Blogs

Taking control of your life: How to reduce stress

We all know how stress can feel. That anxious feeling that builds up in your chest, the tightness in your shoulders, the racing heart. It's uncomfortable, and it can even be tough to concentrate or get a good night's sleep when you're stressed out. We know that stress can take a took on our mental health. But did you know that stress is more than just an unpleasant feeling? Stress can actually have some serious consequences for your health. Over time, high levels of stress can lead to depression and anxiety disorders, as well as physical problems like high blood pressure and heart disease. This means that managing stress is tantamount to keeping ourselves healthy. [stress] Why do we feel stress? Stress is a natural response of the body designed to help us deal with challenging situations. When we feel threatened, our autonomic nervous system triggers the 'fight or flight' response and stress hormones such as adrenaline are released. This helps us react quickly in times of danger, giving us an enhanced focus and increased strength. While this reaction can be helpful in the short-term, long-term stress can take its toll on our health. With this in mind, it's important to know how to recognize the body's stress response and how to manage stress. How does the body let us know when we have increased stress levels? Stress has both mental and physical effects on our bodies. Over time, high levels of stress can lead to health problems such as depression, anxiety disorders, insomnia and hypertension (high blood pressure). Other symptoms include headaches, digestive issues, muscle tension, chest pain and feeling overwhelmed. If stress is left unchecked, it can also lead to serious chronic illnesses such as heart disease and diabetes.[Image] Pay attention to you body's way of telling you to relieve stress. Once you recognize the signs, some techniques can be done to promote relaxation and to combat stress. How can we handle stress in healthy ways? Reducing stress can be challenging but there are a few strategies that may help. To start, try basic techniques like different breathing exercises which can be done anywhere at anytime. Try deep breathing by inhaling through the nose for three to five counts and exhaling slowly through the mouth. This can be a great stress reliever that can be good for your well being in times of stressful situations.  Practicing daily activities that improve mood such as listening to soothing music, journaling and physical activities such as regular exercise and spending time with loved ones can also help lower stress. Your body will thank you for it too. [Image] Having a healthy diet can be of help to manage stress and anxiety as well. Your diet can be contributing to high blood pressure that may already be exacerbated by your stress and anxiety. Avoid unhealthy habits such as drinking alcohol and too much caffeine and incorporate healthier food options into your daily food intake. [Image] Don't be afraid to seek social support. The people you love and trust can help you deal with stress and improve your well being and self esteem; talk to friends and family about your thoughts and feelings. Just a few minutes of conversation can take a load off of your mental stress and fight off negative thoughts. Adopt time management skills as well. Take breaks and give yourself time to do other things that interest you. Your own interests can help reduce stress and deserve the same amount of time and attention you give to your other activities.  Take actions against stress!  Stress is a normal part of life, but the effects it can have on our health should be taken seriously. Over time, it can lead to physical and mental issues such as headaches, lack of sleep, increased levels of anxiety, changes in mood, and a weakened immune system.  To help combat this issue and improve your overall wellbeing, it is important to take active steps against stressors in your life. Taking a break from a stressful situation to practice relaxation techniques like deep breathing or using aromatherapy oils can instantly reduce symptoms of stress. [Image] Additionally, engaging in enjoyable activities such as listening to music or reading outside can help alleviate stress long-term by providing an outlet for releasing built up tension. Remember that taking care of yourself should always be the number one priority! If you or anyone you know is struggling with stress and stress management, do not hesitate to reach out at mosaicmindscounseling.com. Mosaic Minds Counseling cares. 

Mariella Arceo

Mar 05, 2023
Habit Reversal training: What it is and its benefits for your mental health

