So this post is a bit different than my regular posts... Rather than discussing a specific aspect about OCD or anxiety, this post is a request for your assistance in completing an exposure. Here's the background... I have a patient with scrupulosity (religious OCD)...
What: OCD Scriptathon 2017, A Group Scripting Experience Where: Our office! Located at 11380 Prosperity Farms Road, Ste 209A, Palm Beach Gardens, Florida 33410 When: Tuesday, April 11, 2017 from 8:00 PM - Until It Ends If you've ever practiced imaginal exposure,...
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...
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...
In previous posts, I have discussed various aspects of the "OCD Cycle," but it never hurts to have a quick refresher. After all, understanding how OCD works can help you see through its lies and help mobilize you to stand up and challenge it. What is OCD, and how does...
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...
In a previous post on mental checking, I talked briefly about ROCD (Relationship OCD), a form of OCD that involves pervasive doubt and uncertainty about interpersonal relationships. This multi-part series of posts will focus primarily on ROCD in the context of...
Reader Question: My daughter just turned 15, and no matter what I say, I can't seem to convince her to practice her driving. It's strange, because in the past, all she could do is talk about how excited she was to finally get her permit. I truly thought that she'd be...
What is hit-and-run OCD? Hit-and-run OCD (sometimes called MVA-OCD) is a subtype of obsessive-compulsive disorder that involves persistent and recurrent worries that you’ve hit someone while driving. While most people with hit-and-run OCD worry, "What if I...
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...
Obsessions focusing on pets and animals incorporate all the common themes: contamination, checking, harm, scrupulosity, and sex. In this 3-part blog series, I discuss some of the common ways OCD obsessions may target our lovable, snuggable friends. This article, Part...
Obsessions focusing on pets and animals incorporate all the common themes: contamination, checking, harm, scrupulosity, and sex. In this 3-part blog series, I discuss some of the common ways obsessions may target our lovable, snuggable friends. This article, Part 1,...
“I hate having OCD! Why can’t these thoughts just stop?!?! How can I be the person I was before?!?!” Many people with OCD are extremely familiar with the anxiety-related aspects of the disorder. OCD is an anxiety disorder after all, so it’s not terribly surprising...
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...
Long shower times? Just a quick announcement... I'm pleased to announce that with our recent office renovations, we now have a spa-like therapeutic shower room that is perfect for individuals with contamination OCD who have excessively long shower times. This room is...
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...
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...
People new to OCD treatment often walk through the door with more than a few misconceptions. Here are some common ones: Misconception 1: Anxiety is bad. Actually, anxiety is a normal, functional, biologically-based phenomenon that every person is capable of...
Welcome to #OCDWEEK 2016, a week organized by IOCDF to help raise awareness about OCD and related conditions! If you visit IOCDF’s website, you’ll find information about local and online programs and events designed to help increase the general public’s understanding...
Group Therapy for OCD Wow. Our first OCD treatment group met yesterday, and IMHO, it was an incredible experience. Thank you to all who attended and showed such courage in standing up to their OCD. I was reminded anew how group therapy for OCD is so different than...
Teens with social anxiety unite! In this paid treatment group, teens will support each other in developing cognitive behavioral skills to combat social anxiety. This workshop will be interactive and fun. Note: If you are an adult with social anxiety, there's a group...
OCD Treatment Group! I am pleased to announce the availability of our new exposure and response prevention (ERP)-based treatment group. The intent of this group is to provide a supportive environment for completing ERPs. Participants wishing to attend are required to...
OCD is a malevolent advisor that wants to deceive us about the fundamental nature of the world. It wants us to believe that the world shouldn't have any sharp edges and that our experience should be as smooth and snag-free as possible. If snags are apparent, it tells...
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...
The International OCD Foundation (IOCDF) is sponsoring OCD Awareness Week, which means that organizations around the world are hosting special OCD-related events this week. South Floridians, we invite you to join us for our monthly support group meeting tonight...
Flu season will be quickly upon us and with it comes an unfortunate increase in the likelihood of experiencing fevers, coughs, runny noses, vomiting, and the like. Although no one enjoys being sick, this time of year poses particular challenges for individuals...
Parents brace themselves for many changes when a new baby comes home. As new routines replace old, life quickly becomes a confusing jumble of cherished memories, bottles, and dirty diapers. Parenting can be joyful, but it can also be terrifying. Parenting comes with...
