Written by Johanna Younce, MA

Obsessive-Compulsive Disorder (OCD) is a really difficult thing to have and experience for yourself, but it is also difficult to care for someone who experiences it. When someone has a diagnosis of any kind, psychological or physical in nature, it is always better to have support from loved ones. If you are reading this because someone you love has OCD, I want to start by thanking you for caring so much. The first step is to do more of what you are doing right now: Seek out information. One excellent source for information on OCD is the International OCD Foundation website (start with https://iocdf.org/about-ocd/). This will help to get a basic sense of what the disorder actually is. This is important because OCD is often misrepresented in media and popular culture, so what many people think they know about OCD may not be completely accurate. As you learn more, it is important to remember that OCD is a complex problem and it looks different for everyone. Some people with OCD have symptoms that most people are aware of, such as fear of germs and washing rituals, but others experience completely different types of obsessions and compulsions. In fact, some people perform compulsive rituals entirely in their minds (for example, repeating phrases over and over in their head). Look for reputable sources to find information, but also ask your loved one about what OCD looks like for them.

Depending on your relationship with your loved one, you may want to help them find a therapist if they don’t already have one, or if their current therapist is not experienced in treating OCD. When looking for a therapist, look for a specialization in OCD or anxiety disorders, and ask whether the therapist is trained in exposure and response prevention (ERP), the gold standard treatment for OCD. For a list of providers at OakHeart that specialize in treating OCD and utilize ERP, visit our OCD specialty page. ERP for OCD is very well-researched and effective. For more information on finding a therapist, see the past blog post "How to Find the Right Therapist for You" by Dr. Katherine Harris. 

This next piece can be harder to do. When a loved one experiences great anxiety, our impulse is often to help them get rid of the anxiety by helping them avoid or escape their triggers (feared object or situation). This is super helpful when someone’s anxiety is caused by a truly dangerous thing - when our loved ones are actually in danger, we want to help them and ourselves get to safety. However, when the anxiety is unhealthy and disproportionate to the actual danger involved, we find that these escape and avoidance behaviors actually worsen the problem. When loved ones help the client avoid, we call this “accommodation.” When I work with the families of individuals with OCD, we talk a lot about identifying accommodating behaviors and stopping them. This is often very hard to do, because this makes your loved one more anxious in the short-term, but it is essential to their recovery. It’s similar to when a person struggling with alcoholism begs for alcohol - it’s going to make them feel better in the short-term, but it feeds their problem. We wouldn’t want to give alcohol to an alcoholic, so we also don’t want to give accommodations to our loved ones with OCD.

One of the most common accommodations is reassurance seeking. People with OCD will sometimes seek reassurance from others regarding their fears. If the fear is that they are secretly an evil person, they might ask a parent or partner if they did something wrong or if they are a good person. If they have fears that the house will burn down if the oven isn’t turned off, they may ask someone if they did indeed turn the oven off. It is difficult to do at first, but we as loved ones must learn to stop giving reassurance. If the loved one is in treatment, you can remind them of their treatment goals and tell them (gently) that you will not answer their question. Sometimes I will have the client write down the loved one’s typical response to their reassurance seeking, and the loved one can simply remind them to look at what they wrote the next time that client asks for their reassurance. It feels difficult, and it may go against everything you have been doing for this person for a long time, but finding a way to stop accommodations and communicate your love and support in more fruitful ways will be the best you can do to help your loved one with OCD.

Finally, take care of yourself. Those of us in the helping professions put great emphasis on self-care because we cannot support others well unless we are taken care of. Take care of your body, mind, and spiritual self. Look for support from others. 

I believe in you.

If you feel you would benefit from talking with a clinician who specializes in OCD call OakHeart at 630-570-0050 or email us at Contact.OH@oakheartcenter.com.

Written by Johanna Younce, MA

When most people think about Obsessive-Compulsive Disorder (OCD), they think of the stereotypical symptoms: needing everything to be perfectly organized or “just right” and fear of contamination. While these are valid and common presentations of OCD, there are other types of symptoms that are less often discussed. One of these symptom types is the fear of unacceptable thoughts or repugnant obsessions, which feel incredibly scary and threatening to people with OCD. This type of OCD can cause an immense amount of shame and fear, and I believe we need to discuss it more openly to decrease the shame and give less power to these thoughts.

