Treatment For Anxiety and OCD

Treatment for Anxiety & OCDTreatment for Anxiety & OCD

Dr. Edward M. PetroskyBoard Certified & Licensed Psychologist

Forest Hills, Queens, NY(917) 520 – 4444

(C) Dr. Edward M. Petrosky, 2010. Forest Hills, Queens, New York. Treatment for Anxiety & OCD(C) Dr. Edward M. Petrosky, 2010. Forest Hills, Queens, New York. Treatment for Anxiety & OCD

A Word on Dr. PetroskyA Word on Dr. PetroskyBoard Certified & Licensed psychologistBoard Certified & Licensed psychologistSpecializations include: Specializations include: Treatment for anxiety disorders, including Treatment for anxiety disorders, including

Obsessive – Compulsive Disorder (OCD)Obsessive – Compulsive Disorder (OCD) Therapy for anger managementTherapy for anger management Dyslexia, Learning Disability, & ADHD TestingDyslexia, Learning Disability, & ADHD Testing Evaluations of Behavioral and Emotional ProblemsEvaluations of Behavioral and Emotional Problems

Give clients evidence-based strategies for Give clients evidence-based strategies for reducing distress and leading more satisfying reducing distress and leading more satisfying lives.lives.


This presentation coversThis presentation covers

What anxiety and anxiety disorders areWhat anxiety and anxiety disorders are

Obsessive – Compulsive Disorder (OCD)Obsessive – Compulsive Disorder (OCD)

How Cognitive – Behavioral Therapy How Cognitive – Behavioral Therapy (CBT) can be used to treat OCD in (CBT) can be used to treat OCD in children, adolescents, and adultschildren, adolescents, and adults


AnxietyAnxiety

What is it?What is it? State of “arousal” – the body and mind have State of “arousal” – the body and mind have

become “revved up”become “revved up”

Why do we get it?Why do we get it? To prepare ourselves to deal with something To prepare ourselves to deal with something

we perceive as threateningwe perceive as threateningPhysically threatening (e.g. a strange dogs starts Physically threatening (e.g. a strange dogs starts snarling at you)snarling at you)

Psychologically threatening (e.g. a job interview) Psychologically threatening (e.g. a job interview)


What is anxiety?What is anxiety?A Closer LookA Closer Look

Anxiety has 3 components - 3 ways in which it affects usAnxiety has 3 components - 3 ways in which it affects us Physiological (Bodily changes)Physiological (Bodily changes)

Knot in your stomachKnot in your stomach

Heart races or palpitatesHeart races or palpitates

SweatingSweating

NauseaNausea

Many othersMany others Cognitive: (Thoughts)Cognitive: (Thoughts)

Worry and doubtWorry and doubt

Doom (“Something terrible is going to happen”)Doom (“Something terrible is going to happen”)

Incompetence (“I can’t handle this”)Incompetence (“I can’t handle this”)

OthersOthers

Behavioral (Things you do)Behavioral (Things you do)AvoidanceAvoidance

PacingPacing

Snapping at othersSnapping at others

Many othersMany others


ImportantImportant

Some of the symptoms discussed above Some of the symptoms discussed above can be symptoms of medical conditions. can be symptoms of medical conditions. Therefore, if you are concerned that you Therefore, if you are concerned that you may have an anxiety disorder, in addition may have an anxiety disorder, in addition to any mental health services you may to any mental health services you may seek out, you should also consult with a seek out, you should also consult with a physician to rule out a medical condition.physician to rule out a medical condition.


We all get anxiety. We all get anxiety. What makes it a “Disorder?”What makes it a “Disorder?”

