Should OCD Therapists Participate in Exposures?

I've written a lot about exposure and response prevention (ERP) therapy and how to evaluate your therapist. I've said that many good therapists will tell you,“I won’t ask you to do anything I wouldn’t do myself.”

But do these therapists actually go ahead and do these things? Do they, or should they, participate in exposures with you?

In my son Dan's case, as far as I know, his therapist at his residential treatment program worked on creating a hierarchy with him, but never directly participated in any exposures. The same is true for Dan's later therapist whom he connected with after residential treatment. Perhaps this was due to the fact that Dan was 100% committed to ERP therapy and didn't need that type of encouragement. I'm not really sure. There are those, however, who struggle more with ERP and could use all the help they can get.

I have heard from parents who were frustrated because their children were at residential treatment programs, yet refused to participate fully in ERP therapy. One mom described how her daughter just stared out of the window all day because she couldn't tackle her exposures. "Why couldn't a therapist have done them with her, at least in the beginning?" this mom wanted to know. She felt that would have been especially helpful for her child. Instead, time and money were wasted, and her daughter returned home with the same severe obsessive-compulsive disorder she went in with.

Coping Strategies

Gung-Ho About Exposure and Response Prevention Therapy?

It's not uncommon for those with obsessive-compulsive disorder to experience recovery avoidance. Fighting OCD is tough to say the least, and it takes a lot of strength and courage to embrace exposure and response prevention (ERP) therapy.
But what if the opposite happens? What if you have been plagued by OCD for years and have not only just received a proper diagnosis but have also been informed that this disorder you didn't even know you had is treatable. You can get your life back! You hear about ERP therapy and are raring to go! The sooner you can get rid of OCD the better.

Coping Strategies

Do I Really Have OCD?

As many of us know, doubt is the driving force behind obsessive-compulsive disorder. Compulsions are performed to make sure nothing terrible will happen. The problem, of course, is that certainty is unattainable, so when OCD asks the question "Are you 100% sure?" the answer is always "No." With this answer comes the need for more compulsions and the vicious cycle of OCD begins.

If you have OCD,  you know that this doubt can infiltrate all areas of your life. It makes you question your morals, your intentions, and even your relationships with those you love the most. It makes you question everything.

So it's not really surprising that at some point along the way, many people with OCD will even question the validity of their diagnosis - the legitimacy of their disorder:

Do I really have OCD?

Coping Strategies

OCD and Concentration

When my son Dan's OCD was severe, he seemed distracted most of the time. When I'd try to have a conversation with him, he'd either look right through me, oblivious to what I was saying, or he'd stare into the distance, as if he was daydreaming.
I'd get frustrated with him and sometimes lose my patience. "Dan, will you please pay attention?"
What I didn't realize at the time was that Dan was paying attention. In fact he was paying very close attention - just not to me. His focus was one hundred percent on his obsessive-compulsive disorder.


Deep Brain Stimulation for OCD – Taking It To The Next Level

As we know, exposure and response prevention (ERP) therapy is the front line psychological treatment for OCD. Many people are also helped by medication.

While I've written before about confusion surrounding treatment resistant OCD, the fact remains that there are people with obsessive-compulsive disorder who are not helped by ERP therapy or medication.

Is there any hope for recovery from OCD for these people?


OCD Awareness Week

October 9-15, 2016 is OCD Awareness Week and this time in October always holds a special meaning for me. It was during this week in 2010 that I “officially” became an advocate for OCD awareness. Prior to this time, I had connected by telephone with several friends of friends who had children suffering from OCD.  Through these phone calls, I came to realize that what these parents who sought me out needed most was not my opinion on certain doctors, medications, or treatments (though all these can be helpful), but HOPE. They wanted to hear that their children would be okay. I reassured them the best way I knew how, by telling them our family’s story. Yes, our son Dan had obsessive-compulsive disorder so severe he could not even eat. Yes, at his worst he was self-injuring and was "borderline psychotic." And yes, he has recovered. At the time of these phone calls, he had returned to college and was doing really well. I could sense the relief at the other end of the telephone as these parents took in everything I was saying.

