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ANXIETY

Before It Knocks You Down

10.19.12

A while ago, I met a client whose family loved the ocean.  Every opportunity they had to go on vacation, they chose a place where they could body surf.  I asked him to tell me the skills one requires to succeed at this pastime many ocean fans enjoy.  I find the parallels useful in understanding treatment for OCD.  I especially use these comparisons when my clients love the ocean also.   Body surfing: Patience is king if you want to learn the trade. Learning to recognize the waves is important so you know what to do. Be in good physical condition.  You need to know how to swim and tread water, in case the ocean water flows high and you can’t touch the ocean floor. When the wave comes, go under it or ride it before it knocks you down. T

Curing the Doubt

9.22.12

Anxiety is something you want to keep at bay. You probably avoid and do whatever it takes to find relief.  Despite hearing and reading “there is no cure” for OCD, you most likely keep your guard up to find at least a few seconds without the doubt.   Curing a doubt becomes a debt that goes out of control just like those loans people get at the Pay-day Loans Companies.  “I’ll pay this debt as soon as I get paid” you tell yourself.  Unfortunately, the days, weeks and months go by and what began as an immediate and small loan has become an insurmountable debt you have to pay.   What happens when you want to cure the doubt? Logically, satisfying the doubt should work similarly to satisfying your thirst.  When thirsty, you gulp a bottle

ERP: One Step At a Time

9.4.12

When I first talk to my clients about ERP (exposure and response prevention), they have a puzzling and incredulous look on their faces. They seem to be thinking:   “You are telling me, I am paying you so you can make me more anxious?  I am here for you to take away my anxiety, not to give me more of it!” Because I can “read” their mind I explain in detail what ERP means and I will briefly summarize it here:   We clarify the bad reputation ERP has thanks to reality TV shows in which OCD clients are crying, screaming, and on the verge of a full-blown panic attack because they’re being “exposed” to that which they fear the most. ERP is about helping you “habituate” or get used to that which you fear.  However, it is by NO means like you’

When Once Is Not Enough

8.28.12

[View original article published in Psych Central here] “Say good-night mommy, say good-night,” pleaded Johnny every night. It wasn’t as if he had not already read several books, been tucked in, and kissed good night. Johnny’s pleas continued every night. After the third or fourth nagging requests, she would get irritated and say, “I am done! This is the last one. Good night!” Johnny would cry and ask for more “good nights.” Mom didn’t know it at the time, but she was reinforcing Johnny’s need for reassurance. One “goodnight” was not enough, but neither were ten. Ritualized hand-washing or other grooming compulsions were absent. There didn’t seem to be any checking compulsions. If there had been, Johnny’s parents probably would have sough

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