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)

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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)

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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)

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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)

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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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Treatment for Body-Focused Obsessions & Compulsions in OCD (e.g., Swallowing, Breathing, Blinking)

On October 14, 2011, in Body-Focused/Sensorimotor Symptoms, ERP, OCD, by Steven J. Seay, Ph.D.

This post is the last in a series of posts discussing body-focused obsessions and compulsions (aka, sensorimotor, somatosensory, or somatic obsessions and compulsions) in obsessive-compulsive disorder (OCD). This series was inspired by an original article written by Dr. David Keuler for OCDchicago.org. You can access Dr. Keuler’s excellent article here.

Ruling …  (read more)
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OCD Treatment (ERP & CBT): Exposure & Cognitive Restructuring

On September 15, 2011, in CBT, ERP, OCD, OCD - Treatment, by Steven J. Seay, Ph.D.

Question: To what extent would a change of mindset (e.g., changing my expectations for myself) be helpful in recovering from OCD? What is likely to happen if I delay formal treatment with a psychologist and work instead on changing my own mindset?

OCD Treatment Components: Cognitive Restructuring + Exposures

Regardless of whether or not it …  (read more)

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OCD Treatment: OCD vs. Me. How do I Tell the Difference?

On September 14, 2011, in CBT, ERP, OCD, OCD - Treatment, by Steven J. Seay, Ph.D.

Question: Because many of my OCD rituals are related to my professional identity, I’m worried that changing my rituals will somehow change those parts of me that I like (e.g., my personal goals and ambitions). Should I be concerned about this?

Early Onset OCD in Kids & Teens (Pediatric OCD)

Many people worry that by …  (read more)

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Pure-O OCD Rituals: Starting Over, Resetting, & Undoing

On September 12, 2011, in OCD, “Pure-O” Symptoms, by Steven J. Seay, Ph.D.

Question: It’s hard to describe this, but I feel like every few days I need to mentally “start over” by doing a variety of mental and behavioral rituals. I don’t want to live like this, but I’m afraid that if I undergo treatment and stop my OCD rituals, I won’t be the same person with …  (read more)

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Fear, Doubt, Uncertainty, ERP, & the Monster Under the Bed

On September 1, 2011, in CBT, ERP, by Steven J. Seay, Ph.D.

Everyone I know has, at some point, had to deal with the monster under the bed.

Some do it with grace. Others falter.

I’ve always been clumsy.

I can vividly recall many terrified nights from my childhood, when I would lie rigidly in my bed, utterly paralyzed by fear. Afraid to make the slightest movement, …  (read more)

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