OCD (obsessive compulsive disorder) is characterized by presence of obsessions and compulsions. Obsessions are the unwanted intrusive thoughts and images that can include unwarranted concerns about a loved one dying in their sleep, disturbing vivid images of stabbing a person standing nearby, or worrying about having grabbed a used needle and injecting oneself with drugs without even being aware of having done so. Obsessions are all about uncertainty. Compulsions represent attempts at dealing with that uncertainty. Some compulsive behaviours appear to make at least some sense (e.g., being vigilant about wellbeing of others), while others don’t make any sense at all (e.g., counting to 100 each time a thought of potential harm comes to person’s mind). Cognitive behaviour therapy (CBT) protocol for OCD starts with building an inventory of obsessions and compulsions that the affected person engages in. This is followed by cognitive interventions that seek to understand and challenge the beliefs that underpin these symptoms. Many persons with OCD recognize the irrational nature of their thoughts and behaviours. So we use exposure response prevention (ERP) techniques that teach at a very visceral level that despite undeniable initial discomfort, letting go of one’s rituals does not lead to danger. It might not be the most comfortable treatment but, given its proven effectiveness, it’s worth the effort.