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Q&A: Online Therapy for OCD, Anxiety and Related Conditions

OCD Center of Los Angeles April 16, 2020 10:28 am 12 Comments

An interview with Tom Corboy, MFT, of the OCD Center of Los Angeles, about online, webcam-based therapy for the treatment of OCD, anxiety, and related conditions.

Online therapy for OCD and anxiety — Online Therapy is an effective and convenient option
for the treatment of OCD, anxiety & related conditions

What is online therapy and how is it done?

Online therapy is just therapy conducted over the internet via webcam. It is exactly the same as face-to-face treatment that occurs in a therapist’s office, with the only significant difference being that the therapy occurs over the internet.

Our online treatment program focuses on Cognitive-Behavioral Therapy (CBT), which has consistently and repeatedly been found by researchers to be the most effective treatment for all forms of OCD and for most related conditions.

CBT is particularly well-suited to being conducted online because it uses a structured treatment protocol that is easily adapted to online treatment. Our program uses two structured treatment manuals that every client receives, and which are central to therapy. Conversely, psychoanalysis and other forms of traditional talk therapy focus on largely unstructured treatment approaches that are not conducive to online treatment.

Besides OCD, what other conditions does the OCD Center treat with online therapy?

We treat a number of conditions that are related to, or similar to OCD. These conditions have obsessive-compulsive qualities that are quite similar to OCD, and are frequently described as Obsessive-Compulsive Spectrum Disorders. Some of the other conditions we treat include Phobias, Social Anxiety, Health Anxiety, and Body Focused Repetitive Behaviors (BFRBs) such as Dermatillomania (compulsive skin picking) and Trichotillomania (compulsive Hair pulling).

Is online CBT effective for OCD and these other conditions?

There have been scores of studies on online therapy, and they have consistently found this approach to treatment to be just as effective as in-person treatment. One study even found online treatment to be more effective, mostly because the treatment was viewed by study participants as being easier to access than in-person treatment, and so they were less likely to discontinue treatment.

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Making Peace with Uncertainty: Living in the Midst of a Pandemic

OCD Center of Los Angeles April 6, 2020 3:13 pm 23 Comments

How can we use what we know about uncertainty and anxiety to support those who find themselves understandably anxious about COVID-19 and all of the fallout surrounding it?

Making Peace With Uncertainty-Living Amidst a Pandemic — We can’t eliminate uncertainty, but we can
learn to relate to it in a more productive manner.

I cannot count how many times over the last few weeks I have either said or heard the phrase “These are unprecedented times” – and they are. Granted I’ve only spent 34 years on this globe, but in that time my government has never before instructed me to limit time outside of my home or weighed in at all with regard to my proximity to strangers. I’ve never purposefully distanced myself from my parents over concerns for their safety. I’ve never seen so many empty shelves in stores, and if you’d told me on New Year’s Day I’d be wearing a mask on a routine shopping trip, I would have been perplexed to say the least. We each have our own lists of news and firsts, ranging from the strange to the devastating. This novel coronavirus brings with it a great many novel experiences.

What seems to be at the forefront during this strange moment are predictions. Some of these predictions are necessary – how many people will be infected and will we have hospital space to care for them all? How can we prevent the spread of this disease? How many jobs have been, and will continue to be, impacted? How can we support those who are without income?

We have some ideas and some answers, all of which are important as we attempt to save lives, maintain our medical system and support those who’ve lost income. All this said, the common thread that binds us all in this uncharted territory is uncertainty. We can’t know the answers. As each day unfolds it is increasingly clear just how uncertain the world is.

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My Journey to Becoming an OCD Specialist

OCD Center of Los Angeles September 30, 2019 12:55 pm 10 Comments

Debra Dalton Stein, MFT, of the OCD Center of Los Angeles describes her journey as a psychotherapist from working primarily with eating disorders, to becoming an OCD specialist.

Debra Dalton Stein, MFT, of the Santa Barbara branch of the OCD Center of Los Angeles — Debra Dalton Stein, MFT, of the Santa Barbara
branch of the OCD Center of Los Angeles

One of the greatest barriers to effective therapy for Obsessive Compulsive Disorder (OCD) is the lack of mental health treatment providers trained in the treatment of this condition. Most graduate school programs provide a broad overview of the counseling process, without offering much in the way of specialized training for specific conditions such as OCD. As a result, most psychotherapists have a limited understanding of OCD and its appropriate treatment.