What does “unacceptable thoughts” mean? This type of OCD involves sexual, aggressive, and religious/moral obsessions. These obsessions involve very taboo thoughts that are hard to talk about, even with people who we are closest to. Many people with OCD have these unwanted, intrusive thoughts and think they are the only ones. However, research has shown that about 94% of people experience intrusive thoughts. That’s almost everyone! Almost every single person has intrusive thoughts from time to time. It is extremely common; People just don’t talk about it because it is so taboo and uncomfortable. 

So, wait, if so many people have intrusive thoughts, why do only some people have OCD? Thank you for asking; That is an excellent question. The difference is that people with OCD place an enormous amount of meaning on and responsibility for these thoughts. In other words, they interpret the thoughts differently. When most people experience unacceptable intrusive thoughts, they brush them off and recognize them as random and meaningless. People with OCD often think that having the thoughts must mean that they are terrible, awful people. But this simply isn’t true! The fact is, we cannot control what thoughts come into our heads, and sometimes the thoughts are taboo and uncomfortable, and that is ok. The same goes for dreams: Having a dream about something does not mean it is something you want to happen.

To further the cause of normalizing unacceptable intrusive thoughts, let me share some thoughts (in the form of either words or images) that I have had or have heard from others:

• An image of pushing someone down the stairs
• An image of driving one’s car off the road and into a lake
• “Do I love God enough?”
• An image of having sexual relations with one’s father or mother
• An image of having sexual relations with one’s sibling
• An image of having sexual relations with [fill in the blank with someone it would be inapproporiate to have sexual relations with]
• “If I swallow my saliva during Ramadan, am I not fasting?”
• An image of stabbing one’s eye into the corner of a desk
• An image of molesting a child
• “What if I’m secretly a pedophile?”
• An image of stabbing oneself, a loved one, or a stranger
• An image of a spider crawling into one’s vagina
• “What if I said that prayer incorrectly?”
• An image of Jesus Christ with an erection
• “What if I murder my spouse or partner?”
• Imagining the number “666”
• Images related to devil worship
• An image of throwing one’s baby out of the window
• An image of drowning one’s baby
• An image of or urge to throwing oneself into oncoming traffic
• The thought of swearing in church
• “Am I gay but haven’t realized it yet?”
• “Am I wrong about being gay and am actually heterosexual?”
• “What if I somehow accidentally poisoned my child?”
• “What if I somehow ran someone over with my car and didn’t notice?”
• Images of beastiality
• ...and much more.

Reading this list may have made you uncomfortable. You may have even found yourself judging either yourself or others for having these thoughts. The important thing here to remember is that these thoughts are intrusive, meaning they come into your mind without intending them, and they are unwanted, meaning they are not fantasies or desired outcomes. Just having these thoughts pop into your mind does not mean that you want them there and that you like to think about them. Fantasies are things that you enjoy thinking about (and every part of you enjoys it; there is not one part that feels anxious or thinks it is wrong). My random thought of myself driving off the highway this morning is meaningless and it does not worry me because I know that thoughts are just thoughts.

I hope this has helped you feel less alone in your more taboo thoughts or dreams. Almost everyone has them, and they are not meaningful. You are not alone, and you are not an evil person. 

Remember, thoughts are just thoughts.

To hear more about one individual’s experience with unacceptable obsessive thoughts, check out NPR’s Invisibilia Podcast’s Season 1, Episode 1: “The Secret History of Thoughts.” To learn more about intrusive thoughts and OCD, visit the International OCD Foundation website.

If you feel you would benefit from talking with a clinician who specializes in OCD call OakHeart at 630-570-0050 or email us at Contact.OH@oakheartcenter.com. 