So I knew it was helpful to share Dan’s story, and though I was always more than willing to speak to any referrals that came my way my advocacy ended there.

Until OCD Awareness Week, 2010.

I was glued to my computer, watching the live-streamed video of “An Evening of Stories,” which included courageous first-person and family member accounts of what it is like to live with OCD. Simultaneously, there were chat rooms open where people could converse with one another. I had never participated in anything like this before but decided to jump right in. At one point during the chat, I connected with a distraught young woman who had been seeing a therapist for quite some time, but her OCD was getting worse, not better.

“Is the ERP Therapy too difficult for you to do?” I typed.

“ERP Therapy?” she responded. “What’s that?”

This was my light-bulb moment, and in that minute an advocate for OCD awareness was born. Even though our family had fought our way through a disorienting maze of treatments and programs desperately trying to find the right help for Dan, I always assumed we’d had a string of bad luck. I never realized so many others who had OCD  were not receiving the proper treatment. I had no choice. I needed to spread the word that OCD, no matter how severe, is treatable, and exposure and response (ERP) prevention therapy is the front line treatment recommended by the American Psychological Association.

Six years and one book later, I am still working as hard as I can to spread the word about OCD and its proper treatment. I am beyond thankful that my son continues to thrive. Today he is a college graduate working in his chosen field and living with his girlfriend.

Anyone whose life has been touched by OCD knows it can be a devastating disorder. But it is also treatable. If you have OCD and have not pursued proper treatment, please don't wait any longer. With treatment, you can live the life you choose for yourself, not the life OCD chooses for you.

Coping Strategies

OCD, Motivation, and Self-Efficacy


Whether we have obsessive-compulsive disorder or not, I think most of us can relate to lacking motivation at times. We are tired, it's just easier "not to______"(fill in your own blank), we are going to fail anyway, we don't see the point. We just aren't motivated to do what we need to do.

In the context of OCD, motivation is likely one of the most deciding factors in overcoming the disorder. Asking for help isn't always easy, and ERP therapy is hard work. If you're not motivated, you're unlikely to be successful, and OCD will continue to rule your life. I've written before about recovery avoidance and the role incentives and motivation play in fighting OCD.

In this wonderful blog post (which I highly recommend) titled Self-Efficacy: Turning Doubt into Drive, Anna Cutteridge discusses how those who possess self-efficacy are more likely to be self-motivated in the face of a challenge. She says:

With high self-efficacy, one can attempt goals and conquer stress more readily, and as a result, experience better wellbeing. On the contrary, those who have doubts about their own abilities ruminate on personal flaws, slacken efforts and lose faith in the face of failure – a mind-set that in the long run can act as a brake on one’s ambitions and increase proneness to mental illness.


OCD – Where Does It Come From?

When my son Dan was first diagnosed (at age seventeen) with obsessive-compulsive disorder, I wanted to learn everything I could about the illness. I also wanted to figure out why my son developed it. How did he "get" OCD? Is it genetic? Did something trigger its appearance? Was it my fault? Why him and not me?

I remember asking his various treatment providers at the time if a particular event could have triggered Dan's OCD. Three different health-care providers responded with a resounding, "No."

I wasn't convinced. In my mind, OCD made its entrance shortly after a


OCD Studies, Projects, and Hope

There are many people and organizations that work tirelessly, every day of the year, to help those with obsessive-compulsive disorder. Below are a few examples of studies and projects happening now. Please check them out as there might be something that could directly benefit you or a loved one.

Coping Strategies

Anxiety – Avoid or Accept?

According to the Anxiety and Depression Association of America, 40 million adults in the United States over the age of 18 suffer from an anxiety disorder, making it the most common brain disorder in our country.

Who among us hasn’t dealt with anxiety? While experiencing anxiety certainly doesn’t mean we have an anxiety disorder, most of us know what anxiety feels like. Symptoms vary, but often include sweating, racing or unwanted thoughts, palpitations, and a sense of impending doom. Some people think they’re having a heart attack or might actually believe they are dying. It’s a truly horrible sensation and many of us will do whatever we can to avoid feeling anxious.

Maybe that’s the problem.