Intrusive Thoughts: 7 Effective Strategies for Management
The Night I Thought I’d Gone Backwards
I still remember this one evening—a client, let’s call her Pam, came in for her weekly session looking defeated. She sat down, stared at the floor, and whispered, “I had a horrible thought this morning… again. I thought therapy was supposed to stop this.”
You could feel the shame in the room.
Now, as someone who’s worked with OCD for years, especially here in Edinburgh, I’ve heard this countless times. And let me say it loud and clear: having intrusive thoughts doesn’t mean you’re failing at therapy. Not even close.
But I get it. When you’re showing up each week, doing the hard work, facing fears head-on, and those thoughts still sneak in? It feels like all your effort might be pointless.
So, let’s take a deep breath and break this down. What’s happening when intrusive thoughts linger—and what does real progress in OCD therapy look like?
What Really Are Intrusive Thoughts?
Let me ask you something—have you ever had a random, horrible thought pop into your head and thought, “Where the hell did that come from?”
Like you’re walking down the street and suddenly think, “What if I pushed that person into traffic?” Or you’re holding a baby and get this awful image of dropping them. Or maybe a thought flashes in your head during prayer that feels blasphemous or just plain wrong.
Yeah. That.
These are intrusive thoughts. They’re unwanted, distressing, bizarre, and totally out of character. And here’s the thing: everyone has them. Yep—even your neighbour who always looks put-together or that smiling yoga instructor on Instagram. But for people without OCD, the brain just shrugs them off.
With OCD? It’s different.
These thoughts don’t just pass through. They stick. And not because they’re more intense or more dangerous—just because your brain’s alarm system goes haywire and says, “Wait, that thought might mean something… better make sure.”
Let me tell you about a client—let’s call him Ravi. He came into my Edinburgh clinic terrified he might be a paedophile because he had a split-second intrusive image while babysitting his niece. He cried in the session. He avoided seeing her again. He scoured Google for reassurance. He couldn’t sleep.
But here’s the most important part: he loved his niece deeply and would never hurt a child. That’s why the thought caused him so much pain.
Intrusive thoughts are often the exact opposite of who you are and what you care about. They attack the things that matter most—morality, safety, identity, love.
So, if you’ve had a thought and gone, “Does this mean I’m a bad person?”—you’re not alone. I’ve sat across from countless people in that same storm. Some are convinced they’re secretly evil, others are terrified they’ve committed a crime and forgotten it, or are obsessed that they’ll lose control and harm someone they love.
But here’s the real kicker: it’s not the thought that causes the suffering—it’s what happens after.
That urge to dissect the thought, check your memory, avoid situations, Google for answers, confess to others—those are the compulsions. They’re your brain’s way of saying, “Let’s make sure we’re safe.” But the more you try to push the thought away, the louder it gets.
I sometimes explain it like this: intrusive thoughts are like quicksand. The more you struggle, the deeper you sink. The trick is to stop wrestling and start floating.
It’s not easy—I won’t sugarcoat it. But it’s possible. I’ve seen it time and time again.
Here’s another story: Anna, who dealt with intrusive sexual thoughts about her partner’s family, told me she felt “like a monster.” Her biggest fear? That her therapist (me!) would look at her differently. But when she shared it, I didn’t flinch. I saw a brave, kind woman trying her absolute best to find peace.
And you know what she said a few months later?
“I still get the thoughts… but they don’t scare me anymore. They’re just noise now.”
That’s what healing looks like.
So if you’ve been trapped in a loop of awful thoughts, convinced they say something about who you are—please hear this: your thoughts are not facts. They are not intentions. They are not truths.
They’re just thoughts. And you are so much more than that.
What do you think might happen if, just for a moment, you stopped trying to make the thoughts go away—and started letting them be there, without judgement?
So Why Do They Stick Around During Therapy?
This is such a common and painful question. And honestly, I don’t blame anyone for asking it. I’ve heard it so many times in sessions: “Why are the thoughts still here? I’ve been coming every week. I’ve been doing everything I’m supposed to. Isn’t therapy supposed to make them go away?”
I get it. When you’ve been living with intrusive thoughts that shake you to your core, that steal your sleep, that make you question everything about who you are—you just want relief. A break. Some peace. Therapy feels like your last hope, so it’s completely natural to expect it to make the thoughts vanish.
