OCD therapy for adults in Greenwich

What is OCD?

Obsessive-compulsive disorder (OCD) is a mental health condition where a person experiences intrusive, unwanted thoughts that create anxiety, followed by repetitive behaviours or mental rituals carried out to reduce that anxiety. It affects adults across Greenwich and south east London, and it responds well to focused psychological treatment.

The pattern is a cycle. An intrusive thought arrives, often about harm, contamination, doubt or something the person finds distressing to even think about. Anxiety follows. A compulsion, whether that’s checking, washing, counting, repeating a phrase or seeking reassurance, brings short-term relief. Over time the brain learns that the compulsion is what keeps the feared outcome away, and the cycle repeats, often taking up hours of the day. OCD is different from being tidy or careful. The thoughts are unwanted and often the opposite of what the person values, which is part of what makes them so distressing. OCD is one of the more common mental health conditions, and it can start at any age, though it often develops during the teenage or early adult years and can persist without treatment for a long time before someone seeks help.

Symptoms of OCD

Symptoms usually fall into two groups: obsessions and compulsions, though not everyone experiences both in equal measure.

Obsessions might include repeated images or thoughts of harm coming to someone, fears about contamination or illness, a need for objects or actions to feel exactly right, doubts about whether a door was locked or an appliance switched off, or intrusive thoughts with a sexual, violent or religious theme that feel completely at odds with the person’s character.

Compulsions can be physical, such as washing, checking, tapping or arranging objects, or mental, such as silently repeating words, reviewing past events for reassurance, or trying to replace a bad thought with a good one. People with OCD often know the thoughts and rituals don’t make logical sense, which adds a layer of frustration and, for many, real shame. Tiredness, difficulty concentrating and disrupted sleep are common knock-on effects when compulsions take up large parts of the day.

Common themes in OCD

OCD attaches itself to whatever a person cares about most, so themes vary widely. Contamination and cleaning is one of the more visible presentations, but plenty of people never wash their hands more than usual. Harm-related themes involve a fear of causing injury to someone, by accident or on purpose, even when the person has no history of aggression. Symmetry and order themes involve a need for things to feel “just right”. Relationship and sexual themes bring intrusive doubts about attraction, fidelity or identity. Moral and religious themes, sometimes called scrupulosity, involve a fear of having done something wrong or sinful. Health-related themes overlap with anxiety about illness. None of these themes say anything about a person’s character, values or intentions. A thought about causing harm reflects how OCD works, not a hidden wish to cause harm.

How therapy can help

Everyone has strange or unwanted thoughts from time to time. Therapy works by changing the relationship with those thoughts, so the compulsion is no longer needed to manage the anxiety, rather than by trying to make the thoughts themselves disappear. Cognitive behavioural therapy (CBT), including a technique called exposure and response prevention (ERP), is the approach recommended by NICE for OCD. ERP works by gradually facing feared situations or thoughts while resisting the urge to carry out the usual compulsion, so the anxiety has the chance to fall on its own rather than being managed away. Done gradually and with support, this builds tolerance for uncertainty, which is usually the thing OCD is asking a person to resolve completely, and can’t be. For some people, a GP may also discuss medication such as an SSRI alongside therapy, particularly where symptoms are more severe, though therapy alone is often the starting point.

Our approach

Sessions are delivered online by video call, which suits people managing OCD particularly well: rituals and avoidance often make leaving the house, or even a specific room, harder on a bad day, and online sessions remove that barrier. We work with adults across Greenwich and south east London, including Blackheath, Charlton, Deptford, Lewisham, New Cross and Maze Hill, and further afield, since the work happens over video rather than in a waiting room. Each course of therapy starts with time spent understanding how OCD shows up for that person specifically, what the obsessions are, what the compulsions look like, and what they cost, before building a plan around it. We will update this site as the practice develops.

What does OCD therapy involve?

An initial assessment covers the history of the difficulty, the specific obsessions and compulsions involved, and how they affect daily life, sleep, work and relationships. From there, therapist and client build a shared understanding, sometimes called a formulation, of what keeps the cycle going. ERP is then introduced gradually, usually as a hierarchy that moves from situations that provoke mild anxiety towards ones that feel much harder, with practice between sessions as well as during them. Homework matters in OCD therapy: change tends to come from repeated, real-world practice rather than the session itself. Progress is reviewed regularly, and the pace is set collaboratively rather than imposed.

When to seek help

OCD can develop slowly, so it’s often family or a partner who notices first, or the person themselves once compulsions start taking up so much time that work, sleep or relationships are affected. A GP is a reasonable starting point for a diagnosis or referral, and is worth involving if OCD is affecting daily functioning, or if intrusive thoughts are distressing enough to interfere with concentration or sleep. There’s no need to wait until OCD feels unmanageable before asking for support. Reaching out early is often easier than waiting, since compulsions that have been reinforced for years can take longer to shift than ones caught sooner.