OCD therapy onlineBreak the cycle at your own pace.

OCD has two parts. Obsessions are unwanted and unpleasant thoughts, images or urges that repeatedly enter your mind and cause anxiety, disgust or unease. Compulsions are repetitive behaviours or mental acts that you feel driven to perform to reduce that discomfort or to prevent something bad from happening¹.

OCD is found across the world. Analysis of data from the World Mental Health surveys shows that it affects people in many countries, frequently occurs together with other conditions and often goes untreated, which is why early recognition matters⁵.

When an intrusive thought appears, people with OCD tend to interpret it as meaningful and dangerous ("If I thought it, I might do it"; "If I don't check, it will be my fault"). Anxiety rises and the compulsion brings temporary relief, which teaches the brain that the ritual was necessary. Trying to push the thought away also backfires: a classic experiment showed that people asked not to think about a white bear later thought about it more than those who had not tried to suppress it². Avoidance and reassurance-seeking work in the same way, keeping the fear alive.

Clinical guidelines from NICE recommend CBT including exposure and response prevention for OCD, with intensity matched to the level of impairment³, and the NHS describes therapy for OCD as usually a type of CBT with ERP⁷. A meta-analysis of 37 randomised trials published between 1993 and 2014 found very large effects of CBT compared with waiting list and placebo conditions⁴.

Our therapists work in an integrative, evidence-informed way and, for OCD, use techniques from cognitive behavioural therapy, including exposure and response prevention, as a central part of the work. Sessions typically include:

• Understanding your OCD: obsessions, compulsions (including mental ones), triggers and avoidance.
• Making sense of intrusive thoughts: learning how ordinary they are and how the meaning we give them fuels anxiety.
• Building an exposure ladder together, from manageable to more challenging steps.
• Response prevention: gradually delaying, reducing and dropping compulsions, at a pace you agree to.
• Working with doubt and uncertainty, which lie at the heart of OCD.
• Involving family, with your consent, so that loved ones can step out of reassurance and rituals supportively.
• Relapse prevention: recognising early signs and knowing what to do if OCD tries to return.

The work is demanding but structured, and you are never asked to do more than you have agreed to.

Consider therapy if:

• intrusive thoughts and rituals take up a significant part of your day;
• you avoid places, people or objects because of OCD;
• rituals are affecting work, study, relationships or sleep;
• family members are being drawn into reassurance or rituals;
• low mood is building because of the strain.

If OCD is severe, or you are feeling hopeless, we are happy to work alongside a psychiatrist, as medication can also help. In an emergency call 112.