You know the thoughts don’t make sense. You know the rituals won’t actually prevent anything. But you can’t stop. The anxiety is too intense, and the only way to get relief—even temporary relief—is to give in to the compulsion. Again.

Obsessive-compulsive disorder (OCD) traps people in an exhausting loop. Intrusive thoughts trigger intense anxiety. Compulsive behaviors temporarily relieve that anxiety. But the relief never lasts, and the cycle starts again—often taking hours from your day and leaving you feeling frustrated, ashamed, and alone.

At Therapy Group of DC, we understand how debilitating OCD can be. Our therapists specialize in evidence-based obsessive compulsive disorder therapy, helping you understand the patterns driving the cycle, change how you respond to obsessive thoughts, and stop letting compulsive behaviors control your days.

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Is OCD Therapy Right for You?

You might benefit from OCD therapy if you:

• Experience recurring, unwanted thoughts that cause significant anxiety or distress
• Feel compelled to perform certain rituals or behaviors to relieve anxiety
• Spend more than an hour a day on obsessions or compulsions
• Recognize that your fears or behaviors are excessive but can’t stop them
• Have tried to resist compulsions but find the anxiety unbearable
• Notice OCD interfering with work, relationships, or daily functioning
• Experience difficulty completing tasks or leaving situations without repeating rituals
• Feel trapped, exhausted, or ashamed by the cycle

What to Know

• OCD is highly treatable—most people experience significant improvement with proper therapy
• Effective treatment helps you respond differently to obsessive thoughts, not eliminate them entirely
• Therapy for OCD involves gradually facing fears rather than avoiding them
• Treatment typically involves 12-16 sessions, though this varies based on severity
• Many people with OCD also struggle with depression, anxiety disorders, mood disorders, or perfectionism
• Individual therapy tailored to your specific obsessions and compulsions is most effective

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Understanding Obsessive-Compulsive Disorder

OCD is characterized by two components: obsessions and compulsions. Understanding how they interact helps explain why this disorder feels so impossible to escape—and why effective treatment works.

Obsessions

Obsessions are persistent, intrusive thoughts, images, or impulses that cause intense anxiety or distress. They’re not simply worries about real-life problems. They’re unwanted, disturbing, and often feel completely at odds with who you are as a person.

Common obsessions in OCD include:

• Contamination fears: Intense anxiety about germs, dirt, illness, or “contaminating” others
• Harm obsessions: Disturbing thoughts about accidentally or intentionally causing harm to yourself or others. These thoughts about causing harm are particularly distressing because they conflict with your values
• Symmetry and order: Overwhelming need for things to be arranged “just right” or perfectly aligned
• Forbidden thoughts: Intrusive sexual, violent, or blasphemous thoughts that feel deeply wrong
• Doubt and incompleteness: Persistent uncertainty about whether you locked the door, turned off the stove, or completed tasks correctly
• Fear of losing control: Worry that you might act on unwanted impulses or “go crazy”

The content of obsessions often targets what matters most to you. A loving parent might have intrusive thoughts about harming their child. A deeply religious person might experience blasphemous images. This isn’t a reflection of your character—it’s how OCD operates.

Compulsions

Compulsions are repetitive behaviors or mental acts that you feel driven to perform in response to obsessions. They’re aimed at reducing anxiety or preventing a feared outcome, even when you recognize their irrational nature.

Common compulsions in OCD include:

• Checking: Repeatedly verifying that doors are locked, appliances are off, or that you haven’t made mistakes
• Cleaning and washing: Excessive handwashing, showering, or cleaning rituals triggered by contamination fears
• Arranging objects: Needing items in specific positions, patterns, or symmetrical arrangements. Arranging objects compulsions can consume hours ensuring everything is “just right”
• Mental rituals: Silently counting, praying, or repeating phrases to neutralize obsessive thoughts
• Reassurance seeking: Repeatedly asking others for confirmation that everything is okay
• Avoidance: Staying away from situations, places, or objects that trigger obsessions

The cruel irony of OCD is that compulsions provide only temporary relief. Each time you perform a ritual, you reinforce the cycle—teaching your brain that the obsession was a real threat and the compulsion was necessary. Over time, OCD typically demands more.

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How OCD Therapy Works

Effective OCD counseling helps you break the cycle by changing how you respond to obsessive thoughts. Rather than fighting or avoiding obsessions, you learn to tolerate the anxiety they cause without performing compulsions. Professional OCD counseling provides structured support for this challenging work.

Our Approach to OCD Treatment

At Therapy Group of DC, we take a depth-oriented approach to OCD that addresses not just the symptoms but the underlying patterns that fuel obsessive-compulsive cycles. Our therapists integrate psychodynamic and trauma-informed perspectives to help you understand:

• Why certain thoughts become obsessive for you specifically
• How early experiences or relationship patterns may contribute to anxiety and the need for control
• What the compulsions are protecting you from or helping you manage
• How to develop insight into the psychological roots of your OCD

This approach recognizes that while OCD has neurobiological components, it also connects to deeper patterns in how you relate to uncertainty, anxiety, and yourself. Understanding these patterns can create lasting change that goes beyond symptom management.

Evidence-Based Approaches to OCD

The most researched treatment for OCD is Exposure and Response Prevention (ERP), a specific cognitive behavioral therapy technique. ERP involves gradually facing situations that trigger obsessions while resisting the urge to perform compulsions. This allows anxiety to naturally decrease over time and breaks the reinforcement cycle.

Cognitive Behavioral Therapy (CBT) for OCD helps you identify thought patterns that fuel obsessions, recognize how compulsions maintain the cycle, and develop new ways of responding to intrusive thoughts.

