OCD Therapy for Adults

When OCD Is Running the Show

OCD isn’t loud. It’s persuasive.

It shows up as thoughts that feel important, urgent, or morally loaded — thoughts you don’t want, didn’t choose, and can’t seem to ignore. The problem isn’t the thoughts themselves; it’s the doubt they create and the pressure to resolve that doubt at all costs.

Many adults with OCD spend years trying to manage it quietly. They overthink, self-monitor, research, confess, avoid, reassure themselves — all while telling themselves they should be able to stop.

You’re not failing. OCD is very good at hijacking doubt.

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Common OCD Themes I work With

OCD can latch onto almost anything that matters to you. In fact, it often targets your values, responsibilities, and relationships.

I commonly work with adults experiencing:

  • Harm or responsibility OCD

  • Relationship OCD

  • Health-related OCD

  • Moral or scrupulosity-based OCD

  • “Pure O” or primarily mental compulsions

The themes may differ, but the underlying process is the same: imagined possibilities are treated as present dangers, and certainty starts to feel mandatory.

A Different Way of Treating OCD

My primary approach to OCD treatment is Inference-Based Cognitive Behavioral Therapy (I-CBT). I also have training in Exposure and Response Prevention (ERP), which we may integrate thoughtfully and collaboratively when it makes clinical sense.

Many people assume OCD treatment means forcing yourself to tolerate anxiety until it fades. While ERP can be effective for some, it doesn’t address why certain thoughts feel so convincing in the first place.

I-CBT starts earlier in the process — at the point where doubt is created.


What is Inference-Based CBT for OCD?

Inference-Based CBT is an evidence-based approach developed specifically for OCD. Rather than focusing on challenging thoughts or proving fears wrong, I-CBT looks at how OCD pulls you away from present-moment reality and into imagined possibilities.

OCD operates by convincing you that a hypothetical scenario deserves the same attention as something actually happening. Over time, your trust in your own perception erodes, and imagined risks begin to feel more real than what’s right in front of you.

In I-CBT, we work to:

  • Identify how OCD creates false doubt

  • Understand how imagination overrides direct experience

  • Re-anchor decision-making in present-moment reality

  • Restore trust in your own reasoning and perception

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When the reasoning process changes, compulsions often lose their urgency — not because you’re resisting harder, but because the doubt driving them no longer feels credible.

Why This Approach Offers Long-Term Relief

Many adults with OCD are intelligent, analytical, and deeply responsible. Trying to out-argue OCD or suppress thoughts often backfires, reinforcing the very doubt you’re trying to escape.

Inference-Based CBT makes sense for long-term change because it:

  • Targets the mechanism of OCD rather than its content

  • Reduces reliance on reassurance or avoidance

  • Helps you relate differently to uncertainty without constant exposure exercises

  • Builds internal trust rather than compliance

For clients who have felt overwhelmed, blamed, or flooded by past treatment, this approach often feels more respectful and sustainable.

What OCD Therapy is (and Isn’t)

Therapy for OCD isn’t about reassurance, thought suppression, or convincing you that your fears are impossible.

It is about:

  • Understanding how OCD operates in your mind

  • Interrupting compulsive reasoning loops

  • Reducing shame around intrusive thoughts

  • Regaining flexibility and confidence in daily life

Progress tends to be gradual and meaningful — less about white-knuckling anxiety, more about reclaiming agency.

Online OCD Therapy

All sessions are offered online. This allows us to work with OCD as it actually shows up in your daily life — not just in an office.

Online therapy is often especially effective for OCD because the work focuses on internal processes, real-time decision-making, and everyday triggers.

OCD often overlaps with other concerns. Anxiety can exist with and without OCD. If you’ve wondered if some of the rigid thinking you experience might be Autism, you’re not alone. OCD likes to work in tandem with the imaginative processing experienced by folks with ADHD, as well. We can sort it out together and make a plan that fits your unique needs.

Getting Started

If OCD has been quietly dictating your choices, therapy can help you change your relationship with doubt.

You don’t have to prove anything or push yourself past your limits. We can start by understanding how OCD has been operating — and what it would look like to loosen its grip.

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OCD Therapy FAQs

What’s the difference between OCD and anxiety?

OCD centers on doubt and compulsive attempts to resolve that doubt. Anxiety is broader and often situational. The treatments overlap but aren’t identical.

What is Inference-Based CBT for OCD?

Inference-Based CBT focuses on how OCD creates a false narrative that pulls you away from reality. Instead of managing thoughts, it helps you disengage from the doubt itself.

Do you still use ERP?

Yes. ERP can be effective, especially when paired thoughtfully with I-CBT. Treatment is collaborative and paced intentionally.