Opening the why-box. Part 11. Counting Compulsions, Ordering and arranging compulsions

“Counting compulsions” is a category unto itself. This might include counting silently or overtly to oneself (as in “one, two, three, four,…” or “one, two, three; one, two, three;…”) while one does a task or chore. In this case, counting serves as a timekeeper to indicate how long a person has been doing a task. It might Continue reading

Opening the why-box. Part 9. Checking compulsions

Checking compulsions are often paired with harming fears, but can be paired with any kind of uncertainty.

“Checking locks, stove, appliances, etc.” includes multiple forms of checking to see if these were left on, open, or in some manner perceived as unsafe. Checking can be visual (either staring at the item, or looking multiple times), tactile (pushing the button over and over, holding down the lock firmly to make sure it’s closed, Continue reading

The basics of treating hair pulling or skin picking by yourself

Hair pulling and skin picking habits seem, on their surface, like pretty straightforward problems. After all, aren’t these simply inabilities to resist an impulse to pull or to pick? That’s how the Diagnostic Manual describes these Impulse Control Disorders, as the failure to resist an impulse to do a certain thing. But to be successful, Continue reading

When is reassurance OK? Reassuring the person vs reassuring the OCD

So many people with various forms of obsessions and compulsions struggle with anxiety that comes from uncertainty and doubt. After all, OCD is called “The Doubting Disease” for a reason. Doubt, like anxiety and guilt, is a feeling so unpleasant that it drives people to resolve it with great urgency. In the height of this doubt, it makes sense that many people will seek reassurance Continue reading

How to extend your daily assignments into a complete OCD recovery plan

By now, you’ve turned the items from the Y-BOCS Symptom Checklist into a Hierarchy of Exposure and Response Prevention tasks, along with associated SUDs scores. You’ve even figured out what it feels like to take one item in the 20 to 30 range and practice it every day for a week. Hopefully, by the end of the week, the anxiety or uncertainty Continue reading

How to make daily ERP assignments from your hierarchy

You now have your completed hierarchy in front of you. It should consist of a list of exposures along with their associated ritual preventions. Each item on the list should also have a scale score representing how much anxiety or uncertainty the exposure itself will create. Using the scale 0 to 100, items rated at zero and 10 will not create enough anxiety useful. Remember, the purpose of the exposures Continue reading