Let's talk about the elephant in the room (or the bedroom... or the laundry basket...). OCD loves taboo topics, and as such, it can easily infiltrate topics related to semen, sperm, vaginal secretions, and other various sexual fluids...Alright, let's dive into the...
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...
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...
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...
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...
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...
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....
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...
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 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...
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...
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....
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...
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 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...
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...
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...