How Artificial Intelligence Complicates OCD Treatment

I work with many clients who are diagnosed with Obsessive-Compulsive Disorder (OCD). According to the DSM-5, OCD is characterized by obsessions, compulsions, or both. These symptoms are often time-consuming and cause significant distress or impairment. Obsessions are recurrent, intrusive thoughts, urges, or images that feel unwanted and distressing. Compulsions are repetitive behaviors or mental acts performed in response to obsessions, often to reduce anxiety or prevent a feared outcome.

What keeps OCD going is the reinforcement of this cycle. Each time a compulsion (or ritual) is performed, two beliefs are strengthened: (1) that the intrusive thought or worry truly required neutralization, and (2) that the behavior used to reduce anxiety was effective and should be repeated. Over time, this cycle grows stronger, leading to more distress, impairment, and unhappiness.

For years, the core approach to treating OCD has remained consistent. While other modalities can be helpful, the gold standard is Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy (CBT). ERP involves deliberately and gradually confronting feared triggers while resisting the urge to perform compulsions. The emphasis is on gradual—exposures are collaboratively planned to match a client’s tolerance for distress.

In ERP, obsessions are often tied to core fears. For example, someone with contamination-related OCD may compulsively wash their hands not simply to remove germs, but to avoid illness or another feared consequence. In my practice, I commonly see three core fears linked to contamination: (1) fear of harm to self, (2) fear of harming others (even unintentionally), and (3) fear of permanent disgust or inner defilement. Effective ERP should target not just surface-level triggers but also these deeper fears. Doing so makes relapse less likely and treatment more enduring.

In recent years, however, I have noticed a new complicating factor in OCD treatment: the role of artificial intelligence (AI) and related technologies in compulsions. One of the most common compulsions in OCD is reassurance seeking. The drive for absolute certainty pushes sufferers to question, research, and problem-solve endlessly. This often strains relationships, as loved ones can become exhausted from providing repeated reassurance. Although family members may feel pressured to help, reassurance ultimately reinforces OCD rather than resolving it.

With the rise of tools like ChatGPT, reassurance seeking has expanded further into the digital realm. Increasingly, clients describe spending hours engaging with AI to resolve doubts or confirm decisions. For instance, one client reported using ChatGPT for over an hour to determine whether they had been taken advantage of when purchasing a car and whether they had made the “right” choice. Interestingly, after the client disclosed their OCD, the program eventually stopped providing reassurance—but by then, the client’s objective of obtaining reassurance was achieved. From the sufferer’s perspective, turning to AI may feel preferable to burdening family and friends. Yet in the long run, AI-based reassurance seeking risks intensifying OCD symptoms. It strengthens the obsession–compulsion cycle, fosters dependence on technology for short-term relief, and may ultimately worsen distress and impairment.

As technology continues to advance, it is more important than ever for clinicians to remain mindful of the sheer volume of information and resources at clients’ fingertips. While these tools can seem helpful on the surface, they may actually serve as powerful reinforcers of compulsive behavior. With this awareness, clinicians should take extra care to assess not only traditional compulsions but also newer, technology-driven behaviors such as AI reassurance seeking, excessive online research, or repeated digital checking. A thorough exploration of both old and new compulsions can strengthen treatment planning and ensure that ERP interventions address the full range of factors maintaining the disorder.

For anyone struggling with OCD, the purpose of this post is not to sow doubt, but to highlight the ever-growing ways OCD can show up; with awareness of these factors, treatment can be more effective, and managing OCD can feel more possible and hopeful.