OCD Therapy in Virginia, Maryland, and DC
You may be tired of spending your days trying to settle questions that never seem to stay settled.
I offer online OCD therapy for adults in Maryland, Virginia, and Washington, DC, including people who have worked hard in treatment and still feel stuck.
My collaborative, somatic approach brings attention to both your thoughts and your physical experience, with care that respects your trauma history and neurodivergent needs.
However, there is hope for mental peace —it’s within your reach.
When Your Mind Won’t Let a Question Rest
Do you relate to any of these?
You replay conversations long after they end, searching for something you missed.
You keep checking your feelings about your partner, turning moments together into tests of love or attraction.
You feel pulled to check, clean, repeat, or ask for reassurance even when you want to move on.
You get a little relief, only to have another question or doubt take its place.
You recognize the familiar pattern, yet still feel an urgency in your body to find an answer right now.
You spend so much time in your head—analyzing, anticipating, or replaying—that it is hard to feel present with people you love or during activities you enjoy.
You question what an unwanted thought says about your character, intentions, or who you really are.
You put off decisions or avoid situations because you feel you need to be completely certain before moving forward.
From the outside, you may seem to be managing.
Inside, you feel exhausted by the checking, ashamed of thoughts you never wanted, or frustrated that knowing about OCD has not made it stop.
If you are neurodivergent or have experienced trauma, you may also be wondering whether another therapist will understand what overwhelms you and what helps you feel regulated.
Perhaps what you want most is to be present with someone you love, finish a task, or rest without turning it into another question to solve.
You Are Not Alone in Feeling Stuck
OCD can involve private struggles that other people rarely see, including repeated mental reviewing, checking feelings, and seeking certainty.
Those experiences can be difficult to recognize when the familiar picture of OCD centers on cleaning or visible rituals.
Still needing help after therapy does not mean you have failed. Your effort matters, including what you have learned about approaches that fit and those that leave something unaddressed.
We can work toward less time caught in these patterns and more room for the relationships, activities, and rest you care about.
If You’ve Tried ERP, I-CBT, or Talk Therapy and Still Need Help
It can be discouraging to invest in treatment and still struggle. You may have made progress in one area while another remains difficult, or found that an approach did not adequately account for your sensory needs or trauma history.
Exposure and response prevention (ERP) is a well-established OCD treatment. Inference-based cognitive behavioral therapy (I-CBT) addresses the reasoning processes involved in obsessional doubt and has a growing research base. These approaches help many people, and individual responses vary.
I offer a somatic option for adults exploring an alternative to ERP or I-CBT, including those who have not benefited enough from previous treatment. We begin with what helped, what felt difficult, and what you still need. Together, we consider whether my approach is an appropriate next step and whether additional OCD care would be useful.
OCD Therapy: A Somatic Therapy and Brainspotting Approach
You may understand that a thought is part of OCD and still feel an urgent need to check, review, or find an answer. My somatic approach includes attention to that emotional and physical experience.
I draw on Dr. Pie Frey’s Brainspotting OCD Model, which incorporates ideas from Dr. Jeffrey Schwartz’s research and book titled “Brain Lock”. As a Certified Brainspotting Therapist, I have found this combination straightforward, effective, and lasting. Together, we adapt it to your sensory needs, trauma history, and goals.
What are the steps for Somatic-based OCD Therapy?
Step #1:
Recognize When Your Brain Feels Stuck in Gear
OCD involves brain networks that help notice possible problems and guide how we respond. Schwartz describes the difficulty moving on as being “stuck in gear.” You may have already considered a question or checked something, yet the feeling that something needs attention keeps returning.
This is a metaphor for the experience, not a statement that your brain is broken. It helps us understand why moving on can feel difficult and gives us a way to talk about practicing a different response.
Step #2:
Bringing Understanding and Body Awareness Together
Using Brainspotting, we identify focused eye positions connected with recognizing the OCD pattern, noticing its emotional and physical pull, and accessing a supportive or pleasurable experience. This draws on Dr. Frey’s three-Brainspot setup.
You do not have to explain every thought or be skilled at noticing your body. I guide the process, and we adjust the pace together. If focusing on sensations increases overwhelm or monitoring, we adapt.
Step #3:
Practicing a Different Response
We practice noticing the pull of OCD and shifting attention toward something meaningful, enjoyable, or supportive. The aim is to help you return to your life with more flexibility, even when a question remains unresolved.
Repeated practice draws on neuroplasticity, the brain’s capacity to learn and change through experience. We look for practical changes, such as less time spent reviewing and more ability to be present. We also check that the practices are helping rather than becoming another ritual.
Schwartz’s Four Steps for OCD
Dr. Jeffrey Schwartz’s Four Steps from Brain Lock—Relabel, Reattribute, Refocus, and Revalue—help guide this work. Originally developed to support behavioral treatment, including ERP, these ideas also inform Dr. Frey’s Brainspotting model.
