Working With OCD and Intrusive Thoughts

You check, you reassure yourself, you avoid, you try to think your way out. For a moment it works, and then it starts again.

This is OCD. Not the version people joke about, for example, liking things neat or being particular. The real version: intrusive, unwanted thoughts that feel unbearable, paired with compulsions that offer brief relief and then tighten their grip.

There is an effective, evidence-based treatment for this. It is called Exposure and Response Prevention (ERP). Learn more

What OCD Actually Looks Like

OCD shows up in many forms, and most of them do not look the way people expect. Common presentations include:

• Harm OCD: Intrusive thoughts or mental images about harming yourself or the people you love.
• Contamination fears: Excessive fear of germs, dirt, or illness, accompanied by compulsive cleaning or avoidance.
• Checking compulsions: An urgent need to check locks, appliances, stove burners, or messages sent.
• Scrupulosity: Religious, moral, or ethical obsessions and fear of doing something fundamentally wrong or sinful.
• Relationship OCD (ROCD): Obsessive doubts and hyper-fixation about your partner’s suitability or the relationship itself.
• “Pure O”: Intrusive thoughts without visible physical compulsions (though mental compulsions like checking, praying, or neutralizing are almost always present).

If you’ve been told you have anxiety but traditional talk therapy hasn’t helped, it is worth considering whether OCD might be part of the picture.

What ERP Is—and What It’s Not

Exposure and Response Prevention is an evidence-based treatment for OCD. It works by gradually exposing you to the thoughts, situations, or triggers that activate your OCD, while supporting you to resist performing the compulsive response that normally follows.

This might sound intimidating. But it is not about flooding you with your worst fears or pushing you past your limits.

It is a careful, highly collaborative, step-by-step process:

1. We construct a customized hierarchy of exposures together, starting with triggers that feel challenging but manageable.
2. We move entirely at your pace, starting where you feel ready.
3. We practice exposures in session together, giving your nervous system real-time support.

What ERP teaches your nervous system is that the thought is not an actual threat, and that you can tolerate the discomfort without performing the compulsion. Over time, the anxiety naturally decreases. The thoughts lose their power. You get your life and your freedom back.

My Approach to OCD

I bring specialized training in ERP alongside a whole-person, somatic, and deeply compassionate orientation. OCD is not a character flaw, and the shame and exhaustion that accompany it are real. I hold that space with extreme care throughout our work.

I am also highly attentive to the ways OCD intersects with other aspects of your life: trauma, religious background, identity, and attachment patterns. For presentations like scrupulosity rooted in high-control religious environments, or relationship OCD that mirrors attachment wounds, a standard protocol isn’t enough, it requires a nuanced, sensitive, and personalized approach.

If you’ve been looking for someone who understands OCD specifically, reach out.