Obsessive Compulsive Disorder
OBSESSIVE COMPULSIVE DISORDER
OBSESSIVE COMPULSIVE DISORDER
What Dr. Willison Treats
OCD can make everyday life feel exhausting, unpredictable, and out of your control. If intrusive thoughts and compulsive rituals are consuming your time, straining your relationships, or keeping you from living fully, you do not have to face this alone. Dr. L. David Willison IV, MD, PhD, is a Board-certified Adult and Child/Adolescent psychiatrist in Los Angeles who specializes in evidence-based OCD treatment for patients of all ages. His approach combines clinical depth with genuine compassion, because he believes that with the right care, meaningful recovery is within reach..*-
The OCD Cycle
OCD is not simply a habit or a preference for order. It is a relentless mental loop that can take over every aspect of a person’s daily life. Understanding this cycle is the first step toward breaking it.
The OCD cycle begins with an obsession: an intrusive, unwanted thought, image, or urge that generates intense distress or anxiety. In an attempt to relieve that distress, a person engages in a compulsion, which is a repetitive behavior or mental act performed to neutralize the thought or prevent a feared outcome. While the compulsion may bring brief relief, it reinforces the brain’s belief that the obsession was genuinely dangerous, which causes the intrusive thought to return, often stronger and more frequent than before.
This cycle can repeat dozens or even hundreds of times a day, consuming hours, depleting energy, and isolating individuals from the people and activities they love. Over time, avoidance behaviors develop as patients begin structuring their entire lives around their OCD rather than around what truly matters to them.
Dr. Willison works with patients and families to interrupt this cycle at its root, not just to manage symptoms, but to reclaim a life no longer dictated by fear.
Symptoms of OCD
OCD presents differently in every patient. Some individuals are overwhelmed by fear of contamination. Others struggle with intrusive thoughts that feel deeply shameful or out of character. Still others spend hours checking, counting, or arranging and are unable to stop even when they know the behavior is excessive.
Common Obsessions
- Fear of contamination from germs, illness, or toxic substances.
- Intrusive thoughts about harm to oneself or to others.
- Fear of making a serious mistake or acting irresponsibly.
- Unwanted sexual, religious, or violent thoughts.
- An intense need for symmetry, order, or exactness.
- Fear of losing control.
- Doubts that spiral without resolution, such as worrying about whether a door was locked or whether something offensive was said.
Common Compulsions
- Excessive handwashing, showering, or cleaning.
- Repeated checking of locks, appliances, or safety measures.
- Counting, tapping, or arranging objects in a specific way.
- Seeking constant reassurance from others.
- Mentally reviewing events to ensure nothing went wrong.
- Avoiding people, places, or situations that trigger obsessions.
- Silently repeating words, prayers, or phrases to neutralize distressing thoughts.
It is important to recognize that the presence of disturbing thoughts does not reflect a person’s true character or intentions. OCD frequently targets what patients value most, and the distress these thoughts produce is itself a sign that they are ego-dystonic, meaning they go against who the patient truly is. If you or someone you love recognizes these patterns, Dr. Willison can help.
Comprehensive OCD Evaluation
Accurate diagnosis is the foundation of effective OCD treatment. Dr. Willison brings a rare combination of psychiatric and research expertise to the evaluation process, ensuring that each patient receives a thorough, individualized assessment rather than a surface-level screening.
OCD symptoms can overlap with anxiety disorders, ADHD, autism spectrum disorder, and other conditions, making precise diagnosis essential to designing a treatment plan that truly works.
Clinical Interviews
Dr. Willison conducts in-depth clinical interviews to explore the nature, frequency, and severity of a patient’s obsessions and compulsions. These conversations go beyond symptom reporting. Dr. Willison listens carefully to understand how OCD is showing up in the patient’s daily life, relationships, work or school performance, and overall sense of self. For younger patients, he also meets with parents and caregivers to build a complete and accurate picture of the child’s experience at home and in social settings.
Standardized Screening Tools
To complement the clinical interview, Dr. Willison uses validated, evidence-based instruments, including the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), to objectively measure symptom severity and track changes over the course of treatment. These tools provide a reliable baseline and ensure that progress is accurately monitored throughout care.
Medical and Psychological History
OCD does not exist in isolation. Dr. Willison reviews each patient’s full medical and psychological history, including prior diagnoses, previous treatments, medication history, and any co-occurring conditions. This comprehensive perspective allows him to identify contributing factors such as underlying anxiety, neurodevelopmental differences, or trauma that may be driving or intensifying OCD symptoms.
