In the first installment of this series, 35-year-old old Robert told his story of childhood obsessions, teenage compulsions, and his eventual diagnosis with OCD and Bipolar Disorder at age seventeen. He went on to describe suicide attempts and Electroconvulsive Therapy (ECT), as well as his experience with medication and treatment with Exposure and Response Prevention (ERP). In part 2, we focus on the impact of OCD on the family, as told by Robert’s mom, Lisa. 

OCD in the family

When someone is suffering with OCD, it can have a
profound impact on their entire family.

We didn’t suspect anything was wrong until Rob was about fifteen years old. Suddenly, he wanted to change high schools, and though we weren’t excited about the idea, Rob’s father and I decided that if that was what he really wanted, we would let him go for it.  Unfortunately, the problem came when every day for the entire summer, Rob demanded that we review his list of pros and cons of changing schools. We would work on it tirelessly, come to a mutual decision, and then redo it all the next day because of Rob’s uncertainty. He finally confirmed his decision to go to the other school and they hosted a mental health day. Rob came home with a pamphlet on Obsessive Compulsive Disorder and told me he had it. I replied, “That is for really sick people.” I regret that I didn’t listen.

Read More »

    

The impact of OCD and related anxiety based disorders on the family is often overlooked.  In this multi-part series, we present first-hand accounts of the ongoing impact of OCD, BDD, and Bipolar Disorder on one man and his family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

Life with OCD

Those suffering with OCD need
understanding and treatment

My name is Robert and I have Obsessive-Compulsive Disorder (OCD).  I am a thirty-four year old, single man and work as a personal fitness trainer. My story is not typical, but it is the only one I have . . .

I was four years old when I looked at a picture Bible and saw an image of Satan. My thought was, “Satan is cool!” He wore a red cape and was “ripped!”  My obsession was that, since I thought he was cool, I was evil and I would go to hell. I knew that evil people hurt others, and I was terrified of hurting someone. It never occurred to me to tell my parents. I figured all kids thought this way too, but the other kids just seemed to be “managing” it better than I was. They didn’t appear bothered by the eternal consequences of their actions like I was. They were talking back, swearing, being disrespectful and acting cocky, but weren’t worried about going to hell. I figured that thinking Satan was cool and that I was evil was “normal”, and that I just had to be more laid back and figure out how to worry less.

One day when I was fourteen, I had an intrusive thought that I wasn’t funny. I couldn’t shake it and kept a journal of funny quips so I could be “funny” in social situations. I tried to keep up the compulsion of memorizing stuff from the “funny book” so I wouldn’t be “slow”. I wanted to be quick witted, playful and charming.  The irony is people said I was funny – I just didn’t “feel” like I was.  I fought to I remember “my lines” to get rid of the anxiety. At about the same age, I had the obsession that my penis wasn’t the right size. I was pre-pubescent and a “late bloomer.” When in the locker room at school, I compared the boys’ penises to my dad’s penis and thought, ”Wow! They’re tiny!” I even asked my mom one day, “Does size matter?”

Read More »

    

Orthorexia – The Not-So-Healthy Obsession with “Healthy” Eating

Orthorexia = Eating Disorder + OCD

Individuals suffering with Orthorexia exhibit symptoms
similar to those of OCD and Eating Disorders.

Orthorexia Nervosa (also simply known as Orthorexia) is a relatively new term within the psychological and medical fields. Simply defined, Orthorexia is an eating disorder in which an individual has an excessive and ultimately unhealthy obsession about maintaining a diet that is totally “healthy” and “pure”. Because of their extremely restrictive eating, individuals with Orthorexia are often severely underweight, and frequently lack the proper nourishment to perform basic daily activities. Like most cases involving an eating disorder, the outcome of Orthorexia can be severe malnutrition and a significant reduction of one’s quality of life.

