If you feel like your own mind is working against you, you're not alone. Amanda specializes in OCD and anxiety, and she works with people who are ready to stop being controlled by their thoughts and start living their lives again. Amanda prioritizes both ensuring you feel heard and understood, while also providing the gold standard treatment. Amanda identifies as queer and her practice is LGBTQ+ inclusive.
Her desire to provide effective, specialized care in OCD and anxiety came from her own misconceptions about therapy and personal suffering. Amanda went to a number of therapists throughout her life, and never quite found one that specialized and knew exactly how to help with the anxiety she was dealing with. When Amanda became a therapist, she was surprised to learn that there are actually structured tools that can alleviate anxiety suffering and change lives. She became determined to provide folks care beyond talking endlessly about what is wrong to try to "solve" it. Amanda's practice was built on ensuring that folks with anxiety and OCD get exactly the tailored help they need so they can leave therapy with tools that will address exactly what they are struggling with.
Amanda uses evidence based methods called Exposure and Response Prevention, Cognitive Behavioral Therapy, and Acceptance and Commitment Therapy. If you are interested, we can hop on a quick free phone call to talk about if we are a good fit.
Why OCD Needs a Specialist
Most therapists aren't trained to treat OCD, and the wrong approach can make it worse.
Research shows generalized talk therapy either does not improve OCD or can actively worsen it. With over 5 years of specialized experience, I use structured, evidence-based methods such as Exposure and Response Prevention clinically proven to work.
OCD is frequently misdiagnosed and goes undertreated for years.
There is hope. With the right support, you can break the OCD cycle.
OCD wears many faces
01
Contamination OCD
Fear of germs, substances, or feeling contaminated
02
Harm OCD
Intrusive thoughts about harming yourself or others
03
Relationship OCD
Obsessive doubts about your relationship or partner
04
Morality OCD
Fear of violating your values or ethical standards
05
Health Anxiety OCD
Obsessive fears about illness, symptoms, or death
06
SO-OCD & More
Sexual orientation, optimization, "just right," and other subtypes
Telehealth. New York & Florida
Telehealth. New York and Florida.
I see clients entirely via telehealth throughout New York State and Florida.
About Amanda
A therapist who truly specializes in OCD
I'm Amanda Panos, LCSW (Licensed Clinical Social Worker), passionate about treating Obsessive Compulsive Disorder because of how often it goes underdiagnosed and improperly treated. You deserve a clear plan, real tools, and a provider who has walked this road with hundreds of clients.
Maybe you've already been to talk therapy and still find yourself feeling powerless to this recurrent problem. Maybe you've never tried therapy and are hesitant because you're not sure it will actually help. Both experiences make sense. Generalized talk therapy is often not the right tool for OCD.
Research shows that OCD either does not improve or can get worse with standard talk therapy. That's not a flaw in you. It's a mismatch between the treatment and the diagnosis. My approach is different: structured, evidence-based, and built specifically for OCD.
With over 5 years of experience, I have seen countless clients finally access a life free from excessive rumination, doubt, and fear. My goal is to help you learn to overcome the cycle of fear OCD pulls you into, and take your power back.
LCSWLicensed Clinical Social Worker
ERPEvidence-based method
NYLicensed in New York State
I work with adults who may look like they have it all together on the outside, while privately battling an internal world that feels completely out of control. If that sounds like you, you're in the right place.
I am also a queer-identifying therapist and warmly welcome LGBTQ+ clients. I understand firsthand the importance of finding a therapist who gets it, a space where you don't have to explain or justify your identity before getting to the real work.
The Therapy Process
Structure, clarity, and a path forward
Unlike traditional talk therapy, working with me follows a clear, intentional structure designed specifically for OCD. Each phase builds on the last, moving you from understanding to action.
01
Tell Me About Your Experience
First I will understand your history and experience, its patterns, and how it has shaped your daily life. You'll begin curated reading and listening resources.
You'll also begin reading a book about OCD and listening to a recommended podcast, starting to understand what you're dealing with at a deeper level.
02
You Learn About OCD and Anxiety
I will help you become an expert in how this disorder gets dismembered and exactly what it takes to separate yourself from its grip. The more clearly you understand OCD's mechanics, the less control it has over you.
03
We Act
This is where the real work, and the real relief, happens. I guide you through evidence-based methods (primarily ERP: Exposure and Response Prevention) to unhook from upsetting thoughts and compulsive behaviors.
We move at a pace that challenges you without overwhelming you, gradually reclaiming the life OCD has been holding hostage.
Ready to start?
