Archive for Cognitive-Behavioral Therapy (CBT)
Social Anxiety / Social Phobia: Alone With Witnesses – Part 1
Many people mistakenly think of Social Anxiety as nothing more than shyness. In this two-part series, Jon Hershfield of the OCD Center of Los Angeles discusses Social Anxiety, its treatment with Cognitive Behavioral Therapy (CBT), and its relationship to other OC Spectrum Disorders.
Social Anxiety, also known as Social Phobia, is more than just shyness.
When I first began treating people with Social Anxiety Disorder (also known as Social Phobia), it seemed to me that this condition was primarily a problem of interesting people not realizing that they are interesting. While this is a significant element of the disorder, there is more going on than one might initially expect.
In reality, Social Anxiety and Social Phobia are terms used to describe a cluster of symptoms that center around the fear of being negatively evaluated by others. This is often confused with being shy or introverted, or even schizoid. An introvert may genuinely prefer the quiet solitude of turning inwards to the self rather than outwards to other people, while someone with schizoid personality disorder may simply not find the presence of other people to be pleasing. In either of these cases, the experience of isolation from others is essentially rooted in ego-syntonic thoughts, which simply means that the thoughts are consistent with the individual’s true beliefs and values. In other words, those who are truly introverted or schizoid genuinely prefer to be alone.
Conversely, a person suffering from Social Anxiety is burdened by unwanted intrusive thoughts about being judged, rejected, and/or and humiliated by others. › Continue reading
Binge Eating Disorder / Compulsive Overeating and Its Treatment
Binge Eating / Compulsive Overeating is a real problem that can be successfully treated
Binge Eating Disorder, also known as ‘”compulsive overeating”, can perhaps best be described as a condition in which one periodically consumes extremely large amounts of food. Individuals with Binge Eating Disorder have a strong motivational drive for food and experience great difficulty in their attempts to restrain their eating. They frequently continue eating well beyond their satiation level, with many reporting that their behavior feels “unconscious”, and that they have little control over it. It appears that compulsive overeating is often done in response to emotional difficulties or psychosocial stressors. Unfortunately, during and after a binge, one is often left feeling more depressed, anxious and helpless than they did before they overate.
In addition to the psychological issues noted above, some researchers and theoreticians believe that compulsive overeating has played a significant role in the dramatic increase in obesity levels in the Untied States over the past 30 years. Obesity is commonly identified as having a body-mass index (BMI) over 30. Using this guideline, approximately 34% of Americans are currently classified as obese, compared to 15% in 1980. During this same 30 year period, this increase in obesity has led to a concomitant surge in diabetes and hypertension, both of which are risk-factors for heart disease, the number one cause of death in the US. › Continue reading
Sexual Orientation OCD, aka HOCD / Gay OCD – Part 2
Jon Hershfield of the OCD Center of Los Angeles discusses treatment of Sexual Orientation OCD, also known as HOCD or Gay OCD, using Cognitive Behavioral Therapy (CBT) and Mindfulness. Part two of an ongoing series.
Treatment of Sexual Orientation OCD
Sexual Orientation OCD can be successfully treated with Cognitive Behavioral Therapy and Mindfulness
As noted in our previous post, Sexual Orientation OCD is a condition in which an individual, straight or gay, obsessively doubts their sexual orientation. Research has consistently found that the most effective treatment for this and all types of Obsessive Compulsive Disorder (OCD) is Cognitive Behavioral Therapy (CBT), with a focus on Exposure and Response Prevention (ERP).
Over the past ten years, many OCD specialists have also begun to integrate concepts from Mindfulness-Based Cognitive Behavioral Therapy (MBCBT) into their treatment of OCD. In MBCBT, the goal is to change one’s perspective toward one’s thoughts, as well as the behavioral responses these thoughts lead to. Using mindfulness, it is possible to circumvent much of the OCD process and ultimately reverse it into remission.
Mindfulness is particularly helpful when treating the more obsessional variants of OCD, including Sexual Orientation OCD. When combining MBCBT with the traditional tools of Cognitive Behavioral Therapy, the following treatment techniques are used to address the unwanted thoughts and behaviors seen in Sexual Orientation OCD. › Continue reading
Sexual Orientation OCD, aka HOCD / Gay OCD – Part 1
Many people mistakenly think of Obsessive Compulsive Disorder (OCD) solely as a condition in which people wash their hands excessively or check door locks repeatedly. There are actually many sub-types of OCD. In this ongoing series, Jon Hershfield of the OCD Center of Los Angeles discusses Sexual Orientation OCD, also known as HOCD or Gay OCD.
So, Am I Gay or What?
I sat down to write this blog on Sexual Orientation OCD while my wife and I had started to watch a movie (It’s been suggested I work too much). It’s either irony or personalization, but the opening scene of the movie involves a man kissing his lover… another man. This is the second film in two weeks that I’ve rented which involve men and their male lovers, something I was not aware of when I selected the films.
