This week is OCD Awareness Week. It is a time when our goal – as therapists and as a society – is to talk more about obsessive compulsive disorder and help people understand what it is, who it affects, and why seeking treatment is worthwhile.
We’ve touched on this topic in the past, but in honor of OCD Awareness Week, it’s discuss OCD in a way that is simple, easy to understand, and helps people see why many struggle with OCD without realizing it.
Obsessions and Compulsions
Let’s start by talking about “obsessions” and “compulsions.”
Before we can talk about them, we have to first forget what the words mean in normal conversation. In normal conversation, an “obsession” is a desire. We use the term endearingly to talk about people or things that we love.
In the mental health world, an “obsession” is something entirely different. It is a recurring, intrusive thought – one that we do not want, and one that we cannot stop. It is an “obsession” because our brain cannot stop thinking about it no matter how much we want it to.
Because these are thoughts we *do not want*, they cause us to feel distress.
Because we cannot stop these thoughts, we feel distress over and over and over again.
Eventually, we find that some behavior provides some relief from the thoughts. Examples include:
Contamination Obsession – If someone has obsessions about germs or illness, they may wash their hands to feel relief.
Sin/Hell/Religious Obsession – If someone has obsessions about sinning or ending up judged by God, they may pray often.
Perfectionism Obsession – Someone that has an obsession with perfectionism may organize things or be constantly cleaning.
Compulsions can occur entirely organically. If a person has a harm obsession, and finds that they get relief from that thought when they make a noise or touch their knee, they may continue to do so to get some relief. Other times, it relates back to the obsession, like in the case of hand washing.
When these behaviors are visible, some people are encouraged to get help.
But they’re also not always visible.
The Hidden Struggles of Some OCD Types
OCD is also not always easy to see or diagnose.
One of the most common types of “compulsions” is what’s known as “checking.” Checking is where a person physically or mentally tests the obsession to make sure it’s not true. For example, a heterosexual person that has obsessions about being homosexual (again, remember that this person is likely not homosexual, it is just a recurring intrusive thought) may “check” to see if they’re homosexual by thinking about men in sexual encounters, and trying to determine if they’re aroused.
These types of checking behaviors occur entirely internally, which makes them both hard for others to notice and create a sense of extreme distress and self-judgment. People can have these obsessions about sexual violence, causing harm, causing self-injury, and more, and their “checking” behavior is imagining thoughts about it in order to see if it is real.
Not only do obsessions cause distress, but many people also worry that these obsessions mean something negative about themselves. For example, a person may have an “obsession” over sexual violence. Keep in mind that this person is typically *not* a sexually violent person, which is why the obsession causes such distress.
Internally, not only is this person experiencing distress at the obsession, but they may – because of the recurring thought – think they are a sexually violent person and be afraid to tell others. They may not seek help, worried about being branded or judged for these thoughts. Over time, it can be more and more destructive to their mental health and self-esteem.
OCD is Out There – But Not Always Seen or Understood
There was a time when obsessive compulsive disorder was not well known. Most people were unaware how many types of obsessive compulsive disorder exist or how they manifest.
Now, people are more familiar with the term “OCD” but rarely truly understand it. They may even say it as a descriptive tool. For example, they may organize a shelf a specific way and say “I’m a little OCD about this.”
True obsessive compulsive disorder can be very distressing, damaging, and challenging to those that experience it. It can also cause people to feel shame, further anxiety, depression, and more.
This OCD awareness week, it’s important to truly be aware of OCD – what it feels like, what it looks like, and what it means. The more we as a society really understand OCD, the better position we will be in to address it.
Often, when a couple seeks out couples counseling, it is because they are fighting often. They’re arguing, they’re resentful, they’re making snide comments – they see aggression and disgust in ways that cause harm in their relationship, and they want to see if there is a way to solve those issues and make the relationship work.
Still, every couple is made up of two individuals, each one that has their own desires, their own needs, their own wants, and their own feelings. While this has the potential to create frequent conflict, that conflict – while not desirable – is not always a sign of a relationship that’s struggling. While frequent conflict can be upsetting, conflict itself is something that can happen when two distinct people try to make a partnership work.
The Problem is Not Necessarily Conflict – It’s How You Reconnect After
What matters is not necessarily the conflict itself, which is going to occur now and then even in the most loving, most successful of relationships. What often matters more is how you make up afterwards.
One term for this is “Rupture and Repair.” Conflict puts distance between two partners. Repair is how you fix the problem.
It is the “Repair” portion where many struggling couples have the most problems. Most people know how to argue. They don’t always know how to make up. To be successful, couples need to be able to navigate their challenges, listen, learn, grow, and heal. Most couples that are struggling, however:
Give up
Ignore it
Grow resentful
Hold grudges
Argue until they “win”
Rather than trying to understand their partner, they simply allow the issue to linger until it is forgotten, or hold onto it to use it again in the future.
