Lee Solomon on Intrusive Thoughts, Compulsions, and Breaking Free From OCD

Brainz Magazine Exclusive Interview

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Lee Solomon is an OCD specialist, therapist, educator, and founder of Solomon Psychiatrics. Based in Tampa, Florida, he works with teens and adults living with obsessive-compulsive disorder (OCD). His professional work is inseparable from lived experience. After spending years trapped by unwanted thoughts about harming the people he loved, Lee found the language and treatment that helped him understand what was happening. He went on to become the therapist he once needed but could not find.

In this interview, Lee shares how his own experience shaped his mission, why OCD is about far more than tidiness or organisation, and how invisible compulsions such as rumination, avoidance, checking, and reassurance can quietly take over a person’s life. He also explains why intrusive thoughts feel so convincing, how Exposure and Response Prevention (ERP) helps interrupt the cycle and what gives him hope for the future of OCD treatment.

Lee Solomon, Founder of Solomon Psychiatrics

You often say that you became the therapist you needed but could not find. What did life look like when OCD was at its worst, and what ultimately changed?

My childhood included a great deal of instability and trauma. My parents divorced, and there were family challenges involving abuse, substance use, and mental health. As I moved into adolescence, I became increasingly watchful and afraid. I started having intrusive thoughts, but at the time, I did not understand what they were.

Eventually, one particular fear took hold: What if I hurt someone I love? What if I stab my mom or a friend? These thoughts were completely unwanted, but they felt so vivid and convincing that I began to fear I might lose control. I did not hear anyone talking openly about experiences like this, so I assumed something was deeply wrong with me.

I later learned that I was experiencing harm OCD, a presentation of OCD involving unwanted obsessions about harming oneself or others. A close friend who also lived with OCD helped me recognise that this was more than general anxiety. He noticed that I was constantly checking, avoiding, seeking reassurance, and trying to neutralise the thoughts.

That recognition changed everything. Once I understood that there was a name for what I was experiencing, I could stop treating the content of every thought as a personal truth and begin addressing the cycle around it. Many people spend years moving between professionals before they receive an appropriate diagnosis and specialised treatment. I know how lonely that period can be, which is why I became the therapist I once needed.

OCD is often reduced to being neat, organised, or particular. What does it really look like behind closed doors?

OCD involves obsessions, compulsions, or both. Obsessions can appear as intrusive thoughts, images, urges, feelings, or sensations that are unwanted and distressing. Compulsions are the mental or physical behaviours a person feels driven to perform in response, usually to reduce anxiety, prevent a feared outcome, or obtain certainty.

Intrusive thoughts alone are not unusual; people without OCD can experience them too. The problem is the meaning attached to the thought and the cycle that follows. For someone with OCD, the thought can feel so urgent that everything else stops until it has been checked, solved, neutralised, or made to feel safe.

The most visible compulsions include repeated cleaning, arranging, counting, or checking whether a door is locked or an appliance is switched off. The less visible compulsions are often missed. Someone may spend hours reviewing a memory, analysing what a thought “means,” testing their feelings, silently reassuring themselves, praying, or trying to prove that a feared possibility is not true.

That is what OCD can look like behind closed doors: an exhausting amount of mental and physical work that other people may never see.

“OCD is not simply a preference for order. It can be a relentless cycle of fear, compulsion, and temporary relief.”

Why can intrusive thoughts feel so real, and how does the OCD cycle keep someone trapped?

When the body enters a state of alarm, logic can become much harder to access. A person might know intellectually that a thought is irrational or inconsistent with who they are, but the anxiety, physical sensations, and urgency make it feel as though something is happening right now.

That creates a powerful conflict. The mind says, “This does not make sense,” while the body responds as if danger is present. People often try to resolve that conflict by debating with the thought, proving it wrong, or seeking reassurance. Unfortunately, that can become another compulsion.

The cycle often begins with an intrusive thought, image, urge, or sensation. That triggers anxiety and doubt. Because the feeling is so uncomfortable, the person performs a compulsion - perhaps checking, avoiding, researching, asking for reassurance, or mentally reviewing the situation.

The compulsion usually works in the short term. Anxiety falls, and the person feels relief. That temporary relief is precisely what makes the cycle so powerful. The brain learns, “Checking kept me safe,” or “Reassurance solved the danger.” The next time doubt appears, the urge to perform the compulsion becomes even stronger.