Prior to 2013, like so many other therapists, I didn’t know a lot about OCD or its treatment. I was aware that people with OCD had compulsions such as excessive hand washing, and checking doors and stove knobs, but that was about it. Up until that point, I had spent much of my career – over 20 years – working at various treatment programs that focused on other diagnoses, and specializing in the treatment of eating disorders in my private practice. I’d had an eating disorder myself in my 20s, and like all eating disorders, it was a nightmare. And just like so many people struggling with OCD, I found it extremely difficult to find appropriate help (that is, once I finally gave up trying to do it myself). (more…)

OCD vs. GAD and How to Tell the Difference

OCD Center of Los Angeles July 10, 2019 12:44 pm 28 Comments

People struggling with Obsessive Compulsive Disorder (OCD) are often misdiagnosed as having other psychological conditions. One of the most common misdiagnoses for this population is Generalized Anxiety Disorder (GAD). This diagnostic problem arises for two reasons. First, the distinction between OCD and GAD is somewhat vague. And second, many treatment providers have only a limited understanding of the varying ways in which OCD can manifest. While this issue may seem like an esoteric concern to some, making a proper diagnosis is important for those struggling with either condition, as the primary treatment for OCD is different than the treatment for GAD.

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Pure O 101

OCD Center of Los Angeles May 30, 2019 7:26 pm 86 Comments

Everybody experiences unwanted thoughts from time to time, but people with Pure Obsessional OCD (aka, “Pure O”) often feel completely overwhelmed by intrusive, distressing thoughts. Tom Corboy, MFT of the OCD Center of Los Angeles discusses Pure O and its many permutations.

When most people think of OCD (if they think of OCD at all), they think of obvious compulsive behaviors such as repeated hand washing or door checking. This is likely because they have seen television news reports about OCD that focus on these sorts of overt compulsive behaviors. Or perhaps they’ve seen films like The Aviator or As Good As It Gets or Matchstick Men that showcase characters doing these or similar compulsive behaviors.

But these obvious compulsions are really just the tip of the OCD iceberg. Many people with OCD exhibit few, if any, of these outwardly observable compulsions. Based on my 25 years of experience specializing in the treatment of OCD, I posit that the great majority of people with this condition actually struggle with what is colloquially known as Pure Obsessional OCD, or “Pure O”, in which their behavioral symptoms are more subtle, and often unrecognized as “compulsions” by anyone, including themselves. In fact, the great majority of calls we receive at the OCD Center of Los Angeles are from people who are struggling with Pure O. Which begs the question…just what exactly is Pure O? (more…)

Excoriation (Skin Picking) Disorder, aka Dermatillomania

OCD Center of Los Angeles April 6, 2018 2:07 pm 78 Comments

Excoriation (Skin Picking) Disorder is an obsessive-compulsive spectrum condition in which sufferers repeatedly pick at their skin. Crystal Quater, MMFT, of the OCD Center of Los Angeles discusses her personal experience with, and recovery from, Excoriation Disorder, and how she treats clients struggling with this condition.

Excoriation (Skin Picking) Disorder, aka Dermatillomania — Excoriation (Skin Picking) Disorder, also known as
Dermatillomania, can be effectively treated with
Cognitive Behavioral Therapy (CBT).

“I’m not going to do it, I’m not going to do it”, I repeatedly thought on my way home from work. Yet, once again, I found myself in front of my bathroom mirror, picking at those pesky bumps that wouldn’t seem to go away. When something came out, I felt an overwhelming sense of relief and accomplishment.

Next, I grabbed a needle that I had carefully hidden in a small bathroom drawer and went to town on the stubborn bumps that didn’t respond to mere picking. I thought I was being clever by creating smaller incisions and doing what I imagined my facialist did when my eyes were closed. But when I finished, all I saw were raw wounds and a face that looked worse than it did before. I was left wondering how I would ever face the outside world with my unmistakable marks of humiliation.

Unfortunately, it was often difficult to remind myself of these painful episodes the next time I had the urge to pick. That’s because I always thought “I can resist the urge this time”. (more…)

OCD is Fake News

OCD Center of Los Angeles September 9, 2017 3:50 pm 65 Comments

By now, virtually anyone with even a passing interest in politics and current events has heard the term “fake news”. If you haven’t heard this term, just turn on a cable news channel on any given day and you are bound to hear a news story (or ten) about how we are being inundated with fake news that is designed to alter our political beliefs (and our votes). Regardless of your political persuasion, a Google search of the term “fake news” will lead you to a multitude of articles that describe somebody (or some country) that is presenting reality in a distorted fashion in an attempt to persuade you to see things their way. So what does this have to with Obsessive Compulsive Disorder (OCD)? Allow us to explain…

The writers and producers of fake news stories manipulate reality, sometimes by taking facts out of context, and other times by entirely fabricating story details (i.e., lying). Fake news stories always build their narrative on what can most charitably be called “unsubstantiated claims”. But even a cursory examination of these claims would lead any objective observer to conclude that these stories are at best misleading, and at worst, utterly untrue. The stories aren’t backed up by facts, but they sound just real enough to seem feasible.

