10 Mistakes in OCD Treatment to Avoid
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- Опубліковано 2 чер 2024
- NEED HELP FOR OCD & Anxiety?
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ERP boasts an impressive 86% success rate, according to research by Foa et al., 2005. However, the journey can be challenging, with dropout rates ranging from 18.7% to 27%. I wish I had known the information I am sharing today when I started treating clients. So, let's explore the ten common mistakes you should avoid, with concrete examples to shed light on each one.
Mistake 1: **Failing to Plan Exposures that target core fears**.
To plan exposures effectively, it's crucial to pinpoint your core fear. To achieve this, you can start by asking yourself, "What am I afraid could occur if I refrain from performing my compulsion or ritual?"
Mistake 2: * Not Going Deep Enough into your fear**.
Mistake 3: **Ignoring Mental Compulsions**.
Mistake 4: **Preferring Imaginal Scripts**. People often prefer scripted exposures, like reading and listening to recordings about contamination scenarios, rather than confronting real-life situations, such as touching everyday objects. Real life exposures are proven to be more effective than imaginal scripts, However, the two types of exposures can be combined as well.
Mistake 5: **Neglecting Response Prevention**.
Mistake 6: *Overlooking OCPD*
People that experience both OCD and OCPD are twice as likely to relapse in treatment, and perfectionism is an indicator that ERP may not be as effective if it is not incorporated into treatment.
Mistake 7: *Cherry-Picking Themes*
Mistake 8: **Not Educating Family or your Support Network**.
Mistake 9: **Distracting During Exposures**.
Mistake 10: **Avoiding Tough Days**.
If you are interested in taking a deeper dive into any of these topics, check out my ocd the playlist in the description below. And for more OCD treatment resources including free ocd and health anxiety assessments, visit paigepradko.com.
Here is a PLAYLIST for OCD that covers each OCD tip in more detail:
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(Although Paige Pradko is a licensed psychotherapist, the views expressed on this video and this UA-cam channel including comments or any related content should not be taken for medical, psychological or psychiatric advice. Always contact your physician and mental health provider before making any decisions related to your physical or mental health.)
You are such a life saver. I appreciate your dedication. You are making such a difference in the world.
Wow, thank you so much!
Your videos are only support we have to deal with these problems.
I am glad that my videos are helpful. I will do my best to keep providing support. What topic would you like to see covered on videos?
thanks you paige ❤ when the brain is going to not aware emotion place hard for back to be aware and relax i know this not because me it's okay life people effects.
Yes, that is true and it is difficult.
I am glad that you mentioned perfectionism as something that contributes strongly to relapse. It seems as though you can get rid of anxiety using response prevention, but perfectionistic traits remain intact. It's helpful to remind yourself not to fall back into this old habit of making everything perfect. Your videos are of immense help. Thank you!
I am glad you noticed that and like the videos. Thank you.
Hello Mam!
I just can't thank you enough for such amazing videos.
They are really really helpful and changing lives, giving us hopes and I've been able to beat one of thr themes..but I still ruminate
Besides I have done a lot of research in the self help books and online too and found these three things:-
1.ERP Therapy
2.ACT Therapy
3.Not connecting your identity/emotions to your thoughts and letting them go without getting engaged with them.
But still my brain fears or is it mere a new theme (where my brain is dragging me to) making me feel that,, are these three things precisely enough for me to manage OCD forever or there is something more to it???
**Eagerly waiting for the response**
Thank you for your message. Yes, those therapies are the most effective strategies that we have at this time. There may be new strategies in the future, but what you have identified is what I use to treat people with OCD. Sometimes people can use searching for help and listening to help as a compulsion itself. They are afraid that they will miss something important and keep searching. You have what you need. You do not need to keep searching.
@@PaigePradkoTherapy Thankyou Mam!
First of all, thank you so much for all of your helpful videos! ! They have convinced me to finally start doing ERP by myself to deal with my OCD. I am also trying to find a good psychologist to support me in this, as my OCD is currently impacting my day-to-day life. My OCD makes me rehearse humiliating conversations where I am picked at by a group of people and where they are aggressively criticizing me and trying to put me down. Usually I have to rehearse these conversations x-amount of times and with a certain amoutn of arguments in the correct order to feel like I 'won' the argument. It takes a huge chunk of time out of my day and affects my mood and self-esteem a lot, which in turn impacts my interactions with other people. I am now trying exposure by imagining myself being humiliated in the worst way I can imagine without responding with arguments and trying to win the discussion. I have a question though: when I am not doing exposures, and such such a thought pops up, should I expose myself by deliberately imagining a worst-case scenario time and time again, or should I just say something like 'maybe, maybe not' and move on without trying to push the thought away, but also without trying to elaborate on it exposure-style? Again, I can't thank you enough for you videos!
