perfectionism and - Obsessive-Compulsive Foundation

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6/14/13 WHAT DOESN’T APPEAR TO WORK WHAT DOESN’T APPEAR TO WORK CONT. Anti-psychotics when used without an SRI Tricyclic antidepressants (except Anafranil) ECT (can be effective for depression component) Neurosurgery (limited case examples; results mixed) *Source: Phillips, The Broken Mirror, Revised Edition, 2005 Plastic surgery and dermatologic treatments Most likely outcome is either no or limited relief, or another body part becoming focus of concern Psychodynamic psychotherapy (or does it) Everyone with BDD has a story Diet, excessive exercise, natural remedies, hypnosis BDD AND COSMETIC TREATMENTS BDD AND COSMETIC TREATMENTS CONT. Most commonly sought: rhinoplasties and breast augmentation. Other procedures include microdermabrasions and collagen injections Two studies reported 71% to 76% of people with BDD sought cosmetic treatment and 64% to 66% received it* 7.3% of people reported overall improvement with BDD** (lower percentage in another smaller study) Several incidents of patients threatening their doctors and at least 4 reported cases of surgeons murdered by a BDD patient* 29% have threatened cosmetic surgeons with legal action** Self surgery/bodily harm, i.e., home dental work, picking off moles, damaging a part of the body to get surgery for it *Crerand, et al., Plast Reconstr Surg., 2008 **Sarwer, Aesthet Surg J., 2002 *Crerand, et al., Psychosomatics, 2005 and Phillips, et al., Psychosomatics, 2001 **Phillips, et al., Psychsomatics, 2001 -117- 5
6/14/13 BDD AND COSMETIC TREATMENTS CONT. HOW TO ADDRESS MEDIA INFLUENCE Why doesn’t surgery work Can’t fix a psychiatric problem by altering a body part People often overlook that a procedure on one part of the face will then alter how other features look in relation to that Acknowledge that our society places a premium on physical appearance Billboards, Movies, TV, Magazines, etc… We’re all exposed to the same, yet relatively few people have BDD Is patient willing to acknowledge that his/her concerns are beyond what is normal “Anything would be better than I have now” TREATMENT CONT. BDD patients may be more sensitive to aesthetics and beauty than those without it* *Source: Buhlmann and Wilhelm, Psychiatric Annals, 2004 COGNITIVE THERAPY SATURDAY Cognitive therapy: to challenge distorted beliefs Behavior therapy: challenges beliefs by confronting maladaptive coping strategies and behaviors “Exaggerated” exposure therapy To disprove beliefs that appearance means as much as person thinks it does To learn that life can be meaningful without altering or disguising body part(s) -118- 6
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IMAGINE THAT!: A SCRIPTING WORK- SH
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Themes and Variations - Theoretical
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Themes and Variations - Theoretical
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6/14/13 • Subjects (N = 20) with
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The Social Experiment 6/14/13 The
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6/14/13 How Do We Treat Social
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6/14/13 Exposure therapy is: A
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6/14/13 Detailed Inves5ga5on of
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6/14/13 Why Imaginal Exposure
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6/14/13! Common obsessions, continu
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6/14/13! 1# This circuit is called
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6/14/13! -33- 6!