Orthorexia has not yet been accepted as a formal diagnosis by the psychiatric community, and has not been defined within the Diagnostic and Statistical Manual (DSM-IV). However, since first being described by Dr. Steven Bratman in 1996, many health professionals have observed the often debilitating results of this condition. Read More »

    

In part one of this two-part series, we discussed the experience of the Social Anxiety sufferer.  In part two, we examine how to treat this condition with Cognitive Behavioral Therapy (CBT), and how Social Anxiety relates to other Obsessive Compulsive Spectrum Disorders.

Treatment of Social Anxiety

Social Anxiety

Social Anxiety can be successfully treated with
Cognitive Behavioral Therapy (CBT).

The most effective form of treatment for Social Anxiety is the same as in other Obsessive Compulsive Spectrum Disorders – Cognitive Behavioral Therapy (CBT).  This is because, like the other disorders in the spectrum, Social Anxiety involves an obsession and a series of compulsions which form a cycle.

The fundamental obsession in Social Anxiety is the fear of being evaluated negatively.  This generally includes fears of being rejected, as well as the fear of being singled out for humiliation and traumatized by emotional abuse from others.  The primary compulsion in Social Anxiety is the phobic avoidance of social situations in which one fears rejection and/or humiliation (thus its synonym, Social Phobia).

It is tempting to look at avoidance as the absence of engaging in social behavior.  However, avoidance is an overt physical and mental behavior, the primary goal of which is to reduce or eliminate anxiety.  For the individual with Social Anxiety, the act of choosing not to go to the party thus serves the same function as the act of choosing to wash one’s hands serves for the individual with OCD.  Further, those with Social Anxiety who are able to commit to a social interaction may find themselves escaping mentally in the process by spending their energy focusing on things other than the present situation. Read More »

    

Body Dysmorphic Disorder (BDD) is a condition in which one has an obsessive preoccupation with his or her physical appearance. We recently posted two articles about the condition, one on BDD in the media, and the other on BDD in teenagers.  In the final installment of our three part series, we look at recent research related to this condition.

Body Dysmorphic Disorder and How We See Ourselves

BDD - Body Dysmorphic Disorder

Researchers are learning more about
Body Dysmorphic Disorder (BDD).

This past year saw a number of interesting research studies on the topic of body image and Body Dysmorphic Disorder (BDD).  One study surveyed over 2200 men and women of various body types regarding their self-perceptions related to weight and body image.  Those who completed the survey were evaluated for their body-mass index (BMI), a ratio of height to weight that provides a range of numerical values for what could be described as a “healthy weight”.  Participants were also instructed to describe how they perceived their bodies, using a range of terms such as “slim” and “fat”.

The study found that only 13% of the women participants who were evaluated as having a “healthy” weight for their height (BMI) were satisfied with their overall appearance.  More disturbing was the finding that only 6% of these women saw themselves as being “slim”.  Conversely, only 6% of the male participants who were evaluated as having a healthy BMI saw themselves as “fat”.  Furthermore, of the study participants who were actually overweight, twice as many women as men described themselves as being “ashamed” of their bodies.  The most obvious conclusion we can draw from these data is that men and women see themselves in startlingly different ways, and have very different emotional reactions to their weight.

Read More »

    

Increasing numbers of teens are having elective cosmetic surgeries to address body image issues, without fully considering the physical and psychological risks involved. Part two of our three-part series on Body Dysmorphic Disorder (BDD).

BDD - Body Dysmorphic Disorder

Teens are increasingly seeking cosmetic surgery

Our last post focused on Body Dysmorphic Disorder (BDD), body image issues, and cosmetic surgery in the entertainment industry.  While I can appreciate that movie stars and models to some extent depend on their appearance for their livelihoods, I worry about the message that stars’ cosmetic surgeries send to the public, particularly young women who see these stars as role models.  One recent news story focused on the increasing numbers of teens seeking cosmetic surgeries.  The article noted three problematic issues specifically related to this growing trend of teens looking to surgically enhance their bodies:

  • Teens’ bodies are still changing and growing, so having surgeries before their bodies have fully grown is ill-advised;
  • Teens seeking cosmetic surgeries may be suffering from depression and would be better advised to address their feelings about themselves in a non-surgical manner
  • Teens often don’t understand the significant risks involved in having any surgery, including the risk of disfigurement and death.

