Worry & “What If” Questions

On March 5, 2012, in CBT, ERP, Generalized Anxiety Disorder, OCD, OCD - General, by Steven J. Seay, Ph.D.
Anxiety, Worry, & What If Questions

If you have anxiety, it’s likely that you wrestle with worry and “what if” questions. Many what if questions are easily recognizable and start with the obvious, “What if…?” Others are more subtle and begin with phrases like “How am I ever going to…?”

By definition, what if questions …  (read more)

Scrupulosity & OCD: Religious/Moral Symptoms

On February 5, 2012, in ERP, OCD, OCD - Treatment, “Pure-O” Symptoms, by Steven J. Seay, Ph.D.

Question: I have scrupulosity (religious/moral obsessive-compulsive disorder), and I am triggered by religious posts on Facebook.

When I see a religious post, I feel like I have to repost it or God will be mad at me. I also worry about what other people think about these reposts, which then leads me to fear that …  (read more)

Exposure and Response Prevention: An Analogy

On January 31, 2012, in ERP, OCD, OCD - Treatment, by Steven J. Seay, Ph.D.
Exposure and Response Prevention (ERP)

Exposure and response prevention (ERP) is just like a fitness program for your brain. However, instead of shaking up your fitness level, it’s designed to shake up stubborn OCD symptoms. Let’s expand on this analogy.

Reasons for Doing Exposure and Response Prevention (ERP)

People don’t adopt fitness routines for no …  (read more)

Starting Exposure Therapy: What’s it Like?

On January 26, 2012, in ERP, OCD, OCD - Treatment, by Steven J. Seay, Ph.D.

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)

Fear of Saliva Swallowing & Choking: Treatment & Symptoms (OCD)

On January 10, 2012, in Body-Focused/Sensorimotor Symptoms, ERP, OCD, Social Anxiety, by Steven J. Seay, Ph.D.

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)

OCD: Screaming, Blurting Out Obscenities/Cursing/Profanity, & Other Unwanted Impulses

On December 2, 2011, in ERP, OCD, “Pure-O” Symptoms, by Steven J. Seay, Ph.D.

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)

Does Non-Avoidance = Exposure? No! Anxiety Disorder Treatment Principles for OCD, Panic, Social Anxiety, & Phobias.

On November 29, 2011, in CBT, ERP, by Steven J. Seay, Ph.D.

Anxiety Principle of the Day: Non-Avoidance is not equivalent to exposure.

Although exposure is predicated upon the purposeful non-avoidance of anxiety-related stimuli, non-avoidance of anxiety triggers is not equivalent to exposure.

What is non-avoidance?

I liken non-avoidance to being in a particular place at a particular time. Essentially, it involves being in a situation in …  (read more)

OCD Triggers in Daily Life? Don’t Ritualize. Be Strategic! 3 Tips for Fighting OCD.

On November 20, 2011, in ERP, OCD, OCD - Treatment, “Pure-O” Symptoms, by Steven J. Seay, Ph.D.

Question: I know about ERP, and I understand that OCD symptoms can be reduced by resisting rituals and then habituating to the anxiety brought on by obsessive thoughts. However…what if an obsessional thought requires no ritual? Confused!

Great question. I think that in all cases of obsessive-compulsive disorder (OCD), there is some type of ongoing …  (read more)

Exposure Therapy’s Most Common Mistake: All Eggs in the Habituation Basket

On November 4, 2011, in CBT, ERP, by Steven J. Seay, Ph.D.

Many people have an incomplete understanding of exposure therapy

…be it exposure and response prevention (ERP) for OCD, intentional mistake practice for social anxiety, or interoceptive exposures for panic disorder…

This is true for exposure newbies, seasoned exposure veterans, and even some good CBT therapists.

This limited understanding is based on the following flawed …  (read more)

Sensorimotor OCD & Social Anxiety Differential Diagnosis: “Obsessive Swallowing”

On November 1, 2011, in Body-Focused/Sensorimotor Symptoms, ERP, OCD, Social Anxiety, by Steven J. Seay, Ph.D.

Reader Question: For the past year, I have been dealing with OCD-related sensorimotor obsessions focused on swallowing. My symptoms started during a class discussion in which I noticed myself swallow. Since then, whenever I am in a lecture or quiet place surrounded by people, I become deeply focused on my own swallowing and worry that  (read more)

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