OCD & ERP Therapy in St. Louis, Missouri & Chicago, Illinois
Specialized Exposure and Response Prevention (ERP) Therapy for Women and Men with OCD, Intrusive Thoughts, & Compulsions
St. Louis, Missouri ● Online Therapy in Chicago & Throughout Missouri and Illinois
When your thoughts feel distressing, overwhelming, and all-consuming and you feel unable to stop responding to them.
OCD & ERP Therapy in St. Louis, Missouri & Chicago, Illinois
Maybe this sounds familiar: you have a thought that scares you, and suddenly you need to know what it means. What if the thought says something about who I am? What if something terrible happens? What if I can’t be certain?
Many people live with Obsessive-Compulsive Disorder (OCD) for years without realizing that intrusive thoughts—and the things they do to feel better afterward—may be part of OCD.
You may find yourself caught in a cycle of intrusive thoughts and compulsions: checking, seeking reassurance, mentally reviewing conversations or events, researching online, avoiding triggers, repeating behaviors until they feel “just right,” or trying to make unwanted thoughts disappear.
These behaviors may provide temporary relief. But the more you try to achieve certainty, the more powerful OCD can become.
I provide OCD therapy using Exposure and Response Prevention (ERP) for adults in St. Louis and online in Chicago and throughout Missouri and Illinois. ERP can help you recognize the OCD cycle, reduce compulsions, and learn to respond differently to intrusive thoughts and uncertainty.
You don't have to organize your life around what OCD needs you to know, check, avoid, or make certain.
ERP can help OCD take up less space in your life.
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Many individuals with OCD are initially told they have anxiety because their compulsions aren't always visible. Instead of repeatedly washing their hands or checking locks, they may spend hours mentally reviewing conversations, seeking reassurance, researching online, replaying memories, or trying to "figure out" whether their fears are true.
Because these rituals happen internally, OCD can easily be mistaken for generalized anxiety.
An accurate diagnosis is important because OCD responds best to specialized treatment, including Exposure and Response Prevention (ERP), rather than reassurance or simply trying to reduce anxiety.
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OCD often begins with a thought that feels urgent, frightening, or impossible to ignore.
"What if I left the stove on?"
"What if I contaminated my baby?"
"What if I hit someone while driving?"
"What if this intrusive thought means something about me?"
Unlike ordinary worry, OCD rarely responds to reassurance.
Even after checking, washing, researching, mentally reviewing, or asking someone else for certainty, the relief is usually temporary before the doubt returns.
If this sounds familiar, help is available.
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Checking doors, appliances, or locks repeatedly.
Feeling responsible for preventing something bad from happening.
Washing, cleaning, or sanitizing far beyond what feels reasonable.
Constantly seeking reassurance from others.
Experiencing distressing intrusive thoughts you don't want.
Mentally replaying conversations or events.
Avoiding situations because they trigger uncertainty.
Feeling like things need to feel "just right."
Knowing your fears seem irrational—but still feeling unable to stop.
Why Work With Joanna
OCD is frequently misunderstood. Many of the adults I work with have spent years believing they simply have anxiety, are "overthinkers," or need to try harder to control their thoughts.
My approach combines Exposure and Response Prevention—the gold-standard treatment for OCD—with relational psychodynamic psychotherapy. ERP helps reduce the cycle of obsessions and compulsions, while psychodynamic therapy offers a deeper understanding of the emotional patterns, relationships, and life experiences that shape how you relate to yourself and the world around you.
My goal is twofold: to help you break free from OCD's grip while developing a deeper understanding of yourself. Together, we'll work toward reducing compulsions, increasing your tolerance for uncertainty, and helping you reclaim the parts of your life that OCD has taken from you.
Common Types of OCD I Treat
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Contamination OCD
Fear of germs, illness, chemicals, bodily fluids, or contaminating yourself or others through everyday activities.
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Checking OCD
Repeatedly checking appliances, locks, driving routes, text messages, or other situations to prevent harm or gain certainty.
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Harm OCD
Distressing fears of accidentally or intentionally harming yourself, your baby, or someone else—even though these thoughts are unwanted and upsetting.
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Perinatal & Postpartum OCD
Intrusive thoughts, checking, avoidance, and compulsions that develop during pregnancy or after childbirth.
