Our primary mission is to empower our clients to take control of challenging/ difficult areas in their lives through the use of skill-based, present-focused, goal-oriented, and scientifically-proven treatments.
When AI Becomes Part of OCD: Understanding a New Form of Compulsion
Written by Melissa Harrison, LPC
In recent years, artificial intelligence (AI) tools like ChatGPT have become everyday companions. It’s easy to forget how new all of this is; asking questions to a computer and getting an answer that sounds like it really knows you and has the “right” answer in under five seconds. For most people, tools like ChatGPT are helpful, creative, even fun! But for someone with Obsessive-Compulsive Disorder (OCD), the same technology that offers convenience can also feed anxiety. What starts as “just checking” or “doing research” can slip into a pattern of reassurance-seeking that feels impossible to stop.
The Emergence of AI-Based Compulsions
OCD is a shape-shifter, constantly adapting to new environments and technologies. It thrives on uncertainty and the desperate urge to feel sure of things, to have concrete evidence of right/wrong/what is/what isn’t. AI bots, unfortunately, seem to offer endless sources of certainty. It feels like they are giving instant answers, expert opinions, and rational explanations on demand, while in reality, AI is designed to give answers that the user will like and align with their values (based on what it knows about you and your use of it), can give “certain” answers and even links to things that are based on nothing and are not research backed, and are, at their core, non-objective tools.
In OCD, this can quickly become fertile ground for compulsions. In our practice, and many others, we’re seeing people use AI for:
- Health anxiety and reassurance-seeking: People with this focus of OCD may repeatedly ask ChatGPT (or other bots) about the symptoms of brain tumors or the likelihood that a headache means something “serious.” They may find themselves putting in test results, their own physical symptoms, or asking questions about their fears hoping for reassurance.
- Moral or religious scrupulosity: People struggling with fears of being a bad or immoral person might turn to AI for endless moral debates or reassurance that they’re “not evil,” “not racist,” or “not sinful.” They may ask AI, “Does this make me a bad person?” or “Would a good person think this?” or find themselves describing past actions in detail (“I once laughed at something mean in high school, was that immoral?”) and seeking judgment and reassurance that they are “good.”
- Harm OCD and checking: A parent with harm-related obsessions might ask ChatGPT or Google if feeding their allergic child something could have caused an unseen reaction, seeking certainty that they didn’t harm their child. A person might ask if a small bump in the road could mean they hit someone without realizing it, or if touching a doorknob after using cleaning products could poison their pet. Or, they may seek reassurance that eating slightly expired food won’t lead to illness, in search of complete certainty that no harm could have occurred.
- Perfectionism and decision paralysis: Some people may ask AI to help make “the right choice,” to weigh every variable, or even to use it like a digital oracle of sorts to confirm that they’ve made the “right” decision. A person might spend hours asking ChatGPT to compare every possible graduate program, job offer, or apartment, rewriting the same question in different ways until the answer feels certain. Some might even outsource intuition entirely, asking ChatGPT to decide for them what to eat, who to date, or when to end a relationship, seeking relief from the discomfort of uncertainty rather than trusting their own judgment.
One of the hardest parts about these compulsions is that they often feel rational or even productive in the moment (“I’m just researching” or “I’m just double-checking”)! But the underlying function is the same as traditional OCD rituals: to neutralize doubt and avoid distress. In reality, each reassurance-seeking interaction strengthens OCD’s grip, teaching the brain that uncertainty is dangerous and must be resolved.
Why ChatGPT feels so certain: how AI design collides with OCD doubt
The design of AI itself makes it particularly tricky for OCD. ChatGPT and other AI tools are literally designed to sound confident, calm, and helpful, but not necessarily to be correct. The model generates language based on patterns that have comforted, persuaded, or satisfied other users in the past. That means it can sound deeply reassuring, even when the underlying information is uncertain or incomplete.
For someone struggling with OCD or anxiety, this can feel powerful: the AI never gets frustrated, always has an answer, and speaks with certainty when you, or others, can’t. But that’s part of the trap. The system isn’t weighing moral truth, real-world evidence, or your personal safety, it isn’t keeping OCD in mind at all! It’s designed to predict which words will make sense and feel relieving. In other words, it’s built to reduce discomfort in the moment, not to help you tolerate uncertainty over time, the exact opposite of what we want for people struggling with OCD.
