Frequently Asked Therapy Questions

OCD (Obsessive Compulsive Disorder) involves recurring intrusive thoughts (obsessions) that create intense anxiety, followed by repetitive behaviors or mental rituals (compulsions) performed to relieve that distress. Unlike everyday worry, OCD is cyclical — the relief from compulsions is temporary and actually strengthens the cycle over time. It often includes a persistent sense of doubt and an inability to tolerate uncertainty, even around thoughts that feel deeply out of character.

Exposure Response Prevention (ERP) is the gold-standard, evidence-based treatment for OCD. It works by gradually and systematically exposing you to the situations, thoughts, or feelings that trigger your obsessions, while helping you resist the urge to perform compulsions. Over time, your brain learns that the distress you fear will decrease on its own — and that you can tolerate it — which breaks the OCD cycle. Sessions are paced carefully so you are never thrown into the deep end without preparation.

No. We build a fear hierarchy together at the start of treatment — a personalized list of the things you avoid or find distressing, ordered from least to most challenging. We work through that list gradually, starting at a level that feels manageable and building your confidence before moving forward. You set the pace, and we work as a team.

Most clients begin with weekly sessions for at least four to six months, then gradually taper to bi-weekly and eventually monthly appointments as symptoms improve. The total length of treatment depends on the severity and complexity of your OCD, how many different themes are present, and how consistently you can practice between sessions. Many clients see meaningful progress well within the first few months.

We treat the full range of OCD presentations, including contamination OCD, harm OCD, responsibility and checking OCD, symmetry and ‘just right’ OCD, and intrusive thought themes involving relationships, religion, sexuality, and more. OCD takes many forms, and treatment is tailored to your specific obsessions and compulsions rather than a one-size-fits-all plan.

While anxiety and OCD often overlap, OCD is specifically defined by the presence of obsessions (unwanted intrusive thoughts that create distress) and compulsions (behaviors or mental acts performed to reduce that distress). A key marker is the cyclical nature — the relief from compulsions is short-lived and the obsessions return, often more intensely. During your intake appointment, we conduct thorough assessments to help clarify your diagnosis and ensure you receive the most appropriate treatment.

Yes. ‘Pure O’ refers to OCD where the compulsions are primarily mental rather than visible behaviors — such as mental reviewing, reassurance seeking internally, or thought neutralizing. ERP and ACT is highly effective for this presentation. We work to identify the mental compulsions that are maintaining the cycle and gradually reduce reliance on them.

OCD is very treatable. With ERP, CBT and ACT, the majority of clients experience significant symptom reduction. The goal of treatment is not to eliminate all intrusive thoughts or anxiety sensations (that is not possible for anyone), but to reach a point where those thoughts no longer control your decisions, behaviors, or quality of life. Many clients describe feeling like themselves again after completing treatment.

Generalized Anxiety Disorder is characterized by persistent, excessive worry about multiple areas of life — such as work, relationships, health, or finances — that feels difficult or impossible to control. This worry is often accompanied by physical symptoms like muscle tension, fatigue, difficulty concentrating, irritability, and disrupted sleep. GAD is more than everyday stress; it is a recognized clinical condition that responds well to evidence-based therapy.

Most people experience stress in response to specific situations. With GAD, the worry is pervasive and often disproportionate — it jumps from topic to topic and persists even when there is no immediate reason for concern. Clients with GAD often notice that others around them do not seem to worry as intensely, and they frequently feel that their worry is excessive but are unable to stop it on their own. If anxiety is consistently interfering with your daily life, relationships, or sense of wellbeing, it is worth exploring with a professional.

Treatment typically begins with psychoeducation — helping you understand how anxiety works and why certain habits (like reassurance seeking or avoidance) actually reinforce it over time. From there, we use Cognitive Behavioral Therapy to identify and reframe unhelpful thinking patterns, alongside Acceptance and Commitment Therapy to help you engage with life based on your values rather than your fears. Sessions are collaborative, practical, and focused on giving you tools you can use outside of the therapy room.