Habit reversal training (HRT) is a treatment method for certain types of problems, such as tic disorders, obsessive compulsive disorder, nervous habits such as hair pulling, nail biting and skin picking disorder. The goal of HRT is to replace the bad behavior with a new, more positive one. If you're thinking about trying HRT, read on to learn more about how it works. What is habit reversal training? Habit Reversal Training (HRT) is a behavioral technique that incorporates self-awareness and self-management to help individuals stop unwanted repetitive behaviors. The goal of HRT is to use the habit's own cues as prompts for an opposite behavior, thereby “replacing” the original habit and creating a new habit. During HRT, individuals learn to recognize triggers or situations that lead to the unwanted habit as well as how to plan alternative responses. This highly effective form of therapy teaches patients how to become aware of whats happening in their bodies when faced with potential triggers and provides them with strategies on how to replace undesirable behaviors with healthy alternatives. By helping individuals become more aware of their body's environmental cues, HRT has been seen to improve focus and concentration while reducing anxiety levels. How does habit reversal training work? Habit Reversal Training is an evidence-based treatment strategy aimed at helping individuals to break bad habits and replace them with healthier behaviors. It has been successfully applied to problems such as nail biting, hair pulling behaviors, severe tics and skin picking, as well as more specific motor tics, such as facial tics or leg jiggling. HRT involves recognizing the triggers to the unwanted behavior, developing a plan of action, focusing on positive reinforcement and engaging in problem solving skills. It can also be combined with techniques from other disciplines such as cognitive behavioral therapy, mindfulness and other behavioral treatments. By utilizing HRT techniques consistently over time, it is possible to break these types of habits and create a healthier lifestyle. Does habit reversal training really work? Stories abound of people successfully using Habit Reversal Training (HRT) to manage and eventually break the hold of bad habits. An admitted nail-biter adapted HRT to replace his habit with activities like running his fingers through a beanbag or stroking a stress ball. Over time, the changes he made proved successful as he stopped biting his nails entirely. Similarly, another client chose HRT as a way to combat unhealthy addictions to overworking and not taking enough breaks for self care. The client created her own customized plan which included things like rewarding herself with an afternoon walk and something special from the store if she managed to do all her scheduled tasks in the allotted time. Those who have been skeptical have found that HRT does work; it just requires time and effort, along with tailored action plans for each individual situation. How can I get started with habit reversal training? Habit reversal training (HRT) has proven to be a powerful tool in changing behavior and emotional well-being. To get started with HRT, the first step is to identify the habit and its triggers. Once you’ve identified the habit and its triggers, take a few minutes each day to focus on how you feel when you do that behavior. Reflecting on how the behavior makes you feel can help you recognize how to respond differently in certain situations where the habit occurs.  Additionally, practice relaxation techniques like deep breathing which can help reduce stress associated with negative behaviors. Finally, commit to consistently replacing the bad habits with positive alternative behaviors – this will be instrumental in breaking old patterns and forming new healthier ones over time. Habit reversal training might be for you! Habit Reversal Training has proven to be an effective form of behavioral intervention in both short and long term scenarios. Not only can it help make lasting changes, but it also teaches valuable skills such as increased awareness that can be used beyond the specific habit in question. From nail biting to hair pulling and everything in between, habit reversal training is a tool that everyone should consider when looking for ways to conquer their bad habits. Through this type of self-directed treatment, individuals have reported significant improvements which suggests that anyone is capable of changing their behaviors with time and patience. Remember, the first step to success is understanding why you have the compulsion to engage in certain activities, followed by developing alternative behaviors that you can use to replace your existing habits.  If this all sounds too complicated or intimidating – don't worry! At mosaicmindscounseling.com, we provide tailored solutions based on your individual needs. Do not hesitate to reach out if this sounds like something you would benefit from; taking control of your life starts one step at a time!

Mariella Arceo

Jan 29, 2023
Therapy with Kristi Rhebb, LMFT

Kristi's background, specialties and therapy philosophies Kristi Rhebb is Florida-based, Licensed Marriage and Family Therapist who specializes in helping clients dealing with trauma, anxiety, OCD, and chronic illness. Her approach to therapy is collaborative and client-centered, using her expertise to support clients' autonomy of themselves. [Kristi Rhebb] Kristi is experienced in a variety of settings, including adult and pediatric oncology/neurology hospital units, child and adolescent crisis and behavioral health units. Before starting her private practice, Kristi worked as a mental health and grant writing consultant for a cancer care nonprofit and a tech company. Kristi pursued the molecular biology field in college but ultimately found fulfillment in becoming a therapist.  A core foundational belief that Kristi has is that people deserve to be seen, understood, and valued for who they are - without judgment. She believes in collaboration and autonomy; bringing her expertise to the table and the clients' expertise on themselves. Kristi helps her clients grow and heal in a positive, compassionate, and non judgemental space where the clients can explore their issues and create new patterns and behaviors to better show up for one's self and others. Therapy sessions with Kristi The first session is an opportunity to build trust; expectations, goals, and other concerns from both Kristi and the client will be discussed. Progress will be tracked through targeted measures and self-report logs to identify improvements and setbacks. Therapy comes to a close when the client's issues have been addressed. The sessions will be spaced out in advance to consolidate treatment gains and build confidence to manage problems by one's self. Kristi is committed to providing a supportive and empowering environment for her clients to grow and find healing. She recognizes that seeking therapy can be a challenging decision and works with clients to create a treatment plan that meets their specific needs and goals. If you’re considering seeking therapy and think Kristi may be a good fit for you, we encourage you to reach out and schedule a consultation.

