Therapy for OCD

Getting the right therapy for OCD is life changing.

Overview

OCD is a misunderstood and often misrepresented condition. It’s not about a love of organizing or handwashing— it’s about living with distressing, unwanted intrusive thoughts and the exhausting rituals or mental gymnastics used to cope with them. At ED & OCD Therapy, we offer compassionate, evidence-based treatment to help you break free from the OCD cycle, reconnect with your values, and build trust in yourself again.

So what exactly is OCD?

OCD is characterized by recurrent, unwanted intrusive thoughts, followed by compulsions. Compulsions can be physical, mental or avoidance based. This means the stereotypical ‘Hollywood’ picture of OCD is very misleading. We grow up thinking OCD is handwashing and a love for cleaning. While sometimes symptoms can manifest as hand washing and cleaning; the person never ‘loves’ it and it is much more than that. The person feels compelled to do it, in fear that something terrible will happen if they don’t. There is no love inside OCD. There is fear, anxiety and dread. OCD has different subtypes, meaning symptoms present in different ways for different people.

OCD Therapy office with white couch, laptop, table and green rug in San Diego

Common OCD subtypes include:

  • Harm OCD (HOCD):
    Fear of harming someone including kids, partner, friends, family members, fear of hit and run, fear of shoving someone in the train, fear of blurting out obscenities

  • Sexual obsessions
    Including fear of molesting children (POCD), incest, sex with animals, anything taboo you can think of.

  • Religious/moral obsessions
    Feeling compelled to follow religion/morals perfectly out of fear of going to hell if you do one thing wrong.

  • Just right/perfectionism obsessions
    Needing things to feel ‘just right’ or perfect, or something bad will happen.

  • Contamination obsessions
    Fear of getting sick or getting someone else sick, includes emotional contamination fears (i.e. if I talk about this illness I will get it).

  • Symmetry obsessions
    Intrusive thoughts about organization and symmetry

  • Real Event OCD
    Obsessions about past events and what people are thinking

  • Relationship OCD
    “Am I with the right person?” “I’m not attracted to them.”

  • Existential OCD
    “What is the meaning to life? Why am I here?”

  • Perinatal OCD
    Common during pregnancy, often manifests as obsessions about harming the baby

  • Sexual orientation obsessions
    “What if I am actually gay/lesbian/hetero?”

As you read this list, you might be thinking: “wait so if I have had these thoughts, does that mean I have OCD?” Not quite. Everyone gets these thoughts – they are completely normal and mean nothing about you or your values. The difference is for people with OCD, these thoughts become ‘sticky’ and repetitive, and the person develops intense anxiety and fear of the thoughts. Because of that fear and anxiety, the person then develops compulsions in an attempt to make them go away or ease the anxiety. This becomes a vicious cycle and keeps the thoughts coming non-stop. The paradox is, the harder you try not to think about it, the more your brain will fire them! Trying to “stop” your thoughts does not work with OCD, and is actually a compulsion that can keep you stuck!

Therapeutic Approach

We take a multimodal approach, grounded in a client centered and anti-oppression framework. Modalities used include:

  • Exposure and Response Prevention (ERP): This model helps you face their fears head on. We will create a hierarchy of all the compulsions attached to your OCD fears and gradually challenge the compulsions. We go slow, at your own pace, but the idea is to break the O-C cycle. When we stop doing compulsions; the obsessive thoughts eventually lose their grip. The overarching goal is to learn to embrace uncertainty. ERP teaches you to tolerate discomfort, uncertainty and fosters self-trust. 

  • Inference-Based CBT (I-CBT): in this modality, we help you learn about the inferential confusion process- the core of OCD. This is the process that takes us out of reality, and into the “OCD Bubble.” We help you “shine the light’ on the tricks of OCD, so that we can learn to turn away from using OCD’s strategies and learn to tune into our true, reality based sense data to guide our behaviors. In this process we also identify your feared possible self (who you are afraid you might become if your intrusive thoughts are real). This helps us get to the root of your suffering, so that treatment may be lasting. This model is all about building self trust and moving away from trusting OCD. This model requires no exposure and may be a more effective approach for neurodivergent brains that do not habituate or cannot tolerate the extreme anxiety involved in exposure therapy.

  • Acceptance and Commitment Therapy (ACT): ACT is an evidence based model that helps us develop new ways of relating to our thoughts so that we aren’t so fused with our intrusive thoughts. ACT helps us develop mindfulness strategies in order for our thoughts to begin floating by rather than getting hooked into them. It helps us become an observer of our mind so that we can get ‘unstuck’ and make room for us to focus on our true self values. When we can unhook from our thoughts, we can get back into our present life and live more in line with our values, which research has shown leads to greater life satisfaction and psychological relief.

