The OCD Therapy No One Wants to Talk About (But I Will)
The OCD Therapy Mistakes I See All the Time As A Therapist In NYC, Hoboken, and Montclair … and Why They Make You Worse
Let’s start with this truth: OCD is not about being neat or “overthinking.” And most therapists are accidentally treating it the wrong way, which actually strengthens the OCD cycle. Here’s how to spot the red flags, and what real OCD treatment looks like.
Let me just say this upfront:
There are a lot of therapists “treating” OCD who… shouldn’t be.
I know. I said it.
You’re welcome.
OCD is one of those diagnoses that looks simple from the outside - “intrusive thoughts → anxiety → reassurance” - but inside the therapy room?
It’s a clinical minefield if you don’t know what you’re doing.
And unfortunately, a lot of therapists accidentally make OCD worse because they’re doing therapy that feels supportive but actually reinforces compulsions. I’ve had many patients come to see me after working with “OCD trained therapists” in the past, and I am always shocked at what I hear. If a therapist is not talking about ERP (exposure and response prevention) with you … they are NOT an OCD trained therapist. Period.
And listen - this is not to shame anyone. Most therapists were literally never trained in exposure and response prevention (ERP) or how to spot hidden mental rituals.
But clients deserve better.
OCD deserves respect.
And the treatment actually works when it’s done correctly. As an OCD trained therapist in NYC, Hoboken, NJ, and Montclair, NJ, I have seen how real and correctly done OCD can transform my patients’ lives.
So here we go.
I’m finally talking about the mistakes I see every day.
Mistake #1: Turning OCD Therapy Into a Reassurance Factory
If your therapist says things like:
“No, that thought doesn’t mean anything.”
“You’d never do that.”
“It’s okay, you’re safe.”
…I love the intention, but that is not OCD treatment. That’s emotional Febreze. It smells nice, but doesn’t clean anything. It’s actually turning your mind into more of what feels like an internal jumble.
Reassurance is literally the OCD compulsion.
If your therapist gives it to you?
OCD purrs like a happy cat. And it doesn’t stop.
Mistake #2: “Let’s Process the Thought”
OCD does not want to be processed.
It wants certainty.
And OCD can out-process, out-analyze, and out-logic anyone. This is why talk therapy alone is not an effective treatment for OCD. The gold standard treatment for OCD is ERP (exposure and response prevention).
Trying to “understand the thought” is like giving a toddler sugar and expecting them to nap afterward.
ERP says:
“You had a thought. Okay. Keep going.”
Simple. Hard. Effective.
The combination of ERP and ACT (acceptance and commitment therapy) helps you build the tolerance to sit with OCD and keep going. A well-trained therapist will make sure that your OCD symptoms are improving, even if it’s just by 1%.
Mistake #3: Doing Talk Therapy With OCD
Talk therapy has its place, I’m relational, I use ACT, and I care deeply about the person in front of me - but when someone has OCD, talk therapy alone is like bringing a fork to a soup party. You can never go as far with it alone. And at times, it can make the OCD symptoms worse.
Wrong tool. Wrong outcome.
OCD needs:
Exposure (face the fear)
Response prevention (don’t do the compulsion)
Tolerating uncertainty (the skill)
If your therapist never says words like “exposure,” “hierarchy,” or “let the anxiety peak and fall,” that’s a sign. They are likely not trained in real OCD treatment.
Mistake #4: Therapists Who Accidentally Become Part of the Compulsion
This one hurts.
Examples:
The therapist who checks your tone to make sure you aren’t a bad person
The therapist who helps you “make sure” your relationship is right
The therapist who helps you analyze the meaning of your thought again
The therapist who double-checks your symptoms every session
If your therapist helps you feel certain, they’re reinforcing the OCD cycle. You may feel a sigh of relief during the therapy session after your therapist reassures you, but after therapy? You’re still stuck. A good ERP therapist will give you tools that will make you feel equipped to handle OCD in between sessions.
Mistake #5: Not Recognizing Mental Compulsions
People assume compulsions = washing hands or checking locks.
No.
Some of the biggest compulsions happen in your head, quietly:
analyzing
ruminating
mentally reviewing
comparing
neutralizing
counting
replaying memories
Googling
self-reassurance
praying to “cancel out” the thought
If your therapist never talks about compulsions you can’t see, that’s a huge miss. A well-trained OCD therapist can spot mental compulsions from a mile away. If your therapist isn’t working with your mental compulsions, you’re only scratching the surface.
So… what DOES effective OCD therapy look like?
ERP + ACT + a therapist who is both blunt and deeply compassionate
A real OCD therapist:
challenges your compulsions
won’t reassure you
helps you sit with uncertainty
is warm but firm
explains OCD in a way that makes your whole life click
gives you exposures that fit your actual fears
teaches you how to not chase the thought
helps you get your life back without needing 100% certainty
OCD is treatable.
Like… really treatable.
When you work with someone who actually knows OCD.
When You Should Look for an OCD Specialist
You deserve specialized care if you’ve ever thought:
“I’m doing therapy but nothing is changing.”
“I still need reassurance.”
“My thoughts feel even louder.”
“Therapy feels validating but not helpful.”
“My therapist doesn’t get why I can’t stop checking.”
Great therapy isn’t about making you feel better in the moment.
It’s about helping you get better for real.
How I Treat OCD
I specialize in anxiety and OCD and work with adults, teens, and couples in NYC, Hoboken, NJ, and Montclair, NJ, especially in high-achieving adults who are exhausted from trying to “think their way out” of intrusive thoughts.
My approach is:
ERP (exposures that actually work because they’re tailored to real life)
ACT (teaching your brain that a thought is a thought)
Relational therapy (because you still need a human, not a robot)
Humor + blunt honesty (because I will tell you the truth, kindly)
Clients tell me it feels like:
“Finally someone gets what my brain is doing.”