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OCD & Contamination Fears: Feared Outcomes (Example: HIV/AIDS)

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In my last post, I identified several types of obsessions that are associated with contamination/health-related obsessive-compulsive disorder (OCD). These include the fear of: Germs and getting sick. Making others sick. Developing an incurable illness in the future. Experiencing extreme and uncontrollable disgust or distress. Other unwanted negative outcomes related to the spread of germs, contaminants, or other agents. Given the idiosyncratic nature of obsessive-compulsive disorder (OCD), I thought it would be useful to talk a bit more about feared outcomes. Feared outcomes can be very different for different people, even when you’re dealing with the same surface obsession. Moreover, sometimes the immediate feared outcome (getting sick) differs from the ultimate feared outcome (dying from a disease). Consider the OCD fear of being infected with HIV. Individuals who experience this health-related OCD obsession often experience distress related to very different...

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Contamination & Health-related OCD: Obsessions, Fears, & Worries

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What are common obsessions in contamination/disease/illness/health-focused OCD? OCD: Fear of Getting Sick Contamination- or health-related OCD is associated with persistent worries about one’s health or the health of loved ones. Common obsessions in contamination-related OCD include the fear of getting sick with a serious illness like rabies, ebola, H1N1 (swine flu), Creutzfeldt-Jakob disease, mad cow disease, hepatitis, or avian influenza. Other frequent obsessions focus on the fear of contracting sexually-transmitted diseases (STDs) such as AIDS/HIV, herpes, HPV, syphilis, or chlamydia. Chronic progressive diseases, like AIDS, that have no known cure tend to evoke extreme anxiety. Individuals with OCD fear both getting sick and the negative consequences associated with illness, which may range from pain and discomfort to serious repercussions such as death, sterility, or deformity. Some individuals have a strong fear of vomiting (also known as vomit phobia or...

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

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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 feel very anxious whenever these thoughts occur. Do you have any tips for me? These types of symptoms are very similar to other OCD symptoms in which people worry about losing control and acting on unwanted impulses. Most typically, these types of thoughts attach to situations that are considered morally or socially taboo. Related OCD symptoms include fears about losing control and: Harming a loved one (most often fear of harming a child, spouse, or parent). Killing a loved one (i.e., stabbing, shooting, suffocating,...

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

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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 ritual that maintains the obsessional thought. This is because OCD is caused by threat misappraisals that are perpetuated and negatively reinforced by compulsive behaviors. As long as your compulsive behaviors remain in place, you are prevented from having the type of corrective learning experiences that are necessary for you to recover from your OCD. The reason that ERP is so effective is because it allows you to build these types of corrective learning experiences into your daily life. Sometimes a person has very obvious...

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

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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 others will notice my swallowing and then judge me. I am practicing meditation and daily exposures in which I sit down in a quiet room and intentionally invite the swallowing in. I also purposefully invite the swallowing in throughout the day, even when I am in the presence of friends. I try to be mindful of my swallowing without doing anything to avoid it or mask it. Even though my awareness of swallowing has not entirely gone away, the anxiety associated with it has...

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