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Relationship OCD
Persistent doubt about your relationship, reassurance seeking, questioning your feelings, or fearing you're with the wrong partner.
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"Just Right" OCD
You may feel a strong sense that something is off, incomplete, uneven, or not quite right, even when you know logically that nothing is actually wrong. You might repeat an action, adjust something, reread, rewrite, arrange, or mentally review until it finally feels “right.”
Common Questions About OCD & ERP Therapy
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Although OCD and anxiety disorders share many symptoms, they are not the same.
OCD is characterized by obsessions (intrusive, unwanted thoughts, images, or urges) and compulsions (behaviors or mental rituals performed to reduce anxiety or gain certainty).
Many individuals with OCD believe they simply have anxiety because their compulsions are often invisible to others.
Instead of obvious rituals, they may repeatedly seek reassurance, mentally review conversations, research online, avoid situations, or try to "figure out" their thoughts.
If anxiety is being driven by intrusive thoughts and the need to feel certain, OCD may be the underlying issue.
Therapy can help determine what's happening and identify the treatment that's most likely to help.
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OCD doesn't convince you because your thoughts are more dangerous than anyone else's—it convinces you because the thoughts target what matters most to you.
Whether it's your child, your relationship, your health, your faith, or your integrity, OCD latches onto the things you care about most and demands certainty that you can never fully achieve.
Therapy helps you step out of that cycle by learning that you don't need certainty to live a meaningful, fulfilling life. That shift—from chasing certainty to tolerating uncertainty—is at the heart of lasting OCD recovery.
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Intrusive thoughts are unwanted, repetitive thoughts, images, or urges that can feel disturbing or frightening. They are often the exact opposite of your values, which is why they feel so frightening.
Experiencing intrusive thoughts does not mean you want them to happen or that they reflect who you are.
In fact, people with OCD are often deeply distressed precisely because these thoughts feel so inconsistent with their character.
Therapy can help you understand why intrusive thoughts occur and reduce the fear and shame that often surround them.
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Mental compulsions are invisible rituals used to reduce anxiety, such as mentally reviewing events, seeking certainty, replaying conversations, counting, praying, or trying to "figure it out."
They can keep the OCD cycle going just as much as visible compulsions.
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ERP is the gold-standard treatment for OCD.
Rather than trying to eliminate intrusive thoughts, ERP helps you change your relationship with them.
Together, we'll gradually practice facing situations, thoughts, or feelings that trigger anxiety while resisting the compulsions—such as checking, reassurance seeking, avoidance, researching, or mental reviewing—that temporarily reduce anxiety but keep OCD going.
Over time, your brain learns that uncertainty is tolerable and that you don't need compulsions to feel safe.
ERP is collaborative, individualized, and completed at a pace that feels challenging yet manageable.
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Reassurance may reduce anxiety briefly, but it reinforces the OCD cycle by teaching your brain that certainty is necessary.
Over time, this often leads to needing more reassurance rather than less.
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ERP intentionally brings you into contact with situations that trigger anxiety, so it's normal to experience temporary discomfort during exposures.
However, the goal isn't to increase anxiety—it's to help your brain learn that anxiety naturally rises and falls without needing compulsions to make it go away.
As treatment progresses, many people find they spend less time trapped in fear, reassurance seeking, checking, and avoidance.
While ERP can feel challenging, it's completed collaboratively, at a pace that's appropriate for you, and with my support every step of the way.
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No. Effective ERP therapy begins with developing a shared understanding of how OCD works and identifying the specific obsessions and compulsions that keep the cycle going.
Together, we'll create an individualized treatment plan and gradually build an exposure hierarchy based on your goals and readiness.
Exposures are never about forcing you into overwhelming situations. They're thoughtful, collaborative exercises designed to help you build confidence while learning that you can tolerate uncertainty without relying on compulsions.
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Yes. I provide virtual Exposure and Response Prevention (ERP) therapy for women throughout Missouri and Illinois experiencing OCD, intrusive thoughts, and compulsive behaviors.
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Yes. ERP can be effective for relationship OCD (ROCD), where doubts about your relationship can lead to repeated checking, reassurance seeking, comparing, analyzing your feelings, or trying to determine whether your relationship is “right.”
ERP helps you practice allowing uncertainty about your relationship without relying on compulsions to find certainty.