Personalized Treatment Plans
No two patients experience OCD the same way, which is why Dr. Willison never uses a one-size-fits-all approach. Every treatment plan is built around the individual: their specific obsessions and compulsions, their age and developmental stage, their personal goals, and their readiness for different therapeutic approaches. Treatment may include one or more of the following approaches:
- Exposure and Response Prevention (ERP): ERP is the gold-standard psychological treatment for OCD, supported by decades of clinical evidence. Dr. Willison guides patients through a structured process of gradually facing feared situations without engaging in compulsions. Over time, this allows the brain to learn that the feared outcome does not occur and that anxiety naturally decreases without the ritual.
- Cognitive-Behavioral Therapy (CBT): CBT techniques help patients identify and reshape the distorted beliefs that fuel OCD, including inflated responsibility, overestimation of threat, and the idea that intrusive thoughts carry special meaning or danger.
- Medication Management: When clinically appropriate, medication is carefully considered as part of the treatment plan. Selective serotonin reuptake inhibitors (SSRIs) are FDA-approved for OCD and can significantly reduce symptom severity, particularly when used alongside therapy. Dr. Willison’s dual background in psychiatry and research ensures that any medication decisions are grounded in the latest clinical evidence.
- Family Involvement: For children and adolescents, Dr. Willison involves families as active participants in treatment, providing psychoeducation and coaching caregivers on how to support their child without inadvertently reinforcing compulsive behaviors.
Ongoing Support and Care
Recovery from OCD is not a single event. It is a process, and Dr. Willison is committed to walking alongside patients and families through every phase of that journey, from initial evaluation through long-term maintenance.
Regular follow-up appointments allow Dr. Willison to monitor progress, adjust treatment strategies as needed, and address new challenges as they arise. Life circumstances change. Stress increases, new triggers emerge, and developmental transitions can bring new vulnerabilities. Dr. Willison’s approach evolves alongside his patients so they are never left without guidance when it matters most.
For patients in remission, ongoing support provides the structure and accountability needed to maintain gains and prevent relapse. Dr. Willison equips patients with practical tools and a thorough understanding of their own OCD so they can recognize early warning signs and respond effectively on their own.
The relationship between patient and psychiatrist matters deeply. Dr. Willison has dedicated his career to the treatment of OCD not because it is easy, but because he has witnessed firsthand how transformative the right care can be. If OCD has been holding you or your child back, compassionate and expert help is available. Call today to take the first step.
What Dr. Willison Treats
DID YOU KNOW?
Frequently Asked Questions
What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by recurring, unwanted thoughts known as obsessions and repetitive behaviors or mental rituals known as compulsions, which are performed to reduce the distress those thoughts cause. OCD is recognized by the American Psychiatric Association as a distinct condition separate from general anxiety, and it is estimated to affect approximately 2 to 3 percent of the global population across all ages, genders, and backgrounds. Despite its prevalence, OCD is frequently misunderstood and underdiagnosed.
Is OCD just about being a neat freak or liking things organized?
No. This is one of the most common and harmful misconceptions about OCD. While some individuals with OCD do experience a need for symmetry or order, OCD encompasses a wide range of distressing obsessions and compulsions that often have nothing to do with cleanliness or organization. Many patients struggle with intrusive thoughts about harm, contamination, religion, sexuality, or making catastrophic mistakes. The defining feature of OCD is not a personality preference. It is distress, loss of control, and significant interference with daily life.
At what age can OCD develop, and can children have it?
OCD can develop at any age, but it most commonly emerges in childhood, adolescence, or early adulthood. Research indicates that approximately 50 percent of adults with OCD report that their symptoms began before the age of 10. Dr. Willison is specifically trained in child, adolescent, and adult psychiatry, making him uniquely qualified to evaluate and treat OCD across the full lifespan, from young children to adults.
How is OCD different from an anxiety disorder?
While anxiety is a core feature of OCD, OCD is a clinically distinct condition. The key difference lies in the presence of obsessions and compulsions. In generalized anxiety disorder, worry tends to focus on real-life concerns such as finances, health, or relationships. In OCD, obsessions are often ego-dystonic, meaning they feel foreign, intrusive, and entirely out of character with the person’s values. The compulsive response also sets OCD apart, as people with OCD perform specific rituals to neutralize their obsessions, a feature not present in other anxiety disorders.
What causes OCD?
