Many people with OCD know, on some level, that their fears don’t make sense. And yet the thoughts feel urgent, intrusive, and impossible to ignore. You might get stuck in mental loops, repeat behaviors, or constantly seek reassurance, all in an effort to feel certain or safe. OCD can take up enormous mental space, leaving you exhausted and frustrated, and often feeling alone with what’s happening internally.
OCD is not simply “being anxious,” “being controlling,” or “liking things a certain way.” It’s a condition that pulls you into cycles of doubt and compulsion, often around the things you care about most. With specialized, evidence-based therapy, these cycles can loosen. We work with adults in Massachusetts who are living with OCD and want help breaking free from its grip.
Obsessive-Compulsive Disorder is characterized by obsessions and compulsions.
are intrusive, unwanted thoughts, images, sensations, or urges that trigger distress.
are behaviors or mental acts done to reduce distress, restore certainty, or prevent a feared outcome.
The relief from compulsions is usually brief, which is what keeps the loop running. Over time, OCD trains your brain to treat intrusive thoughts as emergencies and compulsions as the solution.
A helpful way to understand OCD is:
Intrusion → distress → urge to neutralize → compulsion → temporary relief → stronger future urge.
OCD often includes one or more of the following:
Many compulsions are invisible. People can look “fine” while spending hours battling OCD internally.
Themes vary, but the process is often the same: OCD targets something meaningful, generates doubt, then demands certainty.
What it can feel like: fear of germs, illness, chemicals, or “contaminated” objects.
Common compulsions: excessive washing, cleaning, sanitizing, avoiding public spaces, changing clothes, showering in rituals, mental checking for “contamination.”
What keeps it going: each cleaning ritual briefly reduces anxiety, which teaches the brain that cleaning is necessary for safety.
What it can feel like: fear of causing harm through negligence, mistakes, or carelessness.
Common compulsions: repeatedly checking locks, appliances, emails, documents, work tasks, driving routes, or replaying memories to confirm nothing went wrong.
What keeps it going: checking reduces doubt temporarily, but increases long-term doubt and “what if” thinking.
What it can feel like: unwanted intrusive thoughts about hurting someone, losing control, or being dangerous.
Common compulsions: avoiding knives, avoiding being alone with loved ones, mental reassurance (“I would never do that”), scanning feelings, confessing thoughts, seeking reassurance.
What keeps it going: treating the thought as meaningful increases its intensity and frequency, even though it’s ego-dystonic (not aligned with values).
What it can feel like: intrusive sexual thoughts that are unwanted, disturbing, and inconsistent with identity or values.
Common compulsions: reassurance-seeking, mental checking (“Did I feel aroused?”), avoidance of children or certain situations, researching, confessing, testing reactions.
What keeps it going: attempts to “prove” certainty about identity or intentions reinforce the obsession.
What it can feel like: fear of being immoral, sinful, dishonest, or a “bad person.”
Common compulsions: excessive apologizing, confessing, reviewing conversations, seeking reassurance, overcorrecting, praying/rituals, avoiding moral ambiguity.
What keeps it going: the demand to feel perfectly certain about goodness becomes a trap, because moral certainty is never complete.
What it can feel like: discomfort when things feel off, uneven, incomplete, or “wrong.”
Common compulsions: arranging, repeating, touching, counting, redoing tasks until it feels right.
What keeps it going: relief comes only after the ritual, teaching the brain that the sensation must be fixed.
What it can feel like: chronic doubt about love, attraction, compatibility, or whether you’re with the “right” person.
Common compulsions: analyzing feelings, comparing partners, googling relationship advice, seeking reassurance, testing attraction, confessing doubts.
What keeps it going: certainty about relationships is impossible; OCD turns normal ambiguity into a never-ending investigation.
What it can feel like: intrusive questions about reality, meaning, consciousness, or “what if nothing is real.”
Common compulsions: mental debating, researching philosophy, seeking reassurance, trying to “solve” the question, scanning sensations.
What keeps it going: the attempt to reach a final intellectual certainty prolongs distress and deepens rumination.
Effective therapy for OCD focuses on changing your response to intrusive thoughts and uncertainty, not proving the thought wrong.
Progress is often less about “feeling certain” and more about learning:
“I can handle not knowing.”
In therapy, you may:
Progress often shows up as less fear of panic, even if sensations still occur occasionally.
ERP is the best-supported approach for OCD, but we may integrate ACT, I-CBT, and other methods based on your needs and how OCD shows up for you.
OCD often targets taboo topics. Intrusive thoughts are common and do not reflect your character or intentions. Therapy provides a nonjudgmental space to work with them.
Treatment can bring discomfort at times, but it’s paced carefully. The goal is not to overwhelm you, but to help you build tolerance and freedom.
Our therapists are licensed mental health professionals with specialized training in OCD and anxiety-related conditions. We use evidence-based approaches and tailor treatment to each individual, with a focus on both effectiveness and respect for your lived experience.
