I think Dr. Michael Greenberg is spot on with OCD treatment. It makes more sense to me than anything else. https://drmichaeljgreenberg.com/articles/

Now that we’ve kicked off the new year, I find myself reflecting on where the OCD community is today—how things have changed for the better, as well as my hopes for the future. Ten years ago, it was almost impossible to access a licensed therapist with specialty training in OCD using health insurance. Most professionals simply didn’t understand what OCD actually looks like, so over 95% of OCD cases weren’t correctly diagnosed. As a result, insurance companies weren’t able to see how widespread OCD actually was—or how effective exposure and response prevention (ERP) therapy was at treating it. Instead, people with OCD had to pay about $350 or more per session, all out of pocket, for their best chance at getting their life back. I know this from personal experience. OCD turned my life completely upside-down, and I reached out desperately for help, only to be misdiagnosed and mistreated by professionals who didn’t understand OCD. When I finally learned about ERP therapy, the evidence-based treatment specifically designed for OCD, I learned that I’d have to wait for months to see the one OCD specialist in my area, and I couldn’t afford the cost. But I was fortunate. My mom found a way to help us pay, and I finally got the help I needed. Otherwise, I don’t think I’d be here today. In a few months, I started seeing improvement. As I continued to get better using the skills I learned while working with my OCD specialist, I learned I wasn’t the only one with this experience—in fact, millions of people across the country were going through the exact same things I was. That’s why we started NOCD. Since 2015, we’ve always had one mission: to restore hope for people with OCD through better awareness and treatment. The OCD community needed an option for evidence-based treatment that they could afford and access, no matter where they live—an option that also provided necessary support between sessions. And the entire healthcare industry needed to understand how OCD actually works. As I write this post, I’m more enthusiastic than ever about our mission. Just recently, we’ve partnered with Blue Cross Blue Shield of Illinois, Texas, New Mexico, Montana, and Oklahoma. To put this into perspective, 155 million Americans can now use their insurance to access NOCD Therapy. This year, I have high hopes for the OCD community. More and more people will be able to use their insurance to pay for NOCD Therapy, and we’re working hard to give everyone who has OCD the ability to access the treatment they deserve. In addition to providing ERP Therapy, our OCD-specialty therapists also support our Members in prioritizing their overall well-being. With a focus on developing important lifestyle habits, including diet, exercise, mindfulness, and healthy sleep hygiene, they help our members build a strong foundation for lasting mental health so people are more prepared to manage OCD long-term. For every person who gains access to a therapist specialized in OCD for the first time, 2025 could be a year that changes their lives. If you or a loved one is suffering from OCD, please comment below or schedule a free 15-minute call with our team to learn more about how to access evidence-based OCD treatment and ongoing support using your insurance benefits.

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?

Looking back, my introverted nature and struggles to find belonging in high school may have set the stage for how OCD would later impact my relationships. I had my first relationship in high school, but OCD wasn’t a major factor then. It wasn’t until my longest relationship—six years from age 18 to 24—that OCD really took hold. The relationship itself wasn’t the issue; it was what happened after. When it ended, I became obsessed with confessing past mistakes, convinced I had to be completely transparent. Even when my partner was willing to work past them, I couldn’t let go of the intrusive thoughts, and that obsession landed me in the hospital. From there, my struggle with ROCD (Relationship OCD) fully emerged. For years, every time I tried to move forward in dating, doubts consumed me. I would start seeing someone and feel fine, but then the questions would creep in: Do I really like her? Do I find her attractive? Is she getting on my nerves? What if I’m with the wrong person? I’d break things off, thinking I was following my true feelings. But then I’d question: Was that really how I felt, or was it just OCD? I tried again and again, each time hoping I could “withstand it this time,” only to fall back into the same cycle. The back and forth hurt both me and the person I was with. By the time I realized it was ROCD, the damage had been done, and I still hadn’t built the tools to manage it. Now, at 28, I know I need to approach dating differently. I recently talked to someone from a dating app, and my OCD still showed up—questioning my every move, making me doubt my own decisions. I haven’t yet done ERP specifically for ROCD, but I know that’s my next step. Just like I’ve learned tools for managing my other OCD subtypes, I need a set of strategies for when intrusive doubts hit in relationships. My goal this year is to stop letting uncertainty control me—to learn how to sit with doubt instead of trying to “figure it out.” I want to break the cycle and be able to build something healthy without my OCD sabotaging it. I know I’m not alone in this, and I know healing is possible. I’m hopeful that working with a therapist will help me develop exposures and thought loops to practice. I don’t expect to eliminate doubt entirely—after all, doubt is a part of every relationship—but I want to reach a place where it doesn’t paralyze me. Where I can move forward without constantly questioning whether I should. And where I can be in a relationship without feeling like OCD is pulling the strings. I would appreciate hearing about your experiences with ROCD. Please share your thoughts or any questions in the comments below. I’d love to connect and offer my perspective. Thanks!