OBSESSIVE-COMPULSIVE DISORDER

Obsessive Compulsive Disorder (OCD) is a complex anxiety disorder that can take many forms. For some people, OCD involves visible compulsions such as checking, washing, repeating, or ordering. For others, the struggle happens almost entirely internally — with intrusive thoughts, mental rituals, rumination, and relentless doubt. Both are valid expressions of OCD, and both require specialized, evidence-based treatment.

I specialize in the treatment of OCD across its full range of presentations, with particular expertise in thought-based OCD (“Pure O”), where compulsions are primarily mental rather than physical. Many of the clients I work with are high-functioning adults who appear outwardly well, yet feel trapped in exhausting cycles of intrusive thoughts, internal checking, reassurance-seeking, and mental analysis.

What OCD can look like

OCD is defined by two core components:

• Obsessions: unwanted, intrusive thoughts, images, urges, or sensations that cause distress
• Compulsions: behaviors or mental acts performed to reduce anxiety or prevent feared outcomes

Compulsions may be:

• Physical, such as checking locks, washing hands, repeating actions, or arranging  objects
• Mental,  such as rumination, mental reviewing, reassurance-seeking, neutralizing  thoughts, or monitoring feelings

Common OCD themes include:

• Contamination and health concerns
• Fear of harm or responsibility
• Intrusive  sexual, violent, or taboo thoughts
• Relationship  obsessions
• Sexual  orientation obsessions
• Moral,  religious, or “right/wrong” concerns
• Excessive  doubt, uncertainty, or “what if” thinking
• Persistent guilt, regret or fixation on real events

While the content of obsessions varies, the underlying process is the same: the brain becomes stuck in a loop of threat detection and false urgency, pulling you into compulsive attempts to feel certain or safe.

Specialized Treatment for OCD

Effective OCD treatment requires more than insight or reassurance. I use Exposure and Response Prevention (ERP) — the gold-standard treatment for OCD — integrated with principles from CBT and ACT.

Treatment begins with a careful assessment of obsessions and compulsions, including subtle mental rituals that are often missed or misunderstood. ERP involves gradually and intentionally facing feared thoughts, images, sensations, or situations while learning to resist compulsive responses — whether physical or mental.

Over time, this process:

• Reduces the intensity and urgency of obsessions
• Increases tolerance for uncertainty and discomfort
• Weakens the compulsion–relief cycle
• Builds confidence in your ability to live without OCD running the show

For thought-based OCD ("Pure O"), treatment is especially nuanced and focuses on disengaging from rumination, reassurance and mental checking — without trying to analyze, disprove or eliminate intrusive thoughts.

OCD is highly treatable. With the right approach, it is possible to live a full, meaningful life without being governed by fear or compulsions.