I see where you are coming from, and you've obviously had some experience with cognitive-behavioral therapy since you just described recontextualization and acceptance. While these are most definitely important parts of the therapy aspect and may help or treat OCD, it may not help everyone with OCD. The unfortunate aspect of OCD, and what makes it ultimately different from depression (I've also been there!), is that OCD can come in different flavors or "fears." I've heard of OCD sufferers who had one type of obsession and compulsion, managed to treat it to near- undetectability for a decent time, but then the OCD would flare up again later in life under a different obsession and compulsion. Some people have mild OCD, some people have intense OCD, and there isn't a one-size-fits-all treatment that has managed to treat all types of OCD. Sometimes OCD sufferers can have no compulsions, sometimes OCD sufferers don't get their obsessions until their later years. The problem is that OCD is not necessarily psychological, but neurological. I can now wank off and see my brother for a split-second and realize that my brain just does things like that. In fact, I may say to myself, "you know what? My brother is a handsome dude," and have a nice laugh. But I take 25mg of clomipramine every night. If I didn't have that in my system, I'd be back to washing my hands and checking my penis to see if it's erect. So while you may think that there is some correlation between the psychological and OCD, and there is lots of literature that will corraborate that, I ultimately believe that OCD is a neurological problem that needs to be treated with both medication and therapy.