Written by Hillary Gorin, PhD, LCP

Regardless of your political views, your understanding of the impact of COVID-19, or your beliefs about societal injustices, nearly every U.S. citizen is experiencing stress, uncertainty, and worry. Worry is an important cognitive function, as it helps humans solve problems effectively, plan for the future, and remain motivated. We may worry about solvable problems and, at other times, unsolvable problems. When we worry about solvable problems, we often find a solution and can put the concerns behind us. However, when we worry about unsolvable problems or problems that extend beyond our control, we can find it difficult to know what to do with the uncertainty. With an immense desire to solve an unsolvable problem, we can fall into what I like to call the ‘worry cycle’ or the ‘hamster wheel of worry.’ Our minds go around and around, searching for answers we cannot seem to find. So, how do you get off this hamster wheel? How do you accept uncertainty, particularly during these times of social unrest, political turmoil, and a terrifying pandemic? 
 
Many may think, ‘I will just reassure myself!’ or ‘Everything is going to be fine.’ Alternatively, many try to distract from or avoid the worry. For some, this strategy may be effective. For others, the worry persists, early in the morning, late in the evening, while watching the presidential debate, while scrolling through social media, while reading about COVID-19, while obsessively searching for polling predictions. The worry persists, even though you say, “Hey brain, everything is just fine.” 
 
Why don’t our brains listen to this self-reassurance? Why is it challenging for some, especially now, to believe that everything will be ok? Because the reality is, many of us have never faced risks/ threats of this magnitude before. These current threats are present and lingering in the background every day. Compared to various other points in our lives, the political unrest and looming pandemic have increased the chances that something bad could happen to us. Thus, no matter how hard we try to find evidence against our worries, we can’t find clear evidence that disproves our worry completely. So, worries propel through our minds, such as, ‘What if my loved one gets COVID? What if I lose my job? What if that candidate becomes president? What if social injustice persists?’ These are all possible, scary outcomes due to current, omnipresent stressors.
 
So, if reassurance and looking for evidence that everything will be ok does not work, how do we get these catastrophic thoughts out of our heads? One possibility is a technique called decatastrophizing. Decatastrophizing involves considering whether or not you could find ways to cope in the face of a feared outcome (Zinbarg et al., 2006). This technique assists us with changing our thinking from, ‘I could never cope if that happened’ to ‘This would be difficult, but I would find a way to cope.’ This could appear as asking yourself, ‘Will I survive this election?” The answer is – yes, you will, even if things don’t go the way you are hoping. Asking, ‘Will I survive this’ helps us see that the threat we are facing is not as imminent as it feels. In other words, we are not in imminent danger all the time, despite how these political, societal, and health crises may make us feel. 
​
So why does your brain make you feel like you are facing an imminent risk while watching a debate from the comfort of your couch? Studies suggest that the area of the brain involved in detecting threat, the amygdala, is triggered by certain thoughts, certain worries, and uncertainty (Hilbert et al., 2014). Decatastrophizing can be an initial step to telling that part of the brain that it can settle down. Instead of telling ourselves, ‘I will never manage to live through this,’ we can say, ‘I don’t like the world right now but I will probably be able to find a way to live in it.’

The next important step can be considering how you would actually cope with certain feared outcomes. This can be accomplished by considering what specific coping strategies could help you manage the situation. For example, if you lose your job, what steps would you take to manage it? For some, a coping strategy could be updating your resume and looking for job opportunities. 

Of course, this thought of losing your job will undoubtedly bring up anxiety, which brings me to another suggestion that I propose for most of my patients: The more we can start to accept uncertainty and sit with it, the less we will be propelled to continue running on the hamster wheel of worry. Sitting with anxiety is challenging and specific techniques are best applied with the assistance of a licensed mental health professional. However, beginning to allow yourself to feel anxiety, to ride the wave, and to let it come up and come down is important for everyone because we must see that we can tolerate anxiety, that it won’t last forever, and that we do not need to fear this emotion. Instead, anxiety/ fear is a critical emotion that keeps us alive. In life threatening situations, these emotions tell us when we are in danger. For example, many people experience anxiety and fear when they stand too close to the edge of a mountain. This anxiety/fear is normal and adaptive to keep us alive, as it prompts us to take a step back! However, sometimes we have this anxiety/fear in situations that are not life threatening, as our brains are mistakenly telling us that our lives are at risk. When there is nothing to act on immediately and when the worry is unsolvable, sitting with the anxiety and accepting that one person cannot eliminate our current health crisis or our political and social unrest, is important. Sitting with anxiety can be as simple as accepting the possibility of your feared outcome occurring. It may or it may not come true.  