OCD is understood to result from a combination of genetic, neurological, and environmental factors. Neuroimaging research has identified abnormalities in brain circuitry, particularly in the orbitofrontal cortex, caudate nucleus, and thalamus, that contribute to the intrusive thought and compulsion loop. A family history of OCD increases risk, as does significant life stress, trauma, or in some cases, streptococcal infection in children, a condition known as PANDAS. Dr. Willison’s background in research allows him to translate the latest neuroscientific understanding of OCD directly into clinical care.
How is OCD diagnosed?
OCD is diagnosed through a comprehensive psychiatric evaluation that includes a thorough clinical interview, a review of medical and psychological history, and validated screening tools such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). There is no blood test or brain scan that diagnoses OCD. Accurate diagnosis depends on an experienced clinician who can differentiate OCD from overlapping conditions such as anxiety disorders, ADHD, autism, body dysmorphic disorder, and tic disorders. Dr. Willison’s expertise across multiple conditions makes him exceptionally well-suited to provide an accurate and complete diagnosis.
What treatments are most effective for OCD?
The two most evidence-based treatments for OCD are Exposure and Response Prevention (ERP) therapy and medication, most commonly selective serotonin reuptake inhibitors (SSRIs). Research consistently shows that a combination of ERP and medication produces better outcomes than either treatment alone for moderate to severe OCD. Cognitive-behavioral therapy techniques that target distorted beliefs are also incorporated into comprehensive treatment plans. Dr. Willison tailors every treatment approach to each patient’s specific symptoms, age, and circumstances.
What is Exposure and Response Prevention (ERP) therapy?
ERP is a specialized form of cognitive-behavioral therapy and is considered the gold-standard psychological treatment for OCD. In ERP, patients are gradually exposed to situations, thoughts, or objects that trigger their obsessions while being guided to resist the urge to engage in compulsions. Over time, this process allows the brain to learn that the feared outcome does not materialize and that anxiety naturally decreases without the ritual. ERP requires courage and commitment, but it produces lasting, meaningful change that medication alone cannot achieve.
Can OCD be cured, or is it a lifelong condition?
OCD is considered a chronic condition for many patients, but it is highly treatable. Many people achieve significant symptom reduction or long-term remission with the right care. The goal of treatment is not simply to manage OCD, but to reduce its interference with daily life to the point where it no longer controls a patient’s decisions, relationships, or sense of self. With consistent treatment and the right support, many patients go on to lead full, productive, and meaningful lives.
How long does OCD treatment typically take?
Treatment timelines vary based on symptom severity, co-occurring conditions, and each individual’s response to therapy and medication. Many patients begin to notice meaningful improvement within 12 to 20 sessions of ERP therapy. Medication, if prescribed, may take 8 to 12 weeks to reach its full therapeutic effect. Ongoing maintenance care is often recommended to consolidate gains and prevent relapse. Dr. Willison works collaboratively with each patient to set realistic expectations and monitor progress throughout every stage of treatment.
Are there medications specifically approved for OCD?
Yes. Several SSRIs are FDA-approved for the treatment of OCD, including fluvoxamine, fluoxetine, sertraline, and paroxetine. Clomipramine, a tricyclic antidepressant, is also FDA-approved for OCD and can be particularly effective for treatment-resistant cases. Medication for OCD typically requires higher doses and longer treatment durations than those used for depression. Dr. Willison carefully weighs the benefits and risks of any medication decision, taking into account each patient’s age, medical history, and treatment goals.
How does OCD affect children differently than adults?
In children, OCD symptoms may present differently. A child may not be able to articulate that their thoughts are intrusive or excessive, and compulsions may be more behavioral than mental. Children with OCD often involve family members in their rituals, a pattern known as family accommodation, which can inadvertently reinforce symptoms over time. OCD can significantly impact a child’s academic performance, social development, and family relationships. Dr. Willison’s specialization in child and adolescent psychiatry allows him to approach pediatric OCD with developmentally appropriate strategies and meaningful family involvement throughout the treatment process.
What is the role of family members in OCD treatment?
Family members play a critical role in both the maintenance and recovery from OCD. When loved ones accommodate OCD by participating in rituals, providing repeated reassurance, or helping a patient avoid triggers, they unintentionally reinforce the disorder. Family psychoeducation and coaching are a core component of Dr. Willison’s approach, particularly for younger patients. Learning how to support a loved one without enabling compulsions is one of the most impactful steps a family can take to support lasting recovery.
Can OCD co-occur with other mental health conditions?
