Therapy for Perinatal OCD & Anxiety
Everyone says new moms are anxious, but your brain won't turn off. The checking, the intrusive thoughts, the worry that follows you everywhere might be perinatal OCD or anxiety, and it's treatable.
You thought all new parents felt this anxious. But if you're constantly checking if your baby is breathing, having disturbing thoughts you're terrified to admit, or unable to relax even when your baby is safe—you're not failing at motherhood. You're struggling with a treatable condition.
At MWC, we specialize in perinatal OCD and anxiety therapy in Maryland and Pennsylvania. We know the difference, we know what helps, and we know you're not dangerous—you care deeply about your baby's safety.
The anxiety is real. But the story might not be.
What It Is:
Why Does This Happen?
Our therapists are highly trained in treatments that help break the OCD cycle rather than provide short-term relief. Our primary modality for OCD is Inference-Based Cognitive Behavioral Therapy (I-CBT), an evidence-based treatment that quickly gaining in popularity due to its effectiveness at treating OCD sustainably, no whack-a-mole approach. I-CBT is a specialized treatment for OCD that addresses the reasoning processes underlying your obsessions. Instead of focusing primarily on exposures, I-CBT helps you understand why certain thoughts feel so compelling and real in the first place. You’re not crazy- there’s a reason these thoughts feel so scary, so real, and so intense. I-CBT aims to help you understand OCD’s tricks so you can respond differently.
We practice with a whole-body approach, so we also include nutritional and lifestyle recommendations to help address OCD from all angles.
Why Specialized Treatment Matters:
Perinatal OCD (Obsessive-Compulsive Disorder) involves two components:
Obsessions: Intrusive, unwanted thoughts, images, or urges that cause significant distress. In the perinatal period, these often (but don’t always) involve harm coming to your baby, either accidentally or intentionally. These thoughts are ego-dystonic, meaning they go against your values and terrify you precisely because they're the opposite of what you want.
Compulsions: Repetitive behaviors or mental acts done to reduce anxiety or prevent the feared outcome. Common compulsions include checking (breathing, temperature, safety), seeking reassurance, avoiding situations, mental reviewing, or excessive researching.
Here's what's critical to understand: Having intrusive thoughts about harming your baby does NOT mean you want to harm your baby or that you will. These thoughts show up precisely because you care so deeply about your baby's safety.
OCD is more than “bad anxiety”, and it’s about way more than washing your hands. Often called “the doubting disorder,” OCD can lead you to question your senses, your memories, your intentions, and even who you are. It starts with a doubt, a worry, an intrusive thought, or a “what if” (the obsession) that prompts some sort of action to reduce the anxiety or resolve the doubt (compulsion). Compulsions can be observable by others (checking locks, asking for reassurance, Googling, repeating actions) or can be mental (analyzing, replaying memories, trying to reassure yourself).
A real pain point with OCD is that you know your compulsions aren’t necessary - and yet, you feel compelled to do them anyway. This is because they are in response to a story your mind is telling you, and stories can be incredibly powerful. Stories rooted in imagination and possibility can prompt real-life emotions in reality. This mismatch can not only be distressing, but can cause signifiant problems in your life.
Perinatal OCD and anxiety develop due to a combination of:
Hormonal changes during pregnancy and postpartum
Sleep deprivation that dysregulates the nervous system
Increased responsibility and the weight of keeping a baby safe
Identity shift and adjustment to parenthood
Pre-existing anxiety or OCD that worsens during this period
Brain changes that make you hyper-focused on threat detection
This is not your fault. You didn't cause this by thinking the wrong thoughts.We practice with a whole-body approach, so we also include nutritional and lifestyle recommendations to help address OCD from all angles.
Only one in six Americans living with OCD are properly diagnosed. Many people spend years in therapy without realizing they have OCD, and some studies suggest it takes 7-10 years to get properly diagnosed. That’s because OCD is tricky, highly individualized, and is not adequately addressed in most therapy training programs. Traditional talk therapy is not only ineffective at treating OCD, but it even has the potential to make it worse due to therapists co-compulsing with clients, diving into possibility/probability, or arguing against the thoughts.