Successful and happy couples, on the other hand, try to navigate these things together. They try to build emotional attachment with each other. They try to heal. Even if they still disagree or they can’t fix anything, they intend to at least understand each other more and feel heard.
This process – this “Repair” – not only helps solve part of the conflict but makes couples stronger. It:
Grows emotional trust and attachment.
Helps provide immediate stress reduction.
Prevents more frequent future conflict.
Often, the strength of a relationship improves considerably when you learn how to connect after in a healthy way. Conflict still arises, but how you solve that connection has real benefits on your ability to feel close, intimate, and in love.
Learning to Repair a Relationship the Right Way
Those that feel they’re really struggling in relationships benefit greatly from learning how to repair relationships more effectively. This involves truly listening and trying to understand what your partner is saying, even if you disagree, taking responsibility for your own role in the conflict, offering reassurance on the relationship, and more.
It’s a process, but it’s an effective one. In that sense, couples counseling isn’t necessarily designed to stop all conflict. Couples in love are still going to have disagreements. But, if you address them in the right way, you can heal from it and maybe even grow closer as a result. Reach out today to learn more.
Couples counseling is the best approach we have for addressing issues in an existing relationship. Couples therapy methods, like Gottman, have been extensively searched and are proven to be effective at supporting a couple that is going through challenges or feels stuck at some stage in their relationship.
But what if you’re single?
Many relationship challenges “start” before a person has even gone on the first date. From patterns to traumas to attractions, a person can learn how to have a deeply committed relationship with a partner long before they have met that person.
Here at Flourish Psychology, we encourage those that are single or dating to also consider whether or not they might benefit from *individual relationship counseling* – counseling that is focused on how to help you find and maintain a fulfilling, happy relationship and love yourself in the process.
If you’re interested in singles counseling in New York City, give us a call and let’s connect you to a therapist that is ready to address your needs.
Benefits of Singles Therapy
Often the success of a relationship starts before you’re even in one. Everything from your relationship habits to the people you choose to date to the love you have for yourself are all affected by how we are when we’re single. The more we’re in a good place psychologically, the easier it is to have more successful, committed relationships with a partner that we’re really connected with – and also to do so in a way where we are not dependent on the relationship for us to be happy.
That is why, while couples counseling is a great way to address the issues of an *existing* relationship, singles therapy is a great way to find a better relationship in the first place. This type of counseling can provide many benefits, such as:
Ability to Address Patterns of Behavior – Rather than wait to repeat a pattern, you can focus on how to address it before it starts, talking to your therapist about habits and issues that recur in relationships. This allows you to start the next relationship without those patterns present.
Ability to Address Patterns in Relationship Choice – We tend to be attracted to the same type of people over and over again, even if those people are not the best for us. Through therapy, we can help determine who you’re really meant to be with and help make sure you’re growing attracted to people that are right for you.
Learning to Love Yourself – People have more successful relationships, and are more likely to find a relationship, when they love themselves. They also are more likely to find happiness from any direction when they are also fine being alone. Indeed, you’re more likely to find someone that’s right for you when there is less pressure to be in a relationship. All of this comes from loving yourself, which is something we can work on in therapy.
Addressing Existing Mental Health Challenges – It’s hard to manage a relationship of any kind when you’re already struggling with mental health issues. If you have anxiety, depression, or something else, therapy can help address it before you’re in a relationship so that it’s not a barrier to finding happiness.
Gaining More Self-Awareness – Relationships often require truly knowing and understanding yourself and your actions. But self-awareness is hard, and many people that are single for a long time become more hardened in their ways. Therapy can help people build the ability to be more self-aware, resulting in the ability to be objective about behaviors in the relationship.
Prepping Your Relationship Skills – You don’t have to be in a relationship to work on things like attachment issues, communication skills, how to open yourself up to intimacy, and more. Those can all come beforehand, as you learn more about yourself.
The idea behind relationship therapy is to have a more successful relationship. But there is no rule that you have to currently be in a relationship to benefit. If anything, the best relationships start when you’re at a place in your life where you feel your best about yourself.
If you are single or dating, and feel like you’re ready for something more, consider singles therapy with Flourish Psychology. Reach out today to learn more.
There are so many joys a person can experience in life, but many of those same joys also come with stresses. For example, you may be happy to see your kids’ smiling faces when you pick them up from school (joy) but to get them, you have to rush and wait in a long line to pick them up (stresses).
Many people have a level of stress (arousal) that they can tolerate where it won’t interfere with their functioning. They can handle stresses, difficulties, noises/sounds, and more while still being mentally present, feeling all their emotions, and otherwise able to stay emotionally regulated.
One term for this is the “Window of Tolerance” – the amount of space someone has that allows for psychological comfort and flexibility. It’s not necessarily about happiness, but it is about being able to function despite what’s going on around them.
Those with mental health challenges, however, typically have a much smaller window of tolerance. Stresses and difficulties end up putting them above or below the window:
Above the Window – This is called the “hyperarousal” zone. It is more common for people with anxiety. It is where their bodies react with excess energy, like nervousness and agitation, when the stresses do not fit into their window of tolerance.
