OCD involves unwanted, distressing thoughts or urges (obsessions) and the repetitive behaviors or mental acts (compulsions) used to relieve the distress. It goes well beyond tidiness or preference, and it often goes unrecognized, so many people wait a long time for effective treatment. Specific phobias, intense fears of particular objects or situations, are treated with related exposure-based methods. We offer specialized, evidence-based therapy for both, for adults, in person and online.
What is OCD?
OCD has two parts. Obsessions are intrusive thoughts, images, or urges that feel distressing and hard to dismiss. Compulsions are the behaviors or mental acts, such as washing, checking, counting, mentally reviewing, or seeking reassurance, that are meant to reduce the distress or prevent something feared. The relief is brief, and the cycle tends to strengthen over time.
Obsessions take many forms, including contamination, doubt, harm, symmetry, and unwanted thoughts about sexuality, relationships, religion, or morality. Compulsions can be visible or entirely mental.
Intrusive thoughts, including distressing or taboo ones, are a common part of OCD, and discussing them with a clinician is a normal part of treatment. You can talk about what is really going on without being judged.
Because analyzing every thought or seeking certainty tends to feed the cycle, OCD is usually treated with focused methods rather than general talk therapy alone.
Common Presentations of OCD
Contamination
Fear of germs, illness, or feeling unclean, with extensive washing or avoidance.
Checking and Doubt
Repeatedly checking locks, appliances, or work for fear that something was missed.
Unwanted Harm Thoughts
Intrusive thoughts or images about causing harm. They are distressing and at odds with your values.
Taboo or Unwanted Thoughts
Intrusive thoughts about sexuality, relationships, religion, or morality that feel disturbing or out of character.
Symmetry and Order
A need for things to feel "just right," with rituals of arranging, counting, or repeating.
Mental Rituals and Reassurance
Mentally reviewing, replaying, or asking others for reassurance to relieve doubt.
What Are Phobias?
A specific phobia is an intense, persistent fear of a particular object or situation that is out of proportion to the actual risk. It leads you to avoid the situation or to endure it with great distress.
Common examples include flying, heights, driving, needles or medical procedures, animals, and enclosed spaces.
Phobias are kept going by avoidance, and they respond well to treatment. Exposure-based therapy helps you face the fear in manageable steps.
Phobias We Treat
Flying
Fear of air travel that limits work, family visits, or vacations.
Heights
Fear of bridges, balconies, stairs, or other high places.
Driving
Fear of driving or of certain roads, such as highways or bridges.
Needles and Medical Procedures
Fear that leads you to avoid injections, blood draws, or necessary care.
Animals
Intense fear of dogs, insects, or other animals.
Enclosed Spaces
Fear of elevators, tunnels, MRI machines, or other closed-in places.
How We Treat OCD and Phobias
ERP (Exposure and Response Prevention)
ERP is the first-line, most extensively studied behavioral treatment for OCD. You gradually face feared thoughts, situations, or images while practicing not performing the compulsion, so you learn to tolerate uncertainty and the anxiety eases without rituals. Exposures are planned with you and built step by step.
Inference-Based CBT (I-CBT)
I-CBT focuses on the reasoning behind obsessional doubt. It helps you see how OCD builds imagined possibilities that are not grounded in what you actually perceive, and how to return to trusting your senses and the real situation.
ACT (Acceptance and Commitment Therapy)
ACT helps you make room for intrusive thoughts and uncomfortable feelings without letting them direct your behavior, so you can act in line with what matters to you.
Exposure Therapy for Phobias
For specific phobias, we build a graded plan of exposure to the feared object or situation, starting with manageable steps and moving up. Exposure takes place in session and in real-life situations, with practice between sessions.
What to Expect
You don't need to have it all figured out before you reach out.
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1
A Free Consultation
A brief call to learn what you are looking for, answer your questions, and match you with a clinician who treats OCD and phobias.
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2
Understanding the Pattern
You and your therapist map your obsessions, triggers, and compulsions, or the situations you fear, and agree on goals and a gradual plan.
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3
Gradual Practice
Treatment moves step by step, with practice between sessions. Your therapist reviews progress with you regularly and adjusts the plan.
Care That Connects Across Specialties
OCD and phobias often overlap with anxiety, low mood, and strain at home. If worry is the main concern, see our anxiety and panic care, and if low mood or exhaustion is part of the picture, see depression and burnout. Our adult OCD support group offers structured peer support alongside or instead of individual therapy. OCD can also draw partners and family members into reassurance and accommodation, so couples therapy and family therapy can help. With your consent, your therapist can coordinate with your physician or a prescriber.