CBT and ERP: Reclaiming Control from AI Compulsions
So what can be done when OCD is wrapped up in AI (or any other obsessions and compulsions)? Cognitive Behavioral Therapy (CBT), and more specifically Exposure and Response Prevention (ERP), is the top-line treatment for OCD. In ERP, clients learn to face uncertainty and resist compulsions, whatever they are. When AI is part of the compulsion cycle, this means learning to resist the urge to “ask the bot” or research endlessly for reassurance. Instead, clients are supported by a therapist to safely, and within the evidence-based model, sit with the discomfort of not knowing, to allow the uncertainty to exist without neutralizing it through checking, seeking, or optimizing. The goal isn’t to eliminate intrusive thoughts or feelings of uncertainty, but to change the relationship with them.
ERP is not a one-size-fits-all approach; it’s carefully tailored to each person’s fears, triggers, and compulsions. What feels like “exposure” for one person might look completely different for another, from resisting the urge to check a door lock to tolerating the uncertainty of not asking ChatGPT for reassurance. It’s also essential to work with a trained therapist to ensure the process is productive, therapeutic, and does not go too hard too fast into the scary discomfort feelings. Together, the therapist and client collaborate to design exercises that are challenging but doable, gradually building tolerance for uncertainty. Decades of research have shown it to be one of the most effective, lasting treatments for OCD. Over time, the brain learns that anxiety and doubt can rise and fall naturally without needing to be “solved,” restoring a sense of choice and freedom that OCD tries to take away.
Learning to Live Without Absolute Certainty
OCD tells us that safety lies in knowing for sure. But real freedom comes from learning that uncertainty is not dangerous. It’s part of being human. AI may offer the illusion of certainty, but for those with OCD, leaning on it for reassurance is just another form of avoidance.
If you notice yourself caught in that loop, you don’t have to navigate it alone. At The Center for Hope and Health, our clinicians specialize in evidence-based treatment for OCD and anxiety, including how technology can complicate the cycle. Reach out today to learn how ERP and CBT can help you step out of the loop, tolerate uncertainty with support, and start reclaiming your peace of mind.
Citations:
Haciomeroglu B. (2020). The role of reassurance seeking in obsessive compulsive disorder: the associations between reassurance seeking, dysfunctional beliefs, negative emotions, and obsessive- compulsive symptoms. BMC psychiatry, 20(1), 356. https://doi.org/10.1186/s12888-020-02766-y
Rector, N. A., Katz, D. E., Quilty, L. C., Laposa, J. M., Collimore, K., & Kay, T. (2019). Reassurance seeking in the anxiety disorders and OCD: Construct validation, clinical correlates and CBT treatment response. Journal of anxiety disorders, 67, 102109. https://doi.org/10.1016/j.janxdis.2019.102109
Kobori, O., & Salkovskis, P. M. (2013). Patterns of reassurance seeking and reassurance-related behaviours in OCD and anxiety disorders. Behavioural and cognitive psychotherapy, 41(1), 1–23. https://doi.org/10.1017/S1352465812000665
Salkovskis, P. M., & Kobori, O. (2015). Reassuringly calm? Self-reported patterns of responses to reassurance seeking in obsessive compulsive disorder. Journal of behavior therapy and experimental psychiatry, 49(Pt B), 203–208. https://doi.org/10.1016/j.jbtep.2015.09.002
Abramowitz, J. S., & Jacoby, R. J. (2014). Scrupulosity: A cognitive–behavioral analysis and implications for treatment. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 140–149. https://doi.org/10.1016/j.jocrd.2013.12.007
Mathews, R. E., & Sarawgi, S. (2025). From Doubt to Direction: Untangling Pediatric Scrupulosity. Children (Basel, Switzerland), 12(4), 528. https://doi.org/10.3390/children12040528
Kim, J., Pacheco, J. P. G., Golden, A., Aboujaoude, E., van Roessel, P., Gandhi, A., Mukunda, P., Avanesyan, T., Xue, H., Adeli, E., Kim, J. P., Saggar, M., Stirman, S. W., Kuhn, E., Supekar, K., Pohl, K. M., & Rodriguez, C. I. (2025). Artificial Intelligence in Obsessive-Compulsive Disorder: A Systematic Review. Current treatment options in psychiatry, 12(1), 23. https://doi.org/10.1007/s40501-025-00359-8