Yes. The length of time you have experienced anxiety does not determine how much you can benefit from treatment. In fact, many clients who have struggled with anxiety for years find that even just developing an increased understanding of the mechanisms behind it gives them significant relief. Evidence-based approaches like CBT and ACT have strong track records even for longstanding anxiety — because they work with how your brain processes worry, not just with the content of the worries themselves.

This varies from person to person. Some clients notice meaningful shifts within the first few weeks of applying new tools between sessions. Others see gradual progress over the first few months. Weekly sessions, and intensives (90 minute sessions 1-2 days per week), tend to accelerate results because they maintain momentum and accountability. The goal isn’t to “fix” anxiety, because we need some anxiety to survive! The goal is to consistently get back toward living a life you value and that pace is variable for each client. We track your progress throughout treatment and adjust our approach as needed so you are always moving forwards

Yes. Anxiety rarely appears in isolation, and it is common for clients to carry more than one anxiety-related diagnosis. Abigail has specialized training in the full spectrum of anxiety disorders including GAD, OCD, panic disorder, social anxiety, and specific phobias, and treatment is designed to address the full picture of what you are experiencing.

Social anxiety disorder involves an intense, persistent fear of social or performance situations where you might be evaluated, judged, embarrassed, or humiliated. It goes beyond shyness — people with social anxiety often anticipate social events with dread, analyze past interactions for perceived mistakes, and may avoid social situations entirely. It is one of the most common anxiety disorders and responds very well to exposure-based treatment.

A specific phobia is an intense, irrational fear of a particular object or situation — such as flying, driving, needles, heights, animals, or vomiting — that leads to avoidance behavior. Treatment uses graduated exposure therapy, where you build a fear hierarchy and systematically face the feared situations in a controlled, supported way. The goal is to build tolerance and reduce the fear response until the phobia no longer limits your daily life.

No. Exposure therapy is always gradual and collaborative. We first build a detailed understanding of your fear and create a hierarchy of situations ordered from least to most anxiety-provoking. You will never be pushed into a situation before you are ready. Many exposures can also be done imaginally or through video before approaching real-life situations. While talking about phobias in session is an exposure, you will be supported each step of the way and not thrown off the deep end into the work.

We treat a wide range of phobias, including fear of public speaking, social situations, driving, flying, elevators and enclosed spaces, heights, storms, needles and medical procedures, animals and insects (such as bees, spiders, and snakes), and fear of choking or vomiting. If you are unsure whether your specific fear is something we treat, please reach out — the answer is most likely yes.

Shyness is a personality trait that many people manage without significant disruption to their lives. Social anxiety disorder involves a level of distress and avoidance that meaningfully interferes with relationships, work, school, or quality of life. If fear of social situations is stopping you from doing things you care about, it is more than shyness — and it is something that therapy can address.

Specific phobias can often be significantly reduced in a relatively short period — sometimes within a 6-12 sessions with homework between sessions. Social anxiety tends to take a bit longer because the feared situations are more varied and ongoing. Treatment length depends on the complexity of the fear and how frequently you are able to practice exposures between sessions. It also depends on if there are other comorbid concerns that we will be addressing in treatment as well.

A panic attack is a sudden, intense surge of fear that peaks within minutes and is accompanied by physical sensations such as racing heart, shortness of breath, dizziness, chest pain, and a sense of impending doom. Panic disorder is diagnosed when someone experiences recurrent, unexpected panic attacks and develops significant anxiety about having future attacks, often leading to avoidance of situations where they fear an attack might occur. You can have a panic attack without having panic disorder.

Panic attacks typically involve an abrupt onset of intense physical symptoms — rapid heartbeat, shortness of breath, sweating, trembling, chest tightness, nausea, dizziness, and a strong sense of danger or dread. Many people who experience them for the first time worry they are having a heart attack or a medical emergency. If you have had unexplained episodes of intense physical distress accompanied by fear, it is worth discussing with both your doctor and a mental health professional.

