You’re Doing ERP. So Why Do You Still Feel Stuck?
If you’re in Exposure and Response Prevention (ERP) therapy for OCD and feeling stuck, frustrated, or confused about why your anxiety isn’t improving, you’re not alone. One of the most common concerns people have during OCD treatment is the belief that ERP “isn’t working.”
But in many cases, ERP is happening.
What’s also happening is something quieter, harder to detect, and incredibly effective at keeping OCD alive: mental compulsions.
Mental compulsions are internal rituals like rumination, mental checking, memory reviewing, self-reassurance, counting, or repeating phrases in your head. Because they happen silently, they often go unnoticed, even by people who are deeply committed to treatment. And they are one of the biggest reasons people feel stalled in OCD recovery.
This article will help you understand what mental compulsions are, how they show up, why they interfere with ERP, and how to recognize them without turning awareness into yet another compulsion.
What Are Mental Compulsions in OCD?
Mental compulsions are behaviors that happen internally rather than outwardly. Just like physical compulsions, their purpose is to reduce anxiety, gain certainty, or neutralize discomfort caused by obsessive thoughts, images, urges, or sensations.
The defining feature is not what you’re thinking. It’s why you’re thinking it.
If the intention is to feel better, feel certain, feel reassured, or feel done, the behavior is functioning as a compulsion.
Because mental compulsions don’t look like rituals, they’re often mislabeled as:
Coping skills
Processing
Insight
Self-talk
Problem-solving
In reality, they serve the same function as checking, washing, or reassurance-seeking. They just happen behind the scenes.
Why Mental Compulsions Make ERP Feel Ineffective
ERP works by teaching the brain that anxiety and uncertainty can be tolerated without fixing, resolving, or neutralizing them. Over time, this leads to new learning: the feared outcome is either unlikely, manageable, or irrelevant.
Mental compulsions interrupt that learning.
Here’s how it typically plays out:
You complete an exposure
Anxiety rises
Your brain feels urgency
You engage in a mental compulsion to cope
Anxiety decreases
Your brain credits the compulsion, not the exposure
The exposure didn’t get the chance to do its job.
Over time, this leads people to believe:
ERP doesn’t work for them
Their OCD is more severe
They’re doing something wrong
They need to try harder
In reality, the issue isn’t effort. It’s that OCD has learned to move inside.
How to Tell If You’re Engaging in Mental Compulsions
A helpful rule of thumb:
If it feels like you’re doing something in your head to reduce discomfort, gain clarity, or make anxiety stop, it’s worth paying attention.
ERP is not passive, but it is non-interfering. Mental compulsions are effortful and corrective.
The question to ask isn’t “Is this allowed?” It’s “What am I trying to get right now?”
Common Mental Compulsions That Keep OCD Alive
Mental Checking
Mental checking involves scanning your thoughts, emotions, or bodily sensations for evidence that you’re okay.
Examples include:
Checking how anxious you feel
Monitoring whether a thought feels real
Checking if you feel relief yet
Assessing whether an exposure “worked”
Mental checking reinforces the belief that internal states must be monitored to stay safe. ERP teaches the opposite.
Rumination
Rumination is repetitive thinking that masquerades as problem-solving or self-reflection.
It often sounds like:
“Why does this keep happening?”
“What does this say about me?”
“If I understand it, I’ll feel better”
“Let me think this through one more time”
If thinking were the solution, OCD would have resolved itself long ago.
Rumination doesn’t lead to clarity. It leads to deeper entrenchment.
Memory Reviewing
Memory reviewing involves replaying past events to check for certainty.
This can include:
Replaying conversations
Reviewing past feelings or reactions
Checking memories for intent or meaning
Trying to confirm nothing bad happened
Memory is not a reliable source of certainty. The more you review it, the less trustworthy it becomes.
ERP does not require certainty about the past. It requires willingness to live without it.
Mental Counting
Counting becomes a mental compulsion when it’s used to reduce anxiety or make discomfort stop.
Examples include:
Counting breaths
Counting steps
Counting repetitions silently
Counting until anxiety decreases
If the goal is relief rather than presence, counting is functioning as a compulsion, not a grounding tool.
Self-Reassurance
Self-reassurance sounds supportive but often keeps OCD going.
Examples include:
“I’m a good person”
“I would never do that”
“This is just OCD”
“I know everything is fine”
Even true reassurance reinforces the belief that certainty is required for safety. ERP teaches that reassurance is unnecessary, not unavailable.
Repeating Words or Phrases Mentally
This can include:
Mentally saying “stop” or “cancel”
Repeating phrases until things feel right
Silently neutralizing thoughts with mantras
When the goal is to undo or neutralize a thought, OCD is in control.
What ERP Is Actually Asking You to Practice
ERP is not about:
Feeling calm
Eliminating anxiety
Gaining certainty
Convincing yourself
ERP is about:
Allowing anxiety to exist
Resisting the urge to intervene
Letting thoughts remain unresolved
Continuing life while discomfort is present
The success of ERP is not measured by how you feel. It’s measured by whether you engaged or disengaged.
Catching Mental Compulsions Without Becoming Compulsive About It
Awareness can easily turn into another ritual. The goal is not perfect monitoring.
Instead, aim for:
Noticing
Labeling
Disengaging
No arguing. No correcting. No reassurance.
A simple response might be:
“There’s the urge to figure this out. I’m choosing not to.”
And then you return to what you were doing.
Not to feel better. But to live your life.
Why ERP Feels Harder When You Stop Mental Compulsions
Mental compulsions often reduce anxiety quickly. Removing them can make distress spike initially.
This is not a setback. It’s a sign that ERP is finally reaching the learning center of the brain.
Discomfort does not mean danger. It means the old strategy isn’t being used.
ERP Isn’t Failing. OCD Is Just Sneakier Than You Were Told.
If ERP feels unfinished, unresolved, or uncomfortable, that doesn’t mean it isn’t working.
It often means:
You’re no longer neutralizing
You’re tolerating uncertainty
Your brain is learning something new
Mental compulsions don’t mean you’ve failed at therapy. They mean you’re human and your brain has been practicing OCD for a long time.
Recovery isn’t about stopping thoughts. It’s about stopping the response.
When to Seek More Specialized OCD Support
If you’re doing exposures consistently but feel stuck, overwhelmed, or unsure whether you’re engaging in mental compulsions, working with a therapist who specializes in ERP and OCD can make a meaningful difference.
You don’t need more effort or more insight. You need clearer guidance on what not to do.
If this article resonated, that’s often a sign that your OCD is treatable with more precise support.
Ready to Take the Next Step?
If ERP feels confusing, exhausting, or ineffective, it may not be because it isn’t working. It may be because mental compulsions are quietly interfering.
You don’t have to figure this out alone.
→ Schedule a free consultation Let’s untangle what’s actually happening and get you unstuck.