OCD Basics: What OCD Is and How I Treat It
Obsessive-compulsive disorder (OCD) can be an overwhelming and isolating condition, making daily life feel like a constant battle against intrusive thoughts and anxiety-driven behaviors. However, with the right approach, it is possible to break free from the cycle of OCD and build a life guided by values rather than fear.
The OCD Cycle: Obsessions, Compulsions, and Avoidance
OCD is defined by two primary components: obsessions and compulsions.
Obsessions are intrusive, unwanted thoughts, images, or urges that cause significant anxiety or distress. These can range from fears of contamination to doubts about morality, relationships, or personal responsibility.
Compulsions are behaviors or mental rituals performed to neutralize or reduce the distress caused by obsessions. These may include excessive handwashing, checking, seeking reassurance, or mental reviewing of past actions.
Avoidance is a lesser-known but equally significant factor in OCD. Individuals often avoid situations, objects, or even thoughts that might trigger obsessions, reinforcing the cycle of fear and anxiety.
Without treatment, obsessions, compulsions and avoidance naturally work together to create a vicious cycle that amplifies anxiety over time, and moves us further away from the things we really care about in life. This vicious cycle of what turns obsessive thoughts themselves (which we all have from time to time, to some extent) into a "disorder" that disrupts our life. The key to breaking free from the cycle lies in learning to respond differently to intrusive thoughts and discomfort. This is not easy, but it is very doable!
A Modern Approach to Treatment: ACT-Based ERP
Thankfully, highly effective and efficient therapies have been developed to support people in breaking out of the vicious cycle of OCD, including Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT). Let's look at each of these approaches:
Exposure and Response Prevention (ERP) is often described as the "gold-standard" behavioral therapy for OCD. It involves gradual, controlled exposure to feared thoughts or situations while refraining from acting on compulsive responses. This process helps us to tolerate uncertainty and discomfort without resorting to compulsions, and often leads to reduced anxiety over time, as our brain learns that we can cope when we face our fears.
Acceptance and Commitment Therapy (ACT) is also highly effective in helping with OCD, and compliments ERP well. ACT helps us develop practical mindfulness skills so we can let obsessions come and go without struggling with them (like an annoying but harmless radio playing in the background). ACT also helps us clarify what matters most to us in life (our values) and set clear goals and intentions based on what matters most. In this way, ACT helps us shift even more powerfully from a mode of NOT having what we don't want in life (obsessions), to having more of what we DO want, which leads to greater fulfillment
Together, these approaches offer a powerful and effective framework for recovery from OCD. ERP helps to develop highly individualized and effective plans for identifying and facing fears gradually, while ACT supports this often challenging work by clarifying what is most important in our lives and how following through on exposures will help us move towards the life we want. With an ACT-based ERP approach, we are not facing our fears solely to reduce anxiety, but in order to pursue the things that matter most in our lives.
From Fear to Freedom: Living a Meaningful Life
Many people with OCD seek treatment with the goal of getting rid of anxiety and intrusive thoughts, which is totally understandable given how distressing OCD can be. But the real path to freedom isn’t about eliminating discomfort—it’s about learning how to handle uncertainty while still pursuing what truly matters.
ACT-based ERP helps individuals:
Let go of the need for absolute certainty. Instead of seeking constant reassurance or performing compulsions, therapy helps individuals develop a tolerance for uncertainty and ambiguity.
Make space for discomfort without letting it dictate actions. Rather than avoiding obsessive thoughts or the situations that trigger them, individuals learn to allow distressing thoughts and emotions to be present while continuing to live in alignment with their values.
Prioritize meaningful living over short-term relief. The goal is not just to reduce symptoms, but to build a fulfilling life based on what truly matters—whether that’s relationships, career aspirations, or personal growth.
Take the Next Step Toward Recovery
If you are struggling with OCD and looking for a therapist who specializes in modern, evidence-based treatment, I’m here to help. Through ACT-based ERP, we can work together to break free from OCD’s grip and build a life that is rich, meaningful, and guided by your values.
You don’t have to let OCD define your life—recovery is possible, and support is available. If you’re in Texas and ready to start your journey toward lasting change, reach out today.
