Archive for Obsessive-Compulsive Disorder (OCD)
Scrupulosity: Where OCD Meets Religion, Faith, and Belief
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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, Kevin Foss, MA of the OCD Center of Los Angeles discusses Scrupulosity, in which an individual’s OCD focuses on issues of religion, morals, and ethics. Part one of a four-part series.
Those with Scrupulosity experience profound feelings of guilt and anxiety related to religion, morals, and ethics
One of the first documented references to Obsessive Compulsive Disorder (OCD) was in a 1691 sermon by Bishop John Moore of Norwich in which he discussed men and women who were overwhelmed with unwanted thoughts, and tormented by feelings of guilt and shame over what he described as “religious melancholy.” Priests had started to notice that some churchgoers were attending confession several times a day, and repeatedly confessing to the same sins and shortcomings that they feared would result in divine judgment and eternal damnation. Their penance and absolution would provide only a fleeting glimpse of peace, and then their fears would come roaring back.
In retrospect, we now know that this obsessive religious fervor is a manifestation of OCD known as Scrupulosity. People of various religions across the world are haunted by feelings of doubt, guilt, and anxiety that torment them by attacking that which they find most dear – their faith. Scrupulosity is a form of OCD in which the sufferer’s primary anxiety is the fear of being guilty of religious, moral, or ethical failure. Those afflicted with Scrupulosity fear that their effort to live according to their spiritual values not only isn’t good enough, but is in direct violation of God. › Continue reading
Mindfulness for OCD and Anxiety
Choosing a Different Route on the Anxiety Highway
Mindfulness can greatly enhance traditional
Cognitive Behavioral Therapy (CBT) for the
treatment of OCD and Anxiety
“Mindfulness” seems to be everywhere these days. In the culture at large, mindfulness is becoming a common practice for many as a means to finding basic peace of mind. And in the field of mental health, mindfulness is quickly coming to be seen as a technique that can help relieve symptoms of OCD, anxiety, and other psychological conditions.
After reading the above paragraph, you may be thinking, “Sign me up!” After all, we live in an era of instant gratification, and most of us usually want a quick fix to our problems. But mindfulness is not something one masters overnight. It is a journey that requires effort, commitment, and dedication. While mindfulness may provide relatively rapid relief to one’s distress in certain situations, it is perhaps better conceptualized as a long-term shift in perspective that allows us to better manage the complexity of human psychological experience. Like learning a new language, mindfulness takes time and patience to master, and ongoing effort to remain fluent. › Continue reading
OCD and Thought-Action Fusion
Virtually everybody experiences unwanted thoughts from time to time, for we human beings are not always in charge of what we think. But for sufferers of Obsessive Compulsive Disorder (especially Pure Obsessional OCD), the problem is not just the presence of unwanted thoughts, but also the attention and meaning one gives to them.
OCD and Thought-Action Fusion
Obsessive Compulsive Disorder (OCD) not only produces constant mental noise and endless worry, but also often includes a cognitive process known as thought-action-fusion. The distorted thought at the heart of thought-action-fusion is the irrational assumption that just because a “bad” thought presents itself to your mind, then it is undeniably followed or accompanied by a specific “bad” action. In other words, thinking something makes it so. For some, this fusion is so strong that they believe that their thoughts actually cause actions to occur.
Clients who suffer from thought-action fusion often report intense fear because of their belief that their thoughts will come true. For example, a teenage girl may worry that if she has a thought of a home invasion happening to her family, then the break-in will undoubtedly occur. Or a college student might fear that he will wander out of his dorm room and harm someone without knowing it. If this student is struggling with OCD complicated by thought-action fusion, he might be overcome with a debilitating belief that, because he thinks this thought, then he is almost certainly a sociopath and is likely to act on it. › Continue reading
OCD, Anxiety, and Resistance
The OCD Center of Los Angeles discusses resistance and certainty-seeking in OCD and related anxiety based conditions. Part one of a two-part series.
Resisting our unwanted thoughts, feelings, and sensations is a futile task that is doomed to fail.
