As important, or potentially more important, than the Ketamine experience itself is the post-session integration.  While therapeutic Ketamine treatments build in a talk therapy session immediately after the effects wear off, moments of integration can happen for a significant time period after treatment.  You are especially receptive and heart-open in the 48 hours following a session.  

OCDland or the Land of Doubt is a magical world that exists in our brains that hijacks reality and replaces it with a fully different narrative about the world. This narrative is one where uncertainty is replaced by a negative certainty, simply to squash the uncomfortable doubt.

As a client relates their OCDland outlook to me, they often interject “But I know this is silly…” or “This sounds crazy but…” We don’t ever fully inhabit our OCDland but there are days when it feels more real.

Obsessive Compulsive Disorder feels like having a very persuasive bully that lives in our brains. Many times we can tell that the OCD is distinct from our core thoughts and core beliefs. We can tell that we are getting led away from our intelligent selves into a viewpoint that does not have a strong basis in logic. Why is the OCD successful in conning us and how does it do it? Here are four techniques that it uses to trick our brains.

I have truly mixed emotions about the phrase “I’m so OCD.” On one hand, I appreciate the attention that this generation is placing on mental health, and the openness with which neurodiversity, mental health, and trauma is discussed in popular discourse. Overall, that is undoubtedly a good thing. Young people know how to recognize a panic attack and how to support their friend with grounding exercises. Friends, often connected on social media and messaging apps, support each other at all hours of the night through dark moments.

In OCD treatment, connecting to fictitious depictions of OCD is actually part of the healing process. In an effort to externalize OCD, we differentiate our core personality from our OCD and attach an image, character, and name to this mental bully.

Thought-Action fusion is an often-overlooked aspect of Obsessive Compulsive Disorder.  In this form of OCD, a sufferer believes that just because they think a thought, that it will come true.  This is a form of superstition – in other words, the distortion of magical thinking. The risk of a thought-action fusion is that it can cause a person a tremendous amount of mental anguish, and can inspire various unhealthy compulsions.

Cognitive Behavioral Therapy (CBT) is known to be a highly intellectual and conversation-based form of therapy that includes homework. How is it that therapists can apply these principles to working with children, even young children?

While children may not be able to readily name the 12 major negative distortions, such as personalization, catastrophization, and discounting the positive, they are usually able to notice a negative interpretation. Children are natural debaters and questioners. When enlisted as detectives rooting out the truth in their thoughts, young minds can be very inquisitive.  

OCD can be easily misdiagnosed as Generalized Anxiety Disorder (GAD) in children.  Most pediatric clinicians are well-versed in GAD but have no training in OCD. Physical compulsions can look like “quirky” kid behavior.  Ordering, arranging, and checking behavior can be rewarded in a school or home environment, as it can be seen as “responsible,” mature behavior.  Adults may feel pleased with how compliant a people-pleasing child may be, without understanding that the root of this behavior is extreme anxiety. 

Checking is essentially a form of reassurance-seeking, where the individual with OCD is responding to the intolerable reality of not being sure. 

This lack of sureness is not actually cured by the checking behavior in the long term (only temporarily!) because as we know, checking is a constant, insatiable need.  

In Exposure Response Prevention, we are asking kiddos to sit with discomfort and have a tolerance of uncertainty. Parents must go through this process as well in order to properly model and guide their children towards healthier coping strategies.  

Contamination is the most commonly known form of Obsessive Compulsive Disorder. However, most of us have a simplified understanding of how contamination obsessions present – it is far more complicated than simply hand washing!

Exposure Response Prevention is, quite simply, the art of finding the area just outside your comfort zone and pushing yourself to spend a little time there.

For many of us with OCD, we develop avoidance compulsions around socializing. Even those of us who do not have a social anxiety presentation of OCD can feel alienated from others because we fear judgement for our behaviors.

Anxiety at its core is an unhelpful triggering to the sympathetic nervous system. Our sympathetic nervous system is our Fight Flight Freeze response, which is biologically important but usually, in modern times, alerted during non-dangerous situations.

For those dealing with Obsessive Compulsive Disorder, planning can become a compulsion that temporarily soothes the fear of the unknown. OCD tries to attain certainty about the future, and this can come in the form of plans. Some planning is necessary and useful, but over-planning detracts from our ability to be in the present.

Over-control of details in the environment, schedule, or in one’s person, is a compulsion. This compulsion is a defense response from a fear of being unsafe. These people are labeled by those in their inner circle as “micro-managers” or “very particular.” In OCD treatment, we let go of one thing at a time, until many things float outside the circle of management/control.

For most of us, OCD is far more entrenched than we even realize when we begin treatment.  Exposure homework gets avoided week after week, and our clients’ progress is slow.  Regular repetition of therapy exposures is the quickest path to healing!  At-home exposure coaching basically helps adults and children actualize the goals of therapy between sessions.  

More and more human beings are experiencing panic attacks during these changing, uncertain times.  However, few know the difference between panic attacks and panic disorder.  Here’s how to differentiate.  

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.  

Obsessional slowness is a commonly misunderstood form of OCD that often presents around showering, getting dressed, or preparing to leave the house.  Basic daily tasks must be done with a deliberateness that often leads to excruciating prep time (s.a. morning routines that begin at 5am) or chronic lateness or truancy.  Obsessional slowness often comes from the OCD compulsion to not stop until something is “just right.”