Mariella Arceo

Jan 10, 2023
6 Tips for Healthier Family Communication

It's no secret that healthy communication is key to a happy family life but during the holiday season, healthy communication may not always persist and present itself. So what does healthy communication actually look like and how can we make sure that we're communicating in a way that is healthy for everyone involved? In this blog post, we will discuss 6 tips for healthier family communication. We'll talk about the importance of empathy, and  some helpful tips for overcoming common communication challenges that can be useful not just during the holiday season but all year round. [Spending the holidays with family can be tough and overwhelming but it doesn't have to.]   First and foremost, healthy family communication requires empathy. Empathy is the ability to put yourself in someone else's shoes and understand their feelings and emotions. When communicating with family, try to take a moment to think about how your words or actions might be impacting them. Put yourself in your family member's shoes and try to see the situation from their perspective. This can help you stay mindful of their feelings and avoid hurtful conversations.  Another important tip for healthy family communication is to practice active listening.  If you want to truly understand someone, you have to do more than just hear the words they're saying. Active listening involves being an active participant in the conversation and trying to understand the meanings and intentions behind what is said. Give them your undivided attention, so that they feel valued and respected during the conversation. Additionally, make sure to use non-verbal cues like eye contact, nodding your head, or smiling appropriately when needed to show that you're engaged in the conversation.  It is also important to communicate with respect and kindness. Everyone should be treated equally and not judged or attacked for their opinions. If disagreements arise, try to remain calm and seek a healthy resolution rather than escalating the situation. Find  common ground; disagreements don't always have to bring your further apart from the people you love.  Avoiding criticism when communicating with family is another key component of healthy communication. Criticism can lead to resentment and damage relationships. Instead of pointing out faults, focus on celebrating successes and building each other up. This will help create a more positive environment where everyone feels safe expressing themselves without fear of judgement or criticism. And if it's necessary to give out criticism, always remember to keep it constructive and never destructive. [Image] In addition, healthy family communication involves being open and honest about your feelings. Don’t be afraid to express yourself, even if it’s difficult or uncomfortable at first. This will help build trust and foster healthy relationships. This will also give your family to the chance to understand you more, which can foster healthier conversations. Finally, healthy family communication requires taking the time to connect with each other. Healthy family communication requires time and effort; it doesn't magically happen overnight. Scheduling regular family dinners or outings can be a great way to stay connected. It can even be as simple as having time everyday to sit down, get comfortable, and just talk about anything.  By following these tips for healthier family communication, you can create a more positive environment where everyone feels heard and respected. Healthy communication with family members helps create stronger bonds and deeper connections, which leads to a happier home life, not just during the holidays, but even on the ordinary days as well. 

Mariella Arceo

Dec 22, 2022
Obsessions and Compulsions: Understanding the Impact and How Therapy Can Help

Obsessive-Compulsive Disorder, or OCD, is a mental health disorder that will affect approximately 1.6 percent of American adults in their lifetime. OCD is characterized by intrusive and distressing thoughts, known as obsessions, that typically lead to repetitive and ritualistic behaviors, called compulsions. [Obsessions can lead to excessive worry.] People with OCD often worry excessively about things, where fears typically fall into categories like contamination and germs, accidents and injuries, and lack of order, symmetry, or completion. As a result of these intrusive thoughts, a person may wash their hands frequently or avoid touching objects that they perceive to be dirty. A person's obsessive thoughts are often rooted in guilt, fear, and disgust, causing significant distress on their own. But the compulsions (actions) carried out, whether to relieve stress or anxiety or prevent something from happening, present more challenges. Even if a person feels some relief at first, these behaviors only feed the cycle. Not to mention, many compulsions are time-consuming and disruptive to a person's life. [Image] Living with OCD can be extremely challenging. The constant worrying and obsessions can take a toll on one's mental and physical health. OCD can lead to anxiety, depression, and even suicidal thoughts when left unchecked. Obsessions and compulsions ofter co-occur with other mental health conditions, including: ·       Anxiety (such as a phobia or social anxiety) ·       Major depression (MDD) ·       Obsessive-compulsive personality (OCPD) ·       Tic condition is a neurological disorder characterized by involuntary muscle movements. For many people with OCD, the anxiety and fear associated with their condition are so intense that they cannot lead normal lives. However, with treatment and support, most people with OCD can learn to manage their symptoms and live happy, productive lives. Cognitive-behavioral therapy or exposure and response prevention may be most helpful depending on the nature of one's obsessions or compulsions. Cognitive-behavioral therapy (CBT) is one of the most effective forms of treatment for OCD. This type of therapy helps you understand and change the unrealistic or distorted thoughts and behaviors that keep your OCD alive. [Image] Exposure and response prevention (ERP) helps individuals confront their obsession and work through the anxiety when exposed to it. If you or someone you know is struggling with OCD, please reach out for help. There are many resources available to you.

