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

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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 the same drives. Starting Over, Resetting, & Undoing Compulsions in OCD First, please rest assured that you’re not alone in experiencing these symptoms. Many people with OCD (“Pure-O” or otherwise) refer to them as “starting over” compulsions, “resetting” compulsions, or “undoing” compulsions, which serve the function of returning to a clean mental slate. Sometimes these compulsions consist of particular movements, self-statements, mental activities, or complex rituals with both behavioral and mental components. They are not as common as other types of rituals (e.g., washing,...

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

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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, to breathe, to call out for my parents…lest I be detected by IT. The pounding of my heart would be so loud in my ears, and my breathing so ragged, that I could swear the entire house could hear me. And yet…no one came to help. The moment would stretch out like taffy. At some point, my raw fear would ever so subtly decline, freeing me up to end the stalemate in one of several ways. Some nights, I would call out for help....

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Mindfulness & ACT-based therapy: Questioning “I hurt; therefore, I suffer.”

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Mindfulness & ACT-based Approaches to Therapy Mindfulness & Acceptance and Commitment Therapy (ACT)-based approaches to treatment might (Hayes, Strosahl, & Wilson, 2003) ask you to consider the truth of the following statement: I hurt; therefore, I suffer. Most of us would probably agree that suffering is usually borne out of hurt. But this doesn’t mean that pain, discomfort, or unwanted emotions necessarily lead to suffering. In truth, many hurts do not lead to suffering. Pain and suffering are distinct entities that exist on two entirely different planes. Pain is based on an experience, whereas suffering is based on how we perceive that experience. In many cases, we may not be able to sidestep pain or hurt; however, suffering may be a different matter. Pain Think about the last time you felt physical pain. Maybe you’re feeling it right now....

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Social Anxiety Treatment: CBT & Intentional Mistake Practice (an example)

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When I was a kid, one form of mischief that was briefly popular in my neighborhood was crank calling strangers. Usually, the bravest kid in the group would pick up the phone, and with the encouragement of all the other kids in the room, would dial a random telephone number. A brief, very Bart Simpson-esque conversation would then ensue. Usually it would go something like this: Kid: Hello, ma’am. I am conducting a brief survey for the Grocer’s Association. Do you have a minute to answer a quick question? Stranger: Of course. How can I help you? Kid: I was wondering if you have Sara Lee in the freezer. Stranger: Why, yes I do. Kid: Well then let her out!!! We would then bust out in laughter and hang up the phone, leaving the recipient of our phone call...

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Therapy as Science: You + Your Therapist + Scientific Method

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I consider myself a scientist.  I wear this hat officially when conducting research, but I also wear it every time I sit with a patient.  In my research, my science is pretty self-evident: I identify a research question, develop falsifiable hypotheses, and then collect quantifiable data to see whether or not the phenomenon I’m studying behaves the way I think it does. A very similar process unfolds when I work with you in my clinic.  However, from your vantage point, you might not realize it right away.  Nevertheless, we are two collaborative empiricists. Most often, you will define the “research question”.  Usually, this is the very reason that you’re coming to see me.  Sometimes the questions we think we’re asking are not necessarily the ones we should be asking.  For example, questions like, “Why is this happening to me?”...

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