These modalities are considered first and second line treatment options (including ‘Gold Standard’) by the International OCD Foundation. While we draw from these modalities, we tailor your treatment plan collaboratively, adjusting based on your unique needs, nervous system, co-occuring conditions and therapeutic goals.

Two young adults sitting in pink chairs in OCD Therapy San Diego

Who is OCD Therapy For?

This service is for teens and adults in CA, UT, FL and WA who are struggling with intrusive thoughts, compulsive behaviors, avoidance patterns, or persistent anxiety driven by OCD. We also specialize in working with neurodivergent individuals, and those whose OCD themes intersect with other co-occurring issues such as Eating Disorders, Generalized Anxiety, Panic Disorder, Depression, ADHD and more. You do not need to have been previously diagnosed with OCD to work with us. We believe that any amount of suffering with intrusive thoughts and compulsions warrants treatment- and research shows the earlier the intervention, the better!

Common Client Goals: What We Can Help You Achieve in OCD Therapy

  • Reduce compulsions and break the obsession-compulsion cycle

  • Learn to tolerate uncertainty and distress without rituals/compulsions

  • Build self-trust and stop over-identifying with intrusive thoughts

  • Reconnect with loved ones and daily life outside of OCD

  • Understand the root fears driving your OCD

  • Relapse prevention

  • Cope with painful emotions that often come with OCD such as shame, grief, embarrassment, etc.

Session Structure: What You Can Expect

Sessions are typically held weekly, either virtually or in-person. The initial sessions focus on building a solid client-therapist relationship as this is the most important factor for long term healing regardless of therapy modality being used! We then work towards understanding your OCD experience, identifying intrusive thoughts, compulsions, your feared possible self and providing LOTS of psycho-ed on why your brain is operating this way (knowledge is truly power here).  We then move into skill-building and targeted interventions using ERP, I-CBT, or ACT — based on your readiness and preferences. As therapy progresses, we may space out sessions or focus on relapse prevention and values-based living.

Special Features and Techniques That We Use

  • Neurodivergent-affirming adaptations (no forced exposures, consent-driven pacing)

  • Real-world and imaginal exposures (for ERP)

  • Exploration of “feared possible self” (in I-CBT)

  • Mindfulness tools and cognitive defusion strategies (from ACT)

  • Ketamine Assisted Therapy- read about the benefits for OCD here!

  • Optional medication consultation referrals

*These are not used with every client- so ignore what may not be wanted or relevant to you!

Client Experience

Clients often arrive feeling overwhelmed, ashamed, afraid or unsure if their thoughts make them “bad” people. In therapy, they discover that OCD is not who they are. It’s something they’re experiencing due to an overactive fear center of the brain, obsessional reasoning process and lack of self trust. Over time, clients learn to identify OCD’s voice, reduce its control, and feel more confident navigating life without compulsions. We create a space where your fears are met with understanding, knowledge and tools to help you recover.

Collaborative Process

We believe OCD treatment should never be forced (example: exposure hierarchies made without your consent and collaboration). Your therapy will be collaborative, paced with consent, and grounded in shared decision-making. We explore your values, unique lived experience, and cultural or neurodivergent identity to ensure the process feels empowering and effective, not just symptom-focused.


Long-Term Benefits

  • Freedom from debilitating OCD rituals and rumination

  • Greater ability to tolerate uncertainty and distress

  • Strengthened self-trust and intuitive decision-making

  • Renewed capacity for connection, joy, and spontaneity

  • Living more fully in alignment with your values, not fear of intrusive thoughts being true

  • Sustainable tools for managing future flare-ups

Final Thoughts

Through a combination of ERP and other therapies such as I-CBT, Acceptance and Commitment Therapy, your life can be a million times better. Treatment changed my life. And we have helped countless clients with OCD find the same freedom. I know it is scary, but you can do this and you are not alone! Book a consultation today and let’s get started!

Ready to start therapy?

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Ready to start therapy? ⟡

Allyson, Georgia & Parisa stand in front of water fountain in Balboa Park

At Eating Disorder OCD Therapy, we offer compassionate, relational, and individualized care, rooted in the belief that healing is not one-size-fits-all. Honoring client autonomy, collaboration, and anti-oppressive, neurodivergent-affirming practices, we walk alongside you as the expert in your own life. We provide therapy for Eating Disorders, OCD, Body Image, Trauma, Perinatal Mental Health, and offer Ketamine Assisted Psychotherapy (KAP), Group Therapy (globally), Recovery Coaching (globally), and Clinical Consultation and Supervision for clinicians. We are currently accepting new clients for in-person therapy in San Diego and virtual services in California, Washington, Utah, and Florida.