Relabel — Notice the Pattern
We practice recognizing an obsessive thought or compulsive urge, including mental reviewing or checking your feelings. Naming the pattern can create an opportunity to choose how you respond.
Reattribute — Understand the Urgency
We explore how the pressure to find an answer can come from OCD. The “stuck gear” feeling does not automatically mean something needs more checking or analysis.
Refocus — Choose Your Next Action
We practice directing attention toward a meaningful activity while allowing some uncertainty to remain. You do not have to wait for a perfectly quiet mind before taking part in your life.
Revalue — Give OCD Less Authority
Over time, we work toward giving OCD thoughts and urges less influence over your choices. The goal is more freedom to connect, make decisions, and spend time on what matters to you.
What to Expect in OCD Therapy
Assessment: We begin by getting to know your experiences, previous treatment, and goals. Assessment includes how much time OCD takes, what you do in response to distress, and how trauma, sensory needs, or other concerns may affect the work.
Developing a treatment plan: You can begin by describing a pattern without sharing every intrusive thought in detail. As trust develops, we work toward enough understanding to guide care appropriately.
Session structure and pacing: Sessions may include education about OCD, Brainspotting, somatic practice, and discussion of what you notice. We agree on the pace, check how the work is affecting you, and adapt when needed. Between sessions, practice can be brief and realistic for your energy and executive functioning needs.
Feedback and evaluating progress: We choose concrete signs of progress together: less time rereading a message, fewer conversations spent checking your feelings, or more ability to continue your day after a doubt appears. Your feedback guides adjustments. If the work is not helping enough, we discuss other approaches or additional support openly.
What You May Work Toward
Imagine having more room to listen to your partner, make an everyday decision, or enjoy an evening without repeatedly returning to the same question. Depending on your needs, our goals might include:
Spending less time reviewing, checking, or seeking reassurance.
Responding to intrusive thoughts with less urgency and self-criticism.
Feeling more present during conversations, activities, and everyday moments.
Making decisions with more flexibility and trust in your judgment.
Allowing changing feelings in relationships without repeatedly testing them.
Keeping the sensory supports and routines that help you function.
Returning to activities and relationships that OCD has crowded out.
Progress can be uneven. We look for changes that matter in your actual life and adjust the work around what you are learning.
Understanding OCD, Intrusive Thoughts, and Mental Compulsions
Mental Compulsions and OCD Rumination
OCD can happen largely in your mind. Unwanted thoughts or doubts may lead to mental compulsions, such as replaying conversations, checking your feelings, or reviewing memories to find certainty.
These patterns can be exhausting even when no one else notices. You do not need visible rituals for OCD to interfere with your life.
Relationship OCD and Doubts About Your Partner
Relationship OCD (ROCD) can involve repeatedly questioning your love, attraction, compatibility, or your partner’s qualities. You may compare relationships or check your feelings without finding lasting relief. We explore these patterns while taking genuine relationship concerns seriously.
Other OCD Themes and Intrusive Thoughts
OCD can focus on what matters deeply to you, creating pressure to find an answer that feels certain.
Harm and responsibility: Fearing you might hurt someone or make a serious mistake.
Morality, identity, and taboo thoughts: Questioning what unwanted thoughts mean about who you are.
Past events: Repeatedly reviewing whether you did something wrong.
Health and contamination: Getting caught in illness fears, symptom research, checking, or cleaning.
Bodily sensations: Becoming preoccupied with breathing, blinking, swallowing, or other sensations.
“Just right” feelings: Repeating or arranging things until they feel complete.
The topic alone does not establish OCD. We consider the pattern, its impact, and your actual circumstances.
Why Knowing It’s OCD May Not Make It Stop
You may recognize OCD and still feel an urgent need to check or review. Reassurance can bring brief relief before another doubt appears.
In our work, we address both your understanding of the pattern and its emotional and physical pull, helping you practice a different response.
OCD, Neurodivergence, and Trauma
OCD can coexist with ADHD, autism, and trauma-related difficulties. Understanding the overlap takes care: similar-looking behaviors can serve different purposes.
If you are neurodivergent, you may also be managing sensory overload, masking, burnout, or the effort of navigating expectations that do not fit how you function. Repeatedly monitoring yourself for mistakes can make an already demanding day feel even harder.
If you have experienced trauma, certain situations may bring up memories, physical alarm, or a strong need for protection. We explore how those experiences interact with OCD without assuming trauma explains every obsession or that every fear is an OCD symptom.
Your history, environment, and present needs belong in the treatment conversation. My work draws on my broader focus in adult ADHD and neurodivergence and trauma therapy.
Care That Respects How You Regulate
Rocking, using a fidget, wearing headphones, or keeping a predictable routine may help you participate in daily life. A behavior’s appearance alone cannot tell us whether it is an OCD compulsion.
We explore what the behavior does for you. Does it meet a sensory need, provide useful structure, or respond to a genuine risk? Does it feel driven by an obsession or a rule that must be followed to prevent something feared? Sometimes these functions overlap.
