OCD
Assessment and therapy for obsessive-compulsive difficulties at the Psychological Help Centre, Karachi — in clinic in PECHS and DHA, or online.
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What people describe
People describe two things that lock together. First, a thought that arrives on its own and will not leave — and which is very often the exact thing the person would least want to think. Then something they do to make the thought quieter: checking, washing, counting, arranging, asking, repeating.
The checking is usually described first. The stove. The gas. The main door, checked at the gate, then again from the car. Others describe washing — hands, clothes, a whole routine after coming home — that started as sensible and grew.
Some describe it around prayer. An ablution begun again because it did not feel right, a rakat repeated because attention slipped, a sentence said once more to be certain. People often tell us this last of all, and are relieved to find it is a familiar thing to bring to a clinical psychologist rather than a failure of faith.
Families describe being drawn in. A spouse asked the same question every night. A mother who now does the checking herself because it is faster.
And nearly everyone describes the secrecy. Years of it, in some cases, because the thoughts themselves felt shameful to say out loud. The thoughts people find hardest to admit are among the most common ones described in a consulting room, and describing a thought is not the same as wanting it.
Recognising yourself in a paragraph on a website is not the same as knowing what is going on. This page describes; it does not assess you, and there is nothing here for you to score yourself against.
When it is worth speaking to someone
Being organised or particular about cleanliness is not the same thing. What brings people to a clinic is different.
What a clinician pays attention to is time, distress and cost. Routines that have started to take real time out of a day — an hour, or the last hour of every night. Distress that comes not from the doing but from trying to stop. Work, study, prayer or sleep arranged around the routine rather than the other way round.
It is also worth speaking to someone when hiding it has become its own full-time job.
Only a qualified clinician can tell you what is going on — a website cannot. What a page like this can tell you is that this is an ordinary thing to bring, that it is described far more often than people assume, and that you will not be asked to justify it.
How PHC approaches it
PHC is an assessment-first practice. Before therapy begins there is an initial session, and its job is to work out what is actually happening rather than to start treating it.
- An initial sessionWe ask what has been going on, for how long, and what it is costing you. You set the pace of what you describe. Nothing is administered before this conversation.
- Emotional assessment and symptom screeningA structured screening of emotional functioning and what you are presenting with, using internationally validated instruments. Its purpose is to decide which further tests, if any, are clinically warranted — you will not be given tests you do not need.
- A psychologist matched to what the assessment foundPsychologists at PHC are not assigned on availability. Assignment is based on speciality, your presenting needs and clinical fit.
- Therapy, reviewed as it goesFor obsessional and compulsive patterns the modality most often indicated is Cognitive Behavioural Therapy (CBT), which PHC uses for depression, anxiety and negative thought patterns. For younger children the same work is usually done through play therapy and behavioural approaches rather than through talking, with the parents closely involved. Sessions are 50 minutes, in clinic at our PECHS clinic or in DHA, or online.
Who you would see
Psychologists at PHC hold a minimum postgraduate qualification in clinical psychology and over 800 supervised clinical hours.
For adults, PHC name Prof. Dr. Tahira Yousaf, who the practice tells us "specialises in the treatment of Borderline personality disorder, bipolar disorder and OCD through hypnotherapy". That is PHC describing their own founder rather than a line from the areas of practice she has published — those are two different things, and you are entitled to know which one this is. Several of our psychologists are also accredited in CBT and work with anxiety. Who you would see is decided at the initial session, on what the screening finds and on clinical fit. If you would like to know who that would be before you book, ask us.
Questions people ask first
I have never said the thoughts out loud. Do I have to?
Not before you are ready, and not in the first session if you would rather not. You can describe the shape of a thought without its content — how often, how long, what it makes you do — and that is enough to begin. Psychologists hear this category of thought routinely and will not be shocked by yours.
Is being clean and organised the same thing?
No. Liking order is a preference and it usually costs nothing. What people bring to a clinic is a routine that has begun to take time, cause distress when interrupted, or spread. Where your own pattern sits is a clinical question, and it is not one to settle from a website.
My child has started doing this. Are they too young to be seen?
No. PHC works with children, and with younger children the work is done through play and behaviour rather than conversation, with parents involved throughout. Bring what you have noticed and for how long.
Do I need a psychiatrist instead?
Possibly, alongside. PHC's clinicians are clinical psychologists and do not prescribe. If your assessment suggests medication is worth considering, we will say so and work with a psychiatrist rather than around one.
Confidentiality, session length, fees and choosing your psychologist are answered in full in questions people ask before booking.
Speaking to someone starts here
PHC is appointment-only. Message or call and a real person answers — Monday to Saturday, 10am to 8pm PKT.
Not sure whether this is us? Contact us anyway. We will tell you directly whether we can help, and refer you elsewhere if we cannot.
Six details, and we can match you
- Name of the person who will attend
- Their age
- What is going on, in your own words
- Whether you would prefer a male or female psychologist
- Online, or in clinic in Karachi
- Whether the person attending is a minor or elderly
If someone else is paying, we will also ask for guardian or payer details. A slot is held once the booking payment is received — half the fee, at least 24 hours ahead.