What is OCD and how do I know if I have it?

OCD (Obsessive Compulsive Disorder) involves intrusive thoughts, images, or doubts (obsessions) that create intense anxiety, followed by behaviours or mental rituals (compulsions) to reduce that anxiety. Common signs include repetitive checking, excessive cleaning, intrusive thoughts about harm or contamination, needing things to feel "just right," or constant reassurance seeking. If these patterns are taking up significant time or affecting your daily life, an assessment can help clarify what you're dealing with.

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What are the main symptoms of OCD?

OCD symptoms vary widely but typically involve obsessions (unwanted intrusive thoughts) and compulsions (repetitive behaviours or mental rituals). You might experience fears about contamination and viruses, repeatedly checking locks or appliances, intrusive thoughts about harm or sexual content, needing symmetry or order, relationship doubts (ROCD), religious fears (scrupulosity), or fears about being attracted to children (POCD). Not everyone with OCD has visible compulsions - some people experience "Pure O," where compulsions are mainly mental.

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What's the difference between intrusive thoughts and OCD?

Everyone has intrusive thoughts - around 94% of people experience them. The difference with OCD is that you get stuck in a cycle: the thought appears, it creates intense distress, you perform a compulsion (checking, seeking reassurance, mental reviewing) to reduce anxiety, you get temporary relief, but the cycle strengthens. In OCD, these thoughts can dominate hours of your day and significantly impact your functioning.

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What types of OCD do you treat?

I work with all OCD presentations including contamination fears (fear of germs, compulsive hand washing), checking compulsions (locks, appliances, car), harm OCD (intrusive thoughts about causing harm), Pure O (mainly mental compulsions), ROCD (relationship OCD), POCD (paedophile OCD), HOCD (homosexual OCD), scrupulosity (religious OCD), "just right" OCD (symmetry, ordering, arranging), and sensorimotor OCD (hyperawareness of breathing, blinking). If your OCD doesn't fit these categories, that's fine - the underlying treatment principles are similar.

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What is CBT and ERP therapy for OCD?

CBT (Cognitive Behavioural Therapy) and ERP (Exposure and Response Prevention) are the gold standard treatments for OCD. ERP involves gradually facing feared situations while resisting compulsions, teaching your brain that you can tolerate discomfort and that feared outcomes either won't happen or aren't as catastrophic as OCD suggests. CBT helps identify and change the thinking patterns that fuel OCD. These approaches are recommended by the NHS and are exceptionally well evidenced for symptom reduction.

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Do you use ACT therapy as well as CBT?

Yes. While CBT/ERP is excellent for breaking behavioural patterns, ACT (Acceptance and Commitment Therapy) helps you change your relationship with uncomfortable thoughts and feelings rather than trying to eliminate them. ACT is particularly effective when combined with exposure work and helps prevent relapse by teaching skills that last. Research shows ACT is effective for OCD, and it addresses the intolerance of discomfort that often sits beneath symptoms.

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Can OCD be treated, or will I always have it?

OCD can be treated very effectively. With the right approach, symptoms can reduce significantly to the point where OCD no longer dictates your choices or dominates your mental space. Many people reach a point where it barely registers in their daily life. However, the goal isn't to eliminate every intrusive thought (which isn't realistic) but to change your relationship with discomfort and uncertainty so OCD doesn't control you.​

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Do you offer NHS OCD treatment or private therapy?

I offer private OCD therapy both in Manchester and online throughout the UK. While I previously worked in NHS services for over a decade, my current practice is private. This allows for flexibility in session frequency, longer sessions when needed, and the ability to combine approaches (CBT, ACT, EMDR) based on what you need rather than following rigid protocols.

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What if I've tried CBT or ERP before and it didn't work?

Many people who found previous CBT "helpful but incomplete" benefit from a more flexible, integrated approach. Sometimes rigid ERP protocols don't address the underlying relationship with discomfort and uncertainty, which is why relapse can occur. I combine ERP with ACT (which addresses this deeper relationship) and EMDR (when past experiences are fuelling current symptoms). If previous therapy didn't work, it doesn't mean you can't get better - it might mean the approach needs adjusting.

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Is online therapy as effective as in-person for OCD?

Research shows that online CBT and ERP are equally effective as in-person treatment for OCD. The therapeutic relationship and the quality of the approach matter more than the medium. I've successfully treated OCD online throughout the UK, and many people find it more accessible and convenient than travelling to sessions. Video sessions allow for the same exposure work, skills practice, and therapeutic connection as in-person therapy.

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How do I get support for OCD in the UK?

You can access OCD support through NHS services (via GP referral), private therapy, or support charities like OCD Action, OCD-UK, and Mind. If you're seeking specialist treatment that combines multiple evidence-based approaches, private therapy often provides quicker access and more flexibility. Many people start with an assessment to understand their specific patterns and get clear recommendations about next steps