OCD therapy · San Diego
OCD is making you do things you hate. That’s what it does.
Exposure and Response Prevention (ERP) is the gold-standard treatment for OCD, and it works. I treat contamination OCD, harm OCD, scrupulosity, relationship OCD, and others. Here’s what that looks like.
What OCD feels like
OCD is not about being neat or organized. It’s obsessions (intrusive thoughts, images, or urges that cause distress) and compulsions (behaviors or mental acts done to reduce that distress, temporarily). The compulsion relieves the anxiety just enough to keep the cycle going.
The harder you try to push the thought away, the louder it gets. That’s not a character flaw. That’s how OCD works.
People with OCD often know their fears are irrational. That doesn’t help. Knowing isn’t the same as being able to stop.
The treatment
What ERP involves.
ERP works by gradually exposing you to the things that trigger obsessions, and resisting the compulsion. Over time, you learn that the discomfort passes without the compulsion, and that the feared outcome doesn’t happen.
I apply ERP flexibly. We build a hierarchy of exposures together. We start where you are and move at a pace that’s challenging but always manageable. Nothing is done that hasn’t been agreed on.
Between-session practice matters for OCD more than for most presenting issues. Avoidance between sessions undoes what we work on in them. We’ll discuss what that looks like for you before starting.
ERP is hard. It’s also the treatment that works.
Common questions about OCD treatment
How long does OCD therapy take?
OCD treatment with ERP typically takes 12–20 sessions for meaningful symptom reduction. Some clients need more, especially with longer OCD histories or severe symptoms. ERP works, but it requires practice between sessions.
Is ERP painful or overwhelming?
ERP involves discomfort by design. But 'challenging' and 'overwhelming' are different things. Good ERP is collaborative and gradual. Nothing is done that hasn’t been agreed on, and we build up systematically.
I’ve tried to stop the compulsions and it doesn’t work. Why would this be different?
ERP isn’t about willpower. It’s about systematic, graduated exposure with support, followed by response prevention. The goal is to teach your nervous system that the obsession isn’t the emergency it feels like. Willpower alone can’t do that. ERP can — when it’s done right, with support, and practiced between sessions.
Do you treat all types of OCD?
Yes. Contamination OCD, harm OCD, intrusive thought OCD, moral/religious scrupulosity, relationship OCD (ROCD), and others. The flavor of OCD is less important than whether ERP is the right treatment approach, and for OCD it almost always is.
You don’t have to keep white-knuckling this.
Reach out. I’ll tell you whether ERP is the right approach for what you’re dealing with.
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