Committed Action is a form of therapeutic goal setting that naturally springs from an exercise of clarifying values.  Values help you understand directionally where you want to go and committed action is a concrete presentation of how you want to get there.  Committed action is a declaration to more fully live out your values.  

Sometimes a therapist cannot set up in vivo exposures either in the therapy room or as homework. Sometimes an in vivo exposure would be too dangerous, too extreme, or simply not viable. In these cases, an imaginal exposure is the next best option.

Moral scrupulosity is a common presentation of Obsessive Compulsive Disorder (OCD) wherein the client feels like they have to “always do the right thing.”  While this sounds like a positive trait, moral scrupulosity can cause a tremendous amount of internal suffering.  

Over-apologizing is a seemingly benign behavior.  Those of us who do it consistently hear from our loved ones “Stop apologizing!” “You didn’t do anything!” “You are fine!”  Why is it that we just can’t resist saying we are sorry?

One presentation of Obsessive Compulsive Disorder involves obsessive doubts about a romantic relationship and compulsions that aim to establish certainty.  Relationship OCD, otherwise known as ROCD, may present as anxiety that our partner doesn’t love us or worries that we have made a mistake in our choice of partners. 

Many clients battling ROCD (Relationship Obsessive Compulsive Disorder) are faced with cognitive distortions as they over-analyze their relationship.  A particularly common thinking pitfall around relationships is emotional reasoning.  Emotional reasoning is the belief that just because we think and feel something, then it must be true.

In Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder, I encourage my clients to choose a “name” for their OCD. A name helps a client understand that their OCD is a bully inside their brain and does not represent their authentic thoughts.

OCD (Obsessive Compulsive Disorder) can be understood as inflammation of our amygdala – the part of our brains that responds to threat. When we suffer from OCD, many safe things can feel like dangers. Part of us can shut down to the outside world to avoid our triggers. So, what if the world demands vulnerability and our OCD fights back to mitigate uncertainty?

For clients with obsessive rumination, therapy sessions can feel like a game of whack-a-mole, where no negative bias can be defeated fast enough before another pops up. Some brains produce hundreds, sometimes thousands of negative self-talk statements every day. Negative self-talk can almost feel like an ever-present hum in the back of our minds; it never actually goes away.

Some responsibility for therapeutic resistance must be borne by the therapist. It is our job to create a safe space for our clients. We must sense when to push and when to soothe. We must prioritize our clients’ readiness to our therapeutic agenda. However, at South Boulder Counseling, I also ask my clients to take ownership of their therapeutic resistance and commit to challenging themselves in the therapy room.

Anxiety has a biological purpose. When our anxiety gets triggered, our bodies literally prepare to take on a threat. While it can feel intensely unpleasant, anxiety is actually trying to protect us. Anxiety is like a siren warning us of danger. We need the siren. But most of us need our overly-sensitive siren to be recalibrated to detect actual danger.

Avoidance of anxiety triggers seems like a logical and easy-to-implement solution to anxiety. For example, if we are anxious when socializing in groups, why not just set ourselves up for success by only socializing one-on-one?

The problem with avoidance is that, over time, it actually feeds our fear. If you avoid the situation that you fear and thus don’t feel a surge of anxiety, your brain gets confirmation that the avoidance pattern was effective.

In Cognitive Behavioral Therapy, we ask our clients to face their anxieties head-on. We support our clients in fighting the urge to avoid anxiety-provoking situations and actions, and we encourage our clients to give voice to their most persistent worries. However, actually facing anxiety and going through with the dreaded action or situation, can be preceded by a painful period of contemplation. Here’s what this can look like:

In our Christmas Eve zoom, my father, a Mexican scientist, started listing all the viable vaccines that he believes will flood the market in late winter.

Most of us feel lonelier in 2020.