For anyone new to exposure-based therapy, such as exposure and response prevention (ERP), there is often much anticipatory anxiety about starting treatment.
“What is it? What will it be like? How bad will it be? Can I handle it? Will I be forced to do things I’m unwilling to do?”
These uncertainties are … (read more)
Fear of Saliva Swallowing & Choking: Treatment & Symptoms (OCD)
Question: I have sensorimotor OCD, and I’m suffering from conscious swallowing. My main fear is that I’ll choke or swallow my own saliva whenever I’m speaking or singing. Any tips for how to tackle this fear via exposure and response prevention (ERP)?
Great question. Consistent with general exposure and response prevention (ERP) principles, your … (read more)
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 … (read more)
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 … (read more)
Sensorimotor OCD & Social Anxiety Differential Diagnosis: “Obsessive Swallowing”
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 … (read more)
Agoraphobia – Symptom Attacks, Triggers, Panic, & Avoidance Behaviors
Let’s dispel a common misconception about agoraphobia. Agoraphobia is not a fear of the outdoors. Many people mistakenly believe this myth, due to the word’s Latin roots. Because agoraphobia can be broken down into the roots agora (“marketplace”) and phobia (“fear of”), many people assume that agoraphobia is a “fear of the marketplace” or a fear … (read more)
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, … (read more)
Social Anxiety Treatment: CBT & Intentional Mistake Practice (an example)
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 … (read more)
School Refusal Causes (Social & Anxiety-Related Factors)
With the summer quickly fading to black and the academic year looming largely, we will soon be entering the season of school refusal. When I use the term “school refusal,” I’m not talking about that once-in-a-blue-moon occasion when a child forgets about an important test or project and decides it’s easier to feign illness … (read more)
Looking for ways to overcome social anxiety or OCD-related perfectionism? At the end of this post, you’ll find some strategies I use to help individuals in South Florida (Palm Beach, Fort Lauderdale, Boca Raton, Boynton Beach, & Miami) overcome their anxiety. These exercises are examples of “Intentional Mistake Practice“, a CBT-based technique … (read more)