And this is exactly what OCD does – it offers up scary thoughts for which there is no factual support, yet which appear plausible enough to lead one to believe that they may actually be true. OCD takes unimportant thoughts that occur in one’s mind completely out of the context of the real world and who the individual actually is as a person, and fabricates nightmarish scenarios (i.e., obsessions) that are not even remotely based in reality. But because these obsessive thoughts initially manifest in the sufferer’s own mind, they seem realistic, even though there is no compelling evidence to support them. In other words, OCD is fake news written, produced and directed by your own wayward brain.
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HOCD: 30 Things You Need To Know

OCD Center of Los Angeles March 28, 2017 9:13 am 512 Comments

HOCD (Homosexual OCD) is ostensibly a variant of OCD in which the sufferer obsesses about being gay. Of course, like most subtypes of OCD, it’s a lot more complicated than that. Unfortunately, the numerous myths and misconceptions surrounding HOCD lead to this condition being poorly understood, under-reported, and ineffectively treated. Here are 30 things you should know about HOCD and its treatment:

1. The term HOCD is not a formal diagnostic term. It is simply a slang term for OCD in which the sufferer’s obsessions focus on their sexual orientation. Some naysayers claim that HOCD doesn’t really exist simply because it is not a formal diagnosis that can be found in the Diagnostic and Statistical Manual of Mental Disorders. That’s a lot like saying broccoli is not really food because it’s not listed as a category of food by the USDA. Broccoli is a type of food and HOCD is a type of OCD.

2. The term HOCD is a bit misleading. While most people with HOCD obsess about secretly being gay, a significant number of gay people who struggle with OCD obsess that they are secretly straight. This is why some people prefer to call HOCD “Sexual Orientation OCD”. The bottom line is that, no matter what you call it, the core obsession in this variant of OCD is the fear that one is secretly not living in accordance with what they see as their their “true” sexuality.

3. Similarly, some people obsess that they are secretly bisexual, or that they are secretly transsexual or transgendered. Basically, people can and do obsess about almost anything, especially when it comes to their sexuality. (more…)

Doubt, Denial and OCD

OCD Center of Los Angeles September 12, 2016 1:42 pm 166 Comments

For many people struggling with OCD, the fear that they do not actually have OCD and are merely “in denial” becomes one of their most intractable obsessions. Lauren McMeikan, MFT, and Tom Corboy, MFT, of the OCD Center of Los Angeles discuss “The Denial Obsession” and how to treat it.

Doubt, Denial and OCD — Fear that one doesn’t really have OCD and is “in denial”
is a common obsession in OCD, especially “Pure O”.

Obsessive Compulsive Disorder (OCD) has often been called “the doubting disease”. OCD certainly lives up to this moniker, especially for those struggling with variants of the disorder that are often informally described as “Pure Obsessional OCD” or “Pure O”. OCD plays on an individual’s greatest fears, leading sufferers to question fundamental aspects of themselves and their character. While those without OCD effortlessly dismiss most of the unexpected thoughts that pop into their consciousness, those with OCD get trapped in a seemingly endless loop of obsessions and compulsions. Some of OCD’s more common refrains include:

• “What if I’m a murderer?”
• “What if I’m secretly gay?”
• “What if I am secretly straight?”
• “What if I don’t really love my partner?”
• “What if I am a pedophile?”
• “What if I have committed a terrible sin?”
• “What if, at my core, I am a bad person with bad intentions?”
• “What if reality, as I experience it, isn’t reality at all?”

You might notice something that ties all of these phrases together – the struggle to answer the question “what if …?” This phrase strikes terror into the hearts of those grappling with OCD. These two short words introduce enough doubt and anxiety into the minds of sufferers that they feel compelled to repeatedly perform compulsive behaviors in a seemingly endless attempt to reduce or eliminate their distress.
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Dermatillomania: A Skin Picker’s Guide to the Dermatologist

OCD Center of Los Angeles June 17, 2016 1:22 pm 44 Comments

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One of our clients with Skin Picking Disorder ( aka Dermatillomania ) recently wrote this essay about her long-standing issues with her dermatologist. She has asked to remain anonymous.

Dermatillomania: A Skin Picker's Guide to the Dermatologist — Those struggling with Dermatillomania (Skin Picking Disorder) often have complicated feelings about their dermatologists.

A skin picker’s relationship with their dermatologist is, to put it lightly, fraught.

It’s a vicious cycle:

The skin picker picks their skin.
The skin picker is unhappy with the way their skin looks.
The skin picker goes to the dermatologist.
The dermatologist, with the medical authority of a white lab coat, tells the picker:
“Don’t pick.”
The picker spirals into shame.

Next time there is a problem, the picker avoids the dermatologist.
Then, maybe, the picker’s picking results in an infection.
The picker remembers:
“Don’t pick.”
“Don’t pick.”
“Don’t pick.”
Those words ring in the picker’s head.
No way is the picker going back there.
All that waits at the dermatologist is more humiliation.

(more…)

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Serving the community since 1999

Q&A: Online Therapy for OCD, Anxiety and Related Conditions

Making Peace with Uncertainty: Living in the Midst of a Pandemic

My Journey to Becoming an OCD Specialist

OCD vs. GAD and How to Tell the Difference

Pure O 101

Excoriation (Skin Picking) Disorder, aka Dermatillomania

OCD is Fake News

HOCD: 30 Things You Need To Know

Doubt, Denial and OCD

Dermatillomania: A Skin Picker’s Guide to the Dermatologist

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