Many ask me, ‘Why doesn’t avoidance/ distraction work? Isn’t that what we learn at an early age?’ Yes, distraction and avoidance are useful, at times, particularly when our anxiety is in the low to moderate range. When we are feeling slightly worried or anxious, watching a funny movie, participating in relaxing activities, or taking a walk tends to help reduce our physical and psychological tension. However, when our anxiety becomes too high, our amygdala, or that threat detector in our brain, is on high alert. This threat detector acts quickly and efficiently, without much input from logical thinking or what are considered, ‘executive functions’ (LeDoux, 2000). Why? Because, in the face of a threat, we need to act quickly. We do not have time to think. Imagine if you are in the woods and you see a bear on the trail! Your first reaction will be fight, flight (run away), or freeze (hide and hope that you are not seen). You likely will not be able to think through the situation logically. In these situations, our amygdala or ‘emotional brain’ holds our ‘thinking/ cognitive brain’ hostage so that we can act on instinct, automatically (Okon-Singer et al., 2015)! So, when politics, health crises, and societal unrest trigger high levels of anxiety, our brain tells us to fight, flight, or freeze. When you tell it to ‘calm down,’ ‘chill out,’ ‘distract yourself,’ ‘Look at all the evidence you will be fine,’ our amygdala tells us ‘NO WAY!’ It believes it still has work to do to keep us safe. 

Thus, I will again emphasize the importance of sitting with anxiety when we can, or with the help of a licensed mental health professional when we cannot. We need to let the anxiety peak and come down so that our logical, thinking brain can take back control! ‘Sit with it’ is a phrase my patients hear often because if you don’t sit with the anxiety and see that you will survive it, see you will cope with it, and see that it will not last forever, the ‘hamster wheel of worry’ can become very exhausting and self-doubt can grow. It is possible that your fears will come true. However, I am confident that you will find a way to survive and to cope with whatever comes your way.   
​
If you're feeling like you need a little more help navigating through worry call or email us today to schedule an appointment to speak with a clinician. Take a look at our provider page for a full list on all clinicians that treat anxiety disorders. 

References

Hillbert, K., Lueken, U., & Beesdo-Baum, K. (2014). Neural structures, functioning and 
connectivity in generalized anxiety disorder and interaction with neuroendocrine systems: 
A systematic review. Journal of Affective Disorder, 158, 114-126. http://dx.doi.org/10.1016/j.jad.2014.01.022

LeDoux, J. E. (2000). Emotion circuits in the brain. Annual Review of Neuroscience, 23(1), 
155-184. https://doi.org/10.1146/annurev.neuro.23.1.155

Zinbarg, R. E., Craske, M. G., & Barlow, D. H. (2006). Mastery of Your Anxiety and Worry: 
Therapist Guide (2nd ed.). New York, NY: Oxford University Press.

Written by Pam Heilman, PsyD, LCP

This year has undoubtedly been one of the most stressful, scary, challenging times for many individuals. As a trained psychologist, I frequently discuss the importance of self-care with clients and my colleagues. Self-care refers to any act in which you are taking care of yourself. This can include tending to your basic needs: showering, brushing your teeth, exercising, eating healthy meals, attending therapy, taking medication as prescribed, and getting regular physicals. Self-care also consists of engaging in activities that bring you relaxation or joy: meditation, spending time in nature, taking a hot bath, having a spa day, listening to music or podcasts, singing, or snuggling with your pet. 

One aspect of self-care I regularly explore with clients is engaging in creativity. Have you ever found yourself so interested or engrossed in a particular activity that you lost track of time and became extremely focused on the task at hand? This is what Mihaly Csikszentamihalyi, one of the founders of Positive Psychology, would refer to as “flow” in his 1990 book, Flow, the Psychology of Optimal Experience.

