About Niles Cook
Thoughts aren’t the problem – fearing them is.
If you have OCD, you already know how terrifying your own mind can feel.
The intrusive thoughts don’t line up with who you are. They feel violent, sexual, immoral, and irresponsible. You replay, analyze, and try to neutralize them by checking, avoiding, confessing, and looking them up on Google. For a few minutes, you feel relief. Then, the doubt comes back louder.
Most of the adults who sit across from me are exhausted and ashamed. Some have been in therapy before and were told to challenge the content of their thoughts. Others were repeatedly reassured, which inadvertently fed the cycle.
Many are frightened that the thoughts mean something about their character. They don’t. OCD is loud. That’s different than dangerous.
What’s ERP like with me?
The therapeutic approach, Exposure and Response Prevention (ERP), has a reputation for being harsh. That’s not how I practice it.
ERP in my office feels structured, collaborative, and surprisingly grounding. We start by clearly mapping your OCD cycle. When does the thought show up? What do you do next? What gives temporary relief? Once we see the pattern, we stop treating the thought like the enemy and start treating the compulsions as the fuel.
You might feel your heart pounding during the session. In addition, you might notice the urge to seek reassurance from me. Instead of giving it to you, I’ll help you sit with the discomfort. We stay long enough for your brain to learn that anxiety peaks and falls on its own.
It feels uncomfortable at first. Then empowering.
Clients often tell me the first shift is subtle – “The thought still shows up, but I don’t react the same way.”
The second shift is bigger – “I can let it be there and keep living my life.”
That’s the goal – not perfect silence but freedom of choice.
Anxiety doesn’t get to make your decisions.
OCD shrinks your world. You avoid, delay, and wait for certainty that never comes. In our work, certainty ceases to be the goal. Tolerance becomes a skill.
Over months, clients describe making decisions faster, spending less time ruminating, and feeling less hijacked by intrusive images.
Relationships improve because reassurance seeking decreases, parenting feels steadier, and work becomes more focused because mental energy isn’t trapped in rituals.
You don’t become fearless, but you do become capable of fear without obeying it.
I don’t flinch at complex thoughts.
I specialize in OCD because it’s one of the most misunderstood conditions in mental health.
I’ve sat with clients who were afraid to say their intrusive thoughts aloud because they worried someone would think they were dangerous. I’ve seen what happens when well-meaning therapy reinforces compulsions instead of treating them.
ERP works. But it works best when it’s grounded in trust and precision. I’m direct, occasionally sarcastic in a way that helps cut through OCD’s drama. However, I am also rounded and clear, and I believe clients should understand precisely what’s happening in their brains and why we’re doing what we’re doing.
Psychoeducation reduces shame. Specialization improves outcomes.
Helping you tolerate uncertainty is the goal.
I trained as a clinical psychologist with a strong focus on cognitive-behavioral therapy and exposure-based treatments.
My approach is research-informed without being cold. You’re not a diagnosis in my office.
If anxiety has been running your life, I can help you take it back.