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Obsessive-Compulsive Spectrum Disorders

In addition to Obsessive Compulsive Disorder (OCD), there are a variety of conditions that have obsessive-compulsive characteristics that are quite similar. At Willow Anxiety and OCD, we are experts in the treatment of OCD and OC Spectrum Disorders, offering you evidence-based therapies that successfully alleviate the symptoms. You’ll learn skills and techniques to manage your own symptoms and to use if and when symptoms return. 

We treat the following OC Spectrum Disorders -

Obsessive Compulsive Disorder (OCD)

All of us have random thoughts pop in our heads. Some of the thoughts may seem scary, anxiety-provoking, funny, painful, sad, and so on.  An OCD sufferer continues to have scary or anxiety-provoking thoughts pop in their heads. Moreover, you may feel the need to get rid of the anxiety and the thoughts, figure out why you’re having the thoughts, or engage in some behaviors to get certainty that what you fear will not happen. In the long run, no amount of reassurance or compulsions will get rid of the anxiety and the thoughts. Being stuck in this cycle is OCD. The diagram below illustrates the OCD cycle. 

Model for OCD is maintained

Some common symptoms are:

Having thoughts, images, or impulses pop in your head that you can’t seem to get rid of, i.e. obsessions

The obsessions don’t make sense or you wish you could get rid of them

The obsessions lead to heightened anxiety

You feel the need to engage in a behavior or mental reassurance to get rid of the obsessions or anxiety, i.e. compulsions; you crave certainty

Your anxiety may go down momentarily after engaging in the compulsions but the obsessions come back

Your OCD may jump from one theme to the other

OCD is only limited by a person's imagination. Below are some common themes in OCD, not a comprehensive list - 

Contamination OCD

Fear of germs, getting sick, making others sick, death

How we can help:
Exposure and Response Prevention (ERP) Treatment for OCD

Know that you’re not alone and you’re not crazy. There’s treatment and so there’s hope! We’re experts at treating all forms of OCD. ERP is the gold standard for treating OCD. We work on gradually and gently exposing you to thoughts, situations, and impulses that make you anxious and then we work on tools to help you refrain from ritualizing. Our goal is to teach you to accept uncertainty. In the process, you’re going to learn acceptance of having OCD, the anxiety that comes with it, and having the obsessions that you may believe are horrible. You will learn to stop ritualizing and deal with the obsessions and the anxiety more effectively. This may sound scary and overwhelming but we will work collaboratively towards progress. This process is going to help you reclaim your life and live according to your goals and values!


Acceptance about having OCD and the specific obsessions

Exposure And Response Prevention

Exposure to feared situations and thoughts; refraining from engaging in rituals. Learning alternative strategies

Uncertainty Tolerance

Learning to live with uncertainty which is at the crux of OCD

Body Dysmorphic Disorder (BDD)

Many people may feel uncomfortable about certain aspects of their appearance. However, if you’re overly focused on certain flaws and it gets in the way of living a well-adjusted life, you may be suffering from BDD. Some common symptoms are:


Discomfort about certain aspects of your appearance or body parts

Avoidance of people, places, or situations

Feeling deformed or ugly

Excessive focus on muscles and weight, especially in men

Certain rituals to cover up or camouflage the defects/perceived defects

Lack of self compassion

How We Can Help:
Cognitive Behavioral Treatment for Body Dysmorphic Disorder

We use Cognitive Behavioral Therapy (CBT) to teach you how to change your self-defeating thoughts and beliefs. The behavioral piece of treatment focuses on gently and gradually exposing you to situations that you tend to avoid. We will also work on how to look at yourself and the environment as a whole instead of just the flaws. We will work on deeper self-esteem related issues so you can start gaining more self-confidence and self-compassion. 

Cognitive Tools

Changing how you think about your thoughts and beliefs about aspects of your appearance 

Behavioral Tools

Exposure to situations that are avoided and not engaging in the usual rituals

Self Compassion

Developing a capacity for self compassion


Some common areas for picking, pulling, and biting are – scalp, face, back, neck, arms, thighs, legs, pubic area, eye lashes, eyebrows, nails, toes. These habits can create guilt, shame, hiding, and isolation.

Body-Focused Repetitive Behaviors (BFRBs), i.e. Skin Picking, Hair Pulling, Nail Biting

A habit of picking at your skin, at scabs, at pimples

A habit of pulling out your hair

A habit of biting your nails and cuticles till they bleed

Realizing you are engaging in these behaviors after damage has been done and you find it difficult to stop

Engaging in these behaviors when you feel anxious, stressed, or bored

You have made many attempts to stop the behaviors but have failed

How We Can Help:
Treatment – COMB Model And Habit Reversal Training

We use a behavioral approach to address the body focused repetitive behaviors. We spend some time to understand when and why you’re engaging in these behaviors. And then we work on tailor-made strategies to help you stop picking, pulling, or biting. These strategies come from a deeper understanding of what is maintaining the behavior.


Analysis to understand the following – your thoughts, feelings, where you engage in these behaviors, certain body positions that may make it easier to engage in the behaviors, sensations that are satisfied

Behavioral Tools

Following the analysis, we will work on behavioral tools to address the triggers

Self Compassion

Developing a capacity for self compassion

Tics and Tourette Syndrome

A tic is a sudden, repetitive movement or sound that can be hard to control. Tics typically appear in young children and tend to increase in frequency and severity into adolescence. There are three types of Tic Disorders - Tourette Syndrome (TS), Persistent (Chronic) Motor or Vocal Tic Disorder, and Provisional Tic Disorder. Most individuals with TS improve by late adolescence, and some become tic-free. You or your child may have a tic disorder if you or they are experiencing the following symptoms:


Sudden, involuntary, repetitive movement or vocalization that can be difficult to control

Simple motor tics include but are not limited to blinking, facial grimacing, jaw movements, bobbing, or jerking. Complex motor tics involving multiple muscle groups or combinations of movements

Simple Vocal tics include but are not limited to sniffing, throat clearing, grunting, or shouting. Complex vocal tics involving words or phrases that may or may not be recognizable and consistently occur out of context

Habit Reversal Training for Tics

We use Habit Reversal Training (HRT), an evidence-based treatment for tics. Treatment involves 1) awareness training to help differentiate the signs that precede a tic behavior, 2) competing response training to develop a competing response - an incompatible action intended to replace the tic behavior, 3) establishing social supports to prompt, reinforce, and praise the use of a competing response.

Awareness Training

Develop greater attention to tics and other behaviors to gain better self-control

Competing Response

Develop a competing response to replace old tic behaviors with

Social Support

Identify and establish social supports to reinforce and prompt the use of a competing response

International OCD Foundation

Anxiety and Depression Association of America


Association for Behavioral and Cognitive Therapies

Freedom from Obsessive Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty, Updated Edition by Jonathan Grayson, PhD

Phillips KA. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford: Oxford University Press, 200 


Wilhelm S. Feeling Good about the Way You Look: A Program for Overcoming Body Image Problems. New York: Guilford Press, 2006.

The TLC Foundation for Body-Focused Repetitive Behaviors

Skin Pick

Tourette Association of America

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