A few interesting things I can say about your game is that choices and their consequences aren't immediate, that for me is what made the experience more engaging. Especially after finishing the game and when you restart your day at work because I experienced one ending of the story it made me curious about other outcomes if my intrusive thoughts had won over in the first place.
Your selection of type and illustration was very fitting too, from comic sans to a very cartoony illustration style and in relation to the "dark" yet violent actions you commit in game, that juxtaposition made me reflect on the quote the therapist says to you in the appointment.
I felt it was clear to navigate through my choices and the overall design choices you made for your hierarchy was what made that possible. Initially I thought it was fun but when I reached the therapist it was almost like a pause in time and made me reflect on the possibilites we all have as people to make a violent decision, yet we never act on it and when I think about it more amazes me. Better yet that quote helped me see that the game isn't only fun but had a neat concept that balanced the fun of possible choices with the serious concept you explore in your game!
It turned out great, it would've been interesting to see in another iteration where you could act out on the therapist. It would put into question whether the player themselves learned something or just wanted to see what would happen if they took the therapists' words for granted... either way had fun playing it!!!