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

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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 which your anxiety is triggered by proximity to anxiety-related cues. Non-avoidance requires no action on your part aside from being physically present in the situation. As such, like a hole, it’s possible for a person to accidentally stumble into a non-avoidance exercise. Isn’t that the same thing as exposure? No. Exposure is not merely a situation, and as such, it can’t be entered into by accident. Although exposure therapy has situational elements, it is a dynamic experience that has best practices, as well as...

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

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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 logic: Premise 1: Anxiety disorders involve fear. Premise 2: Fear is reduced through habituation. Premise 3: Habituation is accomplished via exposure. Conclusion: Habituation is the process by which individuals recover from anxiety disorders. Note: This conclusion is only partially correct. Exposure, when done right, is about much more than just habituation. It’s about learning to see the world in a new way and developing a different type of relationship with your symptoms. Exposure can help you challenge unhealthy, false beliefs about yourself and the world;...

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

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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 fighting their OCD, they will lose essential parts of themselves. This is particularly true for adults with obsessive compulsive disorder, who have had to deal with OCD for most of their lives. Because OCD often begins early in childhood and can have a chronic course, it can be difficult to separate yourself from your OCD symptoms. In many pediatric OCD cases, kids with OCD exhibit symptoms by age 10. Shockingly, in certain cases, even toddlers can show clinical signs of obsessive-compulsive disorder. There are...

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Hoarding: Treatment, symptoms, and personal impact/costs

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The topic of hoarding is rarely met with disinterest.  Maybe that’s because nearly all of us can relate to hoarding on one level or another. Perhaps you yourself have been touched personally by hoarding.  You may have a strong emotional attachment to objects, or you may have a loved one who inexplicably continues to add to an already existing surplus of items.  This surplus may be small, or it  may be quickly exhausting all remaining living space. Perhaps you don’t have issues with surplus, but you consider yourself a “pack rat” or a “collector”.  Maybe you have a nice collection of art or knickknacks, and you can relate to the urge to over-acquire. Perhaps you are “organizationally challenged” and have struggled with how to best categorize and store your possessions.  Maybe you have difficulties with throwing out your newspapers before...

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Hoarding treatment: Choosing the right therapist

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If you are an individual who struggles with hoarding, you might have been frustrated by negative treatment experiences in the past.  For most individuals who hoard, treatment can be challenging.  However, it is an essential ingredient for regaining control and reclaiming your life. When selecting a therapist to help you address your hoarding, make sure that your potential therapist practices cognitive behavioral therapy for hoarding (or CBT for hoarding).  Based on research studies, this type of treatment is most likely to be effective in supporting long-term positive changes and leaving you less vulnerable to relapse.  Unfortunately, there are very few South Florida psychologists who have formal experience with hoarding treatment.  Make sure that when you interview your potential psychologist, you ask them about their experience in treating hoarding.  A CBT orientation alone is not sufficient; make sure that they’ve treated other...

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