On this last note, readers should be reminded that people can and do die as a result of complications from what are considered “routine” cosmetic surgeries.  Many will remember the publicity generated by the November 2007 death of Kanye West’s mother from complications related to having a tummy tuck and breast augmentation.  In fact, many people die each year following cosmetic procedures.  One recent study found the mortality rate for those undergoing liposuction was approximately one death for every 5000 patients, while approximately one out of every 350 patients undergoing this supposedly “routine” procedure experienced “significant complications”.

Read More »

    

Heidi Montag

Heidi Montag after recent cosmetic surgeries

Recently, there have been a number of stories in the media that have touched upon the topic of Body Dysmorphic Disorder (BDD).  These stories suggest the unfortunate extent to which women (and a growing number of men) appear to be internalizing extremely distorted ideas of beauty.

Will BDD become known as Heidi Montag Syndrome?

Perhaps the most public illustration of this growing problem is the case of Heidi Montag.  Until a year ago, I had never heard of Heidi Montag, and I still have no idea why she is famous.  Apparently, she is on a reality TV show called “The Hills”, which Stylite blogger Linda Ripoll describes as an “amazing exploration into self-hatred, body dysmorphic disorder, and addiction to plastic surgery”.

And while I have never seen her show, I would have to live in a cave to avoid hearing about the highly publicized cosmetic procedures she has had in recent months, including one day in which she reportedly had the following ten procedures performed at one time:

  • brow lift
  • botox in her brow
  • Revision of previous nose job
  • fat injections in cheeks, nasolabial folds and lips
  • chin reduction
  • liposuction on neck
  • ears pinned back
  • breast augmentation revision
  • liposuction on waist, hips, and thighs
  • buttock augmentation.

Read More »

    

“If I knew then what I know now.”

Chances are, if you’re reading this, you’ve found yourself saying the same thing at some point in your adult life.  Nowhere is this more relevant than from the perspective of someone looking back on a childhood with Obsessive Compulsive Disorder (OCD) or an Obsessive Compulsive Spectrum Disorder.  When I meet a new client under 18, there is a powerful sense of traveling through time.  I think, “If only I had someone like me to go back and talk to me when I was someone like this.” How much time might I have saved being able to resist repetitive, unnecessary rituals?  How many more events, relationships, and simple moments of peace might I have been able to enjoy if only I had known what was really happening to me? Read More »

    

In late 2008, the drug Lumigan, originally developed to treat glaucoma, was approved by the Food and Drug Administration (FDA) to be prescribed as an eyelash enhancer.  It seems that one of the side effects of the glaucoma drug, now called Latisse when marketed for eyelash enhancement, is eyelash growth.  According to a recent article in the Los Angeles Times, Latisse is being prescribed by dermatologists, plastic surgeons, and day spa physicians to women who want to increase the length and fullness of their lashes.

Is this a good thing?  One of the most common issues we see in our clients with Body Dysmorphic Disorder (BDD) is excessive focus on the appearance of their eyes, including their eyelashes.  Latisse plays right into this common BDD concern. Read More »

    

There have long been rumblings that the American Psychiatric Association (APA) was undertaking a thorough review of its Diagnostic and Statistical Manual, Fourth Edition (DSM-IV).  The ostensible goal of such a review would be to create a more accurate and in-depth edition of the DSM, which was last updated in 1994.