Just a few quick announcements: 1) The 2012 meeting of the International Obsessive-Compulsive Foundation (IOCDF) is just a week away. The IOCDF conference marks the perfect convergence of all things OCD-related. In attendance are some of the best clinicians and...
Thoughts of death, dying, and suicide are an unfortunate reality for many individuals. In the U.S. alone between 2008 and 2009, approximately 3.7% of adults (8.3 million Americans) reported having suicidal thoughts (Crosby et al., 2011). During that same time frame,...
The fear of harming others can be a sign of obsessive-compulsive disorder (OCD), a neurobiological condition that is associated with repetitive, intrusive, distressing thoughts that can't easily be dismissed. Fear of Harming Other People On Purpose Some aggressive...
Aggressive obsessions go by many names. Harm obsessions, violent obsessions, morbid obsessions...the list goes on... These symptoms of obsessive-compulsive disorder (OCD) involve the fear of harming or killing other people. In other cases, aggressive obsessions are...
Imagine that you're leaning down to kiss your young daughter goodnight, when BAM! You are jolted by an image of yourself stabbing her to death. Alternatively, picture yourself as a young child who is intensely afraid of playing with your new puppy...not because you're...
This is a recommended list of OCD books and OCD websites that I consider to be essential reading for individuals with obsessive-compulsive disorder. In addition to my formal training in OCD treatment, these OCD books and websites have had a profound impact on how I...
Behavioral Checking (Overt Checking) Many examples of compulsive checking rituals in OCD involve direct inspection of a target stimulus by sight, sound, or feel. Common OCD checking behaviors include relocking doors, visually examining the position of one's parking...
Compulsive checking often begins innocently enough. One check here, two checks there... But OCD's greed knows no bounds. What starts out as a simple check "just to make sure" eventually spirals into disabling OCD doubt that can come to predominate innumerable...
Fear of Being Gay (Homosexual OCD / HOCD) Emerging sexuality can be confusing for any teen or young adult, and gay teens face a variety of unique challenges over the course of adolescence. In addition to learning to understand their own sexuality, gay teens must...
Sexual obsessions in OCD are recurrent unwanted sexual thoughts, such as the fear of being attracted to something unwanted, taboo, or morally "unacceptable" based on one's particular worldview. Although all forms of OCD can be debilitating, sexual obsessions can be...
Symptoms of Body Dysmorphic Disorder (BDD) Body dysmorphic disorder (BDD) is a somatoform disorder that closely resembles obsessive-compulsive disorder (OCD). Symptoms of body dysmorphic disorder include excessive concern about perceived physical flaws, defects, or...
What is Body Dysmorphic Disorder (BDD)? Body dysmorphic disorder (BDD) is not formally classified as an anxiety disorder; however, it shares many overlapping features with anxiety disorders like obsessive-compulsive disorder (OCD). In contrast to OCD which typically...
Anxiety, Worry, & What If Questions If you have anxiety, it's likely that you wrestle with worry and "what if" questions. Many what if questions are easily recognizable and start with the obvious, "What if...?" Others are more subtle and begin with phrases like...
"Hit and run" OCD involves the fear of accidentally hitting a pedestrian while driving. In most cases of hit-and-run obsessive-compulsive disorder, fears focus on unintentionally killing, injuring, or maiming a victim. Other individuals worry about causing car...
What is Scrupulosity? Scrupulosity is a form of obsessive-compulsive disorder (OCD) characterized by religious and/or moral obsessions. Scrupulosity can sometimes be difficult to recognize because even within a single faith community, religious beliefs and practices...
Question: I have scrupulosity (religious/moral obsessive-compulsive disorder), and I am triggered by religious posts on Facebook. When I see a religious post, I feel like I have to repost it or God will be mad at me. I also worry about what other people think about...
Exposure and Response Prevention (ERP) Exposure and response prevention (ERP) is just like a fitness program for your brain. However, instead of shaking up your fitness level, it's designed to shake up stubborn OCD symptoms. Let's expand on this analogy. Reasons for...
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...
In my post about the treatment of sensorimotor OCD, a reader asked about the ultimate goal of treatment. Should the goal of treatment be to never notice an unwanted thought or symptom? Suppressing Unwanted Thoughts & Sensations in Pure-O & Sensorimotor OCD...
