Comments on
Avoiding Avoidance

Real estate agents are fond of saying that their field can be distilled into three words: location, location, location. When it comes to anxiety and obsessive compulsive disorder (OCD), we turn to three words to capture much of the problem as well: avoidance,

12 thoughts on “Avoiding Avoidance

  • April 8, 2009 at 1:57 pm

    A friend of mine has a considerable anxiety of being touched or hugged, and displays characteristics of somebody with OCD. Would you recommend ERP? What do you think is the root of the problem?

  • April 8, 2009 at 3:33 pm

    Unfortunately, I can’t diagnose via the Internet. And the root of the problem is always highly speculative because OCD can be due to a mix of factors including genes, learning, trauma, biology, and environment. The great news is that it’s not usually critical to understand the roots in order to treat OCD (one exception can be when infection causes OCD–antibiotics may cure it in those cases).

    Typically, ERP is the most effective approach. There are some other strategies including specifically tailored cognitive therapy and medication. But for most people, ERP is a great way to start. Any individual case should be assessed by someone who is experienced in treating and assessing OCD. Treatment usually works very well.

  • April 9, 2009 at 7:23 am

    Anxiety is huge for many people; OCD takes it to another level.

    ERP has shown itself to be effective and isn’t that the good news. Encouraging those who suffer with high anxiety to realize that they are not alone takes the sting out of a diagnosis, particularly if the condition is OCD.

    We all need the playing field to feel level. Certainly life challenges us all.

    Mary Jane Hurley Brant, M.S., CGP
    Author of When Every Day Matters:
    A Mother’s Memoir on Love, Loss and
    Life, Simple Abundance Press, Oct. 1, 08
    Foreign Rights St. Paul’s and Better
    Yourself Books, Mumbai, India, Jan. 21, 09

  • April 18, 2009 at 8:06 am

    More than ERP ( Exposure response prevention ) very often we see patients with OCD symptoms are being encourged indirectly or directly to go for more and more repeated exposure. Example some one with recurrent thougts about his/her own illness repeatedly go to different medical and surgical specialities.The exposure and negative reply from the physicain each time give relief to the pateint. The stigma of meeting the mental health professional is protected.The symptoms of OCD continues or worsens. Like to hear comments and responses

  • April 19, 2009 at 8:28 am

    @Dr.S.D. SINGH I don’t think you’re talking about the same kind of exposure that we are referring to in our blogs. What you seem to be raising is the issue of reassurance seeking that we discuss in our April 13 blog on “When Caring Backfires on Parents: The Reassurance Trap.” You are correct that when patients seek reassurance from their health care providers,their obsessional worries tend to worsen due to the reinforcement they get from the relief of their worry.

    Exposure, on the other hand, is a guided method of exposing clients to their obsessional concerns for a prolonged time without giving reassurance or any other kind of relief through engaging in a compulsive behavior. Slowly over time, the obsessions and compulsions extinguish.

  • April 22, 2009 at 7:24 am

    Yes, I agree if the objective of the exposure is expalined and acceptable to the clinet with no negative or positve reaasrances, there is a good possibility of self learning and the symptoms improves over a period of time

  • January 30, 2010 at 5:17 am

    useful and to the point, thanks

  • September 19, 2011 at 12:33 pm

    I have Post Traumatic Stress Disorder and can totally relate to your article. I live in this little bubble where I feel safe and avoid circumstances which make me feel anxious. Through the help of my psychiatrist, I am slowly learning to expand my bubble. It’s all about taking baby-steps and taking one thing at a time to tackle. Once you overcome one thing, you gain strength to overcome the next. Thank you!

  • October 26, 2011 at 3:39 pm

    It always amazes me that so many therapists still do not realize that ERP Therapy is the therapy of choice for treating OCD……and it works! Thanks for the reminder.

  • May 18, 2014 at 1:14 am

    I am desperate. There is no other case I know as my son. No one can help us. He cannot tolerate music. ANY music, period! Complete music AVOIDANCE. Quiet, loud, soothing, if there is music, he runs away from it (he is a teenager). I beg every restaurant to turn it off, every store, we come at slow times, and because of his autism, they usually turn it off, but it’s a struggle, and they are not happy. In a car it is always quiet, no radio. Talking is fine. Earplugs and headphones are not an option, I think it is his sensory disorder. Same for smells, very few foods he eats and so on. But music he HATED at school and got so sick, eventually I took him to a doctor, and doctor excused him from it. When watching TV, he fast forwards any song or music. When in public place kids have their iPads with games and it has music, I have to ask them to turn it down, so my son can’t hear it. He runs away from any place with music. My life is a living hell, calling places and begging to find a way to have music off. This is a psychological block, music is very disturbing to his brain somehow. But how to fix it, I don’t even know….


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