If you’ve found yourself stuck in endless loops of anxiety, rituals, or “what if” thinking, you’re not alone, and you're not broken. At MWC, we provide specialized, evidence-based OCD therapy in Maryland and Pennsylvania to help you break the cycle and reclaim your life.
You're exhausted from trying to be enough.
Signs You Might Be Struggling:
Understanding Perfectionism, Burnout & Disordered Eating:
Perfectionism & Burnout:
Constant self-criticism or feelings of not being good enough
Difficulty saying no or setting boundaries
"Should" as a top five word in your vocabulary
Fear of making mistakes or disappointing others
Overfunctioning and exhaustion
Struggles with delegation and decision-making
Anxiety when plans change or things feel out of control
Procrastination driven by fear of doing something "wrong"
Avoiding risks unless you can do them perfectly
Body Image & Food Anxiety:
Constant body checking or comparison
Anxiety around food, eating in public, or social meals
Guilt after eating or feeling "good" for restricting
Obsession with exercise, weight, or "clean eating"
Using food or restriction as a way to cope
Feeling like your worth is tied to your body's size or shape
Chronic dieting or "yo-yo" eating patterns
Avoiding mirrors, photos, or your reflection
Healthcare Provider Burnout:
Compassion fatigue that no CEU can fix
Imposter syndrome despite your qualifications
Difficulty relaxing or making space for your own needs
Loss of meaning or direction in your work
Feeling stuck between systemic dysfunction and your values
Thinking "My problems aren't serious enough" or "I should be able to handle this"
Our Approach To Perfectionism, Burnout & Disordered Eating Therapy
OCD often intensifies or appears for the first time during major life transitions like trying to conceive, pregnancy, and postpartum. The high stakes, uncertainty, and responsibility of growing your family can trigger or worsen obsessions and compulsions.
As PMH-C certified specialists, we understand how OCD presents differently during these seasons:
During Fertility Treatment:
Obsessive tracking and rituals around conception
Intrusive thoughts about "deserving" to be a parent
Hypervigilance about body symptoms
Compulsive research and reassurance-seeking from doctors
Magical thinking about what will make it work
During Pregnancy:
Intrusive thoughts about harming the baby or losing the pregnancy
Contamination fears or health anxiety about what you're eating, touching, breathing
Excessive checking or avoidance behaviors
Hyperresponsibility about every decision
Constant reassurance-seeking from doctors or partners
Postpartum:
Disturbing intrusive thoughts about the baby being harmed (the most common and misunderstood presentation)
Compulsive checking (Is the baby breathing? Is the temperature right? Did I feed them correctly?)
Excessive cleaning or contamination fears
Inability to let others care for the baby
Avoidance of being alone with the baby or certain objects (knives, stairs, bathtubs)
Needing to confess every thought or action
In Motherhood:
Continued checking and reassurance-seeking as your kids grow
Intrusive thoughts about harm or safety
Hyperresponsibility about parenting decisions
Difficulty trusting others with your children
Here's the Problem: Society Rewards This
Perfectionism is praised. Most forms of human suffering aren't met with applause. Perfectionism, however, is rewarded by a society that prioritizes success, productivity, and appearance over… well, most things. It's no wonder we keep working harder and harder until we wake up burned out.
The diet industry profits from your insecurity. From SnackWell's and Atkins to Ozempic and "clean eating," the message has stayed the same: shrink yourself. Women are taught that thinness equals worthiness and that their bodies exist to please, produce, or perform.
The healthcare system is broken. If you're a medical provider, therapist, or other helper, you're navigating a system that was never designed to sustain your mental health. If you're struggling, this doesn't make you a bad clinician. This makes you human.
But this comes at a cost: anxiety, resentment, disconnection from what actually matters, and a body you're at war with instead of at home in.
