Some OCD doesn’t show up in obvious rituals.

It doesn’t look like hand-washing.
It doesn’t look like checking the stove.
It doesn’t look like routines anyone can easily point to and name.

Instead, it lives quietly in the mind.

It hides inside rumination loops, mental checking, reassurance-seeking, internal debates, emotional self-monitoring, avoidance, and a relentless attempt to feel certain enough to finally rest.

This is the form of OCD I specialize in treating: the kind that is largely invisible to others, deeply shame-based, and profoundly exhausting to live inside.

It often shows up as:

• Relationship OCD (ROCD)

• Harm OCD

• Religious or Moral Scrupulosity

• Existential OCD

• Identity-Focused OCD

• Meta-OCD

• Chronic rumination loops

• Reassurance-seeking

• Emotional self-monitoring

• Subtle avoidance and mental safety behaviors

Many people don’t come in saying, “I have OCD.”
They come in saying things like:

“I need help with my relationship OCD and anxiety.”
“I can’t stop my mind from dwelling on past negative moments.”
“I’ve struggled all my life with various aspects of OCD and anxiety.”
“I feel out of control inside my own head.”

Underneath all of these experiences is the same core pattern:

A nervous system that has learned to treat thoughts as danger, and certainty as safety.

 

Why This Form of OCD Feels So Personal and So Scary

OCD attaches to what you care about most.

Your relationship.
Your morality.
Your faith.
Your identity.
Your safety.
Your sense of being a good person.

Because the content is meaningful, people often start to believe:

• “This must mean something about me.”

• “If I were truly good, I wouldn’t have these thoughts.”

• “If I were with the right partner, I wouldn’t feel this way.”

• “If I could just figure this out, I’d finally feel okay.”

Instead of recognizing OCD, people begin questioning their entire selfhood.

This is where shame grows.
This is where people try to manage everything privately (through thinking, analyzing, checking, replaying, monitoring, and seeking reassurance), without realizing these strategies are the compulsions themselves.

 

Internal Compulsions Are Still Compulsions

Mental rituals are still rituals.

Rumination is a compulsion.
Reassurance-seeking is a compulsion.
Mental checking is a compulsion.
Emotional self-monitoring is a compulsion.
Trying to “figure it out once and for all” is a compulsion.

They are simply quieter, and therefore often go unrecognized and untreated for much longer.

 

What People Usually Want From Treatment

Most people are not trying to get rid of their thoughts.

They want:

“Not to be so bothered by my thoughts.”
“To stop feeling controlled by my mind.”
“To feel at peace again.”
“To trust myself.”
“For my periods of recovery versus overwhelm to be at a different ratio.”

This is not about thought elimination.

It is about safety, agency, and freedom inside your own mind.

 

How I Treat This Form of OCD: Integrating Several Approaches

This type of OCD cannot be treated only at the surface: it is neurological, cognitive, emotional, relational, and identity-based.

My approach is integrative and collaborative, and it draws from several approaches:

• ERP adapted specifically for internal and subtle compulsions

• Psychoeducation about how OCD works in the brain

• Mindfulness-based ways of disengaging from thought urgency

• Depth Therapy, including Schema Therapy and Enneagram-informed work

 

At the Heart of the Work

At the heart of my work is a gentle, brain-informed way of working with OCD that helps you learn to recognize intrusive thoughts as neurological misfires, and slowly rebuild trust in your own inner authority.

You are not being asked to submit to a rigid method or follow a formula.

Instead, you actively learn how your nervous system has come to treat certain thoughts as emergencies, and how to respond in ways that restore choice, agency, and self-trust.

 

ERP for Quiet and Internal Rituals

ERP is thoughtfully adapted to work with the internal compulsions that keep this form of OCD alive, such as:

• rumination

• reassurance-seeking

• emotional checking

• mental reviewing

• certainty-seeking

Rather than forcing exposure that will feel too triggering, or pushing through distress, the work involves gently allowing uncertainty, discomfort, and "not knowing," while stepping out of the mental rituals that reinforce fear.

Over time, the nervous system learns that uncertainty is not danger, and that life does not need to be paused until certainty arrives.

 

Mindfulness & Psychoeducation

Clients learn:

• why OCD hijacks attention

• how and why the brain falsely flags certain thoughts as threats

• how to observe thoughts without engaging them

• how to step out of urgency and into presence

This builds internal safety and reduces the power thoughts have to dictate behavior.

 

Depth Therapy: Healing What OCD Hooks Into

OCD does not attach randomly.

It latches onto values, identity, meaning, and responsibility.

Depth-oriented work allows us to explore and soften patterns such as:

• shame and defectiveness

• unrelenting standards

• emotional deprivation and abandonment

• hyper-responsibility

• purity, control, and moral perfectionism

This work does not replace ERP, it supports it by addressing the emotional and identity-level terrain OCD exploits.

 

What Healing Actually Looks Like

Healing is not the absence of thoughts.

It often sounds like:

• “The thoughts still show up, but they don’t control my life.”

• “I trust myself again.”

• “I can feel anxious and still move forward.”

• “My calm lasts longer.”

• “My life feels like mine again.”

Not perfect.
Not thought-free.

But freer.

 

If This Feels Familiar

You are not broken.
You are not dangerous.
You are not morally flawed.

You have a nervous system that learned to equate absolute certainty with safety, and that learning can change.

Quiet OCD is real, And it is deeply manageable with treatment.

 

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Meet Rebecca Steele, Registered Social Worker, Psychotherapist (MA, MSW, RSW, CCC)

Rebecca is a Waterloo-based trauma therapist offering virtual counselling across Ontario. With over a decade of experience, she helps adults navigate trauma, anxiety, OCD, and self-esteem. Her insight-driven depth therapy approach supports self-understanding, emotional healing, and lasting change. Book an appointment or learn more about her online therapy services. Located outside Ontario? You can explore Rebecca’s coaching and consulting offerings here.