Paired tVNS With ERP in OCD

Inclusion Criteria: * Adults between the ages of 18 and 55 * Meet DSM-5 criteria for OCD, based on a structured clinical interview and who have a YBOCS score of 15 or higher, indicating at least moderate OCD severity * Participants must be willing and able to provide informed consent. Exclusion Criteria: * Participants with major neurological conditions, autism spectrum disorder, psychosis, major uncorrected sensory deficit, and severe medical disease that may be associated with neurological effects. * People with an active eating disorder that requires treatment, but we will not exclude people who are in remission. * Current illicit or prescription drug abuse * Participants who are receiving pharmacotherapy for their OCD or for other psychiatric disorders will not be excluded * No medication changes will be allowed during the study, and participants must be on stable doses of medications for at least 6 weeks prior to entering the study. Prior ERP treatment (at least 12 months removed) is acceptable