For individuals experiencing persistent intrusive thoughts/ distressing obsessions, or compulsive behaviours that feel impossible to resist, effective evidence-based support is available.
Obsessive compulsive disorder is a serious but treatable condition, and evidence-based therapy, particularly Exposure and Response Prevention (ERP) and Cognitive Behavioural Therapy (CBT) has a strong clinical track record of supporting lasting recovery.
Tara O’Donoghue offers specialist OCD therapy in London, combining ERP, CBT, and EMDR within a structured, compassionate approach tailored to the individual. The following outlines what OCD is, how it is treated, and what to expect from therapy.
What is OCD?
Obsessive Compulsive Disorder (OCD) is a common but serious mental health condition that affects people of all ages, genders, and backgrounds.
OCD is characterised by obsessions, unwanted, intrusive thoughts, doubts, images, or urgesand compulsions, which are repetitive behaviours or mental acts that a person feels compelled to perform, fearing a form of harm will arise to self or others if not performed. This condition is often referred to as “the doubting disorder” due to the constant quest of individuals trying to seek certainty.
Psychotherapy can help reduce this distress and support individuals in reclaiming and rebuilding a life beyond OCD. To explore options for OCD therapy in London and The New Forest including online sessions and home-based therapy (available locally, nationally, and internationally), feel free to get in touch.
What are the symptoms?
Obsessions often cause intense anxiety, distress, or disgust because they typically go against a person’s core values (also known as being ego-dystonic). While these thoughts originate in the mind, they are experienced as intrusive and irrational. In some cases, these obsessions may be regarded as overvalued ideas or, more rarely, delusions (Veale, 2002).
Common obsessions include:
- Fear of causing harm to oneself or others (e.g. through contamination by dirt, germs, bodily fluids, or chemicals)
- Fear of making a mistake (e.g. leaving a door unlocked)
- Intrusive religious or blasphemous thoughts
- Unwanted sexual thoughts (e.g. fear of being a paedophile)
- Intrusive violent thoughts (e.g. harming a loved one)
- Fearing being trapped noticing bodily processes such as blinking, breathing, heart beat etc
Compulsions, also known as safety behaviours, are performed in response to these obsessions. They may be overt (e.g. checking if a door is locked) or covert (e.g. mentally repeating phrases or prayers). These behaviours are intended to neutralise the distress caused by the obsessions, but they often reinforce the OCD cycle.
Common compulsions include:
- Repeated checking (e.g. gas taps, locks, or seeking reassurance)
- Excessive cleaning or washing
- Repeating actions or routines
- Mental compulsions (e.g. silently repeating words or prayers)
- Arranging items for symmetry or precision
- Hoarding items perceived as significant or necessary
To explore whether you’re experiencing symptoms of OCD, you can schedule an initial assessment with a specialist OCD therapist in London—available online or at home, by clicking here.
Common types of OCD
OCD presents differently from person to person. Recognising the specific form it takes is an important part of effective treatment.
- Contamination OCD: Fear of contamination from germs, dirt, bodily fluids, or chemicals, typically leading to excessive cleaning, washing, or avoidance behaviours.
- Pure O (Pure Obsessional OCD): Intrusive thoughts, images, or urges with no visible compulsions. Rituals tend to occur internally, such as mental reviewing, thought suppression, or silent reassurance-seeking.
- Harm OCD: Persistent, unwanted fears about causing harm to oneself or others, despite having no intention or desire to act on them. Also correlated to POCD (Paedophilic OCD)
- ROCD (Relationship OCD): Recurring doubts about a romantic relationship, a partner’s qualities, or one’s own feelings, often accompanied by significant distress and reassurance-seeking.
- Scrupulosity: Excessive preoccupation with religious, moral, or ethical concerns, often involving intrusive blasphemous thoughts or fears of having sinned.
- Symmetry and “Just Right” OCD: A need for things to look or feel precisely correct, often involving repeating, arranging, or counting until a sense of completeness is achieved.
- Health OCD: Preoccupation with having or developing a serious illness, distinguished from general health anxiety by the presence of rituals such as repeated body-checking or seeking repeated medical reassurance.
All of the above respond well to ERP-based therapy. If you are unsure which subtype applies to your experience, an initial assessment can help clarify this.
What causes OCD?
The exact cause of OCD is not fully understood, but a combination of biological, genetic, and environmental factors is thought to play a role.
- Biology: Changes in brain chemistry or function may contribute to OCD symptoms.
- Genetics: Individuals with a family history of OCD or other anxiety-related conditions may have a higher risk.
- Learning & environment: OCD behaviours may develop through modelling (observing others), stressful life events, or traumatic experiences. Infections and other environmental factors may also be triggers.
During your initial therapy session, it’s important to mention any relevant family history or life events. Cognitive Behavioural Therapy (CBT) is effective in reducing stress, anxiety, and depression—often improving the long-term outlook for those with OCD.
Do I have OCD?
OCD can present very differently from person to person, and symptoms are often misunderstood or dismissed. Common signs include recurring intrusive thoughts that feel distressing, ritualistic behaviours that temporarily reduce anxiety, and difficulty tolerating uncertainty.
You can take a commonly used OCD symptom questionnaire used by professionals to better understand your experiences. Click here to access the assessment.
How is OCD treated?
Effective OCD treatment involves evidence-based psychological therapy, particularly Exposure and Response Prevention (ERP), a form of CBT. For treatment to work, ERP must focus on the individual’s unique fears and how they interpret them.
In the UK, the NICE guidelines recommend Cognitive Behavioural Therapy (CBT) with ERP as a frontline treatment for OCD. Access the official NICE guidelines here→
Another evidence-based approach, Eye Movement Desensitisation and Reprocessing (EMDR), is also increasingly used to support treatment of OCD, especially when trauma or distressing events are involved. EMDR helps reduce the emotional charge of intrusive thoughts and may support recovery from OCD-related anxiety, depression, and imagery.
Treatment typically begins with an initial assessment to understand your specific symptoms, history, and the way OCD is affecting your daily life. This is followed by a structured course of therapy, usually between 12 and 20 sessions depending on severity and individual factors. Sessions can be delivered online, in clinic or at home, or in a combination of all three home-based sessions are particularly well-suited to ERP, as therapy can be carried out in the environments where OCD most commonly occurs.
What to expect from OCD exposure response prevention therapy?
OCD exposure response prevention (ERP) therapy transforms recovery by breaking the cycle of fear and compulsive behaviour. It involves gradually and safely confronting feared thoughts or situations in a controlled environment, helping to retrain the brain’s response.
This therapeutic process reduces emotional distress, fosters resilience, and allows individuals to move forward without being controlled by their obsessions or compulsions. Rather than avoiding fear, therapy helps individuals embrace uncertainty, leading to increased confidence and a greater sense of freedom.
OCD exposure therapy doesn’t just reduce symptoms, it reshapes lives by redefining recovery as a path toward sustainable well-being and mental clarity.
Contact
To find out more about evidence-based OCD therapy in London, or to arrange an initial assessment, you can get in touch with Tara O’Donoghue a licensed senior OCD specialist trained in CBT, ERP, and EMDR, by booking online here or emailing info@homebasedtalkingtherapy.com.
Home-based and online sessions are available, and home visits are particularly beneficial during ERP treatment. All enquiries are welcome and responded to promptly.
Websites and additional information
- OCD Action: A UK charity supporting individuals with OCD and their families
- NICE OCD Guidelines: Evidence-based treatment guidelines for OCD in the UK