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Specializing in OCD and related conditions

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Hoarding, Cluttering, and Compulsive Shopping: My Childhood Story



Hoarding affects the entire family.  Here is one woman’s story of her struggle as the daughter of multiple generations of hoarders. She has asked to remain anonymous. 

Hoarding affects the entire family
Hoarding and cluttering affect the entire family
(cc image courtesy of puuikibeach)

I am the daughter of a hoarder. I am also the granddaughter of a hoarder. Somewhere amidst the cluttered chaos, I was a child. Competing with nine cats, three large dogs and compulsive shopping sprees was nothing but ordinary. Our 1500 square foot condo was stuffed wall-to-wall with dusty antique furniture, balls of cat fur, and the potent smell of animal urine masked by dozens of cheap burning candles.  Taking in animals and acquiring things were my mother’s attempt to fill the absence of her husband and distract her from her long battle with cancer. She barricaded herself from the real world, consequently shutting down the needs of her only child and leaving no room for a relationship.

An unlikely suspect, my mother is an entrepreneur who dresses sharp, presents with confidence, and is admired and respected by her peers. What many people don’t know about the world of hoarding is that it is often a secret to outsiders. Although some hoarders can be detected by the clutter surrounding their homes, others present the exterior of their homes as well as they present themselves. From the outside world, we went unnoticed, further silencing my cry for help.

(more…)

OCD and Thought-Action Fusion

Thought-Action Fusion in OCD
Thought-Action-Fusion is a common
problem for many struggling with OCD.

Virtually everybody experiences unwanted thoughts from time to time, for we human beings are not always in charge of what we think.  But for sufferers of Obsessive Compulsive Disorder (especially Pure Obsessional OCD), the problem is not just the presence of unwanted thoughts, but also the attention and meaning one gives to them.

OCD and Thought-Action Fusion

Obsessive Compulsive Disorder (OCD) not only produces constant mental noise and endless worry, but also often includes a cognitive process known as thought-action-fusion.  The distorted thought at the heart of thought-action-fusion is the irrational assumption that just because a “bad” thought presents itself to your mind, then it is undeniably followed or accompanied by a specific “bad” action.    For some, this fusion is so strong that they believe that their thoughts actually cause actions to occur. Clients who suffer from thought-action fusion often report intense fear because of their belief that their thoughts will come true.  Thought-action fusion is particularly common in the Pure O variant that is colloquially known as Harm OCD. For example, a teenage girl may worry that if she has a thought of a home invasion happening to her family, then the break-in will undoubtedly occur.  Or a college student might fear that he will wander out of his dorm room and harm someone without knowing it.  If this student is struggling with Harm OCD complicated by thought-action fusion, he might be overcome with a debilitating belief that, because he thinks this thought, then he is almost certainly a sociopath and is likely to act on it. (more…)

OCD, Anxiety, and Resistance


The OCD Center of Los Angeles discusses resistance and certainty-seeking in OCD and related anxiety based conditions. Part one of a two-part series.

Resistance and acceptance in OCD and anxiety
Resisting our unwanted thoughts, feelings, and
sensations is a futile task that is doomed to failure.

When treating clients with Obsessive-Compulsive Disorder (OCD) and other anxiety based conditions, two of the most important topics we discuss are “resistance” and “certainty-seeking”.  People suffering with these conditions often have unpleasant and unwanted thoughts, feelings, and bodily sensations, and resistance to these experiences is a normal, natural reaction.  Simply put, when faced with something uncomfortable or painful, we humans instinctively resist it, and quickly look for ways to reduce our discomfort through avoidance.  But unfortunately, while resistance may internally feel like the correct response to our uncomfortable thoughts, feelings and sensations, it actually serves to inflame them.

For most people, it seems counterintuitive to reduce resistance and allow uncertainty to remain in the face of these uncomfortable internal experiences.  Many are likely to think something along the lines of “I must find a way to keep this thought, feeling, or bodily sensation from happening again”.  But this philosophy of resistance in regards to our unwanted internal experiences will actually cause them to become more powerful.  As illogical as it may seem, oftentimes the best solution is to lower our resistance, surrender, and accept what is being offered.

