OCD and Exposure Therapy

When your mind won’t let a thought go, and what actually helps

Part of The ShieldMee Guide: Anxiety & OCD →

“What if I did something terrible and don’t remember?”

“I know it doesn’t make sense. I still have to check.”

“Why do I keep having this awful thought? What does it say about me?”

“If I don’t do it right, something bad will happen.”

If you have OCD, you may never have told anyone about the thoughts.

They can feel too scary, too strange or too shameful to say out loud.

You’re not alone. And OCD is very treatable.

What OCD is

OCD stands for obsessive-compulsive disorder.

Obsessions are thoughts, images or urges that show up uninvited and bring a lot of fear, disgust or doubt.

Compulsions are things you do, out loud or in your head, to make that feeling go away or to stop something bad from happening.

The relief is real. But it doesn’t last. Next time, the thought comes back louder.

That loop is the heart of OCD.

It’s not about being neat. “I’m so OCD” jokes miss how painful it really is.

It can be about almost anything

• Germs, illness or contamination
• Fear of harming someone, even someone you love
• Unwanted sexual or violent thoughts
• Religious or moral fears, like having sinned or being a bad person
• Doubts about your relationship or your partner
• Needing things to feel “just right”
• Fear that you left the stove on or the door unlocked

Compulsions can be checking, washing, counting, asking for reassurance, searching online, praying a certain way, confessing, or replaying events in your head.

A thought is not a wish

This part matters, so I’ll say it plainly.

People with OCD often have thoughts about doing things they would never want to do.

The thoughts are upsetting because they go against who you are.

Having an unwanted thought does not mean you are dangerous or that you secretly want it.

If you ever feel you might act on a thought to hurt yourself or someone else, that’s different. Call or text 988, or call 911, right away.

What exposure therapy is

The most studied therapy for OCD is called exposure and response prevention, or ERP.

It’s simple to explain and hard to do. That’s why it helps to have someone with you.

Exposure means facing the thoughts and situations that set off your fear, a little at a time, on purpose.

Response prevention means not doing the compulsion afterward.

Over time, you learn that you can handle the anxiety, and that the ritual isn’t what keeps you safe.

We start small. You help choose every step. Nothing is forced on you.

Medication prescribed by a doctor, usually a type of antidepressant, also helps many people with OCD. ERP and medication can work together.

How I work

I do exposure work with my clients. We build the plan together, step by step.

I also listen closely to your words. OCD has its own language: “What if…,” “Just to be sure…,” “I need to know for certain.” Catching those phrases is part of how we catch the loop.

And I look at the people around you, because OCD rarely affects just one person.

OCD and your relationship

Partners and family usually want to help. So they answer the same question again. They check the lock for you. They avoid things that upset you.

That makes sense. It’s love.

But research shows this kind of help, called accommodation, can keep OCD going.

Sometimes OCD is about the relationship itself: “Do I really love them?” “Are they the right one?” Checking those feelings over and over can wear both of you out.

Bringing your partner into a few sessions can help. They learn how to support you without feeding the loop. You learn how to ask for support in a way that actually helps.

Who this work is for

• Adults in Florida with OCD, or who think they might have it
• People who tried talk therapy for OCD and it didn’t help
• People ready to try exposure work at a pace they help choose
• Partners and family members who want to stop feeding the cycle
• Spanish-speaking or bilingual adults

You don’t have to tell me your worst thought on day one.

Who this isn’t for

I work with adults. If you are under 18, this page is not describing services for you.

If you are in immediate danger or thinking about suicide, call or text 988 for the Suicide & Crisis Lifeline.

If you’re hearing voices or losing touch with what’s real, I’ll help you find a specialist who treats that.

Sessions must take place while you are physically located in Florida.

Frequently asked questions

Will exposure therapy make me do something terrifying right away?

No. We start with small steps you agree to. You stay in charge of the pace.

Is it OCD or anxiety?

They overlap, and many people have both. The rituals and the loop of relief and doubt are what point to OCD. We’ll sort it out together.

Do you prescribe medication?

No. If medication could help, I’ll coordinate with your doctor or psychiatrist.

Can my partner come too?

Yes. I see individuals, couples and families. Whether couples sessions are covered depends on your insurance plan. You’ll see your estimated cost on my Headway page before you book.

Do you offer therapy in Spanish?

Yes. Sessions can be in Spanish, English, or both.

How much does therapy cost?

It depends on your insurance plan. Most clients pay a copay or coinsurance. You’ll see your estimated cost on my Headway page before you book.

Do you take insurance?

Yes. I’m in-network with Aetna, Cigna, Florida Blue, UnitedHealthcare, Oscar, and other plans through Headway. Check your coverage and book on my Headway page.

When can I start?

Appointments are generally available the next day or within the same week, every day except Saturday.

Related reading: High-Functioning Anxiety · Catastrophic Thinking · Why I Replay Conversations