A free 20-minute consultation is your first step. We'll talk about what you're experiencing, what to expect, and whether we're a good fit.
OCD is not what most people think
Most people picture OCD as quirky habits or a love of neatness. The reality is far more painful, and far more varied, than that.
How We Work Together
A structured path forward
A structured process built around the science of OCD and anxiety treatment.
Tell Me About Your Experience
First I will understand your history and experience. You'll begin curated reading and listening resources.
You Learn About OCD and Anxiety
I will help you become an expert in how this disorder gets dismembered and exactly what it takes to separate yourself from its grip.
Science-Backed Methods
Guided evidence-based methods to unhook from upsetting thoughts, spirals, or troublesome behaviors, reclaiming your life.
Subtype 01
Relationship OCD (ROCD)
Obsessive doubts and intrusive thoughts about romantic relationships, friendships, or any close bond, even when the relationship is objectively healthy and loving.
Constantly questioning whether you truly love your partner or whether the relationship is "right"
Obsessive fear that your partner will cheat on you or secretly wants someone else
Analyzing every text, tone of voice, or facial expression for hidden meaning
Friendship ROCD, compulsively checking if a friend has texted back, reading into response time, and fearing the friendship is over
Seeking constant reassurance from your partner, friends, or family about the relationship
Subtype 02
Existential OCD
Obsessive, unanswerable philosophical questions about reality, existence, and consciousness, not curious exploration, but a distressing loop that won't turn off.
Wondering if you are actually real or if life is a simulation
Feeling like you are living in the Truman Show, that none of this is real
Obsessively questioning whether other people have consciousness or if you're the only real person
Panic about the nature of time, death, or the universe that spirals for hours
Derealization, feeling detached from yourself or your surroundings, fueled by OCD loops
Subtype 03
Sexual Intrusion OCD
Unwanted, intrusive thoughts or fears related to sex and sexual performance, not a reflection of desire, but an OCD loop that latches onto sexuality as its theme.
Obsessing over whether you will become aroused in an unwanted or "wrong" situation
Fear of not being able to perform sexually, with a partner or alone, and spiraling about what that means
Worrying your partner is judging your body, performance, or desire during intimacy
Intrusive sexual thoughts about inappropriate people followed by intense shame, even though you find them repulsive
Avoidance of sex or intimacy altogether to escape the anxiety
Subtype 04
Sexual Orientation OCD (SO-OCD)
Intrusive, unwanted doubts about one's sexual orientation or gender identity, not genuine questioning, but obsessive uncertainty that causes distress regardless of evidence.
Excessive questioning of identity even when evidence of clarity exists
Scrolling online for hours seeking the "correct" label or definitive answer
Bisexual individuals doubting which gender they "should" be with
Analyzing every feeling, reaction, or attraction as proof of something
Subtype 05
Pedophilia OCD (POCD)
One of the most distressing and misunderstood subtypes, intrusive thoughts about harming children, despite having no such desire whatsoever. The horror felt about these thoughts is itself evidence they are OCD, not intent.
Unwanted intrusive thoughts about children, followed by extreme shame and self-disgust
Avoiding children, schools, or playgrounds out of fear of one's own thoughts
Repeatedly seeking reassurance: "Am I a bad person? Does this make me a predator?"
The distress felt is the hallmark, people with genuine predatory intent do not experience this horror
Subtype 06
Harm OCD
Intrusive, unwanted thoughts about harming yourself or others, even though you have absolutely no desire or intention to do so.
Ruminating about saying something inappropriate at work and obsessively checking coworkers' reactions
Fear that not saying "I love you" before a goodbye will cause something terrible
Worrying about involuntarily blurting offensive words, leading to going quiet or pressing lips together
Intrusive images of hurting someone you love, followed by deep shame and reassurance-seeking
Subtype 07
Morality OCD (Scrupulosity)
Obsessive fears of violating your own moral code, ethical values, or religious beliefs, often in ways that are impossible to fully resolve.
Spending hours reviewing past actions to confirm 100% ethical behavior
Confessing perceived wrongdoings repeatedly to try to feel absolved
Fear of accidentally offending someone and endlessly analyzing what you said
Religious OCD, intrusive blasphemous thoughts causing intense guilt
Subtype 08
Health Anxiety OCD
Obsessive fears about illness, disease, dying, or physical symptoms, for yourself or people you love, leading to compulsive checking and reassurance-seeking.