Mariella Arceo

Dec 13, 2022
The Distressing Impact of OCD and Where to Get Help

Obsessive-Compulsive Disorder, or OCD, is a mental disorder that affects nearly 2 in 100 adults in the United States in their lifetime. [OCD can be overwhelming at times.] People with OCD experience persistent and intrusive thoughts (obsessions) that often lead to compulsions or repetitive behaviors that they feel compelled to do to ease their anxiety, fear, or worry. Common obsessions include fear of contamination, worries about making mistakes, and intrusive thoughts about harm coming to oneself or others. Common compulsions include excessive hand-washing and cleaning, repeated checking of doors and appliances, and counting or organizing objects in a certain way. [Image] Often, someone with OCD will perform these compulsive acts in response to their obsessive thought to avoid the severe distress they experience if they do not follow through. While these behaviors may provide temporary relief from anxiety, they ultimately reinforce the cycle of OCD, which can be a very debilitating condition, causing significant distress and impairment in daily functioning. Many individuals will go out of their way to avoid triggers or spend multiple hours each day focused on their compulsions. [Image] The constant worry and fear associated with OCD can lead to feelings of isolation and despair. OCD symptoms interfere with schooling, work, relationships, and general well-being. Even when a person's compulsions aren't visible to others, such as someone who counts in their head or repeats thoughts, the disorder can still take a toll. A lack of external signs of compulsions does not make OCD (or, in this case, pure obsessional OCD) any less distressing. People with OCD often realize that their obsessions are irrational, but they cannot control them without help. Fortunately, effective treatments are available for people with OCD, such as cognitive-behavioral therapy (CBT) and exposure-response prevention (ERP). With the help of a mental health professional and medication when it's needed, people with OCD can stop their compulsive behaviors, significantly lower their distress, and improve their quality of life.

