If you’ve been thinking about exploring therapy for OCD, you might be wondering what actually happens once you start. Maybe you’ve spent a lot of time trying to understand your thoughts and experiences on your own, or you’re worried that talking about them will be overwhelming and too difficult. And if you’ve never tried therapy before, starting the process might feel uncertain and overwhelming. It makes sense to want to know what you’re walking into before taking that first step. You deserve to feel informed, comfortable asking questions, and included in the process.
Your first session: Getting to know you
Our first session is a chance for me to learn about what’s been bringing you to therapy, how OCD or intrusive thoughts have been affecting your life, and what you hope might feel different over time. You can expect space to share at your own pace, ask questions, and begin getting a sense of whether working together feels like a good fit.
What you might notice: You may feel nervous, relieved, unsure what to say, or a mix of emotions. Please know you don’t need to have everything figured out before we meet, or after the first session!
Your first month: Understanding your patterns
During the first few weekly sessions, we’ll begin exploring how OCD shows up for you, including intrusive thoughts, compulsions (which can be mental or physical), reassurance seeking, checking, or other patterns that may be keeping you stuck. We’ll talk about how approaches such as Cognitive Behavioral Therapy, Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT) may support your goals, and we’ll work together at a pace that feels manageable. At this stage I will likely ask you to start keeping a diary to track intrusive thoughts and compulsions. This helps to build awareness and starts to put you back in the drivers seat, instead of letting OCD run the show.
What you might notice: You may begin recognizing patterns you hadn’t fully understood before, including how much energy goes into trying to feel certain, prevent something bad, or make an uncomfortable thought go away.
The months after: Practicing a different response
As therapy continues, we’ll work together on responding to uncertainty and intrusive thoughts in ways that help you spend less time caught in compulsive patterns and more time engaging with the life you want to live. Depending on your needs and goals, sessions may include ERP, ACT, mindfulness, self-compassion, and somatic or experiential practices that help you notice your experience with greater awareness, and respond differently. It’s important to remember that therapy is a process, and these things don’t change over night! They change with practice and consistency.
What you might notice: Progress may look like recognizing a familiar OCD loop sooner, spending less time reviewing or engaging in compulsive behaviors, or returning your focus to something meaningful even when uncertainty is still present.
There may also be sessions that feel difficult, frustrating, or slower than you hoped. We can talk about that together and adjust our approach as we go. Therapy isn’t about getting every step right. It’s about learning what helps you move toward the life you want, and trusting the process of growth and change.
Common questions about OCD therapy
How long does OCD therapy take?
There isn’t one timeline that fits everyone. The length of therapy depends on your goals, your experiences, and what feels helpful as we work together.
Am I expected to do things between sessions?
Depending on your goals and the approach we’re using, we may discuss practicing skills or working on agreed-upon steps between sessions. I highly recommend doing homework in between sessions, because this helps the process move along. We will practice skills in session, but applying them in your day-to-day life will help them stick!
What if talking about my intrusive thoughts feels hard or scary?
Intrusive thoughts can feel scary to open up about. They often conflict with our values, or even directly attack them. You don’t have to share everything at once or find the perfect words. Like any relationship, it takes time to build trust with your therapist and it may take you time to fully open up. That’s okay.
What if I’m not sure whether I have OCD?
You don’t need to arrive with all the answers. We can talk about what you’ve been experiencing and explore whether OCD-focused support may be a good fit, without relying on a social media checklist to define your experience.
Will therapy make my thoughts disappear?
I cannot promise that you’ll never have an intrusive thought again- but I do know that this work can change the way you respond to and relate to intrusive thoughts. Therapy can also reduce the intensity of compulsive patterns, and make more room in your life for the things that matter to you.
Thinking about starting OCD therapy?
I’m Victoria Shore, a Licensed Marriage and Family Therapist offering in-person therapy in West Hollywood, and virtual therapy throughout California and Tennessee. I work with people navigating OCD, including “Pure O” and mental compulsions, alongside anxiety and complex or relational trauma.
If you’re curious about working together, you can reach out through my contact page to schedule a free 15 minute phone consultation. I’d be honored to support you.
