For anyone new to exposure-based therapy, such as exposure and response prevention (ERP), there is often much anticipatory anxiety about starting treatment.
“What is it? What will it be like? How bad will it be? Can I handle it? Will I be forced to do things I’m unwilling to do?”
These uncertainties are … (read more)
In my post about the treatment of sensorimotor OCD, a reader asked about the ultimate goal of treatment. Should the goal of treatment be to never notice an unwanted thought or symptom?
Suppressing Unwanted Thoughts & Sensations in Pure-O & Sensorimotor OCD
Let’s explore this idea in detail. Suppose I adopt the goal of … (read more)
OCD & Thought Control
Can I learn to eliminate my OCD thoughts?
I hear this question all the time from new patients who are searching for ways to suppress their unwanted thoughts. When I answer this question with a resounding “no”, there is often much surprise and grief. After all, this is why they’re … (read more)
Question: I have sensorimotor OCD, and I’m suffering from conscious swallowing. My main fear is that I’ll choke or swallow my own saliva whenever I’m speaking or singing. Any tips for how to tackle this fear via exposure and response prevention (ERP)?
Great question. Consistent with general exposure and response prevention (ERP) principles, your … (read more)
Although contamination OCD and washing rituals often go hand-in-hand, many rituals in this domain do not actually involve cleaning or disinfecting. These more subtle rituals are often based around reassurance seeking behaviors that become ingrained in everyday habit. In the context of exposure and response prevention (ERP), reassurance seeking OCD rituals are just as … (read more)
OCD: Common Compulsions
In my last post about OCD, I discussed reasons why people do rituals. This time, I’ll identify specific rituals that are common in obsessive-compulsive disorder (OCD) characterized by a fear of germs, contamination, diseases, and other health-related ills.
OCD: Hand-washing Rituals/Compulsions
Hand-washing is a very common ritual and typically involves prolonged … (read more)
In my last post, I identified several idiosyncratic feared outcomes in OCD that are associated with contamination/health-related obsessive-compulsive disorder (OCD). Obsessions are intrusive, recurrent, and distressing thoughts, impulses, or images related to these feared outcomes. Today, I’ll discuss the function of compulsions.
Why do people with OCD do rituals?
Compulsions, or rituals, are the … (read more)
In my last post, I identified several types of obsessions that are associated with contamination/health-related obsessive-compulsive disorder (OCD). These include the fear of:
- Germs and getting sick.
- Making others sick.
- Developing an incurable illness in the future.
- Experiencing extreme and uncontrollable disgust or distress.
- Other unwanted negative outcomes related to the spread of germs, contaminants,
What are common obsessions in contamination/disease/illness/health-focused OCD?
OCD: Fear of Getting Sick
Contamination- or health-related OCD is associated with persistent worries about one’s health or the health of loved ones. Common obsessions in contamination-related OCD include the fear of getting sick with a serious illness like rabies, ebola, H1N1 (swine flu), Creutzfeldt-Jakob disease, mad cow … (read more)
Question: I’m a teenager and keep having OCD symptoms related to impulse control. I often worry that I’ll lose control and scream or blurt out obscenities. I am especially triggered in quiet public places like classrooms, churches, and movie theaters. I have never actually acted on my impulses and cursed in public, but I still … (read more)