Mariella Arceo

Dec 07, 2022
The Five Stages of Grief: How to Cope with Loss

It's no secret that loss is a part of life. We experience it in different ways, and often times we aren't prepared for it when it happens. The death of a loved one, the end of a relationship, or the loss of a job can be incredibly difficult to cope with. In this blog post, we will discuss the 5 stages of grief as identified by Kubler-Ross. If you are experiencing loss, know that you are not alone. These stages are universal and everyone goes through them at some point in their lives. [Five Stages of Grief] What is Kübler-Ross theory of grief? The Kübler-Ross stages of grief, also known as the DABDA model, were first proposed by Swiss psychiatrist Elisabeth Kübler-Ross in her 1969 book On Death and Dying. The theory has been controversial since its inception, with many mental health professionals arguing that it oversimplifies the grieving process. Nevertheless, the stages have become widely accepted and are often used to help people understand what they are experiencing. The five stages of grief are: 1. Denial: This is the first stage of grief and it is characterized by a sense of disbelief or denial. This is a natural defense mechanism that allows us to cope with the overwhelming reality of loss. It is important to remember that this is a normal part of the process and not to be ashamed of it. 2. Anger: The second stage of grief is characterized by feelings of anger, resentment, and frustration. This is often directed towards the person who has died, or towards the situation that caused the loss. It is important to express these negative emotions in a healthy way, such as through writing or talking to a therapist. 3. Bargaining: The third stage of grief is characterized by a sense of desperation and a need for control. We may try to negotiate with the situation, or make deals with God in an attempt to change what has happened. This is a normal part of the process, but it is important not to dwell on this stage for too long. 4. Depression: The fourth stage of grief is characterized by feelings of sadness, loneliness, and despair. This is a natural response to loss, and it is important to allow yourself to feel these emotions. Do not be afraid to seek help from a professional if you are struggling during this stage. 5. Acceptance: The fifth and final stage of grief is characterized by a sense of acceptance and peace. This does not mean that the pain of loss is gone, but rather that we have come to terms with it. We are able to remember the good times without being overwhelmed by sadness. This is the end of the grieving process, but it is important to allow yourself as much time as you need to get there. How long does each stage of grief last? There is no right or wrong way to answer this question. People grieve in their own way and at their own pace. Some people may move through the stages quickly, while others may cycle back and forth between them. Allow yourself as much time as you need to work through your grief. There is no timeline for grieving, so take all the time you need. The healing process is not the same for everybody. How do you know when you have finished grieving? The final stage of grief is acceptance. This does not mean that the pain of loss is gone, but rather that you have come to terms with it. You are able to remember the good times without being overwhelmed by sadness, denial, anger and other unpleasant emotions. If you find yourself at this stage, know that you have completed the grieving process. What are some tips for coping with grief? [Image] Since the healing process is not the same for everyone, this also means that not everyone will cope the same way. However, here are a few general tips to cope with grief: 1. 2. Acknowledge your feelings: It's important to allow yourself to feel whatever you're feeling, even if it's painful. Denying your emotions will only make them worse in the long run. 3. Seek out support: Talk to friends, family, or a professional if you're struggling to cope with your loss. It's important to know that you're not alone. 4. Be patient: Grief is a process, and it takes time to work through it. Don't be too hard on yourself if you're not moving as quickly as you'd like. Just take things one day at a time and eventually, the pain will start to fade. Coping with grief also involves a lot of self care, which may involve doing your favorite activities, interacting with family members and friends, or even seeking therapy. You might also want to consider attending bereavement groups for people who are grieving. This can be a great way to connect with others who understand what you're going through. What if I get stuck in one of the stages? If you find yourself struggling in one particular stage of grief, it may be helpful to seek out professional help. A therapist can provide support and guidance as you work through your emotions. Remember, there is no right or wrong way to grieve. Everyone copes in their own way and at their own pace. Just allow yourself the time and space to feel whatever you're feeling, and know that eventually, the pain will start to subside. If you or anyone you know is struggling with grief, do not hesitate to reach out to mosaicmindscounseling.com. Mosaic Minds Counseling is here.

Mariella Arceo

Nov 18, 2022
Body Focused Repetitive Behaviors: What They Are and How to Address Them

Do you sometimes feel like you can't stop moving? That your body is just constantly in motion, and you don't know how to make it stop? If so, you may be experiencing body focused repetitive behaviors, or BFRBs. These are a type of obsessive-compulsive disorder  that can be very difficult to deal with. In this blog post, we will discuss what body focused repetitive behaviors are, and how to address them. What are body focused repetitive behaviors? [Body Focused Repetitive Behaviors] Body focused repetitive behaviors are a type of obsessive-compulsive disorder that is characterized by repetitive, body-focused actions. Common examples of BFRBs include hair pulling (trichotillomania), skin picking (dermatillomania), nail biting (onychophagia), lip biting, and cheek chewing, among others. Body focused repetitive behaviors can be very difficult to control , and may cause significant distress and impairment in everyday life. Some patients engage in these activities to some degree automatically (ie, without complete awareness); others are more conscious of the activity. The behaviors aren't caused by obsessions or concerns about appearance but may be preceded by a feeling of tension or anxiety that is relieved by the behavior, which is often also accompanied by a feeling of gratification. People with body-focused repetitive behavior disorder usually try to stop their behavior or to do it less frequently, but they can't seem to manage it. In the DSM-5, body focused repetitive behavior is listed in the obsessive compulsive and related disorders section. Below are examples of common BFRBs: 1. 2. Trichotillomania (hair pulling disorder)[Image] 3. This is an ongoing and repetitive picking of the hair around the face and head, resulting in noticeable hair loss. Other areas that aside from the face and head also include the arms, legs, pubic region, and even other individuals such as pets. These pulling episodes can last between several minutes to hours. 4. 5. Dermatillomania (skin picking disorder/ skin excoriation)[Image] 6. This involves picking at one's skin obsessively, which may be set off by a scab or other blemish (such as a mosquito bite or pimple), tearing open or worsening a skin wound. The typical sites are the face, arms, and hands, although any body part can be involved – for example, the legs and pubic area where ingrown hairs might occur more often. Skin picking episodes can also last between several minutes to hours. Onychophagia (nail biting)[Image] The process involves removing the nail plate, and sometimes the soft tissues of the nail bed and the cuticle. Onychophagia is also known as onychotillomania, which includes the habit of picking or otherwise manipulating the nails. How do you treat BFRB? Fortunately, there are a number of ways to address these bad habits such as: Cognitive-behavioral therapy (CBT) is one type of treatment that can be effective for BFRB. CBT can help you to understand the thoughts and emotions that are associated with your BFRBs, and to develop new, healthier coping strategies. Habit reversal training (HRT) is another treatment option that can be helpful for BFRB. HRT involves learning to become aware of the behaviors and triggers associated with your  BFRBs, and developing new, healthier coping strategies. This method consists of awareness training that compels the individual to be more aware of when the behaviors will most likely occur as they focus on their circumstances and social support that involves family members and loved ones to give positive feedback.  Another approach that may be worth trying is acceptance and commitment therapy, which encourages individuals to experience their negative behaviors in order to observe without judgement. The knowledge that you don't have to act on every urge or emotion can be liberating. Medication may also be an option for treating body-focused repetitive behaviors. Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that can be effective in treating BFRBs. If you are struggling with body focused repetitive behaviors, don't hesitate to seek help. There are a number of effective treatments available, and with the right support, you can learn to manage your BFRBs. If you or someone you know might benefit from the help of licensed professional therapists, do not hesitate to reach out at mosaicmindscounseling.com   

