Obsessive Compulsive Disorder Treatment in Toronto
Doctoral-Level Psychological Care

Obsessive Compulsive Disorder (OCD) treatment at Laksman Doell Psychology is delivered by doctoral-level registered psychologists, both in person at our office in the Annex neighbourhood of Toronto and virtually across Ontario.

What Obsessive Compulsive Disorder Looks Like

“OCD isn’t about being tidy, organized or meticulous. It’s about a spiral of doubt, mistrust in yourself and the facts that you know to be true, and an urge to feel ‘sure’ that only leaves you feeling more confused.”

One of the most challenging parts of experiencing Obsessive Compulsive Disorder (OCD) is how lonely it can be. Many people are familiar with a particular version of OCD that is characterized by compulsive handwashing, checking, or needing for things to feel “right”. But there are many other expressions of OCD that are less well known.

OCD can also look like the sudden thought of harming someone you love, the gnawing doubt that you don’t actually love your partner or that they are not right for you, the feeling that you are about to blurt out an offensive word, the idea that you could do something terrible, and the shame that your mind even went there at all. Even people quite close to you might not see the hours spent seeking reassurance, mentally reviewing a memory to ensure that you haven’t missed something, writing and re-writing emails to guarantee that you didn’t accidentally write something inappropriate, and the non-stop line of questioning in your mind that is too raw for you to share with anyone. Although OCD can be incredibly distressing and confusing at first, with an appropriate diagnosis and treatment you can reclaim your life.

OCD involves two core experiences. Obsessions, which are intrusive thoughts, images, urges, or doubts that are experienced as highly distressing, and compulsions, the behaviors or mental rituals that are performed in order to relieve that distress. With OCD, the relief doesn’t last. The thought comes back, often louder. And the cycle starts again.

What makes OCD particularly “sticky” isn’t just the thoughts. It’s what your mind says about the fact that you are having those thoughts in the first place. The belief that only a terrible person would think about harming their child, that if the stove is on and you don’t check it then it will be all your fault that your house burns down, that the tightness in your chest really could be a heart attack, and so on. These thoughts are not evidence of anything. But OCD is very good at persuading you to take them very seriously. So seriously that they can start to consume your life.

Ultimately what OCD does, over time, is shrink your world. The places you’ve stopped going. The hobbies and interests you’ve put down because you are exhausted after a day of engaging in compulsions. The relationships that have quietly reorganized themselves around your symptoms without anyone meaning for that to happen. By the time that most people reach out, the losses have been accumulating for years. Getting those things back is exactly what treatment is for.

It is important to be clear about what OCD is not. First and foremost, OCD is not a sign that you are dangerous or that you are fundamentally “different” from other people. It is also not a personality quirk or some other version of a life sentence. It can change and improve. Finally, and unfortunately, OCD is not something that insight alone will fix. Simple talk therapy often does not help. In fact, it might actually make the OCD stronger.

It is also important to be clear about what OCD is. A recognized and highly treatable condition. The right treatment doesn’t just help you to cope. It interrupts the cycle at its roots, and helps you to get back to the life that OCD stole from you. Effective treatment does more than just reduce the frequency and intensity of unpleasant thoughts. It changes your relationship with your own thinking in a way that leaves you able to live in the world as a more empowered and authentic version of yourself.

IF YOU ARE READING THIS

You may not be sure what you need, but something brought you here…

You’ve tried to reason your way out of it. You know, somewhere, that the thought isn’t real. But it keeps coming back. And each time it does, a part of you wonders…“what if?”
The rituals started as a way to cope. They were so brief and so simple that they felt like a low-cost way to keep the peace. But without noticing when, they started to take up hours of your day.
You may have tried therapy before and found it unhelpful. Maybe your therapist was treating anxiety in general rather than OCD specifically. Maybe you were told to sit with the discomfort, with very little structure or guidance for how.
OCD has started to affect your relationships. The people who love you don’t always understand what’s happening. Sometimes they play along with the OCD, and sometimes they don’t. Conflicts are more common, and you can feel the relationship becoming more about the anxiety and less about the people in it.
You are exhausted. Exhausted by the compulsions, by the time that this has taken, by how much of your life has quietly narrowed around it. But you haven’t stopped looking for something that actually works.

This is what has brought you here. And you are in the right place.

