Okay, but how?
ERP
Exposure and Response Prevention
OCD and its cousins aren’t easy, but those of us with these conditions are also incredibly lucky that there’s a treatment for us that works extremely well. We’re 6 decades into using ERP for OCD (a century into exposure therapy for anxiety!) and it’s helped a wild number of people get better, myself included. Join the dark side!
HRT/ComB
Habit Reversal Training / Comprehensive Behavioral Model of Treatment
With body-focused repetitive behaviors or BFRBs (skin-picking, hair-pulling, cheek- biting, etc.), people often describe themselves as “lacking willpower,” much like folks dealing with addictions. Many other therapy approaches can be so lovely, but unfortunately ineffective for this condition. HRT/ComB is similar to ERP but is just for BFRBs, and helps you methodically train yourself out of those maddening behaviors. No more white-knuckling.
CBT
Cognitive Behavioral Therapy
CBT is a rich collection of therapy techniques with tons of practical applications and an excellent research basis. I pull from the CBT pile as needed, especially with 1) misophonia and 2) problem-solving tricky situations or relationships that impact your anxiety apart from your diagnosed condition (e.g., your boss, your mom, your partner, your president). Fun fact: ERP is actually under the CBT umbrella! Two for one!
Fascinating, tell me more!
The Consult Call: In a snappy 20 minutes, you give me a sprinkling of information - where you are now vs. where you’d like to be. I give you some information - how you get from A to B. We ask each other questions. There is usually some laughing, and sometimes crying - totally cool. At the end of the call, if you want to proceed, I send you intake forms. If either of us thinks you would be better served by a provider with a different specialty, we will discuss that and I will send you referrals.
The Assessment: We spend the very beginning of treatment collecting data points until we both understand the exact tricky cycle of situations-thoughts-feelings-behaviors that has you feeling so stuck. Most importantly, we want to identify the exact feared outcomes you have been working so hard to prevent - the rationale for all the compulsive “just in case” behaviors.
The Response Prevention: Once we have the information we need, it’s time for fun new skills! We practice mindfully acknowledging fears and urges and letting them pass WITHOUT compulsions (including the ones you do in your head - mostly they are some version of painful and inefficient decision-making), all in a manner consistent with exposure and response prevention (ERP) best practices. Fortunately for you, while there are surface similarities, the technique is far more effective and far easier than the torturous white-knuckling you have been doing at home.
The Exposures: We design challenging-but-doable exposure exercises so you can practice your sweet new ERP skills in response to your triggers. We practice together in session and you practice on your own for a few minutes a day. After enough high-quality exposures in a relatively short space of time, it dawns on your brain that your feared outcomes are super unlikely, so the fear response goes down when you encounter your triggers. The urges to engage in compulsions go down too, because your brain is no longer trying to gear up to deal with a major threat.
The End: You finally get to relax and live your best life, yay! Feel free to stay in therapy if there are other things you would like to work on, drop in here and there as stuff comes up, or ride off into the sunset like the rockstar you always were.
WHAT’S THE PROCESS?
Schedule a free 20-minute phone consult!
And if you cry on the call that’s fine
