Anxiety Disorders

Video- “My OCD Story”

   My OCD Story by “Birdy” age 12   “Birdy” (her nickname) entered our Intensive Outpatient Program in April of 2014. When we met Birdy she was experiencing very severe OCD which made it difficult for her to walk, eat, go to school, and do most basic activities. Every moment of her day was filled with stomping, blinking, tapping, and other movements meant to ward off sickness. Not only was Birdy consumed by rituals, she was also fearful of hundreds of words that OCD associated with sickness.  This made it difficult to write, say or hear words such as ballerina blonde, nine, and blue.   Birdy had become trapped by her OCD and she was no longer the happy, vivacious kid she was before.  Birdy missed her old self and wanted to return to who she was before OCD. Every day that Birdy practiced ERP she got stronger and stronger. Some of her biggest early accomplishments were walking and getting in and out of the car without rituals. With each passing day she learned how to weaken her OCD by “bossing it back” and “messing up” her rituals.  What used to be an elaborate stomping ritual became a silly dance chosen by Birdy. OCD was no longer in charge!  Instead of returning to the girl she was before OCD, she transformed into a girl who was stronger and braver than we could have imagined. Birdy’s experience of overcoming OCD inspired her to become an OCD advocate. We are delighted to support this budding young film-maker share her inspiring story with others.  Here is “My OCD Story” directed and produced entirely by Birdy. Read “A Mother’s Story” by Birdy’s...

Read More

A Mother’s Story

A Mother’s Story

OCD is a mysterious and complex creature that has been controlling my older daughter, Birdy (age 12), for the past several years and robbing her not only from her passions and success but also the basic pleasures of adolescence and joy of life. As a parent, there is nothing more painful and terrifying than watching your child suffer from the oppressive demands of OCD and being controlled by this “inner demon.” My husband and I felt helpless, bewildered and full of despair as we witnessed our once vibrant and successful daughter sink further into the trap of OCD until she was “stuck” to the point of being unable to perform even basic life skills: getting out of bed, walking, reading, eating, bathing, etc.… Historically, Birdy had been a fairly cautious little girl with periods of anxiety starting in the fourth grade, but she seemed to manage her anxiety most of the time, and was highly successful in school, athletics and music. She began her 7th grade year as she had always approached school and life: honor student, competitive swimmer, performing musician, publicist on student council, avid reader, role model big sister and friend to all. But by mid-year she was unable to keep up with the demands of her OCD rituals and compulsions and began isolating herself from everything. Ultimately unable to go to school, swim, read, play her flute, spend time with friends, etc. she became trapped in our home, her actions ruled by fear, anger and frustration. Birdy’s entire life became an exhausting sequence of tapping, stomping, and blinking rituals, which were “protecting her from getting sick.” As her OCD intensified, and her compulsions seemed to multiply exponentially, Birdy’s frustration became unbearable and she began harming herself and running away. Ultimately I had to quit my job to stay home with her and provide full-time care, while we searched to find solutions. Trying to make sense of it all, my husband and I sought help from OCD books, on-line resources and professionals in our rural community for a couple months, but soon realized that Birdy’s condition required a different level of care. All of our research pointed to Exposure and Response Prevention therapy (ERP). We looked at programs all over the country, both inpatient and outpatient programs, hoping to find a program within driving distance. The closest program we found was in the Bay Area, which was 4 hours away. We had family in the Bay Area so we decided to stay with family during the week and drive home for the weekends. Birdy was evaluated for their Intensive Outpatient Program (IOP). I cannot explain the relief we all felt after this initial consultation. The therapist who met with Birdy “normalized” her symptoms and she finally felt like she was being heard, as if her OCD story was being understood for the first time. We left that first appointment feeling a sense of hope and a commitment to the journey of getting our daughter back on track. Birdy began the IOP program with ERP therapy soon thereafter. Four to six weeks into the program, Birdy started making amazing progress—it was as if her brain was suddenly unlocked and she could apply the tools and strategies she had learned. Though challenging and exhausting, the ERP therapy allowed her to walk ritual free, read once more, play her flute and have fun. Birdy regained her lost abilities and ERP therapy gave her the confidence to move forward on her life path. Through this process our whole family became involved as coaches and supporters for Birdy. Her younger sister helped...

