OCD Therapy
If you are living with OCD, you already know that the rituals and the checking are not irrational to you. They are the only things standing between you and an anxiety that feels unbearable without them.
As an OCD therapist in Beverly Hills, I offer psychoanalytic psychotherapy for adults and adolescents seeking to understand what drives the obsessions and compulsions. In-person and online across California.
Understanding OCD
Most people think of OCD as a problem of behavior: the washing, the checking, the counting, the need to get things just right. But OCD is not a behavioral problem. It is a psychological one. The rituals exist because the mind built a system to manage an anxiety that felt otherwise unbearable, and that system became self-reinforcing.
This is what the OCD cycle looks like from the inside: an intrusive thought arrives, unbidden and disturbing. Anxiety floods in. The ritual provides a moment of relief. And then the thought returns, often stronger, demanding more. The cycle tightens over time because the relief never addresses what the anxiety is actually about. It only postpones the encounter.
What appears irrational from the outside is not irrational to the person caught inside it. The rituals are doing psychological work. They are containing something, keeping at bay a fear or a conflict or an unthinkable thought that feels too dangerous to face directly. In psychoanalytic work, we are interested in what that something is. Not to eliminate the anxiety through force or exposure, but to understand what drives it so the need for that level of control can begin to ease from within.
I work with adults and adolescents from my office in Beverly Hills and online throughout California.
Common Signs of OCD
What does OCD feel like? For most people, it begins long before anyone uses the word obsessive-compulsive. It feels like being trapped in a loop you cannot escape, where the relief of completing a ritual lasts only a moment before the doubt rushes back in. You may recognize some of the following:
Checking locks, appliances, or messages repeatedly, even when you know you already checked.
Washing or cleaning until your skin is raw, driven by a contamination fear that logic cannot touch.
Rewriting, erasing, or restarting work because something looked or felt wrong in a way you cannot fully explain.
Intrusive thoughts that feel alien or disturbing, thoughts about harm, morality, or contamination that do not reflect who you are but refuse to leave.
A need for reassurance that provides relief for a moment and then demands more, so that no amount of confirmation is ever enough.
Avoidance of situations, places, or people that trigger obsessive thoughts, gradually narrowing your life.
Rituals that expand over time, taking longer, becoming more elaborate, consuming hours of the day.
In adolescents, OCD often appears as rigidity around homework or routines, difficulty leaving the house on time, or sudden distress when a sequence is interrupted. Symptoms of OCD in teens are frequently misread as defiance, laziness, or anxiety alone, when the underlying pattern is compulsive.
My Approach to Working with OCD
My approach to OCD therapy is psychoanalytic. I am not an ERP therapist and I do not ask you to expose yourself to feared situations and resist the compulsion. Instead, I work to understand what the rituals are containing and what the intrusive thoughts are circling around, so the grip of OCD can loosen from the inside rather than being overridden from the outside.
In our sessions, we will:
Explore what the obsessions and compulsions are protecting, the unbearable thoughts, fears, or conflicts that the rituals exist to keep at bay.
Understand what the intrusive thoughts are circling around, because obsessions rarely land on their subjects by accident. The content of the thought carries meaning, even when it feels senseless.
Work with the need for control as it appears in our relationship, because the same patterns that drive OCD in daily life often emerge between us, giving us something to understand together in real time.
Create conditions for the anxiety to ease from within, not through forced exposure, but through the kind of understanding that makes the defenses less necessary over time.
This is a different path than behavioral treatment. Exposure and Response Prevention works by building tolerance to anxiety. Psychoanalytic therapy works by understanding what the anxiety is about. Some people come to me after ERP, finding that the symptoms returned or shifted. Others come because they want to understand why their mind works this way, not only learn to manage it.
How OCD Affects Daily Life
OCD does not stay contained. It extends into every domain of life, consuming time and energy that you cannot recover through willpower alone.
Time and Routine: Rituals that consume hours of the day. Inability to leave the house because the checking sequence was not completed correctly. Lateness, exhaustion, and a sense that your time does not belong to you. Sleep disrupted by rituals that must be performed before the day can end.
Relationships: Reassurance-seeking that strains patience and trust. Hiding rituals from people close to you out of shame. Difficulty with intimacy and vulnerability because closeness can trigger obsessive doubt about the relationship itself.
Work and School: Checking and rechecking work until deadlines pass. Inability to complete tasks because they never feel done. Procrastination driven not by laziness but by the fear of beginning something that cannot be made perfect.
Self-Worth: Shame about the thoughts, particularly intrusive thoughts involving harm or morality. Feeling defective or broken for having a mind that produces content you find repulsive. Isolation that follows from the belief that others would be horrified if they knew what you think.
Frequently Asked Questions about OCD
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Psychoanalytic therapy helps with OCD by exploring the unconscious conflicts that give obsessions and compulsions their power. Rather than focusing solely on stopping the behavior, this approach asks what the symptoms mean: what fear, guilt, or unresolved experience keeps the cycle in motion. As the emotional sources of OCD become visible and speakable in therapy, the symptoms often lose their grip.
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Moral OCD, sometimes called scrupulosity, is a form of OCD centered on an intense, distressing preoccupation with right and wrong. People with moral OCD experience intrusive thoughts about whether they are a good person, whether they have done something harmful, or whether their intentions are pure. The compulsions often take the form of mental reviewing, reassurance-seeking, or confession. The suffering is real and disproportionate to any actual moral failing.
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Harm OCD centers on intrusive thoughts about causing harm, thoughts that feel unbearable precisely because they contradict everything you value. The person experiencing harm OCD is not dangerous, and the thoughts do not reflect hidden desires. The intensity of the distress is itself evidence of how deeply opposed you are to the content of the obsession. Therapy can help you understand why these particular thoughts have taken hold and what gives them their power.
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OCD and anxiety share features like persistent worry and difficulty tolerating uncertainty, but they differ in structure. Anxiety tends to focus on realistic concerns taken to an extreme. OCD involves intrusive thoughts that feel foreign to who you are, paired with compulsions aimed at neutralizing the distress. Many people experience both. A thorough assessment can clarify whether what you are experiencing is anxiety, OCD, or a combination.
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OCD and trauma frequently coexist, and traumatic experiences can trigger or intensify OCD symptoms. From a psychoanalytic perspective, OCD may develop as the mind's attempt to impose order and control in response to an experience where control was lost. The rituals and obsessions serve a protective function, even as they become a source of suffering. Therapy that addresses the underlying trauma often helps the OCD as well.
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Perfectionism and OCD can overlap, but they are not the same. In OCD, the drive for exactness or correctness is experienced as compulsive: it does not feel chosen, and it is accompanied by significant distress when the standard is not met. Perfectionism without OCD may involve high standards and self-criticism but typically lacks the intrusive, repetitive quality of obsessions. When perfectionism feels involuntary and consuming, an OCD evaluation may be warranted.
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OCD does not follow a single trajectory. For some people symptoms fluctuate over time, intensifying during periods of stress and easing during calmer periods. Others experience a gradual worsening without treatment. OCD rarely resolves on its own, but therapy can change its course significantly. The earlier OCD is addressed, the less entrenched its patterns tend to become.
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Yes. I offer OCD therapy in person at my Beverly Hills office, located at 9615 Brighton Way. I also offer telehealth sessions to clients throughout California. I see adults and adolescents from across the Westside, including Santa Monica, Brentwood, Westwood, and West Hollywood. If you are looking for a perfectionism therapist in Beverly Hills or the greater Los Angeles area, both in-person and online sessions are available.
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I offer a free 15-minute consultation to see if we're a good fit.