ERP for OCD
OCD is loud. ERP is how we turn the volume down.
(the thoughts aren't the problem. what OCD makes you do about them is.)
OCD is not being tidy. It's not liking things a certain way. It's your brain handing you the same intrusive thought on repeat and demanding you do something — check, wash, confess, mentally review — to make the feeling stop.
Exposure and Response Prevention is the gold-standard treatment. It's the approach with the most evidence behind it, and it's what I use. I'm a member of the International OCD Foundation.
What it looks like
The thought shows up. Then the ritual.
- Intrusive thoughts about harm, contamination, relationships, morality, sexuality, or 'what if I'm actually a bad person.'
- Mental review, reassurance-seeking, googling, or confessing to try to feel certain.
- Physical rituals: checking, counting, tapping, washing, re-doing.
- Avoiding people, places, or situations because the thought might show up there.
- 'Just Right' OCD — the low-grade feeling that something is off until you fix it.
- You know it's not rational. That doesn't make it stop.
How ERP actually works
We let the thought show up. And we don't do the ritual.
(that's it. that's the treatment. the middle is the hard part.)
ERP has two parts. Exposure: we deliberately bring up the thing OCD is afraid of — in a graded, planned way, together. Response Prevention: we don't do the compulsion that usually follows.
The first time you do it, it's uncomfortable. The tenth time, less. That's habituation, and it's how your brain learns the alarm was a false one. You are not white-knuckling this alone. We build the hierarchy together, step by step, and I'm in it with you.
ERP is evidence-based, time-limited, and it works. Most clients see real change in 12–20 sessions.
What you'll actually do
A plan that meets your OCD exactly where it is.
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01
Map your OCD
We name the themes, the triggers, and every ritual — including the invisible mental ones. You'll be surprised how many there are.
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02
Build the hierarchy
Together we make a ladder of exposures from mildly uncomfortable to 'nope.' We start at the bottom. Always.
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03
Practice with support
We do exposures in session first, then you take them into your week. You'll never be assigned something we haven't rehearsed together.
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04
Cut off the ritual
The exposure only works if you don't do the compulsion after. We plan for the wobble, the urge to check, and the 'just this once.'
Straight talk
When I'm not the right fit.
- You have severe, high-acuity OCD that's kept you housebound or unable to work — you likely need an intensive outpatient or residential OCD program, and I'll help you find one.
- You want to talk about your OCD without ever doing exposures. ERP is not talk therapy about OCD; it's doing the uncomfortable thing on purpose.
- You're seeking reassurance that your thoughts don't 'mean' anything. In ERP, reassurance is a compulsion — I won't give it, because it makes OCD worse.
If any of that is you, I'll say so on the consult and point you toward someone who's a better fit.
Common questions
Before you book.
- What if my intrusive thoughts are really dark?
- They usually are. Harm, sexual, religious, relationship — the 'taboo' themes are the most common ones I see. Nothing you say will shock me, and none of it means what OCD is telling you it means.
- How is ERP different from regular talk therapy?
- Talk therapy alone can actually make OCD worse (all that analysis becomes a compulsion). ERP is structured, active, and time-limited.
- Do you do ERP virtually?
- Yes. ERP works very well over telehealth — sometimes better, because exposures often need to happen in your actual environment.
Ready when you are.
A free 15-minute call. You tell me what's going on. I tell you honestly whether I'm the right fit.