Read More

Exposure and Response Prevention Therapy

Exposure and Response Prevention Therapy

What is Exposure and Response Prevention for OCD? If you or a family member recently received an OCD diagnosis you may have a lot of questions. Having a name for your symptoms may provide some amount of relief, but you need more answers. “I know I have OCD now, so why is it still so hard to stop my compulsions” “How can I get some real relief?” Let’s start with answering the first question—why is it so hard to stop compulsions? Well, to put it simply, your brain has learned that compulsions and avoidance work to reduce anxiety and discomfort!    It might be small and have taken some time to achieve relief, but at least it’s some relief. Logically, you might be fully aware that the compulsion is unnecessary and causing you more harm than good. However, it might be the ONLY thing that gives you any relief in the moment. There you have the battle that leaves so many with OCD feeling discouraged with themselves and trapped in compulsions they know full well they don’t need. If you are feeling trapped by Obsessive-Compulsive Disorder in this way, it is NOT because you have weak willpower or self-control. It’s just the way our brain are wired. Our brains are wired to avoid discomfort. The way it learns to avoid discomfort effectively is through something called negative reinforcement. Negative reinforcement may occur when something unpleasant is taken away. An example would be when we turn the faucet to cold when the water gets too hot; excuse ourselves from an awkward conversation; take an alternate route to work when we see construction ahead; or go inside when the weather is rough. However, in OCD, when we feel anxious the compulsion can take the feeling away. Every time we use the compulsion we are strengthening the habit and fuel the cycle. Every time you use a compulsion you add more fuel. This is why it’s so difficult to stop compulsions–they work in the short term.  But it isn’t in your long term best interest. Just like scratching an itch gives relief but aggravates the rash, compulsions relieve anxiety, but aggravate OCD. So are you doomed to be stuck in an endless loop of negative reinforcement? Absolutely not! However, beating your fears is a process of learning through addition, not subtraction. You can never fully erase fears from your brain, but each time you face a fear you have the opportunity to strengthen your brain, dampen those fears, and have them no longer control your behavior. This type of learning takes place when fearful expectations are not realized even in the face of what you fear. Let’s take the example of getting bit by a dog and developing a phobia of dogs. That association between dogs, danger, and an urge to escape may be very strong indeed. It’s likely to be an experience you’ll never forget. However, if you make a point to continue to interact with dogs and stay safe, that fear of being bitten “looses its teeth.” The benefits of facing your fears are achievable in OCD as well. The answer is in a treatment called Exposure and Response Prevention Therapy (ERP) for OCD. ERP is designed to help patients break free from the OCD trap. It consists of two components. The first is exposure to things that trigger OCD fears. This is the facing your fears element. The second part is response prevention and refers to preventing one’s self from performing compulsions. This keeps artificial relief from interrupting the process before it has a chance to start working. So...

Read More

20/20 Episode on Childhood OCD

Watch this very important episode on treatment for childhood OCD. 20/20 Episode on Exposure and Response Prevention

