Obsessive compulsive disorder (OCD, ERP)
Obsessive compulsive disorder can make the mind feel like a difficult place: repetitive thoughts, images or sensations appear, together with constant doubt and a feeling of urgency to resolve them or feel safe. Many people feel they have to understand, control or eliminate what they think, but those attempts often increase distress.
What happens in OCD?
In OCD, intrusive thoughts, sensations or images appear and generate anxiety, doubt, fear or guilt. To relieve that discomfort, the person carries out behaviours or rituals, which may be visible, such as checking or avoiding, or mental, such as analysing, repeating or trying to “neutralise” a thought.
In the short term these rituals bring relief, but in the long term they maintain the problem, because they reinforce the idea that doubt or discomfort must be resolved.
What does OCD treatment involve?
Treatment is based on learning to relate differently to thoughts, without entering the constant attempt to control, analyse or eliminate them. It is not about agreeing with them, but about stopping the response as if they were important or dangerous.
In this work I use ERP, Exposure and Response Prevention, a central approach in OCD treatment that helps you gradually face doubt or discomfort without doing the ritual that maintains the loop.
Work focuses on progressively reducing rituals, such as checking, avoiding or analysing, and learning to tolerate discomfort, doubt and uncertainty without responding automatically. This process is usually structured and supported, so that it is effective and sustainable.
What you can start changing
- Start noticing when you are entering the OCD loop: thought, anxiety and ritual.
- Gradually reduce automatic responses, such as checking, analysing or avoiding.
- Practise leaving thoughts unresolved, without trying to reach total certainty.
- Learn to tolerate discomfort without responding automatically.
- Recover activities and spaces that OCD has been limiting.
Recovering space in your life
The goal is not for thoughts to disappear, but for them to lose importance and stop directing your life. Over time, when you stop responding to them, they often appear with less intensity and frequency.
Treatment helps you step out of the OCD (ERP) loop and return your focus to what matters to you.
I am Carolina Palau Oltra, a psychologist in Barcelona. If you are looking for psychotherapy in Barcelona or support with OCD treatment using ERP, this may be a good place to start.