Hours researching symptoms online, convinced you have a serious illness like ALS, cancer, or rabies
Compulsive doctor visits or body-checking for lumps, spots, or changes
Fear of contracting disease from everyday exposure, lakes, animals, public spaces
Classic fears: rabies from a bat, brain-eating amoeba from swimming in a lake, flesh-eating bacteria from a cut
Subtype 09
"Just Right" OCD
A persistent need for things to feel balanced, complete, symmetrical, or exactly right, or else something feels deeply off.
Needing to re-read, re-write, or re-say something until it "feels right"
Extreme distress if a daily routine is disrupted in even small ways
Arranging objects symmetrically and being unable to move on if it's not perfect
Obsessive worry about eating "perfectly", right foods, right amounts, right timing (often treated in collaboration with a dietitian)
Subtype 10
Checking OCD
Compulsive, repetitive checking behaviors driven by the fear that something terrible will happen if you don't verify, again and again.
Checking that the stove is off, doors are locked, or appliances are unplugged multiple times before leaving
Returning home repeatedly to verify something was done
Re-reading emails or texts over and over before sending to catch a mistake
Mentally reviewing conversations to make sure nothing offensive was said
Subtype 11
Superstitious / Magical Thinking OCD
A belief that certain thoughts, numbers, words, or actions are linked to bad outcomes, and that rituals must be performed to prevent catastrophe.
Avoiding certain numbers, colors, or phrases because they feel "unlucky" or dangerous
Needing to repeat an action a specific number of times to "cancel out" a bad thought
Believing that thinking about something bad will make it happen
Touching objects in a particular order or saying specific words as a protective ritual
Subtype 12
Contamination OCD
Intense fear of germs, dirt, chemicals, or substances, leading to compulsive cleaning, avoidance, or rituals to feel "clean." The most commonly recognized subtype, but often more complex than it appears.
Avoiding cooking meat despite knowing how to cook safely
Excessive hand washing after touching safe surfaces like doorknobs
Fear of public bathrooms, other people's homes, or shared objects
Tapping or wiping hands in a specific pattern as a ritual after contact
Subtype 13
Optimization OCD
Feeling stuck in endless overthinking, trying to perfect a situation, routine, or solution, to avoid waste or regret over not "optimizing" the situation to its perceived capacity.
Walking into a restaurant and feeling a high level of anxiety and stress about not getting the "best" table, then ruminating about it for the entire meal
Spending long periods trying to solve how to get the best table, seat, parking spot, or route, even after the moment has passed
Inability to enjoy an experience because of persistent doubt that a better option existed
Compulsive research, comparison, or replanning to achieve an ideal outcome that never feels settled
Subtype 14
Postpartum OCD
Intrusive, unwanted thoughts related to harm coming to a newborn or infant, often terrifying a new parent who has no intention of acting on them. Postpartum OCD is frequently misunderstood and underdiagnosed, leaving parents drowning in shame when they most need support.
Intrusive images of accidentally dropping or harming the baby, followed by compulsive avoidance of certain activities or objects
Excessive checking on the baby's breathing, sleeping position, or safety, far beyond typical new-parent concern
Avoiding being alone with the baby out of fear of thoughts, not intent
Seeking reassurance repeatedly from a partner, doctor, or online sources that you are not a danger to your child
Don't see your experience here?
OCD is endlessly varied and can attach to virtually any theme. If you're experiencing intrusive thoughts, compulsive behaviors, or overwhelming doubt and fear, reach out. We'll figure it out together.
Anxiety Treatment
Anxiety that is finally getting treated properly
Whether you have been in and out of therapy for anxiety, or it's your first time, I have seen through my experience that anxiety is best treated using Cognitive Behavioral Therapy (CBT).
01
CBT. The Foundation
A session with CBT guides you through identifying the core thoughts driving the anxiety, and then a series of guided methods designed to dismember that belief.
02
Supplemental Approaches
I also use Acceptance and Commitment Therapy and Exposure and Response Prevention for anxiety to attack it at different angles. I take a trauma-focused lens as well, because I often see many people have been through things in their life that have contributed to what you struggle with today.
03
Real, Honest Partnership
People would describe me as genuine and empathetic, but I'll also be direct about what is going to help you reduce spiraling, grow more confident in yourself, and feel more in control.
Ready to start?
A free 15-minute consult is the first step. No pressure, no commitment.
Common Questions
Frequently Asked Questions
Answers to what people usually want to know before reaching out.
What will we talk about?
In the phone consult, I'll explain how I can help you feel better, ask about your goals for therapy, and we'll decide together if we're a good fit. In therapy, you'll talk to me about what you've been struggling with and get support from me. I'll teach you about what you're dealing with so you can understand how to overcome it, along with tools each session designed to help you feel better. We'll celebrate your achievements and growth along the way.
