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 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...
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...
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...
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...
Teen Social Anxiety Group (Cognitive Behavioral Therapy/Group Therapy)
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 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...
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...
Does Non-Avoidance = Exposure? No! Anxiety Disorder Treatment Principles for OCD, Panic, Social Anxiety, & Phobias.
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...
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...
Exposure Therapy’s Most Common Mistake: All Eggs in the Habituation Basket
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...
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...
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 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...
Fear, Doubt, Uncertainty, ERP, & the Monster Under the Bed
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 therapy: Questioning “I hurt; therefore, I suffer.”
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....
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...
Therapy as Science: You + Your Therapist + Scientific Method
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...
The Power of Being Selfish: Selfishness as a Key to Mental Health
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....
Symptoms of Depression / Major Depressive Disorder (MDD)
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...
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...
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....
Hoarding: Treatment, symptoms, and personal impact/costs
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...
Hoarding treatment: Choosing the right therapist
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...
Specific phobias: symptoms & CBT treatment (reader question)
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...
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 & 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,...
The beginning of something new
Welcome to my blog. My name is Steven J. Seay, Ph.d., and I am a licensed psychologist in Florida and Missouri. I am currently the Director of the Center for Psychological & Behavioral Science. Over the coming weeks and months, I plan to use this blog to offer a...