OCD Treatment in Rockville Centre, NY

OCD is a cycle of obsessions and compulsions. Obsessions are intrusive thoughts, images, or urges that feel urgent or threatening. Compulsions are behaviors or mental rituals done to get relief or certainty. Relief is short lived, which keeps the cycle going. OCD can look very different from person to person. Many people have primarily mental compulsions like rumination, reassurance seeking, or checking how they feel.

Intrusive thoughts are unwanted thoughts, images, or urges that pop into your mind. Most people have them sometimes. In OCD, the problem is not the thought. It is the way the brain treats the thought as important or dangerous, and the compulsions used to neutralize it. Intrusive thoughts in OCD often target what matters most to you. They feel upsetting because they are unwanted, not because they reflect your character.

Obsessions are the intrusive experiences. Compulsions are what you do next to reduce distress or gain certainty. Compulsions can be visible, like checking or washing. They can also be mental, like reviewing conversations, repeating phrases, analyzing your feelings, praying until it feels right, or seeking reassurance. A quick rule. If you feel driven to do it to feel better or more certain, it is likely a compulsion.

“Pure O” is a common term for OCD that looks mostly internal. People still have compulsions. They are just mental. Rumination, mental checking, reviewing, reassurance seeking, and avoidance are common. Because the compulsions are less visible, people often feel confused about why they cannot stop. Treatment still targets the same cycle. Learning to respond differently to obsessions without doing rituals.

Yes. Many clients have primarily mental compulsions such as rumination, reassurance seeking, reviewing conversations, or testing their feelings. ERP and ACT can be tailored for these internal rituals.

Both can involve worry. OCD tends to involve intrusive, sticky doubts and urges, and a strong drive to do compulsions to get certainty or relief. Anxiety can involve more realistic worry about life stressors without a specific ritual pattern. Many people have both. A structured assessment can clarify what is happening and what treatment approach will work best.

Exposure and Response Prevention (ERP) is the gold standard treatment for OCD. It involves gradually approaching triggers while practicing response prevention, meaning you do not do compulsions. Over time, your brain learns that the obsession is not an emergency and anxiety can rise and fall on its own. ERP is collaborative and paced. Good ERP is not flooding. It is tailored to your symptoms, values, and goals.

Yes. Acceptance and Commitment Therapy (ACT) helps you change your relationship to intrusive thoughts and feelings. Instead of trying to eliminate uncertainty or discomfort, you practice making room for them while taking valued action. ACT skills pair well with ERP. Especially for rumination, self-judgment, and the urge to control internal experiences.

It depends on symptom severity, how long OCD has been present, and how consistently you can practice between sessions. Many people see meaningful improvement within a few months with weekly sessions and regular practice. Some benefit from more intensive treatment at the start. The goal is not to never have intrusive thoughts. The goal is to stop getting stuck in the OCD cycle.

Some people benefit from medication, especially when symptoms are severe or depression is present. Many people improve with therapy alone. If medication is part of your plan, it can work alongside ERP and ACT. If you are unsure, we can talk about the pros and cons and coordinate with a prescriber if needed.

Yes. Telehealth is available for clients located in New York and New Jersey, and in person sessions are available in the Nassau County, Long Island area. If you are not sure what applies to your location, you can ask during a free 15-minute consultation.