“So do you have experience with this?”
Quite a few people who want to begin therapy ask me this. Of course, this is a perfectly reasonable question, but I still usually find myself searching for a good response. The answer should be easy. My specialization as a therapist is the treatment of anxiety and my subspecialty is OCD therapy. Many people, therefore, contact me because they are struggling with one of these issues or both. Of course, I have experience as well as training and skills working with people on these matters, so I could just say “Yes” with confidence and conviction.
It took me a bit to get to the bottom of my own hesitation, but eventually I realized where it stemmed from…Continue reading in “Psyched in San Francisco” Magazine
Today I want to share a tool I have created to explain the mechanisms of Obsessive Compulsive Disorder (OCD) to children who are struggling with it. I work with a mindfulness based version of Exposure and Response Prevention. In mindfulness practice I find it helpful to imagine one’s own awareness as a wide open blue sky. Thoughts and images pop up and pass through this sky like planes, clouds, balloons and other flying objects. They can appear big and loud and strong but they inevitably become smaller and finally disappear out of sight. From the perspective of the wide open blue sky they may rough up things for a bit but they don’t change the sky. If we can treat the thoughts and images our mind creates with non-judgmental awareness, look at them, appreciate the feeling that comes with them and then let it drift away, we can become “unstuck” and our emotional pain can diminish. When we practice mindfulness we can learn to accept our inner experiences without avoidance. I will write more about this later and this book about “Acceptance and Commitment Therapy” (ACT) is a fantastic introduction, “Get out of Your Mind and into Your Life: The New Acceptance and Commitment Therapy,” by Stephen C. Hayes, PhD.
For people who struggle with OCD certain intrusive, repetitive, negative thoughts and images (obsessions) create intense feelings of anxiety. To relieve these feelings they tend to engage in concrete or mental rituals. The way our mind tends to work, however, when an anxiety provoking thought gets negatively reinforced via a response (a compulsion) it comes back bigger and stronger. To explain this mechanism to children I have created these images:
Children can write one of their obsessions into the first balloon and can fill some of the other flying objects with thoughts that are not coupled with anxiety for them. They can then also fill in a compulsion they use to feed the “Bad Feeling Monster.” On the second page they can see how the monster and the balloon have grown and are still right in front of them while the other “thoughts” have moved away and are leaving their “sky of awareness.”
Let me know if you find this tool helpful!