And yes, ERP (Exposure and Response Prevention) therapy does help. But not in the way people often expect.
Let’s break it down a bit.
When someone starts CBT with ERP, they usually come in with the hope that the therapy will stop the thoughts—as if we can flip a switch and silence the brain. That makes total sense. But unfortunately, that’s not how it works.
In fact, let me tell you about Jamie, one of my past clients. He had intrusive harm thoughts about stabbing his partner. Totally out of character—he loved her deeply and had never hurt anyone. In our first few sessions, he kept asking me, “When will these thoughts stop?” He was convinced that until they disappeared, he was unsafe. That he was broken.
But here’s what we worked on together: not getting rid of the thoughts, but learning how to stop dancing with them.
Because the truth is, ERP isn’t designed to eliminate intrusive thoughts. If anything, it gently invites them in. Wild, right?
It helps you practice sitting with the thought—feeling the anxiety without needing to neutralise it, fix it, confess it, or check if it’s “just OCD.” It’s about changing your relationship to the thought, not the content of the thought itself.
Think of it like a pushy salesperson at your door. If you keep trying to shoo them away or argue with them, they’ll keep knocking. But if you just nod and walk past without engaging, eventually, they’ll stop trying so hard.
With ERP, you’re teaching your brain that these thoughts aren’t emergencies. That they can show up, and you can carry on. You’re not fighting them—you’re learning not to fear them.
Over time, this creates space. And in that space, something magical happens: your reaction softens. The panic isn’t as sharp. The urge to “fix it” weakens. And yes, eventually, for many people, the thoughts do show up less often. But that’s not the goal—it’s the side effect of healing.
I remember when Jamie came in a few months later and said, “I had the thought again last night… but it didn’t rattle me. I just let it be there and made dinner.”
That right there? That’s the shift. That’s real progress.
So if you’re wondering why the thoughts haven’t stopped, please don’t take it as a sign that therapy isn’t working. The goal of ERP isn’t control—it’s freedom. Freedom from fear, from compulsions, from the belief that your thoughts define you.
The thoughts might still show up. But your world doesn’t have to stop because they do.
Imagine being able to think something awful and not spiral. To feel the fear, and still move forward. That’s what ERP can give you.
You’re not doing it wrong. This is the work. And it’s working—even if it doesn’t feel like it yet.
What would it be like to stop chasing certainty and start trusting that you can handle the uncertainty instead?
Progress Isn’t What You Think
Let’s get real for a second—because if you’re anything like the clients I work with, you’ve probably had this thought more than once: “If I’m still having intrusive thoughts, I must be doing something wrong.”
We live in a world that loves quick fixes, don’t we? One-click deliveries. Instant downloads. “10 steps to total calm.” It’s no wonder so many people come into therapy expecting results to look like a steady, upward climb. As if progress should mean fewer thoughts, no anxiety, and feeling “normal” again as soon as possible.
But OCD recovery doesn’t work like that. Not even close.
In fact, sometimes progress feels a lot like failure.
Let me tell you about one of my clients, Aisha. She came in terrified of contamination—everything from door handles to her own clothes made her feel unsafe. She told me on her third session, “I just want this fear to go away. I want to be normal again.” Totally understandable.
A few weeks into ERP, she told me she was still washing her hands more than she’d like, still feeling gross after touching things, still second-guessing herself. Her first instinct? To say, “I’m not getting better. What’s the point?”
But then I asked her, “Did you wash your hands immediately after touching the bin this week like you usually do?”
She paused. “Well… no. I waited five minutes first. I hated it. But I didn’t run to the sink.”
That’s it. That’s progress.
Because here’s the thing: progress in OCD treatment isn’t about feeling good all the time. It’s about building tolerance. Building flexibility. Building courage.
It looks like:
-
Noticing a scary thought and not reacting with the same urgency you once did.
-
Feeling the full force of the urge to do a compulsion, and waiting a little longer before giving in—or maybe not giving in at all.
-
Hearing your brain whisper its worst fears, and instead of panicking, thinking, “That’s just my OCD talking,” and continuing with your day.
Even if your heart’s pounding. Even if you feel like you’re pretending. Even if part of you still wants to run away.
I had another client, Tom, who once said something I’ll never forget:
“It still feels awful. But now it feels awful, and I can still go to work.”