The relief does not last. The doubt returns, sometimes within minutes or hours, and the cycle begins again. Over time, a person may need to perform more compulsions or repeat them more precisely to achieve the same sense of safety.

One of the biggest lessons in my recovery was that the brain learns from repeated behaviour. If I respond to a thought as an emergency every time it appears, I reinforce the message that it is dangerous. Recovery is not about finding the perfect argument against every intrusive thought; OCD will always produce another “what if?” It involves changing the response and allowing doubt to be present without repeatedly trying to remove it.

“The brain does not only learn from what we tell it. It learns from what we repeatedly do.”

What are some everyday compulsions people may not recognise as part of OCD?

Checking is a common one. A person might repeatedly check the locks, appliances, messages, social media posts, or apps on their phone because they fear they have made a mistake. Taking photographs of a locked door or an unplugged appliance can also become a way to seek certainty later.

Avoidance is another major compulsion. In my case, “harm OCD” led me to avoid knives, weapons, and violent content because they triggered intrusive thoughts. Avoidance brought immediate relief, but it also strengthened the belief that those triggers were dangerous and that I could not cope with the feelings they created.

Reassurance can be particularly difficult to spot. Someone might ask a loved one, “You know I would never do that, right?” or “Do you think I am a good person?” The question may sound ordinary, but internally, the person is trying to neutralise a specific fear.

Then there are mental compulsions: replaying an event, analysing a thought, testing attraction, monitoring emotions, replacing a “bad” thought with a “good” one, or repeatedly telling yourself that a feared event will never happen. Rumination can feel like problem-solving, but when its purpose is to eliminate uncertainty, it may be maintaining the OCD cycle.

The behaviour itself is not always enough to identify a compulsion. Intent and pattern matter. Checking something once does not automatically mean OCD. The important questions are: What fear is driving this? Do I feel unable to move on until it feels certain? How much time, distress, or interference is this creating?

ERP is widely recognised as an effective treatment for OCD. How does it work in practice?

Exposure and Response Prevention is a structured form of cognitive behavioural therapy. The exposure element involves gradually and intentionally approaching a thought, situation, image, or sensation that triggers the obsession. Response prevention means resisting the compulsion that would normally follow.

The first step is understanding the person’s specific cycle: their triggers, obsessions, compulsions, avoidance patterns, and reassurance-seeking. From there, therapist and client can create a personalised hierarchy, usually beginning with manageable exercises and building towards more difficult ones.

An exposure might involve writing a short scenario about a feared possibility, reading it without neutralising it, viewing carefully selected material, or completing a real-life task while allowing uncertainty to remain. The goal is not to prove that the feared outcome is impossible. It is to learn that anxiety can rise and fall without the person performing a ritual to make it disappear.

ERP should be collaborative, carefully planned, and appropriate to the individual. It is not about placing someone in genuine danger or forcing them into the most frightening situation immediately. Especially when obsessions involve harm or self-harm, exercises should be developed with a properly trained clinician rather than improvised alone.

For me, the turning point was realising I did not have to fight fear with more analysis. I could outlast the urge to perform a compulsion. Each time I stayed with the discomfort and responded differently, I weakened the cycle.

For someone who recognises themselves in this conversation, what are the first practical steps they can take?

My first recommendation is to seek an OCD specialist, someone trained to assess OCD and deliver evidence-based treatment such as ERP. Many excellent therapists are not specialists in this condition, and approaches that work well for other concerns can unintentionally become reassurance or rumination when applied to OCD.

The second step is awareness. Begin noticing the pattern without immediately trying to fix it. You might say, “I am noticing an intrusive thought,” or “I am noticing the urge to check.” Labelling the experience can create a small amount of distance between you and the OCD cycle.

I sometimes ask myself, “Is this something I genuinely want, or is this something I am afraid of?” That question is not a diagnostic test and should not become another ritual. It is simply a way to notice when fear is demanding an immediate answer.

Some people also find it helpful to give OCD a nickname. The point is not to mock the suffering but to separate the disorder from identity. Instead of saying, “Here I go again; something is wrong with me,” you can recognise, “OCD is asking for certainty again.”

Most importantly, do not assume you have to overcome it alone. Specialised support can help you understand which responses are compulsions and build a recovery plan that is both challenging and safe.