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Yes. OCD can begin or intensify during pregnancy or the postpartum period. Perinatal and postpartum OCD may involve intrusive thoughts about harm, contamination, responsibility, or your baby’s safety, along with checking, avoidance, reassurance seeking, or mental compulsions.
ERP can help you respond differently to these intrusive thoughts without relying on compulsions for certainty or relief.
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The length of OCD treatment varies depending on the severity of symptoms, the types of obsessions and compulsions you're experiencing, and your goals for therapy.
Many people begin noticing meaningful improvement within several months of consistent ERP practice, while others choose longer-term therapy to continue strengthening skills and explore broader emotional patterns.
Recovery doesn't mean never having another intrusive thought—it means learning that thoughts no longer control your decisions, your relationships, or the way you live your life.
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Yes. Many people experience significant improvement with ERP alone.
ERP is considered the first-line psychological treatment for OCD and has extensive research supporting its effectiveness.
For some individuals, medication may also be helpful, particularly when symptoms are more severe, and therapy can be very effective alongside medication.
The decision to use medication is personal and can be discussed with your therapist and prescribing provider.
My role is to provide evidence-based ERP while helping you develop lasting skills for responding differently to OCD.
Looking for an ERP Therapist in St. Louis or Chicago?
If you’re looking for an OCD therapist or ERP therapist in St. Louis or Chicago, you may already know that reassurance, checking, avoidance, and trying to “figure out” intrusive thoughts can provide temporary relief while ultimately keeping the OCD cycle going.
Exposure and Response Prevention (ERP) is an evidence-based treatment for OCD that helps you gradually face uncertainty and anxiety without relying on compulsions to feel relief.
I provide OCD and ERP therapy for adults in St. Louis and online in Chicago and throughout Missouri and Illinois. Treatment may address intrusive thoughts, checking, contamination fears, relationship OCD (ROCD), “just-right” OCD, mental compulsions, and perinatal or postpartum OCD.
My approach combines structured ERP treatment with space to understand the emotional and relational patterns that may accompany OCD.
You may already know that your checking, reassurance seeking, avoidance, mental reviewing, or need to feel completely certain is keeping you stuck. Knowing that—and being able to stop doing it—are two very different things.
That’s where Exposure and Response Prevention (ERP) comes in.
We’ll start by understanding how OCD operates in your life: what triggers the anxiety or uncertainty, what you feel compelled to do in response, and how those patterns have gradually narrowed your sense of freedom.
From there, we’ll gradually build exposures together.
You’ll practice facing situations that bring up uncertainty or discomfort while resisting the compulsions that OCD typically asks you to perform.
This is the “exposure” and “response prevention” part of ERP.
What is ERP Therapy Like?
ERP is collaborative. You won’t be expected to immediately confront your biggest fear, and the goal isn’t to make you anxious simply for the sake of being anxious.
We will work at a gradual pace that is challenging enough to create meaningful change while helping you develop greater confidence in your ability to experience uncertainty without relying on OCD rituals.
ERP gives us a concrete way to interrupt the OCD cycle.
The goal isn’t to reach a place where you never feel anxious or uncertain.
It’s for OCD to take up less space so your decisions, relationships, routines, and everyday life can increasingly be guided by what matters to you rather than by the need to feel completely certain.
ERP can give you more freedom. You don’t have to keep organizing your life around OCD.
Related Resources
REASONS TO BOOK
REASONS TO BOOK
You’re drawn to therapy that goes beyond symptom relief—a space with a curious, reflective, and empathetic therapist who helps you uncover the unconscious origins of your thoughts, feelings, and relational patterns, and understand how they continue to shape your present experience.
CLINICALLY TRAINED
DEEP, INSIGHT-ORIENTED APPROACH
Therapy can be challenging work, and having a skilled, clinically trained therapist by your side makes all the difference. After transforming my own career from attorney to therapist, I completed several years of advanced clinical training at both the St. Louis and Chicago Psychoanalytic Institutes. This depth of training allows me to look beyond symptoms alone, helping you understand the underlying patterns that keep you feeling stuck.
I am also clinically trained in ERP—the gold standard treatment for OCD.
WARM AND APPROACHABLE
Starting therapy can feel vulnerable. My goal is to make the process feel approachable by creating a space where you feel comfortable being yourself, asking difficult questions, and exploring what matters most to you.