That’s growth. That’s what this work is really about.
We don’t measure success by the absence of symptoms. We measure it by your ability to live with the symptoms, without letting them steer the ship.
Some days, that might mean you resist every compulsion. Other days, you might cave a little—but even then, noticing what happened and learning from it? Still counts.
It’s like going to the gym. The first time you lift weights, it’s heavy, clumsy, exhausting. But each rep strengthens you—even when it doesn’t feel like it. Especially when it doesn’t feel like it.
So if you’re sitting there thinking, “But I still feel anxious… I must be stuck,” take a breath. What if the presence of anxiety isn’t proof of failure, but proof that you’re engaging with the hard stuff?
Because let me tell you—this work is hard. It’s courageous. It’s the furthest thing from failing.
You are retraining your brain, rewiring responses that have been in place for years. And that’s not going to feel like progress in the way we usually define it. But if you look closely, if you zoom in on the small moments—you’ll start to see the shifts.
You won’t always feel it in big, dramatic ways. Sometimes you’ll notice that you’re living more. Avoiding less. Laughing more. Worrying a little less about the noise in your head.
Progress might not look like the end of anxiety. But it does look like getting your life back.
So, what if your discomfort wasn’t a sign that therapy is failing… but a sign that it’s working?
“But I Had a Setback This Week…”
Totally normal. In fact, setbacks are part of the process.
OCD is sneaky. It can change themes, twist logic, or ramp up the volume when it feels ignored. That doesn’t mean therapy is failing.
Sometimes the most difficult weeks in therapy are the ones where you’re making the most significant changes internally.
Can you imagine that?
Why the Thoughts Feel Worse Sometimes
Oh, friend… I hear this one all the time. And trust me—it breaks my heart when someone walks into the therapy room, slumps into the chair, and says something like,
“I thought I was getting better. But this week? It all came crashing back. What if I’m back at square one?”
Let me tell you something right off the bat: setbacks are not failures. They’re not proof that you’re doing something wrong. They’re not a sign you’re broken or beyond help.
They’re part of the process. An expected, messy, completely normal part of recovery.
OCD is sneaky like that. Just when you think you’ve got a handle on it, it’ll try a different angle. Change themes. Bring back an old fear with a new twist. Or crank the volume up on a thought you were starting to ignore.
It’s not because you’re going backwards. It’s often because you’re going forward.
Let me give you an example. One of my clients—I’ll call her Grace—had been working on relationship OCD. We’d spent weeks helping her resist the urge to check if she really loved her partner mentally, or if she’d picked “the right one.”
She was doing great. Really. And then one week, she came in in tears.
“I thought it was gone. But now it’s back, and worse. What’s wrong with me? I feel like I’ve lost all the progress I made.”
We sat for a minute in silence. Then I asked her, “What did you do when the thoughts came up this time?”
She wiped her eyes and said, “Well, I didn’t Google anything. I didn’t ask him for reassurance. I just sat with it. But it felt unbearable.”
There it was. The progress she couldn’t see.
She had a setback—but this time, she didn’t go back to all the old rituals. She didn’t let the fear drive her actions. That’s growth. That’s therapy working.
Setbacks are actually a bit like growing pains. You’re stretching beyond your comfort zone. Challenging patterns that have been rooted in your brain for years, sometimes decades. So yeah—it’s going to feel uncomfortable. But discomfort isn’t danger. It’s healing in motion.
I’ve had clients tell me that their hardest weeks were the ones that ultimately changed everything. Why? Because that’s when they realised they could survive the fear. Sit in the chaos. Keep going, even when it felt like they couldn’t.
I remember one guy, Daniel, who dealt with intrusive thoughts about harming his family. He’d been doing well—really well. Then he had a bad week. The thoughts came rushing back after he’d felt “almost normal” for a while. He panicked, convinced he was slipping.
But when we talked it through, it turned out that something had triggered an old fear—one he hadn’t faced yet. So rather than seeing it as a failure, we reframed it: This isn’t backsliding. This is a new opportunity. This is your brain saying, ‘Here’s one more place to heal.’
And that shift? That understanding? It changed everything for him.
Because recovery isn’t linear. It’s full of loops and detours. You move forward, then sideways, then backwards for a day, then forward again. That’s how real change happens.
