Laura and I sometimes amuse ourselves by noticing how language and expressions gradually morph over time. For example, have you ever taken note of how often people preface something they’re about to say with the single word, “Look!”? I think in the past, folks used to call attention to what they were about to say with “Listen.” Why the change? Go figure (another one of my favorite phrases).

And then there’s the ever popular “Seriously?…Really?” I like that one a lot. Why? I really don’t know. It just conveys a tone that I like. Perhaps it’s my sarcastic streak. At any rate, I find myself wanting to say “Seriously?….Really?” pretty often when I confront the thoughts that constantly bombard the minds of people who have obsessive compulsive disorder (OCD).

I recently ran across a Behavioral Intervention Plan (BIP) for an elementary school girl. Behavioral Intervention Plans are often a good idea and can be used to teach students to focus better, reduce their oppositionality, follow rules more often, and become more cooperative. These plans usually emphasize positive interventions (such as rewards and attention) although they also employ negative consequences judiciously, when called for.

The original idea behind BIP’s was grounded in something called learning theory. In brief, learning theory proposes that kids will do more of what they are rewarded for and less of what they aren’t. They’re also likely to engage in disruptive behaviors less often if those behaviors result in a loss of something the child likes or if the behavior is followed by a mildly unpleasant consequence.

However, some of the BIP’s that I’ve seen in recent years seem to have lost their original grounding in learning theory. The school girl I mentioned (we’ll call her Nicole) had been failing to follow rules, blurting out inappropriate comments in class, banging her head, arguing with the teacher, and sometimes trying to leave the classroom when she shouldn’t. Here are some relevant snippets from Nicole’s BIP:

People with OCD often hold beliefs that are, well, believable. For example, who doesn’t worry about blurting out something inappropriate (or hitting the send button) without thinking? That’s a typical OCD worry, but it’s also a worry that most people have.

In fact, just today I was quickly doing some email and not paying a lot of attention and ended up sending someone a note with the wrong name. Now, as a perfectionist, I’ll be thinking about that mistake around 3 in the morning.

My email gaff might lead me to change my routine. I might start making sure that when I do email I’m not at the same time thinking about the blog I have to write, or the statement I have to send, or the reservation for the dog groomer I have to make, or the dry cleaning I need to pick up, or the checkbook I need to balance—you see what I mean. To change my routine, I might have to come up with changing the way I do email.

I’ve been thinking I should anyway. Maybe I should start with clearing off my desk before I do email. Then perhaps I should vow to read my email twice before I send it.

What happens to those who have OCD is that their normal, believable thoughts grow. So let’s say I am coming down with a case of OCD. I find that I’m still pretty obsessed with my email mistake. Now, thoughts of not only sending out emails with the wrong name but thoughts of sending inappropriate email are flooding my brain.

Parents worry a lot about their kids nowadays. Life has become more complex and the world seems to deliver a constant stream of unpredictable stressors, challenges, calamities, toxins and traumas. Parents naturally want to help their kids overcome these difficulties and succeed in life. In other words, they want their kids to feel happy, secure, and competent.

So naturally, many parents feel quite upset when they see their kids experiencing distress. At those times, they feel highly motivated to help their kids calm down. To accomplish that goal, these parents will often:

• Explore what may be bothering their kids

• Reassure their kids that everything will be alright

• Hug their kids to help them calm down

• Talk with their kids for as long as it takes to help them feel better

• Find ways of making their kids feel better by giving them things they want (e.g., ice cream, money, etc.)

Generally speaking, one or more of these strategies will, in fact, result in both kids and their parents feeling better. There can’t be any problem with that can there? Well, actually there is.

A couple of days ago, we wrote about exposure. The opposite of exposure is avoidance. We touch on the topic of avoidance fairly often in this blog, but it’s been years since we focused on the topic exclusively.

