Living with OCD can feel like a constant battle between what you know logically and what you feel emotionally. You might recognize that your fears are irrational, but they still cause intense anxiety, leaving you caught between reality and your mind’s relentless "what if" questions. You don’t have to live this way forever—there is help.

OCD can make you feel like you're stuck in an exhausting cycle of obsessive thoughts and compulsive behaviors. Whether it’s checking, counting, or repeating certain actions, these rituals can feel like the only way to relieve the anxiety, even if it’s just temporary. Breaking free from this loop is possible through therapy that targets the core of these patterns.

One of the most painful parts of OCD is the relentless doubt. Even when you try to reassure yourself, the uncertainty just won’t go away. You may find yourself endlessly questioning, unsure of your actions or thoughts and craving reassurance, which can be mentally and emotionally exhausting.

Differential Diagnosis and Assessments

Before we begin OCD treatment, it’s essential to conduct a thorough assessment to ensure we’re addressing the correct diagnosis. OCD shares many features with other anxiety disorders, like generalized anxiety, social anxiety, or panic disorder, which can make it difficult to distinguish. Through careful evaluation, we’ll determine whether OCD or another anxiety disorder is present. This process ensures that you receive the most appropriate and effective treatment tailored to your needs.

How Therapy Can Help: ERP and IFS

One of the most effective treatments for OCD is Exposure and Response Prevention (ERP). ERP helps you face your fears head-on by gradually exposing you to the thoughts or situations that trigger your anxiety, without engaging in the compulsive behaviors that usually follow. Over time, this process helps reduce the power those fears have over you, allowing you to break the cycle of obsessions and compulsions.

In addition to ERP, I also use Internal Family Systems (IFS) to help you explore and understand the different parts of yourself involved in OCD. There may be parts of you that are trying to protect you from anxiety or discomfort, even if those methods—like compulsions—are unhelpful. IFS allows us to work with these parts to create a healthier, more balanced internal system.

Common Subtypes of OCD

OCD can manifest in many different ways, and it’s important to know that you’re not alone, no matter what form it takes. Here are a few common subtypes:

• Relationship OCD (R-OCD): In this subtype, obsessions focus on doubts and fears about your relationships. You might constantly question whether you love your partner enough, if they love you back, or if you’re with the "right" person. These doubts can become overwhelming, even if there’s no evidence to support them.

• “Pure O” OCD: Purely Obsessional OCD, Cognitive OCD, or Pure O, involves intrusive thoughts or mental obsessions without the more obvious compulsive behaviors. These obsessions often revolve around distressing themes, like harm, perfectionism, sexuality, or morality, leading to intense guilt or shame. Compulsions in Pure O tend to be mental rituals, such as reassurance-seeking or thought suppression.

• Eating and Body Image-Related OCD: OCD can also manifest through obsessive thoughts about food, weight, or body image. You may feel the need to perform rituals related to eating, such as repeatedly checking calories or measuring food, over-exerting your body, or you may obsess over your body’s appearance, comparing it to others or fixating on perceived flaws. This can blur the lines between OCD and disordered eating.

• Scrupulosity OCD: This subtype is characterized by obsessive concerns about morality, ethics, or religion. You might be impacted by fears of sinning, blasphemy, or not being “good enough” according to your moral or religious standards. To alleviate the anxiety, you may engage in compulsive behaviors such as excessive praying, confessing, or seeking reassurance from religious authorities.

• Existential OCD: In existential OCD, obsessions center around deep philosophical questions about life, death, the universe, and reality. You might feel stuck in a loop of constantly questioning the meaning or purpose of life, or whether any of this is "real." These intrusive doubts can lead to compulsions like excessive research, rumination, or reassurance-seeking in an attempt to find certainty. It is often difficult to find solid footing and meaning in day-to-day life.

Finding Freedom from OCD

OCD can feel isolating and all-consuming, but therapy can provide the tools you need to reclaim control over your life. By combining ERP’s evidence-based approach with the deep, compassionate work of IFS, we can address the roots of your OCD and help you create lasting change. No matter which subtype of OCD you’re dealing with, there is hope for relief and healing.