Cognitive-behavioral models of OCD and models of cognitive dissonance have converged in emphasizing how intrusive or dissonant thoughts conflict with – and therefore threaten - one's self-concept. In the present article, we review the rich history of theory on self-concept in OCD, culminating in the contemporary fear of self conceptualization. We then draw conceptual parallels between the internal psychological tension generated by intrusive thoughts, and the experience of cognitive dissonance. A review of the literature reveals considerable overlap between these two cognitive phenomena and demonstrates particular compatibility between self-affirmation theory and models of OCD in which fear of self is a central feature. Drawing on a theoretical synthesis of these literatures, it is suggested that cognitive dissonance research can provide insights that can be utilized to gain a deeper understanding of OCD. Potential applications of self-affirmation theory to OCD treatment are discussed.