Treating OCD can be deceptively simple. People tell you how their OCD makes them suffer, and together you reverse engineer it, changing the thinking and the behavior that keep it running. If you found your way here, it’s because you got so good at this that it made you mad the first time you met someone you couldn’t seem to help. That someone almost certainly had the audacity to draw outside the lines of the little DSM box provided for OCD. Then you started noticing how many of them there are, and wondering why.

That person in front of you isn’t a tidy textbook case of contamination or checking. They arrive with anxiety, trauma, perfectionism, mood difficulties, neuro-differences — a whole weather system. So you might refer out for all the non-OCD messiness (“Get thee to a DBT-ary!”), only to find that splitting up the work worsens the very OCD you offered to treat. And if you go the other way and just treat the OCD diagnosis instead of the whole person, the OCD ducks behind whatever’s standing next to it.

So here’s what we’ll do for a full day together. Not a rigid manualized protocol you have to force your clients into, but a way of seeing the person in front of you. We’ll cover the meat and potatoes: ERP and CBT done well. Then I’ll show you how to smuggle in the pieces of DBT, RO-DBT, and ACT that keep a dysregulated or over-controlled client actually able to do the exposure work.

We’ll explore eight common OCD themes and the exact questions I ask to tell OCD apart from the things that only look like it. And we’ll get into the stuff that’s harder to fit in an outline: why self-criticism is itself a compulsion, why reassurance quietly turns into “proving,” and how to keep your compassion alive when a client’s behavior makes no sense to you at all.

You’ll walk away with a framework you can use Monday morning with the messy, real, wonderfully complicated people who actually sit down across from you. I appreciate your passion for reducing suffering. Let’s do this.