Why Therapy Didn’t Help Your OCD (And Why That Wasn't Your Fault)
If You’ve Been in Therapy for Years and Still Struggling with OCD You’re Not Alone
This might be a strange thing for a therapist to say, but I’m going to say it anyway:
Not all therapy is helpful.
And when it comes to Obsessive-Compulsive Disorder (OCD), the wrong kind of therapy can actually make things worse.
I say this not as an outsider looking in, but as someone who has spent years sitting in the therapist’s chair thinking I was helping, only to later realize I wasn’t.
This is a post for the people who’ve tried therapy, sometimes for years, and still feel stuck. For those who’ve done the “deep inner work,” processed childhood trauma, journaled about core beliefs, and explored every corner of their past… only to find themselves still checking, still ruminating, still obsessing.
This is also a post for therapists because if I’m being honest, I wrote it for myself a few years ago.
When Good Therapy Isn’t the Right Therapy
There are so many ways therapy can be helpful. It can heal relationships, resolve trauma, change self-narratives, and create space for authenticity and growth. But when it comes to OCD, talk therapy alone won’t cut it.
In fact, it can lead you further away from recovery.
Here’s why:
OCD isn’t about the content of your thoughts, it’s about your relationship to uncertainty. And talk therapy, when applied like a blanket solution, often makes the mistake of trying to solve the content.
As therapists, we’re trained to validate feelings, explore past wounds, and offer insight. We want to help clients make sense of their thoughts. But when a client comes in with OCD and says, “What if I hurt someone and don’t remember it?” and the therapist responds with, “Let’s explore why that thought is coming up,” it sends the wrong message.
Because to the OCD brain, exploration is reassurance. And reassurance is the compulsion. It’s the thing we need to resist, not lean into.
The Hard Truth: I’ve Reassured Clients Too
There are moments I look back on in my early years of practice with a pit in my stomach. I remember clients describing intrusive thoughts, sometimes deeply disturbing ones, and me trying to soothe them:
“It’s okay, I don’t think you’re a bad person.”
“That sounds like anxiety, not reality.”
“I know you and you would never actually do something like that.”
I meant well. I truly did. But I was accidentally reinforcing the very loop that kept them stuck. I was co-compulsing, which is doing the compulsion for them under the guise of therapy.
I was helping them feel better in the short term, while unknowingly strengthening the OCD cycle in the long term.
It took specialized training, and a lot of humility, for me to recognize what was happening. And once I saw it, I couldn’t unsee it. I’ve had to go back, consult, retrain, and, in some cases, apologize.
If Your Therapist Doesn’t Specialize in OCD, It’s Not Your Fault
Let’s be clear: if therapy hasn’t helped your OCD, you are not broken, and you did not fail treatment. More likely, treatment failed you.
OCD is incredibly nuanced, and unless a therapist has received specific training in Exposure and Response Prevention (ERP) or related protocols like Inference-Based CBT, they probably weren’t equipped to treat it effectively, no matter how compassionate, skilled, or well-intentioned they were.
In fact, many therapists graduate with little to no training in OCD-specific interventions. That’s not your therapist’s fault either, it’s a flaw in the broader mental health system.
What’s heartbreaking is how many clients stay in therapy for years, building rapport, feeling seen, but not getting better because the clinical approach doesn’t match the condition.
Rapport Is Important. But It’s Not Enough.
I’ve had clients tell me, “I really liked my therapist. I just didn’t feel like I was making progress.” And that makes sense. A strong therapeutic relationship is vital because it creates safety, trust, and motivation. But rapport without the right intervention is like trusting your GPS while driving in the wrong direction.
You can feel connected. You can feel supported. You can even feel heard. But if you’re doing traditional talk therapy for OCD, you might still be stuck in a loop that therapy alone can’t break.
That’s because OCD isn’t just about understanding the “why.” It’s about learning to tolerate the “what if” without solving it.
Why Talk Therapy Doesn’t Work for OCD
Let’s look at why traditional talk therapy falls short for OCD:
It encourages analysis. But OCD sufferers are already over-analyzing.
It seeks insight. But insight doesn’t change compulsive behavior.
It validates fears. But OCD craves certainty, not truth.
It creates space to express. But expression can turn into mental rumination.
It reinforces self-reassurance. Which keeps the compulsion loop alive.
ERP (Exposure and Response Prevention) flips this model on its head. Instead of digging into the fear, we lean into the uncertainty on purpose. We expose ourselves to the thought and practice not doing the compulsion.
It’s uncomfortable. It’s counterintuitive. And it works.
So What Does Effective OCD Treatment Look Like?
Effective OCD treatment requires more than insight. It requires action. Here's what that often looks like in a well-structured program:
Psychoeducation: Understanding how OCD functions as a cycle
Hierarchy building: Gradual exposure to fears based on distress levels
ERP (Exposure and Response Prevention): Facing triggers without ritualizing
Values-based work: Helping clients live in alignment with their values—not their fears
Skill-building: Tolerating discomfort, resisting compulsions, building resilience
When you’re in the right kind of therapy, progress feels different. It’s not always fast, but it is measurable, directional, and empowering.
What You Deserve to Know as a Client
If you’ve been in therapy for years and you’re still caught in the same loops, please know:
You didn’t fail therapy. It just wasn’t the right approach.
You’re not weak for not getting better with talk therapy. OCD needs more.
You’re not ungrateful for questioning a therapist who cares deeply for you.
You deserve effective, evidence-based treatment.
Therapists are human too. We don’t always know what we don’t know. But you shouldn’t have to carry the cost of our learning curves. You deserve care that’s informed, ethical, and tailored to what actually helps.
What to Ask When You’re Seeking OCD Treatment
If you’re currently in therapy (or looking for a new therapist), here are some questions you can ask:
“Do you have training in ERP or OCD-specific treatment protocols?”
“How do you approach compulsions in therapy?”
“What’s your stance on reassurance-seeking in OCD?”
“Do you create exposure hierarchies or use behavioral experiments?”
A trained OCD therapist won’t just say, “I’ve worked with anxiety.” They’ll know the specific treatment models and how to apply them.
Final Thoughts: From One Human to Another
Writing this post brings up both humility and hope. Humility, because I know I’ve made these mistakes. Hope, because I’ve also seen what happens when clients finally receive the treatment they needed all along.
They get better.
Not instantly. Not effortlessly. But steadily, meaningfully, and often, dramatically.
If you’ve spent years in therapy without progress on your OCD, it’s not because you didn’t try hard enough. It’s not because you’re resistant or complicated. It’s likely because no one gave you the tools that actually work.
Now you know what to look for. And that changes everything.
If you’re ready for treatment that truly targets OCD, we’d be honored to help. Our clinic is built around evidence-based interventions like ERP and the Unified Protocol. We don’t just support your healing, we structure it. Reach out today to see how we can help.