Therapy for perinatal and postnatal OCD
CBT and ERP for intrusive thoughts about your baby — with a BABCP-accredited OCD specialist, online across the UK so you can be seen at home, in English or Spanish.
Does this sound familiar?
A thought or an image arrives involving your baby — dropping them, the bath, the stairs, something happening in the night. It lasts a second. What follows is horror, and then a question that will not let go: what kind of parent thinks that?
So the day starts rearranging itself around making sure. You check that they are breathing, then check again on the way past. You hand over bath time. You find reasons not to be alone with them. The knives move, the windows stay shut, the stairs get taken differently or not at all. You replay the moment you felt a flash of irritation at four in the morning and examine it for what it proves. You look inwards for the rush of love everyone described, and monitoring for it is the surest way to stop being able to find it — and then the absence becomes the evidence.
And you tell nobody. Not your partner, and certainly not the health visitor. You sit through the six-week check being asked whether you have been feeling low, and you say you are tired.
This is perinatal OCD. It can begin in pregnancy or at any point in the first year, it is one of the most recognised presentations there is, and it is treatable. Intrusive thoughts about harm coming to a baby are reported by the great majority of new parents — what makes it a condition is not the thought, but everything you have started doing about it.
How I treat it
The treatment is CBT with Exposure and Response Prevention (ERP), which NICE recommends for OCD, and this theme responds as well as any other. What we will not do is try to settle whether you are safe to be around your child. Answering that is the compulsion, and every answer you have found so far has expired within the hour.
So we map the cycle first: the trigger, the intrusion, the meaning it has taken on, and everything that follows — the checking, the avoiding, the mental reviewing, the reassurance. Each of those buys a few minutes and teaches your brain the danger was real. We withdraw them gradually, by agreement, and let your own experience do the teaching instead.
One thing said plainly, because it is what stops people starting: exposure work here never involves any actual risk to your baby. That is not what exposure means, and anyone suggesting otherwise has misunderstood it. The work is giving up the safety behaviours — bathing your own child, carrying them down your own stairs, keeping the knife where knives go, being alone with them without a running commentary.
Assessment also separates this from postpartum psychosis, which is a different thing and a medical emergency — see the questions below. That distinction is routine clinical work, not something you need to have worked out before you get in touch. Where you want it, I am glad to work alongside your GP, health visitor or perinatal mental health team.
The goal is your ordinary life back in your hands: bath time, the school run in three years, being alone with your own child without a guard posted.
What to expect
We start with one or two assessment sessions to understand how your OCD works and what you have stopped doing because of it. A typical course runs 12–16 weekly sessions of 50 minutes, with practical work between them. Every step is planned together first and paced by you — nothing is sprung on you, and nothing involves your baby coming to any harm.
Sessions run over secure video, which for new parents is often the difference between having therapy and not having it. You can feed during a session. The baby can be in the room, and it is genuinely fine if we are interrupted. In-person sessions at Sanctuary Therapy Centre in Prestwich and Hebden Bridge are there if you would rather, in English or Spanish.
If you have never said any of this out loud, the first session can go at whatever pace that needs. Many people start with the theme in general terms and fill in the detail over several weeks. Detail helps the treatment; it is not the entry fee.
Common questions
Does having these thoughts mean I am a danger to my baby? This theme is defined by how much the thoughts horrify you — they run against everything you want, which is exactly why they stick and why you have spent the week making sure. Notice, too, that answering this question is what the OCD is asking for, and that no answer has held yet. That is why we treat the cycle rather than the question.
Will you have to report me if I tell you? I am not going to pretend safeguarding responsibilities don't exist — every therapist has them. What triggers them is risk to a child, not a parent in distress about thoughts they find repellent. Telling those apart is ordinary clinical work and part of what assessment is for. Professionals who know this presentation recognise it quickly.
How is this different from postpartum psychosis? In OCD the thoughts appal you and your insight is intact — you know they make no sense, which is precisely why they are so distressing. Postpartum psychosis is a medical emergency: it usually comes on fast in the first days or weeks, the beliefs feel true rather than horrifying, insight is lost, and there may be confusion, elation or not sleeping at all. If you are unsure which you are describing, contact your GP, midwife, health visitor or NHS 111 today rather than waiting for an appointment with me.
Is this just postnatal depression? They are different, though they can occur together and OCD is often recorded as depression when nobody asks the right question. Postnatal depression centres on mood, exhaustion and loss of pleasure; this centres on intrusive thoughts and the checking or avoiding they drive. If both are present we treat both.
Can I be treated while I am still pregnant? Yes. "Perinatal" covers pregnancy as well as the year after birth, and this often starts before the baby arrives. There is no reason to wait.
It's my partner who has this, not me. Fathers and non-birthing partners get this too, and disclose it even less often, because every leaflet in the building is addressed to someone else. The treatment is the same. So is the welcome.
Can sessions be in Spanish? Yes — I offer therapy in English and Spanish.
Ready to take the first step?
Send an enquiry and Gisela will be in touch within one working day.