Justin’s Blog: “The Jog”

Accidental workouts are great; just don’t base your exercise off of them.   Has this ever happened to you?  You have an exercise routine (walk, weights, circuit, CrossFit), and while expecting to take a holiday break, say Thanksgiving…..until someone challenges you in the paint for pickup game of basketball (in my family we had the 6 […]

Mark* was generally confident in his therapy, but bringing up sex….well, he got a little sheepish.  He had these small avoidances that he never realized were behavioral and cognitive avoidances.  For example, he would never have sex with his wife when the kids weren’t away from home.  He intentionally steered conversation away from topics with […]

“I feel like I really love my baby, but, I just don’t know. I have these terrible thoughts that pop into my mind. Thoughts of harming my baby. I actually vomited last night it made me so upset. I don’t know why I’m having these” “Everyone around me, including my pastor, seems to think I […]

When clients become experts in doing exposures (Social Anxiety, PTSD, OCD, Phobias), they become used to facing fear, disgust, and other uncomfortable feelings square on without tricks and escapes- while still pursuing the valued behaviors and thought processes they want.  Sounds too good to be true?  It’s not, but it takes discipline and hard work, […]

OCD in context. You may already be very familiar with references to OCD, especially in the larger culture.  “I’m soooooo OCD” is a phrase, often unhelpful to true sufferers, that reflects the current sentiments of many as to what it is.  Neat.  Picky.  High Standards.  Demanding.  This is NOT necessarily OCD in and of itself.  […]

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If you have experience with cancer treatment, you may already know what is meant when I say, “cut out the margin.”  Margin is the edge or border of tissue that is being removed through surgery.  Why can’t you just cut out the “bad” part?  Why must you go further?  Simply, it is only deemed clean when all […]

Teddy pumped the sanitizer bottle for the second time in three minutes.  “I know, I know, it doesn’t help when I haven’t touched anything else, but I want to be sure.  You never know these days, right?”  Freda waits to enter gatherings and meetings until everyone else has shown up- “It just helps me know I […]

“You want me to do what?!” Many of my clients, and particularly for the sake of this article, Christian clients, are a bit surprised when I ask them to practice exposure.  Repeating scary, terrible thoughts on paper or aloud.  Doing things that feel risky.  It seems as a clinician I’m disrespecting your beliefs and don’t […]

Imagine intentionally telling yourself- again and again- “Maybe I’ll get sick and die.”  Or, “I’ll have a sudden urge to kill someone.” Or, “Maybe I blasphemed God and will go to hell.”  What if your therapist asked you to repeat these things to yourself?  Does that sound like negative self-talk?  A cause for grave concern?  […]

One of my first questions to a professor in my earliest IOCDF BTTI (Exposure Therapy training) at Massachusetts General Hospital was, “What happens if someone actually gets sick after a contamination exposure?”  I haven’t forgotten the simplicity of the answer that went something like this: “People get sick all the time. Yes, that might create some additional […]

Exposure and Response Prevention (ERP), the gold standard treatment for OCD, can be fairly straightforward once understood.  However, certain nuances are crucial for facilitating learning, growth, and maximal fear disconfirmation (fancy terms for successfully overcoming fearful responses).  Here are 10 tips- click on the picture for a downloadable version: ​ Be prepared to feel uncomfortable- a […]