OCD TREATMENT IN TORONTO

The OCD presentations that we treat:

At Laksman Doell Psychology, we treat the full range of OCD presentations, including many that people don’t immediately recognize as OCD. We treat Existential OCD, which involves intrusive, urgent questions about reality, consciousness, identity, free will, or the nature of existence, and which commonly focuses on global crises, like climate change or the rise of artificial intelligence. We treat Purely Obsessional (or “Pure O”) OCD, which involves compulsions that are mostly internal: mental reviewing, reassurance-seeking in your own head, trying to neutralize a thought with a counter-thought, distracting yourself so a thought goes away, or trying to mentally figure out whether a feared thing is true. We also treat a wide range of OCD related disorders like Body Dysmorphic Disorder (BDD) and Body-Focused Repetitive Behaviours such as skin-picking and hair-pulling.

Our doctoral-level psychologists treat a number of different OCD presentations, including:

Contamination OCD

Contamination OCD involves an intense fear of germs, chemicals, illnesses, or the possibility of spreading harm to others. Compulsions typically include washing, cleaning, or avoidance that expands over time until everyday life becomes significantly restricted. Some people also experience emotional contamination, which is a felt sense of being tainted by proximity to certain people, places, or memories. It looks different from hand-washing OCD, but it responds to the same treatment.

Harm OCD

Harm OCD involves unwanted, intrusive thoughts about causing harm to yourself or to someone you care about, whether accidentally or on purpose. These thoughts are deeply distressing precisely because they’re so inconsistent with your actual values. The distress itself is the evidence: people who want to harm others don’t find these thoughts unbearable. If, while reading this, you checked in with yourself to see if that idea distresses you, then this theme may resonate with you.

Relationship OCD

Relationship OCD involves relentless doubt about a romantic relationship. Repetitive and intrusive thoughts about whether you really love your partner, whether they’re the right person, or whether what you feel is real. The doubt can be present even in a relationship that is, by any external measure, healthy and positive. It isn’t a sign of incompatibility. It’s OCD that has found a target.

Scrupulosity (Religious and Moral OCD)

Scrupulosity involves intrusive fears about sin, moral failure, offending God, or being a fundamentally bad person. It can show up within religious practice, with prayers that must be repeated and confessions that never feel complete, or as a secular preoccupation with honesty, ethics, and the fear of causing harm that others wouldn’t even register as a concern.

Sexual Intrusive Thoughts, POCD, and SO-OCD

Some of the most distressing and least discussed OCD presentations involve intrusive sexual thoughts: fears of attraction to children (POCD), fears about sexual orientation (SO-OCD), or fears of acting on impulses that are entirely inconsistent with who you are and that clash with your deepest values and beliefs. The shame that they carry can lead these thoughts to become a living nightmare of doubt and self-recrimination that can prevent people from seeking help for years.

Perinatal and Postpartum OCD

OCD can emerge or worsen significantly during pregnancy or following childbirth. Intrusive fears about harming the baby, catastrophic images, fears about your child’s health, worries about your parenting, and compulsive reassurance-seeking are common presentations that are frequently underreported and that are often mistaken for postpartum depression or generalized anxiety. Experience of these thoughts does not mean that you are a bad parent, but it may mean that treatment would be helpful.

OUR APPROACH

Treatment that starts with understanding you.

OCD is one of the most misunderstood conditions in all of mental health. General talk therapy, insight-focused approaches, and even standard CBT that isn’t adapted for OCD can inadvertently reinforce the cycle of obsessions and compulsions rather than interrupt it. Effective OCD treatment is different. It’s structured, evidence-based, and requires specific clinical training in how OCD works and how to treat it. The first few sessions are about understanding you and your OCD specifically. The content of your obsessions, the compulsions and safety behaviors that you’ve developed in order to manage them, the avoidance that has built up over time, and what you want your life to look like on the other side. We also make sure to ask people about other mental health experiences like depression, trauma, difficulties with body image, attentional difficulties, and more, as they can often intersect with OCD in important ways. Effective treatment requires a thorough, compassionate, and highly individualized approach that honours your expertise about you.

Exposure with Response Prevention (ERP) is the gold-standard, most empirically supported treatment for OCD. It works differently from most therapy, by having you steadily demonstrate to your brain that contact with a feared thing is not dangerous. The exposure component involves gradually and deliberately confronting the thoughts, situations, or sensations that trigger obsessions. The response prevention component means resisting the urge to engage in compulsions or safety behaviors afterward. By doing this, your brain eventually learns that the anxiety signals it is sending you are unnecessary, and it stops sending them as frequently or as strongly. With repetition, this pattern forms a new cycle, one that reduces anxiety and that reconnects you with your life. ERP is not comfortable. That’s an honest thing to say. But it’s the approach that actually changes things, not just in the short term, but in a way that lasts. And in our experience, people are often surprised by how manageable it can be when it’s done well: at the right pace, with the right support, and designed around the life that they actually want back.

