How Does Exposure Response Prevention (ERP/ExRP) for OCD Work?
One of the really frustrating things about living with OCD is that the ways we try to cope with having OCD tend to become the compulsions that make OCD worse. In order words, we struggle to deal with obsessive thoughts that cause anxiety, such as a fear that touching things will make us sick (contamination type OCD), or the uncertainty about whether we might be going to hell (scrupulosity type OCD), or the fear that maybe we hurt someone in the past (harm type OCD). Then we come up with creative ways to deal with the intense fears and uncertainty, like washing our hands after touching something, or saying repeated prayers, or seeking reassurance about our past behavior. But it is exactly those creative ideas that become the compulsions that take up increasing effort and time in our lives, and which edge out more and more of the things that give us pleasure. Also trying to avoid the kinds of experiences that trigger our fears can gradually make our lives smaller. Going to therapy with people who are untrained in working with OCD can also make OCD worse since well-meaning therapists will teach coping skills, offer reassurance, or help analyze and reality-test past experiences using methods like Cognitive Behavioral Therapy (CBT), but those actions can also worsen compulsions or become compulsions themselves.
Understanding OCD
Over the past few years with the increasing popularization of mental health therapy, many therapy terms have entered common language. This has had a positive effect in many ways with the increasing normalization of self-care and healthy boundaries. However, there has also been increasing confusion, such as in the dilution of the meaning of serious mental health conditions, over self-diagnosis of these conditions, and resulting confusion in what these conditions actually are and the extent to which people suffer from them (consider the many articles that start with “I cured my depression by…”, which make major depressive disorder sound a lot less serious and easier to recover from than it actually is).
How to Grow a Backbone
“How do I grow a backbone? I tend to say yes to everything and everyone. Then I get taken advantage of and angry at myself. It happens at work a lot, not [being] compensated for things that I'm spending money on or asked to do some extra jobs that cause extra work and to lose focus on my actual work… When I spoke up most recently, I got hostility, a long and loud argument about why it's impossible. That becomes scary, i HATE confrontation and disappointing people. I can't quit, I need to be heard and understood.”
Don’t Get Over It
I used to think that grief was something you just get over. You go through the 5 stages and poof! The sadness and pain of the loss are over. You just had to ride out this one big, horrible storm. It wasn’t until my own experiences with grief over the last several years, that I realized this will be with me forever. Grief will always be a part of you once you lose someone. And I also learned that it is a journey to grieve someone and you can learn to carry the grief with you in life. Grief can help you repurpose that person into your life you never thought possible and offer moments to heal and grow.
Narcissism Is Not Who You Are
I learned a very interesting and useful perspective on narcissism recently: narcissism is not who a person is, and is not something people are born with, but is instead a set of tools. Tools like blame-shifting, grandiosity, admiration-seeking, manipulation and entitlement.
This raises an important question, if narcissism is actually a set of tools, then what is the problem that the tools have been developed to cope with?
Questions about Self-Care
Something that I’ve come across again and again in my personal life and clinical practice is people (myself included) bumping up against the fact that we have a harder time offering ourselves support when we’re struggling than we do offering it to others. In fact, this comes up so commonly that it’s led me to be suspicious about the whole thing. Is there something not quite right about our expectations for self-care?
Self Care is a Revolutionary Act for Child Trauma Survivors
For adult survivors of neglectful, abusive or otherwise harmful parenting, one of the messages we likely received in our childhood experience is that our feelings and needs do not matter.
Healing the Inner Child
Inner child healing, reparenting, gentle parenting, soul wounds…we hear these terms thrown around nearly daily by therapists, life coaches, yogis, the cashier at Starbucks…but what does any of it actually mean? Who is the inner child and why does it need reparenting?
What is Mental Health Therapy?
If you’re like me, you’ve probably seen a lot of representations of mental health therapy in movies or TV. Maybe you’ve seen therapists on social media who are using their platform to discuss various topics related to mental health. Or maybe you’ve heard a family member or friend say “my therapist told me…” With that being said, I might be biased, but I couldn’t be more happy that therapy is being represented in the media or becoming a part of casual conversation; arguably, this can help lessen the stigma surrounding mental health and mental health treatment. However, along with increased attention toward mental health treatment comes misinformation. That’s where I come in; I’ll be writing an ongoing series starting with this post about mental health treatment myths. My hope is that by busting some of these myths and promoting the facts we can reduce the stigma around mental health treatment.