Yes. OCD frequently co-occurs with other conditions, including anxiety disorders, depression, ADHD, autism spectrum disorder, tic disorders, and body dysmorphic disorder. Research suggests that up to 90 percent of individuals with OCD meet criteria for at least one additional psychiatric diagnosis. Accurate identification and treatment of co-occurring conditions is essential, as untreated comorbidities can significantly limit the effectiveness of OCD-specific treatment. Dr. Willison’s broad expertise across multiple conditions uniquely positions him to provide integrated, comprehensive care.
Why choose Dr. Willison for OCD treatment in Los Angeles?
Dr. L. David Willison IV holds both an MD and a PhD, bringing a rare integration of clinical psychiatry and research expertise to his private practice in Los Angeles. He is trained in child, adolescent, and adult psychiatry, making him one of the few psychiatrists in the area qualified to treat OCD across the full lifespan. Dr. Willison considers OCD treatment to be one of the most personally and professionally rewarding aspects of his career, and he approaches every patient with the clinical rigor, compassion, and individualized attention that lasting recovery requires. His practice serves patients throughout Los Angeles from his office at 10850 Wilshire Blvd, Suite 850. To schedule a consultation, call 415-412-4613 or submit a request online.
DID YOU KNOW?
Frequently Asked Questions
What is obsessive-compulsive disorder (OCD)?
Obsessive-compulsive disorder (OCD) is a chronic mental health condition characterized by recurring, unwanted thoughts known as obsessions and repetitive behaviors or mental rituals known as compulsions, which are performed to reduce the distress those thoughts cause. OCD is recognized by the American Psychiatric Association as a distinct condition separate from general anxiety, and it is estimated to affect approximately 2 to 3 percent of the global population across all ages, genders, and backgrounds. Despite its prevalence, OCD is frequently misunderstood and underdiagnosed.
Is OCD just about being a neat freak or liking things organized?
No. This is one of the most common and harmful misconceptions about OCD. While some individuals with OCD do experience a need for symmetry or order, OCD encompasses a wide range of distressing obsessions and compulsions that often have nothing to do with cleanliness or organization. Many patients struggle with intrusive thoughts about harm, contamination, religion, sexuality, or making catastrophic mistakes. The defining feature of OCD is not a personality preference. It is distress, loss of control, and significant interference with daily life.
At what age can OCD develop, and can children have it?
OCD can develop at any age, but it most commonly emerges in childhood, adolescence, or early adulthood. Research indicates that approximately 50 percent of adults with OCD report that their symptoms began before the age of 10. Dr. Willison is specifically trained in child, adolescent, and adult psychiatry, making him uniquely qualified to evaluate and treat OCD across the full lifespan, from young children to adults.
How is OCD different from an anxiety disorder?
While anxiety is a core feature of OCD, OCD is a clinically distinct condition. The key difference lies in the presence of obsessions and compulsions. In generalized anxiety disorder, worry tends to focus on real-life concerns such as finances, health, or relationships. In OCD, obsessions are often ego-dystonic, meaning they feel foreign, intrusive, and entirely out of character with the person’s values. The compulsive response also sets OCD apart, as people with OCD perform specific rituals to neutralize their obsessions, a feature not present in other anxiety disorders.
What causes OCD?
OCD is understood to result from a combination of genetic, neurological, and environmental factors. Neuroimaging research has identified abnormalities in brain circuitry, particularly in the orbitofrontal cortex, caudate nucleus, and thalamus, that contribute to the intrusive thought and compulsion loop. A family history of OCD increases risk, as does significant life stress, trauma, or in some cases, streptococcal infection in children, a condition known as PANDAS. Dr. Willison’s background in research allows him to translate the latest neuroscientific understanding of OCD directly into clinical care.
How is OCD diagnosed?
OCD is diagnosed through a comprehensive psychiatric evaluation that includes a thorough clinical interview, a review of medical and psychological history, and validated screening tools such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). There is no blood test or brain scan that diagnoses OCD. Accurate diagnosis depends on an experienced clinician who can differentiate OCD from overlapping conditions such as anxiety disorders, ADHD, autism, body dysmorphic disorder, and tic disorders. Dr. Willison’s expertise across multiple conditions makes him exceptionally well-suited to provide an accurate and complete diagnosis.
What treatments are most effective for OCD?