What are out-of-network benefits?
You'll pay out of pocket for therapy, but a claim can be submitted to your insurance that may reimburse you for a portion of what you paid.
How often are therapy sessions?
I recommend weekly sessions, especially at the beginning of therapy. Once you start to feel better, we may meet less often.
What happens in the first therapy session?
You won't need to prepare anything. I'll listen and ask questions about what you've been struggling with, as well as your history with it, and work hard to make sure you feel supported and safe. It's an honor to hear your story. I'll also likely give you a book or podcast to start reading or listening to.
Do you identify as queer/LGBTQ+?
Yes. It's a very special and important part of my life, my friendships, my love, and my career. Many of my clients also identify as queer, though I treat people who don't as well. OCD and anxiety affect all walks of life. Come as you are.
Is your therapy effective? How long does therapy last?
Yes. I use the gold-standard treatment for OCD and anxiety. Many clients reach their goals and end treatment within several months, though it varies from person to person. How quickly treatment moves often depends on how willing you are to do the recommended exposure therapy, read the books, listen to the podcasts, and make healthy changes in your life. Sometimes I'll recommend you also see a medication provider, or work with another provider, if I notice something else may be getting in the way of our progress.
What is exposure and response prevention?
Exposure and Response Prevention (ERP) means intentionally facing your fears without doing the compulsions or rituals that keep the fear alive. If you're afraid of heights, we would slowly work our way up to high places. If you're afraid of blood or spiders, we might start with small, zoomed in photos of less frightening images and gradually build up to harder ones. If you're afraid of death, we might visit a cemetery, read obituaries, plan your funeral, or repeat "I will die" out loud, without reassuring yourself that everything will be okay, analyzing what happens after death, or trying to control, fix, or prevent it. We repeat these exposures so your brain can desensitize to the fear over time.
Exposure therapy might sound scary, but it's actually incredibly powerful, and most people feel noticeably better once they get through an exposure. You learn that you can do hard things, that the mental rituals around a fear are often what make it worse, and that the thing you're afraid of usually isn't as catastrophic as your brain has made it out to be. We go at whatever pace works for you, and we can start small. Sometimes it helps to build up some coping skills first before diving into exposures. Either way, this is always done at your pace.
What is CBT?
CBT is Cognitive Behavioral Therapy. A CBT session might look like identifying a core fear or the root of what you're worrying about, then working through methods designed to help you think differently about it, literally rewiring your thinking. CBT also involves making day-to-day changes in your life based on the science of what helps a person feel mentally well. This could include starting to exercise, limiting phone time, spending more time outdoors, starting a hobby, connecting more with family and friends, meditating, or getting more sleep.
Rates & Insurance
I offer services as a private-pay, out-of-network provider. Many insurance plans reimburse a significant portion of out-of-network therapy costs.
Session Rates
My rates reflect the specialized, evidence-based care I provide. As a private-pay therapist, sessions are paid directly at the time of service.
Please reach out during a free consultation to discuss current session fees. I'm happy to walk you through what to expect.
Out-of-network benefits: Your insurance plan may cover a portion of my fees. I work directly with a service that handles the OON reimbursement process for you, automatically.
Before committing to therapy, let's talk. A free 20-minute consult is an opportunity to:
✓ Hear what to expect from therapy with me
✓ Ask questions about my approach
✓ Determine if we're a good fit to work together
✓ Schedule your intake session if we both feel ready
Why private pay?
Choosing a private-pay therapist means your care is never dictated by an insurance company. Sessions aren't limited by arbitrary restrictions, diagnoses don't need to be filed in your medical record without consent, and your treatment can be as long or as focused as you actually need.
Get in Touch
Let's find out if we're the right fit
A free 20-minute consultation is the first step. I'll explain my approach, ask a few questions, and you'll have space to briefly share what's been going on.
Telehealth OnlyAccepting clients located in New York State and Florida
Psychology TodayVerified therapist profile
Free 20-Minute Consult
A focused conversation to see if we're the right fit.
✓ I'll walk you through what therapy with me looks like
✓ You'll briefly share what's been going on
✓ You can ask me anything about my approach
✓ If it feels like a fit, we'll schedule your intake
Currently booking new clients. Schedule directly through Psychology Today.
Secure scheduling · HIPAA compliant
Phobia Treatment
You don't have to live a life ruled by fear.
Phobias are among the most treatable conditions in mental health, and with the right approach, most people experience a dramatic, lasting reduction in fear. I have seen countless clients go from completely controlled by their phobia to living freely, doing the things that once felt impossible.