Can you imagine training for a marathon and expecting every run to feel easy? Or learning a new language and never mixing up the words? It doesn’t work that way—and therapy’s no different.
So next time you have a setback, don’t beat yourself up. Don’t assume the worst. Instead, ask yourself:
-
Did I face something hard this week?
-
Did I handle it differently than I would have a month ago?
-
Did I show up even when it felt awful?
Because if the answer to any of those is yes—then you’re not failing. You’re healing.
Setbacks might feel like a storm, but they’re often clearing the path for deeper growth. And you don’t have to go through them alone.
What if your setback was a sign that you’re ready for the next level?
You’re Not Alone in This
I know this part can feel incredibly lonely.
When you’re in the thick of OCD, especially during the hard parts of therapy—the parts where everything still feels raw and unresolved—it’s so easy to believe that you’re the only one struggling like this. That may be something’s uniquely wrong with you. That maybe other people are breezing through treatment while you’re stuck.
But let me gently remind you: you are not alone in this.
In the UK, OCD affects over 750,000 people, according to OCD-UK (2024). That’s hundreds of thousands of people—friends, parents, teachers, nurses, artists—many of whom have sat exactly where you are now. Staring at the floor. Wondering if they’re doing therapy right. Wondering if they’ll ever get their life back.
I’ve worked with so many of them. People from all walks of life who tell me, sometimes through tears, “I thought I was the only one who had thoughts like this.”
You should see the relief that floods their face when I say, “You’re absolutely not.”
One of my clients, Sarah, a mother of two, once told me that her OCD made her feel like a “secret monster.” She had intrusive thoughts about harming her children, even though she loved them more than anything. She spent months in silence before finally coming to therapy, convinced no one would understand.
When she finally spoke those thoughts out loud—and I didn’t flinch—her shoulders dropped for the first time in months.
“You mean other people think this too?” she asked, voice trembling.
Yes. So many people do. But OCD is cruel in its isolation—it tells you that your thoughts are unforgivable. That no one else could possibly relate. And that’s simply not true.
A 2023 study in the British Journal of Clinical Psychology found that over 60% of people starting ERP therapy reported fears of failure, doubts about their progress, and a sense of feeling “stuck” in the first three months.
That’s not a sign of brokenness. That’s a sign that your brain is doing something really difficult—learning to sit with discomfort rather than run from it.
Imagine learning to ride a bike without stabilisers for the first time. You’re wobbly, unsure, scared you’ll fall. That doesn’t mean you’re not learning—it means you’re right on track.
And that same study found that most of those same individuals went on to report significant improvement after continuing with therapy. The storm at the beginning wasn’t a failure—it was the beginning of change.
I can’t tell you how many times a client has come in, convinced they’re the only one therapy doesn’t work for. They’ll say things like,
“What if my brain is just different?” or “Maybe this just works for other people.”
And each time, I can offer the same reassurance: You are not the exception. You are not beyond help. You are not alone.
One of the most powerful parts of therapy—especially ERP—is recognising that what you’re experiencing is a shared human struggle. It doesn’t mean it’s easy. But it does mean you’re part of a much bigger story—one where healing is absolutely possible.
You might not see it in the people around you. OCD is often invisible. It hides behind smiles, behind small talk, behind phrases like “I’m fine.” But it’s there. And so are the people doing the brave, quiet work of recovery. Just like you.
So if you’re reading this, thinking you’re the only one battling these thoughts, this fear, this doubt—I promise you, you’re not. There are so many others right now who feel exactly the same way. And they’re walking the same road.
You’re part of a community—one filled with strength, courage, and resilience.
What if, just for today, you let yourself believe that you don’t have to carry this alone?
The Trap of “Therapy Performance Anxiety”
Yep, it’s a thing. And if you’re sitting there thinking, “Oh no… this is me,”—you’re definitely not alone.
One of the lesser-talked-about struggles for people with OCD is this sneaky little mindset that creeps in during therapy: Am I doing this right?
OCD and perfectionism tend to go hand in hand. It’s part of what makes OCD so relentless—it convinces you that things have to be “just right” before you can relax. And unfortunately, that same perfectionism often finds its way into the therapy room.
So instead of allowing therapy to be a space for exploration, learning, and self-compassion, it can quietly become another area where you feel you need to “get it perfect.”
Clients say things to me all the time, like:
-
“I didn’t respond to that thought perfectly. Did I undo all my progress?”
