Perfectionism in OCD Therapy: Why “Doing It Right” Can Hold You Back
Anything can become a compulsion. You may have heard it before. But what do we do when OCD latches onto treatment itself? It’s not uncommon for clients with OCD to become anxious about whether treatment will “work” for them. For some, this understandable concern can lead to attempts to do exposures “perfectly.” Wanting to do exposures correctly is not a bad thing, and this issue often occurs with people who are really motivated to get better! Unfortunately, focusing too much on “doing it right” can undermine how exposure and response prevention (ERP) works. For more on the basics of ERP and how it works, click here.
Perfectionism in OCD therapy is usually driven by uncertainty about recovery. Because OCD involves intolerance of uncertainty, it will often turn treatment itself into something to control. Anxiety is a clever trickster, constantly pulling your focus toward getting therapy exactly right, rather than allowing you to practice living with not knowing. Even though your goal is to do a good job, you end up getting in the way of your goal by focusing too much on the wrong things.
How Does Perfectionism Show Up in OCD Treatment?
It is important to do exposures correctly, and there are ways to do it wrong. However, for some, overconcern about “doing it right” can lead to ineffective exposures! This might look like treating ERP like a test that you can pass or fail, following rules rigidly instead of flexibly, and constantly focusing on your anxiety level. Here are more examples of thoughts and behaviors I have seen when clients are struggling with perfectionism in OCD treatment:
Example thoughts:
What if I did the exposure wrong?
What if I didn’t give my therapist all the right information, and the exposures they suggest won’t help?
What if this exposure doesn’t count?
What if I wasn’t focused on the exposure the whole time?
What if I am wasting time, and this is my only chance to get better?
Example behaviors:
During exposures
Giving very exact anxiety rating scores (also called subjective units of distress; SUDS) like 5.5 out of 10, or 67 out of 100.
Checking your level of anxiety and whether you are anxious enough, rather than just allowing whatever happens to happen.
Focusing all your attention on whether you are doing it right, rather than the trigger itself.
Rushing through exposures because you want to get better faster.
Redoing exposures just “to be sure” or until they feel “just right.”
After exposures
Mentally reviewing exposures for possible errors.
Reassurance-seeking about how to do the exposure from your therapist, online forums, or loved ones.
Researching how to do ERP correctly.
Overall
Over-tracking symptoms, anxiety, or progress.
Reassurance-seeking about progress or comparing your progress to others with OCD.
Avoiding exposures until you feel more confident or certain.
Sticking only to exposures that match a narrow idea of what ‘should’ be anxiety-provoking.
Excessively watching or reading ERP content to make sure you’re “doing it right.”
Why Trying to Perfect ERP Holds You Back
When we try to perfect exposure work, treatment becomes another way to feel safe. Instead of learning that we can handle uncertainty and fear, the brain learns, “I survived because I did it right.” ERP treatment isn’t about doing something perfectly. It can involve some experimentation, and flexibility is important. As long as we hold to the main principles of ERP, the rest is a leap of faith.
No amount of trying to rigidly control your treatment (as tempting as that can be) is going to change the fact that recovery is messy and weird and uncertain.
What Do You Do When You’re Struggling With Perfecting ERP?
So, now you know why perfecting treatment is a problem. So how do you stop it? There are several strategies that I use with my clients when they are struggling with this.
Shift Your Focus
First and foremost, it’s important to remind yourself what ERP is actually asking of you: to sit with uncertainty. Shift your focus from outcome to willingness. Ask yourself: Can I stay present even if I don’t know how this will turn out?
Do exposures focused on this fear. The goal of ERP is to learn you can handle uncertainty and discomfort. The specific content you are afraid of doesn’t matter. Concern about doing exposures correctly is just another theme, so we treat it the same way! The goal of the exposures is not to prove you are doing ERP correctly. It is to live with the possibility that you might be doing it wrong (because you might!), and you can still move forward anyway.
Develop Fear-Focused Exposures
Your OCD therapist can help you develop exposure ideas. Here are a few examples:
Do an exposure “wrong.”
Record your SUDS as a number that feels incorrect.
End an exposure too early.
If you are doing them every day, skip a day.
Give yourself a new rule: No repeating or redoing an exposure, even if you think you did it wrong.
Skip tracking or measuring altogether: don’t rate your SUDS or record how it went.
Do an exposure on a “bad day” or when you don’t feel ready.