The two most evidence-based treatments for OCD are Exposure and Response Prevention (ERP) therapy and medication, most commonly selective serotonin reuptake inhibitors (SSRIs). Research consistently shows that a combination of ERP and medication produces better outcomes than either treatment alone for moderate to severe OCD. Cognitive-behavioral therapy techniques that target distorted beliefs are also incorporated into comprehensive treatment plans. Dr. Willison tailors every treatment approach to each patient’s specific symptoms, age, and circumstances.
What is Exposure and Response Prevention (ERP) therapy?
ERP is a specialized form of cognitive-behavioral therapy and is considered the gold-standard psychological treatment for OCD. In ERP, patients are gradually exposed to situations, thoughts, or objects that trigger their obsessions while being guided to resist the urge to engage in compulsions. Over time, this process allows the brain to learn that the feared outcome does not materialize and that anxiety naturally decreases without the ritual. ERP requires courage and commitment, but it produces lasting, meaningful change that medication alone cannot achieve.
Can OCD be cured, or is it a lifelong condition?
OCD is considered a chronic condition for many patients, but it is highly treatable. Many people achieve significant symptom reduction or long-term remission with the right care. The goal of treatment is not simply to manage OCD, but to reduce its interference with daily life to the point where it no longer controls a patient’s decisions, relationships, or sense of self. With consistent treatment and the right support, many patients go on to lead full, productive, and meaningful lives.
How long does OCD treatment typically take?
Treatment timelines vary based on symptom severity, co-occurring conditions, and each individual’s response to therapy and medication. Many patients begin to notice meaningful improvement within 12 to 20 sessions of ERP therapy. Medication, if prescribed, may take 8 to 12 weeks to reach its full therapeutic effect. Ongoing maintenance care is often recommended to consolidate gains and prevent relapse. Dr. Willison works collaboratively with each patient to set realistic expectations and monitor progress throughout every stage of treatment.
Are there medications specifically approved for OCD?
Yes. Several SSRIs are FDA-approved for the treatment of OCD, including fluvoxamine, fluoxetine, sertraline, and paroxetine. Clomipramine, a tricyclic antidepressant, is also FDA-approved for OCD and can be particularly effective for treatment-resistant cases. Medication for OCD typically requires higher doses and longer treatment durations than those used for depression. Dr. Willison carefully weighs the benefits and risks of any medication decision, taking into account each patient’s age, medical history, and treatment goals.
How does OCD affect children differently than adults?
In children, OCD symptoms may present differently. A child may not be able to articulate that their thoughts are intrusive or excessive, and compulsions may be more behavioral than mental. Children with OCD often involve family members in their rituals, a pattern known as family accommodation, which can inadvertently reinforce symptoms over time. OCD can significantly impact a child’s academic performance, social development, and family relationships. Dr. Willison’s specialization in child and adolescent psychiatry allows him to approach pediatric OCD with developmentally appropriate strategies and meaningful family involvement throughout the treatment process.
What is the role of family members in OCD treatment?
Family members play a critical role in both the maintenance and recovery from OCD. When loved ones accommodate OCD by participating in rituals, providing repeated reassurance, or helping a patient avoid triggers, they unintentionally reinforce the disorder. Family psychoeducation and coaching are a core component of Dr. Willison’s approach, particularly for younger patients. Learning how to support a loved one without enabling compulsions is one of the most impactful steps a family can take to support lasting recovery.
Can OCD co-occur with other mental health conditions?
Yes. OCD frequently co-occurs with other conditions, including anxiety disorders, depression, ADHD, autism spectrum disorder, tic disorders, and body dysmorphic disorder. Research suggests that up to 90 percent of individuals with OCD meet criteria for at least one additional psychiatric diagnosis. Accurate identification and treatment of co-occurring conditions is essential, as untreated comorbidities can significantly limit the effectiveness of OCD-specific treatment. Dr. Willison’s broad expertise across multiple conditions uniquely positions him to provide integrated, comprehensive care.
Why choose Dr. Willison for OCD treatment in Los Angeles?
Dr. L. David Willison IV holds both an MD and a PhD, bringing a rare integration of clinical psychiatry and research expertise to his private practice in Los Angeles. He is trained in child, adolescent, and adult psychiatry, making him one of the few psychiatrists in the area qualified to treat OCD across the full lifespan. Dr. Willison considers OCD treatment to be one of the most personally and professionally rewarding aspects of his career, and he approaches every patient with the clinical rigor, compassion, and individualized attention that lasting recovery requires. His practice serves patients throughout Los Angeles from his office at 10850 Wilshire Blvd, Suite 850. To schedule a consultation, call 415-412-4613 or submit a request online.