"Clients tell me they finally feel safe saying the things they've been too afraid to speak out loud. That's exactly the space I'm here to create."
— Cheryl Reeley, LCSW-S, PMH-C
If you're having scary, disturbing, or violent thoughts about your baby that you would never act on — and they're filling you with horror and shame — you are not alone, and you are not dangerous. What you're experiencing is likely perinatal OCD, and it is one of the most treatable conditions in perinatal mental health.
Perinatal OCD is a form of obsessive-compulsive disorder that emerges during pregnancy or in the postpartum period. It's estimated to affect up to 9% of postpartum women — yet it's dramatically underdiagnosed because most women are too afraid to tell anyone what they're experiencing.
At its core, perinatal OCD involves unwanted, intrusive thoughts that are ego-dystonic — meaning they feel completely foreign to who you are and cause intense distress. They are followed by compulsions: mental or behavioral rituals designed to reduce that distress or prevent a feared outcome.
The cruel irony of OCD is that the harder you try to push the thoughts away, the stronger they become. The rituals that feel like relief in the moment actually feed the cycle, keeping anxiety high and the thoughts coming back.
The thought is not the problem. Your reaction to the thought — the horror, the shame, the desperate need to make it stop — that's what we work with in therapy.
Intrusive thoughts in perinatal OCD are often shocking, violent, or sexual in nature — which is exactly why they cause so much shame. They tend to cluster around the thing you love most: your baby. Here are examples of the kinds of thoughts women bring into my office:
Intrusive thoughts aren't always violent. They can also take the form of obsessive doubt (did I check the breathing monitor enough times?), contamination fears (what if the baby gets sick because of something I did?), or harm avoidance that leads to excessive checking and reassurance-seeking.
If you've been trying to just not think about it, you've probably noticed it doesn't work. There's a well-documented psychological phenomenon — sometimes called the "white bear problem" — where actively trying to suppress a thought actually makes it more frequent and more intrusive.
OCD feeds on avoidance and reassurance. Every time you check, avoid, or seek reassurance to relieve the distress, you're teaching your brain that the thought was a real threat that needed addressing. The relief is temporary. The thoughts come back — often stronger.
Checking — repeatedly checking that baby is breathing, verifying that something bad hasn't happened, reviewing the baby monitor footage multiple times.
Avoidance — refusing to be alone with the baby, avoiding knives or stairs, staying away from the baby's bathtime out of fear.
Mental rituals — replaying the thought to "prove" you wouldn't act on it, praying, counting, or neutralizing with a "good" thought after each bad one.
Reassurance-seeking — asking your partner "do you think I'd hurt the baby?" repeatedly, Googling "am I a danger to my baby," confessing the thoughts hoping someone will tell you you're fine.
You've been working so hard to make these thoughts go away. Therapy isn't about trying harder — it's about changing the approach entirely.
These two conditions often overlap, and many women experience both. Here's how they typically differ:
The gold-standard treatment for OCD is Exposure and Response Prevention (ERP) — and it works remarkably well. It's not about eliminating the thoughts (that's impossible, and trying to do it makes things worse). It's about changing your relationship to them so they lose their power.
I also bring CBT and mindfulness-based approaches into the work, especially when anxiety and OCD are both present. Everything is paced to where you are — no forcing, no exposure you're not ready for.
The most evidence-based treatment for OCD. ERP involves gradually facing feared situations or thoughts without performing the compulsive response — teaching your brain that the thought is not a threat and that distress can be tolerated without rituals.
CBT helps you identify and challenge the unhelpful beliefs that fuel OCD — like "having this thought makes me a bad person" or "I must eliminate all uncertainty to be safe." These beliefs keep the OCD cycle spinning, and we work to loosen them gently.
Mindfulness teaches you to observe intrusive thoughts without reacting to them — seeing them as mental events rather than facts or intentions. This is a powerful complement to ERP and helps build the distress tolerance that OCD recovery requires.
"Clients tell me they finally feel safe saying the things they've been too afraid to speak out loud. That's exactly the space I'm here to create."
— Cheryl Reeley, LCSW-S, PMH-C
I know that telling someone about intrusive thoughts for the first time feels terrifying. Here's exactly what to expect.
You don't have to share the specific thoughts in the consultation call if you're not ready. We can talk about what you're experiencing in general terms, and you can decide from there if you want to move forward. Nothing you say will surprise me or change how I see you.
In our first full session, we'll do a careful assessment — your history, your symptoms, how long this has been going on, and what's been tried. I'll explain what perinatal OCD is, why you're experiencing it, and why the things you've been doing to cope (while completely understandable) may be making it worse.
We'll build an ERP hierarchy together — a graduated plan that starts where you are, not where a textbook says you should be. You're in control of the pace. The goal is to expand your life, not overwhelm you.
Perinatal OCD responds very well to ERP when it's done correctly. Many clients notice meaningful improvement within 8–12 sessions. The thoughts don't always disappear entirely, but they lose their grip — and that changes everything.
This is the question most women are afraid to ask. The answer is no — not for intrusive thoughts. Therapy is confidential. I am a mandated reporter, which means I'm legally required to report credible evidence that a child is being harmed. Intrusive thoughts that you find distressing and would never act on are not reportable — and in 25 years of clinical research, there is no documented case of a person with ego-dystonic intrusive thoughts harming their child. The distress you feel about the thoughts is the strongest possible evidence that you are safe.
No. This is one of the most important things I can tell you: the content of intrusive thoughts in OCD is completely unrelated to a person's actual intentions or character. In fact, intrusive thoughts in OCD are ego-dystonic — meaning they are fundamentally contrary to who you are and what you want. The horror you feel is proof that you love your baby. People who actually intend harm to their children don't lie awake terrified of their own thoughts.
Googling is a form of reassurance-seeking — a compulsion. It gives temporary relief ("the internet says I'm probably not dangerous") that quickly fades, and then you need to search again. Each time you seek reassurance, you're reinforcing the OCD cycle by teaching your brain that the thought was a real threat that needed addressing. Therapy helps you break this cycle rather than feeding it.
ERP does involve facing fears — but it's done gradually, collaboratively, and at your pace. We build a hierarchy together and start at the lower rungs. The goal isn't to flood you with distressing thoughts — it's to gently teach your nervous system that it can tolerate distress without performing rituals, and that the thoughts themselves are not dangerous. Most clients find the process much more manageable than they expected.
For Texas clients, I accept BCBS and UnitedHealthcare, in addition to self-pay. For clients in Colorado, Florida, Illinois, and Ohio, I am self-pay only. I provide a superbill after each session so you can submit for out-of-network reimbursement — many PPO plans cover 50–80% of costs. Payment accepted via credit card, HSA, and FSA.
Saying these thoughts out loud for the first time — to someone who won't flinch — is often the moment everything starts to shift. Let's talk.