​As Csikzentamihalyi described it, flow is “a state in which people are so involved in an activity that nothing else seems to matter; the experience is so enjoyable that people will continue to do it even at great cost for the sheer sake of doing it.” Many people refer to this as being “in the zone” which happens when there is a balance between challenge and skill level. So, what are some of the reasons that flow might be so helpful? According to Arne Dietrich (2004), flow has been associated with decreased activity in the prefrontal cortex (in Oppland, 2020). This is the area of the brain that is responsible for executive function, or organization of thoughts and actions in accordance with internal goals. As Dietrich (2004) suggests, this temporary inactivation may trigger feelings of distortion of time and loss of self-consciousness (in Oppland, 2020).

Perhaps the idea of flow has been catching on in more recent years. Many local businesses such as Pinot’s Palette, Chilled Palette, Bleu Palette, Board and Brush, Arts on Fire, and Color Me Mine have become popular for gathering with friends or for a date night. Businesses like these offer workshops where you can learn how to paint on a canvas, paint pottery, or even stain and paint a bench or wooden sign to decorate your home. 

As a psychologist I like to practice what I preach. I had my first experience with painting acrylic on canvas several years ago with a group of friends at Pinot’s Palette. I was surprised by the amount of joy I experienced that night. Ever since then, I began attending more workshops and tried different types of projects. During the quarantine, I stocked up on painting supplies (acrylic paints, canvases, an easel, and brushes) from Michael’s. I began trying to set aside time every week to paint something new. In spite of the increased stressors during this difficult time, I have found my painting to be an amazing source of comfort and pride. I’m working on my skill level but what is more important to me is that I can create something with a blank canvas and just a few tools. I make myself a nice cup of coffee, put on some of my favorite music, have my basset hound close by, and I am content. 

My hope is that I can help my clients to find something that gives them a sense of passion or purpose to help them get into their “flow” state of mind. It doesn’t have to involve creating art. This can be anything that you are so interested in that you are able to focus solely on the task and lose yourself in the moment. Think writing, playing an instrument, gardening, yoga, working with tools, putting together a jigsaw puzzle, doing crossword puzzles or sudoku. Feel free to try different things to see what you like. It took me quite some time to stumble upon painting but I am so glad I was willing to try different activities to get there. I’d like to share some of the artwork I have done in recent months. These pieces are filled with imperfections but they are mine and I am proud of them. 

“The desire to create is one of the deepest yearnings of the human soul.” ~ Dieter F. Uchtdorf

If you'd like to schedule an appointment with one of our clinicians call (630) 570-0050 or email Contact.OH@OakHeartCenter.com. 

For more blogs on self-care written by OakHeart clinicians, read Surviving Social Distancing or Practice Self-Care. 

Resources:
Csikszentmihalyi, Mihaly. Flow: The Psychology of Optimal Experience. New York: Harper & Row, 1990
Oppland, M. (2020, January 9). 8 Ways to Create Flow according to Mihaly Csikszentmihalyi. Positive Psychology.com. Retrieved from:  https://positivepsychology.com/mihaly-csikszentmihalyi-father-of-flow/
​

Written by Brittany Male, LCSW, CADC

​This is a stressful time for so many of us. Between social distancing, changes at work, a new and unique start to the school year, and the political climate, we’re all navigating through a lot of stressors. The stress that we feel, impacts those around us, including our partners. If you or your partner have been struggling to communicate in a productive way, take a moment to read these tips for fighting fair that you can start practicing today.
​

• Identify why you’re upset. Maybe you’ve heard the phrase, “The first step, is admitting you have a problem”, well this tip is similar. You have to be able to identify clearly, why it is you’re upset. It is important to be self-aware regarding what you’re really upset about. If you’re really upset about a cup being left on the counter then fine, but if you’re feeling resentful about not feeling appreciated for the work you do, then that is what the conversation needs to be about. The cup is only acting as a representative of the real issue. If you only bring up the cup to your partner, it has the likelihood of being dismissed as a minor issue.

