by Peter Klein, Guest Contributor
Introduction by Dr Esthefanea F. Santos
I’m pleased to welcome Peter Klein, a CBT psychotherapist based in Richmond, London, to our blog. In this post, Peter takes us through a side of obsessive compulsive disorder (OCD) that’s easy to miss; the reassurance-seeking that happens quietly, in someone’s own head, long before it ever looks like a “typical” compulsion. His insights complement our Anxiety Series, adding an important piece to the picture: what happens when reassurance itself becomes the thing keeping the cycle going.
The OCD you don’t see
When most people picture OCD, they picture hand-washing or a desk arranged just so. The reality is often far quieter than that. A lot of the people I work with don’t wash or tidy anything excessively. They are caught in a loop of doubt and reassurance that happens almost entirely inside their own head, and it is one of the most exhausting forms of OCD there is.
What reassurance-seeking actually looks like
Reassurance-seeking is the urge to check, ask, or search in order to quiet a nagging doubt. In OCD it takes specific shapes:
- Asking a partner, again and again, “Are you sure I locked the door?” or “Am I a good person?” • Re-reading a text message before sending it, over and over
- Searching online for answers to a “what if” question you already know the answer to • Mentally replaying a moment to prove that nothing bad happened
On the outside it can look like simple caution or diligence. On the inside it is a compulsion, and it runs the same loop as any other.
Part of why it goes unrecognised is that reassurance-seeking is mostly invisible. There is no cracked skin from over-washing, no locked door being checked a dozen times where anyone can see. People often describe it as “just how I am” or “being careful”. Friends and family often fall into the pattern too, offering the reassurance each time because it seems kinder than refusing without realising they are feeding the loop.
Why it makes things worse, not better
Here is the crux of it: the reassurance works. For a few minutes, the anxiety drops and relief arrives. Then the doubt creeps back in, a little louder this time, and you need reassurance again.
Every round teaches your brain something unhelpful, that the doubt was dangerous, and that reassurance is what saved you. The loop tightens. The more you seek certainty, the less of it you can tolerate.
In OCD, certainty is the trap. Recovery doesn’t come from finally feeling sure. It comes from learning to sit with the uncertainty and discover that it passes on its own.
What CBT with ERP does instead
The treatment with the strongest evidence for OCD is Cognitive Behavioural Therapy, and specifically Exposure and Response Prevention (ERP). NICE guidance recommends it as the first-line psychological treatment, and it is what I use in my own practice.
ERP has two halves:
Exposure: deliberately and gradually facing the feared thought or situation, in a planned, graded way.
Response prevention: choosing not to carry out the compulsion afterwards, including not asking for reassurance.
For someone whose compulsion is reassurance-seeking, response prevention usually means sitting with the doubt without asking, checking, or searching. That is genuinely hard at first. The anxiety spikes, and everything in you wants to reach for the phone or ask the question. The work is learning to ride that wave out.
A small, concrete starting point
Take someone who repeatedly asks their partner to confirm the front door is locked, several times a night. A first step isn’t “stop asking forever”. It might be agreeing that they can ask once, and after that they must sit with the urge without acting on it for a set period, five minutes, then ten.
Nothing dramatic happens. The anxiety rises, stays uncomfortable, and then falls. That falling part is the lesson: the feeling was tolerable, and it ended without any reassurance at all. The next step builds on it. Slow and graded, never a leap in the dark.
Where the sensible line sits
It’s worth saying clearly, because people worry about this: not all reassurance is OCD. Checking the door once is normal. Asking your partner once is normal. The problem is the repetition, and the fact that the relief never lasts.
Treatment is not about giving up all certainty or never asking anyone anything again. It targets the compulsions that are running your life. A qualified therapist helps you find that line, and the work always moves at your pace.
Getting help
OCD responds well to treatment, and ERP is effective whether it’s delivered in person or online. If reassurance-seeking or any other compulsion is taking up more of your day than you’d like, it’s worth talking to someone who understands how the loop works.
Peter Klein is a CBT therapist in Richmond, London, specialising in anxiety and OCD. He offers CBT for OCD in person, online and by phone.
For more conversations like this, you can explore other articles in our blog section or reach out for resources tailored to your situation.