Read More

Client Story: OCD, teen

Client Story: OCD, teen

By “Beth” In retrospect my OCD began in childhood but the symptoms that brought me into therapy began out of the blue, years later. One day, I woke up and had the thought, “what if I molested a child?” I was horrified and shocked that I had even thought this, and immediately tried to get rid of the thought. I felt awful about it, but I literally couldn’t get the thought out of my mind. The harder I tried, the more it seemed to cement itself in my consciousness. Every day was a nightmare. I was flooded with anxiety constantly, and I couldn’t let myself relax or enjoy anything at all. I looked for ways to punish myself for having this intrusive thought; I thought I didn’t deserve happiness anymore. Eventually, it got so bad that I began having suicidal thoughts. This was the point where I realized that something was seriously wrong. I found a list online of intrusive thoughts common to people with OCD, and I was immediately flooded with relief and apprehension. If this was what I had, then it meant that I could be treated! However, I was also terrified that I didn’t have OCD, that I would go to a therapist and they would tell me that I was actually a pedophile or something. I was already suicidal, so I figured I had nothing to lose. I had also read online that the “gold-standard” for OCD treatment was called “Exposure and Response Prevention”, a type of cognitive behavioral therapy (CBT). I sought out a therapist who specialized in OCD and other spectrum disorders, because I wanted to treat both the intrusive thoughts I was having and my phobia of vomiting (emetophobia), that I’d dealt with since childhood. My only knowledge about going to therapy was from what I’d seen in the media, so I didn’t have much of an idea of what to expect. My therapist and I set goals for tackling my fears, strategized, and talked out whatever I happened to be going through. Inexplicably, the obsession that I was a child molester faded into the background as randomly as it had appeared. It was immediately replaced by the obsession that I was gay, then that was replaced by the concern that I was developing another mental illness, like bipolar disorder or schizophrenia. I realized that, this whole time I had been looking for reassurance for specific obsessions, but OCD will take any form it can to provoke anxiety. It didn’t matter what the content of the intrusive thought was, it all centered around the same core fears. Once I was officially diagnosed with OCD, the real work began. My therapist and I created fear hierarchies for my obsessions, as well as one for my phobia.  We began to complete the least anxiety-provoking items on the list and gradually worked our way up. Unfortunately, my anxiety was just too high and resilient for CBT to work on its own. I had to look for additional support to really be able to tackle this. I had been extremely reluctant to take any medication, but eventually I decided to try an SSRI. I was scared that it would change who I was as a person, or that I would have bad side effects, or that I would be dependent on it for life. Today, my only regret is that I didn’t try it sooner. My quality of life is so drastically improved that it sometimes feels like a miracle. I no longer have intrusive thoughts, and I don’t constantly worry about feeling sick. I went...

Read More

Client Story: Panic Disorder

Client Story: Panic Disorder

By ST Earlier this year, I was facing a lot of change in my life. I got married, quit my job, started consulting, got pregnant, and moved to the East Bay from San Francisco, all within the space of a few months. These were all exciting and positive changes for me, but they sparked an identity crisis. After 13 years of living in the city, I didn’t quite know who I was outside of it. The panic disorder took over slowly. At first, I started having trouble making the calls I needed to make as a new consultant. I questioned my ability to sell my services to new clients as a representative of “me” and not a larger company. Then I had a panic attack on Bart. Then I had a panic attack on the freeway. Then I had a panic attack in a meeting. Pretty soon I found myself sitting in my new house and scared to do much, lest I have a panic attack. I sought out the help of a CBT therapist because I was stuck, and didn’t know how to get moving again. In the past when panic disorder had visited my life (an unfortunate side effect of being violently mugged in the Mission years ago), I had been able to go on antidepressants and sort things out. Now being pregnant, I knew I needed to conquer my fears meds-free. When I first went to see my CBT therapist, I was very afraid. I couldn’t imagine facing a panic attack without my Xanax. The idea of actually putting myself in a situation where I might have a panic attack was unfathomable (and thus the reason why I was pretty much confined to my house). And yet, I knew that CBT and exposure therapy would bring me face-to-face with panic again and again. Luckily, we started slowly. My CBT therapist practices ACT (Acceptance and Commitment Therapy), so we first set out to define my values when it comes to marriage, family, friendships, personal growth, leisure time, spirituality, etc. Clearly identifying my values gave me the courage to participate in the exposure therapy to come – it helped me to remember who I was and what I was fighting for. We then started working through the book Mastery of Your Anxiety and Panic. The book made a very convincing argument as to the effectiveness of exposure therapy in getting rid of panic, and the worksheets in the book helped me to identify some of my underlying beliefs about panic attacks and the terrible things I thought would happen to me if I had one. My CBT therapist also started teaching me mindfulness techniques to retrain my brain to relate to fear symptoms differently. Every week, we started off our appointment with a mindfulness session. As negative thoughts or feelings arose, I was encouraged to just label them and let them disappear naturally, rather than judging them. This ability to bring curiosity and kindness to uncomfortable experiences would turn out to be key to my recovery. Finally, it was time to face the panic and give exposure therapy a try. I was unbelievably nervous. We decided I would start out by driving the Caldecott tunnel – I had been avoiding it since having a panic attack inside of the tunnel on the way to my sister’s house. My therapist armed me with all sorts of mindfulness tools – such as breathing techniques and imaginal tapes – to give me the guts to drive the tunnel that first time. The fastest way to decrease panic in a given situation...

Read More