You've been in therapy before. Maybe for years. You've talked through your anxiety, your patterns, your history. And still, something keeps pulling you back into the same loops — the what-ifs that won't resolve, the checking that only helps for a moment, the intrusive thoughts you've never said out loud to anyone. You've wondered if something is just fundamentally wrong with you, or if you're somehow too anxious to get better.
What if the missing piece isn't more talk therapy — but a different understanding of what's actually happening?
Many people living with OCD don't know that's what they have. It doesn't always look like hand-washing or locked doors. It can look like years of health anxiety that no amount of reassurance touches. It can look like intrusive thoughts you've kept secret because you're convinced having them means something terrible about you. It can look like rumination so constant it feels like just the way your mind works.
At Compassionate Tides Therapy, I work with adults who are ready to understand what's driving the loop — and to find a way out that actually holds.
OCD Therapy
Online in California & Bay Area
You might be in the right place if:
You've been told you have anxiety or depression, but something about that explanation has never quite fit. You spend significant time each day managing worry, doubt, or intrusive thoughts — even when nothing "bad" is happening. You seek reassurance from others, from Google, or from your own mental reviewing, and it helps briefly before the doubt returns. You've developed rituals or routines that feel necessary even though you know, on some level, they aren't solving anything. You avoid certain situations, conversations, or even thoughts because of how distressing they feel. You have thoughts that frighten or disgust you and you've never told a therapist — because you're afraid of what it says about you.
OCD is one of the most underdiagnosed and misdiagnosed conditions in mental health. If any of this sounds familiar, it's worth exploring whether OCD might be part of your picture.
Is this you?
What makes this approach different
Most OCD treatment is built around Exposure and Response Prevention, and ERP is genuinely powerful — it has the strongest research base of any psychological treatment for OCD, and it forms the foundation of the work I do. But ERP alone doesn't address everything. It doesn't ask why the doubt felt so believable in the first place. It doesn't account for the parts of you that have organized around OCD for years, sometimes decades, convinced that the vigilance is the only thing keeping you safe. And it can feel impossible to engage with when your nervous system is already overwhelmed.
My approach to OCD is blended and trauma-informed, drawing on:
ERP (Exposure and Response Prevention) — the behavioral foundation. Gradually building your capacity to face uncertainty without compulsive response, and teaching your nervous system that the alarm doesn't require a ritual to resolve.
I-CBT (Inference-Based Cognitive Behavioral Therapy) — working upstream of the doubt. Rather than focusing on what you do after an obsessional thought arrives, I-CBT examines how OCD convinced you the thought was worth listening to in the first place. Particularly useful for health anxiety, Pure O, and presentations rooted in deep doubt or distrust of your own perception.
IFS (Internal Family Systems) — parts work. Many people with OCD have parts of themselves that are exhausted, ashamed, or terrified of what would happen if the OCD were gone. IFS creates space to understand those parts rather than fight them, which often makes the behavioral and cognitive work more sustainable.
Somatic and trauma-informed approaches — because OCD lives in the body too. If your nervous system has been in a state of chronic threat for years, cognitive and behavioral work alone may not be enough. I integrate body-based approaches to help regulate the nervous system alongside the OCD-specific treatment work.
This is not a softer version of OCD treatment. It is a more complete one.
Frequent presentations I work with:
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The worry that something is wrong with your body — a symptom, a sensation, a result — that no doctor's reassurance can fully resolve. Health anxiety is one of the most common and least recognized presentations of OCD, and one of the most exhausting to live with.
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Intrusive thoughts about harm, relationships, identity, morality, or existence that feel sticky, distressing, and impossible to dismiss. Pure O is often invisible to others — there are no external rituals, just a relentless internal process. Many people with Pure O have never told anyone what they're experiencing because the thoughts feel too shameful or too strange.
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The more recognizable face of OCD — but no less complex underneath. Contamination and checking presentations often involve a profound distrust of one's own memory and perception, and can be deeply intertwined with trauma history and nervous system dysregulation.
What to Expect
We begin with a thorough assessment to understand your OCD presentation, your history, and what has and hasn't worked before. From there, treatment is individualized — there is no single protocol that fits every person. Some people begin with psychoeducation and parts work before moving into exposure-based approaches. Others are ready to start behavioral work sooner. The pace is yours.
Sessions are telehealth, available to adults across California. I am a private-pay practice and can provide superbills for potential out-of-network reimbursement.
Frequently Asked Questions
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Yes — and this is more common than most people realize. OCD is frequently misdiagnosed as generalized anxiety, depression, or a personality issue, particularly when it doesn't involve visible rituals. If you've been working on anxiety in talk therapy for a long time without meaningful traction, OCD is worth exploring.
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Exposure work is part of the gold-standard treatment for OCD, and I do incorporate it, but not as a starting point for everyone. We build toward it in a way that makes sense for your nervous system, your history, and your readiness. Some people also benefit significantly from I-CBT as a primary approach, particularly if exposure work has felt impossible before.
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No. Intrusive thoughts — including violent, sexual, or morally distressing ones — are a core feature of OCD, not a reflection of your character or desires. One of the most important things I can offer is a space where you can say the thought out loud, possibly for the first time, without it being treated as evidence of who you are.
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The short answer is that a proper assessment is the best way to find out. The longer answer is that OCD and anxiety share features but have important differences in how they're maintained and what helps. A 20-minute consultation is a good place to start.
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Yes — this is actually a population I work with often. A previous experience of ERP feeling overwhelming or unhelpful doesn't mean treatment can't work. It often means the approach needs to be different, better paced, or supplemented with other modalities that address what ERP alone left untouched.
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Yes. I offer a free 20-minute consultation for prospective clients. You can book directly here.
If you've spent years managing something that never fully resolves; the doubt, the loops, the thoughts you can't say out loud.
You don't have to keep doing it alone.
OCD is treatable. And treatment can be humane.