Inference-Based CBT (I-CBT) is another treatment for OCD that is supported by over twenty years of clinical research, including randomized controlled trials showing effectiveness comparable to exposure-based treatment. It can be used as a standalone approach or in combination with ERP, and it is particularly well-suited to presentations where the obsessional doubt feels highly convincing or where previous ERP has been difficult to sustain. I-CBT involves application of distinct concepts and skills that target the logical tricks and faulty reasoning that OCD uses to convince us that our doubts are legitimate and worth acting on. It is organized around the core concept of inferential confusion, which refers to a particular moment in the OCD reasoning process where your mind transitions from paying attention to things that are happening in the tangible, directly observable, present moment and crosses into playing out imagined scenarios and possibilities. You can see the stove is off. Your senses confirm it. But OCD redirects your reasoning toward “what if?” rather than “what is,” and a hypothetical possibility begins to feel like an urgent, real threat.

One common analogy for ERP and I-CBT is that they are two different ways of walking through the haunted house of OCD. ERP is like gradually walking through the haunted house a little bit at a time. First just looking at the house, then going through the first room, and eventually working up to walking through each floor, over and over, so many times that the house no longer holds any shock factor. I-CBT on the other hand, is like turning on the lights before walking into the house, and getting to see how what your brain was telling you was going to be a terrifying ordeal is really nothing other than a few old costumes being worn by some tired and underpaid actors.

OUR DIFFERENCE

Specialist training.
Private practice access.

Every clinician at Laksman Doell Psychology is a doctoral-level psychologist who is registered with, or working toward registration with, the College of Psychologists and Behaviour Analysts of Ontario (CPBAO). Our team has trained at sites including, but not limited to, the Centre for Addiction and Mental Health (CAMH), the Frederick W. Thompson Anxiety Disorders Centre (Canada’s leading centre of care for the treatment of OCD and related disorders) at Sunnybrook Health Sciences Centre, St. Joseph’s Healthcare Hamilton, Princess Margaret Cancer Centre, Toronto General, North York General, Cleveland Clinic Canada, and the University of Toronto.

We have clinicians with specific training in ERP and I-CBT for OCD. Not just those trained in general anxiety treatment. OCD-specific care. This is a meaningful distinction. When you reach out, please let us know that OCD is your presenting concern so that we can match you with the right person.

Sessions are available in person at 27 Prince Arthur Avenue in the Annex neighbourhood of Toronto, or virtually across Ontario via PHIPA-compliant video. All services are available virtually to any Ontario resident. No referral required.

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Frequently Asked Questions

I’ve tried therapy for OCD before and it didn’t help. What’s different here?

It’s one of the most common things that we hear. General talk therapy and standard CBT can feel like the logical starting point, but for OCD specifically, they often miss what matters. Standard anxiety strategies such as cognitive restructuring, breathing exercises, or exploring the origins of your fears, can actually strengthen the OCD cycle rather than interrupt it. In some cases, sessions can themselves function as a form of compulsion. That is, if therapy becomes a place to process fears and to receive reassurance, the OCD can fuel itself from these exchanges.
Effective OCD treatment requires a clinician who understands the specific mechanics of OCD. What drives compulsions, how avoidance functions, what response prevention actually means in practice, and how to build an exposure plan that’s gradual enough to sustain and challenging enough to produce change. Every clinician at Laksman Doell Psychology is a doctoral-level registered psychologist. When OCD is your presenting concern, we match you with someone who has specific, supervised clinical training in ERP and I-CBT for OCD. Not general mental health training. OCD-specific expertise. That distinction is why people who have tried therapy before and found it unhelpful often find that this is where things actually shift.

I’m scared that ERP will make my OCD worse. How do you address this?

The fear of ERP is very understandable, and we hear it often. If it was as easy as “facing your fears” then you would have done that a long time ago. ERP, when done well, is not about confronting your most distressing fears all at once. It’s a graduated, collaborative process built around what you’re actually ready to do. You and your clinician build an exposure hierarchy together. You decide what goes on the list and when you move forward. The pace is yours. And if ERP doesn’t feel like the right fit, or if you’ve tried it before and it wasn’t sustainable, we also offer Inference-Based CBT (I-CBT). I-CBT works differently: rather than habituating to distressing thoughts through repeated exposure, it targets the faulty reasoning process that gives those thoughts their power in the first place. Some people find this approach more accessible, particularly when the thought content is very distressing or when the obsessional doubt feels very convincing. We can talk through the options with you and find an approach that you feel confident about.

