Therapy for OCD

After thoroughly assessing your symptoms, we typically create a hierarchy of your fears from lowest to highest. We then work on exposure exercises together in sessions as well as assign them for practice in between sessions. Depending on what works best for you, exposure exercises can be in real life, imagined, or virtual reality (VR) situations. For VR, we can simulate different environments—like driving, flying, or a medical office—to optimize exposure.

The goal of OCD counseling is to learn how to be okay with anxiety and uncertainty. Building up a tolerance for anxiety-inducing thoughts without engaging in the compulsions they trigger allows you to gradually break free from the OCD loop. Even though you will feel anxious when you don’t give in to your compulsion at first, you’ll realize that the worst-case outcome you imagined won’t happen, and that you can handle the uncertainty that it could happen. Not only can you decrease obsessions and compulsions and learn to live with lingering thoughts or urges, but you can also develop strategies to manage OCD symptoms should they return.

ERP focuses on summoning intrusive thoughts while refraining from acting on compulsive behaviors. Although this may sound absurd, scary, and counterintuitive, the idea is to trick your brain and demonstrate that you don’t have to listen to it. Utilizing ERP, you will target specific obsessions and compulsions. If or when OCD changes themes—as it often does—it no longer has to impede your life. You will have the tools you need to keep it at bay.

In addition to ERP, we may incorporate strategies from Acceptance and Commitment Therapy (ACT), which can help you identify what you value most and discover how to live in alignment with your values. We will also teach mindfulness skills, grounding exercises to address anxiety symptoms, and cognitive defusion exercises to help you separate yourself from intrusive thoughts.

While OCD can seem insurmountable, there is hope. We have seen, both in our practice and through research, that it’s possible to break free from endless obsessions and compulsions. You can learn to accept OCD without letting it interfere with your goals and values. With ERP therapy, you show OCD that you are the boss. 

Exposure therapy can sound counterintuitive because it means bringing on your obsessions to overcome them. The problem is that when we try not to think about something, we think about it more. For example, what happens when you read, “Don’t think about a pink elephant?” Exposure therapy will show OCD that you are in control and desensitize you to your obsessions while also teaching you how to tolerate anxiety. ERP has also been shown to decrease anxiety and the frequency of intrusive thoughts over time. [2]

The gold standard treatment for OCD is a combination of medication and Cognitive Behavioral Therapy (CBT), especially Exposure and Response Prevention (ERP). We often recommend that our clients consult a psychiatrist to see if medication can be useful. If so, we will work collaboratively with your psychiatrist to continuously assess your progress and treatment plan. Many of our clients find that the combination of medication and therapy is helpful, and some find therapy alone works great.

Treating OCD in children is a team effort. For childhood OCD treatment, we actively involve you, the parent, so you can learn how to respond to your child’s anxiety and OCD behaviors in the most helpful way for them. You know your child best, and we want to hear from you throughout their OCD treatment to ensure your child is making progress. Since we can’t be with your child round the clock, we will enlist your help with exposure exercises. And if you need more support, we offer individual therapy and parent coaching services as well.