 

• Focus on one topic at a time. Although it may seem that an argument is an opportune time to bring up the list of other things that have been bothering you--it is important to focus on one topic at a time. If you start to add other things, it can get overwhelming and confusing for the other person as well as yourself. This confusion, can lead to misunderstandings and further frustration with limited ability to resolve anything. 

 

• Be aware of language used. Name calling. put-downs. swearing. These are all elements that do NOT have a place in a fight. Offending the other person will not accomplish the goal to find resolution. It is very hard to move forward in a healthy way once these are used, because the other person may be navigating through additional feelings of hurt as a result. The result may be a shift in focus away from the actual issue. This contributes to a lack of trust and safety and negatively impact the ability for resolution. 

 

• Express feelings in words and take accountability for them. If you have a hard time identifying your emotions or think that you only have three (happy, sad, angry), then it may be time to do some feelings work individually. We have a plethora of emotions and although they generally fall into these three categories (happy, sad, angry), it’s important to be specific about your feelings, in order to find the most effective solution. 

 

• ​Take turns talking. In order for a resolution to be made, you both must be able to share your thoughts and feelings. Remind yourself of your goal. If your goal is to be right instead of to find a resolution, then I would encourage you to evaluate your values within your relationship. If your goal is to find a resolution, then make sure to listen to your partner. It may seem silly, but using a talking stick or object can help in order to take turns talking. Sometimes we need physical reminders because they can help us stay accountable to the goal.

 

• No Stonewalling. If you haven’t heard of stonewalling, it is as it seems...you create a wall between yourself and your partner. This may mean you stop responding if they're talking or you may physically leave the room in the middle of the conflict with no indication of when you’ll return. It shouldn’t come as any surprise that doing this does not help to resolve the conflict. If you’re guilty of stonewalling in difficult conflicts, it may be helpful to begin utilizing timeouts with your partner. They do not involve ghosting your partner, but instead allow you to take a necessary break and return to the conversation at a designated time. 

 

• No yelling. Self disclosure here, I’m loud. I’m Italian and Puerto Rican and I speak passionately. When I’m happy I can get loud, when I’m sad I can get loud, and when I’m angry it is likely that I can get loud. Growing up, my family often dealt with conflict by getting loud. Because of my 'loudness', I try to be aware when I’m becoming loud and ask myself if it’s productive or counterproductive as well as what the comfort level is of those around me. Most of the time, it is counterproductive and leads to more conflict. Because of this, I attempt to avoid resolving conflict by yelling and encourage others to do the same. 

 

• Take a timeout if needed. Using timeouts effectively involves discussing the timeout prior to a conflict. Below are some simple guidelines when discussing timeouts with your partner. 
  • ​Have a signal (verbal or tangible) for the use of a timeout so that both you and your partner can easily recognize that the other person would like or is needing a timeout to be taken.
  • Discuss and agree on situations that may require a timeout.   
  • Clarify what the timeout means. An example may be: We will each get physical space from each other and finish the conversation after 30 minutes. 
  • Confirm a commitment to utilize the timeout as agreed upon.   
  • Define what the purpose of the timeout will be. (self-care, calming, reflection)
  • Revisiting the initial conflict.

​

• Attempt to come to a compromise if needed. If I notice that I'm rigid in my way of thinking in an argument I ask myself, where am I willing to compromise? This compromise may look differently for each conflict, but it can be a helpful question to ask yourself in order to find resolution. You can maintain your truth while also compromising. 

I’m hopeful that you are able to utilize these tips the next time you find yourself in a conflict with your partner or anyone in your life. Again, if you’re finding that you need more support, call (630) 570-0050 or email Contact.OH@OakHeartCenter.com to schedule an appointment with one of our clinicians. Relationships can be challenging, especially when there are so many external stressors that are out of our control. The key is knowing that you’re not alone and you can utilize help. 

​You've got this. 

