What type of therapy helps with OCD?
If you live with OCD, you may already know how exhausting in your body the cycle can be
An intrusive thought appears, you make meaning of it, and now it feels worse. Your body reacts with anxiety, fear, disgust, or a sense that something is terribly wrong, off, or not quite right.
You try to make the feeling go away, perhaps by checking, researching, ruminating, avoiding, seeking reassurance, spriraling, or mentally reviewing what happened.
For a while, you may feel better.
Then the doubt comes back. Uncertainty feels like the only certain thing.
This is the cycle of OCD.
The good news is that OCD is treatable. The therapy with the strongest evidence for OCD is Exposure and Response Prevention (ERP), a specialized form of cognitive behavioral therapy (CBT).
ERP helps you gradually face thoughts, situations, or sensations that trigger OCD while learning not to respond with compulsions. ERP in EMDR has been shown to be even more effective due to the co-regulation during the exposures.
Where do Somatics fit in?
Somatic therapy focuses attention on what happens in the body—not just what happens in your thoughts.
OCD isn't only a mental experience. You may notice a racing heart, tight chest, stomach discomfort, agitation, tension, dread, or an intense feeling that you need to do something to make the uncertainty stop.
Learning to notice these sensations without immediately reacting to them can become an important part of developing a different relationship with anxiety and uncertainty.
Somatic work may be especially relevant when OCD exists alongside trauma, chronic anxiety, ADHD, burnout, or a nervous system that feels constantly in fight, flight and freeze. Did you know that your depression could just be a functional freeze trauma response in your OCD diagnosis?
It doesn't mean trying to make every uncomfortable sensation disappear.
Instead, the goal is to develop greater capacity to experience discomfort without automatically treating it as an emergency.
Finding the right OCD therapist
If you're looking for an OCD therapist, one of the most important questions to ask is whether they have specific training and experience treating OCD.
Not every therapist receives specialized OCD training. The International OCD Foundation recommends looking for a clinician who understands evidence-based OCD treatment, particularly ERP. In my case, ERP in EMDR.
You may also want to ask:
Do you treat OCD specifically?
Are you trained in ERP?
How do you work with mental compulsions and reassurance seeking?
How do you approach intrusive thoughts?
How might you incorporate somatic or nervous-system work when appropriate?
OCD treatment doesn't have to mean fighting your thoughts
One of the most important shifts in OCD treatment is learning that you don't have to solve every thought that your brain produces.
The goal isn't to achieve perfect certainty.
It's to become more comfortable with uncertainty, and to recognize that you can experience an uncomfortable thought, feeling, or body sensation without having to perform a compulsion.
ERP remains the first-line psychological treatment for OCD, while approaches such as mindfulness and ACT may be used as complementary approaches. EMDR currently has much less research support for OCD and should not be presented as a first-line OCD treatment.
If you're wondering whether OCD, trauma, anxiety, or a combination of these may be contributing to what you're experiencing.
You don't have to figure it out alone.
Kelli Lane Redfield, LMFT
Kelli is a licensed marriage and family therapist in California #158231, a private practice owner and trauma therapist highly specialized and trained in focused clinical work. She specializes in Somatic EMDR, working with creatives, professionals and high functioning adults seeking focused nervous system change. She offers weekly, ninety-minute and intensive formats, tailoring care to the nervous system, not a fixed timeline. If you're curious about Somatic EMDR or intensives, you're invited to reach out.
