"What if I'm making it all up?"

OCD runs on doubt. It attaches to whatever matters most to you: safety, relationships, morality and, often, your own mind. "Am I really ill or just seeking attention?" is the same pattern as "Did I lock the door?" The topic changes; the need for certainty does not.

• Worrying that you learned your symptoms from social media and talked yourself into them
• Fearing you have a condition where people invent illness for attention
• Downplaying symptoms in therapy so you are not "lying"
• Feeling unable to say what you need from therapy, in case it turns out to be made up
• Researching your symptoms to confirm or rule out the diagnosis

People who invent symptoms for attention usually want others to believe them. People with OCD usually want to be told they are fine, and are distressed by their own thoughts. A clinician looks at the pattern: intrusive thoughts, the anxiety they cause, and the mental or physical things you do to get relief.

You don't need to arrive with a clear goal. If being asked "what do you want to work on?" makes you freeze, say so. A good therapist will offer options, explain their thinking, and help you put words to what is going on. That is how I tend to work.

Read about OCD and ERP therapy, or about assessment.

Free tools: OCD themes quiz · printable OCD doubt toolkit