Acceptance and Commitment Therapy (ACT) focuses on accepting uncomfortable thoughts while committing to actions aligned with your values, rather than letting OCD dictate your choices.

Depending on your specific concerns and what resonates with you, therapy may integrate elements from different approaches to create treatment that addresses both the symptoms and their deeper roots.

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OCD Treatment in Washington DC

DC’s achievement-oriented culture can intensify OCD in particular ways. The pressure to perform perfectly, fear of making mistakes, and need to have everything under control aren’t just personality traits here—they’re professional requirements. For people with OCD, this environment can fuel obsessions about competence, checking behaviors, and relentless self-doubt.

Common patterns we see in DC clients with OCD:

• Excessive checking of emails, reports, or work before sending
• Difficulty delegating due to fear others won’t do things “correctly”
• Intrusive thoughts about making career-ending mistakes
• Perfectionism that extends checking rituals into every area of life
• Hiding symptoms from colleagues while struggling internally

The isolation of OCD can feel especially acute in a city where everyone seems to have it together. Many people suffer for years before seeking treatment, not realizing how common and treatable OCD actually is. The condition can strain relationships, limit career opportunities, and make everyday interactions feel overwhelming.

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What to Expect in OCD Therapy

Initial sessions focus on understanding your specific obsessions and compulsions, how they developed, and how they affect your daily life. Your therapist may conduct an assessment to confirm the diagnosis and rule out other conditions. Together you’ll create a treatment plan tailored to your needs and goals, establishing a foundation for effective obsessive compulsive disorder therapy.

The core work involves gradually facing your fears while learning not to engage in compulsive behaviors. This is challenging—intentionally triggering anxiety goes against every instinct. But with proper support and pacing, most people find it more manageable than they expected.

Progress isn’t linear. You may have setbacks, especially during stressful periods. OCD therapy teaches you skills to manage symptoms long-term, not just during treatment. Learning to manage anxiety without compulsions becomes easier with practice. Many clients find their tools become more effective with practice even after therapy ends.

Timeline varies based on OCD severity and how many areas of life are affected. Many people see significant improvement within 12-16 sessions of consistent ERP practice. More severe or longstanding OCD may require longer treatment.

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Our OCD Therapist

Dr. Jennifer Melo, Psy.D.

Dr. Melo works with clients struggling with obsessions and compulsions, bringing curiosity and warmth to understanding each person’s unique experience. She integrates trauma-informed and psychodynamic approaches to address not just the symptoms but the underlying patterns that may fuel anxiety. Her collaborative style helps clients feel understood while developing practical tools for managing OCD.

Dr. Melo also specializes in anxiety, phobias, trauma, eating disorders, and mood concerns. View Dr. Melo’s full profile →

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Begin OCD Therapy in Washington DC

Living with OCD is exhausting. The constant mental battle, the time lost to rituals, the shame of having thoughts you can’t control—it takes a toll that others rarely see.

But OCD is one of the most treatable mental health conditions. With the right therapy, you can change how you respond to obsessive thoughts and stop letting compulsions dictate your choices.

We offer both in-person sessions in Dupont Circle and telehealth throughout DC, Maryland, and Virginia. Therapy Group of DC is an out-of-network practice, and we provide documentation to help you seek reimbursement and maximize your out of network benefits from your insurance.

Schedule an Appointment →

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Frequently Asked Questions

What kind of therapist should I see for OCD?

Look for a licensed mental health professional (psychologist, licensed clinical social worker, or licensed professional counselor) with specific training in obsessive compulsive disorder treatment. An experienced obsessive compulsive disorder therapist who uses cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) has the strongest evidence base for treating OCD effectively.

Which therapy is best for obsessive-compulsive disorder?

Exposure and response prevention (ERP), a type of cognitive behavioral therapy, is considered the gold-standard obsessive compulsive disorder therapy. Research consistently shows it’s the most effective therapeutic approach for treating OCD, helping 60-80% of people experience significant symptom reduction. Obsessive compulsive disorder therapy works best when it includes systematic exposure work rather than reassurance or avoidance.

What will a therapist do for OCD?

A therapist will help you understand your specific obsession and compulsion patterns, develop a personalized treatment plan, and guide you through gradually facing fears while resisting rituals. They provide support, teach coping strategies, and help you build skills for managing OCD long-term. OCD counseling works for both adults and children, though treatment approaches may be adapted based on age and specific symptoms like contamination fears, harm obsessions, or hoarding behaviors.

What is the 15-minute rule for OCD?

The 15-minute rule is a technique where you delay performing a compulsion for 15 minutes when you feel the urge. During this time, the anxiety often naturally decreases, helping you realize you can tolerate discomfort without completing the ritual. It’s a stepping stone toward full response prevention.

What is the 3-3-3 rule for OCD?

The 3-3-3 rule is a grounding technique: name 3 things you can see, 3 sounds you can hear, and move 3 parts of your body. While not OCD-specific, it can help interrupt anxiety spirals and bring you back to the present moment when obsessions feel overwhelming.

What should you not say to someone with OCD?

Avoid saying things like “just stop thinking about it,” “everyone’s a little OCD,” or “have you tried just not doing the ritual?” These minimize how difficult OCD is to manage. Instead, acknowledge their struggle and encourage professional treatment without judgment.

Do I need medication for OCD?

Medication isn’t required for everyone with OCD, but it can be helpful—especially for moderate to severe cases or when OCD co-occurs with depression or other anxiety disorders. SSRIs (selective serotonin reuptake inhibitors) at higher doses than typically used for depression are the most common medications for OCD. Many people benefit from combining medication with therapy. We can coordinate with a psychiatrist if medication might be appropriate for you.