My Approach
Exposure therapy, at your pace, with your readiness leading the way
The gold-standard treatment for phobias is Exposure Therapy, a structured, evidence-based method where we gradually and intentionally face your fear together. The key word is gradually. We build a personalized roadmap that moves at your pace, and you will never be pushed into something before you feel ready.
The reason exposure therapy works so well is simple: your brain learns by doing. Each time you face the fear and survive it, your brain quietly updates its threat assessment. Over time, the alarm stops going off.
We build your ladder
Together we create a step-by-step hierarchy of your fear, from least to most anxiety-provoking, so there's always a clear, manageable next step.
You lead the pace
You will never be forced into anything before you're ready. Your readiness guides every step. This is collaborative, and we work as a team.
Fear loses its power
Countless clients have gone from unable to function around their fear to doing things they never imagined possible. That is the goal: reclaiming your life.
Common phobias we can work through together
If your fear isn't listed here, that doesn't mean I can't help. Phobias come in endless varieties. Reach out and we'll talk about whether exposure therapy is right for what you're experiencing.
Blood
Fear of blood, injuries, or medical procedures involving blood
Needles & Injections
Fear of syringes, injections, blood draws, or IV lines
Spiders & Bugs
Spiders, cockroaches, bees, wasps, ants, beetles, moths, and other insects
Snakes
Fear of snakes, even in photos or on screens
Dogs
Fear of dogs or other animals, including avoidance of parks or public spaces
Heights
Fear of high places, bridges, balconies, escalators, or flying
Fear of contamination, illness, or being unclean, beyond typical OCD
Ready to stop letting fear make your decisions?
I have seen this work over and over. Clients who finally took the trip their fear had stopped them from taking, conquered the appointment they had been avoiding for years, faced the thing that once felt impossible, and the pride, relief, and accomplishment that follows is unlike anything else. That is waiting for you too.
Blog
Insights on OCD, anxiety, and finding your way back to yourself
Written by Amanda Panos, LCSW, licensed therapist and OCD specialist serving New York and Florida via telehealth.
Optimization OCD · OCD Subtypes · Anxiety
Optimization OCD: How to Stop It
After years of training, hundreds of clients, and more consultations than I can count, I had never heard of Optimization OCD. And it turns out, past me would have qualified.
Read the full post →
SO-OCD · Queer Identity · Anxiety
When Doubt Takes Over: OCD, Queerness, and Why I, as a Therapist, Hate the Comment Section of TikTok if You Have SO-OCD
If you've spent hours, days, or years questioning whether you're actually gay, straight, bisexual, trans, or any other identity, and no amount of reassurance ever seems to stick, it might be OCD.
Read the full post →
Relationship OCD · ROCD
What Is ROCD (Relationship OCD), and How Is It Treated?
Do you feel like you obsessively doubt your relationship, even though you know it's a healthy, good one? You may be experiencing Relationship OCD, one of the most misunderstood and undertreated OCD subtypes.
Read the full post →
Optimization OCD · OCD Subtypes · Anxiety
Optimization OCD: How to Stop It
By Amanda Panos, LCSW, Licensed Therapist | OCD Specialist | Telehealth, New York & Florida
I'm an OCD and anxiety therapist, and I have been at this game for some years now, but tell me how after a couple hundred clients, years of trainings, and consultations, I had never heard of Optimization OCD. And guess what person in their early to mid 20s would have most certainly qualified for Optimization OCD herself. Little old me. Woof.
To be fair, Optimization OCD technically does not classify as an official subtype, as far as I am aware. I would have named those symptoms, if I saw them, as Just Right OCD. Just Right is a category of OCD where something needs to be just right, or else an immense amount of fear and anxiety can come from this. I have had clients with Just Right OCD who may spend 10 hours on an hour-long homework assignment because it does not feel right, or the way they wrote could look strange to them, or they are afraid they made a mistake, afraid of getting in trouble or bad grades, or even being a bad student.
Optimization OCD hits different to me. Optimization OCD goes a little like this: I remember when I went with my spouse many years ago on a van life trip around the Pacific Northwest for two weeks. I'm in love with hiking, the outdoors, and nature. Surely this will be fun. I remember feeling, quite literally, in agony each day like I was being hurt, because of how much anxiety I had. I worried, no, that sounds too gentle of a word. I agonized over whether we were hitting the best camping spots and towns. I felt sick over picking out a restaurant to eat. Yep, a restaurant. Forget it with having fun, I was fighting for my life internally while being surrounded by some of the most beautiful places on earth.