(more…)

Harm OCD Treatment: Cognitive Restructuring


A discussion of the treatment of Harm OCD using Cognitive Restructuring.   Part three of a series.

Harm OCD treatment
For those with Harm OCD,
Cognitive Restructuring is a key part of treatment.

In our previous installment of this series, we looked at Mindfulness for the treatment of Harm OCD, and how a change in perspective towards unwanted thoughts and feelings can lead to a change in compulsive behaviors.  But as many sufferers well know, one’s response to intrusive harm thoughts is frequently automatic.  Those with Harm OCD have conditioned themselves to respond to their harm thoughts in a certain way, and very little thinking may go into it.

Mindfulness encourages us not to waste time and energy attending to thoughts and feelings with urgency when those thoughts and feelings could be simply observed and allowed without response.  This is not only difficult to do, but requires practice, training, and education that may not always be immediately practical early in treatment.  If we must attend to the content of our thoughts directly, we should attempt to do so with as little mental ritual as possible.  So we ask the question, “What is it that I am thinking about my thoughts that appears automatic, yet may be voluntary and may be pointing me in the wrong direction?

Cognitive Distortions Commonly Experienced in Harm OCD

The reason why a harm sufferer feels compelled to compulsively analyze, avoid, or otherwise over-respond to harm thoughts is because they are filtering these meaningless little ones and zeroes through distorted lenses that spit them out as unacceptable indictments.  These lenses are called cognitive distortions.  Here are some examples of common cognitive distortions experienced in Harm OCD: (more…)

OCD & Anxiety: Five Common Roadblocks to Treatment



Cognitive Behavioral Therapy (CBT) is the gold standard for the treatment of OCD and related anxiety based conditions.  But some simple mistakes can interfere with treatment.  Kimberley Quinlan, MFT, of the OCD Center of Los Angeles discusses five common roadblocks to effective treatment for OCD and anxiety.

CBT for OCD: Five Common Roadblocks
Avoid these five common roadblockswhen undergoing Cognitive BehavioralTherapy (CBT) for OCD and anxiety.

Research has consistently found that the most effective treatment for Obsessive Compulsive Disorder (OCD) and most other anxiety disorders is Cognitive Behavioral Therapy (CBT).  The cognitive component of CBT involves investigating and challenging the individual’s irrational thoughts related to their fears.  These thoughts are described as “cognitive distortions”, and the process of challenging them is known as “cognitive restructuring”.  This process takes place during therapy sessions, and is also practiced by the client between sessions throughout the course of treatment.

The behavioral component of CBT is more time intensive, and requires the client to be gradually, purposefully and systematically exposed to the very thoughts and situations which generate their discomfort, and to do so without responding with either compulsive or avoidant behaviors.  This process is known as Exposure and Response Prevention (ERP). (more…)

Harm OCD Treatment: Mindfulness Based CBT

    

The OCD Center of Los Angeles discusses treatment of Harm OCD using Mindfulness Based Cognitive Behavioral Therapy.   Part two of an ongoing series.

Mindfulness for Harm OCD
Mindfulness Based CBT is a key component of
successful treatment for Harm OCD.

In our previous installment of this series, we defined the symptoms of a sub-type of Obsessive Compulsive Disorder (OCD) known as Harm OCD. The defining characteristics of Harm OCD are intrusive thoughts of a harming/violent nature (obsessions), and the behavioral response of engaging in physical and mental strategies (compulsions) in an effort to relieve the inherent discomfort one experiences when having these thoughts. In upcoming articles in this series, we will discuss each of the main elements of Cognitive Behavioral Therapy (CBT) used to treat this form of OCD.

