A thought pops into your head that disturbs you. You try to push it away, but it keeps coming back. So you do something. Check the lock again, wash your hands one more time, replay the conversation until it feels “right.” For a brief moment, the anxiety eases, but it never stays away for long. If this cycle sounds familiar, you may be living with obsessive-compulsive disorder (OCD).
At Old Town Psychology, our specialized therapists provide evidence-based OCD treatment for children, teens, and adults in Alexandria, VA. We have immediate openings, so you can start breaking the cycle now, not after a six-month waitlist.
What Is OCD?
Obsessive-compulsive disorder is a mental health condition defined by two interconnected experiences: obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that create intense distress and feel impossible to dismiss. Compulsions are the repetitive behaviors or mental rituals a person performs in an attempt to neutralize that distress or prevent a feared outcome.
It is important to understand that having an occasional intrusive or unwanted thought is a universal human experience. The difference with OCD is that these thoughts get stuck. They loop. They feel threatening. And the temporary relief provided by compulsions only teaches the brain to keep sounding the alarm, reinforcing the cycle rather than resolving it.
OCD can feel profoundly isolating and frightening, particularly because the content of obsessions is often disturbing or at odds with a person’s deeply held values. Many people with OCD feel shame about their thoughts, not realizing that the distress those thoughts cause is actually evidence of their character, not a reflection of their intentions. Understanding this distinction is a cornerstone of effective OCD treatment.
OCD Symptoms
OCD organizes itself around specific themes, and the obsessions and compulsions a person experiences tend to cluster around one or more of these areas. That said, symptoms can shift over time, and some people experience multiple themes simultaneously.
Common obsession themes include:
- Perfectionism: An intense fear of making mistakes, failing, or doing something imperfectly, often paired with a sense that something terrible will result from even small errors.
- Contamination: Fear of coming into contact with germs, bodily fluids, chemicals, or other perceived contaminants, and the distress of feeling “dirty” or unsafe.
- Harm: Intrusive thoughts about accidentally or intentionally harming oneself or others, even when the person has absolutely no desire to do so.
- Responsibility: An overwhelming fear of being responsible for a catastrophic event, such as a fire, accident, or someone’s illness or death.
- Sexual and relationship themes: Unwanted sexual thoughts, or excessive doubt about one’s relationship, partner, sexual orientation, or gender identity.
- Religious and moral themes: Fear of committing a sin, acting in an immoral way, or being fundamentally bad despite living according to one’s values.
- Health and illness: Persistent worry about contracting a serious illness or about physical symptoms that may signal disease.
- Existence and death: Recurring, distressing thoughts about mortality, the meaning of life, or the nature of reality.
- Body-focused: Preoccupation with automatic bodily processes such as breathing, blinking, or swallowing, which can become impossible to ignore once noticed.
Common compulsions include:
- Seeking repeated reassurance from others to temporarily quiet doubt or anxiety
- Checking behaviors, such as repeatedly verifying that doors are locked, appliances are off, or tasks have been completed correctly
- Excessive cleaning, handwashing, or showering to neutralize perceived contamination
- Rewriting, rereading, or editing messages, notes, or emails until they feel “just right.”
- Performing rituals or routines in a precise order or a specific number of times
- Compulsively researching topics online to confirm or disprove fears
- Arranging or organizing objects until they feel correct or symmetrical
- Mentally replaying events or conversations in search of certainty or relief
- Tapping, touching, or counting in a specific way to prevent something bad from happening
It is worth noting that compulsions are not limited to observable behaviors. Many people with OCD engage in mental compulsions, such as internally arguing against an intrusive thought, mentally reviewing past events, or silently praying. that are just as reinforcing as physical rituals.
Who Is Affected by OCD?
OCD does not discriminate by age, background, or personality. It affects an estimated 2 to 3 million adults and approximately 500,000 children in the United States alone. It is also one of the more commonly misunderstood conditions and is often trivialized in everyday conversation (“I’m so OCD about my desk”) in ways that fail to capture how seriously it can disrupt a person’s daily life, work, and relationships.
OCD frequently emerges in childhood or adolescence, though it can develop at any point across your lifespan. Because the content of obsessions can be so alarming or confusing, many people suffer for years before seeking help or receiving an accurate diagnosis. At Old Town Psychology, we treat OCD across the full lifespan, from children and teenagers navigating early symptoms to adults who have struggled for years without the right support.
How Is OCD Treated?
OCD responds exceptionally well to the right treatment. Research consistently shows that approximately 70% of people with OCD experience significant symptom relief with evidence-based therapy. At Old Town Psychology, our therapists specialize in Exposure and Response Prevention (ERP), the most well-researched and effective treatment for OCD available.
ERP works by targeting the cycle that keeps OCD going, rather than simply managing symptoms on the surface. Treatment involves three interconnected elements:
Exposure
With the guidance and support of your therapist, you gradually face the thoughts, situations, objects, or images that trigger your obsessions. Exposures are carefully planned and paced. You are never pushed further than you are ready to go.
Response Prevention
Rather than performing the compulsion that normally follows the trigger, you practice sitting with the discomfort and allowing it to pass on its own. Over time, this breaks the link between the obsession and the compulsion, and you build genuine confidence in your ability to tolerate uncertainty.
Retraining Your Brain
As you accumulate these new experiences, your brain begins to update its threat assessment. Intrusive thoughts lose their power. The urge to perform the compulsion weakens. Activities and situations you once avoided become accessible again.
In addition to OCD, our therapists have specialized expertise in treating a range of related conditions, including body-focused repetitive behaviors (such as skin picking and trichotillomania/hair pulling), tic disorders, hoarding disorder, body dysmorphic disorder, misophonia, and emetophobia. While these conditions share some features with OCD, each has its own distinct profile, and your therapist will work with you to develop a treatment approach tailored specifically to your experience.
Treatment at Old Town Psychology is always collaborative. We work alongside you, at your pace, to help you reclaim the parts of your life that OCD has taken over.
"We brought our daughter in for testing and the OTP team was amazing. They were so kind, caring and great with children. My daughter is shy and takes a little time to warm up when first meeting someone new. The Doctor was patient and encouraging and my daughter had a wonderful time. They also provide fast results and meet with you to explain everything in the report. I would definitely recommend them."
"Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met."
"Excellent service, knowledgeable staff, incredible responsiveness, diligence and follow through -- we feel lucky we found such a great therapy practice. We cannot recommend them highly enough!"
“My daughter took WISC-V test there and we are very pleased with our experience. They are professional, patient and wonderful throughout the entire process. My daughter had such a great time that she hardly felt that was a test - she even asked when she could take it again. I would highly recommend them to whoever needs child IQ testing services.”
“I took my children here for TAG testing. Both of my kids actually enjoyed their assessments. I was very pleased with the time and care taken to assess my children, the thoroughness of the report, and the fact that there was a follow-up session to discuss any questions that I had relative to the assessment included. Also-- the tea selection in the waiting room is top tier :)”
“Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met.”
Take the Next Step
Living with OCD is exhausting, but it does not have to be permanent. Effective treatment exists, and recovery is possible. At Old Town Psychology, we maintain immediate availability for new therapy clients. While many practices in the area have waitlists stretching six months or longer, we are ready to see you now.
Old Town Psychology is a boutique, concierge-level psychology practice in the heart of Old Town Alexandria, offering personalized, expert care for children, teens, and adults across the full lifespan.
To schedule a consultation or to ask any questions about OCD therapy, contact us today.
