Living with Obsessive-Compulsive Disorder (OCD) can feel like being trapped in a cycle of intrusive thoughts and compulsive behaviors. It's a relentless struggle that impacts every aspect of life. Exposure and Response Prevention (ERP) therapy for OCD continues...
OCDSupportGroups.com: Free Support & Evidence-Based Treatment
I'm excited to announce the launch of a new companion website: OCDSupportGroups.com! This site is designed to be a resource for individuals and families affected by OCD and other severe anxiety disorders including social anxiety and panic disorder. It expands...
Scrupulosity Exposure Help?
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)...
OCD Scriptathon 2017: A Group Scripting Experience
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,...
OCD and Uncertainty
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...
ROCD
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...
OCD Treatment: Back to Basics
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...
Relationship OCD (rOCD) – Unwanted Impulses & Images
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...
ROCD – Relationship OCD
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...
Driving Fears & Driving Avoidance in Teens & Young Drivers
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...
Hit-and-Run OCD vs. Other Driving Fears
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...
OCD & Pets: Sexual Thoughts & Scrupulosity
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...
Pets & OCD: Contamination
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...
OCD About Pets and Animals: Harm
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,...
Anger and OCD – Getting Mad…
“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...
ERP Tip of the Day #2
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...
Contamination OCD – Long Shower Exposures
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...
ERP Tip of the Day #1
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...
Imaginal Exposure vs. In Vivo Exposure for OCD
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...
Common Misconceptions About Anxiety & OCD Treatment
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...
OCD Awareness Week 2016
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: Power in Numbers
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...
OCD Treatment Group Using ERP
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...
What is OCD?
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...
Scary Thoughts as Costumes: The Illusion of Danger
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...
OCD Awareness Week
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...
Vomit Phobia – Fear of Vomiting (Emetophobia)
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...
Postpartum OCD – Fear of Harming Your Baby
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...
Suicide Obsessions: Fear of Killing/Harming Yourself
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,...
Fear of Hurting Other People
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: Fear of Harming or Killing Others
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...
Harm Obsessions & Violent Obsessions
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...
OCD & Checking: Part 2 (Mental Checking)
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...
Checking & OCD: Part 1 (Checking for Safety)
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...
HOCD: Homosexual OCD & Sexual Orientation OCD
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 (Obsessive-Compulsive Disorder)
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...
Worry & “What If” Questions
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
"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...
Scrupulosity
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...
Scrupulosity & OCD: Religious/Moral Symptoms
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: An Analogy
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...
Starting Exposure Therapy: What’s it Like?
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...
Treatment of Unwanted Thoughts & Sensations in OCD
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...
Thought Control & OCD (Obsessive-Compulsive Disorder)
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...
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....
Reassurance Seeking in OCD
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 & Contamination: Washing & Cleaning Compulsions/Rituals
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...
OCD & Contamination: Reasons Why People Do Rituals/Compulsions
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...
OCD & Contamination Fears: Feared Outcomes (Example: HIV/AIDS)
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....
Contamination & Health-related OCD: Obsessions, Fears, & Worries
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...
OCD: Screaming, Blurting Out Obscenities/Cursing/Profanity, & Other Unwanted Impulses
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...
OCD Triggers in Daily Life? Don’t Ritualize. Be Strategic! 3 Tips for Fighting OCD.
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...
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...
Palm Beach (South Florida) OCD Support Groups: Adults, Kids, Teens
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...
Treatment for Body-Focused Obsessions & Compulsions in OCD (e.g., Swallowing, Breathing, Blinking)
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...
OCD Core Fears Related to Body-Focused Obsessions & Compulsions (e.g., Swallowing, Breathing, Blinking)
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...
Sensorimotor OCD Body-Focused Obsessions & Compulsions (Swallowing, Breathing)
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...
OCD Treatment (ERP & CBT): Exposure & Cognitive Restructuring
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...
OCD Treatment: OCD vs. Me. How do I Tell the Difference?
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...
Pure-O OCD Rituals: Starting Over, Resetting, & Undoing
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...
OCD & D-cycloserine: A Promising Medication for OCD Treatment
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...
“Pure-O” OCD: Common Obsessions & Mental Rituals
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 (Pure Obsessional OCD): Hidden Rituals
"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...
Exposure & Response Prevention (ERP) for OCD: Treatment Mechanism
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...
Obsessive-Compulsive Disorder (OCD) – Decision Making Abnormalities
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...
Obsessive-Compulsive Disorder (OCD) – Cognitive Deficits
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,...
Obsessive-Compulsive Disorder (OCD) – Neurobiology
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...
Obsessive-Compulsive Disorder (OCD) – Overview
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...
OCD perfectionism & social anxiety treatment: Tweet your way to greater health
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....
Perfectionism in OCD: When the pursuit of success turns toxic
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...
Parenting Kids & Teens with OCD: Don’t Feed the Reassurance Monster…and Other Quick Tips
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...
ERP therapy for OCD: Shifting from destructive to constructive to gestalt notions
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...
Advanced ERP for OCD: how subtle rituals can limit your progress
What is exposure and response prevention (ERP) for OCD? As any good psychologist experienced in treating OCD can tell you, the most effective treatment for OCD is exposure and ritual prevention (ERP). You may also see this type of therapy referred to as exposure and...
OCD and DSM-V: Taking the “anxiety” out of OCD
Psychiatrists and psychologists continue to debate the fundamental nature of OCD, trying to decide whether or not OCD should continue to be classified as an "anxiety disorder." In some ways, OCD overlaps with other anxiety-related conditions, such as panic disorder,...
OCD & ECT (electro-convulsive therapy): Not a first-line treatment
If your only diagnosis is OCD and you don't have any other complicating factors, be cautious when considering electro-convulsive therapy (ECT) for treating your OCD. ECT can be a very helpful intervention for many types of conditions (e.g., severe depression, bipolar...
OCD guilt, shame, disgust, anxiety & depression: Why treatment sometimes fails (and what to do about it)
OCD isn't just about anxiety. Although anxiety is certainly a prominent feature of the disorder, clinicians who only attend to anxious symptoms can easily overlook some of its other core features. As a psychologist in Palm Beach, Florida, I work closely with kids,...
OCD, ERP, & doubt sensitivity: Shattering the illusion of certainty
Many individuals with OCD hunger for certainty. It's a craving that often can't be easily sated. Early conceptions of OCD from the 19th century acknowledged this issue directly, in that OCD was often termed the "doubting disease." It is this need for certainty, the...
Miami/Fort Lauderdale OCD support groups for adults and kids
Several support groups for individuals with OCD are conveniently located near Miami, Fort Lauderdale, and Boca Raton. Some groups are facilitated by licensed clinical psychologists, whereas others are led by individuals with OCD. To view current support groups in...
OCD symptoms: the obvious (and the not so obvious)
Symptoms of OCD are everywhere. Turn on your television, and you're likely to catch at least a fleeting glimpse of obsessive-compulsive disorder (OCD). Many popular TV shows feature characters with OCD (e.g., Emma on Glee, Monk), and it is through this lens that many...
Palm Beach OCD support group
UPDATE (10/19/11): These free OCD support groups are now running in Palm Beach County, Florida (i.e., Palm Beach Gardens, FL). If you would like to receive email reminders about upcoming support groups, you can access our sign-up form here. See our events calendar for...