Treatment at Limitless begins with psychoeducation — helping you understand what panic attacks are and why your body responds the way it does. From there, we use exposure therapy to gradually help you approach the situations and physical sensations you have been avoiding. This builds tolerance and breaks the cycle of fear-avoidance that maintains panic disorder. CBT tools are also used to address the catastrophic thinking patterns that often accompany panic.

The goal of treatment is not necessarily to eliminate panic attacks entirely, but to significantly reduce their frequency and intensity, and — most importantly — to eliminate the fear of panic attacks that drives avoidance. Many clients find that as they stop avoiding their triggers and build tolerance to the physical sensations, panic attacks become far less frequent and feel far less threatening when they do occur.

Yes. Exposure therapy for panic disorder is carefully designed and paced, and it is the most evidence-supported approach for this condition. We start with psychoeducation so you understand what is happening in your body during a panic attack and why it is not dangerous. Exposures are introduced gradually and always with your input and readiness. You will not be put in a situation that is unsafe.

Panic disorder often responds to treatment relatively quickly compared to some other anxiety disorders. Many clients see significant improvement within a few months of weekly sessions. Treatment length depends on how severe the avoidance has become and whether there are other contributing factors such as agoraphobia or additional anxiety diagnoses.

Perinatal mental health refers to the psychological and emotional wellbeing of individuals during pregnancy and in the period following birth — typically considered up to one year postpartum, though many professionals take a broader view. It encompasses a range of conditions including anxiety, OCD, depression, and mood changes that can arise during this significant life transition. You do not have to be in crisis to benefit from perinatal mental health support.

Postpartum depression is primarily characterized by persistent low mood, loss of interest, feelings of hopelessness or worthlessness, and at times difficulty bonding with the baby. Postpartum anxiety involves excessive worry, fear, and hypervigilance — often focused on the baby’s safety or your ability to parent. These conditions can occur together, and many new parents experience elements of both. Abigail specializes in postpartum anxiety and OCD specifically, and can provide referrals if other support is needed.

No. Intrusive thoughts about harm coming to your baby are extremely common in the postpartum period and are actually a recognized symptom of postpartum anxiety and OCD — not a sign that you would ever act on them. In fact, the distress you feel about these thoughts is evidence that they go against everything you value. These thoughts are treatable, and you do not have to suffer through them alone or in silence. Please reach out — this is exactly the kind of thing we are here to help with.

Postpartum OCD involves intrusive, unwanted thoughts (obsessions) related to the baby’s safety or wellbeing, followed by compulsive behaviors designed to reduce anxiety — such as excessive checking, reassurance seeking, avoidance of certain situations, or over-researching. Common obsession themes include harm coming to the baby, contamination, and fears about doing the ‘wrong’ thing. Postpartum OCD is highly treatable with ERP and cognitive behavioral therapy.

Some level of anxiety during pregnancy is very normal — it is a time of significant physical, emotional, and logistical change. However, when anxiety becomes excessive, intrusive, or begins to interfere with your daily functioning or enjoyment of life, it may be time to speak with a professional. You do not have to wait until things feel unbearable to ask for support.

Yes. We understand that finding childcare can be a significant barrier to getting support, especially in the early postpartum period. You are welcome to have your baby with you during sessions. Virtual therapy also makes this easier, since you can attend from the comfort of your own home on your own schedule.

Yes. Perinatal and postpartum mental health challenges are not exclusive to birthing parents. Partners, grandparents, adoptive parents, and parents of all gender identities and family structures are welcome at Limitless Counseling Center. The transition to parenthood affects the whole family, and everyone deserves support.

If anxiety or intrusive thoughts are affecting your sleep, your ability to care for yourself or your baby, your relationships, or your enjoyment of daily life — it is time to reach out. You do not need to be in crisis, and you do not need a formal diagnosis before making contact. Even if you are not sure whether what you are experiencing is ‘enough’ to warrant therapy, we encourage you to get in touch. That is what we are here for, and it may prevent a greater issue down the road.

