Obsessive-Compulsive Disorder (OCD) is a disorder characterized by repetitive cycles of obsessions and compulsions.

Obsessions are unwanted and intrusive thoughts, images, or urges that trigger distressing feelings. Obsessions sometimes do not feel like they fit your personality, but return over and over. Examples can include excessive and irrational worries about health, safety, relationships, cleanliness, right and wrong/morality, bathroom routines, health of family members, certain illnesses, needing things to be “just right” or exactly a certain way, or doubting something about yourself or your personality. However, OCD can “latch onto” anything, therefore obsessive thoughts vary, and these examples are just a handful of the thousands of “OCD worries” our therapists have heard and treated.

Compulsions are behaviors, actions, rituals, or mental acts that an individual engages in or with in an attempt to get rid of the obsessions and/or decrease the intense distress. Examples include excessive or ritualized routines, checking behaviors, cleaning/washing self or items, counting or number rules, ordering/arranging, confessing, superstitions, feeling as if things need to be “even” or symmetrical, redoing things, and asking others (like a family figure) for reassurance or to answer specific questions. Another very common compulsion is avoidance of fears and things that an individuals thinks might cause them distress.

At MBH, we often call OCD the “doubting disease”, as it tends to create a vicious cycle of needing certainty about possible bad outcomes, difficulty dealing with not knowing, not having complete certainty about the things we fear, and/or dealing with the unknown.

There are many misconceptions about OCD. The phrase, “I’m so OCD” can be used in conversations as if OCD were a small personality quirk or only related to mild cleanliness. In reality, OCD is a debilitating disorder that often does not remit without adequate, evidence-based treatment, such as Exposure-Response prevention, or Exposure Therapy.

Exposure-response prevention is the gold standard treatment for Obsessive-Compulsive Disorder, phobias and related disorders. Our process begins with completing a thorough assessment by our OCD experts, that includes research-based symptom severity measures to determine the best course and frequency of treatment.

Social Anxiety Disorder (SAD), or Social Phobia, is a disorder characterized by persistent and excessive worry about being judged by others and/or being perceived negatively by others in social situations or groups. It can sometimes lead to avoiding making friends, spending time with friends or peers, speaking in front of others or giving presentations, eating in front of others, or any other situations that may lead to fear of embarrassment or judgement. Panic reactions such as sweating, increased heart rate, shaking, and shortness of breath can occur. It can lead to more serious consequences such as reducing participation in class or hobbies, difficulty focusing on daily school or work tasks, and school avoidance/refusal.

The gold-standard treatment for Social Anxiety is often a combination of Exposure-Response prevention (or Exposure Therapy) and Cognitive Behavioral therapy techniques.

Our process begins with completing a thorough assessment by our anxiety experts, that includes research-based symptom severity measures to determine the best course and frequency of treatment.

Generalized anxiety disorder (GAD) is a common anxiety disorder characterized by excessive, daily worry about a variety of different topics. Often times, it feels as if you are worrying more than half of the day, throughout the day. Worrying is often accompanied by restlessness, irritability, muscle tension and aches, fatigue, difficulty concentrating, upset stomach, sweating, sleep issues, and increased heart rate.

Individuals with GAD may struggle with uncertainty, “what if” scenarios, catastrophizing, assuming negative or bad things will happen, and black and white thinking. These are examples of negative thinking patterns that can be targeted in therapy with evidence-based tools that challenge these patterns, increase values-aligned behaviors, and increase tolerance for distress and uncertainty.

Dr. Lazaroe has a decade of experience working with generalized anxiety. Please contact our clinic to set up a consult.

Trichotillomania, or hair pulling, is a chronic condition involving pulling one’s own hair that often results in hair loss on the scalp, eyebrows, eyelashes, pubic area, face, arms, legs, and/or other body parts. It is sometimes accompanied by a feeling of tension, that can feel relieved during or after pulling. Trichotillomania is categorized as a body focused repetitive behavior, often called “BFRBs” by researchers, clinicians, and others in the BFRB community. Trich can cause significant stress, anxiety, and self-esteem issues. Trich often initially presents in childhood, but it can effect an individual at any age. Someone suffering with trich can try very hard to “stop” pulling, but it is often extremely difficult to reduce or resist the “urge” to pull. Sometimes we can find ourselves in the middle of pulling without even realizing we began doing it! It is not uncommon for individuals to spend large amounts of time on pulling behaviors, as well as attempt to conceal or hide hair loss. Sometime these avoidant strategies by themselves cause impairment and additional stress.

Trichotillomania is a condition that can be treated with an adapted version of Habit Reversal Training. This is a behavioral treatment that focuses on 1) awareness, 2) environmental triggers, 3) competing responses, 4) education about trichotillomania, and 5) self-esteem building and identity development.

It is not only important to build self-efficacy in managing pulling, but also building self-esteem and identity in areas outside of trich, such as hobbies, interpersonal skills, personal passions, academic performance, and roles in family and community. Patients are not just someone who struggles with hair pulling, but also a great sister, grandson, friend, soccer player, artist, mathematician, etc.!

It is important to know that a “cure” for body focused repetitive behaviors, such as trich, does not exist; HRT is system that adds ‘tools to your toolbelt’ to better manage unwanted behaviors/habits and improve quality of life.

Dr. Lazaroe trained in HRT for trichotillomania at both the University of Florida and University of South Florida Rothman Center. Contact her today to set up a consult.

Excoriation disorder, dermatillomania, or skin picking, is a chronic condition involving repeatedly picking at one’s own skin that often results in swollen or broken skin, open sores or wounds, and can lead to injury or scarring. It is sometimes accompanied by a feeling of tension, “wrongness”, or sense of imperfection, or alternatively a sense of relief or stress reduction while picking. It is sometimes comorbid with Obsessive-compulsive disorder.

Skin picking is categorized as a body focused repetitive behavior, often called “BFRBs” by researchers, clinicians, and others in the BFRB community. Skin picking can cause significant stress, anxiety, and self-esteem issues. This issue often initially presents around puberty, but it can effect an individual at any age. Skin picking sometimes is exacerbated by skin conditions like eczema or acne. Though facial skin is one of the most common areas where skin picking occurs, other areas of the body can also be effected, such as arms, legs, back, scalp, and pubic areas. Someone suffering with a BFRB like skin picking can try very hard to “stop” picking, but it is often extremely difficult to reduce or resist the “urge” to pick. Sometimes spending excessive amounts of time performing checking behaviors in the mirror can occur. It is not uncommon for individuals to spend large amounts of time on picking behaviors, as well as attempt to conceal or hide skin issues. Sometime these avoidant strategies by themselves cause impairment and additional stress.

Skin picking is a condition that can be treated with an adapted version of Habit Reversal Training. This is a behavioral treatment that focuses on 1) awareness, 2) environmental triggers, 3) competing responses, 4) education about skin picking, and 5) self-esteem building and identity development.

It is not only important to build self-efficacy in managing picking, but also building self-esteem and identity in areas outside of this, such as hobbies, interpersonal skills, personal passions, academic performance, and roles in family and community. Patients are not just someone who struggles with skin picking, but also a great sister, grandson, friend, soccer player, artist, mathematician, etc.!

It is important to know that a “cure” for body focused repetitive behaviors, such as skin picking, does not exist; HRT is system that adds ‘tools to your toolbelt’ to better manage unwanted behaviors/habits and improve quality of life.

Dr. Lazaroe trained in HRT for skin picking at both the University of Florida and University of South Florida Rothman Center. Contact her today to set up a consult.