​OCD* occurs when people experience obsessions and/or compulsions.  Obsessions are often experienced as intrusive, recurrent and persistent thoughts, urges, or images that cause significant anxiety or distress for most people.  People with OCD often try to ignore or suppress their obsessions, or, try to “neutralize” them with another thought or action (i.e., a compulsion). Compulsions are repetitive behaviors or mental acts that people feel like they have to perform because of their obsession or based on some set of rules they have created.  The purpose of the compulsions are to decrease anxiety or prevent another dreaded outcome (e.g., “If I don’t check the locks 5 times, someone might break in”).  However, the compulsions are often either excessive or not realistically connected to what they are designed to prevent (e.g., “If I put my cup down in this spot only, it will prevent my loved ones from getting sick”).  Furthermore, the obsessions and/or compulsions are time-consuming and may cause impairment in school, work, relationships, etc.  Unfortunately, some people tend to erroneously only label OCD after observing the more explicit compulsive behaviors (e.g., repetitive hand washing, checking locks, constantly cleaning, etc.); however, many people with OCD have what is referred to as “pure O,” or purely obsessional OCD.  In these cases, the compulsive acts occur as hidden mental rituals, such as un-doing or re-doing certain actions in your mind or constantly seeking reassurance (e.g., researching things online to decrease anxiety, getting reassurance from others to feel better and decrease anxiety, etc.).  "Pure O" OCD is a bit of a misnomer, as the compulsive behaviors are still very much present, just less overt, which can sometimes lead to misdiagnoses (e.g., with Generalized Anxiety Disorder, etc.). OCD can present in many different forms, often acting as a "shape shifter," with themes changing over time.  Themes of intrusive thoughts can range anywhere from harm to oneself or others, to, fixating on one's relationship or various moral issues.  

​

I treat OCD with exposure and response prevention (ERP), a specific type of CBT treatment, which is considered the "gold standard" evidence-based treatment for this diagnosis. This treatment involves gradually facing the anxiety-producing thoughts, images, objects, or situations related to one’s obsessions, while working toward not engaging in the behavior (i.e., compulsion), which leads to a reduction of anxiety symptoms over time as you learn to cope more effectively. 

 

Group Therapy for OCD

I provide both individual and group therapy to treat OCD using ERP.  There are various pros and cons (e.g., cost, other participants, etc.) that may impact your decision to begin either individual or group therapy, so please contact me with any questions you may have.

​

Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD)* involves excessive preoccupation with one or more perceived defects in appearance that are either not observable or could be considered mild to other people. People with BDD often perform repetitive behaviors due to their concerns about their appearance. For example, a person make compulsively check how they look in the mirror, avoid mirrors entirely, cover up areas of concern, seek reassurance from others about how they look, excessively groom themselves to remove/improve perceived blemishes, etc. People suffering from BDD experience significant distress or impairment in their daily functioning, such as at work, school, or socially. I treat BDD with cognitive behavioral therapy and exposure and response prevention, which is considered an evidence-based treatment for this diagnosis.

​

Hair Pulling Disorder

Hair-Pulling Disorder (HPD)*, also known as trichotillomania, involves repeatedly pulling out one's hair, which results in hair loss, along with repeated attempts to decrease or stop hair pulling. People suffering from HPD experience significant distress or impairment in their daily functioning, such as at work, school, or socially, but also often experience a good feeling from pulling and may use it to relieve stress. For example, people may experience intense guilt or shame after pulling or if other people observe pulling behaviors or bald spots, while also avoiding activities due to pulling (e.g., swimming, being outside on a windy day, physical intimacy, etc.). People may also experience a positive feeling while pulling, such as when either over- or under-stimulated (e.g., bored or stressed). I treat HPD and other body-focused repetitive behaviors using the Comprehensive Behavioral (ComB) treatment approach, which includes habit reversal training (HRT), CBT, ACT, and DBT skills. ComB is considered an evidence-based treatment for this diagnosis.

​

Skin-Picking Disorder 

Skin-Picking Disorder*, also known as excoriation, involves repeated skin picking that results in skin lesions, along with repeated attempts to decrease or stop skin picking. People suffering from skin-picking disorder tend to experience significant distress or impairment in their daily functioning, such as at work, school, or socially, but also often experience a good feeling from picking and may use it to relieve stress. I treat skin-picking disorder and other body-focused repetitive behaviors using the Comprehensive Behavioral (ComB) treatment approach, which includes habit reversal training (HRT), CBT, ACT, and DBT skills. ComB is considered an evidence-based treatment for this diagnosis.

​

Body-Focused Repetitive Behaviors

Body-Focused Repetitive Behaviors (BFRBs)* include disorders with similar behavior patterns as Hair Pulling and Skin-Picking Disorder, that involve other behaviors not captured in the aforementioned diagnoses, such as nail picking or biting, lip biting, interior cheek chewing, etc. Presentations involve recurrent body-focused repetitive behaviors with repeated attempts to decrease or stop the behaviors. People suffering from BFRBs experience significant distress or impairment in their daily functioning, such as at work, school, or socially, but also often experience a good feeling from the behavior and may use it to relieve stress. I treat BFRBs using the Comprehensive Behavioral (ComB) treatment approach, which includes habit reversal training (HRT), CBT, ACT, and DBT skills. ComB is considered an evidence-based treatment for this diagnosis.

​

If you feel you may be suffering from a mental health issue and are ready to get help, or even if you’re unsure if you need help and just want more information, please contact me today.   If you are experiencing a psychiatric emergency, meaning likely to harm yourself or others, please call 911 or go to your nearest emergency room. 

​

*Basic information about the disorders listed above comes from the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR)