Therapy for OCD & Phobias
The loop stops here.
You know the thoughts aren't logical. It doesn't matter.
OCD speaks in what-ifs. What if I harmed someone and don't remember it? What if I said something offensive? What if I'm not really who I think I am? What if I can't be certain? The content shifts, but the structure is always the same: intrusion, doubt, urgency, compulsion, temporary relief, repeat. Phobias work differently but land in the same place — a situation, object, or sensation your nervous system treats as catastrophic, regardless of what you know to be true.
The compulsions and avoidance work, but only temporarily. The more you use them, the stronger the pattern gets. ERP is designed to break it.
What is ERP and why does it work?
Exposure and Response Prevention is the gold-standard, evidence-based treatment for OCD and phobias, and one of the most effective psychological treatments ever studied for any condition. It works by systematically and collaboratively approaching feared situations, thoughts, or sensations while resisting the urge to perform compulsions or escape. Over time, your nervous system learns that the feared outcome either doesn't happen, or that you can tolerate it if it does. The anxiety loses its grip — because you've moved through it enough times that it no longer runs the show.
ERP is a graduated, structured process we build together, starting where you are and moving at a pace that is challenging without being overwhelming.
OCD looks different for everyone
OCD is one of the most misrepresented conditions in mental health and one of the most undertreated. On average, people wait over a decade between when symptoms begin and when they receive effective treatment, often because most therapists aren't trained in ERP.
It doesn't always look like hand-washing or checking locks. OCD organizes itself around themes like harm, contamination, religion or morality, relationships, identity, sexuality, symmetry, and many others. The content shifts from person to person, but the structure is always the same: an intrusive thought, image, or urge that feels completely at odds with who you are and what you value, followed by an overwhelming urge to neutralize it — to check, avoid, seek reassurance, confess, or repeat. The compulsion brings relief. Briefly. And then the loop starts again.
The gap between who you are and what your mind is throwing at you is one of the hallmarks of OCD. The thoughts don't reflect your character, intentions, or desires. What your mind keeps returning to reveals what you care about the most. OCD weaponizes that.
Phobias don’t care what you know
Phobias are more focused than OCD but no less consuming. Where OCD casts a wide net, a phobia locks onto something specific: a situation, object, or sensation. Your nervous system responds as though the threat is immediate and catastrophic, regardless of what you know to be true. Heights, flying, needles, vomit, spiders, driving, medical procedures, choking, storms — the trigger varies, but the experience is the same: terror that feels completely disproportionate and completely beyond your control.
Most people with phobias know their fear is irrational. That knowledge changes nothing. Your rational mind and your threat system are not in conversation with each other, and your threat system is louder. Avoidance works! Every time you avoid the thing, you get relief. And every time you get relief through avoidance, the phobia gets stronger. The loop tightens without you doing anything wrong.
Phobia treatment is often shorter and more focused than OCD treatment. For some phobias, a few sessions of targeted exposure work produce significant results. What changes isn't your knowledge about the threat. It's your nervous system's response to it.
What working together looks like
We start with a thorough assessment, understanding your specific OCD presentation or phobia, and mapping out what avoidance and compulsions look like in your daily life. We also explore whether trauma is at the root of any of the compulsions and whether it makes sense to address that first before beginning exposure work.
When we move into ERP, we start by identifying priorities — what matters most to you, what's getting in the way of your life, and what motivates you to do this hard work. From there we build an exposure hierarchy together: a graduated map of what we'll work toward and in what order.
Sessions are structured and goal-oriented. You'll always know what we're doing and why. I hold the framework firmly while staying genuinely responsive to what you bring each week, because real life doesn't follow a script and good ERP doesn't either.
Many people with specific phobias see significant results in a few sessions of targeted exposure work. OCD treatment is more variable and the timeline depends on the complexity of your presentation, your history, and what we find along the way.
I work with OCD and phobias as a primary therapist and in adjunct roles for clients already in therapy elsewhere who need targeted ERP without starting over from scratch. If you're ready to find out whether ERP might help, reach out for a free 15-minute consultation. We'll talk about what you're dealing with and whether this approach is the right fit.