Austin Postpartum OCD Therapist

Normal new parent worry is manageable and doesn't consume your day. Postpartum OCD involves specific, graphic intrusive thoughts that feel disturbing and foreign. You may engage in compulsive behaviors like checking your baby's breathing dozens of times per night, cleaning excessively, or seeking constant reassurance to reduce anxiety. If your thoughts are interfering with your ability to care for your baby, bond with them, or function day-to-day, it's likely postpartum OCD. Dr. Rundle can provide a comprehensive assessment to determine the right diagnosis and treatment.

No. Having intrusive thoughts about harm does NOT mean you will act on them. The intense distress you feel about these thoughts proves you would never want to harm your baby. Moms with postpartum OCD are often the most vigilant, protective parents. These intrusive thoughts are a symptom of OCD, a misfiring of your brain's threat-detection system, not a reflection of your true desires. With proper treatment, these thoughts become less frequent and less distressing.

Sharing your intrusive thoughts can be relieving, but it's important to share with people who understand postpartum OCD. Many partners initially feel shocked or confused, which can increase shame. We recommend starting therapy first, where you can process these thoughts in a safe, non-judgmental space. Dr. Rundle can help you decide when and how to share with your partner, and can provide education to help them understand that these thoughts are symptoms of a treatable condition, not true intentions.

Most moms notice improvement within 4-6 weeks of starting ERP therapy. Significant symptom reduction (typically 70-80% improvement) occurs within 8-12 weeks of consistent treatment. The exact timeline depends on symptom severity, frequency of sessions, and engagement with between-session exercises. Some moms continue maintenance therapy for several months to prevent relapse, especially during stressful periods or transitions.

Yes. ERP therapy and CBT are non-medication treatments and do not interfere with breastfeeding. If your symptoms are severe and medication is recommended, many SSRIs and anti-anxiety medications are considered safe while breastfeeding. The decision about medication is always yours to make with your healthcare providers. Dr. Rundle provides therapy-based treatment and can coordinate with your medical team if medication is being considered.

Exposure and Response Prevention (ERP) is the therapy with the strongest research support for OCD. 'Exposure' means deliberately, gradually getting closer to the thought or situation that sets off the alarm, starting small. 'Response prevention' means not doing the thing that usually brings relief: the checking, the mental reviewing, the asking someone to tell you it's fine. Each time you let the anxiety rise and fall on its own, your brain collects new evidence that the thought is noise, not a warning. You never have to do anything unsafe, and you never skip ahead to the hardest step. Dr. Rundle builds the ladder with you and climbs it at your pace.

This fear keeps more moms silent than almost anything else, so let's address it directly. Intrusive thoughts are a symptom of OCD, not a disclosure of intent. Clinicians trained in perinatal mental health are trained to tell the difference between an unwanted thought that horrifies you and an actual risk, and asking for help with OCD symptoms is exactly what they hope you'll do. In therapy, these thoughts are discussed in a confidential space with someone who has heard them many times before. Confidentiality does have legal limits, which Dr. Rundle explains at the first session, and intrusive OCD thoughts on their own are not what those limits are about: they're a symptom, not evidence of risk. If you're nervous about how a partner or OB-GYN will react, Dr. Rundle can help you decide what to share, when, and how, and can give them the education they need to understand what postpartum OCD is.

Unwanted thoughts are something every brain produces; what changes in treatment is their grip. For most moms the thoughts become less frequent, less vivid, and far less distressing, and the compulsions that were built around them fade. A stray scary thought may still pass through on a hard day, and the difference is that it reads as 'that's OCD noise' rather than a verdict on who you are. Part of treatment is planning for those moments so one bad night doesn't turn into a relapse.

General talk therapy, and even standard anxiety work, often doesn't touch OCD, and reassurance from a well-meaning therapist can actually feed it. OCD responds to a specific set of tools: ERP, inference-based CBT, and acceptance-based skills, delivered by someone who recognizes perinatal OCD when they see it. If past therapy focused on analyzing why you have the thoughts, or on calming you down after each one, it was working on a different problem than the one OCD actually is. The approach here is structured and active, with work between sessions, and it treats the OCD cycle itself rather than circling it.