Obsessive-compulsive disorder (OCD)

The Frustration

Frustration is mounting because those unwanted, distressing thoughts won’t go away, no matter how irrational they seem. Adding to that those around you are saying you are “quirky” and need to “just stop” the preoccupations.

Consistently Some of the Following Occurs

Unwanted, distressing, and repetitive thoughts, images, or urges that pop into your mind. They can be about anything—contamination, harm, perfectionism, relationships, morality, or even absurd things that don’t make sense.

These thoughts trigger overwhelming anxiety, dread, or discomfort. It feels like something terrible will happen unless you do something to prevent it. To ease the anxiety, you might feel compelled to perform rituals or mental routines (e.g., checking, counting, repeating phrases, washing, seeking reassurance). The relief is temporary, and the cycle starts again.

You question everything: Did I lock the door? Did I say something offensive? Am I a bad person? The doubt never fully goes away, no matter how many times you check or analyze.

Your brain is running a marathon, constantly stuck in a loop of fear and reassurance-seeking. Even if you look fine on the outside, your mind is constantly working overtime.

Relationships and Socializing can be Exhausting

While having a conversation, your mind is looping over an intrusive thought, making it hard to focus.

Social interactions trigger these obsessions: Did I say something offensive? Do they secretly dislike me?

Past conversations are overanalyzed, worrying you said or did something wrong.

Friends say you ask the same questions repeatedly: Are we okay? Did I offend you?

After social events, your mind mentally replays everything to make sure you didn’t embarrass yourself.

Although reassured, the doubt often creeps back in.

Those physical tendencies like tapping, checking, or repeating things, make you worry people will notice and think you’re “weird.”

Your more internal thoughts (like obsessive analyzing), people might assume you’re distracted or uninterested when you’re just stuck in a mental loop.

You find yourself declining invitations or avoiding people to prevent triggering obsessive thoughts.

Perfectionism happens so you avoid conversations or group settings for fear of saying the “wrong” thing

So much energy is spent suppressing compulsions or intrusive thoughts that socializing feels draining instead of fun.

When things do go well, you may still overthink and spiral afterward.

Benefits of Therapy for OCD at Heart and Mind Counseling:

Learning to Manage Obsessions and Compulsions

Therapy helps you face fears without engaging in compulsions, gradually reducing their hold over you.
Instead of feeling trapped in the OCD cycle, you gain tools to tolerate uncertainty and anxiety.

Gaining Control Over Thoughts

OCD makes thoughts feel overwhelming and urgent, but therapy teaches you that thoughts are just thoughts—they don’t define you or control reality.
Techniques will help reframe obsessive thinking patterns.

Reducing Anxiety and Emotional Distress

OCD can make life feel exhausting, but therapy helps lower stress by challenging irrational fears and compulsions.
You learn healthier coping mechanisms rather than relying on rituals for relief.

Breaking the Cycle of Reassurance-Seeking

Many with OCD rely on others to confirm things are “okay” (e.g., Are we good? Did I lock the door?).
Therapy helps you build confidence in tolerating uncertainty instead of seeking constant reassurance.

Feeling Less Alone

OCD can feel isolating, especially when people don’t understand it.
A therapist provides a judgment-free space where you can talk openly without fear of being dismissed.

Improving Relationships and Daily Life

OCD can strain relationships due to compulsions, avoidance, or the need for reassurance.
Therapy helps you set boundaries, communicate better, and rebuild connections without OCD interfering.

Learning Long-Term Strategies

Counseling isn’t just about short-term relief—it gives you lifelong tools to handle OCD in a healthier way.
With the right approach, symptoms can become much more manageable, and you can regain control over your life.

What Happens in Sessions Treating OCD?

Therapy at Heart and Mind Counseling for OCD can be structured and goal-oriented, however we will first look to understand your needs.

1. Assessment & Understanding Your OCD

• Heart and Mind Counseling’s therapist will ask about your symptoms, thoughts, and compulsions.
• Your therapist will help identify your obsession themes (e.g., contamination, harm, perfectionism) and compulsions (e.g., checking, avoiding, seeking reassurance).
• They may use questionnaires to measure OCD severity and track progress.

2. Psychoeducation

• You’ll learn how OCD works—why intrusive thoughts happen, why compulsions don’t actually help, and how the cycle keeps going.
• Understanding OCD makes it less scary and more manageable.

3. Developing an Exposure Hierarchy (ERP)

• You and your therapist will create a list of fears, from least to most distressing.
• You’ll start with low-level exposures and work your way up, practicing facing fears without performing compulsions.

4. Exposure and Response Prevention (ERP)

• ERP is the core of OCD treatment.
• You’ll be guided to gradually face your fears while resisting compulsions, teaching your brain that anxiety naturally fades over time.
• Example: If you fear germs and compulsively wash your hands, an exposure might be touching a doorknob and not washing.