Does OCD therapy actually work?

Yes. Exposure with Response Prevention (ERP) is one of the most rigorously studied treatments in all of psychology, with decades of research supporting its effectiveness across every OCD subtype. Most people who engage in well-delivered ERP see meaningful reductions in their symptoms. Many go on to feel genuinely free of the disorder’s grip on their daily life. The research is consistent: with the right treatment, real change is possible.

How is ERP different from regular CBT?

Most talk therapy and standard CBT work on evaluating the accuracy of a thought. This focus on the interpretation can end up leading people to engage in an endless inner debate about whether their doubts are accurate or not. This process can inadvertently become a form of reassurance-seeking, which is a compulsion in and of itself, and which makes the anxiety stronger in the long run. ERP instead stops the overarching cycle of obsessions and compulsions, leading to sustained change over time.

How do you treat “Pure O” or OCD where the compulsions are actually mental behaviours?

This is one of the most common points of confusion in OCD treatment, and one of the most common reasons that people end up with therapists who don’t quite understand what’s happening for them. The term “Pure O” implies no compulsions. That’s not entirely accurate. What’s true is that the compulsions are internal and invisible to others: mental reviewing, internal reassurance-seeking, trying to figure out whether a thought is true, neutralizing a “bad” thought with a “good” one, mentally replaying events, or praying to undo something that you thought or said.
These mental compulsions are every bit as exhausting as physical rituals, and they respond to the same core treatment approaches. ERP can be adapted for mental rituals, and I-CBT in particular can be highly effective for presentations where the compulsions are primarily cognitive. This is where working with someone who has specific OCD training and a body of experience can be most crucial. Designing exposures for “Pure-O” expressions requires some creativity, and benefits from the experience of having worked with many others who have had similar experiences. This is why we are passionate about hiring psychologists with specific OCD training and experience, and then carefully matching clients seeking OCD treatment with them.

What if the thoughts I am having don’t match examples of OCD I found online?

Part of the importance of working with doctoral-level psychologists is their focus on assessment. If you are not sure about the best way to understand and address your mental health concerns, your psychologist can work with you to clarify that. In addition, intrusive thoughts can focus on essentially any topic. It is common for individuals with OCD to have intrusive thoughts that do not closely resemble the various “subtypes” described online. In these cases, evidence-based treatments are often just as effective because they target the cycle underlying OCD, not the thoughts themselves.

I don’t have OCD, but someone I care about does. What can therapy offer me?

OCD is hard, whether you are experiencing it directly or caring for someone who is. It is common to feel at a loss for how to help your loved one. Do you assist them in doing compulsions? How do you control feelings of sadness or frustration when they are doing their best? How can you help them without them feeling controlled or judged? In situations like this, talking to a psychologist with OCD training can be very helpful. They can give you important information about OCD, and what helps and hurts when caring for a loved one with OCD. They can help you to find ways to communicate effectively with your loved one, to learn skills and strategies to help them in moments of distress, and to set compassionate boundaries so that their OCD does not overwhelm your life and relationship.

How long does OCD treatment take?

This varies considerably depending on the severity of your symptoms, how long OCD has been present, and how much avoidance has accumulated over time. Many individuals begin to see meaningful change within twelve to twenty sessions. Some require longer engagement, particularly when OCD has been present for many years or has affected multiple areas of life. You’ll have a much clearer picture of what to expect after the first few sessions, once your clinician has a thorough understanding of your presentation.

Is OCD therapy at your practice covered by OHIP?

Private practice services are not covered by OHIP. Coverage may be available through extended health benefits, as many plans cover the services of a registered psychologist. We recommend confirming with your provider before commencing treatment.

Can I receive OCD therapy virtually in Ontario?

Yes. All services, including ERP for OCD, are available via PHIPA-compliant video for any Ontario resident. We see clients virtually from across the province, including Ottawa, London, Kingston, Hamilton, Thunder Bay, and smaller communities where OCD specialists aren’t available locally. ERP can be delivered effectively online, and for presentations where exposures involve home or community environments, virtual therapy is often more practical than in-person care.

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The first step is a brief consultation to help understand what you are looking for. Email us at [email protected] or complete our contact form online.