Katie

OCD is sly. It whispers that one more check will keep everyone safe and make things feel right. But it always wants more: one more question, one more hour in your head, one more thing you stop doing.

What nobody sees is everything you've already pictured, over and over, in more detail than you'd ever say out loud. We don't have to unpack every single one.

It's not the thought that's the issue. It's how we respond to it. Over time, the thought can show up in the middle of dinner with people you love, and it doesn't take over the way it used to. You stay at the table.

ERP is the first-line treatment for OCD, and I build on it with I-CBT and ACT. Reassurance usually feeds OCD, even when it's well meant, and talk therapy that isn't OCD-specific can turn into more of it.

You lost track of a deadline weeks ago, and now you can't make yourself check it, because it might already be too late, or close enough that you'll be cramming it all into a few miserable days.

Maybe you feel like a burden, so nobody knows how bad things have gotten. You can tell me, and we'll just let it be for a second. Then we can check that deadline right there in session, so you're not alone when you find out.

Some weeks nothing is on fire, just the car registration, the class you signed up for, and twelve more like them, all equally important. The calendar you set up for all of it worked beautifully until the part where you had to keep using it, and you started to wonder what that said about you.

You may not need a new calendar. We look at when you stopped opening the old one and what was going on that week, then pick the two or three things you'll do before we meet again. The rest can wait. I want ordinary things to stop costing you so much.

You don't need a diagnosis to start, and if you'd like one, I can diagnose ADHD.

The world has already decided what it means to be autistic, and it can be hard not to start seeing yourself through that lens. Maybe you've spent years masking and dimming parts of yourself just to make everyone else more comfortable, or being told that things that work for you should be done differently.

Some parts of being autistic are genuinely hard. I'm not here to make you easier for other people to understand, and I don't have a template in my head for how you're supposed to live. If something works for you and you want to keep it, I don't need to turn it into a problem. If it's getting in your way, then we can look at it together.

In session, whatever helps you be more comfortable is completely okay with me. You don't have to spend therapy translating yourself into something that makes more sense to me before we can get to what you actually came in for.

Some things are too ugly to look at, let alone say out loud. Others are so quiet, nothing like what you've seen on TV, that you're not sure they count. Embarrassing, shameful, infuriating. Maybe you've never told anyone. Or you did, and they got awkward, asked stupid questions, or tried to make it all better.

Whether it happened once or went on for years, you never have to tell me any of it. Just the feelings, or just that something bad happened, is enough. If you want to say more, I can hear it. I believe you. I won't ask questions that make it sound like your fault, or tell you what you should do now.

Some feelings are total opposites and make no sense at all. They don't have to.

I don't have a magic answer. We work on where it still shows up and what helps when it does. Living with it is a lot like living with grief. You might not forget, and you may still think about it every day. We figure out how it can be there without taking up every part of your life.

PTSD and complex PTSD, however it happened.

Sometimes there is one clear thing you can point to. Sometimes there isn't. You may try to explain it and find that people rush to an answer before you have one. They tell you to just talk to them, set a boundary, or leave, and some get frustrated when you stay. Even when they mean well, all of that can make it harder to hear yourself think.

You don't need to know whether what's happening “counts.” We can look at what actually happens. What does saying no cost you? What have you stopped bringing up?

If I notice a pattern in how you've been treated, or I'm worried about your safety, I'll say so. If something I suggest would make things worse, tell me. I'll believe you, and we'll try something else.

I'm not secretly waiting for you to leave. We can talk seriously about safety without that meaning you have to go anywhere.

Your history may help us see what you need now. But I'm not going to look inside you for the reason someone else treated you this way.

Including domestic violence and coercive control, whether you've left or not.

Anxiety can take up far more of your life than anyone sees. You think through what could go wrong, watch your body for anything that feels off, and start avoiding things you used to do. Little by little, your life gets smaller.

In session, my questions aren't about making you prove every anxious thought is illogical. You may have thought it to death already, and it still hasn't helped.

I'm trying to figure out what actually needs to change and what doesn't need another hour of your attention. Maybe the job really is the problem, or maybe the spiral about it is. Maybe panic has started deciding whether you get on a plane.

You might get on anyway, knowing you could panic. I'll tell you what I'm seeing, but I won't make the choice for you. I want you to have a choice before anxiety makes it for you.