OCD Therapy and the Practice of Responding Differently
In my last post, I talked about the idea of surrendering control and learning to do nothing-not more-when you have anxiety. I discussed how this is a paradoxical approach to managing anxiety, rumination, and OCD in a world that is (no pun intended) obsessed with "emotional regulation."
I also talked about how tools used to regulate emotions can become compulsive and feed into anxiety sensitivity (when you become overly sensitive to the sensations associated with anxiety), which can actually make anxiety and OCD worse. With anxiety disorders, anxiety sensitivity, and OCD, we often want to learn to do less, not more, when we are experiencing distress.
Why "Nervous System Regulation" Isn't One-Size-Fits-All
I know this might sound confusing, especially in today's world, where everyone and their mother is preaching nervous system regulation as if it's a cure-all. And please don't get me wrong-I value feeling regulated and taking good care of ourselves. But nervous system regulation is not one-size-fits-all: what regulates you might not regulate me, especially if I have OCD.
A Real Life Example
So, as always, let me use a hypothetical situation to better illustrate my point. Let's say Maria has health OCD, and she recently noticed that she has been having a lot of heartburn. This isn't unusual for her, especially during times of stress, and she's been under a lot of stress recently. Maria has had her heartburn checked out before, and her doctor was not concerned that it could be anything serious.
Still, every time she experiences heartburn, she feels anxious. Anxious that it could be something life-threatening, like stomach cancer, but also anxious that the anxiety itself will lead to more heartburn, and then more anxiety. (In short, she is having anxiety about anxiety.)
How Rumination Fuels the OCD Cycle
Maria gets lost in rumination: What if this is stomach cancer? What if I can't stop thinking about it, and then I get more anxiety, and then more heartburn? What if it never goes away? The more she ruminates and tries to answer these "what if" questions, the more her anxiety increases-which is the last thing Maria wants.
When Self-Care Becomes a Way to Control Anxiety
Maria enjoys self-care and is athletic, so she tries to bring her anxiety down through self-care tools and by trying to "regulate" her nervous system-a term she keeps hearing on the Instagram accounts she follows. She goes to the gym daily, stops drinking caffeine, practices grounding and breathing exercises, and journals regularly. On the outside, she is taking great care of herself, and these tools are helpful for supporting a healthy lifestyle-which is why Maria feels so frustrated. If she is taking such good care of herself and trying to regulate her nervous system, why is she still so anxious? Why can't she stop obsessing about the heartburn?
The Problem: Trying to Control the Uncontrollable
It's because she is doing all of these things in an attempt to make her anxiety and thoughts go away. She is trying to control her mind, her emotions, and ultimately the future of her health. The problem is that she cannot fully control these things. That's right-we are not in control of our thoughts or our emotions, and many aspects of our lives, including our bodies and health, are ultimately outside of our control.
Yes, there are preventative things we can do to support our minds, our mood, and our health-and I think this is where these tools can be incredibly valuable. For example, I'm all for going to the gym, meditating and grounding exercises, spending time in nature, and slowing down. These are all things I try to do consistently because they can support overall well-being. But these tools won't make anxiety disappear, just like they can't guarantee that we won't experience health issues.
Why Trying Harder Can Make OCD Worse
Going back to the example of Maria-the fact that she leads a healthy lifestyle and incorporates nourishing activities for her mind and body into her daily life may make her less vulnerable to OCD and anxiety spikes, but they don't make the condition disappear. In fact, the more she increases these tools in a desperate attempt to make OCD go away, the more she sends the message to her mind that her thoughts and anxiety are dangerous. She is giving them more energy by trying so hard to get rid of them.
The more her mind perceives these intrusive thoughts and anxious feelings as dangerous, the more anxiety she will feel when they show up.
The Paradoxical Approach: Allowing Anxiety Instead of Fighting It
This is where the paradoxical approach comes in. If we can allow sensations of fear, panic, and anxiety to exist in our body-without interpreting them as an emergency, real danger, or a failure of our nervous system-then over time, our bodies learn that it is safe to feel anxious sometimes. And paradoxically, we begin to feel less anxious.
Our minds also learn that intrusive thoughts are not dangerous if we accept a few key things:
We are going to have them from time to time.
We cannot control them or make them go away (think about it-if I tell you not to think of a pink elephant, could you do it? Probably not).
We can only change how we respond to them-by learning to disengage, not answer "what if" questions, and ultimately surrender control over what we cannot control.
Rebuilding Trust in Yourself
Trust- in Maria's case, this means trusting the information her doctor provided, trusting that she would likely recognize if she were having a medical emergency, and trusting the general guidelines around heartburn. Learning to trust again is a big part of OCD therapy.
OCD Counseling in Boston, MA & San Diego, CA
If you see yourself in Maria's experience-trying to do everything "right" but still feeling stuck in anxiety, rumination, or intrusive thoughts-this is often where OCD therapy can be especially helpful.
Jen Lescher offers OCD counseling for individuals in Boston, MA and San Diego, CA, working with clients who feel caught in cycles of overthinking, anxiety about anxiety, and the pressure to control their 1. internal experiences.
Working with an OCD therapist focuses on helping you step out of those cycles-learning how to respond differently to intrusive thoughts, reduce compulsions (including the subtle ones), and build a more trusting relationship with your mind and body.
Begin Practicing a Different Approach to Anxiety & OCD
If this idea of "doing less, not more" feels unfamiliar-or even uncomfortable-that makes sense. It goes against a lot of what we're taught about managing anxiety.
But this is the shift: not trying to get rid of anxiety, but changing how you relate to it. If you’re ready to begin OCD counseling, follow the steps below:
Reach out here to learn more about OCD counseling and schedule a consultation
Explore more blogs on rumination, intrusive thoughts, and ERP
Start noticing where you might be trying to control your internal experience-and gently practice letting go, even in small ways
Additional Services Offered
Along with one-on-one OCD therapy, I also offer supportive resources that address challenges many clients face outside of sessions. On the Common OCD Themes page, you can explore detailed insights into recurring thoughts and behaviors. The OCD and Social Life page offers guidance for managing friendships, dating, and relationships while living with OCD and anxiety.
About OCD Therapist Jen:
Hi, I'm Jen.
I'm a therapist, coffee enthusiast (honestly, it's my favorite ritual of the day), and a big believer in finding small moments of presence-whether that's through mindfulness, photography, or a quiet walk with my camera in hand. Photography helps me stay grounded and see the world with a little more curiosity, and that same mindset shows up in my work with clients. I've been drawn to spirituality and healing work since I was a teenager, exploring everything from meditation to energy practices. But I'm also someone who loves blasting music in the car and getting lost in a true crime podcast. I think healing can include both stillness and movement, reflection and laughter. Therapy should have room for all of that. Since 2007, I've worked in a range of mental health settings, which taught me that healing isn't one-size-fits-all. It's personal, evolving, and sometimes messy-but always possible.
Training & Background:
Inference-Based CBT (ICBT) for OCD - The OCD Training School & The Cognitive Behavioral Institute
Certified in Exposure and Response Prevention (ERP) - The Cognitive Behavioral Institute
Gottman Method Couples Therapy - Level 1
Master's in Social Work - Portland State University, 2012
