Delay the ritual

In 1966, at a hospital in London, the psychologist Victor Meyer tried something new with patients whose washing and checking rituals took over their lives. OCD was then thought to be almost untreatable. Meyer's team helped patients face the things that set off their fears, and then supported them not to do the ritual afterward.

Most of them improved, many a great deal. The approach became exposure and response prevention, refined over the following decades by researchers such as Edna Foa, and it's still the leading treatment for OCD.

It usually goes like this: a trigger, then an anxious thought ("Did I leave the stove on?"), then a strong urge, then the ritual (go back and check), then relief. The relief is real, but it teaches your brain that the check was necessary. Next time the urge is stronger.

Rituals aren't always visible. Asking someone "are you sure?", searching symptoms online, or replaying a memory to make sure all count. Response prevention means riding out the urge without the ritual, and delaying it is the first step toward not doing it at all.

Most mornings, Hana gets halfway down the block, turns around, and goes back to check the stove. Sometimes she does it three times and is late for work. On the bus, she texts her roommate: "Can you look at the stove? Just to be sure." Her roommate always says it's off, and Hana feels better for about an hour.