It Matters How We Talk About OCD: The Importance of Using Language of Agency
OCD isn’t random or illogical. It is a comprehensible, logical strategy (avoidance and compulsion) aimed at preventing the Core Fear. Recovering from OCD requires recognizing that you are employing a strategy that doesn’t work, and learning that you have the ability to make different choices that lead to feeling better. Put another way, recovering from OCD […]
Rethinking the Process and Treatment of Compulsive Rumination
The below is the first article I wrote on this topic a few years ago. These ideas have evolved significantly since that time. Rumination-Focused ERP: Turning Exposure On Its Head and Targets and Rationales for RF-ERP Exposures offer the most current version of my approach to exposure. I believe that the issue of compulsive thinking, or […]
Why Rumination is a Continuous Loop
Please note that the below is an older article that requires significant revision in light of how my definition and conceptualization of compulsive rumination have evolved over the past few years. I do not think this article presents a complete, or completely accurate, description of compulsive rumination. Nonetheless, I have chosen to keep it posted […]
Exposure Is About Learning, Not Habituation
Please note that this is an older article. Thinking about exposure in terms of learning was a conceptual stepping stone between thinking in terms of habituation (the classical model) and thinking in terms of restoring agency (my current model). Rumination-Focused ERP: Turning Exposure On Its Head and Targets and Rationales for RF-ERP Exposures offer the most […]
Using Imaginal Exposure When Practicing ERP from the Perspective of Learning
Please note that this is an older article. Thinking about exposure in terms of learning was a conceptual stepping stone between thinking in terms of habituation (the classical model) and thinking in terms of restoring agency (my current model). Rumination-Focused ERP: Turning Exposure On Its Head and Targets and Rationales for RF-ERP Exposures offer the most current version of my […]
Treating Sensorimotor OCD (AKA Somatic OCD)
I recommend reading Awareness, Attention, Distraction, and Rumination before reading this article, since the concepts discussed there are foundational to the approach outlined below. Sensorimotor OCD (also known as Somatically Focused OCD) refers to cases in which people become hyper attentive to their bodily sensations, such as breathing, swallowing, or heartbeat. While this might not sound so […]
Rumination-Focused ERP: Turning Exposure On Its Head
Please note that Rumination-Focused ERP is a new and evolving approach to ERP. It has not yet been researched, and therefore to the extent that it differs from classical ERP, it is not evidence-based. In classical ERP, it is considered important that the patient feel anxious during exposure, because the goal of exposure is habituation. […]
Understanding Pure O: You Are Not Having Intrusive Thoughts All Day, You Are Ruminating
Most people with intrusive thoughts (often referred to as Pure O) and most people who treat intrusive thoughts, think that these thoughts are involuntary and uncontrollable. The truth is that the vast majority of what people call intrusive thoughts — almost all of them — are actually being thought or imagined on purpose, in an effort to […]
Defining Rumination
Different therapists and researchers (and farmers, actually) use the word rumination in different ways, and that makes it important to define exactly what I mean when I use that word. When I talk about rumination, I’m talking about any type of mental engagement with the problem; put another way, I’m talking about shifting into problem-solving […]
Rumination is a Compulsion, Not an Obsession, and That Means You Have to Stop
The fact that rumination is a compulsion is foundational to effective OCD treatment. In order to explain why, let’s start by defining our terms: An ‘obsession’ is a distressing thought that occurs to a person. The thought is distressing because it’s associated with the possibility of making an irreversible mistake that has permanent consequences (for […]