Optimization OCD often feels really silly to struggle with. Shame always worsens OCD, by the way. It felt so dumb to be so consumed with these things. And honestly it is. And that was half my problem. My thoughts would be like, "Why can't you just have fun? What is wrong with you? Look where you are, anyone would be so lucky to have this experience. You are wasting it. Why do I feel like all I want to do is go home and feel safe?" Optimization OCD may have come from some sort of trauma, but it can also be hereditary. I am the oldest sibling, a parentified one at that, and I have done a lot of trying to fix and control my family at some of our darkest moments. Somehow along the way, this translated to being physically unable to relax at a table at a restaurant, and that's on OCD.
The fact is, OCD is quite silly. All forms are. And that's the disorder. Worrying about if you are a pedophile but you wouldn't hurt a fly, or you did once so that means you are capable of hurting a child, or worrying your partner who loves you dearly is cheating on you. Kim, there's people who are dying. You know. You are aware. Probably more aware than most. You would love to not feel this way. That is why OCD is not a choice, it's not being ungrateful, or bad. We are not our thoughts, but we can have control over it when given the proper tools.
What Do I Do About It?
One core tool for overcoming Optimization OCD is the "Stories Method." This tool is simple: put a reminder in your phone once per day that says "Storytelling" and you are going to practice in random moments telling a delightful story you can soak yourself in with your five senses. If you can see people laughing or talking near you, say to yourself, "How incredible that we possess the ability to bring love and connection to one another." Feel the joy and curiosity of that conversation. Notice there could be a negative story being told about this as well. "I could never look that confident in a conversation," "I am such a loser just watching these people talk to each other." Hear the songs the birds sing, the tone and pitch of their little voices. You might tell the story, "That bird song is so beautiful, it reminds me of a flute, or when I was younger playing outside." The negative story may be, "That bird is so annoying, my life was better when I was younger, now it sucks." Notice the difference in the stories and how they make you feel. Ask: which story is correct or right? There is no correct story. Your OCD symptoms are no different than this exercise. There is a story behind your OCD. What is that story, and is there another story you could tell yourself?
But of course, I am going to tell you to also go to a specialized OCD therapist. I beg of you to not go to a generalized, non-OCD-trained therapist. Maybe you stumbled upon one and it worked for you. Congratulations, that is amazing, but not a common experience. Gold standard OCD therapy means Exposure and Response Prevention, but perhaps also Acceptance and Commitment Therapy, and Inference Based Cognitive Behavioral Therapy. It provides structured, actionable tools from your therapist. I urge you to reach out to me and I will give you referrals or help you myself.
If therapy is not in the cards for you right now, I love the book "Overcoming Unwanted Intrusive Thoughts" by Martin N. Seif PhD and Sally M. Winston PsyD, and I will make you read it anyways if you are my client. I also love "The Happiness Trap" by Russ Harris. The podcast by Kimberly Quinlan, "Your Anxiety Toolkit," is incredible.
Amanda Panos, LCSW, is a licensed therapist and OCD specialist serving adults in New York and Florida via telehealth. She identifies as queer and her practice is LGBTQ+ inclusive. She uses structured, evidence-based methods, primarily ERP, to help clients break free from OCD and reclaim their lives.
SO-OCD · Queer Identity · Anxiety
When Doubt Takes Over: OCD, Queerness, and Why I, as a Therapist, Hate the Comment Section of TikTok if You Have SO-OCD
By Amanda Panos, LCSW, Licensed Therapist | OCD Specialist | Telehealth, New York & Florida
If you've spent hours, days, or years questioning whether you're actually gay, straight, bisexual, trans, or any other identity, and no amount of reassurance ever seems to stick, this post is for you. I want you to know that what you're experiencing might not be confusion about your identity at all. It might be OCD.
It's Normal to Explore and Question
Questioning your sexuality or gender is a completely normal and often meaningful part of being human. Plenty of people spend time sitting with uncertainty about who they are, who they're attracted to, or how they relate to their own body and gender. That kind of exploration, although it can be uncomfortable for many, or even scary, manifests differently than OCD. OCD demands proof you can never quite produce. OCD is urgent, you often need to figure it out right now, and it does not allow for time, space, or even giving yourself the grace of years of exploration to come to a greater idea of what feels right for you. With OCD, there is excessive rumination, trying to "solve" something in your head that can't be solved just living inside of your head.