Mariella Arceo

Nov 14, 2022
Types of Exposure in Exposure and Response Prevention Therapy

[Exposure Response Therapy] OCD (obsessive compulsive disorder) is a debilitating condition that affects millions of people worldwide. It is marked by individuals struggling with obsessions and compulsions. Obsessions are intrusive, unwanted, distressing thoughts, images, or urges that cause anxiety or distress. The body's alarm system activates, our anxiety grows, and the person wonders what that intrusive thought must have meant. Compulsions are repetitive behaviors or mental acts that a person feels compelled to do in order to relieve OCD-related anxiety or distress. A person's obsessions may focus on intrusive thoughts about harm to themselves or others, sexual intrusive thoughts, contamination fears, relationship based thoughts, morality/scrupulosity based thoughts, and more. Compulsive behaviors and mental acts may look like checking, mentally reviewing, mentally rehearsing, excessive hand washing, thought neutralization, etc. One common approach with significant treatment outcomes for anxiety management and obsessive compulsive disorder is exposure and response prevention (ERP), a type of Cognitive Behavioral Therapy (CBT). ERP involves gradually exposing clients to their feared stimuli in order to help them overcome their anxiety and learn to tolerate situations without engaging in compulsive behaviors or avoidance behaviors. ERP aims to have patients habituate (gradually reduce their anxiety over time) and also learn to manage the distress around anxiety provoking situations. Exposure exercises will be done in session with your therapist and clients will also have a practice exposure for outside of session, while engaging in ritual prevention. Even though exposure therapy is often the intervention used to treat OCD symptoms, it can also be done with those experiencing other types of anxiety related disorders and mental health issues (social anxiety disorder, panic disorder, generalized anxiety disorder, post traumatic stress disorder, etc.) If you haven't experienced an exposure treatment before, you may be unsure of what this looks like. The types of exposures in ERP are imaginary, in vivo, and interoceptive exposures. In Vivo Exposure In vivo exposure involves facing distressing situations related to one's obsessions in real life. Even though this involves directly facing fears, this can also be done gradually. For example, if someone has contamination based OCD with fear of contracting an illness, this exposure may involve directly touching a doorknob that someone fears may be contaminated. Gradually increasing the difficulty of this exposure would look like touching a doorknob at home, then at a public restroom at a location where a few people go to, and then touching a doorknob at a location where many people may have access to the same doorknob. While doing this, it is very important to engage in response prevention (not engaging in compulsions). For someone who has harm OCD and has intrusive thoughts regarding harm and driving, an exposure may look like driving a parking lot, then driving on a busy road, driving on a highway, and driving over a bridge. Imaginary Exposure Imaginary exposure involves visualizing the feared situation in your mind. This can take the form of creating an imaginary script or verbally hearing or saying statements related to your intrusive thoughts and core fears. An imaginary script may be written by the therapist, on your own, or collaboratively with your therapist. The script is similar to the mindfulness practice of "guided imagery," where you are directly envisioning the script in your mind, as if this is currently happening. This could also involve the therapist asking someone to describe what they envision the tiny, microscopic germs on the doorknob may look like. This could also involve mimicking what some of the obsessive thoughts would naturally say when you are exposed to a trigger, such as, "what if you do get sick?" For harm OCD, this may look like statements that mimic similar obsessive thoughts, such as, "what if you drove off the bridge?" You may also create a script that access the core fear around the harm and driving that you envision happening while sitting in session. Interoceptive Exposure Interoceptive exposure involves experiencing the physical sensations that are associated with the fear, such as feeling one's heart racing or feeling like one is about to vomit. For someone with contamination OCD, this may look like creating a physical sensation that we fear could be a sign of being sick or contaminated. You might run in place to get your heart rate up or do an activity to create a tingly sensation in the body. Conclusion These are examples just around contamination OCD, but will look very different based on the type of obsessions and compulsions the individual has. Even if contamination OCD is what you currently struggle with, your exposure sessions should and will look different as well because they should focus on your core fears and situations/items that are triggering that are unique to you. An exposure can be done individually, but can also be done in combination with another type of exposure. Some clients with obsessive compulsive disorder may find that one type of exposure is particularly effective for them, while others may need to incorporate multiple types in order to effectively manage their OCD symptoms. Incorporating multiple types can be more anxiety provoking than the ones done individually, but may also more closely mimic what happens when someone is triggered in their day to day life. Often we may come across an in vivo exposure (we touched a doorknob in a public restroom) and then we have the imaginary exposure (intrusive thoughts, such as, "I think I felt something on the doorknob. What if that was body fluids that could be harmful and get me sick?"), and the interoceptive exposure occurs (maybe our hand starts pulsing because we are anxious and we are unsure if this is a sign that we did come in contact with a contaminant). Exposure and Response Prevention (ERP) is a powerful and proven treatment modality. Treating obsessive compulsive disorder with these repeated exposure can help individuals learn to cope with and manage their OCD symptoms over time. If this is something that may be helpful for you, please reach out to Mosaic Minds Counseling, LLC. Mosaic Minds is a group private practice with therapists that understand ERP treatment. The international OCD foundation (IOCDF) also has a wide range of resources to begin your treatment journey, as well.

