Is OCD Curable? It is commonly accepted that OCD is a chronic condition for which there is no cure. This idea is frequently used as an excuse for incomplete treatment, especially of compulsive rumination. Many patients who have completed ERP no longer do any physical compulsions but still ruminate. These patients are often told that the reason they’re not completely better is that OCD is a chronic condition, when the real reason is that no one has taught them how to completely stop ruminating. So, am I saying OCD is curable? Let’s answer that question with another question: Would you say someone who engages in absolutely no compulsion or avoidance has OCD? I would say they don’t. I would say that OCD consists of compulsion and avoidance, and that therefore, by definition, no compulsion or avoidance means no OCD. The counterargument I would expect is that this person would still have intrusive thoughts. But this argument falls apart when you break down ‘intrusive thoughts’ into (1) uncomfortable thoughts that occur to you, and (2) any engagement whatsoever with these thoughts — i.e., compulsive rumination. While an uncomfortable thought occurring to you isn’t controllable, this is also not a symptom of OCD; it’s a symptom of being human. And any engagement whatsoever with the thought is controllable and is a compulsion — and we said this person doesn’t do any compulsions. So would you say that someone who engages in absolutely no compulsion or avoidance — who sometimes has uncomfortable thoughts like all other humans, but doesn’t engage with them at all — has OCD? I would say they don’t, or at least they don’t right now. Thus, drawing a clear distinction between a thought occurring to you, and any engagement whatsoever with that thought, leads to the conclusion that a person can completely eliminate their OCD. So does this mean OCD is curable? Well, it’s definitely much more curable than people think it is. But if the word ‘cure’ means that something is permanently better, I wouldn’t say OCD is curable, because OCD will only remain better as long as compulsion and avoidance are completely eliminated. Consider the imperfect analogy of someone who gets their cholesterol under control by changing their diet.* Have they been cured? Only as long as they maintain the changes that made them better. While it might sound daunting, eliminating compulsion and avoidance does not entail an ongoing struggle. In fact, once a person sees that they have complete control over these behaviors, staying away from them becomes easy. This is why, in my mind, the goal of treatment is not only to eliminate current symptoms, but to help the patient see that they are completely in control of their behavior, including their mental behavior. That way even if they do fall back into compulsion or avoidance in the future, they know they have the ability to get back on track immediately. So I’m not sure whether I can say that OCD is ‘curable,’ but I know that it is possible to get completely better, to the degree that OCD is no longer a part of your life or even something you think about. And this is the standard that I think every patient and therapist should strive for. * The difference is that the dietary changes cause a change in the cholesterol, while the elimination of compulsion and avoidance are themselves the elimination of OCD.

Looking back, I realize I’ve had OCD since I was 7. though I wasn’t diagnosed until I was 30. As a kid, I was consumed by fears I couldn’t explain: "What if God isn’t real? What happens when we die? How do I know I’m real?" These existential thoughts terrified me, and while everyone has them from time to time, I felt like they were consuming my life. By 12, I was having daily panic attacks about death and war, feeling untethered from reality as depersonalization and derealization set in. At 15, I turned to drinking, spending the next 15 years drunk, trying to escape my mind. I hated myself, struggled with my body, and my intrusive thoughts. Sobriety forced me to face it all head-on. In May 2022, I finally learned I had OCD. I remember the exact date: May 10th. Reading about it, I thought, "Oh my God, this is it. This explains everything." My main themes were existential OCD and self-harm intrusive thoughts. The self-harm fears were the hardest: "What if I kill myself? What if I lose control?" These thoughts terrified me because I didn’t want to die. ERP changed everything. At first, I thought, "You want me to confront my worst fears? Are you kidding me?" But ERP is gradual and done at your pace. My therapist taught me to lean into uncertainty instead of fighting it. She’d say, "Maybe you’ll kill yourself—who knows?" At first, it felt scary, but for OCD, it was freeing. Slowly, I realized my thoughts were just thoughts. ERP gave me my life back. I’m working again, I’m sober, and for the first time, I can imagine a future. If you’re scared to try ERP, I get it. But if you’re already living in fear, why not try a set of tools that can give you hope?

How long did it take to make this? And is it actually possible?

December 14, 2024, marked two years since my first ERP therapy session with my NOCD therapist, Mixi. And October 2024 marked a year of being free from OCD. It was not an easy journey, confronting my fears face to face. Exposing myself to the images and thoughts my brain kept throwing at me, accepting that I might be the worst mother, that my daughter wouldn’t love me, and that I deserved to be considered a bad person. It was challenging having to say, “Yes, I am those things,” feeling the desire to run, but realizing the thoughts followed me. At the start of my therapy, I remember feeling like I couldn’t do this anymore. Life felt unbearable, and I felt so weak. I longed for a time before the OCD, before the flare-ups, before the anxiety, the daily panic attacks. I thought I’d never be myself again. But I now know that ERP saved my life. The first couple of sessions were tough. I wasn’t fully present. I lied to my therapist about what my actual thoughts were, fearing judgment. I pretended that the exposures were working, but when the sessions ended, I went back to not sleeping, constantly overwhelmed by fear and anxiety. But my therapist never judged me. She made me feel safe to be honest with her. She understood OCD and never faltered in supporting me, even when I admitted I had been lying and still continued my compulsions. My biggest milestone in therapy was being 100% transparent with my therapist. That was when real change began. At first, I started small—simply reading the words that terrified me: "bad mom," "hated," "unloved." Then, I worked on listening to those words while doing dishes—not completely stopping my rumination, but noticing it. Just 15 minutes, my therapist said. It wasn’t easy. At one point, I found myself thinking, “Will I ever feel like myself again?” But I kept pushing through. Slowly, I built tolerance and moved to face-to-face exposures—sitting alone with my daughter, leaning into the thought that my siblings might die, reading articles about my worst fears, and calling myself the things I feared. Each session was challenging, but with time, the thoughts started to lose their grip. By my eleventh session, I started to realize: OCD was here, and it wasn’t going away, but I could keep living my life despite it. I didn’t need to wait for it to be quiet or go away to move on. Slowly, it began to quiet down, and I started to feel like myself again. In fact, I am not my old self anymore—I’m a better version. OCD hasn’t completely disappeared, but it’s quieter now. Most of the time, it doesn’t speak, and when it does, I know how to handle it. The last session with my therapist was emotional. I cried because I was finishing therapy. I remember how, in the beginning, I cried because I thought it was just starting—because I was overwhelmed and terrified. But at the end, I cried because I was sad it was ending. It felt like I had come so far, and part of me wasn’t ready to say goodbye, even though I had already learned so much. It was a bittersweet moment, but I knew I was walking away stronger, equipped with the tools to handle OCD on my own. If I could change anything about my journey, it would be being open and honest from the beginning. It was the key to finding true healing. The transparency, the honesty—it opened the door to lasting change. I’m no longer that person who was stuck in constant panic. I’m someone who has fought and survived, and while OCD still appears from time to time, I know it doesn’t define me. I'd love to hear your thoughts and comments. Have you started therapy, is something holding you back? Is there something you want to know about ERP therapy? I'll be live in the app answering each and every one today from 6-7pm EST. Please drop them below!