It’s causing you a lot of emotional painIt’s causing you a lot of emotional pain

It’s bothering you frequentlyIt’s bothering you frequently

It limits your life (e.g. there are things you It limits your life (e.g. there are things you would like to do but don’t because of it)would like to do but don’t because of it)

It gets in the way ofIt gets in the way of Relaxing and having funRelaxing and having fun Your relationshipsYour relationships Your jobYour job Your school workYour school work


Types of Anxiety DisordersTypes of Anxiety DisordersGeneralized Anxiety Disorder Generalized Anxiety Disorder Uncontrollable worryUncontrollable worry

Panic DisorderPanic Disorder Panic attacks, frequently causes the person to avoid leaving the Panic attacks, frequently causes the person to avoid leaving the

house by him or herselfhouse by him or herself

Social PhobiaSocial Phobia Fear of “looking bad” or being embarrassed in front of othersFear of “looking bad” or being embarrassed in front of others

Posttraumatic Stress Disorder Posttraumatic Stress Disorder The after effects of an unresolved past traumatic eventThe after effects of an unresolved past traumatic event

Obsessive-Compulsive DisorderObsessive-Compulsive Disorder Uncontrollable thoughts and behaviorsUncontrollable thoughts and behaviors


A Focus on Obsessive – A Focus on Obsessive – Compulsive Disorder (OCD)Compulsive Disorder (OCD)


Obsessive – Compulsive Disorder (OCD)Obsessive – Compulsive Disorder (OCD)Two types of symptomsTwo types of symptoms ObsessionsObsessions CompulsionsCompulsions


ObsessionsObsessions


DefinitionDefinitionUnwanted, disturbing, and unpleasant Unwanted, disturbing, and unpleasant thoughts that pop into the person’s mind thoughts that pop into the person’s mind against the person’s will. Sometimes against the person’s will. Sometimes obsessions take the form of urges to do obsessions take the form of urges to do things the person definitely does not want things the person definitely does not want to do.to do.


ExamplesExamplesThoughts of being contaminated, infected, or having Thoughts of being contaminated, infected, or having germsgerms

Thoughts about belongings being out of order, messy, Thoughts about belongings being out of order, messy, or not in their proper placeor not in their proper place

Preoccupation about imperfectionPreoccupation about imperfection

Taboo sexual thoughts Taboo sexual thoughts

Grotesque mental imagesGrotesque mental images

Thoughts the person feels are “dirty,” “gross,” or Thoughts the person feels are “dirty,” “gross,” or “immoral”“immoral”

Thoughts of aggression towards beloved family Thoughts of aggression towards beloved family membersmembers


Examples (Continued)Examples (Continued)An urge to shout obscenities when it would be An urge to shout obscenities when it would be extremely improper to do so, such as when extremely improper to do so, such as when speaking with one’s boss, on a first date, or in a speaking with one’s boss, on a first date, or in a court room (In contrast to Tourette Syndrome, the court room (In contrast to Tourette Syndrome, the person with OCD does not actually shout the person with OCD does not actually shout the obscenities, but just has a fear s/he will). obscenities, but just has a fear s/he will).

An urge to say something extremely embarrassing An urge to say something extremely embarrassing about oneself in public, such as a high school about oneself in public, such as a high school teacher telling the class s/he doesn’t know what teacher telling the class s/he doesn’t know what s/he is talking about s/he is talking about

Sacrilegious thoughtsSacrilegious thoughts


In OCD it’s as if the mind serves up the In OCD it’s as if the mind serves up the exact opposite exact opposite of what the person thinks s/he “should” be thinking of what the person thinks s/he “should” be thinking about. This is one reason why OCD causes so much about. This is one reason why OCD causes so much anxiety, is so frustrating, and can lead people to think anxiety, is so frustrating, and can lead people to think they must be “going crazy” (which they are NOT).they must be “going crazy” (which they are NOT). E.g. A deeply religious person with OCD might have an E.g. A deeply religious person with OCD might have an

obsession about cursing at God – the obsession about cursing at God – the last last thing s/he would thing s/he would want to do. It is specifically because God is important to want to do. It is specifically because God is important to him or her that s/he would have this obsession. On the him or her that s/he would have this obsession. On the other hand, a person for whom thoughts of God are not other hand, a person for whom thoughts of God are not particularly important would not have this type of obsession. particularly important would not have this type of obsession.

Characteristic of ObsessionsCharacteristic of Obsessions


CompulsionsCompulsions


DefinitionDefinition

Repetitive actions and “meaningless” Repetitive actions and “meaningless” rituals the person feels driven to do to rituals the person feels driven to do to “counter-act” an obsession or because of “counter-act” an obsession or because of a sense that something terrible will happen a sense that something terrible will happen if s/he does not perform the compulsion.if s/he does not perform the compulsion.


