Cognitive Behavioral Strategies

Lynne S. Gots, Ph.D.
Licensed Psychologist


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Don’t Bow Down to OCD

By Lynne Gots, posted on November 14th, 2016.

OCD is a tyrant. It will control you with threats of the most horrific consequences if you don’t follow its commands.

“Don’t touch that or you’ll get sick and die.”

Go back and check the stove five…no, ten…no, fifteen times or the apartment building will burn down and it will be your fault.”

“Don’t hug your niece. If you put your hand in the wrong place, she’ll be scarred for life.”

“That bump you felt while you were driving was a body. The police will arrest you for a hit-and-run and you’ll go to jail for the rest of your life.”

“You had a bad thought while you were in church. If you don’t repeat the prayer the right way, you’ll go to hell for eternity.”

Who wouldn’t be terrified by such thoughts? They may seem preposterous to people who don’t suffer from OCD, but to those who do, they’re grimly familiar.

To break free from OCD, you have to refuse to follow its orders. Its demands are unreasonable. You may think you can appease it to arrive at an uneasy truce. But unless you say no to the rituals, OCD will keep escalating its requirements and make you its prisoner.

So you have to stand firm. Push back. Do the opposite.

Terrifying? Yes! But it’s a tactic—called “response prevention”—that works.

In his book, Stopping the Noise in Your Head: the New Way to Overcome Anxiety and Worry, psychologist Reid Wilson outlines specific steps you can take to break free from the tyranny of anxiety. One of the messages he drives home is that OCD worries are NOT ABOUT THE CONTENT despite what  OCD is brainwashing you into believing.

So if you’re doing rituals to protect yourself from contamination, repugnant or blasphemous thoughts, or the risk of being responsible for harming others, you can shift your perspective instead of blindly following OCD’s orders. Don’t try to convince yourself you’re protecting yourself from the content of your fears; instead, remind yourself you’re doing compulsive behaviors to eliminate doubt about something that feels threatening.

Practice moving towards those feelings of uncertainty, and you’ll be on your way to freeing yourself from the stranglehold of OCD.




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Why You Shouldn’t Look to the Internet to Answer Your Questions about Distressing Thoughts

By Lynne Gots, posted on April 17th, 2016.

 

If you struggle with OCD, you’ve probably searched online for answers to the questions that consume you. Finding virtual communities of like-minded sufferers can make you feel less isolated, especially if your worries involve the very common but shameful-to-admit obsessions such as doubts about sexuality and thoughts about violence. But extensive researching and comparing yourself to others with similar symptoms—even if your efforts seem to give you some relief—can make your OCD much worse in the long run.

Here’s why the Internet can be problematic for someone with OCD:

1) Much of the information you’ll find is wrong.

This is hardly groundbreaking news, but I can’t emphasize it too much. One of my patients recently told me about a blog (which I won’t name) written by someone with OCD. Even under my careful professional scrutiny, it looked pretty helpful at first glance. There were some informative discussions about the symptoms of OCD and the importance of seeking treatment from an experienced cognitive-behavioral therapist.

But then I scrolled to a post the author had clearly meant to be reassuring (if you’ve been under my tutelage for any time at all, you’ll know where I’m going with this) but was completely off base in its message.

She had done an “informal survey” of 4 of her friends, two identified as gay and two as straight but with the type of OCD causing them to wonder if they really might be gay. She proceeded to list the differences she found between them: how certain they were about their attraction to individuals of the same/opposite sex, when they first “knew” (in the case of the two gay respondents), whether they sometimes found individuals of the same/opposite sex attractive in the absence of sexual feelings towards them, and so on. And then she went on to draw some conclusions clearly designed to be comforting to people with OCD doubting their sexual identity.

2) Advice, however well intended, can reinforce compulsions.

Aside from the obviously unscientific nature of her “study” (a comically small and biased sample, for starters), her attempt to ease the suffering of OCD doubters was misguided. It provided some with relief and had exactly the opposite effect for others, as evidenced by the varied responses to the post. Many even questioned whether they actually had OCD because they weren’t exactly like the people she described.

That’s what OCD does! It makes you wonder and doubt, dragging you down the rabbit hole of uncertainty. And the well-meaning blogger (who claims to be “cured” of her own OCD) unwittingly served as its accomplice by encouraging others to seek reassurance with “facts” and comparisons—thereby perpetuating the “checking compulsions” her followers had certainly already been relying on to make themselves feel less anxious.

So if you’re struggling with distressing thoughts and find yourself tempted to Google for answers, I recommend you consult one site and one site only (or none at all, if you won’t be able to keep yourself from looking further): the International OCD Foundation (iocdf.org). You’ll find credible information and a referral database of reputable professionals skilled in treating OCD.

 

 

 

 

 

 

 

 

 




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Old advice about coping with OCD is new again

By Lynne Gots, posted on May 4th, 2015.

OCD is a formidable opponent. It’s the sharpest prosecutor, the meanest bully, the dirtiest thug. Arguing, appeasing, or getting into a fight with it won’t work. You’ll lose.

If you suffer from repugnant mental intrusions, you may believe your thoughts are the problem. You’ve probably spent hours, days, or, quite possibly, years trying to reason with them or push them away. One obsession may resolve only to have another one surface. It’s exhausting and demoralizing.

Surprising as it may seem, your thoughts are not the problem. Everyone has thoughts, even bad ones. In a seminal 1978 experiment, psychologists Stanley Rachman and Padmal de Silva found that nearly 90% of the “ordinary” people (that is, a non-clinical population) they sampled admitted to having had occasional thoughts about committing violent crimes, engaging in taboo sexual acts (with children, family members, or animals), blurting out obscenities or racial slurs in public, harming themselves or loved ones, or doing something inappropriate (such as laughing at a funeral). The main differences between these so-called “non-clinical” obsessions and the “clinical” ones of someone with OCD are the frequency of the thoughts, the distress they cause, and the efforts expended (ie, the compulsions) to get rid of them.

British writer David Adam has recently published an excellent memoir, interspersed with fascinating historical accounts of the disorder, about his struggles with OCD, The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought.

Here is some cutting-edge advice in Adam’s book on how to cope with obsessional thoughts:

“Grit your teeth in the face of your thoughts and for God’s sake be more obstinate, head strong and wilful [sic] than the most stubborn peasant or shrew. Indeed, be harder than an anvil . . .If necessary speak coarsely and disrespectfully like this: Dear devil, if you can’t do better than that, kiss my toe.”

The statement embodies all we’ve learned from evidence-based treatment. It’s exactly the type of approach psychologist Reid Wilson advocates when he talks about “chasing the bogeyman” (I attended a workshop he gave on this treatment method just a few weeks ago).

An up-to-the-minute strategy for dealing with intrusive thoughts. From the 16th century, courtesy of the theologian–and OCD sufferer–Martin Luther.

 

 

 

 

 




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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.

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