That’s too long because avoidance is arguably the most important thing for you to understand in order to successfully battle anxiety and OCD, or for that matter, most types of emotional disorders. Humans have an understandable desire to avoid feeling distress, anxiety, sadness, and upsets of all kinds. If you’re like most people, when you experience these feelings, you’ll do almost anything to get rid of them. Common strategies include:

• Abusing substances like drugs or alcohol
• Distraction
• Smoking
• Staying in the house
• Making great efforts to avoid the triggers for your upsets

We have been writing this blog for a few years. When we started, we decided to call the blog Anxiety and OCD Exposed. It’s been a long time since we have discussed why we decided on that title so we thought that new readers might want some explanation.

The term “exposed” may bring up a lot of different thoughts such as:

• Finding out that a politician was cheating on his wife
• Discovering a dumping ground of toxic waste
• The feeling of your hands when you forget to wear gloves in cold weather
• A politician taking opposite positions in the same campaign
• Not noticing the piece of toilet paper stuck to your shoe
• The most effective treatment for anxiety and OCD

Research says that overall the best treatment for anxiety and OCD is a method called exposure. When people are afraid or anxious about something, they tend to avoid it. The more they avoid what they fear, the more fearful they become.

Exposure helps people face their fears in a gradual way. Most people find that after being exposed to their fear or OCD triggers, over a period of time, their anxiety decreases. The goal of exposure is not to eliminate all anxiety, but to make anxiety manageable.

As you no doubt know, bad things happen to good people from time to time. There’s no rhyme or reason for it and it’s not particularly fair, but such things do happen. Sometimes these events are quite awful such as serious traumas or illnesses. And when these things happen out of the blue, people often experience a huge wave of difficult feelings.

Emotions such as great upset, distress, anger, and despair are quite typical and frankly, normal at these times. It’s also pretty typical to find yourself railing about the unfairness of it all and the fact that you don’t deserve what’s happened. When these thoughts and feelings occur, generally the person will take on a new role in life—that of a patient or even a victim. And friends, healthcare providers, therapists, and family generally pick up the appropriate role of helpers.

When people you care about or love have problems with anxiety, the most natural thing in the world is to help. You may find yourself wanting to reassure them that everything will be OK. That sounds good, but in other blogs, we’ve discussed how reassurance can boomerang and easily make things worse. No doubt, we’ll write about how reassurance works in more blogs down the road because people fall into that trap all of the time.

Alternatively, you may want to coach your loved one through the problem. That strategy actually works sometimes, but it’s very tricky and we recommend professional guidance for both yourself and your loved ones if you want to become their coach.

Coaching, like reassurance, can easily backfire, cause arguments, or be perceived as criticism by people you’re trying to help.

No doubt you’ve encountered or even read numerous blogs, articles, and/or books that extoll the virtues of optimism. Some research has shown that optimists tend to have better relationships, happier lives, and greater accomplishments. Some authors suggest that you can never be too optimistic and that, by implication, you should worry if you tend toward the pessimistic side of things.

I suppose I should be concerned about all of this hoopla over optimism. You see, as my wife will readily verify, I rather often take a different approach. It’s something that Dr. Julie Norem calls “defensive pessimism.” Sounds sort of awful doesn’t it? Does this mean that I walk around morose and glum and project nothing but doom and gloom? Not at all.

However, I do frequently imagine “worst case scenarios.” I run various “what if” scenarios through my mind such as:

Most people, who have more anxiety than they want, work hard to rid themselves of their anxiety. They try relaxation training, meditation, medication, and more, all in a desperate attempt to conquer uncomfortable, distressing feelings. And who can blame them? After all, isn’t that the goal of therapy—to rid yourself of anxiety, uncertainty, doubts, and discomfort once and for all?

Well, yes and no. Of course most therapists would love for you to be able to feel calm, relaxed, and peaceful all of the time. However, that goal isn’t possible for anybody. Life is full of unpredictable, often random, dangers, hassles, and perils. Therefore, if you have the goal of eliminating these things, you will almost certainly fail.