ExamplesExamplesExcessive washing or cleaning to combat an Excessive washing or cleaning to combat an obsession over germs or contamination.obsession over germs or contamination.

Spending an inordinate amount of time Spending an inordinate amount of time ensuring that belongings are arranged ensuring that belongings are arranged perfectly neatly to combat an obsession about perfectly neatly to combat an obsession about things being messy or in disarray.things being messy or in disarray.

Checking (e.g. making sure 100 times that the Checking (e.g. making sure 100 times that the stove is turned off or the front door is locked)stove is turned off or the front door is locked)

CountingCounting


Examples (Continued)Examples (Continued)Mentally reviewing certain events or Mentally reviewing certain events or scenarios over and over (e.g. replaying in scenarios over and over (e.g. replaying in one’s mind a conversation with a friend)one’s mind a conversation with a friend)

Other ritualistic behaviorOther ritualistic behavior Touching certain objects, including in a specific Touching certain objects, including in a specific

sequencesequence Repeating the same phrase over and over, either Repeating the same phrase over and over, either

out loud or in one’s mindout loud or in one’s mind Repetitive actions (e.g. turning on and off a light Repetitive actions (e.g. turning on and off a light

switch over and over)switch over and over)


Treatment for Anxiety Treatment for Anxiety DisordersDisorders

Focus on Focus on

Obsessive – Compulsive Disorder (OCD)Obsessive – Compulsive Disorder (OCD)


What is Cognitive – Behavioral What is Cognitive – Behavioral Therapy or “CBT”? Therapy or “CBT”?

An evidence-based form of psychotherapy that helps clients An evidence-based form of psychotherapy that helps clients with a range of concerns, including anxiety, stress, with a range of concerns, including anxiety, stress, depression, and life fulfillment issues.depression, and life fulfillment issues.

CBT for anxiety emphasizes:CBT for anxiety emphasizes: Understanding what anxiety is, how it works, and how to beat itUnderstanding what anxiety is, how it works, and how to beat it Learning how our thoughts, interpretations, expectations, and Learning how our thoughts, interpretations, expectations, and

assumptions often drive unpleasant feelingsassumptions often drive unpleasant feelings Learning practical skills and tools for reducing symptoms and Learning practical skills and tools for reducing symptoms and

accomplishing goalsaccomplishing goals

Learn practical skills for reducing anxiety and live a more Learn practical skills for reducing anxiety and live a more freeing lifestyle.freeing lifestyle.


CBT for OCDCBT for OCD

CBT for OCD is an CBT for OCD is an evidence-based evidence-based type of type of psychotherapy that provides clients with psychotherapy that provides clients with specific techniques for reducing specific techniques for reducing obsessions and compulsions. obsessions and compulsions.

In short, CBT for OCD helps clients get In short, CBT for OCD helps clients get their life back.their life back.


Who is this treatment for?Who is this treatment for?

Children, adolescents, and adults can Children, adolescents, and adults can benefit.benefit.


Characteristics of CBT for OCDCharacteristics of CBT for OCD

StructuredStructured Based on the individual needs of the client, Based on the individual needs of the client,

Dr. Petrosky develops a specific “game plan” Dr. Petrosky develops a specific “game plan” to treat OCD. to treat OCD.

Treatment has specific Treatment has specific goals and objectivesgoals and objectives. . This is not the type of therapy that drifts This is not the type of therapy that drifts along, with clients talking about whatever along, with clients talking about whatever comes to mind, with no clear goal in sight. comes to mind, with no clear goal in sight.


Characteristics of CBT for OCDCharacteristics of CBT for OCD

Feedback Feedback Dr. Petrosky provides clients with detailed Dr. Petrosky provides clients with detailed

feedback so they can understand their feedback so they can understand their symptoms. symptoms.

ToolsTools Dr. Petrosky teaches clients specific tools and Dr. Petrosky teaches clients specific tools and

strategies for overcoming distressing strategies for overcoming distressing symptoms. symptoms.


For more information or to For more information or to make an appointment…make an appointment…

Call Dr. Petrosky at: (917) 520 - 4444Call Dr. Petrosky at: (917) 520 - 4444

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Thank You!Thank You!


Treatment For Anxiety and OCD

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