What Is ACT and How Can It Help with OCD?
If you live with obsessive-compulsive disorder (OCD) or feel like your mind is constantly looping through “what-ifs” and “shoulds,” you already know how exhausting it can be. Intrusive thoughts, mental reviewing, the urge to control, and the endless search for certainty can start to take over. Life begins to feel smaller.
You may have heard of Exposure and Response Prevention (ERP), the gold standard for OCD treatment. But there’s another approach that often works hand-in-hand with ERP: Acceptance and Commitment Therapy (ACT).
In this post, we’ll explore:
What ACT actually means
How it works in practice, especially for OCD
Why it can feel like the “missing piece” in treatment
What to expect if you include ACT in your therapy
What Is ACT?
Acceptance and Commitment Therapy (ACT) is about acceptance, presence, and values-based action. Instead of trying to get rid of unwanted thoughts or emotions, ACT helps you build a new relationship with them.
In practice, this means shifting from control to connection.
Rather than fighting your thoughts or trying to analyze them into silence, you start to notice them with curiosity. You learn to make space for whatever shows up (i.e., fear, doubt, guilt, uncertainty) while still choosing actions that align with your values.
For someone with OCD, this might look like noticing a thought such as “What if I hurt someone?” or “What if I’m contaminated?” and allowing it to be there without treating it as danger.
You don’t need to argue with it or push it away. Instead, you can refocus on what truly matters: connection, creativity, purpose, or simply being present in your life again.
Why ACT and OCD Work Well Together
For many people with OCD, ERP provides the foundation of healing: helping them face fears, reduce rituals, and rebuild trust in themselves. Yet even after progress, it’s common to feel caught in subtle loops of “what if?” or perfectionistic self-monitoring.
ACT fills that gap by teaching psychological flexibility: the ability to stay grounded and make values-based choices even when anxiety or uncertainty show up. It helps shift the question from “Will I ever get rid of this?” to “How can I live fully even when this shows up?”
Think of it like this:
ERP helps you turn the engine back on. ACT helps you decide where you want to go.
What to Expect if You Include ACT
Here’s what the process might look like:
Early sessions often explore your relationship with control, certainty, and discomfort.
You’ll begin mindfulness and values exercises that build awareness and self-compassion.
If you’re also practicing ERP, ACT provides tools to approach exposures with greater willingness and perspective.
Over time, your urges may still appear, but your responses shift. You begin acting from values instead of fear.
The goal isn’t to eliminate thoughts. It’s to find freedom from being ruled by them.
Is ACT right for you?
You might consider ACT if you:
Still feel stuck after trying ERP
Find yourself spinning in “what if” thoughts, even as rituals decrease
Want your life to feel bigger than symptom management
Practice mindfulness, but sense something’s missing
Crave more clarity about what truly matters to you
Final Thoughts
Living with OCD doesn’t mean you’re broken—it means your mind is trying to protect you in the only way it knows how. But when control and certainty start running the show, that protection can become a prison.
ACT helps you step out of that prison of “what if,” loosen the grip of fear-driven loops, and move toward what truly matters. You don’t have to wait for your thoughts to disappear.
You can begin now—with curiosity, presence, and the commitment to live a meaningful life.
If you’re curious how ACT could fit into your treatment for OCD or anxiety, reach out here to schedule a session or free 20-minute consultation.
