Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist

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202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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OCD in The Age of #MeToo

By Lynne Gots, posted on February 3rd, 2018.

OCD is like an opportunistic pathogen, invading hosts with weakened immune systems. So it’s not surprising to see it thrive and spread when daily news reports stoke uncertainty and fear in those who are vulnerable.

The recent spate of revelations about sexual misconduct among the rich and famous, along with controversial reports in the last few years of a campus rape crisis, have brought a new demographic into my practice: young men in their twenties who worry about committing or having committed a sexual transgression.

Some of these men have been accused—and all exonerated—of inappropriate touching, nonconsensual or consensual but inappropriate sex with colleagues, students, or classmates; others live in fear of having a casual sexual encounter from their past surface and become fodder for an accusation.

OCD is having a field day.

As reporter Emily Yoffe chillingly details in a series of articles in The Atlantic , Obama-era federal directives governing the handling of sexual-assault allegations have prompted universities to craft vague and overarching definitions of sexual assault designed to protect the (mostly) female victims while stripping the accused of their right to due process. The Kafkaesque scenarios Yoffe describes—such as a third party accusation in which a friend reported her roommate’s boyfriend as an abuser and the alleged victim, refuting the claim, was told she was in denial– create the perfect medium for OCD to flourish.

Let me be perfectly clear. I am in no way minimizing the trauma experienced by assault victims. I believe charges of rape on college campuses should be taken very  seriously. They should be investigated thoroughly and, if the evidence points to a crime, prosecuted in a court of law. And I am not excusing the predatory behavior of the Harvey Weinsteins who have abused their power to intimidate and sexually exploit women.

But the men with OCD I see in my practice are not predators or rapists. In fact, most share two thinking patterns common in people with OCD: an excessive sense of responsibility and a highly developed sense of morality. They worry about causing harm and about being bad people even though, in the paradoxical way of OCD, they’re actually good people with a strong—perhaps even excessively rigid—moral compass.

So, no, I don’t secretly question if they might have done what they’ve been accused of or fear being accused of, just as I know with a reasonable degree of certainty that the people with OCD who confess to me their fears of being pedophiles are not a danger to children.

As with all OCD worries, however, facts and probability do little to assuage anxiety. So the challenge is to acknowledge the possibility of a dreaded occurrence—such as a false accusation–while not letting fear get in the way of living.

While it’s hard to push back, I can recommend a few guidelines to follow if you’re consumed by worries of being unjustly accused of sexual assault.

  • Don’t try to convince yourself that your worst fear is unlikely to materialize.
  • Don’t review the past for possible evidence of transgressions.
  • Don’t ask friends and family for reassurance.
  • Don’t scour Facebook posts for evidence that an ex might be angry with you.
  • Move forward with relationships rather than avoiding them.
  • Treat prospective or current sexual partners with respect, not suspicion.

Shakespeare said, “Misery acquaints a man with strange bedfellows.” Resist the temptation to lie down with OCD.




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Posted in Anxiety, Obsessive Compulsive Disorder |

Why You Don’t Need Willpower to Change a Habit

By Lynne Gots, posted on December 27th, 2017.

There’s no shortage of advice this time of year about eating clean and getting ripped. And while the prospect of a new you in the new year can be seductive, especially after a month of overindulgence, I’m not a fan of restrictive diets or New Year’s resolutions. They simply don’t work over the long haul.

Any rigid regimen carries with it the whiff of deprivation, of restraint, of saying “no” when your mind wants you to say “yes.” The key, we’re told, is willpower.

Just say no. Just do it.

Let’s be real. If it were so easy to turn away from that donut or force yourself out the door on a dark, frigid January morning to go to spinning class, we wouldn’t be having this discussion.

We know from research that willpower is a limited resource. Over time, with repeated use, it becomes depleted, just like any energy source. And the moments when we most need it—say, after a stressful workday at happy hour when the margaritas are $5 and the queso and chips beckon—it’s gone.

So I suggest changing the narrative. It’s too easy to throw in the towel when you tell yourself, “I don’t have any willpower.” Those words render you powerless in the face of overwhelming forces beyond your control.

Instead of recruiting willpower to help you pursue your goals, consider building willingness power.

