Obsessive Compulsive Disorder
A fear loop of intrusive thoughts and compulsions that promise safety but tighten anxiety’s grip. It's ok to be in the uncertainty.
Definitions
Obsessive-Compulsive Disorder (OCD) is a cycle that motivates mental and physical actions through fear.
It typically involves two parts: Obsessions and Compulsions.
Obsessions are intrusive thoughts, images, or urges that feel distressing and difficult to shake.
Compulsions are the physical or mental actions taken in response to said thoughts in an attempt to reduce fear or prevent something bad from happening. This might include checking, cleaning, asking for reassurance, mentally reviewing conversations, or avoiding situations that feel threatening.
Avoidance plays a central role in how OCD operates.
The discomfort of an intrusive thought or image can feel unbearable, and the nervous system may go into overdrive trying to make it stop. It makes sense that someone would do whatever they can to escape that feeling. In the short term, avoidance often brings a sense of relief. But over time, it teaches the brain and body that anxiety and distress are dangerous. That pattern, while protective, can also perpetuate the cycle of OCD.
As this loop continues (obsession, compulsion, relief, obsession again), the fear becomes more persistent and harder to manage. What starts as an attempt to find safety becomes a system that creates more fear. This doesn't happen because something is wrong with the person. Rather, it happens because their brain is doing its best to protect them. Therapy begins with honoring that effort—and gently offering new ways forward.
Symptoms
One of the most challenging aspects of OCD is the urgency it creates around deeply painful thoughts and feelings.
Thoughts like "What if I hurt someone I love?" or "What if I'm a bad person and don't even know it?" don’t just pass *through* the mind—they land hard and stick. The response is often an immediate effort to analyze, fix, or neutralize the discomfort. When that momentary relief arrives, it reinforces the pattern.
Avoidance plays a significant role here too.
Avoidance doesn’t only mean staying away from specific places or objects—it can also mean avoiding emotional experiences like anxiety or distress. The mind may try to block a thought, push it away, or endlessly analyze it in the hope that certainty or peace will follow. But each time anxiety is avoided, the body learns that anxiety is unsafe. Over time, this can make ordinary emotional experiences feel intolerable and increase the intensity of OCD symptoms.
Avoidance may feel like it’s helping.
In the moment, it often does. But in the long term, it gives power to the idea that certain thoughts, feelings, or sensations are dangerous and cannot be tolerated. Good therapy doesn't involve forcing someone to confront everything at once. It’s about gradually helping them notice when avoidance is happening, and gently building the capacity to stay present, even when the urge to escape is loud.
Patterns of obsessions, compulsions, and avoidance aren’t evidence of weakness or failure.
They are signs of just how hard someone has been working to stay safe. OCD often grows from the places someone cares most deeply about—their morality, their identity, their love for others. That vulnerability is not a flaw. It’s a reflection of their deepest values.
Why Does It Show Up?
OCD often emerges in the context of earlier experiences with fear, uncertainty, or emotional vulnerability.
Many people with OCD grew up in environments where certain emotions weren’t safe to express or where perfection and control felt necessary to maintain stability. In those environments, hypervigilance and internal monitoring made perfect sense.
Over time, these coping strategies can become deeply ingrained ways of processing threat. They *aren’t* signs of personal flaws. They *are* learned responses that helped someone navigate their past. But when those same strategies carry into adulthood, they can become patterns that no longer protect and instead contribute to pain and isolation.
Understanding OCD in this context doesn’t erase the suffering it causes, but it does help to reframe it.
These are not random symptoms. They are meaningful patterns with histories behind them. Therapy is a place to honor and untangle those histories—to understand what was once necessary, and what is now asking to be released.
Why Now?
OCD symptoms often become more intense during moments of transition or instability:
Starting school, navigating a relationship change, moving to a new place, or living through a collective crisis. When the world feels unsteady, the mind often grasps for control wherever it can find it. That might be through rituals, thoughts, or compulsive behaviors. It’s not a sign of failure. It’s a signal that someone’s system is trying to find safety.
The emergence or intensification of symptoms is rarely random.
Often, it signals that something in life is shifting or asking for attention. Therapy isn’t about pushing change or suppressing discomfort—it’s about making space to explore what’s happening and why it makes sense, and then slowly building new ways to respond.
There’s no shame in a spike in symptoms.
It often means someone is at a threshold: grieving, growing, questioning, moving. OCD may intensify when the stakes feel existential—when questions of meaning, safety, connection, or identity are most alive. The goal is not to control everything perfectly. It’s to support that process with care.
How Therapy Can Help
OCD treatment begins by making room for everything that’s happening: the fear, the doubt, the exhaustion. Therapy creates space for it all, without judgment.
This work uses evidence-based practices like Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT), but always at a pace that honors the person’s readiness and nervous system.
Avoidance is a key part of the OCD cycle, and therapy focuses on building skills to notice it, relate to it, and respond differently.
Avoidance doesn’t just relate to objects or fears—it includes the urge to escape discomfort, anxiety, and distress. In treatment, clients begin to explore what it’s like to pause, to feel, to stay. Over time, this can help retrain the brain and body to know that it’s safe to feel and experience, even when things are hard.
Many people with OCD have also learned to disconnect from their feelings in their bodies.
That’s why our work integrates somatic practices and Internal Family Systems (IFS). These approaches help clients reconnect with the physical sensations of emotion and allow for a more compassionate, embodied form of processing. Not everything has to be worked out through logic—some things shift through breath, movement, and presence.
This work doesn’t function through force or pressure. It meets people where they are. It grows with them. Therapy honors that every mind and body has its own rhythm of healing—and that there is no single "right way" to move forward.
Our Work Together
The work of OCD therapy is not just about managing symptoms. It’s about building a life that’s rooted in presence rather than control. A life where fear doesn’t get to decide what someone does or doesn’t do.
This process takes time. It often involves practicing distress tolerance, strengthening self-compassion, and building the ability to stay present with uncertainty. It’s not easy, but it can be transformative. My goal is to help clients move forward despite fear, in ways that are grounded in their values and connected to the people and experiences they care about.
Ultimately, therapy helps expand someone’s life beyond the boundaries that OCD has drawn.
It helps people come home to themselves, not as someone who needs fixing, but as someone who has always been doing their best to feel safe in a world that can be overwhelming. Therapy becomes a way of reclaiming agency, meaning, and connection, and from that place, real change becomes possible.
