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Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT) focuses on helping individuals accept difficult thoughts and feelings, rather than trying to eliminate or change them. The therapy encourages individuals to commit to taking action towards values and goals that are important to them, despite the presence of difficult thoughts and feelings.

ACT is based on the idea that psychological suffering often arises from attempting to avoid or control thoughts, feelings, and experiences that are ultimately unavoidable. Instead, ACT encourages individuals to develop psychological flexibility, which involves learning to experience difficult thoughts and feelings without becoming overly absorbed by them, and being able to take action in line with personal values and goals.

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Agoraphobia

Agoraphobia is anxiety about being in places or situations from which the escape may be difficult or embarrassing (i.e., traveling in a car or a bus, crossing a bridge, being outside the home, being in a crowd, being in an enclosed place, standing in line, etc.) In many cases, the person suffering from agoraphobia tries to avoid feared situations or endures them with great distress. In severe forms, a person may become completely homebound.

The treatment of choice for agoraphobia is Cognitive Behavioural Therapy (CBT). Treatment includes identifying and if needed, modifying the thoughts that underlie and drive the person's fear.

Additionally, it involves gradual step-by-step exposure to feared situations with the purpose of helping the person unlearn the conditioned fearful response. Most people with agoraphobia have other psychological conditions such as panic disorder, phobias, social anxiety, etc. It is very important to establish the correct diagnosis as it will guide the treatment.

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ARFID (Avoidant/Restrictive Food Intake Disorder)

ARFID is a condition characterized by a persistent failure to meet appropriate nutritional and/or energy needs due to restrictive food intake, fear of certain foods, or a lack of interest in eating.

Individuals with ARFID may experience significant weight loss or failure to grow and develop, and may also have difficulty with social interactions related to food.

It is different from anorexia nervosa, as individuals with ARFID do not have an intense fear of gaining weight and do not have a distorted body image.

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Anxiety

Everybody feels anxious sometimes. We feel anxious when we are scared or think something bad or dangerous may happen. Anxiety is a normal, even helpful and adaptive emotion. It allows us to deal effectively with danger. At times, however, anxiety may become overwhelming and negatively affect our functioning in daily life. We may start avoiding things that make us anxious, or deal with things differently than we normally would. It is important to deal with unhelpful anxiety that might have gotten in the way you live your life.

Cognitive Behavioural Therapy (CBT) is the evidence-based treatment for anxiety. Using CBT tools, your therapist will guide you in learning helpful strategies for managing your anxiety. You will learn what anxiety is and how to recognize and interpret its signs. In therapy, the unhelpful thoughts that make you anxious and keep your anxiety going will be explored, challenged and modified. Additionally, you and your therapist will identify the behaviours that may contribute to your anxiety, and work of gradually changing them.

You can stop anxiety from controlling your life! To learn more about various aspects of anxiety, check out recent posts on our blog.

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Adjustment Disorders

Life changes, such as an illness, going away to school, marriage, divorce, unemployment, new job, being involved in a car accident, etc., cause stress. In most cases, people adjust to those events within a few months. In some cases, however, the emotional (anxiety, depression, worry, tension, stress), behavioural (impaired functioning at home, at work or socially), or physical symptoms do not go away even several months after the occurrence of the stressor. It is important to seek therapy to address those symptoms before they become chronic.

The treatment of adjustment disorders usually involves assessing the person's problem-solving and coping skills, as well as encouraging and supporting more effective coping. Relaxation techniques and lifestyle changes are often addressed in therapy. Treatment includes helping the person to gain perspective through addressing possible cognitive errors, reevaluating his or her role in the situation, and coming up with specific steps in dealing with the stressor and moving on.

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Anger

Has your life, or the lives of people around you, been negatively affected by your anger? Have you regretted some of the decisions made in anger? Are you ready to make some positive changes in your life and to learn to express your anger in a non-destructive way?

Together, we can examine in depth what triggers you, how some of our thinking patterns may contribute to anger, and which ways of expressing your anger may lead to undesirable outcomes. With the help of cognitive and behavioural strategies (CBT), we will work on re-examining unhelpful assumptions, modifying the ways anger is expressed, taking a step back from the "tornado" of anger, and greatly reducing conflicts and stress in your life.

