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.
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We treat the following OC Spectrum Disorders -
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Body-Focused Repetitive Behaviors (BFRBs)
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Trichotillomania (Hair Pulling Disorder)​
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Dermatillomania (Skin Picking Disorder)
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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.
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 -
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
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
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
Resources
International OCD Foundation
https://iocdf.org/
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Anxiety and Depression Association of America
Association for Behavioral and Cognitive Therapies
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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.
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The TLC Foundation for Body-Focused Repetitive Behaviors
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Skin Pick
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Tourette Association of America