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...
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...
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...
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...
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...
OCD Books & OCD Websites
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...
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 & 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...
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...
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...
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...
One Panic Treatment Basic that Even Your Therapist Might not Know
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...
Test Anxiety Treatment & Diagnostic Considerations
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...
Test Anxiety & Test-taking Anxiety Myths
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...
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....
Although it might feel like you’re dying, you’re not. That’s just what the panic wants you to think.
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...
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...
Trichotillomania: Goodbye “Trich Police”, Hello HRT
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...
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...
Website updates: Research, treatment philosophy, & information sections
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...