Intense and overwhelming anger may be a symptoms of several psychiatric disorders, such as Borderline Personality Disorder (BPD), Post-Traumatic Stress Disorder (PTSD), one of the mood disorders (Depression, Bipolar Disorder), Oppositional Defiant Disorder, etc. It is, therefore, crucial to see a professional who will be able to establish a differential diagnosis as in those cases different therapeutic strategies will be useful in addition to CBT. For example, Dialectical Behavioural Therapy (DBT) is usually helpful to individuals with Borderline Personality Disorder. In case of a mood disorder, it is important to treat Depression or Bipolar Disorder, which may be the root cause of angry and irritable mood.

Working in therapy to address your anger is not easy. It requires perseverance and hard work. But it is well worth it of anger is currently getting in the ay of important things in your life. Anger is an important emotion that can play a positive role in your life if you learn to understand it, manage it, and use it appropriately.

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Cognitive Behavioural Therapy (CBT)

Cognitive-Behavioural Therapy (CBT) is a goal-oriented approach that addresses problems related to the interactions between our thinking, feelings, and behaviour. This is an evidence-based treatment that has been proved to be effective in dealing with various emotional disorders, as well as daily life challenges.

CBT-trained clinician will work with you helping you to not only resolve your problems, but also learn the various effective CBT strategies so that you can become "your own therapist." Those strategies include goal setting, identifying and changing distorted thinking, modifying beliefs, challenging "rules for living", developing a "Fear Ladder", conducting behavioural experiments, addressing and changing behaviour, relapse prevention and learning to relate to others in healthier ways.

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Depression

Do you sometimes feel hopeless and helpless? Have you lost interest in things you used to enjoy? Do you believe that nothing will ever work out? Do you criticize yourself and feel that you just can't do the things that are expected of you? Please do not despair. Those are symptoms of depression and are not a reflection of the reality.

Cognitive Behavioural Therapy (CBT) has been proven to effectively relieve the symptoms of depression. Through scientifically proven tools, such as behavioral activation, challenging unhelpful cognitions, and practicing mindful awareness, you can change the way you think, feel and behave.

It is important to seek treatment for depression as early as possible as depression is a self-limiting condition that often takes a persistent and recurring course if left untreated. It affects people on cognitive, emotional, physiological, motivational, and behavioural levels.

In treatment you will learn techniques that will help you overcome your depression. We will work collaboratively in therapy on reclaiming your life one step at a time.

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Disgust OCD

Individuals with disgust OCD often experience intense anxiety, fear, and shame related to their intrusive thoughts and images, which can center around a variety of themes, such as bodily secretions, bodily fluids,

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Compulsive Speech OCD

Compulsive Speech OCD is characterized by the urge to repeatedly ask questions, make statements, or repeat certain words or phrases. People with Compulsive Speech may feel an overwhelming need to clarify or confirm information, even if it is already known, or may experience anxiety and discomfort when they are unable to express themselves adequately. This type of OCD can be both distressing and disruptive to daily life, impacting social relationships, work, and other important areas of life.

Compulsive Speech is sometimes driven by the fear of saying the wrong thing or making a mistake, and the compulsive behaviors associated with it are often performed in an attempt to alleviate this anxiety. The compulsions can range from mild and occasional, to severe and persistent, and can interfere with daily life and cause significant distress. It can also often lead to avoidance of social interaction.

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Dialectical Behaviour Therapy (DBT)

Dialectical Behaviour Therapy (DBT) has been shown to be effective in working with people suffering from intense emotional misery. Such individuals tend to feel things deeper, more intensely, and for longer time than other people. They react excessively to relatively low levels of stress and it takes them longer to return to normal after the stressful situation passed. Such emotionally vulnerable people find it hard to change their thoughts and behaviours without first learning to accept themselves, including their thoughts and feelings. DBT helps people balance acceptance and change.

DBT is a form of behavioural therapy that focuses on teaching people specific skills that help them cope with distressing emotions. It includes mindfulness, distress tolerance (crisis survival and reality acceptance), interpersonal effectiveness, and emotion regulation skills.