When treating clients with Obsessive-Compulsive Disorder (OCD) and other anxiety based conditions, two of the most important topics we discuss are “resistance” and “certainty-seeking”. People suffering with these conditions often have unpleasant and unwanted thoughts, feelings, and bodily sensations, and resistance to these experiences is a normal, natural reaction. Simply put, when faced with something uncomfortable or painful, we humans instinctively resist it, and quickly look for ways to reduce our discomfort through avoidance. But unfortunately, while resistance may internally feel like the correct response to our uncomfortable thoughts, feelings and sensations, it actually serves to inflame them.
For most people, it seems counterintuitive to reduce resistance and allow uncertainty to remain in the face of these uncomfortable internal experiences. Many are likely to think something along the lines of “I must find a way to keep this thought, feeling, or bodily sensation from happening again.” But this philosophy of resistance in regards to our unwanted internal experiences will actually cause them to become more powerful. As illogical as it may seem, oftentimes the best solution is to lower our resistance, surrender, and accept what is being offered.
Harm OCD Treatment – Part 3: Cognitive Restructuring
A discussion of the treatment of Harm OCD using Cognitive Restructuring. Part three of a series.
Cognitive Restructuring can be a valuable part of treating Harm OCD
In our previous installment of this series, we looked at Mindfulness for the treatment of Harm OCD, and how a change in perspective towards unwanted thoughts and feelings can lead to a change in compulsive behaviors. But as many sufferers well know, one’s response to intrusive harm thoughts is frequently automatic. Those with Harm OCD have conditioned themselves to respond to their harm thoughts in a certain way, and very little thinking may go into it.
Mindfulness encourages us not to waste time and energy attending to thoughts and feelings with urgency when those thoughts and feelings could be simply observed and allowed without response. This is not only difficult to do, but requires practice, training, and education that may not always be immediately practical early in treatment. If we must attend to the content of our thoughts directly, we should attempt to do so with as little mental ritual as possible. So we ask the question, “What is it that I am thinking about my thoughts that appears automatic, yet may be voluntary and may be pointing me in the wrong direction?
Cognitive Distortions Commonly Experienced in Harm OCD
The reason why a harm sufferer feels compelled to compulsively analyze, avoid, or otherwise over-respond to harm thoughts is because they are filtering these meaningless little ones and zeroes through distorted lenses that spit them out as unacceptable indictments. These lenses are called cognitive distortions. Here are some examples of common cognitive distortions experienced in Harm OCD: › Continue reading
OCD & Anxiety: Five Common Roadblocks to Successful Treatment
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Cognitive Behavioral Therapy (CBT) is the gold standard for the treatment of OCD and related anxiety based conditions. But some simple mistakes can interfere with treatment. Kimberley Quinlan, MA, of the OCD Center of Los Angeles discusses five common roadblocks to effective treatment for OCD and anxiety.
Avoid these five common roadblocks when undergoing Cognitive Behavioral Therapy (CBT) for OCD and anxiety.
Research has consistently found that the most effective treatment for Obsessive Compulsive Disorder (OCD) and most other anxiety disorders is Cognitive Behavioral Therapy (CBT). The cognitive component of CBT involves investigating and challenging the individual’s irrational thoughts related to their fears. These thoughts are described as “cognitive distortions”, and the process of challenging them is known as “cognitive restructuring”. This process takes place during therapy sessions, and is also practiced by the client between sessions throughout the course of treatment.
The behavioral component of CBT is more time intensive, and requires the client to be gradually, purposefully and systematically exposed to the very thoughts and situations which generate their discomfort, and to do so without responding with either compulsive or avoidant behaviors. This process is known as Exposure and Response Prevention (ERP). › Continue reading
Harm OCD Treatment – Part 2: Mindfulness Based CBT
The OCD Center of Los Angeles discusses treatment of Harm OCD using Mindfulness Based Cognitive Behavioral Therapy. Part two of an ongoing series.
Mindfulness Based CBT is a key component of successful treatment for Harm OCD
In our previous installment of this series, I defined the symptoms of a sub-type of Obsessive Compulsive Disorder (OCD) known as Harm OCD. The defining characteristics of Harm OCD are intrusive thoughts of a harming/violent nature (obsessions), and the behavioral response of engaging in physical and mental strategies (compulsions) in an effort to relieve the inherent discomfort one experiences when having these thoughts. In upcoming articles in this series, we will discuss each of the main elements of Cognitive Behavioral Therapy (CBT) used to treat this form of OCD.
