perfectionism and - Obsessive-Compulsive Foundation

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6/14/13 Similarities Between HC and OCD Differences Between HC And OCD • Intrusive thoughts (about illness in the case of HC) • Repetitive self-checking and vital sign monitoring (body vigilance) as an escape from anxiety • Frequent reassurance-seeking • Repeatedly going for medical consults and tests • Recurring doubts about results of medical testing • and examinations • Overconcern with the possible significance of bodily sensations • Both have a 1:1 sex ratio Where Does OCD vs. HC lie on a Continuum of Doubt More Doubt Less OCD HC (OCD) (HC) -255- 5
6/14/13 Cognitive-Behavioral Model of Hypochondriasis/Health-Related OCD A = Activating health related event D = Action taken to reduce fear, worry and uncertainty B = Dysfunctional appraisal of bodily sensations C = Heightened fear, worry and uncertainty • The human body is “noisy” • Most bodily sensations are mild, transient and not associated with any serious disease - for example: – Dizziness, faintness, rapid heartbeat from not eating for a long time – Rapid heartbeat from eating a meal rich in carbohydrates – Arm and joint discomfort from sitting or standing in one position for a long time – Stomach pain from overeating or indigestion – Headaches from being out in the sun too long – Muscle pain after a lengthy workout in the gym B = Dysfunctional Appraisal • Blank-and-White thinking– – “Bodily complaints are always a sign of disease” – “I’m only certain I’m healthy if I don’t have any body sensations” – “Unless I’m absolutely sure that there is nothing wrong, I must assume the very worst” • Negative interpretation bias / disqualifying the positive – “Just because these doctors says I’m healthy doesn’t mean I am. They could be missing something.” • Catastrophizing- attributing horrible consequences to minor events – “I have a headache – I must have a brain tumor” – “My back aches – I must have bone cancer” • Intolerance of Uncertainty – “I must have 100% proof that I’m not ill, otherwise I’m probably sick” – “I must frequently check my body and watch my health carefully in order to catch the first signs of serious illness” – “If I stop thinking about my health, even for a short time, it’s dangerous” • Superstitious thinking – “If I tell myself I’m healthy, I’m tempting fate” – “Seeing a TV show about herpes by chance at the very same time that I’m worrying about it is an omen that I probably have it” – “Worrying about my health will keep me safe from illness” • Emotional Reasoning: feelings = facts SUNDAY -256- 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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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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6/14/13 Defining the Problem- Raci
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6/14/13 Time for ERP Separation A
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Manipulating Language to Improve Pa
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6/24/13 SHIFT LANGUAGE TO PROMOTE H
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6/24/13 LABEL ANXIETY AND OCD Agai
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The BDD Challenge 6/14/13 The BDD C
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6/14/13 WHICH BODY PARTS ASSOCIATED
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6/14/13 WHAT DOESN’T APPEAR TO WO
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6/14/13 COGNITIVE THERAPY CONT. IDE
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6/14/13 ERP HIERARCHY #1 BDD ISSUE:
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6/14/13 IN CLOSING EDUCATION TREA
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6/14/13 FAMILY ACCOMMODATION & MAIN
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6/14/13 HMO HMO = Health Maintenan
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6/14/13 RECOGNIZE THE SIGNS OF OCD
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6/14/13 COLLABORATING WITH SCHOOLS
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Conceptualizing and Treating Hoardi
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6/24/13 DSM-‐5 criteria for
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6/24/13 Family Burden • Growin
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6/24/13 Biological vulnerability
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6/24/13 • Depression • Self-
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6/24/13 Mo8va8on and Ambivalence
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6/24/13 Skills Training: Objec8ve
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6/24/13 Behavioral Experiment: C
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6/24/13 Treatment Responders (%)
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Perfecting Perfectionism Perfecting
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Types of Perfectionism Being th
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Healthy Perfectionism In general
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The cost of perfectionism • T
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Let’s Focus on Two Problemati
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• Are we there yet • The r
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Addressing Relapse in CBT for OCD 6
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6/14/13 Lisa’s Exposure Hierar
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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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Page 224 and 225: Challenging Kids Challenged Adults
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Page 228 and 229: Tips for Non-OCD Anxiety Disorders
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Page 232 and 233: EXECUTIVE FUNCTION “He is such a
Page 234 and 235: Write It or Regret It! CL UE Tips f
Page 236 and 237: Slow Processing Speed (Sluggish Cog
Page 238 and 239: Tips for Handwriting • Reduce cop
Page 240 and 241: Curiosity vs Judgment! © Sheryl K.
Page 242 and 243: Prepare the child for the path….
Page 244 and 245: How Can the Whole Family Fight OCD
Page 246 and 247: Task Description & Reminder of spec
Page 248 and 249: Using Scaffolding Steps in Unplanne
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Page 256 and 257: 6/14/13 iCompulsions (OCD) or Cyber
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Page 262 and 263: 6/14/13 Sample Exposures For Health
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WHEN REASSURANCE IS HARMFUL By Paul
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APOSTOLIC CHRISTIAN Counseling and
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