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Eating Disorders

Eating Disorders are characterized by disturbed eating or eating-related behaviours. Frequently, a person with an eating disorder is preoccupied with their weight or with food. The three main types of eating disorders are anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Some people exhibit more subtle signs and symptoms of disordered eating that do not meet the full criteria for any of the eating disorders, but are, nevertheless, a cause for serious concern.

Many people with eating disorders are scared to seek treatment because they are afraid that they will have to gain weight. Others are afraid to give up their eating behaviours that provide emotional comfort and/or a sense of control. The adverse psychological, physical, and social consequences of eating disorders, however, are profound. Eating disorders are usually a sign of a bigger emotional problem and are real, treatable medical illnesses.

Treatment of eating disorders usually includes Cognitive Behavioural (CBT) strategies, such as addressing over-evaluation of shape and weight, as well as unhelpful weight-control behaviours (dietary restraints and restrictions, binging, purging, etc.), restoring adequate nutrition, bringing weight to a healthy level, and relapse prevention. It is important to understand that in many cases, other psychological issues, and interpersonal relationship difficulties contribute to disordered eating. Those issues need to be identified and addressed in therapy with the goal of developing healthier ways of dealing with them.

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Emetophobia

Emetophobia is an intense irrational fear of vomiting. Most sufferers of emetophobia fear vomiting themselves, while some fear seeing someone else vomit. The standard treatment for emetophobia, as any anxiety disorder, is Cognitive-Behavioural Therapy (CBT), which involves cognitive restructuring and gradual exposure to feared stimuli. This treatment does not require that the individual actually vomit. The person learns to stop avoiding situations, objects and activities that they fear might lead to vomiting.

Emetophobics frequently suffer from agoraphobia and ritualistic behaviour that may look like OCD. They may wash their hands until raw for fear of germs from an illness that may make them vomit. They may fear seeing someone vomit or catching germs so much that they will not leave the house. Many emetophobics have a variety of rituals to keep from vomiting or to reassure themselves that they are not sick (i.e., obsessive temperature-taking), or superstitions about numbers and dates (especially the date they last vomited). It is, therefore, important to see a therapist who has an understanding of this disorder and is able to provide differential diagnosis and create an appropriate treatment plan.

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Excoriation (dermatillomania, skin-picking disorder)

Skin-Picking Disorder is characterized by frequent and intense picking of skin resulting in bleeding, sores, and scars, in spite of recurrent attempts to stop. This is often done in an attempt to remove small irregularities or perceived imperfections, but individuals may pick at healthy skin as well. The most commonly picked sites are the face, arms, and hands; however, in some cases, multiple body sites are picked. People usually use their fingernails to pick, but often tweezers and other instruments may be used. Skin picking frequently starts as a regular grooming behaviour (everyone picks their skin at times), but it may change into a highly disturbing and embarrassing condition. The majority of skin-pickers are women, and this disorder often starts in adolescence.

The act of picking can be preceded by a sense of tension and may be followed by a sense of relief or pleasure. It is often accompanied by feelings of shame and guilt and can lead to significant impairment in one's daily functioning.

Excoriation disorder is classified as a body-focused repetitive behavior (BFRB) and is considered a subtype of obsessive-compulsive and related disorders. It can occur alone or in combination with other BFRBs such as trichotillomania (hair-pulling disorder) or onychophagia (nail biting).

Unfortunately, many people with skin-picking disorder are reluctant to seek help because of embarrassment and shame. It is important, however, to see a psychologist who is knowledgeable in treating excoriation, as even though skin-picking intensity frequently fluctuates, it rarely remits completely. Some of the treatments of choice for excoriation are Habit Reversal Training, Stimulus Control, and Cognitive Behavioural Therapy (CBT).

In treatment, you will increase your awareness of this habit by identifying the emotional, social, and other consequences of picking, and whether your picking is usually preceded by a feeling or by a thought. Your therapist will then help you develop a new behaviour (a competing response) that would compete with your picking. You will be then guided in consistently implementing that response.