Below the Window – This is known as the “hypoarousal” zone. It is more common in those with depression. It is where a person’s response to issues not fitting in their window is to shut down, become numb, and give up.
Note: Admittedly, one of the limitations of the “Window of Tolerance” analogy is that it doesn’t explain why some people go “above the window” and some people go “below” other than an individual’s mental health. But the window of tolerance itself does help beneficially describe what a person can handle, and why it differs from one person to the next.
The Shrinking Window of Tolerance with Depression
When a person has depression, they have a smaller window of tolerance. That means that there are fewer things that they can handle before their window becomes full and overwhelmed. For example, a light criticism from a coworker becomes a head on collision, because their window is full and nothing else can fit through before it spills out below the window.
But why does this window shrink?
Low Battery – Depression is exhausting, so a person with depression often has a low battery that is less capable of handling multiple tasks before being depleted.
High Threat Systems – Those with both depression and anxiety have a higher than active threat detector, which misinterprets neutral or only mild threats as more significant threats.
Minimal Backup – When your mental health is functioning, you have mechanisms in place to keep you “in your window.” Not so with chronic stress and depression, where the systems that usually calm us, like neurotransmitters, are not able to do their job.
The smaller the window, the less a person feels like they can handle. So our role as therapists is to try to get the window bigger.
How Do We Increase the Size of the Window of Tolerance?
Improving the size of the Window of Tolerance is something we do indirectly in therapy, by teaching coping tools and stress reduction mechanisms that allow us to stay grounded, present, and reduce negative critical thoughts.
If you feel like you may be struggling with a smaller window of tolerance and want help addressing your depression, please reach out to Flourish Psychology, today.
We often talk about social anxiety by referring to its effects on relationships. Yet, what make social anxiety so challenging and so problematic is that it affects us even when we are not engaging in social activities. Like other forms of anxiety, social anxiety is ongoing and constant, and it is in our best interests to make sure that we are addressing this anxiety so that we can improve not only our social life, but the rest of our decision making as well.
The Ways Social Anxiety Shapes Decision Making
Remember, social anxiety is always there. It does not just appear when you’re in a party or a meeting. It, like most forms of anxiety, touches everything that you do.
That means that it can also guide choices that you make throughout the day. It affects decisions you make about work, school, dating, marriage, and much more.
Many people living with social anxiety make decisions based on fear of judgment rather than personal preference or practical benefit. This can influence everything from small routines to major life paths.
Avoiding Opportunities – A person with social anxiety may decline a job interview, pass on a promotion, or avoid signing up for a class because they anticipate embarrassment or fear not meeting expectations. These choices limit personal growth.
Over-Preparation and Perfectionism – Decisions can become slowed by the need to prepare excessively. Writing an email, submitting work, or even posting online may require multiple drafts because of concern about how others might perceive mistakes.
Choosing Convenience Over Preference – Something as simple as deciding where to shop or which restaurant to order from may be shaped by which option feels less likely to involve social stress, even if it is not the person’s preferred choice.
Difficulty Saying “No” – Fear of disappointing others or being seen negatively can lead to agreeing to commitments that do not align with personal goals or comfort.
Withdrawing from Conflict – When facing disagreements, the decision may be to avoid confrontation entirely, even at the expense of personal needs or fairness.
Trouble Analyzing Others – Negative self talk may cause people to misunderstand social media posts, texts, and more, as they assume that other people do not see the world the way they do, leading to worse decisions.
Any decision that is fueled by anxiety is one that may not be right for the person experiencing it. Instead of going through life in such a way that they’re able to make decisions that benefit them, they may be choosing things not just based on the anxiety itself, but on the way it shapes their opinions.
The Ongoing Effects of Social Phobia
Another factor to consider is the way that social anxiety reinforces its own behaviors. When you make small decisions in the moment based on your social anxiety, you create patterns that reinforce avoidance behaviors and problematic thinking.
This both:
Causes you to have more social anxiety and allow it to control you further.
Leads to situations where you’re in a job, relationship, or something else you do not want, leading to more unhappiness and, ultimately, more anxiety about life.
This is one reason why social anxiety is never limited to social experiences. When you have social anxiety, it quietly influences everyday decisions, leaving less space for spontaneity, growth, or authenticity.
Moving Toward Healthier Decision Making
Addressing social anxiety means more than reducing fear in social events. It involves building awareness of how anxiety guides decisions and working to shift the decision-making process back toward personal goals rather than avoidance.
Even if you feel like your social anxiety is manageable – maybe you have a few close friends, or you’re in a good relationship, or you’ve accepted this anxiety as a part of yourself – it’s always touching the decisions you make and the behaviors you do.
Treat social anxiety instead. You’ll find that you’re happier and more fulfilled when your anxiety is in your control.
Location: 300 Cadman Plaza West Floor 12 - Brooklyn, NY 11201
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