We help moms navigate a wide range of challenges, including anxiety, burnout, overwhelm, mom guilt, difficulty setting boundaries, identity changes that come with motherhood, and perinatal or postpartum mental health concerns. Therapy for moms at Limitless is not limited to clinical diagnoses — if you are feeling depleted, disconnected, or like you are just surviving rather than living, that is a valid reason to come in.

The guilt you are describing is one of the most common things moms bring to their very first session. Taking time to care for your mental health is not selfish — it is one of the most important things you can do for yourself and for your family. You cannot pour from an empty cup, and therapy is one way to start refilling it. The fact that you feel guilty is often a sign that you are already giving a great deal of yourself to others.

No. Therapy for moms at Limitless is for mothers at any stage — whether you have a newborn, a teenager, or grown children. This also includes services for women trying to conceive or going through a challenging fertility journey. Motherhood is a long-term identity and role, and the challenges it brings do not stop after the first year. Wherever you are in your motherhood journey, there is a place for you here.

Yes, fully. Our therapy for moms services are inclusive of all types of mothers, including single moms, LGBTQ+ mothers, adoptive mothers, stepmothers, mothers via surrogacy, and non-gender-conforming parents. Every mom’s experience is unique, and our approach is tailored to yours.

Sessions are 50 to 55 minutes and typically begin with a check-in about how the past week has felt and what you most want to focus on today. From there, we explore what is coming up for you, practice relevant coping skills and tools, and end with setting meaningful goals for the week ahead. The approach is practical and collaborative — not just a space to vent, but a space to actively build skills and make progress.

Yes, please reach out. You do not need to be at a breaking point to benefit from therapy. If something is weighing on you, making daily life harder, or keeping you from being the person you want to be — that is enough. Many clients wish they had started sooner. There is no threshold you have to meet to deserve support.

Limitless Counseling Center specializes in OCD, generalized anxiety disorder, panic disorder, social anxiety, specific phobias, and perinatal and postpartum anxiety and OCD. We also work with clients experiencing trichotillomania, PTSD, seasonal affective disorder, and depression. Our strength is in evidence-based anxiety and OCD treatment, and we use approaches — including ERP, CBT, and ACT — that have strong research support.

We currently work with adults and young adults 18 years of age and older. If you are looking for therapy for a child or adolescent, we are happy to provide referrals to trusted colleagues who specialize in that age group.

Yes. Abigail is trained in Prolonged Exposure (PE), an evidence-based approach for treating PTSD and trauma-related symptoms. This involves working through traumatic memories in a structured, supported way and gradually approaching feared situations related to the trauma. If you are experiencing symptoms of PTSD, please reach out to discuss whether this would be a good fit.

While Limitless Counseling Center’s primary specialty is anxiety, OCD, and perinatal mental health, depression is often treated alongside anxiety disorders and is listed among the conditions we work with. Please reach out to discuss your specific situation so we can assess whether our services are the right fit for you.

Yes. During the intake appointment, all clients complete a series of validated assessment tools. Abigail reviews these before your first full session and discusses the results with you, including what your scores suggest about your primary concerns. This helps ensure that treatment is targeted to what is actually going on for you, rather than working from assumptions.

Yes. Trichotillomania and body-focused repetitive behaviors (BFRBs) are conditions we work with at Limitless. These often respond to ERP and habit reversal training, and treatment is tailored to your specific patterns and triggers.

Clinical consultation and supervision at Limitless is designed for licensed and provisionally licensed mental health clinicians who want to deepen their skills in evidence-based treatment for OCD and anxiety disorders. Whether you are brand new to this specialty or want to sharpen your existing ERP skills, supervision provides structured support and practical guidance.

Sessions can be tailored to your needs. Common topics include case conceptualization for OCD and anxiety presentations, designing exposure hierarchies and in-session exposure work, navigating client resistance to ERP, and applying ACT and CBT frameworks. You can bring specific case questions or use the session to build foundational knowledge of evidence-based approaches.