OCD Treatment: Inference-Based CBT (I-CBT)

OCD is a condition of the imagination. Obsessional doubt originates in the mind, through a narrative that bypasses sensory reality to arrive at a feared possibility: “What if I am, or could be, the kind of person who...” Compulsions follow, in an attempt to resolve a doubt that was never grounded in evidence to begin with.

I-CBT treats this reasoning process directly. Rather than building tolerance for uncertainty, it addresses how the obsessional narrative gets constructed and why it feels credible. The goal is not to manage the doubt, but to stop being convinced by it.

I will support you in understanding the specific logic of your obsessional doubts: their content, their triggers, their internal coherence. I-CBT focuses on recognizing obsessional narratives as imagination—not suppressing them, but no longer regarding them as meaningful input about reality.

OCD, autism, and ADHD

For people who are autistic or have ADHD, years of masking and social confusion can make the mind a well-practiced generator of self-doubt—especially around identity, social belonging, and relational safety. Obsessional themes centered on rejection, how one is perceived, or whether one has caused harm/offense are common, and can be easily mistaken for ordinary social anxiety or other conditions. I-CBT's focus on the reasoning process, rather than the content of the fear and tolerating discomfort.

My approach

OCD frequently targets identity—what you might be capable of, who you might really be. I will support your process without judgment, and with the understanding that the content of the obsession reflects OCD itself, rather than you as a person.