Are intrusive thoughts normal?

Yes. Many people experience intrusive thoughts. OCD involves getting stuck on them, interpreting them as dangerous or meaningful, and feeling compelled to neutralise them.

What’s the difference between OCD and being a perfectionist?

Perfectionism can overlap with OCD, but OCD involves obsessions and compulsions aimed at reducing threat and uncertainty. The behaviours often feel urgent, repetitive, and hard to resist.

Does reassurance help OCD?

Usually only briefly. Reassurance tends to reduce anxiety in the moment but reinforces the need for reassurance long-term. Therapy helps you step out of that pattern.

What if my OCD is mostly in my head?

That’s very common. Mental compulsions like reviewing, analysing, and neutralising can be just as powerful as visible rituals. Therapy works with both.

Can therapy help if I’ve had OCD for years?

Yes. OCD can be persistent, but it is treatable. Therapy focuses on the maintaining cycle and helps you rebuild confidence and freedom over time.

Do you offer OCD therapy in London and online?

Yes. We offer therapy in London and online across the UK.

OCD Therapy

Obsessive Compulsive Disorder (OCD) involves intrusive thoughts, images, urges, or doubts (obsessions) and the pressure to do something to reduce the anxiety they create (compulsions). OCD can feel exhausting because the mind demands certainty and safety, but certainty never lasts for long.

Many people with OCD know their fears don’t fully make sense, yet the anxiety still feels real. Others worry that having a thought means something about them, or that failing to do the “right” mental or behavioural ritual could lead to harm, guilt, or unbearable responsibility.

At Hampstead Psychology, we offer evidence-based therapy for OCD in London and online across the UK. We help you understand your OCD cycle and reduce the patterns that keep it going, in a paced and compassionate way.

This page is for information and does not replace a clinical assessment, diagnosis, or medical advice.

When OCD starts to take over

You might recognise some of these experiences:

You get stuck in doubt and feel you can’t relax until you’re certain.
You check things repeatedly (locks, appliances, messages, work) but still don’t feel reassured.
You seek reassurance from others, but the relief fades quickly.
You repeat actions or routines until they feel “just right.”
You avoid people, places, or situations that trigger intrusive thoughts or uncertainty.
You feel distressed by intrusive thoughts and worry they mean something about you.
You do a lot of mental rituals: reviewing, counting, praying, neutralising, or “figuring it out.”
You spend a long time researching or analysing risks to feel safe.
You feel guilty, responsible, or terrified of making a mistake.
OCD is taking time, energy, and freedom from your life.

If this fits, it doesn’t mean you’re dangerous or “going mad.” Intrusive thoughts are a common human experience. OCD is what happens when the mind treats them as urgent threats and pulls you into a cycle of compulsive coping. Therapy helps loosen that cycle.

How OCD can show up

Intrusive thoughts and fear of what they “mean”

OCD often targets what matters most to you: safety, morality, relationships, responsibility, or identity. The thoughts feel unacceptable or frightening, and the mind tries to get certainty that you’re not a bad person, not at risk, or not capable of harm.

Compulsions you can see, and compulsions you can’t

Some compulsions are visible: checking, washing, ordering, repeating, asking others. Others are internal: mental reviewing, analysing, neutralising, counting, or trying to “feel sure.” Both can keep OCD powerful because they teach the brain that the obsession was a real danger.

Rumination and “solving”

Many people experience OCD as endless mental problem-solving. The mind insists that if you think long enough, you’ll finally get certainty. Therapy helps you step out of the rumination loop and tolerate uncertainty without having to resolve every doubt.

Avoidance and life shrinking

Avoidance can look like staying away from triggers, reducing responsibilities, postponing decisions, or avoiding relationships and intimacy. It can also look like avoiding your own mind. Avoidance gives short-term relief, but it strengthens OCD over time. Therapy helps you expand life again, carefully and safely.

Related difficulties we often see alongside OCD

OCD often overlaps with anxiety, low mood, panic symptoms, insomnia, perfectionism, intense self-criticism, and burnout. People may also experience shame and isolation because OCD can feel difficult to explain.

Therapy takes the whole picture into account while keeping the work focused on the OCD cycle.

What keeps OCD going?

OCD is often maintained by a loop that makes sense in the moment.

An intrusive thought, doubt, image, or sensation appears.
Your mind interprets it as important and dangerous: “I must be certain,” “I can’t risk it,” “What if this means something?”
Anxiety rises and you feel pressure to do something to neutralise it.
You respond with compulsions: checking, reassurance, avoidance, or mental rituals.
Anxiety reduces briefly.
The brain learns, “That worked — good thing we did it,” so the obsession returns and the cycle strengthens.

Therapy helps you step out of this loop by reducing compulsions and changing the way you relate to intrusive thoughts and uncertainty.

How therapy for OCD helps

At Hampstead Psychology, we use approaches that are widely used in evidence-based psychological practice. For OCD, therapy is typically CBT-informed and often includes principles from Exposure and Response Prevention (ERP), tailored carefully to your needs. We may also integrate ACT and compassion-focused work where it helps, especially when shame and self-criticism are central.

In practice, therapy involves mapping your OCD pattern clearly, identifying the compulsions that keep it going (including mental rituals), and gradually building the ability to face uncertainty without neutralising. This is done in a paced, collaborative way, so the work is effective without feeling overwhelming.

The aim isn’t to get rid of every intrusive thought. The aim is to reduce the fear response and the compulsion cycle, so OCD stops dictating your life.

What to expect from sessions

We begin by understanding your OCD in context: what the themes are, what triggers it, what you do to cope, and what impact it has on your day-to-day life. We’ll create a shared map of the cycle and agree goals that matter to you.

Sessions are structured and collaborative. You’ll leave with insight that feels usable and practical steps to try between sessions, reviewed and refined over time. Progress often comes from small, consistent changes rather than pushing through with willpower.

How long does therapy take?

This varies. Some people want focused work on a specific OCD theme or compulsion pattern. Others benefit from longer work, especially when OCD has been present for years, overlaps with depression or trauma, or is tied to long-standing self-criticism and fear of responsibility.

We review progress together so therapy stays purposeful and aligned with your goals.

Menopause therapy in Hampstead and online

We offer menopause-related therapy in person in London and online across the UK. Many people choose online sessions for convenience and privacy, and it can work extremely well when you have a quiet space to focus.

Take the next step

If OCD has been pulling you into doubt, checking, reassurance, or exhausting mental loops, you don’t have to keep living under that pressure. With the right support, the cycle can soften, and your life can start to feel more open again.

Contact Hampstead Psychology to enquire about OCD therapy in London or online.

Useful links: Anxiety Therapy, Panic Attacks, Insomnia and Sleep Problems, Stress and Burnout, Depression Therapy, Fees, Meet the Team, Contact.

Urgent Help

If you are worried about immediate risk to your safety, call 999 or go to A&E. If you need urgent support but it isn’t an emergency, contact NHS 111 or your GP. You can also contact Samaritans on 116 123 (24/7).

Meet The Team

At Hampstead Psychology, all of our psychologists have extensive training to doctoral level and decades of experience in their field of expertise. You will be matched with a psychologist that has the knowledge and skill to help you understand and overcome your problem - not just in the short term but for good.