By 
By Ron James
Taking the first step in dealing with life’s challenges can be the hardest. Fear of failure or fear of success can feel like a stop sign.
Douglas (name changed) came to me with a severe case of obsessive compulsive disorder which manifested itself with compulsions such as excessive counting and overchecking. He spent much of the day engaged in repetitive behaviors such as making sure he had turned off the stove or that he had counted the right change at the grocery store.
Doug and I became collaborators in creating a safe environment for the inception of a brief course of cognitive behavioral therapy which is a form of psychotherapy where negative thought patterns about the self and the world are challenged in order to alter unhealthy behaviors and treat mood disorders such as depression. It emphasizes the key role that thoughts have in how we feel and behave. The goal is to change the way we think in order to feel & act better even though the situation doesn’t necessarily change in a significant way. CBT as it is often referred to is a structured & time limited talk therapy that gives patients the tools to better handle conflictual relationships, manage chronic pain, prevent mental health and substance abuse relapse and generally cope better with life’s stressful situations. It has been proven effective in the treatment of depression, anxiety, phobias, sleep disorders, eating disorders and obsessive compulsive disorder to name a few.
With Douglas we initiated a six week trial of exposure response prevention therapy (a form of cognitive behavioral therapy) that focused on resisting the urge to check or count excessively and rather sitting with and best tolerating the accompanying anxiety. As the treatment progressed, he was able to refrain from the behaviors and reported a reduction in anxiety from 9 to 3 on a 0-10 scale.
The lesson to be learned is that the first step is the most important one! Restore your emotional health by finding a practitioner you can trust and start telling your story.
Rafael “Rafi” James is a San Diego based LCSW psychotherapist who has started the private practice, San Diego Center for Integrated Healing. For a telephone consultation with him, call (914) 215-1508, or email therapy@rafaeljames.com
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