Obsessive-Compulsive Disorder (OCD)
OCD is widely misunderstood as tidiness or perfectionism. It is neither. It is a condition in which intrusive, unwanted thoughts, images, or words/phrases generate intense distress, and compulsions develop as attempts to neutralize that distress.
What are obsessions and compulsions?
Obsessions are recurrent, intrusive thoughts, images, or urges that feel alien and are distressing. They are unpleasant and unwanted.
Compulsions are repetitive behaviors or mental acts performed to reduce the distress — checking, washing, counting, lining up objects, seeking reassurance, mentally reviewing, and engaging in self-soothing rituals. They work briefly, which is exactly why the cycle strengthens.
Does OCD always involve cleaning or checking?
No, and this is the most consequential misconception. Substantial subtypes involve no visible behavior at all. Common themes include harm obsessions, taboo obsessions of a sexual or religious nature, relationship obsessions, and health-related obsessions. The compulsions in these subtypes are often entirely mental — reviewing, analyzing, seeking certainty — which is why they can persist for years without anyone recognizing OCD.
I am having disturbing intrusive thoughts. Does that mean I want to act on them?
No. The defining feature of OCD intrusive thoughts is that they are horrifying to the person having them. That distress is the opposite of intent.
People with harm-themed OCD are not dangerous. They are frightened, and they typically go to great lengths to avoid the very thing they fear. The fear of being dangerous is the symptom.
This is particularly relevant postpartum, where intrusive thoughts about harm coming to the baby are common and treatable. Please see postpartum depression and anxiety.
How is OCD treated?
OCD responds well to treatment, though the approach differs from anxiety in important ways. Serotonergic medications are first-line and often require higher doses and longer trials than for depression — frequently ten to twelve weeks for adequate assessment. Stopping at week four because “it isn’t working” is a common and avoidable error.
Exposure and response prevention (ERP) is the therapy with the strongest evidence, and it is specific — general talk therapy is not the same thing, and reassurance-focused therapy can make OCD worse by feeding the compulsion. We refer to ERP-trained clinicians and manage the nutraceutical and medication side.
Why does reassurance make it worse?
Because reassurance-seeking is itself a compulsion. It relieves distress briefly and reinforces the underlying belief that certainty is required and obtainable. Treatment involves tolerating the uncertainty rather than resolving it — which is counterintuitive, and is why the specific therapy matters.
If you are in crisis, please immediately call or text 988 for the Suicide & Crisis Lifeline, or call 911. Safety is our top priority, and our outpatient office is not equipped to handle emergencies.
Treatment in person and throughout Arizona
We see patients in person at our office in Glendale (in the Arrowhead area) and via telehealth anywhere in Arizona — from Tucson, to Flagstaff, to the east valley, and everywhere between. Virtual visits are the same appointment with the same provider at the same rate.
Getting Started
Our comprehensive, new patient evaluations are $375 and require 60 to 90 minutes.
Our psychiatric follow-up visits are $125 and require 30 minutes.
(Thank you for arriving early, as we are unable to see late patients and must reschedule if life gets in the way of you arriving on time.)
We are out-of-network with all insurance carriers but will gladly provide a superbill you can submit to insurance to seek reimbursement.
For more info, please see our fees page.
Pinnacle Psychiatry
17505 N 79th Ave, Suite 309, Glendale, AZ 85308
Phone 623.321.2221 · Text 877.749.7502
Monday–Wednesday 8:00am–5:00pm · Thursday 7:00am–5:00pm