Standard CBT was developed with neurotypical presentations in mind. But when applied without modification, it can miss the mark significantly for autistic or ADHD individuals.

However, when it’s thoughtfully modified by a therapist who understands neurodivergence, CBT can offer something genuinely useful. Not by trying to make neurodivergent people think more neurotypically, but by building tools that work with how their brains actually function.

OCD is usually framed as an individual experience. The intrusive thoughts, the anxiety, the compulsions. All of these happen inside one person’s mind and body. But OCD doesn’t stay contained to the person who has it; it moves through relationships. It shapes how someone communicates, how much they trust themselves and others, and how close they’re able to feel to the people they love most. When that dynamic goes unrecognized, it can quietly do a lot of damage to a relationship that both people are genuinely trying to protect.

Most people have a mental image of OCD that looks pretty specific. Someone checking their locks repeatedly. Someone washing their hands until the skin is raw. Or someone who needs everything arranged just so before they can move on with their day. While these are real presentations of OCD, they represent a narrow slice of what the disorder actually looks like in practice. A lot of people living with OCD don’t recognize themselves in that picture at all, which means many go years without understanding what’s actually happening to them.

For someone with OCD, ERP can be extremely helpful. It allows you to face your fears or the things causing certain behaviors in a controlled and safe setting.