Therapy for OCD:

What is Obsessive-Compulsive Disorder (OCD)?

OCD can show up in deeply personal ways that often feel as unique as a fingerprint. At its core, OCD consists of two main components: obsessions and compulsions.

  • Obsessions are unwanted, intrusive thoughts, images, or impulses that repeatedly enter a person’s mind and feel outside of their control.

  • Compulsions are repetitive behaviors or mental acts that a person performs in an effort to reduce the anxiety caused by those obsessions or to prevent a feared outcome.

While many people experience intrusive thoughts or engage in repetitive behaviors from time to time, a diagnosis of OCD involves obsessions and/or compulsions that:

  • Occur for more than an hour per day, or

  • Cause significant distress, or

  • Interfere with important areas of life such as work, relationships, or daily functioning.

Though everyone’s experience with OCD is different, here are some common ways it can manifest:

  • Obsessional Doubt: Persistent “What if?” thoughts around topics like faith, morality, sexuality, relationships, perfection, losing control, being doomed, illness, embarressment or harm (e.g., What if I committed an unforgivable sin? What if I’m a pedophile? What if I don’t really love my partner? What if I have cancer? What if I said something stupid? What if I hit a pedestrian?)

  • Mental Reviewing/Replaying: Repeatedly analyzing past events to reassure oneself that nothing bad happened or to prevent imagined harm.

  • Unwanted Thoughts or Images: Unwanted and often disturbing thoughts or mental images that feel out of alignment with one’s values.

  • Compulsive Researching: Excessive online searches about health, legal matters, or other areas to alleviate uncertainty or anxiety.

  • Rechecking Communication: Rereading texts or emails to ensure nothing was said "wrong," or feeling intense anxiety about potential miscommunication.

  • Physical Checking: Repeated checking of locks, lights, appliances, or physical symmetry.

  • Avoidance: Steering clear of situations that might trigger obsessions or compulsions.

A key concept in understanding OCD is the distinction between ego-syntonic and ego-dystonic thoughts:

  • Ego-syntonic experiences align with a person’s values and beliefs.

  • Ego-dystonic experiences, like those in OCD, feel intrusive, unwanted, and in conflict with one's sense of self.

This inner conflict is often what makes OCD so distressing — the thoughts and urges don’t reflect what the person actually believes or wants.

What Causes OCD?

OCD is believed to arise from a complex interaction between genetic, neurological, and environmental factors. It often attempts to "protect" us from becoming a feared, vulnerable version of ourselves, but the methods OCD uses to achieve this — the compulsions and avoidance — never solve the “problem” and create more harm than healing.

Sources contributing to the material above include: International OCD Foundation, National Library of Medicine, American Psychiatric Association, Inference-Based Cognitive Behavioral Therapy

My Approach to OCD Treatment

Just as OCD looks different for each person, so too should treatment. While Exposure and Response Prevention (ERP) is often considered the gold standard for treating OCD, it’s not always the best fit for everyone — especially for those with co-occurring trauma, highly sensitive personalities, or scrupulous (i.e. religious) OCD.

Some of my clients have found strict ERP protocols overwhelming or even retraumatizing. The good news is, there are other evidence-based options for treating OCD, including:

I use an integrative approach that honors each client’s unique story and nervous system. For some clients, ERP may be helpful, while others benefit more from EMDR or I-CBT, which work directly with the underlying doubt, trauma, and meaning behind OCD themes.

What Working Together Might Look Like

  1. Assessment
    We begin with a thorough assessment. I take the time to understand your history, your symptoms, and how OCD shows up in your life. OCD tends to target what matters most to you — and “OCD logic” is often formed through life experiences.

  2. Psychoeducation
    I’ll help you better understand what OCD is and how it operates, using accessible resources and tools like the I-CBT workbook.

  3. Skill Building & Exploration
    Together, we’ll develop practical grounding and regulation strategies. We’ll also identify your obsessional themes, "vulnerable self" narratives, and personal OCD storylines.

  4. Reshaping the Narrative
    As you learn to distinguish your true self from OCD’s voice, we’ll work on building trust in your own senses and experiences. The goal is to shift from listening to the doubting OCD voice to grounded self-trust, helping the obsessive doubt lose its power, in turn mental and behavioral compulsions cease.

  5. Deeper Healing
    For some, this may involve using EMDR or IFS (Internal Family Systems) to explore and resolve the deeper negative beliefs that fuel OCD.

Healing is possible. Many clients have moved from a place of overwhelming dread to feeling peace in their faith, security in their relationships, and deeper trust in themselves. If you are interested in working with me or learning more, please contact me here for a free 15-minute consultation.

Picture of scattered letters, with the letters "OCD" in the middle, representing Obsessive Compulsive Disorder.
Blurred picture of man's head moving, creating image of two faces, representing the concepts of ego-syntonic and ego-dystonic, important concepts for understanding Obsessive Compulsive Disorder.
Image of two people sitting together in a therapy session, representing OCD therapy services with Tara Quick, OCD therapist in Nashville, TN and Georgia.