This post was co-authored by Melissa Mose, LMFT.

Obsessive-compulsive disorder (OCD) is a cycle characterized by unwanted, intrusive thoughts, feelings, images, and urges (obsessions) that cause distress, followed by repetitive behaviors or mental acts (compulsions) that aim to relieve distress. Common obsessions involve contamination, harm, morality, or symmetry, while compulsions include excessive checking, washing, ordering, counting, ruminating, and seeking reassurance.

Today we know that OCD arises from brain circuits—particularly those connecting the orbitofrontal cortex, anterior cingulate, and striatum—that have become biased toward detecting threat and generating uncertainty signals while struggling to register safety and completion. This reflects a combination of genetic predisposition and developmental factors; stressors may activate this vulnerability, but are not always necessary or identifiable.

The first-line, evidence-based treatment for OCD is called exposure and response prevention (ERP). When skillfully delivered, it provides roughly 50 percent symptom relief in at least 75 percent of the clients who complete a course of treatment. Unfortunately, far too many individuals with OCD are unable to access trained OCD specialists, or they are unable to fully participate or follow through. Medications are most effective when combined with ERP.

In her new book, OCD expert Melissa Mose (a co-author of this post) looks at the OC cycle through the lens of Internal Family Systems (IFS), a therapy model that views the mind as a community of parts. According to IFS, vulnerable........

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