My aim is to preserve supports that help you function while addressing patterns that restrict your life. Sessions can include movement, sensory accommodations, clear explanations, and extra processing time. We also consider whether attention to body sensations is helpful for you and adapt when it increases monitoring or overwhelm.
Meet Micah Saviet, Your OCD Therapist
I’m Micah Saviet (he/him), a licensed clinical social worker and Certified Brainspotting Therapist. I work with adults through a holistic, trauma-informed, and neurodiversity-affirming approach.
My practice may be a fit if you want therapy that includes your physical and emotional experience, especially if previous treatment has left you with unresolved difficulties. I welcome both neurodivergent and neurotypical adults.
I provide online therapy for adults ages 18 and older in Maryland, Virginia, and Washington, DC. A consultation gives us a chance to discuss what you are looking for and whether my approach fits your needs.
Questions You May Have Before Reaching Out
What If I Invest in Therapy Again and Still Feel Stuck?
After putting time, money, and energy into treatment, it makes sense to be cautious. We can talk about what ERP, I-CBT, or other therapy helped with and what remains difficult. I will explain how I work, discuss the evidence and its limits, and help you consider whether this approach fits your needs. If we work together, we will review progress and revisit the plan when needed. With your consent, we can also coordinate with another provider.
What If Therapy Feels Overwhelming or I Do Not Want Exposure Exercises?
My approach centers on somatic work and Brainspotting. It is an option to discuss if you are seeking an alternative to a structured ERP protocol. Therapy may still bring up distress, and we talk through exercises beforehand, agree on pacing, and adjust based on your response. You can tell me when something feels too much or does not fit. Sensory accommodations and useful regulation supports belong in that conversation.
What If I Feel Too Ashamed to Explain My Thoughts?
You can begin with a broad description, such as “I keep questioning my relationship” or “I have unwanted thoughts that frighten me.” My role is to understand your experience with care and curiosity. You do not have to share every detail at the outset. We discuss what information is needed for assessment and treatment as we build a working relationship.
Frequently Asked Questions About OCD Therapy in VA, MD, and DC
Can Somatic Therapy Help If I Spend Most of My Time in My Head?
Yes. You do not need to be skilled at noticing body sensations or quieting your thoughts to begin somatic work. We start with what is accessible to you, which might mean noticing the support of your chair, looking around the room, or connecting with an activity you enjoy.
In our work, these experiences offer opportunities to practice bringing attention back to the present when mental reviewing pulls you away. The aim is greater flexibility in where you place your attention and more participation in your life, even when thoughts are still present.
If focusing inward increases anxiety, sensory discomfort, or compulsive monitoring, we adapt. Being present does not require constant awareness of your body or a perfectly quiet mind.
Can I Have OCD If Most of It Happens in My Head?
Yes. Compulsions can involve reviewing, comparing, counting, or reassuring yourself internally. You do not need obvious outward rituals for OCD to interfere with your life. Assessment helps distinguish these patterns from other kinds of repetitive thinking.
How Is Relationship OCD Different From Ordinary Relationship Doubt?
The difference involves the pattern and impact of the questioning. With ROCD, doubts can lead to repetitive checking or reassurance seeking that takes significant time and provides little lasting resolution. We also take real relationship concerns seriously.
Is Rumination a Compulsion?
It can be. Repeatedly analyzing a thought to neutralize distress or reach certainty can function as a mental compulsion. Rumination also occurs in other conditions, so we consider its purpose and context rather than labeling all overthinking as OCD.
Can OCD and Trauma Be Addressed Together?
Both can be considered in a coordinated treatment plan. We assess which symptoms relate to OCD, trauma, or overlapping difficulties and decide where to begin. Your history matters, and we do not assume that processing trauma alone will resolve OCD.
How Do You Distinguish OCD From Autistic Traits or Sensory Needs?
We explore the function of a behavior, what happens around it, and your own experience. A routine or stim may provide needed regulation; an OCD ritual may be driven by a feared consequence or an urgent need for certainty. Sometimes both are involved.
What Is the Evidence for Brainspotting for OCD?
Research on Brainspotting specifically for OCD is limited. I use this integration based on my clinical experience and training. ERP has substantially stronger OCD-specific research support, and Schwartz’s brain-imaging studies did not test Brainspotting. We can discuss these differences when considering your options.
Do You Offer Online OCD Therapy in Maryland, Virginia, and DC?
Yes. I work with adults through secure online sessions, including clients in Silver Spring, Falls Church, and Washington, DC. You must be physically located in Maryland, Virginia, or DC during each session. A consultation can help us explore whether online work fits your needs.
Ready to Feel More Grounded, Calm, and in Control?
Start With a Free Consultation
If you are looking for another way to work with OCD, you can start with a conversation about what you have tried and what you still need. A free 15-minute consultation gives us a chance to answer your questions and explore whether working together feels like a fit.
I provide somatic OCD therapy for adults in Silver Spring, MD, Falls Church, VA, and Washington, DC, as well as through secure online sessions for clients across the region.
👉 Book your consultation today