OCD? The Science Behind the Cycle

If you live with OCD—or support someone who does—you’ve probably asked yourself: “Why does it feel so hard to break free from this?” Even when someone knows their fears might be irrational, and even when they want to stop the rituals, it can feel like they’re trapped in a loop that won’t let go.

That loop has a name: the OCD cycle. And it’s not just habit or personality—it’s a well-studied psychological and neurological process that science is still working to fully understand.

In this post, we’ll explore some of the leading psychological models of OCD, and why they all agree on one thing: OCD isn’t about logic—it’s about learned patterns of fear and avoidance.

Why OCD Feels So Automatic: The Brain's Role

Some early research into OCD focused on the brain itself—looking at how certain areas might be wired differently. For example, brain scans have shown that people with OCD sometimes have unusual activity in the circuits that help us make decisions and filter out irrelevant information (Menzies et al., 2008).

This helps explain why OCD can feel so automatic or out of control—like your brain is getting stuck on repeat. But while these biological ideas are helpful, they don’t tell the whole story. They can’t fully explain why certain fears take hold, or why doing a compulsion seems to bring short-term relief but long-term distress.

To really understand how people get stuck, we need to look at the psychology behind it—specifically, how the brain learns to avoid fear.

The Cognitive-Behavioural Explanation: The OCD Cycle

Cognitive-behavioural theories (CBT) are now the most widely accepted model for understanding and treating OCD (Foa, 2010). These models help explain how certain thoughts, images, or urges become perceived as dangerous—and how the behaviours we use to manage them, even with the best intentions, can accidentally make them worse over time.

Here’s a breakdown of how the cycle typically works:

1. Intrusive thought, image, or urge:
   A distressing idea, mental picture, or impulse suddenly appears.
   Examples: “What if I left the oven on?”, "“What if I get sick from touching this and infect someone else?”, “What if I’m secretly a paedophile and don’t know it?”, “What if I hit someone with my car and didn’t notice?”, or “What if I lose control and hurt someone I love?”

2. Misinterpretation of threat or meaning:
   Instead of letting the experience pass, the brain assigns it serious emotional or moral weight.
   “If I had that thought, it must mean I’m dangerous.”
   “If I felt an urge, it must mean I want to act on it.”
   “If I don’t do something about this, I’ll be responsible for whatever happens.”

3. Emotional distress
   This interpretation sparks intense anxiety, guilt, shame, or disgust.

4. Compulsion or mental ritual
   To reduce the distress—or prevent a feared outcome—you perform a behaviour.
   This could be something visible (washing, checking, avoiding people), or internal (praying, analysing, repeating words in your head).

5. Short-term relief → Long-term reinforcement
   The compulsion gives a temporary sense of safety or control. But this relief teaches your brain that the intrusive experience was dangerous—and that the compulsion “worked.”
   So the next time it happens, your brain is even more likely to sound the alarm.

This repetition is what keeps the OCD cycle going.

Why the Brain Buys Into the Loop: Erroneous Beliefs

But it’s not just the behaviours that keep OCD stuck—it’s also the underlying beliefs. Researchers like Foa and Kozak (1985) showed that people with OCD often make exaggerated judgments about danger. They may:

• Overestimate how likely something bad is to happen

• Overestimate how terrible it would be if it did

• Feel deep responsibility for preventing harm—even if the actual risk is low

Salkovskis (1985) took this further. He identified common beliefs that drive compulsions, such as:

• Thinking about harm is as bad as doing harm

• If I don’t prevent harm, I’m morally responsible

• Not neutralising a thought means I want it to come true

• I must control all my thoughts

When someone believes these things deeply—even if they “know” logically it’s not true—it’s incredibly hard not to engage in compulsions.

And here’s the paradox: Every time you do the ritual, you feel safer—but you also teach your brain that the danger was real. As Rachman (1997) described, this strengthens the obsessive fear rather than reducing it.

The Bigger Picture: Why It Feels So Hard to Break Free

If you’ve ever felt frustrated with yourself—or if someone you love seems “stuck” in OCD—please remember this:
It’s not about willpower. It’s about a deeply wired fear-learning system that keeps getting reinforced.

Even with insight, even with motivation, people can feel trapped because their brains have learned a shortcut:
Fear → Compulsion → Relief → Repeat.

The good news? This cycle can be reversed—but it takes targeted therapy, like Exposure and Response Prevention (ERP), to help retrain the brain.

Final Thoughts

Understanding why people get stuck in OCD is the first step to changing how we treat it—with more compassion, more clarity, and more courage. When we stop blaming ourselves or others for "getting stuck" and start recognising the power of these learned loops, we can begin to untangle them.

If this cycle sounds familiar, you’re not alone—and you’re not broken. You're just human. And your brain is doing what it learned to do.

With the right help, it can learn something new.

References

1. Foa, E. B. (2010). Cognitive behavioral therapy of obsessive-compulsive disorder. Dialogues in Clinical Neuroscience, 12(2), 199–207. https://doi.org/10.31887/DCNS.2010.12.2/ebfoa

2. Foa, E. B., & Kozak, M. J. (1985). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35. https://doi.org/10.1037/0033-2909.99.1.20

3. Menzies, L., Chamberlain, S. R., Laird, A. R., Thelen, S. M., Sahakian, B. J., & Bullmore, E. T. (2008). Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: the orbitofronto-striatal model revisited. Neuroscience and biobehavioral reviews, 32(3), 525–549. https://doi.org/10.1016/j.neubiorev.2007.09.005

4. Rachman, S. (1997). A cognitive theory of obsessions. Behaviour research and therapy, 35(9), 793–802. https://doi.org/10.1016/s0005-7967(97)00040-5

5. Salkovskis, P. M. (1985). Obsessional-compulsive problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23(5), 571-583. https://doi.org/10.1016/0005-7967(85)90099-2