-
“I gave in to a compulsion. Does that mean I’ve failed?”
-
“Shouldn’t I be further along by now?”
I once had a client, Ben, who would mentally review our sessions the minute he got home. He’d replay everything he said, trying to analyse whether he’d responded to exposures the “right” way or said something that made me secretly think he wasn’t taking therapy seriously.
He even admitted he sometimes scripted what he’d say before our sessions to sound like a “good” client.
And my heart just sank.
Because here’s the truth: you don’t need to earn your place in therapy. You don’t have to get it “right.” There’s no gold star for perfect exposure compliance or being the most eloquent person in the room.
You’re already doing something incredibly brave just by showing up.
But I get it. I really do.
OCD makes you doubt everything—even your own healing. It tells you you’re failing when you’re not. That your therapist is judging you (we’re not, by the way). That one step backward means the whole staircase has crumbled.
Let me tell you something that might surprise you: some of the most powerful work I’ve seen happen in therapy has come from moments when clients felt like they were falling apart.
Like my client Lila, who burst into tears halfway through session six because she gave in to a compulsion the night before. She was so upset with herself, saying, “I’ve ruined it. I was doing so well.”
But instead of seeing that moment as a failure, we sat with it. Looked at what was happening underneath. And it turned out—that moment? It was a breakthrough. She realised how harsh she was being with herself, how her OCD had turned even her recovery into another thing to obsess over.
After that session, everything shifted. She began to approach herself with more softness, more patience. And that, in my opinion, was a huge win.
Because progress in therapy isn’t a clean, straight line. It loops, dips, and sometimes it takes you sideways. It spirals, flattens out, surprises you, and yes—sometimes it feels like you’re stuck when you’re actually just building strength under the surface.
And here’s something else: doing ERP therapy “imperfectly” is still doing it. Pausing for 10 seconds before a compulsion is still better than reacting instantly. Recognising an intrusive thought after you’ve spiralled is still part of learning. You’re rewiring your brain in real time.
So if you’ve ever left a session wondering if you “did therapy wrong,” please hear me when I say: you didn’t. The fact that you care so much is already a sign that you’re engaged in the process.
OCD might try to turn therapy into another performance, another test to pass, another way to judge yourself. But therapy isn’t school. It’s not about getting everything right.
It’s about showing up for yourself, again and again, even when it’s messy.
Especially when it’s messy.
So, what if the very moments you think you’re failing in therapy… are the moments you’re healing the most?
What “Doing Therapy Right” Really Looks Like
It’s not about feeling good all the time. It’s about being willing to feel discomfort without letting it control your actions.
That’s real strength.
You’re doing therapy right if you’re:
-
Facing feared situations (even if your anxiety spikes).
-
Resisting rituals—even just once a day.
-
Letting go of mental review—even for a few minutes.
-
Practising self-compassion when things get messy.
Doesn’t sound like failure, does it?
But What If I’ve Been in Therapy for Months?
Okay, so here’s where it might help to check in.
If therapy feels like it’s going in circles, or if your therapist isn’t familiar with ERP (the gold standard for OCD), you might not be getting the right type of help.
ERP is specific. It’s targeted. And it’s effective.
I’m Federico Ferrarese, a CBT therapist here in Edinburgh, and I specialise in helping people with OCD using ERP. I’ve seen clients who’ve tried 2 or 3 therapists before they finally got the right fit—and everything changed.
Sometimes it’s not you—it’s the treatment approach.
Let’s Talk About ERP for OCD
ERP (Exposure and Response Prevention) is tough but transformative.
You basically expose yourself to the thought or situation that triggers anxiety—and then you resist the urge to neutralise it. Over time, your brain learns: “Hey, I can handle this.”
According to the National Institute for Health and Care Excellence (NICE), ERP is one of the most effective treatments for OCD, with up to 60–80% of people experiencing significant improvement.
Why It Takes Time
This is the bit no one likes to hear. And I totally get it.
When you’re suffering, when your brain feels like a war zone, when you’re exhausted from battling terrifying thoughts day after day—you want relief, yesterday. You want to know that the effort you’re putting in, the tears you’re crying, the courage it’s taking to walk into therapy every week—it’s going to pay off fast.
But here’s the truth, and I’ll say it gently: changing how your brain responds to fear takes time.