Intentionally break a self-imposed rule.
Think or write “I might not be doing my exposures correctly.”
Do an exposure while thinking, “I’m probably doing this wrong” or “this might not count.”
Write a worst-case scenario (imaginal exposure) about never recovering from OCD.
Do an exposure that doesn’t feel like you are targeting your fear.
Use Mindfulness
If you are struggling with concerns about feeling anxious enough or thinking the right thoughts, mindfulness can help you stay in the moment. Mindfulness is about being in the present moment, on purpose, without trying to change anything. So it can help us practice allowing whatever thoughts and feelings we have (or don’t have) to happen without trying to force anything. Anxiety is unpredictable. Success is showing up and being present in the exposure and resisting compulsions, not how you felt or didn’t feel.
Let go of the question: “Did I do this right?” At Leap Counseling, I like to tell my clients, “If it feels right, you’re doing it wrong. If it feels wrong, you’re doing it right!” Remember, the goal is to move toward discomfort, uncertainty, and anxiety.
Stop Letting OCD Grade Your Work
OCD treatment is really hard work as it is. You don’t need to let OCD bully you into submission by turning therapy into a performance review. Recovery doesn’t come from earning a passing grade. It comes from showing up imperfectly, again and again, and choosing willingness over certainty.
Perfectionism in ERP isn’t a sign you are failing. It is OCD doing what it does best: finding new places to hide. The way forward isn’t to outsmart it or finally get things exactly right. It’s to recognize what it is doing and stop playing its game. ERP is a leap of faith. Not faith that you’re doing it perfectly, but faith that you can handle whatever comes next. That’s where real freedom begins.
Let Go of Perfectionism and Make Real Progress in Online OCD in Wauwatosa, WI
If you’re approaching OCD therapy with the fear of making mistakes or not doing ERP “correctly,” you’re already experiencing a common OCD trap. ERP works best when progress—not perfection—is the goal, helping you respond to uncertainty with flexibility instead of rituals or avoidance.
Leap Counseling and Consultation provides specialized ERP-focused OCD therapy through a Wisconsin-based solo practice led by Dr. Johanna Wood. With advanced training in OCD and anxiety disorders, Dr. Wood offers individualized, evidence-based care that helps clients loosen perfectionistic expectations and build confidence in their ability to face intrusive thoughts without needing certainty. Starting online ERP therapy is straightforward:
Take a leap of faith and schedule a free 15-minute consultation
Meet one-on-one with an experienced online OCD therapist in Wauwatosa, WI
Begin practicing ERP in a supportive space that prioritizes progress over perfection
Other Services Leap Counseling Provides Throughout Wisconsin
Perfectionism often shows up in ERP as pressure to respond “correctly” to every intrusive thought or exposure. In OCD treatment, learning to allow imperfection and uncertainty can actually lead to greater progress, helping anxiety lose its power over time.
Although ERP for OCD is a primary focus of my Wisconsin-based online therapy practice, it is not the only area of support I offer. Anxiety frequently overlaps across different areas of life. As a licensed online therapist serving Wisconsin, Minnesota, Illinois, and Michigan, I also provide therapy services for Panic Disorder, Agoraphobia, Generalized Anxiety Disorder, Social Anxiety Disorder, and specific Phobias.
No matter where you are in your process, change is possible with compassionate, evidence-based care. I encourage you to explore my mental health blog to learn more about ERP and OCD treatment, and when you feel ready, reach out to schedule an appointment and take a meaningful step toward greater flexibility, relief, and confidence.
About the Author
Dr. Johanna Wood is a Wisconsin-based clinical psychologist who specializes in ERP for OCD and brings both professional expertise and personal insight to her therapy work. Having experienced relationship OCD herself, she understands firsthand how intrusive thoughts and uncertainty can fuel anxiety—and how ERP helps by encouraging clients to face fears without compulsions. Her own treatment taught her to view exposures as meaningful “leaps of faith,” a perspective that now guides how she supports clients in making progress without perfection. Dr. Wood earned her PhD in Clinical Psychology from Northern Illinois University, completed her doctoral internship at Rogers Behavioral Health’s OCD and Anxiety Adult Residential Program, has supervised clinical staff in residential treatment settings, is licensed in Wisconsin with PSYPACT authorization, and remains actively involved with the International OCD Foundation through education and advocacy.