Jessica Bell

Oct 26, 2022
Therapy with Sergio Perez, LMHC

Sergio Perez is a Licensed Mental Health Counselor based in Florida. He provides remote therapy sessions to clients throughout the states of Florida and Colorado, with a focus on adolescents and young adults. Sergio specializes in helping his clients work through anxiety, depression, trauma, grief, ADHD, or attachment issues. His approach to therapy is flexible and client-centered - focused on drawing out existing strengths to help overcome difficulties. [Sergio Perez, LMHC] Sergio’s background, specialties and therapy philosophies Before going into private practice, Sergio worked for a nonprofit mental health agency focusing on children and adolescent mental health. Sergio works with a wide range of clientele, which he believes to be one of his strengths as a therapist as he is able to relate and understand a diverse set of people from many different backgrounds and age ranges. When asked about his guiding principles, Sergio considers empathy, congruence, and unconditional positive regard at the forefront of his work with clients. He believes that clients already have the solutions to their problems and that it is his job to help them find those.  Sergio believes that fear is debilitating; it is often the fear of something that prevents us from moving forward. He also believes grief is a complex response. Opposing thoughts and feelings can battle for our attention, and this emotional volatility can be exhausting and confusing—especially when we let judgments influence how we view our grief. The impact of trauma often uproots our worldview, values, and perspectives which can leave us stranded in an unsafe and scary world. With these, Sergio aims to help those struggling with anxiety, grief and trauma to move forward by gradually confronting their fear, accepting their experiences and regaining control of their lives.  In Sergio's free time, he enjoys playing with his pup, Rush. Sergio also enjoys basketball, hiking, and playing video games.   Therapy sessions with Sergio Typically, clients see Sergio for 8 sessions, the first session focused on getting to know the client more. The process of therapy, Sergio's style, the client's presenting issues, and goals for treatment are discussed. The first session will also focus on developing personalized techniques and strategies. After the client has made therapeutic gains and can rely on the skills and knowledge learned in treatment to handle new challenges that come up, it may be time to end therapy. 

Mariella Arceo

Oct 25, 2022
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