5. Learning to Tolerate Uncertainty

• OCD thrives on the need for certainty, but therapy helps you accept uncertainty instead of seeking reassurance.
• Instead of saying, “I need to be 100% sure I locked the door,” you’ll learn to say, “I can handle not knowing for sure.”

6. Cognitive Restructuring (CBT Techniques)

• Your therapist will help you challenge irrational thoughts and reframe them in a healthier way.
• Example: Instead of “If I don’t check the stove 10 times, the house will burn down,” you’ll learn to say, “Checking once is enough, and my anxiety will pass.”

7. Homework & Real-World Practice

• You’ll be assigned exercises to practice outside of therapy, like resisting a compulsion or doing an exposure.
• The more you practice, the more control you gain over OCD.

8. Relapse Prevention

• OCD can flare up under stress, so therapy includes strategies to handle setbacks and prevent compulsions from taking over again.
• Over time, therapy helps you build long-term resilience.

What Kind of Modalities May be Used by my Therapist at Heart and Mind Counseling for OCD?

Several therapy modalities effectively treat OCD, with Exposure and Response Prevention (ERP) being one of them. Here’s a breakdown of the most commonly used approaches:

1. Exposure and Response Prevention (ERP)

• Involves gradually exposing you to feared situations while preventing compulsions.
• Helps your brain learn that anxiety naturally fades without rituals.
• Example: If you have contamination OCD, you might touch a doorknob and resist washing your hands.

2. Cognitive Behavioral Therapy (CBT)

• Focuses on identifying and changing irrational thought patterns.
• Uses cognitive restructuring to challenge obsessive fears.
• Often combined with ERP.

3. Acceptance and Commitment Therapy (ACT)

• Helps you accept intrusive thoughts rather than fight them.
• Teaches mindfulness techniques to reduce the power of OCD thoughts.
• Encourages focusing on values instead of compulsions.

4. Mindfulness-Based Cognitive Therapy (MBCT)

• Uses meditation and mindfulness to observe thoughts without reacting.
• Helps reduce compulsive urges by promoting awareness and detachment from thoughts.

5. Inference-Based Cognitive Therapy (I-CBT)

• Focuses on the doubt and faulty reasoning that fuels OCD.
• Helps you recognize when OCD is making irrational inferences.
• Less exposure-based than ERP but can be effective for some.

6. Medication (Often Combined with Therapy, Heart and Mind Counseling has a PMHNP for our Michigan clients)

• Selective Serotonin Reuptake Inhibitors (SSRIs) (e.g., fluoxetine, sertraline) are commonly prescribed.
• Can help reduce OCD symptoms, especially when combined with ERP.

Common Questions and Answers about OCD

What is Obsessive Compulsive Disorder (OCD)?

OCD (Obsessive-Compulsive Disorder) is a mental health condition where a person experiences:
• Obsessions – Intrusive, unwanted thoughts, images, or urges that cause anxiety.
• Compulsions – Repetitive behaviors or mental rituals done to reduce anxiety or prevent something bad from happening.

What are examples of obsessions?

• Fear of contamination (e.g., “What if I touched something dirty?”)
• Fear of harming someone (e.g., “What if I accidentally hurt someone?”)
• Need for symmetry or exactness (e.g., “Things must be perfectly aligned, or something bad will happen.”)
• Relationship doubts (e.g., “What if I don’t really love my partner?”)

What are examples of obsessions?

• Excessive hand-washing or cleaning
• Checking things repeatedly (locks, stoves, emails)
• Counting, tapping, or repeating words to “neutralize” thoughts
• Seeking reassurance from others (“Are we okay?” “Did I offend you?”)

Can you have OCD without visible compulsions?

Yes! This is called Pure O (Purely Obsessional OCD), where compulsions happen mentally. Examples:
• Mentally reviewing past events to “make sure” nothing bad happened.
• Silently repeating prayers or phrases for reassurance.
• Analyzing thoughts for proof of meaning (e.g., “Does this thought mean I’m a bad person?”).

Can’t people with OCD just stop?

No, OCD isn’t a habit or a choice—it’s a disorder that causes intense anxiety if compulsions aren’t done. Therapy helps people learn to resist compulsions over time.

What causes OCD?

OCD is linked to differences in brain function, genetics, and environmental factors. It’s not caused by personality flaws or weak willpower.

Can OCD go away on its own?

OCD doesn’t typically go away without treatment. However, therapy can help reduce symptoms significantly and give people long-term control over their OCD.

Is OCD just about cleanliness and order?

No! While some people have contamination OCD, OCD can involve many other themes, including harm, morality, relationships, and existential fears.

