Thoughts that will not leave, checking that does not end, rituals nobody sees. Here we work with the cycle behind them, with the shame that comes with them, and with the difference between a ritual that consumes you and one that calms you. I do not stamp out what helps you, and I do not give the reassurance you are looking for.
This is for you if
Do not start with me if
You are in crisis right now
If you feel you might hurt yourself, or you are not sure whether a thought like that has to be taken seriously, do not start with me. Call 999, or in the UK, Samaritans on 116 123, free and open around the clock. In Romania, depreHUB on 0374 456 420, also free and non-stop. Your place here stays afterwards.
You want the structured programme of exposure and response prevention (ERP)
ERP is the treatment with the most evidence in OCD, and it needs a therapist trained specifically for it. I am not that therapist, and I would rather say so straight away than offer something that resembles it. I can help you look for one, and if you want, we work in parallel on what ERP usually does not reach: shame, the critical voice and what sits underneath.
The rituals take hours of your day or hurt you physically
If you can no longer leave the house, if your skin is breaking from washing, or you eat and drink less than you need, one session a week is not enough, and it would not be responsible to pretend it is. Your GP or a psychiatric assessment come first, and I can walk alongside. I do not prescribe medication and I do not carry out psychiatric assessments.
Someone is sending you so your rituals disappear
If a partner, a parent or a doctor wants you to give up rituals and you do not feel them as a problem, tell me. A ritual that calms you, gives you predictability or brings you pleasure is not a compulsion, and I do not work to remove it. If it hurts you or limits you, that decision is yours.
What this looks like day to day
You locked it, felt the handle, stepped onto the landing. And there, a small question: what if not? You go back, check, leave. The third time you no longer trust your own eyes, you only have a "not yet right". You are not afraid for lack of logic, because you know it is locked. Fear simply does not argue with logic.
At dinner you said something. Maybe it sounded harsh. In the evening you run the sentence forty times, looking for how the other person took it, for what you could have said. From outside you look calm. Inside you are doing an hour of work that nobody sees, and sometimes you yourself call it just thinking a lot. A mental ritual tires you as much as one done with your hands.
You are with someone you love, on a quiet evening, and an ugly thought crosses your mind, about them or about yourself. You did not want it, it frightens you, and that is exactly why it stays. You start to check it: what does it mean that I had it, what kind of person am I? Many people with OCD grew up believing they were bad because of thoughts they never chose, which is where the shame that gathers over the years comes from.
What we do together
Almost everyone has thoughts that do not belong to them. In OCD, they stay and move into your life.
The starting point is simple: intrusive thoughts, ugly, strange or shameful ones, are had by almost everyone, and in most cases they pass. In OCD the thought is read as danger, and everything you do to get rid of it (checking, asking for reassurance, washing, repeating in your head, avoiding) makes it come back stronger. The content attaches itself to what matters most to you, which is why it feels so personal and so dreadful.
One more thing, for anyone who is also autistic or has ADHD: not every repetition is a compulsion. Stimming, routines and rituals that calm you or bring you pleasure are not OCD, and with me they are not stamped out. The difference, briefly: autistic repetition usually lowers anxiety, while a compulsion in OCD keeps it high and is unwanted. Whether a ritual is a problem for you is for you to decide. Both can sit in the same person, and then we separate them carefully, together.
What we work on, concretely: we look at your cycle, what set the thought off, what you felt, what you did to get away and what followed. I do not negotiate with the thought and I do not give the reassurance you are looking for: if I answer "no, it is not dangerous" every time, I become the ritual. We also look at what you avoid and at what shifts around you so the people close to you can help, because help that takes over your rituals for you can keep the OCD in place.
What I work with, from what is on the Approach page: Internal Family Systems, which treats the obsession and the ritual as parts of you with a protective job that have become overloaded, not an enemy to defeat. Schema Therapy, for the critical voice and shame formed in the years when you believed you were a bad person. Nervous System Regulation, for the alarm in the body. Person-Centred Therapy as the foundation. And some skills from Dialectical Behaviour Therapy, when the emotional wave is too big. I do not do structured ERP; if you want it, you do it with a specialist and we work in parallel, not in its place.
The psychometric questionnaires
The questionnaires: to see the picture, not to receive a verdict.