Hi. I am glad you are doing ERP. Both methods you mentioned are different forms of ERP. You can have the thoughts on purpose, you can stay with uncertainty as in the “maybe” example, or you can use the I. A.M. method and (I) Identify the thought as an ocd thought, (A) Allow the thought to float there in the background of your mind without checking on it, and (M) shift your focus to something that you can do in the moment. It is called an incidental exposure and we use it when thoughts pop up in the moment, yet want to stay in response prevention.
Thanks for your answer, this makes it very clear for me :) I have been doing the ERP succesfully now for four days, so I think I made a good beginning. Some days are easier than others but I think I will get there@@PaigePradkoTherapy
Hi Paige. Big fan of yours. You mentioned Dr Greenberg and I agree, he’s the only one (you are good and Ali Greymond is good) that is doing the correct rumination focused erp as opposed to the old traditional habituation focused erp. The old habituation focused erp doesn’t work. Both erp forms use response prevention which is correct. But exposure doesn’t work using habituation. Exposure only works to stop avoiding things in life and helping with response prevention.
Hi Joe. The treatment of OCD is evolving as we learn more and conduct more research. We have shifted from a habituation model of ERP to an inhibitory learning model of ERP. Dr. Greenberg’s model and the I. A.M. technique I teach are similar in that we are applying techniques in the moment to shift focus away from the intrusive thought or the urge to ruminate or compulse. The emphasis is to not engage with the unwanted thoughts, urges, rumination, etc. Yet, we do not want to signal “avoidance” or “distraction” in our brain, or that can cause the brain to be more selectively focused on the unwanted thoughts. Greenberg’s method, my I. A.M. method and even Dr. Reid Wilson’s methods are not evidenced-based methods. That requires years and extensive research before a technique or theory becomes evidenced-based and fully recognized by therapists and the research community. But, as a clinician, I am pragmatic when it comes to treatment methods. I go with what works for my clients. ERP is the theory that has the most evidence for effectiveness as this time. The next theory to be evidenced based for OCD is I-CBT (Inferential Cognitive Based Therapy). That theory works on resolving obsessive doubt. I use all of the theories and methods I mentioned above because there is not one solution or theory that works for all.
@@PaigePradkoTherapy I’m so glad you and others are shifting from habituation focused erp. I find the rumination focused erp so much more effective.
Thanks again for this amazing video. I want to ask you a question which is not so much related with tia video. From your latest videos i see that you are using ACT techniques primarily in order to help people with anxiety disorders. Are you using any classical CBT techniques like challenging and disputing thoughts with these people? And how about clients with depression? Are you still using ACT or more classical CBT techniques? Thanks again for your wonderful videos!!
I tend to be pragmatic with my clients and shift theories to whatever works. I incorporate ACT to help people move in directions that they value versus getting caught in the weeds of feeling broken, only focusing on their symptoms. I use what we have learned about neuroscience and understand that we have the ability to change at any age. I incorporate what we know about how we learn by using inhibitory learning theory and cognitive behavioral theory. I incorporate Behavioral Activation to help people with depression because I do believe that we have to behave our way out of depression versus trying to reason our way out. I do incorporate cognitive approaches regarding psychoeducation when treating people with conditions like panic disorder. People have to understand what is happening in their body. I do not do much classical CBT like challenging beliefs, although I do believe that negative interpretations about what one is experiencing is going to derail their progress. Our beliefs do have to more reality focused in the present moment. I also incorporate narrative therapy because we tend to believe our own stories. If we believe our stories, we best have an empowering story to tell ourselves. As you can see, I am a pragmatic therapist that will use what works with each client. It helps to have a large tool box and to not be hard fast committed to one therapy and inflexible if that particular therapy doesn’t hit home with a client. No one therapy is the answer. We need to be flexible as therapists.