OCD & Thought Control Can I learn to eliminate my OCD thoughts? I hear this question all the time from new patients who are searching for ways to suppress their unwanted thoughts. When I answer this question with a resounding "no", there is often much surprise and...
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....
Although contamination OCD and washing rituals often go hand-in-hand, many rituals in this domain do not actually involve cleaning or disinfecting. These more subtle rituals are often based around reassurance seeking behaviors that become ingrained in everyday habit....
OCD: Common Compulsions In my last post about OCD, I discussed reasons why people do rituals. This time, I'll identify specific rituals that are common in obsessive-compulsive disorder (OCD) characterized by a fear of germs, contamination, diseases, and other...
In my last post, I identified several idiosyncratic feared outcomes in OCD that are associated with contamination/health-related obsessive-compulsive disorder (OCD). Obsessions are intrusive, recurrent, and distressing thoughts, impulses, or images related to these...
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....
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...
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...
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...
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...
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...
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...
OCD Support Groups - Palm Beach Gardens|Jupiter|West Palm Beach|Florida Attention all South Florida residents with OCD in Palm Beach Gardens, Jupiter, Juno, West Palm Beach, Boca Raton, Boynton Beach, Lake Worth, Royal Palm Beach, Wellington, Delray Beach, Pompano...
This post is the last in a series of posts discussing body-focused obsessions and compulsions (aka, sensorimotor, somatosensory, or somatic obsessions and compulsions) in obsessive-compulsive disorder (OCD). This series was inspired by an original article written by...
This post is the second in a series of posts discussing body-focused obsessions and compulsions (aka, sensorimotor, somatosensory, or somatic obsessions and compulsions) in obsessive-compulsive disorder (OCD). This series was inspired by an original article written by...
This post is the first in a series of posts discussing body-focused obsessions and compulsions (i.e., sensorimotor obsessions and compulsions) in obsessive-compulsive disorder (OCD). This series was inspired by an original article written by Dr. David Keuler for...
Question: To what extent would a change of mindset (e.g., changing my expectations for myself) be helpful in recovering from OCD? What is likely to happen if I delay formal treatment with a psychologist and work instead on changing my own mindset? OCD Treatment...
Question: Because many of my OCD rituals are related to my professional identity, I'm worried that changing my rituals will somehow change those parts of me that I like (e.g., my personal goals and ambitions). Should I be concerned about this? Early Onset OCD in Kids...
Question: It's hard to describe this, but I feel like every few days I need to mentally "start over" by doing a variety of mental and behavioral rituals. I don't want to live like this, but I'm afraid that if I undergo treatment and stop my OCD rituals, I won't be the...
Think about the most significant health scare you have ever experienced. Then multiply this experience by a factor of about 10. Unfortunately, this is a daily reality for many individuals suffering from health-related anxiety, a debilitating condition that can have...
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...
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....
Mindfulness & ACT-based Approaches to Therapy Mindfulness & Acceptance and Commitment Therapy (ACT)-based approaches to treatment might (Hayes, Strosahl, & Wilson, 2003) ask you to consider the truth of the following statement: I hurt; therefore, I suffer....
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...
As someone who has long been enamored with basic science, I find it fascinating when classic medications are re-purposed in surprising ways. One of the newest examples of this is the use of D-cycloserine (also known as Seromycin) in the treatment of...
I consider myself a scientist. I wear this hat officially when conducting research, but I also wear it every time I sit with a patient. In my research, my science is pretty self-evident: I identify a research question, develop falsifiable hypotheses, and then...
I'm about to tell you something that your mother might not approve of...so for those of you sensitive souls out there, you might want to click on something less controversial. Here it is: It's okay (and sometimes even essential!) to be a little bit selfish....
Signs of depression can be obvious or subtle, but regardless, they often severely impact your quality of life. For help in addressing your symptoms of depression, seek the assistance of a therapist or psychologist trained in cognitive behavioral therapy (CBT), which...
For some individuals with major depressive disorder, signs of depression can be pretty obvious. Depressive symptoms can be utterly disabling and leave you with very little hope that things will ever get better. Depression can make you feel like giving up or actually...
Like any other behavior, school refusal does not have a singular cause. This is pretty self-evident, but in the heat of the moment when your child is having a tantrum, this fact is quickly forgotten. It is simply too easy to conclude that you have raised a "bad...
