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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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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Five Common Myths about OCD

By Lynne Gots, posted on July 9th, 2017.

The people I treat for OCD hate it when someone says, “I’m so OCD!,” usually as a way of explaining pickiness or excessive neatness. I do, too. Not only does the comment minimize the severe suffering a person with actual OCD experiences; it also perpetuates a number of prevalent misconceptions about the disorder.

  1. OCD isn’t a personality quirk. It’s a  neuropsychiatric illness involving persistant, intrusive mental images or thoughts (obsessions) that create extreme emotional distress–typically anxiety, but sometimes disgust. Compulsions develop as a way of alleviating the intolerable feelings.
  2. OCD isn’t perfectionism. Perfectionism is one thinking style commonly, but not always, seen with OCD. Other cognitive patterns, such as an excessive sense of responsibility, a tendency to overestimate danger, and an intolerance of uncertainty also frequently accompany OCD.
  3. Not everyone with OCD is a neat freak. Neatness may be characteristic of people with OCD who have a compulsion to create order and symmetry to feel “just right.” Or the need to clean and wash may be a response to contamination obsessions. But other forms of OCD involve primarily mental images and rituals often invisible to the casual observer.
  4. OCD is easy to spot. Washing and checking compulsions may be obvious to family and friends. But many other obsessions and compulsions occur strictly in the sufferer’s mind, making them hard to detect even for mental health professionals. Given the shameful nature of these mental intrusions, such as thoughts of committing a violent act, people afflicted with this type of OCD may suffer in silence for years–seventeen, on average–before obtaining the proper diagnosis and treatment.
  5. OCD is hard to treat. Many traditional mental health practitioners hold this view. In fact, with the correct, evidence-based treatments (Cognitive-Behavioral Therapy and medication, if needed), people with OCD can feel relief within a few months.

These myths do a disservice to those in the grips of OCD. Let’s set the record straight.

 

 

 

 




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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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