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Exposure and Response Prevention (ERP)

Exposure and Response Prevention (ERP) is a type of behavioral therapy used to treat obsessive-compulsive disorder (OCD). The therapy involves exposing the individual to the thoughts, images, or situations that trigger their obsessions (exposure) and then preventing them from engaging in the compulsive behaviors (response prevention) that they typically use to reduce anxiety.

The ultimate goal of ERP is for an OCD sufferer to reclaim their life. That is, to go back to living life without restrictions imposed by OCD. When doing ERP, individuals learn that they can handle the anxiety and discomfort associated with their obsessions without engaging in compulsive behaviors and without avoidance.

ERP typically begins with a comprehensive assessment of the individual's specific obsessions and compulsions. This helps the therapist to develop an individualized treatment plan. The exposure component of ERP involves exposing the individual to the specific thoughts, images, or situations that trigger their obsessions, in a controlled and safe environment.

Response prevention involves preventing the individual from engaging in the compulsive behaviors they typically use to reduce anxiety. This can be challenging, as these behaviors may provide temporary relief, but it is crucial to the success of ERP. The therapist will help the individual to develop alternative coping strategies that can be used in place of compulsive behaviors.

ERP therapy is usually done in a one-to-one setting with a therapist trained in cognitive-behavioral therapy (CBT) and can be done in individual or group therapy sessions. It typically requires a commitment to several weeks or months of regular therapy sessions, as well as homework assignments that involve real-life exposure exercises. The therapy is considered to be highly effective in treating OCD, with research showing that the majority of individuals who complete ERP experience significant reductions in their symptoms.

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False Memory OCD: Navigating Distorted Reality

False memory OCD is a subtype of OCD in which individuals experience intrusive thoughts and doubts about the accuracy of their memories. These doubts can lead to significant distress, as individuals may question their own perceptions and reality.

False memory OCD can manifest in many ways, including questioning the accuracy of past events, thoughts about harming others, and intrusive thoughts about inappropriate or sexual acts. The fear of having acted on these thoughts can lead to intense guilt and shame, further fueling the cycle of obsessions and compulsions.

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Fear of saying the wrong thing

For some individuals, OCD may involve a fear of saying the wrong thing, which can cause significant distress and interfere with daily functioning.

Individuals with this type of OCD may experience intrusive thoughts or images about saying something inappropriate, offensive, or embarrassing. These thoughts can cause intense anxiety and shame, leading individuals to engage in compulsive behaviors aimed at reducing their anxiety, such as seeking reassurance from others, avoiding social situations, or excessively self-censoring their speech.

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Fear of losing one's mind

This is a type of illness anxiety that involves a fear of losing one’s mind or developing a mental or neurocognitive disorder. This fear can manifest in many different ways, including a fear of postpartum psychosis, schizophrenia, bipolar disorder, and Alzheimer’s disorder, and can have a profound impact on one's daily life. This fear leads to repetitive and intrusive thoughts, which can take many different forms, including a fear of losing control of one's thoughts or actions.

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Fear of impregnating someone

One of the common themes of OCD is fear of harm or fear of causing harm to oneself or others. This is a fear of accidentally impregnating a woman even if no intercourse occurred.

Common compulsions include excessive hand and whole body washing, especially after masturbating, using several forms of birth control simultaneously, avoiding public showers, gyms, swimming pools, and saunas, asking for reassurance, etc.

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Fear of getting pregnant

This type of OCD typically involves excessive worry about the possibility of becoming pregnant. These kinds of intrusive thoughts may occur even in the absence of any sexual activity.

Some examples of compulsions that might be associated with a fear of accidentally getting pregnant include:

  • Constantly checking for pregnancy symptoms or taking pregnancy tests multiple times a day (often even in cases where there was no sexual intercourse)

  • Repeatedly asking others for reassurance that you are not pregnant

  • Checking if a sexual act somehow accidentally happened during the day without the person noticing it

  • Checking for the possibility of “catching” semen at gyms, saunas, swimming pools, subways, public washrooms, crowds, etc.

  • It is important to note that while these behaviors may provide temporary relief from anxiety, they ultimately serve to maintain and exacerbate the cycle of obsessions and compulsions.

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