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ERP Tip of the Day #2

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It’s ERP tip time. This series of posts focuses on tips to enhance the effectiveness of your exposure and response prevention (ERP). If you’re interested in more ERP tips, click the following link for all the posts in this series. Exposure and Response Prevention (ERP) Tips for OCD Without further ado, here’s another ERP tip to consider when designing your next exposure. ERP Tip #2 When completing your next exposure, avoid rules that dictate what you’re allowed to think during the exposure. If you try to complete an exposure without having a certain bad thought, chances are that you’re setting yourself up to think that very thought. Instead, design your exposure around having that very same unwanted thought. I love it when people with OCD do exposure, but I don’t love it when they have a long list of...

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ERP Tip of the Day #1

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Starting today, I am going to start posting random ERP tips as they occur to me, as there are certain roadblocks that many of my OCD patients tend to encounter. If it’s helpful for my patients, maybe it’s helpful for you. If you’re interested in more ERP tips, click the following link for all the posts in this series. Exposure and Response Prevention (ERP) Tips for OCD These posts will probably be a bit shorter unless the concept requires a more thorough discussion. Please feel free to leave comments below, if you need more information. Today’s tip is… ERP Tip #1 Do not label your rituals as ERP. Instead embrace openness, defenselessness, and vulnerability. You might think that you never do this, but it happens more often than you think. Some people that I know will encounter triggers for...

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Imaginal Exposure vs. In Vivo Exposure for OCD

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As I’ve talked about in numerous posts, overcoming OCD involves learning to co-exist with doubt and uncertainty. This idea can be a bit counter-intuitive at first, as many people initially expect OCD treatment to reduce uncertainty. One therapeutic approach that helps with this process is exposure and response prevention (ERP) for OCD. Not surprisingly, ERP consists of two parts: 1) exposure, and 2) response prevention. An exposure is when you do something on purpose to provoke an anxiety spike. By definition, exposures are not accidental; rather, they are pre-planned, deliberate offensive strikes against your OCD. Exposures are designed to help you build up your tolerance to fear-producing situations. Exposures are often completed according to an exposure hierarchy, meaning that people typically complete lower level exposures (i.e., less distressing exposures) before gradually working up to higher level ones. Response prevention...

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Scary Thoughts as Costumes: The Illusion of Danger

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It’s nearly Halloween, and kids around the country are digging through dusty closets and plundering the aisles of local Halloween shops in search of the perfect costume. Halloween is the one night of the year when we give ourselves permission to be silly, scary, or fantastical. We can act a little weird, and nobody will disapprove. On Halloween, it’s normal to see the ghastly holding hands with the divine; fairy princesses walk amongst zombies, lions, and super heroes. There is something thrilling about handing over the reins to your imagination…even if it’s only for a single night. But what would happen if the masks got stuck? What if every goblin remained a goblin and every ghost remained a ghost? The children underneath the make-up would still be our children, but their appearance would remain altered. How would we feel...

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Postpartum OCD – Fear of Harming Your Baby

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Parents brace themselves for many changes when a new baby comes home. As new routines replace old, life quickly becomes a confusing jumble of cherished memories, bottles, and dirty diapers. Parenting can be joyful, but it can also be terrifying. Parenting comes with many important responsibilities, and it can be intimidating–if not downright frightening–to be responsible for protecting and caring for a vulnerable new life. What is Postpartum OCD (ppOCD)? For some parents (mothers and fathers alike), new parenthood may spark postpartum obsessive-compulsive disorder (OCD), a surprisingly common anxiety disorder that is associated with violent and disturbing thoughts, images, or urges (Fairbrother & Abramowitz, 2007). Symptoms may begin suddenly after the new baby arrives home, or pre-existing OCD symptoms may be exacerbated by new parental responsibilities. Postpartum OCD symptoms can involve virtually any type of OCD symptom, but harm obsessions...

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HOCD: Homosexual OCD & Sexual Orientation OCD

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Fear of Being Gay (Homosexual OCD / HOCD) Emerging sexuality can be confusing for any teen or young adult, and gay teens face a variety of unique challenges over the course of adolescence. In addition to learning to understand their own sexuality, gay teens must navigate complex situations and pressures that may not be relevant for straight teens. They must also deal with opinionated parents, friends, and others who sometimes hold differing views about sexuality. Anxiety, distress, and confusion are often part of this process. This post is not about the anxiety associated with being gay or with “coming out” but instead discusses homosexual OCD (“HOCD”), an anxiety disorder that affects a small number of individuals. HOCD is not unique to teens but can occur at any age. What is HOCD? Homosexual OCD (“HOCD”) is a specific subtype of...

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