RITUALS
[View original article published in Psych Central here] Megan felt miserable. She and her family had relocated in the middle of the school year to another city. She was missing her friends and changes were difficult for her. It seemed the problems began one morning when she was getting ready for school. While washing her hair, she thought she had swallowed some of the shampoo. She wondered if it was toxic. She worried she’d get sick and die. She rinsed her mouth incessantly until she felt safe. “Is it poisonous?” she would ask her mom, every day before taking a shower. Her mom would reassure her that it was harmless. But Megan wasn’t satisfied with the answer. She couldn’t take a chance and took safety measures each time. Soon, her worries
Rick was eighteen when he came in for his first session. His main goal was to learn ways to get rid of his “bad” thoughts and the anxiety and guilt that accompanied those obsessions. “They are torturing me,” he said. We reviewed the OCD cycle and learned the necessary steps to start interrupting it. Rick knew the triggers that caused his obsessive thoughts and how they brought excruciating anxiety and guilt. He was surprised to learn that his singing, praying, and reciting were compulsions that were reinforcing the OCD cycle. He mistakenly believed that compulsions were supposed to be “weird” or silly behaviors. He found out that anything he did to find relief was actually a compulsion. He said, “Sometimes I analyze my thoughts and t
An Update from the NIMH (National Institute of Mental Health): Exposure / Ritual Prevention Therapy Boosts Antidepressant Treatment of OCD This is another study that confirms Exposure and Ritual Prevention (a specific form of cognitive behavior therapy) makes a significant difference in treating OCD. Read the article here.
[View original article published in Psych Central here] Patty was feeling frustrated and depressed. No matter what she tried, she felt she was stuck. As a young child, she remembers she would come unglued if anyone walked in her room and messed up her belongings. She would arrange and rearrange things until they felt just right. When going to school, she remembered asking her mom if her hair looked perfect. Her mom would say, “You look beautiful!” Patty didn’t believe her. She would ask her mom to fix it better, or she would try to do it herself until it felt right. She wanted to be the best at everything she tried, but when things didn’t go as she expected, sadness and depression ensued. Her all-or-nothing thinking was getting in the way
[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