Willingness starts with motivation. Begin by looking at the costs and benefits of the behavior you want to change. If you want to improve your diet, for instance (notice I didn’t say “eat clean”), pay particular attention to what you get from the undesired habit. The costs will be readily apparent to you. But the benefits? Not so much.

To get you started, here are some real-life examples of the benefits of overeating (continuing to eat past the point of satiety or even to discomfort) I’ve heard over the years:

  • It relaxes me.
  • I enjoy the taste of food.
  • It keeps me from feeling bored/ lonely.
  • It’s social.
  • I don’t like rules.
  • I deserve a reward.
  • It passes the time.

Then look at the costs (I’ll bet you won’t have any trouble coming up with a long list) and review them daily or more frequently if necessary. Remind yourself why it’s worth it to forego all the positive associations with the behavior you want to change in order to achieve your goal.

In a nutshell, willingness means being open to feeling short-term discomfort for long-term gain. It’s a useful skill to cultivate, and not just for sticking with a diet or exercise plan but for all the challenges life brings.

So in 2018, ditch the idea of willpower and practice willingness power. You’ll be laying a more solid foundation for success.




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OCD By Any Other Name . . .Is Just OCD

By Lynne Gots, posted on December 1st, 2017.

OCD is a shape-shifter. Its content often changes, especially with primarily internal obsessions and compulsions (involving thoughts about harm, sexual orientation, and relationships). For many with the disorder, addressing the ever changing obtrusive thoughts is like playing Whack-a-Mole.

The internet is full of articles about “hOCD,”(OCD about sexual orientation), “rOCD,” (OCD about the “rightness” of a relationship) and “Pure O” (obsessions in the absence of compulsions) OCD. Although these designations can be appealing if you’re trying to make sense of distressing thoughts, I find this alphabet-soup approach to OCD problematic for several reasons.

  • It places too much emphasis on form over function. OCD isn’t about what it seems to be about. Every subtype of OCD has at its root the inability to tolerate uncertainty.
  • It encourages compulsive checking and reassurance-seeking. Many of the forums and sites dedicated to OCD subtypes list the differences between OCD doubting and signs of a genuine issue, such as sexual identity conflicts or relationship problems. Checklists contain generalizations. But individuals don’t necessarily fall into neat categories. So more confusion results, leading to an endless cycle of checking and searching for reassurance.
  •  It implies a definitive, black-and-white answer. In reality, OCD won’t accept yes or no. If doubts about a specific content fade, new ones will surface unless the driving mechanism—intolerance of uncertainty—has been addressed.
  • In the case of so-called “Pure O” OCD, it’s inaccurate. OCD by definition involves obsessional thoughts and compulsive actions performed to neutralize the distress from the thoughts. The compulsions may not observable to others, as they are with, say,hand-washing; they may involve covert mental rituals, such as reviewing, comparing, or silently repeating prayers, words, or numbers. Rumination and worry in the absence of compulsions do exist but are more likely symptoms of generalized anxiety or depression, not OCD.

Addressing the form OCD takes is important only in designing a treatment plan for ERP (Exposure/Response Prevention).  To keep the OCD from becoming a pattern in which one obsession dissipates only to have another pop up, focus on accepting uncertainty.

Here’s how to begin the process of response-prevention:

1) Refrain from checking and analyzing.

2)Acknowledge that OCD is causing you to doubt yourself and that no amount of research will help you arrive at an answer you’ll believe.

3)Don’t try to categorize your OCD.

4)Give up trying to figure out if your fears are justified.

5)Stop seeking advice from internet forums.

Taking these steps will start you on the path to recovery and keep the moles from lying in wait to ambush you.

 

 

 

 

 

 

 




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This blog is intended solely for the purpose of entertainment and education. All remarks are meant as general information and should not be taken as personal diagnostic or therapeutic advice. If you choose to comment on a post, please do not include any information that could identify you as a patient or potential patient. Also, please refrain from making any testimonials about me or my practice, as my professional code of ethics does not permit me to publish such statements. Comments that I deem inappropriate for this forum will not be published.

Contact Dr. Gots

202-331-1566

2440 M Street, NW
Suite 710
Washington, DC 20037

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If you don't receive a response to an email from Dr. Gots in 48 hours, please call the office and leave a voicemail message.

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