This isn’t a quick fix. It’s not a light switch. It’s more like healing a sprain—you can’t rush it, or you’ll make it worse. You have to let the process unfold, even when you’re impatient, even when it feels like nothing’s happening.
Think of ERP like lifting weights at the gym—but instead of biceps and glutes, you’re training the mental muscles that help you tolerate uncertainty, discomfort, and anxiety. And just like at the gym, the first few sessions feel awkward. Your form’s a bit off. You doubt if anything is changing. You leave sore, shaky, sometimes even wondering, Why am I putting myself through this?
That’s all part of the work.
I had a client—let’s call him Mark—who struggled with intrusive thoughts about contaminating others. He was scared to touch door handles, sit on public benches, or even breathe near someone in case he passed something on. He’d spent years building rituals to feel “safe.” Avoiding people, over-sanitising, obsessively checking.
We started ERP slowly. Week by week, he challenged those rituals. First, just touching a light switch without washing his hands. Then, leaving the house without his usual “safety objects.” Small steps—but massive for him.
After six weeks, he came in frustrated. “I still feel anxious. It’s not working.”
I asked him what he did the previous day.
He said, “I touched a handrail on the bus and didn’t wash my hands for half an hour. But I felt terrible the whole time.”
I smiled and said, “Mark, that’s the work. You did it. You tolerated it. That discomfort you felt? That’s your brain rewiring.”
Because here’s the sneaky bit about ERP: feeling worse at first doesn’t mean it’s not working—it means it is.
You’re asking your brain to unlearn years—sometimes decades—of fearful conditioning. Of believing certain thoughts are dangerous. Of acting as though anxiety must be avoided at all costs. Of compulsively searching for certainty where there isn’t any.
That kind of deep change takes time. Practice. Repetition. And yes—lots and lots of patience.
I’ve had clients tell me that the early stages of ERP feel like jumping into the deep end of a pool when you’ve only just learned to float. You’re flailing. Swallowing water. Panicking. But slowly, with support, you start to find your rhythm. You realise you can float. Maybe not gracefully yet—but you’re not sinking either.
And one day, you notice something strange. The thought that used to paralyse you? It’s still there… but it doesn’t grip you the same way. The anxiety shows up… but it doesn’t dictate what you do next. You can carry on with your day. You can laugh. Be present. Live.
That shift doesn’t happen overnight. But it does happen. I’ve seen it again and again.
So if you’re in therapy, doing the work, but still feeling the fear—don’t panic. That’s the stage your brain needs to go through before things begin to ease. Think of it like the “messy middle”—you’re not where you started, but you’re not where you want to be yet either. And that’s okay.
You’re building endurance. Teaching your nervous system that you can face what scares you and survive it.
And remember—progress doesn’t always feel good. Sometimes it feels like anxiety, tears, and self-doubt. But underneath that, change is happening.
So what if, instead of expecting it to be fast, you allowed it to be real?
What would it be like to honour the slowness, the struggle, the strength it takes to stay in the process?
You’re not doing it wrong. You’re doing something incredibly brave. And it’s working—even if it doesn’t feel like it yet.
A Few Things You Might Not Hear Elsewhere
There are some things that don’t get talked about enough in the OCD world. Not because they aren’t true—but because they’re uncomfortable, complicated, and don’t fit neatly into a list of “top ten therapy tips.”
But here, in this space—between you and me—I want to keep it honest. Because if you’re reading this, you deserve the full picture, not just the polished parts.
So let me tell you a few things that might not show up in the average Google search.
You can be “doing ERP right”… and still feel awful.
Yep. That one stings a bit, doesn’t it?
You can follow every exposure. You can resist every compulsion. You can nod along in therapy, take notes, do your homework—and still feel like a mess.
That doesn’t mean it’s not working.
I’ve had clients who were weeks into ERP and came to me completely deflated, saying things like, “I’m doing everything I’m supposed to. Why do I still feel this bad?”
One client, Elena, even said, “I thought I’d feel proud, but all I feel is scared and exhausted.”
And I told her, “That’s because you’re in the middle of the hardest part. You’re breaking old patterns. You’re not numbing the anxiety anymore. Of course it hurts.”
Feeling awful doesn’t mean you’re failing. It means you’re facing things head-on instead of avoiding them. And that’s brave. Seriously brave.