Can people with OCD live normal lives?

Yes! With proper treatment people with OCD can manage their symptoms and live fulfilling lives. Many successful individuals have OCD and learn how to work with it.

What happens in OCD counseling?

• Your therapist will help you understand OCD and identify your obsessions and compulsions.
• You’ll work together to create an exposure hierarchy—a list of feared situations from least to most distressing.
• You’ll practice Exposure and Response Prevention (ERP) by facing fears without engaging in compulsions.
• Cognitive strategies help challenge obsessive thoughts and reduce anxiety over time.

What is Exposure and Response Prevention (ERP)?

ERP is a structured approach where you gradually expose yourself to feared thoughts or situations while resisting compulsions. Over time, your brain learns that anxiety naturally fades without needing rituals.
Example: If you have contamination fears, an ERP exercise might be touching a doorknob and not washing your hands.

How long does OCD counseling take?

It depends on the individual, but ERP therapy typically lasts 12–20 sessions. Some people see significant improvements within a few months, while others need longer-term support.

Will therapy get rid of OCD completely?

There is no “cure” for OCD, but therapy can make symptoms much more manageable. Many people with OCD go on to live full, happy lives with the right coping strategies.

What if I don’t want to talk about my intrusive thoughts?

Many people with OCD feel ashamed of their thoughts, but therapists are trained to handle them without judgment. Thoughts are just thoughts—they don’t define you!

Can counseling help if I only have mental compulsions (Pure O)?

Yes! Even if your compulsions are mostly mental (rumination, checking memories, repeating phrases), therapy can help reduce them using ERP, mindfulness, and cognitive strategies.

Will therapy make my anxiety worse?

In the short term, ERP can feel uncomfortable because you’re facing fears head-on. But over time, your brain learns that anxiety fades naturally, making life much easier.

Do I need medication, or is therapy enough?

Some people manage OCD with therapy alone, while others benefit from Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine or sertraline. A therapist or psychiatrist can help determine the best approach for you.

What if therapy doesn’t work for me?

Sometimes, adjustments are needed—like trying a different therapist, modifying ERP strategies, or combining therapy with medication. OCD is very treatable, but it may take time to find what works best for you. We have multiple therapists at Heart and Mind Counseling who can help you with OCD.

You can live a fulfilling life with OCD, Heart and Mind Counseling can help you get there!

Living a fulfilling life with OCD doesn’t mean being completely free of intrusive thoughts or anxiety, but it does mean learning how to manage symptoms, reduce compulsions, and focus on what truly matters to you. Here’s what that can look like after spending time with your Heart and Mind Counseling Therapist!

OCD No Longer Controls Your Decisions

• You still have intrusive thoughts sometimes, but they don’t dictate your actions.
• You resist compulsions and accept uncertainty instead of chasing reassurance.
• You can leave the house, have conversations, or do daily tasks without OCD interfering.

Anxiety Becomes More Manageable

• Instead of panicking over a thought, you let it exist without reacting.
• You recognize that anxiety naturally rises and falls—and you don’t need compulsions to “fix” it.
• You trust that you can handle discomfort, and it doesn’t last forever.

You Spend More Time Doing What You Love

• OCD no longer steals hours of your day with rituals or mental loops.
• You engage in hobbies, relationships, and work without obsessing over mistakes or worst-case scenarios.
• You live in the present instead of mentally replaying past conversations or worrying about the future.

You Feel More in Control

• OCD thoughts may still pop up, but you decide how to respond.
• You don’t let fear keep you from taking risks, socializing, or pursuing goals.
• Instead of feeling trapped in the OCD cycle, you feel empowered.

Setbacks Don’t Define You

• You accept that OCD might flare up sometimes, but you have tools to handle it.
• A bad OCD day doesn’t mean you’ve “failed”—it’s just a bump in the road.
• You’ve built resilience, so you bounce back faster after difficult moments.

You Have Support and Self-Compassion

• You surround yourself with people who understand and support your journey.
• You don’t beat yourself up for having intrusive thoughts—you treat yourself with kindness.
• You recognize that you are not your OCD—you are a whole, valuable person beyond it.

You Feel Free to Be Yourself

• OCD no longer dictates your identity, choices, or happiness.
• You embrace imperfection and uncertainty, knowing life is about living, not controlling everything.
• You are proud of how far you’ve come and focus on what truly matters.

Living a fulfilling life with OCD is possible—it takes therapy, practice, and patience, but it can lead to a life where OCD is in the background, not the driver’s seat.
If this sounds like the future you are hoping for, keep your momentum going and contact us now so we can get you started on your journey with a Heart and Mind Counseling therapist for you! Call us at (904) 896-4998, or email us at admin@heartandmindcounseling.com

We look forward to accompanying you on your journey!