After ten years of ongoing debate, the numerous APA work groups investigating potential revisions to various diagnoses and categories to be included in a planned fifth edition have presented their suggestions to the APA.  Some of these changes are likely to be as controversial as current classifications in the DSM-IV, while others will pass barely noticed into the new DSM-5 (for example, the switch away from Roman numerals in the title).  A number of these proposed changes directly impact conditions treated here at the OCD Center of Los Angeles.  To wit: Read More »

  • HOCD: 30 Things You Need To Know

    HOCD is a type of OCD in which the individual obsesses about their sexual orientation. Here are 30 things you should know about HOCD. From the OCD Center of Los Angeles.

  • Doubt, Denial and OCD

    A discussion of “The Denial Obsession” in OCD, in which sufferers obsess that they don’t really have OCD, but are merely “in denial”. By Lauren McMeikan, MA, and Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • Dermatillomania: A Skin Picker’s Guide to the Dermatologist

    How one woman with Dermatillomania finally opened up to her dermatologist about her longtime struggle with skin picking.

  • Imaginal Exposure for OCD and Anxiety

    Imaginal exposure for the treatment of OCD and anxiety is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles.

  • ROCD: Relationship OCD and The Myth of “The One”

    ROCD (Relationship OCD) is an often misunderstood variant of OCD. By Sheva Rajaee, MMFT and Tom Corboy, MFT of the OCD Center of Los Angeles.

  • Moral Scrupulosity in OCD: Cognitive Distortions

    Cognitive distortions are common in the Moral Scrupulosity subtype of OCD. Part three of a multi-part series.

  • OCD in the Family

    One mom’s story of her son’s battle with OCD and its profound impact on their family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity in OCD: Cognitive Distortions

    A discussion of cognitive distortions in the religious Scrupulosity subtype of OCD. Part two of a multi-part series.

  • OCD and Eating Disorders

    Diagnostic similarities and differences between OCD and eating disorders are discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment With ERP

    Harm OCD treatment using Exposure and Response Prevention (ERP) is discussed by Tom Corboy, MFT, Executive Director of the OCD Center of Los Angeles .

  • My Life with OCD

    The impact of OCD and related anxiety based disorders on the family is often overlooked. In this multi-part series, we present first-hand accounts of the ongoing impact of OCD, BDD, and Bipolar Disorder on one man and his family, as told to Elizabeth Kassel, MSW, of the OCD Center of Los Angeles.

  • Scrupulosity: Where OCD Meets Religion, Faith, and Belief

    The Scrupulosity sub-type of OCD is discussed by Kevin Foss, MFT, of the OCD Center of Los Angeles. Part one of a four part series.

  • Mindfulness for OCD and Anxiety

    Using mindfulness to enhance traditional CBT for OCD and anxiety is discussed by Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Hoarding, Cluttering, and Compulsive Shopping: My Childhood Story

    One woman’s story of her life as the child of multiple generations of hoarders.

  • OCD and Thought-Action Fusion

    Thought-Action-Fusion is a frequent problem for those with OCD. This issue is discussed by Laura Yocum, MFT, of the OCD Center of Los Angeles.

  • OCD, Anxiety, and Resistance

    Resistance and acceptance in OCD and related disorders is discussed by the OCD Center of Los Angeles.

  • Harm OCD Treatment: Cognitive Restructuring

    Harm OCD is often misunderstood, but it can be effectively treated using an integrated treatment plan that includes Cognitive Restructuring. Part three of our ongoing series that explores “Harm OCD” and its treatment .

  • OCD & Anxiety: Five Common Roadblocks to Treatment

    Learn the five common mistakes that interfere with successful treatment of OCD and anxiety. By Kimberley Quinlan, MFT, Clinical Director of the OCD Center of Los Angeles.

  • Harm OCD Treatment: Mindfulness Based CBT

    Harm OCD is an often misunderstood condition that can be effectively treated using Mindfulness integrated with CBT. Part two of a multi-part series from the OCD Center of Los Angeles.

  • Dermatillomania / Skin Picking Disorder Treatment

    Treatment of Dermatillomania (Skin Picking Disorder) with CBT. Part two of a series from the OCD Center of Los Angeles.

 

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