With OCD, we don't accept that some things take a lot of time. For a few years you may say, "I am bisexual." And then in a few years you may say, "I am a lesbian." This is perfectly okay. It's not illegal, and it's not wrong to have this experience. A quick simple tool I teach clients is called "So what." So... so what? So what if I say I'm bisexual and date a woman for a long time and maybe I am a lesbian, maybe I am straight. I don't know yet, but right now, this feels right. So what? It speaks to being human, and the uncertainty that inherently exists with the human experience. That's what everyone does when they get married even if they feel certain in their sexuality, right? We say, I sure think I love this person and we make a good fit, and anything can happen but I'm going to do my best to commit myself to this person. Could you get divorced and change your mind about them two decades later? Yes, you could. We sit with uncertainty all day long every day of that possibility and accept that could happen. It might, it might not. That's okay.
For many Gen Z and Millennial generations, the internet makes us feel like we need to label ourselves and get it right the first time. There is a lot of biphobia on the internet, and the comment section of posts can be a breeding ground for OCD. I have seen comments that are downright hateful and ridiculous about this topic. I have personally had dozens of clients come to me, in tears, expressing their self-doubts and not recognizing they are regurgitating something that Chad from rural Arkansas, who has never met you and knows nothing about you, commented on a post when he was in a bad mood. Our psychology is funny like that, we can hear something one time, even if we wouldn't agree with it when prompted, and it can weasel its way into our subconscious. And now Chad from rural Arkansas is essentially allowing you to doubt your whole identity. Plus that TV show you watched one time where they thought they were gay but then they weren't, and then Renée Rapp was bisexual for years and then she realized she was a lesbian, and then it all gets to you and you are more confused and stressed out than you were five minutes ago.
What Sexual Orientation OCD and Gender OCD Actually Look Like
OCD latches onto whatever matters most to you. For many people, it finds a grip on identity.
Sexual Orientation OCD (sometimes called SO-OCD) involves intrusive, unwanted thoughts about your sexuality, followed by compulsive attempts to neutralize the anxiety those thoughts cause. Gender OCD works similarly, targeting doubts about gender identity.
It might look like:
Obsessively replaying interactions or memories to figure out if your attraction was "real." Seeking reassurance from partners, friends, or TikTok, Instagram, and Google, only to feel temporary relief before the doubt rushes back in. Avoiding certain people, media, or situations because they trigger the questions. Testing yourself mentally: imagining scenarios and monitoring your reaction, trying to "catch" the truth about who you are. These actions are all called compulsions. Feeling like you've finally figured it out, then waking up the next morning and starting all over.
The exhausting part is that none of it works. The compulsions actually feed the cycle rather than breaking it. That's the cruel nature of OCD. The harder you try to find certainty, the more uncertain you feel.
This Is Not the Same as Being Confused About Your Identity
This is important, and I want to say it carefully.
OCD doubt and genuine identity exploration can look similar on the surface, but they feel very different from the inside. Identity exploration tends to come with moments of curiosity, openness, and possibility. OCD doubt comes with dread. It's not really about figuring yourself out. It's about escaping the anxiety.
People with SO-OCD or Gender OCD are not more or less likely to be any particular sexuality or gender. The content of the obsession doesn't tell you who you are. What it tells you is that your brain is stuck in a loop, and the loop is causing you real suffering.
It's also worth saying: queer people can have OCD too, and their OCD can show up around queer themes. Someone who knows they're gay might still experience intrusive doubts that feel like they're undermining that. Someone who knows they're trans might still get caught in OCD loops about whether they're "really" trans or just confused. OCD doesn't care about the truth. It just cares about the doubt.
Why Queer People Are Especially Vulnerable to This
For queer folks, there's an added layer. Many of us grew up in environments where our identity actually was questioned by family, by culture, by religion, by a world that told us we needed to be sure before we could be accepted. That kind of experience can make OCD's demands for certainty feel more familiar, more urgent, and harder to push back against.
When the world has spent years asking "are you sure?" it can be hard to recognize that the voice asking that question now is OCD, not reality.
What Actually Helps
I'm Amanda! I'm a lesbian (until proven otherwise, I should say, and embrace, because... so what), and I'm a therapist. I treat OCD all day long and in the queer community. When looking for OCD treatment, look for a therapist that specializes in it and uses ERP, Exposure and Response Prevention. It is the gold standard treatment, and it's extremely effective. I see the majority of my clients leave therapy with OCD behind them using this approach primarily quite often. But I also recommend you look for a therapist that has a few other tricks up their sleeve, such as fancy names like Cognitive Behavioral Therapy (works on getting at the root of the OCD problem) and Acceptance and Commitment Therapy (teaches mindfulness and how to unhook from intrusive thoughts). OCD hates to see this treatment cocktail coming, and that is exactly what I do.