Or was I?
Sexual orientation OCD is sometimes referred to as HOCD (an abbreviation for Homosexual Obsessive Compulsive Disorder) or Gay OCD. › Continue reading
Treatment of OCD and OC Spectrum Disorders in Children
“If I knew then what I know now.”
Chances are, if you’re reading this, you’ve found yourself saying the same thing at some point in your adult life. Nowhere is this more relevant than from the perspective of someone looking back on a childhood with Obsessive Compulsive Disorder (OCD) or an Obsessive Compulsive Spectrum Disorder. When I meet a new client under 18, there is a powerful sense of traveling through time. I think, “If only I had someone like me to go back and talk to me when I was someone like this.” How much time might I have saved being able to resist repetitive, unnecessary rituals? How many more events, relationships, and simple moments of peace might I have been able to enjoy if only I had known what was really happening to me? › Continue reading
Trichotillomania, Compulsive Skin Picking, and the Resistor’s High
Jon Hershfield, MA, of the OCD Center of Los Angeles discusses Cognitive Behavioral Therapy (CBT) for the treatment of Trichotillomania (compulsive hair pulling) and Dermatillomania (compulsive skin picking, or CSP).
My wife and I recently became vegetarians. Well, she started using the word “vegetarian” to describe already never eating meat. For me it required more of a lifestyle change. I grew up on a small beef cattle farm, so I was used to the idea that you could grow meat the same way you grow vegetables. Throughout my life it always felt as if meat was how one defined the difference between a “snack” and a “meal”. So as part health experiment and part social consciousness attempt, I have given up meat for the time being.
At first I felt like I was denying myself something purely enjoyable. I’m used to it, I like it, so why don’t I just do it? Saying, “I want to change” or “I’m not happy with the consequences” doesn’t seem to be much comfort. However, nearly 4 months into this experiment, I now get what can only be described as a “resistor’s high” – an addictive satisfaction derived from choosing not to eat meat. › Continue reading
Memory Hoarding in Obsessive Compulsive Disorder (OCD)
I was surprised to discover that Webster’s dictionary defines “hoard” as a kind of temporary fence put up around a structure being built, presumably with the intention of protecting it in a fragile state. Dictionary.com had a more familiar definition: “to accumulate for preservation, future use, etc., in a hidden or carefully guarded place.” Both definitions refer to the behavior of creating certainty around an uncertain state.
Squirrels hoard acorns to make sure they don’t starve during the winter. Armies hoard weapons to ensure they never run out. And some people with Obsessive Compulsive Disorder (OCD) hoard objects of uncertain value, usually with the belief that the object’s value may be revealed at an important point in the future. › Continue reading
OCD Stockholm Syndrome
The “Stockholm Syndrome” is a term used to describe the phenomenon of hostages defending their captors. As a psychotherapist specializing in Cognitive Behavioral Therapy (CBT) for the treatment of Obsessive Compulsive Disorder (OCD), I have seen something akin to the Stockholm Syndrome many times. Clients struggling with this issue often have a mysterious internal debate that goes something like this:
“If I hate OCD so much, why do I fight so hard to keep it around? Maybe my OCD is a good thing. Maybe I need my OCD. After all, If I am not my OCD, then who am I?”
This scenario typically (although not always) presents itself several months into therapy, long after the client has gained some autonomy from their OCD through the use of Cognitive Behavioral Therapy.
Treatment of OCD and Anxiety: A Brief History
As long as people have been having thoughts, they have been having unwanted ones. For most people, unwanted thoughts are little more than a nuisance or a curiosity. But for those with Obsessive Compulsive Disorder (OCD) and related anxiety disorders, these thoughts can be a debilitating nightmare. Unwanted thoughts often trigger unwanted emotions (anxiety, panic), which in turn lead to compulsive attempts to avoid, suppress, and control these emotions.
Traditional Treatment Strategies for OCD and Anxiety
Before the development of psychological treatments, disorders such as OCD and other anxiety conditions were often considered spiritual problems. The sanctioned response was to do your compulsions harder and more frequently. And for those who drew too much attention, a not uncommon result was persecution, imprisonment, or being subjected to brutal, misguided experiments. › Continue reading
Tiger Woods, Sex Addiction, and OCD – Part 2
This is the second and last of a two-part series that discusses the differences between sex addiction and Obsessive-Compulsive Disorder (OCD).
In part 1 of this series, we discussed the growing interest in sex addiction in the wake of recent revelations that Tiger Woods has had a wealth of mistresses. We also discussed how many people, including professional psychotherapists, inappropriately conceive of sex addiction as a form of Obsessive Compulsive Disorder (OCD). Finally, we reviewed the inherent experiential differences between these two conditions, as well as the innate problem of trying to treat sex addiction using therapeutic techniques known to be effective for the treatment of OCD.
In light of the significant differences between these two conditions, it seems clear that sex addiction is not OCD. So what is it? › Continue reading
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