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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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“Pure-O” OCD: Common Obsessions & Mental Rituals

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As a follow-up to my previous post on Pure-O OCD, I thought it might be helpful to identify some obsessions that are commonly reported by individuals with Pure Obsessional OCD.  These same obsessions may also be experienced by individuals with non-Pure-O forms of the disorder.  Keep in mind that some of these symptoms are quite common (when experienced in a limited form) and may or may not represent an underlying psychological condition.  If you experience symptoms like these, consult with your doctor for clarification.  I am also available to conduct assessments and provide treatment if you’re located in South Florida (Palm Beach Gardens, Jupiter, West Palm Beach, Fort Lauderdale, Boca Raton, Boynton Beach, & Miami). Remember that most people who have Pure-O OCD actually perform compulsions.  These compulsions just tend to be mental rather than behavioral in nature.  Mental rituals...

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Pure-O OCD (Pure Obsessional OCD): Hidden Rituals

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“Pure-O” OCD, or Pure Obsessional OCD, is a relatively less common form of OCD that seemingly differs from classic presentations of the illness.  What distinguishes Pure Obsessional OCD from classic OCD is that in Pure-O OCD, symptoms are predominantly obsessive (rather than compulsive) in nature.  Although individuals with Pure-O OCD frequently experience intense and distressing obsessions, they typically report few (if any) overt compulsive behaviors.  However, in almost all cases, pure obsessionals do engage in a variety of rituals.  These rituals  just manifest as mental compulsions rather than behavioral compulsions. Unfortunately, most psychologists haven’t been trained in how to ask the types of questions that are necessary to identify these “hidden rituals.”  As a consequence, these rituals often go undetected.  Because effective treatment requires consistent response prevention, a failure to recognize and resist mental compulsions makes true exposure and response prevention (ERP) impossible.  Treatment...

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