The process is the one on the other pages: a starter pack (WHO-5, PHQ-9, GAD-7) before the first session or shortly after, so we can see where you are with wellbeing, mood and anxiety. If depression comes out high, I will tell you openly that it may take priority, because severe depression changes the order in which we work.
For OCD there is the OCI-R on the site, an 18-item inventory, five minutes. It shows which of six dimensions are more present for you: checking, washing, ordering, hoarding, thoughts that will not leave, and counting. For autistic people it has to be read with care, because a preference for order and arranging can come out high without being OCD. That is why we read it together, and I do not treat it as a verdict.
They are not an exam, they do not give a diagnosis and they do not replace an assessment. Nor are they a condition for working together. The answers stay in your account in the client area, you see them too, and a draft is saved if you stop halfway.
The first few months
The opening conversation, 30 minutes, free
On Meet. No form beforehand. You can ask everything and say as much as you like about what is happening, including nothing about the content of your thoughts if you feel ashamed. You do not need to say it for us to work.
The first session
We get to know each other. I listen to what you have tried, what helped, what did not, and what a ritual that calms you means to you compared with one that consumes you. We do not start from what is wrong with you.
The first weeks
We make the map: what sets the thought off, what you feel, what you do, what you avoid, who around you helps without knowing they are feeding the cycle. No tasks fixed by me; if you want to note something between sessions, we do it together.
The first months
We move into work with parts and with shame: who in you says what if, why it learned to shout like that, what it would need in order to settle without a ritual. In parallel, work with the body, for the alarm that fires before the thought.
What we work on next
The life around OCD: relationships, work, what you have avoided for years. At what pace and with what steps, we decide together. If you also chose ERP with a specialist, this is where you keep your support.
How we know it is working
The thoughts do not necessarily disappear, and that is not what we are aiming at. The sign I look for: the thought lasts less, disturbs you less, and the ritual takes less of your day. Two short questions at the end of sessions, if you want to fill them in.
How long it takes
I cannot promise a number and I do not give a deadline. If you stop for a while and come back, it is not a failure and I do not ask for explanations.
Questions people ask me
I cannot prove on a page that your thought is harmless, and it would not help: proof asked for again and again becomes a ritual. What I can say is what is known: intrusive thoughts, including ugly ones, occur in almost everyone, and in OCD it is how they are read that differs, not that they appear. What it means for you, we look at together, at your pace.
Yes, and it happens fairly often. They are often mixed up: autistic routine can be taken for OCD, and real OCD can be put down to autism. We separate them by a simple test, whether the repetition calms you or keeps your fear high, and I leave it to you to decide what is a problem for you.
Yes. I do not give diagnoses and I do not carry out assessments. We work with how you function, not with a label, and if you want an official assessment, I help you find where one can be done.
I do not make you do anything you have not chosen. We set the pace together, and where the fear is big we go first to what holds it, not to confrontation. If you want a structured exposure programme, that is a job for an ERP specialist, and I will tell you honestly how to look for one.
I could, and you would feel better for ten minutes. But every reassurance you receive trains the mind to ask for another, and the cycle tightens. That is why I do not give it, and it is not coldness. I give you something else: to stay with the uncertainty a little longer than you can alone.
Only if you ask for it. I can suggest what to try between sessions, and if it does not work out, we do not discuss why you did not do it, but what came up when you tried.
They stay in your client area account, we both see them, and you can reread them any time. They do not reach your GP or employer unless you ask in writing. The details are on the privacy page.
A standard session is £80 for 50 minutes. Reduced rate of £50 for Romania, Eastern Europe and Türkiye. For people who are unemployed or receiving social benefits, outside Romania, Eastern Europe and Türkiye, the rate is £60. The opening conversation is free, 30 minutes.
One small step
Start with whatever seems easiest. None of the steps below asks you to say what thoughts you have.
What clients say
“With Giancarlo, you will feel heard, respected, and most importantly, understood.”
OCD — Thoughts That Will Not Leave, Rituals That Tire
Thoughts that will not leave, checking that does not end, rituals nobody sees.
Book sessionIf you care about someone with OCD and you are asked, again and again, to confirm that everything is fine: two videos on how to answer without feeding the loop.
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