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Obsessive thoughts and compulsive urges are part of the normal feedback and control loop between our thoughts and our actions. It is only when these obsessive thoughts become so intense and frequent and these compulsive rituals become so extensive that they interfere with an individual’s functioning that the diagnosis of Obsessive Compulsive Disorder (OCD) is made. The mainstays of treatment of OCD includes Serotoninergic antidepressant medications, particular forms of Behavior Therapy (Exposure and Response Prevention and some forms of CBT), education and family interventions. Because they are aware of how irrational their behavior is, many sufferers are ashamed of their actions and go to great lengths to hide their symptoms. It is extremely important that as a therapist, one is able to build a safe and accepting therapeutic environment and also structures therapy based on the unique presentation of illness where sometimes symptoms themselves may cause non compliance to therapy process. The author presents and discusses a case where Cognitive Behavior Therapy was used.