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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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ROCD

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Although ROCD is often characterized by intrusive worries about your relationship, relationship OCD treatment often specifically targets the compulsions and avoidance behaviors related to ROCD (rather than the obsessions themselves). This is because ROCD treatment is based on the premise that compulsions and avoidance behaviors are what strengthen and maintain the condition. In the absence of rituals and avoidance, relationship OCD symptoms tend to diminish and weaken over time. This general principle is true for all types of OCD, not just ROCD. As a quick refresher, this multi-part series of posts on rOCD (aka “relationship OCD”) discusses obsessive thoughts that are common in rOCD, ROCD intrusive impulses and images, ROCD compulsions and avoidance behaviors [THIS PART!], and ROCD in non-romantic relationships [FORTHCOMING!]. Let’s get to it. What are common ROCD compulsions? ROCD (Relationship OCD) & Compulsions/Avoidance Behaviors Compulsions are...

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Relationship OCD (rOCD) – Unwanted Impulses & Images

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This multi-part series of posts will focus primarily on rOCD, also known as “relationship OCD.” Part 1 focused on obsessive thoughts that are common in rOCD. This part discusses other relationship OCD obsessions, including intrusive impulses and images. Part 3 will review common compulsions and avoidance behaviors that are typical in rOCD (relationship OCD). Part 4 will discuss “Relationship-Focused OCD” more broadly in the context of other types of relationships, including friendships, parent-child relationships, and professional relationships. As I mentioned in my previous post on rOCD, many people with “relationship OCD” experience recurrent doubts about whether or not they are with the “right” person. Many also infer that if they have doubts about their current relationship, they might secretly want to cheat (or will cheat). They may fear that they will be unfaithful, even if they’re committed to their...

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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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Scary Thoughts as Costumes: The Illusion of Danger

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It’s nearly Halloween, and kids around the country are digging through dusty closets and plundering the aisles of local Halloween shops in search of the perfect costume. Halloween is the one night of the year when we give ourselves permission to be silly, scary, or fantastical. We can act a little weird, and nobody will disapprove. On Halloween, it’s normal to see the ghastly holding hands with the divine; fairy princesses walk amongst zombies, lions, and super heroes. There is something thrilling about handing over the reins to your imagination…even if it’s only for a single night. But what would happen if the masks got stuck? What if every goblin remained a goblin and every ghost remained a ghost? The children underneath the make-up would still be our children, but their appearance would remain altered. How would we feel...

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