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6/14/13! People with OCD experience
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6/14/13! 1a. Behavior Therapy! •
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ERP Exposed OCD Cycle Obsessions Re
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OCD Definition: OCD Cycle COMPULSIO
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Somatic Obsessions Miscellaneous Ob
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Exposure and Response Prevention -
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Strategic Model of Cognitive Treatm
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Segment 3 Every step of the way, ch
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You also have to tolerate anxiety
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Segment 9 Segment 10 Habituation re
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Get rapport (and get it again) Get
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6/14/13 Example #2: “Dave”
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6/14/13 Talking about Accommoda@o
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6/14/13 Making Decisions about A
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6/14/13 Dealing with Arguments
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Ask an Attorney - What Are My Right
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Page 90 and 91: Rewards Fear Stimulus CBT Model of
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Page 96 and 97: Roger is a 52 year old widowed dent
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Page 100 and 101: Fear of loss of impulse control ERP
Page 102 and 103: Sandra Practices walking with delay
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Page 110 and 111: Manipulating Language to Improve Pa
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Page 114 and 115: 6/24/13 LABEL ANXIETY AND OCD Agai
Page 116 and 117: The BDD Challenge 6/14/13 The BDD C
Page 118 and 119: 6/14/13 WHICH BODY PARTS ASSOCIATED
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Page 124 and 125: 6/14/13 ERP HIERARCHY #1 BDD ISSUE:
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Page 128 and 129: 6/14/13 FAMILY ACCOMMODATION & MAIN
Page 130 and 131: 6/14/13 HMO HMO = Health Maintenan
Page 132 and 133: 6/14/13 RECOGNIZE THE SIGNS OF OCD
Page 134 and 135: 6/14/13 COLLABORATING WITH SCHOOLS
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Page 144 and 145: 6/24/13 • Depression • Self-
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Page 154 and 155: Perfecting Perfectionism Perfecting
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Page 158 and 159: Healthy Perfectionism In general
Page 160 and 161: The cost of perfectionism • T
Page 162 and 163: Let’s Focus on Two Problemati
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Page 166 and 167: Addressing Relapse in CBT for OCD 6
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6/14/13 Is Performance During E
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6/14/13 Frame ERP to Mismatch
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6/14/13 Implica:ons for Psychoed
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6/14/13 Jenny Jenny • Referred
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6/14/13 Appraisals of intrusions
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6/14/13 Bill • His intrusive
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6/14/13 Response Prevenaon • D
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6/14/13 Study Comparing Individual
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6/14/13 Exclusionary Criteria Struc
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6/14/13 Contact Information The OCD
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6/14/13 Acceptance vs. Change Chan
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6/14/13 Positive Reacting Styles P
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6/14/13 What is P-N-P What is P-N-
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People and Places - Emotional Conta
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6/14/13 CASE EXAMPLE • 67 year
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6/14/13 THE ROLE OF BETRAYAL
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6/14/13 THE ROLE OF ACCEPTANCE
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Challenging Kids Challenged Adults
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Regulatory Disorders Challenging Ki
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Tips for Non-OCD Anxiety Disorders
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Sleep Problems Tips for Sleep Probl
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EXECUTIVE FUNCTION “He is such a
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Write It or Regret It! CL UE Tips f
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Slow Processing Speed (Sluggish Cog
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Tips for Handwriting • Reduce cop
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Curiosity vs Judgment! © Sheryl K.
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Prepare the child for the path….
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How Can the Whole Family Fight OCD
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Task Description & Reminder of spec
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Using Scaffolding Steps in Unplanne
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6/14/13 Examples of Behavioral
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Assessment and Treatment of Postpar
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Cognitive-Behavioral Strategies in
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6/14/13 iCompulsions (OCD) or Cyber
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6/14/13 Similarities Between HC and
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6/14/13 C = Increased Fear and Doub
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6/14/13 Sample Exposures For Health
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6/14/13 The Effect of Attention (Ta
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6/14/13 Health-Related OCD Case Exa
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6/14/13 Treatment • Stop all comp
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So You Expect Them to Leave Home So
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Daniel G. Pruitt, Jr., PCC, SCAC In
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NEEDED TRANSITION SKILLS: • Time
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Memory Functioning CL UE Short-Term
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Taking Medications Exercise! •Und
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Washer and Dryer TRANSITION SKILLS:
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TRANSITION SKILLS: Ready ! Money Ma
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TRANSITION SKILLS: • Tell them wh
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TRANSITION SKILLS: This Isn’t It!
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Tigers, Too Tigers, Too: Supplement
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WHEN REASSURANCE IS HARMFUL By Paul
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APOSTOLIC CHRISTIAN Counseling and
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