The thoughts are irrational. You already know that. It has not stopped them.

You already know your thoughts are irrational. You've known for years, maybe decades. That hasn't stopped them. You can describe the cycle perfectly: the thought comes, the anxiety spikes, you do the thing to make it stop, the relief lasts a few minutes, and then it starts again. You've read about OCD. You've taken the quizzes. You can explain it better than most therapists you've seen. Understanding the cycle has not broken it.

What most people don't see is everything else. The hours lost to rumination that nobody knows about. The way you've gotten stealthy at hiding your rituals so that coworkers just think you're distracted or tired. The second, secret life you run inside your head while maintaining a competent exterior. By the time you get home, you're not tired from your day. You're tired from your own mind.

OCD has been called the doubt disorder, and the name captures something essential. It doesn't just make you doubt whether the door is locked. It makes you doubt whether you're a good person. Whether you love your partner. Whether your thoughts say something true about who you are. And then it doubts its own diagnosis: what if you don't actually have OCD, and you're just in denial about the kind of person you really are?

What this therapy is for

People with OCD wait an average of 14 to 17 years before getting help. Not because they don't know something is wrong, but because saying the thoughts out loud feels impossible. More than half of people with OCD say that shame itself prevented them from seeking treatment. You've been carrying this alone, putting on a normal face, terrified that if anyone knew what was actually going on in your head they'd think you were dangerous, or crazy, or disgusting. You're none of those things. But you probably don't fully believe that yet.

This therapy is for the parts of OCD that symptom management doesn't reach.

The shame that runs deeper than the rituals. OCD attacks moral identity. It targets the things you value most and inverts them. If you care about being a good parent, it sends you images of harming your child. If you care about your relationship, it fills you with doubt about whether you really love your partner. If you care about your faith, it gives you blasphemous thoughts. And then it tells you that having those thoughts means something about who you are. People have carried this for years, sometimes decades, without telling a single person. They've described it as tormenting thoughts and secret rituals, a hidden life that nobody around them suspects. Shame grows in secrecy, and OCD runs on secrecy. In therapy, saying the unsayable to someone who hears it without flinching is often the moment something shifts. Not reassurance. Not "you're not a bad person." Just: I hear you, and I'm still here.

The rigidity that extends into everything. This goes far beyond specific compulsions. It's the hour spent on an email that should take five minutes. The conversation replayed for days to determine whether you said the wrong thing. The need to get things exactly right, and the inability to call anything good enough. The psychologist David Shapiro described this as the obsessive-compulsive style: a way of moving through the world where everything feels like it must be done, where duty has replaced desire, where even rest feels like something you have to earn. It's how you do your job, how you treat yourself, how you are in relationships. It's exhausting in ways that go far beyond the specific obsessions. And it doesn't go away when the compulsions decrease.

The anger nobody makes room for. You're angry. At the disorder, at your brain, at the years it's taken from you. At the therapists who missed it, the friends who trivialized it, the medical system that made you feel like a checkbox. And the deeper anger: at the relentless internal voice that has been telling you, for as long as you can remember, that you are not good enough. A lot of people with OCD turn the anger inward and it becomes depression. Or they suppress it because they're already afraid of losing control, and anger feels like one more thing they can't trust themselves with. For someone who has violent intrusive thoughts, feeling actual anger is terrifying, because it seems to confirm what OCD has been saying all along. That anger deserves a place. Expressing it in a relationship where it doesn't produce catastrophe is one of the most important things therapy can do.

Your relationships. OCD doesn't stay inside your head. It leaks into everything. The reassurance-seeking that exhausts the people around you: "Do you still love me?" "Am I a good person?" "You don't think I'd actually do something like that?" Partners become unofficial therapists. The dynamic corrodes both people. And the relief from reassurance never lasts. The doubt comes back worse than before. Beyond reassurance, there's the avoidance, the difficulty with intimacy (which requires exactly the kind of uncertainty OCD can't tolerate), and the years of concealment that have eroded trust. Couples therapy or individual therapy can help you find a different way to be in your relationships.

What this isn't

I don't do ERP (Exposure and Response Prevention). ERP is the gold standard behavioral treatment for OCD. Response rates in clinical trials run between 62% and 65%. For many people it produces meaningful, lasting change. If that's what you're looking for, I can help you find someone who specializes in it.

I also don't do the kind of therapy where we explore the "meaning" of your intrusive thoughts. The International OCD Foundation rightly warns that treating obsessions as meaningful communications from the unconscious can make OCD worse. Searching for the hidden significance of an intrusive thought is just another compulsion. I don't do that.

What I do is different from both of these. I work with the person who has OCD, not with the obsessions themselves. There is a fundamental difference between working with the obsessions and working with the person who has them. The intrusive thought about harming your child doesn't need to be decoded. It needs to stop being a source of identity-level shame. The rigidity that runs your life doesn't need an exposure hierarchy. It needs to become visible as a pattern so you can start to loosen it. The anger you've been suppressing for decades doesn't need a cognitive reframe. It needs a place where it's welcome.

You don't have to be in crisis. You don't even have to have a formal diagnosis. You just have to be tired of carrying this alone.

How I work

My approach comes out of character-analytic and psychodynamic traditions, particularly the work of David Shapiro, who described the obsessive-compulsive style not as a set of symptoms but as a way of being: the narrowed attention, the driven quality of activity, the sacrifice of spontaneity to deliberateness, the rigid moral code. I take seriously how the ongoing pressure of living with OCD shapes who a person becomes. How you think, yes, but also how you move through the world.

For someone with OCD, that means looking at the patterns that extend beyond the rituals. How the rigidity shows up in your work, your relationships, your self-talk. How the shame has shaped what you're willing to let people see. How the internal voice that judges your thoughts has become the voice that judges everything you do. How the doubt has made you second-guess not just your obsessions but your entire sense of who you are. These are not things that go away when you learn to resist a compulsion. They require a different kind of work.

I'm a therapist, not a doctor. This is talk therapy, not medical treatment. I don't diagnose, I don't prescribe, and I don't run ERP protocols. What I offer is a space where you can say the things you've been hiding and find out that they don't make you the person you're afraid you are. For patients who have completed ERP and still feel stuck in a rigid, shame-driven way of being, this addresses what remains. For patients who have never tried ERP, this work can create the conditions of trust and reduced shame that make engaging with exposure-based treatment more possible. For patients who have found symptom-focused treatment insufficient, this work goes where ERP was not designed to reach.

Sessions are 60 minutes over secure video. Before your first session, we have a brief 15-minute call to see if this feels like the right fit for you. Before your first session, we have a brief 15-minute call to see if this feels like the right fit for you. We can see if it's the right fit.

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