perfectionism and - Obsessive-Compulsive Foundation

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Perfecting Perfectionism Perfecting Perfectionism Jeff Szymanski, Ph.D. Executive Director, International OCD Foundation Clinical Instructor, Harvard Medical School Author, “The Perfectionist’s Handbook” Steven D. Tsao, Ph.D. Clinic Coordinator Center for the Treatment and Study of Anxiety University of Pennsylvania First things 0irst…. what do we actually mean By “perfectionism” Jesse M. Crosby, Ph.D. Postdoctoral Fellow OCDI OfHice of Clinical Assessment and Research McLean Hospital / Harvard Medical School Types of Perfectionism Absence of mistakes or 0laws We often consider something to be “perfect” when we can no longer 7ind any errors, mistakes or 7laws. Types of Perfectionism Personal Standards Sometimes when you’ve done something “perfectly”, it means that you achieved a particular standard you set for yourself. -151-
Types of Perfectionism Types of Perfectionism Meeting an Expectation Order and Organization One might also de7ine perfectionism as having matched an expectation that someone else has set. Order, organization, and having “everything in its place” is yet another way to think about perfectionism. Types of Perfectionism Types of Perfectionism SATURDAY Ideals and “Just Right” Experiences Sometimes we “know” that something is ideal because it hits us “just right”; it looks, feels, and sounds right. Absolutes: knowledge, certainty, safety To have absolute, complete, comprehensive knowledge about something – to be convinced that this is the right direction to take -‐-‐ is very satisfying and reassuring. -152-
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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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What is a major life activity Basic
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What is Reasonable Accommodation Mo
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Family and M edical L A eave ct IOC
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THE SPENCER LAW FIRM 2727 Camino de
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Importantly, the ADA requires cover
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Some possible reasonable accommodat
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THE SPENCER LAW FIRM 2727 Camino de
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insurance, sick leave, education be
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Protection and Advocacy The Protect
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Can’t - vs. -Won’t • If you s
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Rewards Fear Stimulus CBT Model of
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My Child-Brother-Sister Has OCD But
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I’m Afraid I’m Really Gonna Do
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Roger is a 52 year old widowed dent
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Fear of loss of impulse control: B:
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Fear of loss of impulse control ERP
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Sandra Practices walking with delay
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Page 106 and 107: 6/14/13 Defining the Problem- Raci
Page 108 and 109: 6/14/13 Time for ERP Separation A
Page 110 and 111: Manipulating Language to Improve Pa
Page 112 and 113: 6/24/13 SHIFT LANGUAGE TO PROMOTE H
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
Page 120 and 121: 6/14/13 WHAT DOESN’T APPEAR TO WO
Page 122 and 123: 6/14/13 COGNITIVE THERAPY CONT. IDE
Page 124 and 125: 6/14/13 ERP HIERARCHY #1 BDD ISSUE:
Page 126 and 127: 6/14/13 IN CLOSING EDUCATION TREA
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
Page 136 and 137: Conceptualizing and Treating Hoardi
Page 138 and 139: 6/24/13 DSM-‐5 criteria for
Page 140 and 141: 6/24/13 Family Burden • Growin
Page 142 and 143: 6/24/13 Biological vulnerability
Page 144 and 145: 6/24/13 • Depression • Self-
Page 146 and 147: 6/24/13 Mo8va8on and Ambivalence
Page 148 and 149: 6/24/13 Skills Training: Objec8ve
Page 150 and 151: 6/24/13 Behavioral Experiment: C
Page 152 and 153: 6/24/13 Treatment Responders (%)
Page 156 and 157: Types of Perfectionism Being th
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
Page 164 and 165: • Are we there yet • The r
Page 166 and 167: Addressing Relapse in CBT for OCD 6
Page 168 and 169: 6/14/13 Lisa’s Exposure Hierar
Page 170 and 171: 6/14/13 Is Performance During E
Page 172 and 173: 6/14/13 Frame ERP to Mismatch
Page 174 and 175: 6/14/13 Implica:ons for Psychoed
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Page 196 and 197: 6/14/13 Jenny Jenny • Referred
Page 198 and 199: 6/14/13 Appraisals of intrusions
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Page 202 and 203: 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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