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Feel controlled by your own mind, and a pattern it keeps making you repeat? Obsessive-compulsive disorder can be a terribly lonely and alienating experience that leaves you feeling ashamed and different to others, even though it's beyond your control. The good news is that talk therapy can really help. 

What is OCD? 

OCD sees your mind fixate around something unpleasant (obsession), which can be a consistent thought, visual, or urge. And your way of trying to find relief from the unease or anxiety this creates for you involves taking a certain action or mental routine each time (compulsion). 

Of course we can all at times obsess on something or act compulsively. But if you have obsessive-compulsive disorder, you can't stop yourself. It all leads to significant distress and makes daily coping more of a challenge, whether that is at home or work, or with school or your social life. 

Obsessions and compulsions

Obsessions can be things like worries about dangers or bad things happening, like contamination or that someone will be harmed because of your negligence. They can also be pictures in your mind of violent or sexual images which are completely out of character, or an urge to do something.

Compulsions can be physical things like washing things repetitively, constantly checking or arranging things, or touching things a certain number of times. But they can also be mental, like repeating phrases or running through lists or 'steps' in your mind. 

What therapy is best for OCD?

Cognitive behavioural therapy (CBT) in particular has been proven to provide relief from intrusive thoughts and compulsive behaviours, and is the treatment recommended for OCD by the National Institute for Health and Care Excellence (NICE).They also recommend that exposure therapy be part of your treatment, also called 'exposure and response prevention' (ERP).

New research also sees positive results for obsessive-compulsive disorder using mindfulness-based cognitive therapy (MBCT).2

The NHS also recommends SSRI medications in the case of severe OCD, but this is up to you and something you can discuss with your therapist. If you both decide medication could help you can be referred on to one of our psychiatrists

How does OCD therapy work? 

CBT helps you recognise, challenge, and change your intrusive thinking, breaking the cycle between such thoughts and the damaging compulsions that follow. You and your therapist can also explore and address the underlying causes of your OCD.

Exposure and response prevention (ERP) is a behavioural tool some therapists use where they help you gradually face your fear in measured increments, while you resist resorting to your usual coping methods. With practice this reduces or even neutralises your anxiety response. This will of course be done at your own pace, and you will not be made to do anything you do not wish to do. 

OCD treatment at Harley Therapy, London

At Harley Therapy we put you in the hands of true experts. All of our therapists have minimum of ten years experience working with clients just like you, if not more, and trained at top UK institutions.

They are also 'integrative', meaning they have all trained in several forms of talk therapy they can combine with CBT to best suit your personal requirements. And they are committed to providing a safe, confidential, and friendly environment for you to work in. 

Ready to gain control back from your thinking and compulsions? Give us a call to discuss how we can help, or use our online booking form now to make a first appointment. 

How long does OCD therapy last for?

NICE recommends a minimum of 10 hours of CBT treatment when dealing with obsessive-compulsive disorder. You can decide with your therapist if you need further treatment beyond ten sessions. 

Benefits of counselling for OCD

  • understand the root causes of your OCD
  • recognise how your thoughts and behaviours are connected and how to break the cycle 
  • gain self-understanding and insight around what triggers you
  • start to feel back in control of your thinking and choices
  • lower or even neutralise any need to resort to compulsive behaviours 
  • develops tailor-made coping strategies to replace your compulsions
  • feel better about yourself and more hopeful about your future. 

Examples of OCD

Obsessive-compulsive disorder can be a routine unique to you, but examples can look like:

  • being convinced that you will be contaminated if you don't repeitively wash certain items or your hands 
  • constantly checking on your new baby as your thoughts say if you don't something terrible will happen 
  • thinking your car will be stolen if you don't check each door twice every time you park
  • feeling your house will burn down if you don't go back to check all appliances are unplugged 
  • being sure something bad will happen to your family if you don't tap everything you pass two times
  • avoiding a certain place or situation as if you go there your thoughts say something bad will happen
  • a routine where your thoughts tell you that you are going to become something and each time you must go spend an hour researching to 'prove' it's not true
  • having embarrassing images of all your friends undressed flash through your head followed by a precise system of chanting religious verses. 

Can't I treat my OCD myself? 

It's always helpful to educate yourself on what you are dealing with and use self-help tools like mindfulness to manage symptoms. But like any anxiety disorder, obsessive-compulsive disorder can be complicated to treat alone, and self-help tends to stave off symptoms over alleviate them. A research study, for example, found that guided self-help meant OCD symptoms didn't reach 'high intensity' levels, but did not result in symptoms clearing up.3


1Obsessive-compulsive order treatment guide by the National Institute of Health and Care Excellence (NICE). Released in 2005 and under review since 2019. 
2Zhang Tianran, Lu Lu, Didonna Fabrizio, Wang Zhen, Zhang Haiyin, Fan Qing. Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up. Frontiers in Psychiatry  2021: Vol 12. DOI=10.3389/fpsyt.2021.661807.
3Lovell K, Bower P, Gellatly J, et al. Clinical effectiveness, cost-effectiveness and acceptability of low-intensity interventions in the management of obsessive-compulsive disorder: the Obsessive-Compulsive Treatment Efficacy randomised controlled Trial (OCTET)Health Technol Assess. 2017;21(37):1-132. doi:10.3310/hta21370. 

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Updated Jan 24, 2024 by Dr. Sheri Jacobson Dr Sheri Jacobson

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Issues for OCD Counselling

  • Checking
  • Contamination Fears, e.g. excessive washing
  • Compulsive Habits
  • Intrusive thoughts (sexual, religious, violent, magical thinking)
  • Mental Rituals
  • Hoarding
  • Symmetry and Ordering
Obsessive Compulsive Disorder - Help Guide
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Issues for Counselling

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