Psychotherapy for Anxiety and OCD, Trauma and PTSD, and Perinatal Mental Health Concerns
OCD involves a combination of intrusive, unwanted, thoughts images or impulses that are distressing to you, coupled with rituals or compulsions that are used to try to relieve distress. Obsessions and compulsions can be extremely upsetting, take up significant time and energy, and interfere with important aspects of a person’s life including their relationships, work, school, and other daily living tasks.
What is OCD?
Obsessions or intrusive thoughts often include fears related to responsibility, control, perfectionism, and difficulty tolerating uncertainty.
Compulsions are behaviors or mental acts that a person does to neutralize the distressing feeling or threat from the obsession. Although they provide temporary relief, often more and more rituals are needed and distress continues in the long-term.
Obsessions can include:
Fears that I could harm myself or others
Fears of doing something embarrassing or uncontrollable
Fears related to contamination, illness, or dirt/germs
Uncomfortable sounds or images that pop into your mind when you don’t want them to
Desires for symmetry or exactness
Unacceptable thoughts related to sex, sexuality, religion, morality or others
Fears around making the wrong decisions or making mistakes
Compulsions often include:
Checking (doors, locks, stoves, body for symptoms, etc)
Washing/Cleaning self or items
Arranging items to look or feel “just right”
Confessing or seeking reassurance
Mental reviewing, mental reassuring, “overthinking”
What is ERP?
Exposure and Response Prevention is an evidence-backed approach to treating OCD that involves gradually approaching feared stimuli that have been typically avoided to help you gain new information about the feared situations that helps to decrease distress. ERP has helped many people overcome OCD and take back their life.
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Exposure and Response Prevention is an evidence-backed approach to treating OCD that involves gradually approaching feared stimuli (situations, thoughts, feelings, bodily sensations) that have been typically avoided and are relatively safe. It aims to help you learn that these situations are relatively safe and that distress often goes down without needing to engage in compulsions. People often learn that they are very capable of tolerating their difficult emotional responses.
In ERP you and your therapist collaborate on creating an exposure hierarchy (list of situations you want to approach) and working through it gradually at your pace. At the same time, you work on gaining more control over urges to ritualize by reducing rituals over time.
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ERP is aimed at learning important lessons that help you combat fear and distress such as that you are able tolerate uncomfortable feelings (eg “I am competent”), that the feared outcome does not occur (and therefore is less distressing), and that the uncomfortable thoughts do not need to control your life.
As you approach feared situations repeatedly, the fear decreases naturally, your mind can better differentiate actual threat from perceived threat, obsessions carry less weight and become less upsetting, and you learn to tolerate a range of emotional responses. I find that as people move through ERP, they learn to trust themselves, their minds, and their emotional responses again, learn to accept and live with uncertainty, and can prioritize their valued-driven behavior over OCD driven behavior.
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My approach to ERP is compassionate, supportive, and encouraging. My hope is to help you tolerate the uncomfortable feelings now so that you can make meaningful changes and move toward the life you want. I integrate ACT-based strategies emphasizing doing exposures from committed action that takes into account your values and desires for your life and includes mindfulness or defusion techniques to help unhook from compulsive thought loops. My hope is that ERP is a collaborative endeavor where your expertise about yourself is in conversation with my expertise in treating OCD.