OCD and Intrusive Thoughts
OCD can involve distressing intrusive thoughts, images, doubts or urges that feel difficult to dismiss.
You may find yourself checking, seeking reassurance, repeating actions, avoiding certain situations or spending a great deal of time trying to work out what your thoughts mean.
Although these responses may bring some temporary relief, the anxiety and doubt often return, leaving you feeling trapped in an exhausting cycle.
I offer online Cognitive Behavioural Therapy, including Exposure and Response Prevention, for adults, children and teenagers experiencing OCD and intrusive thoughts.
Does this sound familiar?
OCD can affect people in many different ways. You may experience unwanted thoughts, images, doubts or urges that feel frightening, upsetting or completely out of character.
You might find yourself repeatedly checking, asking for reassurance, avoiding certain situations or carrying out actions in a particular way to reduce anxiety or prevent something bad from happening.
Even when part of you knows the fear may be unlikely, the doubt can still feel extremely difficult to ignore.
Repeatedly checking doors, appliances, messages or past events
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Seeking reassurance from other people
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Worrying that you may cause harm or be responsible for something bad happening
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Distressing intrusive thoughts about harm, relationships, sexuality, religion or morality
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Fears about contamination, illness or things feeling unclean
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Repeating words, actions or routines until they feel “right”
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Mentally reviewing conversations, memories or decisions
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Avoiding people, places, objects or situations that trigger intrusive thoughts
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Feeling a strong need for certainty
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Spending a great deal of time trying to work out what your thoughts mean
Intrusive thoughts are not the same as intentions or actions. Having a distressing thought does not mean that you want it to happen or that it says something important about who you are.
You do not need to have a formal diagnosis of OCD before contacting me.
How can CBT and ERP help with OCD?
CBT can help you understand how intrusive thoughts, anxiety and compulsions become linked, and what may be keeping the OCD cycle going.
You may respond to intrusive thoughts by checking, seeking reassurance, avoiding triggers, repeating actions or trying to analyse the thought until you feel certain. These responses are understandable and may reduce anxiety for a short time, but they can also reinforce the belief that the thought is dangerous or must be resolved.
Exposure and Response Prevention, often called ERP, is an important part of CBT for OCD. It involves gradually facing situations, thoughts or feelings that trigger anxiety while learning to reduce the compulsions or reassurance that usually follow.
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Understanding your individual OCD cycle
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Identifying compulsions, avoidance and reassurance seeking
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Learning how intrusive thoughts become significant
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Reducing attempts to gain complete certainty
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Gradually approaching feared situations or thoughts
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Practising responding differently when anxiety or doubt appears
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Reducing checking, rituals and mental reviewing
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Building confidence in your ability to tolerate uncertainty
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Developing skills to help you manage future setbacks
ERP will be planned collaboratively and adapted to you. You will not be forced or surprised. We will agree each step together and work at a pace that feels manageable while still helping you move towards the life you want to lead.
Different forms of OCD
OCD is not always visible. Some people carry out physical compulsions, such as checking, washing or repeating actions. Others experience mainly mental compulsions, such as reviewing memories, analysing thoughts, silently repeating phrases or trying to reassure themselves.
The theme of OCD can vary, but the underlying cycle of intrusive thoughts, anxiety, doubt and compulsive responses is often similar.
Contamination fears and washing or cleaning compulsions
Checking and fears of being responsible for harm
Intrusive thoughts about harming yourself or someone else
Relationship doubts and repeated checking of feelings
Sexual intrusive thoughts
Religious or moral fears, sometimes called scrupulosity
Fears about identity, character or what thoughts may mean
A need for symmetry, order or things to feel “just right”
Health-related fears and repeated checking or reassurance
Mental reviewing, rumination and attempts to achieve certainty
The content of intrusive thoughts can feel deeply upsetting or shameful. You will be treated with compassion and without judgement, whatever form your difficulties take.
OCD in children and teenagers
OCD can also affect children and young people. They may repeatedly ask for reassurance, confess thoughts, check things, repeat actions or become extremely distressed when routines cannot be completed in a particular way.
Some compulsions may be less obvious. A young person might silently repeat words, review events in their mind or avoid people, objects and situations that trigger intrusive thoughts.
I have extensive experience working with children, teenagers and families. Therapy will be adapted to the young person’s age, understanding and individual needs.
Parents or carers may be involved where this is helpful. This can support families to understand OCD, reduce unhelpful reassurance or accommodation and help the young person gradually respond differently to anxiety and doubt.
What happens next?
I offer a free, informal 10–15-minute introductory call. This gives you the opportunity to briefly explain what has been happening, ask any initial questions and decide whether you feel I may be the right therapist for you.
If you decide to go ahead, we will begin with an assessment. This gives us time to explore the intrusive thoughts and compulsions in more detail, understand how they are affecting everyday life and consider what you would like to be different.
We will then work together to develop a shared understanding of what may be keeping the OCD cycle going and agree some goals for therapy.
Sessions take place online and usually last 50–60 minutes. Therapy will be tailored to you and we will regularly review how things are progressing.
Online CBT sessions: £95