OCD
Online OCD Therapy
Psychotherapy for obsessive compulsive difficulties: intrusive thoughts, compulsions, checking and reassurance seeking.
Psy. Moustafa Kamel, Psychotherapist. Online sessions of 50 minutes in English and Arabic.
The problem is not the thought
Almost everyone has strange, violent or repugnant thoughts occasionally. They pass without significance. In obsessive compulsive difficulties they do not pass, because they are treated as meaningful: as evidence about character, or as a warning that must be answered.
What follows is an attempt to make the discomfort stop. Checking. Repeating. Washing. Mental reviewing. Praying in a particular way. Confessing. Asking someone close to you, one more time, whether you are a good person. Each of these works briefly, which is precisely what makes them so hard to give up.
The cycle, described plainly
An intrusive thought arrives and produces sharp anxiety. A compulsion reduces the anxiety within minutes. The brain records that the compulsion was necessary and that the thought was genuinely dangerous. The threshold drops, the thought returns sooner, and the compulsion is required more often. Over months, a large amount of life is quietly given over to managing the loop.
People with OCD are usually not confused about this. They can describe it accurately and still be unable to stop, which is exactly what distinguishes OCD from ordinary worry and why willpower advice is useless.
Common presentations
Religious and scrupulosity-related presentations are common among the clients I see, and require a therapist who can take faith seriously while distinguishing it from the compulsion attached to it.
- Intrusive thoughts about harm, morality, religion, sexuality or relationships
- Contamination fears and washing or cleaning rituals
- Checking locks, appliances, messages, work or the body
- Reassurance seeking from partners, family or online searching
- Mental compulsions such as reviewing, counting or neutralising
- Symmetry, ordering and the need for something to feel right
- Intolerance of uncertainty, and a demand for a level of certainty life does not offer
- Avoidance of situations that might trigger the thoughts
How I work with it
We begin with a detailed assessment: which obsessions are present, what the compulsions are, what is being avoided, and how much time and relational strain the loop is consuming. That map matters, because the compulsions are often less visible than the thoughts.
The work then focuses on the response rather than on the content of the thought. Arguing with an obsession strengthens it; the change comes from altering what you do when it arrives, and from building tolerance for uncertainty rather than resolving it. Alongside that we look at the beliefs about responsibility, danger and morality that give the thoughts their weight, and at how the family or partner has become involved in providing reassurance.
I work within depth-oriented and integrative psychotherapy, using structured evidence-based methods that fit the individual. I do not present myself as an exposure and response prevention specialist. If a formal ERP programme is what your presentation calls for, I will say so and support you in finding it.
What to expect
- A clear formulation of your specific cycle rather than a generic description of OCD
- Agreed, gradual changes to compulsions rather than sudden removal
- Work on uncertainty tolerance as a skill
- Guidance for a partner or family member caught in the reassurance loop
- Regular review of whether the approach is producing change
Practical details
Sessions are 50 minutes by secure video, in English or Arabic. Sessions are held online. Whether I can work with you depends on where you are living at the time of the sessions and on the professional and legal requirements that apply there, so it is worth telling me your location when you first write.
OCD frequently comes with generalised anxiety and low mood, and those are addressed in the same plan. Therapy is planned work, not emergency care. If you are in immediate danger, or you are thinking about ending your life and feel unable to keep yourself safe, contact your local emergency number or your nearest emergency department. Ongoing therapy can begin once you are safe.
Bring the version you have never said out loud
Intrusive thoughts are not a verdict on your character, and there is nothing you can say here that will be treated as one.