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OCD and Uncertainty

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These are difficult times. Lately, it seems, each week brings with it something truly horrifying. A shooting or an act of terrorism, a hate crime committed against an individual, a disease that affects the unborn. You can hardly turn on the news without hearing about something that incites fear. Yet… We get up every day and go about our normal lives. We get in the car, we drive to work, we come home to our families. We live as if we are untouchable. Technically, we’re not, but we’re often happiest when we live as if we are. Some of us do this easily. The awareness of our own fragility doesn’t linger. Others of us are tortured by possibilities. What if this happens to me? What if this happens to someone I love? OCD brings with it superhuman attention to...

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OCD & Pets: Sexual Thoughts & Scrupulosity

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Obsessions focusing on pets and animals incorporate all the common themes: contamination, checking, harm, scrupulosity, and sex. In this 3-part blog series, I’ll discuss some of the common ways obsessions may target our lovable, snuggable friends. Part 1 focused on harm obsessions, including the fear of accidental and intentional harm, and Part 2 covered contamination obsessions. This final part, Part 3, will address sexual obsessions and scrupulosity, as they pertain to pets. Our animals are members of our family. We treat them as our own. It’s not surprising, then, that OCD extends unwanted thoughts to our furry, fluffy companions. OCD loves to attach taboo thoughts to things we love, and our pets are no exception. Just as many parents struggle with obsessions that target their children (e.g., What if I secretly want to harm my child?; What if I...

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ERP Tip of the Day #2

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It’s ERP tip time. This series of posts focuses on tips to enhance the effectiveness of your exposure and response prevention (ERP). If you’re interested in more ERP tips, click the following link for all the posts in this series. Exposure and Response Prevention (ERP) Tips for OCD Without further ado, here’s another ERP tip to consider when designing your next exposure. ERP Tip #2 When completing your next exposure, avoid rules that dictate what you’re allowed to think during the exposure. If you try to complete an exposure without having a certain bad thought, chances are that you’re setting yourself up to think that very thought. Instead, design your exposure around having that very same unwanted thought. I love it when people with OCD do exposure, but I don’t love it when they have a long list of...

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ERP Tip of the Day #1

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Starting today, I am going to start posting random ERP tips as they occur to me, as there are certain roadblocks that many of my OCD patients tend to encounter. If it’s helpful for my patients, maybe it’s helpful for you. If you’re interested in more ERP tips, click the following link for all the posts in this series. Exposure and Response Prevention (ERP) Tips for OCD These posts will probably be a bit shorter unless the concept requires a more thorough discussion. Please feel free to leave comments below, if you need more information. Today’s tip is… ERP Tip #1 Do not label your rituals as ERP. Instead embrace openness, defenselessness, and vulnerability. You might think that you never do this, but it happens more often than you think. Some people that I know will encounter triggers for...

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Imaginal Exposure vs. In Vivo Exposure for OCD

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As I’ve talked about in numerous posts, overcoming OCD involves learning to co-exist with doubt and uncertainty. This idea can be a bit counter-intuitive at first, as many people initially expect OCD treatment to reduce uncertainty. One therapeutic approach that helps with this process is exposure and response prevention (ERP) for OCD. Not surprisingly, ERP consists of two parts: 1) exposure, and 2) response prevention. An exposure is when you do something on purpose to provoke an anxiety spike. By definition, exposures are not accidental; rather, they are pre-planned, deliberate offensive strikes against your OCD. Exposures are designed to help you build up your tolerance to fear-producing situations. Exposures are often completed according to an exposure hierarchy, meaning that people typically complete lower level exposures (i.e., less distressing exposures) before gradually working up to higher level ones. Response prevention...

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