Psychoeducation and the Treatment of Harm OCD
The first step in treating Harm OCD is psychoeducation. Unfortunately, sufferers who are not already well-versed in OCD are likely to approach treatment with extreme apprehension and doubt. This is because the pain of being burdened with unwanted thoughts of causing harm has worn them down to a point that they may genuinely believe it’s possible that a therapist will take one look at them, smile, and call the men in white coats. So before any discussion of treatment can begin, a Harm OCD sufferer has to have a better understanding of the nature of the condition, and why some people are hyper-aware of these types of thoughts, while others appear not to be. › Continue reading
Harm OCD: Symptoms and Treatment – Part 1
"Harm OCD" is a common variant of OCD, and is very treatable with Cognitive Behavioral Therapy (CBT)
Harm OCD is a manifestation of Obsessive Compulsive Disorder (OCD) in which an individual experiences intrusive, unwanted, distressing thoughts of causing harm. These thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.
It is not fair to say that one form of OCD causes more pain than another. In my experience of treating individuals with OCD, those with compulsive hand washing appear to be in no less pain than those who live in fear of being sexual deviants or psychopaths. What sets Harm OCD apart is the way in which it attacks the things we love the most, and does so with such brutality and lack of mercy as to astound even the most creative minds. The moments that we most want to be highlighted by memories of peace and contentment suddenly become contaminated by mental imagery of horrific violence and feelings of relentless guilt. › Continue reading
Orthorexia: Where Eating Disorders Meet OCD – Part 2
Effective Strategies and Predictable Complications in the Treatment of Orthorexia
In our previous article about Orthorexia, we described this relatively unknown and misunderstood condition. In this, the second and final installment in this series, we discuss strategies and pitfalls in the treatment of Orthorexia.
Orthorexia can be effectively treated with Cognitive Behavioral Therapy (CBT) and Mindfulness
Orthorexia, being a somewhat new conceptualization of a psychological disorder, is under-researched and often misunderstood within the mental health and medical communities. Many mental health professionals have found success treating individuals with Orthorexia using evidence-based treatment methods that are used to treat other Eating Disorders, OCD, and related OC Spectrum Disorders.
Cognitive-Behavioral Therapy (CBT) and Mindfulness are two highly effective treatment methods used to treat Orthorexia. Using CBT, individuals with Orthorexia learn to challenge and change their distorted thoughts (cognitions) related to their body and the foods they eat. Education about nutrition and what is considered “healthy” should also be integrated into CBT when treating Orthorexia, using logical, evidence-based strategies. › Continue reading
Casey Anthony, Reasonable Doubt, and OCD
The concept "reasonable doubt" may help some better understand OCD
When most people think of Obsessive Compulsive Disorder (OCD), they think of people excessively washing their hands or repeatedly checking their doors and windows to see if they are locked. But there are many variations of OCD, including a subtype in which people have intrusive, unwanted thoughts about harming spouses, friends, co-workers, strangers, or even their own children. Sometimes called “Harm OCD”, this condition falls under the category of what is commonly called Pure Obsessional OCD, or “Pure O”, because both the obsessions and the compulsions are primarily mental.
People with Harm OCD often perform mental checking rituals just as others with OCD might physically check their stove over and over again in an effort to feel sure that they haven’t accidentally left a burner on. They might repeatedly monitor and analyze their mental processes in an effort to convince themselves that they will not act on their unwanted thoughts, and that their intrinsic character or their love for the other person is strong enough to prevent them from doing some sort of harmful action. They may also repeatedly seek to determine whether they are a bad person for even dreaming up such a thought. And it is quite common for those with harming obsessions to repeatedly ask others for reassurance that they have not harmed someone or that they are not going to do so. But as anyone with Harm OCD knows, these efforts to gain certainty almost never provide the desired reassurance for the OCD sufferer, and the unwanted thoughts almost always increase in frequency and intensity. › Continue reading
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