@@PaigePradkoTherapy Thank you very much!!! I do a have one more question about ERP. I am a psychologist too ans i use ERP for my clients with anxiety disorders and especially OCD. Sometimes i have one problem. When my clients do formal exposures as we together have planned they dont get triggered and they don't have obsessions. But the get triggered and have obsessions the rest of the day. How are you dealing with this, when the clients dont get triggered with formal exposures? I am sorry if i am asking too much but i want the best dor my clients!!!
Hey…there’s perpetual anxiety all day and as a result of that the OCD thought appears suddenly and goes sending a weird sensation through my mind. Before I even have time to practice response prevention, it’s already gone.I think that the thought itself is a compulsion because the anxiety is present all day long. Also, a sort of ‘wave’ passes through my mind when the thought has occurred. Initially I could manage response prevention cause there was tingling in my mind during anxiety and I could refrain from doing compulsions. But with the last few fears left, it’s difficult to do ERP because it’s too sudden & there’s no apparent anxiety but just an Uncomfortable feeling in my mind all day. There’s little anxiety present all day and as the thought passes, the wave occurs, sending relief for a few seconds and then back to that anxious feeling. Sometimes, there’s not even a thought just that ‘wave of fear’ passes through my mind. What can I do about this?
So sorry you experience that. If it is a very sudden wave, I would say that is an adrenaline response to your intrusive thought. But, I wonder how you are interpreting that fear wave? How you are interpreting it or what your thoughts are about it may explain why it is hanging around.
I think I interpret it as something scary/real feeling eg. a feeling that somebody is actually standing behind me while I’m doing something/trying to sleep/while I sleep. And sometimes, followed by a compulsion on how I’ll deal with this when I’m alone. Any tips on how to be immune to this adrenaline response?
I have been trying to do ERP for a while now. Often I can succeed in about two minutes and at other times it can take up to half an hour to complete. Not exactly sure what I am doing wrong. ......hmmmm oh well, all the best.... thoughts????
Hi Martin. Sometimes our thoughts get stickier than other times. It could be any number of factors like not being as rested, feeling more stressed, or the fear trigger is just more intense that day. What you are experiencing is normal and I want to encourage you to keep at it. 😊
I have pocd and keep going back over my calendar adding peoples ages up over and over from half a decade ago nearly.. is this compulsive? My fear is being something bad.
I keep wondering when things occurred and in what order,
I need an answer and it’s driving me crazy. It all started when someone lied about their age but I added them again in the future and wonder when how soon and if they were the right age. I’ve been upping my Sertraline and using benzos to cope
Hi. I’m sorry you are going through that. Yes, that is definitely a compulsive behavior and you will not find peace doing that. Your brain will keep wanting you to do more adding. You have to accept that you will not have an answer or get any kind of certainty here. This is OCD and you will want to use ERP or another evidenced based therapy to treat it. I do have a playlist on OCD and Pure O on UA-cam. Here are some other resources as well:
The Top 10 Things you Need to Know to Practice ERP: Exposure and Response Prevention for OCD, Phobias and Anxiety
www.paigepradko.com/erp
OCD Self Assessment Quiz
www.paigepradko.com/ocdquiz
OCD course
www.paigepradko.com/ocd
Thank you so much Paige for your reply, what would u recommend if I feel its important to keep going back mentally to achieve a feeling of comfort that I'm not a predator
You have to trust yourself, Dylan. You likely are the last person that would be a predator. You care about not harming people. Trust yourself and don’t listen to OCD.
@@PaigePradkoTherapythanks for the responses. Sometimes I wonder is it worth going on anymore.. When we look back years ago, we can't recall things for how or what they were. I find it hard to no reassurance seek when the answer matters so much to me. Your videos are great and the level of empathy you have in remarkable❤
Hi paige, i am a student and my ocd thoughts keep annoying me while i try to concentrate on my studies. I tried my best to suppress it but its keep poping up. Its like a cycle like i try to concentrate but again it pops up again i try to concentrate but again it repeats. How do i deal with this?
That sounds so frustrating. Do your best to not engage with the thoughts, but you also do not want to push them away. Allow them to float there in the back of your mind, but don’t check on them or get frustrating or try to push them away. If you haven’t seen my video on using the I. A.M. method, this may be helpful. ua-cam.com/video/9nEC8yIgFKg/v-deo.htmlsi=ES9PCRdxwj4hNBz2