I watched the SoftWhiteUnderbelly interview of a guy with OCD who works as a clown, and used to serve in the Navy. His form of OCD wasn't self-loathing intrusive thoughts but intrusive thoughts that stemmed from the anxiety or fear of something bad happening. Like, the fear that he was going to be dishonorably discharged or drown if there's a storm, was perceived as a sort of bad mojo that he had to combat with drowning it out with positive thoughts, and by repeatedly carrying out certain mundane actions as ritualis to eliminate the bad mojo that his OCD thoughts manifested. And failure to do so meant that those bad things mentioned by his negative thoughts were actually going to happen. So, he would obsessively repeat certain words or phrases to himself, or repeat in a specific action until the thought went away.

In the interview he repeatedly mentions feeling self-conscious about how he must have looked crazy to other people in the Navy or in public, talking to himself repeatedly or being stuck in one of his rituals battling the intrusive thought that was overwhelming him, but the alternative was letting it actually drive him crazy.

And a part of his psyche believed if he didn't engage in those coping rituals, than the things his intrusive thoughts said we're going to happen, might actually happen. And so those two things were his only coping strategy for dealing with being overwhelmed by all the crippling anxiety and fear, from which his OCD was manifesting.