The problem with perfectionism is that it's a rigged game where we feel like we're "winning" when things go well, and feel like we're failing when they don't. That feeling of failure sucks, and often leads us to try harder at the same goal.
However, despite what you may have been told, more effort does not always lead to a better outcome.
Sometimes, the goal is to shift the goal entirely. And that's where we come in.
Therapy with us is rooted in the belief that your worth isn't defined by performance, productivity, or the size of your body.
We practice through a Health at Every Size (HAES), intuitive eating, and body neutrality lens, which means:
All bodies are welcome and worthy: no exceptions.
Food is not the enemy. It's fuel, culture, connection, and joy.
Movement is for joy and vitality, not punishment or weight loss.
Health includes mental, emotional, and physical well-being…not appearance.
This is about partnering with your body, not fighting it.
We won't throw vague advice at you like "self-care" or pretend like systemic burnout can be solved with a planner and a bubble bath. Instead, we'll acknowledge the reality, work within your limits, and find ways to bring joy, meaning, and autonomy back into your life.
Frequently Asked Questions:
What is the difference between perfectionism and high standards?
1
High standards mean you care about doing well and feel satisfied when you achieve your goals. Perfectionism is often less about moving towards perfection, and moreso about moving away from fear. It means nothing ever feels good enough, and even when you succeed, you focus on what could have been better. The finish line always keeps moving. Perfectionism is driven by fear of failure, criticism, or not being enough, while high standards are driven by genuine values and growth.
Can postpartum OCD or anxiety start during pregnancy?
2
Yes. Perfectionism is one of the leading causes of burnout because it creates an unsustainable cycle of overworking, self-criticism, and never feeling like you've done enough. Over time, this constant striving depletes your energy, increases anxiety, and leads to emotional and physical exhaustion.
What is postpartum psychosis and how is it different from postpartum OCD?
3
Postpartum psychosis is a rare (1-2 per 1,000 births) but serious medical emergency involving delusions, hallucinations, paranoia, confusion, and disorganized behavior. Someone with postpartum psychosis may believe their baby is possessed, hear voices telling them to harm the baby, or lose touch with reality. Postpartum OCD involves unwanted, intrusive thoughts that cause distress precisely because they go against your values. With Postpartum OCD, you're terrified of these thoughts and doubts, and engage in compulsions and mental behaviors to prevent them from happening. With OCD, you know the thoughts are irrational and you don't want to act on them. Postpartum psychosis requires immediate medical intervention; postpartum OCD is treated with therapy and sometimes medication but is not a psychiatric emergency.
Is therapy for disordered eating only for people with eating disorders?
4
No. You don't need a formal eating disorder diagnosis to benefit from therapy. If you struggle with anxiety around food, chronic dieting, body image issues, orthorexia, or using food to cope with emotions, therapy can help. Many people exist in a "gray area" where their relationship with food and their body is causing distress but doesn't meet clinical criteria for an eating disorder.
What is orthorexia?
5
Orthorexia is an obsession with "clean" or "healthy" eating that becomes harmful. Unlike anorexia, which focuses on quantity, orthorexia focuses on food quality and purity. People with orthorexia may avoid entire food groups, experience anxiety around "impure" foods, and feel morally superior for their eating choices. It often disguises itself as wellness but causes significant distress and social isolation.
Your Body Is Not the Problem. It Never Was.
Whether you're feeling burned out, a bit crispy, or lightly toasted, you deserve to feel better.
Online Therapy for Perfectionism, Burnout & Disordered Eating in Maryland and Pennsylvania
We offer secure, HIPAA-compliant virtual therapy sessions throughout Maryland, Pennsylvania, South Carolina and Vermont. Whether you're in Baltimore, Bethesda, Annapolis, Rockville, Philadelphia, or anywhere else in these states, you can access compassionate, specialized care from the comfort of your home.
You hold space for everyone else. Let's make this space yours.
An empty lantern provides no light. It's time to refill yours.