Psychoeducation and the Treatment of Harm OCD

The first step in treating Harm OCD is psychoeducation. Unfortunately, sufferers who are not already well-versed in OCD are likely to approach treatment with extreme apprehension and doubt. This is because the pain of being burdened with unwanted thoughts of causing harm has worn them down to a point that they may genuinely believe it’s possible that a therapist will take one look at them, smile, and call the men in white coats. So before any discussion of treatment can begin, a Harm OCD sufferer has to have a better understanding of the nature of the condition, and why some people are hyper-aware of these types of thoughts, while others appear not to be. (more…)

Dermatillomania / Skin Picking Disorder Treatment

    

Skin Picking Disorder (Dermatillomania)
Cognitive Behavioral Therapy (CBT) is the most effective treatment for Skin Picking Disorder (Dermatillomania)

In our previous article on Skin Picking Disorder (also known as Dermatillomania or Excoriation),  we wrote about a classification system for skin picking. Let’s review “The ABC’s of Skin Picking”:

An “A” is something that almost anyone would pick. This could be a piece of dry skin hanging off your arm, a pus-filled whitehead on your chin that pops at your mere touch, or a scab that’s barely hanging on which you can easily detach.

A “B” is a “bump”, pimple, scab, etc. that only a skin picker would pick, frequently causing it to bleed, ooze, scab, and possibly become infected. This in turn will cause two additional problems – it will cause the picker significant distress, and it will give him or her something new to pick at later. In our experience, clients with Dermatillomania classify at least 50% of their picking as “B’s”. (more…)

Harm OCD: Symptoms and Treatment

    

Harm OCD
Harm OCD is a common variant of OCD, and is very
treatable with Cognitive Behavioral Therapy (CBT).

Harm OCD is a manifestation of Obsessive Compulsive Disorder (OCD) in which an individual experiences intrusive, unwanted, distressing thoughts of causing harm. These harming thoughts are perceived as being ego-dystonic, which simply means that the thoughts are inconsistent with the individual’s values, beliefs and sense of self. Harming obsessions typically center around the belief that one must be absolutely certain that they are in control at all times in order to ensure that they are not responsible for a violent or otherwise fatal act.

It is not fair to say that one form of OCD causes more pain than another. In our experience of treating individuals with OCD, those with compulsive hand washing appear to be in no less pain than those who live in fear of being sexual deviants or psychopaths. What sets Harm OCD apart is the way in which it attacks the things we love the most, and does so with such brutality and lack of mercy as to astound even the most creative minds. The moments that we most want to be highlighted by memories of peace and contentment suddenly become contaminated by mental imagery of horrific violence and feelings of relentless guilt. (more…)

Orthorexia: Where Eating Disorders Meet OCD – Part 2

    

Effective Strategies and Predictable Complications in the Treatment of Orthorexia

In our previous article about Orthorexia, we described this relatively unknown and misunderstood condition.  In this, the second and final installment in this series, we discuss strategies and pitfalls in the treatment of Orthorexia.

Orthorexia treatment
Orthorexia can be effectively treated with Cognitive
Behavioral Therapy (CBT) and Mindfulness

Orthorexia, being a somewhat new conceptualization of a psychological disorder, is under-researched and often misunderstood within the mental health and medical communities.  Many mental health professionals have found success treating individuals with Orthorexia using evidence-based treatment methods that are used to treat other Eating Disorders, OCD, and related OC Spectrum Disorders.

Cognitive-Behavioral Therapy (CBT) and Mindfulness are two highly effective treatment methods used to treat Orthorexia.  Using CBT, individuals with Orthorexia learn to challenge and change their distorted thoughts (cognitions) related to their body and the foods they eat.  Education about nutrition and what is considered “healthy” should also be integrated into CBT when treating Orthorexia, using logical, evidence-based strategies. (more…)

Casey Anthony, Reasonable Doubt, and OCD

    

Casey Anthony and 'reasonable doubt'.
The concept of ‘reasonable doubt’ may help
some people to better understand OCD.