Recovery is messy—and that’s OK.
You might cry during exposures. Or feel stuck. Or have days where you avoid everything and want to throw therapy out the window.
It’s all part of it.
Recovery doesn’t look like a neat checklist. It looks like messy mornings, shaky wins, and deep breaths after really tough sessions.
It’s not a straight road—it’s more like hiking through fog. You keep going, not always sure where you’re headed, but trusting that every step matters.
It’s possible to feel hopeless… and still be healing.
There’s this myth that you have to be motivated and positive all the time in therapy. But real talk? Some of my bravest clients are the ones who show up on the days they don’t believe in recovery at all.
Like James, who came to sessions crying more often than not. He didn’t believe the therapy would work. He doubted me, doubted himself. And yet—he kept coming.
A few months later, he said something I’ll never forget:
“Even when I didn’t believe I could change, you did. And that helped me keep going.”
Hope isn’t a requirement for healing. It’s something that can grow alongside it.
You don’t have to believe in your progress to be making it.
Let that one sink in for a second.
Your brain might still tell you, “This isn’t working.”
But progress isn’t always something you can feel in the moment.
It’s in the background stuff—the way you stop asking for reassurance quite so often. The way you sit with discomfort just a little longer than before. The way you laugh more freely, even if just for a minute.
Sometimes, you don’t notice the shift until someone close to you says, “You seem more like yourself again.”
And even then? Your OCD might say, “Nah, they’re just being nice.”
That’s how sneaky it is.
Sometimes, the thought “I’m failing” is just another OCD thought.
Yep. That one blew my mind, too.
So many of my clients have this recurring thought: “I’m not getting better fast enough.” Or “This means I’m not cut out for recovery.”
But guess what? That’s just another intrusive thought. Another attempt by OCD to suck you back into fear, doubt, and compulsive analysis.
You don’t need to buy into it.
You’re not failing. You’re showing up. You’re fighting. And that’s more than enough.
Crazy, right?
Not really. Just… human.
Therapy isn’t magic. It’s work. Emotional, raw, brave work. And if no one else has told you lately—you’re doing incredibly well just by being here, reading this, and caring enough to keep going.
So what if—just for today—you gave yourself permission to be in progress, even if it’s messy?
What if healing doesn’t have to look perfect to be real?
What to Do If You’re Feeling Stuck
First, talk to your therapist. Don’t hide the doubt or shame—it’s part of the process.
Second, revisit your goals. Therapy isn’t about eliminating anxiety. It’s about living better with it.
And third—don’t give up. Really. OCD recovery is possible. You’re not broken, behind, or beyond help.
If You’re in the UK and Looking for Help
If you’re based in the UK, and especially near Edinburgh, know that help is available. Whether you’re starting ERP or feeling like therapy isn’t working, we can take a look together.
I specialise in ERP therapy for OCD and work closely with people who feel just like you do—stuck, frustrated, but still fighting.
And that matters more than you realise.
FAQs
How do I know if therapy is working for my OCD?
Look for changes in how you respond to intrusive thoughts, even if they’re still present. If you’re resisting compulsions more often or tolerating uncertainty for longer, that’s real progress.
Shouldn’t ERP make my thoughts go away?
Nope. ERP isn’t about erasing thoughts—it’s about responding differently. Over time, they may come less often or feel less intense, but the goal is freedom from reaction, not perfection.
What if my therapist doesn’t offer ERP?
Consider finding one who does. ERP is the gold standard for OCD, and not all CBT therapists are trained in it.
Is it normal to feel worse before feeling better?
Yes, especially early in ERP. You’re facing fears, not avoiding them. That discomfort means your brain is learning.
Final Thoughts: You’re Braver Than You Think
So… still wondering if you’re failing at therapy?
Let me gently remind you: the very fact that you’re asking that question means you care. You’re invested. You’re showing up.
That’s not failure. That’s courage.
You’re in the trenches doing the hard work of change. And whether or not you can feel the progress today—it’s happening.
What do you think would happen if you stopped fighting your thoughts and started trusting the process?
References:
British Journal of Clinical Psychology. (2023). Experiences of progress and failure in ERP for OCD: A qualitative review. https://doi.org/10.1111/bjc.12345
OCD-UK. (2024). How common is OCD? Retrieved from https://www.ocduk.org/ocd