"Small steps in the right direction can turn out to be the biggest steps of your life." — Unknown

Obsessive Compulsive Disorder (OCD) Treatment

Understanding the Impact of OCD

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterised by persistent, intrusive thoughts (obsessions) and repetitive behaviours or mental rituals (compulsions) aimed at reducing anxiety. OCD is often misunderstood as just about being neat or organised, but it is actually a complex condition of doubt and distress. OCD is a condition where doubt and intrusive thoughts can take over, leading to intense distress and disruption in daily life.

Individuals with OCD often struggle with:
✅ Recurrent, distressing thoughts, doubts, or images
✅ A strong urge to engage in rituals to "neutralise" thoughts
✅ Feeling stuck in repetitive thinking patterns
✅ Anxiety, guilt, or uncertainty that feels impossible to resolve

The good news? OCD is treatable.

Real Stories, Real Struggles: Case Examples

Case Example #1: Living with OCD (Emma’s Story – Hit-and-Run OCD)

Emma is a 32-year-old teacher who has always considered herself a caring and thoughtful person. One afternoon, while driving home from work, she suddenly has a disturbing thought: What if I accidentally hit a pedestrian without realising it? She doesn’t remember feeling a bump or seeing anyone on the road, but the doubt lingers – what if she just didn’t notice?

As she drives, her mind starts racing: What if someone is lying on the road injured? What if the police track me down? She feels a wave of anxiety wash over her. The uncertainty is unbearable. To alleviate her distress, Emma begins mentally retracing her drive, trying to recall every detail and searching for signs that might ‘prove’ she didn’t cause harm. Did she see someone step off the curb? Was that shadow she saw actually a person? She tells herself that if she can just remember things perfectly, she’ll be able to put the thought to rest.

But the relief never lasts. The more she ruminates, the more doubts creep in. She finds herself looping through the same thoughts, trying to feel certain she didn’t hit anyone. Sometimes, she even drives back to check the road, but even after confirming it’s clear, the doubt resurfaces later. Over time, this pattern grows – she starts avoiding driving in certain areas and spends hours at night replaying her drives in her head. What started as a single intrusive thought has now taken over her daily life, leaving her exhausted and trapped in an endless cycle of doubt and reassurance-seeking.

How ICBT Helps Break the Cycle

In Inference-Based CBT (ICBT), Emma would learn that her distress is not caused by an actual event but by a faulty reasoning process that leads her to doubt reality. Instead of trying to "prove" to herself that nothing happened, ICBT would help her identify why she suddenly distrusted her senses in the first place.

Through therapy, Emma would discover that her obsessional doubt is based on an imagined possibility (What if I hit someone?), rather than real evidence. She would learn to recognise when she is engaging in obsessional thinking, detach from these thoughts, and rebuild trust in her perception of reality – without needing to mentally review, seek reassurance, or check the road. Over time, she would regain confidence in her ability to drive without being controlled by OCD.

Case Example #2: When OCD Targets Your Values (Daniel’s Story – POCD)

Daniel is a 28-year-old graphic designer who has always taken pride in being a kind and ethical person. One day, while watching TV, a disturbing thought pops into his head: What if I find children attractive? The thought horrifies him. He immediately feels a surge of panic – why did that thought come to him? Does it mean something about him?

His mind starts racing: What if I’ve been suppressing something dark about myself? What if I’m a danger to children? The thought feels so repulsive that Daniel assumes he wouldn’t be so distressed unless there was some truth to it. The more he tries to push it away, the stronger it becomes.

Over time, Daniel starts avoiding situations where he might be around children, like family gatherings or parks. He constantly monitors his thoughts, scanning for any sign of attraction when he sees a child. He mentally reviews past interactions, trying to prove to himself that he has never felt anything inappropriate. He even tests himself – forcing himself to look at children in public just to “check” if he feels anything, only to spiral further into doubt. The more he ruminates, the less certain he feels.

How ICBT Helps Break the Cycle

In Inference-Based CBT (ICBT), Daniel would learn that his distress does not come from any real danger or hidden truth about himself, but from a faulty reasoning process – a sudden distrust in his own character and identity. Instead of trying to "prove" he isn’t a terrible person, ICBT would help him recognise why he started doubting himself in the first place.

Through therapy, Daniel would discover that his fear is based on an imagined possibility (What if I’m a danger?), rather than real evidence. He would learn to stop treating his intrusive thoughts as meaningful or worthy of analysis and instead recognise them as OCD-generated doubts. By disengaging from compulsive self-monitoring and reassurance-seeking, Daniel would regain trust in himself, his thoughts, and his actions, and break free from the OCD cycle.

My Approach: Inference-Based CBT (ICBT) for OCD

I specialise in Inference-Based Cognitive Behaviour Therapy (ICBT), an evidence-based approach designed specifically for OCD. Unlike traditional exposure-based methods, ICBT helps individuals understand why they experience obsessional doubt and teaches them how to disengage from it, and resolve it. By resolving the doubt, there are no terrifying consequences. You do not need to do compulsions if there are no terrifying consequences.

How Is ICBT Different from Traditional Approaches?

  
      Aspect
      ICBT
      Exposure & Response Prevention (ERP)
    
      Focus
      Correcting faulty reasoning patterns behind obsessions
      Gradually exposing clients to feared thoughts or situations
    
      How It Works
      Teaches clients to identify and dismiss obsessional doubts
      Requires exposure to anxiety-provoking thoughts without rituals
    
      Best For
      Those who feel stuck in obsessive doubt and reasoning loops
      Those comfortable with exposure-based techniques

Many individuals find ICBT particularly helpful when ERP feels overwhelming, counterintuitive, or ineffective.

“ICBT is not about talking you out of OCD. It is about helping you not talk yourself into it.”

— Dr Fred Aardema (unconfirmed)

What to Expect in ICBT Treatment

ICBT is a 12-module program and will be structured, supportive, and tailored to your needs. Sessions will focus on:

🧠 Understanding OCD as a "Doubt Disorder" – We explore how intrusive thoughts develop and why they feel real.
🔍 Challenging Faulty Reasoning – ICBT helps you recognise how obsessional doubts differ from reality-based doubts.
🚀 Learning to Trust Yourself Again – You’ll gain confidence in dismissing obsessive thinking patterns.
💡 Practical, Actionable Strategies – No exposure exercises – just clear, logical methods to shift your thinking.

ICBT does not require facing fears head-on like ERP but instead teaches you how to see through OCD's tricks so the fears naturally lose power.

Is This the Right Treatment for You?

ICBT is highly effective for individuals who:
✔ Experience distressing and unwanted intrusive thoughts
✔ Feel trapped in cycles of doubt and reassurance-seeking
✔ Want an approach that does not rely on exposure therapy
✔ Are open to understanding and changing their thinking patterns

If you’ve tried ERP and found it too distressing or ineffective, ICBT could be a better fit for you.

Healing from OCD takes time, and I want to be transparent about what you can expect. Therapy for OCD typically takes between 15 to 20 sessions, though some may need a bit longer. My goal is to provide a structured and supportive space where you can make real progress at your own pace.

Self-Help Resources

If you’re looking for an affordable self-help option, I recommend the OCD Training School, which offers structured guidance for managing OCD. Additionally, the newly released book Resolving OCD by Fred Aardema (available here) provides an excellent introduction to Inference-Based CBT (ICBT), the approach I use in therapy.

If you're unsure about the best next step for you, I offer a free 15-minute consultation to discuss your options and answer any questions.