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...
Panic attacks feel awful. However, despite the unpleasantness of panic attacks, we're actually lucky to have the neural circuitry that drives them. Although it might not feel like it, panic is caused by one of your body's most important self-protective mechanisms....
If you have panic disorder or suffer from panic attacks or agoraphobia, chances are you might be inadvertently doing one simple thing that is making your panic attacks and anxiety worse. You might have even learned this strategy from your therapist. Although...
When considering treatment for test-taking anxiety, make sure that you have a comprehensive diagnostic assessment to rule out other possible causes of your symptoms. Not all cases of test anxiety are alike, and sometimes symptoms of test anxiety actually reflect a...
Although most of us (at one point or another) have experienced significant fear, uncertainty, or dread about an upcoming examination or evaluation, oftentimes these milestones pass without incident. We get scared, our hearts race, and we ultimately live to fight...
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...
"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...
How does ERP work? What mechanism underlies it? Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions are disturbing thoughts, images, or impulses that increase feelings of anxiety. Compulsions (also known as "rituals") are...
Does OCD affect decision making processes? Now that we have reviewed the neurobiology of OCD and cognitive deficits associated with OCD, what relevance might this have for predicting abnormalities on tasks of decision making? Sachdev and Malhi (2005) recently have...
What cognitive deficits are associated with OCD? Research has been successful in characterizing the underlying neurobiology of OCD, and cognitive abnormalities associated with the disorder have been documented within the domains of basic learning processes, attention,...
What causes OCD? Researchers have had much recent success in elucidating the neural circuitry involved in obsessive-compulsive disorder (OCD). Advances in functional neuroimaging have identified robust alterations in neural activity within particular functional...
What is OCD? Obsessive-compulsive disorder (OCD) is a debilitating mental illness that affects nearly 2.5% of the population (American Psychiatric Association, 2000). The primary features of the disorder include obsessions, which are recurrent and persistent...
Lately, I've been experimenting with new and better ways of incorporating social media tools into my practice. Just yesterday, I developed a list of CBT-based exposure ideas for reducing symptoms of OCD, perfectionism, and social anxiety. What was unique about these...
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....
There is more than one type of perfectionist. First, there is the adaptive perfectionist. This perfectionist is the prototypical workaholic student/employee who goes above and beyond expectations. This person is intelligent, hard-working, dependable, and passionate...
Disclaimer: Because panic attacks can mimic the symptoms of several serious medical conditions, it's important that you talk with your doctor before beginning any panic treatment program. Never begin panic treatment without first obtaining medical clearance from your...
Many excellent parents struggle with how to appropriately parent their child/teen with obsessive-compulsive disorder (OCD). Unfortunately, this process is rarely straightforward and is often counter-intuitive, which leaves many parents feeling anxious and confused. As...
Imagine that you have a rather large blemish right in the middle of your forehead. It's not one of those pseudo-invisible blemishes that can only be perceived by you. Rather, it's an angry, red mark that is readily apparent to nearly all the people with whom you...
Social media tools like Facebook and Twitter are poised to revolutionize healthcare. Social media sites can be useful for quickly disseminating health-related information and giving users a place to connect around shared interests. In some cases, online support...
The topic of hoarding is rarely met with disinterest. Maybe that's because nearly all of us can relate to hoarding on one level or another. Perhaps you yourself have been touched personally by hoarding. You may have a strong emotional attachment to objects, or you...
If you are an individual who struggles with hoarding, you might have been frustrated by negative treatment experiences in the past. For most individuals who hoard, treatment can be challenging. However, it is an essential ingredient for regaining control and...
Question: Basically, I wanted to know from an expert, what can a phobia do to a person? How does it affect them mentally? Also I see that you've got a new treatment philosophy -- is there any way you can talk me through it? One of the goals of cognitive behavioral...
I am working on some substantial content changes to this website, which will be rolling out gradually. Just to orient you: 1. My OCD research section has been updated. 2. I have added a section about my treatment philosophy. 3. I am in the process of developing a...
Here's a question for you: Is exposure and response prevention (ERP) fundamentally a destructive or constructive process? I think that many people naturally conceptualize it as more of the former than the latter. They conceive of ERP as being the process by which we...
