Population studies suggest that OCD affects roughly 3 out of 100 people (likely underestimated) with typical age of onset spanning early childhood to late teens, although uncommon, in women, symptoms can start during menopause.

OCD is classified as a chronic condition with symptoms ranging from mild-moderate to severe and debilitating. Although, OCD is often life-long, there is now an innovative treatment, with roots in Cognitive and Behavioral Therapy known as Inference-Based Cognitive and Behavioral Therapy I-CBT that offers hope for significant remission where symptoms, when they do recur, can be easily managed

Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy (CBT), has long been considered a first-line psychological treatment for OCD. However, not everyone benefits fully from ERP, and some people find exposure-based treatment difficult to tolerate or discontinue treatment prematurely. Inference-Based Cognitive Behavioral Therapy (I-CBT) offers an evidence-based alternative that addresses the reasoning process underlying obsessional doubt without relying on deliberate exposure exercises. Clinical trials have found significant reductions in OCD symptoms with I-CBT, including among people with different OCD symptom presentations and those with poor insight or previous limited response to treatment.

Inference-Based Cognitive Behavioral Therapy (I-CBT) is an evidence-based treatment for OCD that offers an alternative for people who have not benefited sufficiently from ERP or have found exposure-based treatment difficult to tolerate. I-CBT was developed through the pioneering work of psychologist Dr. Kieron O’Connor and subsequently expanded through decades of research and clinical work with Dr. Frederick Aardema and colleagues at the University of Montreal and the Montreal Mental Health University Institute. Today, I-CBT has a growing research base as a treatment for OCD and offers a distinct approach that does not rely on deliberate exposure exercises.

I-CBT differs from traditional cognitive approaches that focus on how intrusive thoughts are interpreted or appraised. In I-CBT, the obsessional doubt itself is understood as the product of a faulty reasoning process. Through a process known as inferential confusion, the person discounts what is directly known or perceived in the here and now and gives greater credibility to an imagined possibility.

For example, a locked door might somehow be unlocked; a visibly clean surface might be contaminated; an organized shelf might not be arranged “just right”; or an unwanted image of harming someone might be incorrectly inferred as evidence of an intention or capacity to cause harm.

During treatment, clients are taught to identify what I-CBT refers to as the "crossover" from what is perceived and real to what is imagined. They also learn about a key thinking error called inverse inference where people reach conclusions based on what they imagine vs what is perceived or known as we normally do. I-CBT has pinpointed the "reasoning devices" that trick people, with OCD into believing the stories or narratives that spring from imagination instead of trusting their senses and common sense.

Once in the "OCD bubble" people are compelled to behave or think a certain way to protect themselvess from the feared imaginary outcome. When people with doubt and checking OCD see that a door is locked they are tricked by their imagination into doubting what they perceive and are, thus, compelled to lock the door again. When people with OCD act on a compulsion or "neutralize" fear in some way, the imaginary story, that is, the obsession, becomes "lived In". People with OCD know that compulsions might deliver brief relief but fail to deliver change and make the obsession stronger. In I-CBT clients learn that compulsions only strengthen because there is no resolution to obsessional doubt: You cannot lock a door that is already locked, and that by trying to lock it you merely reinforce the imaginary idea that the door is unlocked.

Clients are guided to use knowledge of OCD reasoning to deconstruct the obsessional narratives and then create alternative or real stories. By repeatedly taking apart the pieces, obsessions start to weaken and fall apart. At the same time, clients are practicing what ICBT refers to as reality sensing: letting what the senses perceive gudie behavior and thought. If a door is locked, you trust your sense and move on. By sensing reality, over time the mind resets and clients are able to leave obsessions behind and live in the world that is

By the end of therapy people, recover their relationship with life. Many of my clients find themselve more present in relationships and work. Free of the hell of OCD, they are motivated to explore that they previously feared, seeking out new endeavors ways of living or sometimes new careers

To understand your specific needs and whether we might be a fit to work together, I offer a free phone screening. I gather initial information about the condition and symptoms for which you are seeking treatment, why you have made this decision now, co-existing conditions, past treatment as well as your motivation and commitment to change. I also I briefly explain the CBT approaches I use, including Inference-Based Cognitive and Behavioral Therapy (I-CBT) The screening is also an opportunity for prospective clients to ask questions and get a sense of who I am and how I work.

If the phone screening suggests that there could be a fit, I usually propose one initial assessment session to get more information about your symptoms as well as your relationship and family histories. At the end, I share initial diagnostic impressions along with a sketch of a treatment plan and paths we might take if we agreed to go further.