If any of this resonates with you, you're not alone, and you're not broken. The doubt you're feeling is real. The suffering is real. And there is a way through it.
Feel free to reach out if you'd like to talk about whether therapy might be a good fit for where you are right now.
Amanda Panos, LCSW, is a licensed therapist and OCD specialist serving adults in New York and Florida via telehealth. She identifies as queer and her practice is LGBTQ+ inclusive. She uses structured, evidence-based methods, primarily ERP, to help clients break free from OCD and reclaim their lives.
Relationship OCD · ROCD
What Is ROCD (Relationship OCD), and How Is It Treated?
By Amanda Panos, LCSW, Licensed Therapist | OCD Specialist | Telehealth, New York & Florida
Do you feel like you obsessively doubt your relationship, even though you know it's a healthy, good relationship? Do you feel like no matter how hard you try to solve it, how much you think it through, write about it, or talk about it, you can't figure out if you want to be with your partner, or whether your partner wants to be with you, or if you are in the "right" relationship?
You may spend hours thinking about it, and other moments you feel totally fine. If this sounds familiar, you may be experiencing Relationship OCD, or ROCD.
What Is ROCD?
ROCD is a subtype of Obsessive Compulsive Disorder in which intrusive doubts and fears center on your romantic relationship. It's not cold feet. It's not intuition. It's OCD latching onto the thing that matters most to you and using it as fuel for an endless loop of anxiety and doubt.
There are several ways Relationship OCD manifests:
Other-Focused ROCD
You love your partner and feel like it's a healthy, good relationship, and yet you can't stop asking yourself: Do I really? Are they the right person? What if I'm making a mistake? Are they the one? Maybe I'm not attracted to them. Do they annoy me too much? Do we fight too much? Will this love last?
Self-Focused ROCD
You know your partner loves you, they tell you, they act like it, they're committed, and yet you worry you're not good enough, that they'll leave or cheat, that they want to be with someone else. You think: "They don't want to be with me," "They'd rather be with their ex," "They wish I looked different."
Relationship-Focused ROCD
You ask yourself: Is this the "right" relationship? Are we really happy? Should I be with someone else? The doubt isn't about a specific person, it's about the relationship itself.
ROCD can also show up in friendships, obsessing over whether a friend is pulling away, reading into response times, or constantly seeking reassurance. Relationship OCD can translate to practically any relationship: family, friends, coworkers, bosses, children.
Why It's Often Misunderstood
ROCD is frequently mistaken for genuine doubt, ambivalence, or incompatibility. People spend years, sometimes entire relationships, thinking they just need to "figure out their feelings." Therapists who aren't OCD specialists sometimes reinforce this by encouraging clients to explore why they feel unsure, which keeps the OCD loop running.
I am also trained in several relationship-strengthening methods rooted in the Gottman Method. Sometimes these obsessive doubts flare up because there are genuine areas where the relationship can grow. I can teach you skills that improve the quality and good feelings in your relationship, while also helping you break the cycle of doubt that is harming both you and your relationship.
The hard truth: reassurance-seeking is a compulsion. Every time you seek reassurance, from your partner, a friend, a search engine, or even just try to solve the problem in your own head over and over, you teach your brain that the doubt was worth responding to. This makes the obsession stronger over time.
What Actually Helps: ERP
The most effective treatment for ROCD, and all forms of OCD, is Exposure and Response Prevention (ERP), a structured, evidence-based method clinically proven to work.
2. Tolerate uncertainty rather than trying to resolve it through compulsions
3. Gradually face feared thoughts and situations without performing the usual rituals
This doesn't mean forcing yourself to "just stop worrying." It's a step-by-step process done with a trained therapist who understands exactly how OCD operates.
General talk therapy, while valuable for many issues, often isn't the right tool for OCD and can sometimes make it worse. Working with a specialist is the recommended treatment.
Working with an OCD Specialist via Telehealth
I work with adults experiencing ROCD and other OCD subtypes throughout New York State and Florida, entirely via telehealth.
Many of my clients look like they have it together on the outside while privately battling an internal world that feels out of control. They've often spent years in therapy that didn't quite address what was actually going on. If that resonates. I have seen quite a few clients with these exact thoughts, and I can show you how to get out of this loop just like I did with them.
If you're in New York or Florida and wondering whether what you're experiencing might be OCD, I'd love to talk. I offer a free 20-minute consultation so we can figure out together whether we're a good fit.
Amanda Panos, LCSW, is a licensed therapist and OCD specialist serving adults in New York and Florida via telehealth. She uses structured, evidence-based methods, primarily ERP, to help clients break free from OCD and reclaim their lives.