When most people think of Obsessive Compulsive Disorder (OCD), they think of people excessively washing their hands or repeatedly checking their doors and windows to see if they are locked.   But there are many variations of OCD, including a subtype in which people have intrusive, unwanted thoughts about harming spouses, friends, co-workers, strangers, or even their own children. Sometimes called “Harm OCD”, this condition falls under the category of what is commonly called Pure Obsessional OCD, or “Pure O”, because both the obsessions and the compulsions are primarily mental.

People with Harm OCD often perform mental checking rituals just as others with OCD might physically check their stove over and over again in an effort to feel sure that they haven’t accidentally left a burner on.  They might repeatedly monitor and analyze their mental processes in an effort to convince themselves that they will not act on their unwanted thoughts, and that their intrinsic character or their love for the other person is strong enough to prevent them from doing some sort of harmful action.  They may also repeatedly seek to determine whether they are a bad person for even dreaming up such a thought.  And it is quite common for those with harming obsessions to repeatedly ask others for reassurance that they have not harmed someone or that they are not going to do so.  But as anyone with Harm OCD knows, these efforts to gain certainty almost never provide the desired reassurance for the OCD sufferer, and the unwanted thoughts almost always increase in frequency and intensity. (more…)

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    People with OCD often struggle with 'mental compulsions'. The OCD Center of Los Angeles explores how to manage this sometimes baffling problem. […]
    186 Comments
  • Cyberchondria: Health Anxiety in the 21st Century
    The twin explosions of television and the internet have spawned a sharp increase in Hypochondria, and spawned a new mental health issue - 'Cyberchondria'. […]
    8 Comments
  • Is Compulsive Overeating OCD?
    A discussion of compulsive overeating (aka binge eating) and how it differs from OCD. From the OCD Center of Los Angeles. Serving clients internationally. […]
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  • Cy Young, Zack Greinke, and Social Anxiety
    Zack Greinke has overcome his Social Anxiety to become a superstar in major league baseball. […]
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  • Exposure Therapy for OCD and AnxietyExposure Therapy for OCD and Anxiety
    Exposure therapy for OCD and other anxiety conditions is discussed by Tom Corboy, MFT, of the OCD Center of Los Angeles. […]
    46 Comments
  • Social Anxiety Research
    Recent Social Anxiety research is discussed by Tom Corboy, MFT, executive director of the CD Center of Los Angeles. […]
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  • OCD Awareness Week
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  • CBT and Evidence Based Psychotherapy
    Unfortunately, many psychotherapists dismiss evidence-based treatments such as CBT, instead choosing to do what feels comfortable for them. […]
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  • OCD, Mental Health, and the National Health Care Debate
    A look at the national health care debate, especially as it pertains to OCD and related anxiety based conditions. […]
    No Comments
  • Childhood OCD, Strep Infections, and PANDAS
    There is a growing body of research that indicates strep infections are related to rapid-onset OCD in children. […]
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  • OCD and the Swine Flu – Part 2
    Panic about the Swine Flu continues, despite facts that suggest there is no cause for increased concern. […]
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  • 2009 Obsessive-Compulsive Foundation Conference
    A review of the 2009 Obsessive Compulsive Foundation conference. […]
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  • New Trichotillomania Research
    A look at recent research related to Trichotillomania. From the OCD Center of Los Angeles. […]
    No Comments
  • Parenting a Child With OCD
    Parenting any child is a full-time job. But parenting a child with OCD can be particularly challenging. From the OCD Center of Los Angeles. […]
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  • Social Anxiety in Baseball
    A look at the recent rash of pro baseball players struggling with Social Anxiety Disorder. […]
    No Comments
  • Michael Jackson and Body Dysmorphic Disorder (BDD)
    A look at the sad tale of Michael Jackson and his mental health issues. […]
    No Comments
  • OCD and the Swine Flu
    The past few months have seen an avalanche of news stories on the Swine Flu, despite its relatively low impact in the US. […]
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  • Meet the OCD Center of Los Angeles Staff
    Meet the OCD Center of Los Angeles Staff […]
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  • Welcome to the OCD Center of Los Angeles Blog
    Welcome to the OCD Center of Los Angeles Blog […]
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OCD Center of Los Angeles