I still experience intrusive thoughts and difficult feelings. Recovery does not mean never having an unwanted thought again; it means those thoughts no longer control my behaviour in the same way. That lived experience is central to the way I practise. I understand how convincing OCD feels, but I also know that feeling convinced does not mean a person is beyond help.

OCD is sometimes called “the doubting disorder.” Why is uncertainty so central to it?

OCD does not merely ask for reassurance; it asks for complete certainty. The difficulty is that complete certainty does not exist. No one can guarantee that they will never make a mistake, become ill, hurt someone, damage a relationship, or experience something painful.

Compulsions offer the illusion that certainty is possible. The more often a person checks, avoids, or seeks reassurance, the more dependent they become on those behaviours whenever doubt appears.

Acceptance was a major part of my recovery. For me, that meant responding to OCD with: “Maybe that could happen, and I am not going to spend the rest of the day trying to prove that it will not.” This is not agreement that the fear is true, nor is it giving up. It is giving up the impossible task of achieving a 100% guarantee.

I often picture the moment I stopped fighting as putting down my sword and shield. I had been trying to defeat every thought, but I was really fighting myself. I did not need more protection from uncertainty; I needed to learn how to move through it.

“The goal is not to win an argument with OCD. It is to stop letting the demand for certainty run your life.”

Has technology made OCD harder to manage?

Technology can be useful for education and for finding the right support. Many clients first discover my work through social media because they finally hear someone describe an experience they thought no one else understood.

The problem begins when information becomes reassurance. Search engines, social media, online forums, and AI tools can provide an almost endless stream of answers. For a person with OCD, that can turn into repeated research: asking the same question in different ways, comparing symptoms, reading another post, or watching another video in the hope of finally feeling certain.

I have had clients tell me they cannot stop watching my videos because the content temporarily makes them feel safe. Once they are working with me, we look at the intention behind that behaviour. Are they learning something once, or are they returning repeatedly to neutralise fear? If it is the latter, even helpful content can become part of the compulsion.

Technology is not inherently the problem; the pattern of use matters. Sometimes one of the most useful experiments is to postpone reassurance-seeking, write down the question, and bring it to treatment instead of researching it immediately. That pause allows a person to practise tolerating uncertainty rather than feeding the cycle.

When does OCD usually begin, and what can contribute to its development?

OCD can emerge at different stages of life. I have worked with people whose symptoms began early and others who did not recognise a serious pattern until adulthood. There is no single story that applies to everyone.

Genetic and biological vulnerability can play a role, and OCD may run in families. Stress, trauma, major life events, or a panic episode can also coincide with symptoms becoming more visible or severe. Sometimes a person has experienced anxiety for years, then a frightening event intensifies the need to prevent uncertainty from ever returning.

What matters is that no one should assume they are too far gone because the pattern has been present for a long time. Treatment may require patience, particularly when compulsions and avoidance have become deeply established, but people can learn new ways of responding.

That lesson extends beyond OCD. Some of the most important changes in my own life came from doing what fear had always told me not to do.

As someone who treats and educates people about OCD every day, what gives you hope for the future?

Earlier generations often lived without access to the language, specialist care, or evidence-based support available today. My grandfather struggled with OCD throughout his life, and he did not have the opportunities for treatment that many people can now find.

Awareness of ERP is growing, more clinicians are pursuing specialist training, and organisations are helping the public recognise presentations of OCD that were once hidden or misdiagnosed. That gives me tremendous hope.

My own goal is to expand the reach of specialised OCD care. I have a practice in Florida and work with people in different places, but I want to help make this support more accessible around the world. I would love to see centres in the UK, Australia, and beyond, with more people receiving the right guidance earlier.

The issue was never that people with OCD were incapable of recovery. Too often, they simply did not know what they were experiencing or could not find treatment designed for it. We now understand far more about how to interrupt the cycle. The more accurately we talk about OCD, the more people will recognise that they are not alone - and that their lives do not have to remain organised around fear. Lee Solomon’s message is a reminder that OCD is not defined by tidiness, organisation, or the presence of an unwanted thought. It is the cycle of fear, doubt, and compulsive behaviour that can begin to control a person’s life. Whether he is talking about harm OCD, reassurance-seeking, technology, or ERP, the principle remains the same: recovery begins when people stop trying to achieve impossible certainty and learn that they can experience fear without obeying it.

To learn more about Lee or get in touch, visit the Solomon Psychiatrics website, follow him on Instagram, or connect with him on LinkedIn.