Written by Megan Allegretti 

​2020 has been a year to remember!  Maybe not for the reasons we initially set out to remember - but one we will never forget.  Think back to January and what plans or resolutions you had set for yourself.  Was learning how to manage when your life gets flipped, turned upside down one of them?  I am going to say with confidence that most of us had no idea what this year would look like.  So, I wanted to start by congratulating you on doing what you needed to do to get through!  The object of this post is not to make us feel bad about what we are doing or not doing, but rather increase our intentionality in the behaviors we are using.  By being aware, we can see if we are in fact coping or avoiding a situation, and then observe to see if our actions are serving us well, or maybe not so much.  

Coping is a big buzz word currently, particularly in the COVID-19 world of uncertainty.  In the context of this article a coping skill will be defined as techniques that an individual applies to manage difficult emotions.  Coping is different from avoidance.  They look so similar!  Both reduce distress, but there is a curtail difference- avoidance does not address why you are feeling the way you are.  Instead it pushes the uncomfortable feeling away or deep down.  This might be rewarding in the short term, because there is a good chance you will feel better by not engaging in whatever thought or behavior that triggered the distressing emotion.  But by not confronting the situation or avoiding it, that emotion will find a way to come back out.  Often it will leak out when you are least expecting it.  

For all of my metaphor learners out there, this one's for you!  Say you have a beach ball and you try to shove it down as far as it can go underwater.  You can hold it there for some time but eventually your body gets tired, and it comes shooting out of the water with explosive force.  This looks a lot different than holding the beach ball where it is at, instead of shoving it down, and then slowly bringing the ball back to the surface.  This way you have more control over when you do want to bring the emotions back up to be addressed. That is the difference between avoiding and coping. The following tips are aimed at helping draw our awareness to our behaviors and choosing them with more intention.  

• Stop and observe the behavior. This is so much easier said than done, trust me!  There are many times when I come up from my phone to learn that 30+ minutes have flown by without even realizing what I was doing.  Or start pouring myself another drink without even thinking about why.  When you do notice that maybe you are acting on autopilot, it helps to slow down for just a minute and observe what you are engaging in and what purpose it is serving.  

 

• Be honest with yourself about the purpose. Is what you are doing helping you or hurting you?  Sometimes I will use cleaning as an avoidant behavior.  Cleaning! Something that sounds like a good thing, right?  It is absolutely healthy to practice disinfecting surfaces, especially in the current age of COVID-19.  That said, there are times I will use cleaning as an excuse to avoid something that is distressing, like answering work emails, or paying my bills.  The difference is the intentionality, am I cleaning for my health, or because I am trying to avoid doing something that I feel an uncomfortable emotion attached to.  

 

• Evaluate and see if your behaviors are addressing emotions or buying you time. While listening to the news, do you find yourself searching for anything else to do?  Maybe scrolling through your feed, or playing a game or just not listening?  This can be a distractor that says I am feeling something upsetting from listening to the news, so I will divert myself until I have woken up to confront what the news is actually saying. Distractors are temporary. Distractors can be amazing when you are looking to buy yourself some time and allow the logic side of your brain to kick in.  This type of behavior can help slow down the emotional response of the brain to allow us some perspective from the prefrontal cortex or critical reasoning area of the brain.  As helpful as they are, they are not actually addressing what made us have such an emotional response.  

 

• If it is a distraction, set yourself a time limit.​ If you find yourself using distracting behaviors, that is okay!  Allow yourself some time and space, if you need it, to help access your logic brain.  If you do so, provide yourself with a time limit.  I like to set  between 15-30 minutes of time to continue to engage in distractions.  A word of caution: It is sometimes more difficult to go back and address the situation the more time has passed.  If the emotions are not addressed then, your distractor has morphed into avoidance.  

 

• If it is avoidance, look and see what other options you have. If you find yourself not addressing what is creating the distressing emotion, look and see what else you can be engaging in that would be healthier for you.  Maybe instead of having another drink, I take the time and write solutions to my anxious thoughts.  Or instead of suppressing my hurt feelings to a loved one, use that time to communicate with them and find a solution.  

• Figure out what coping skills work for you. Some people feel better after talking through a situation or writing it out.  While others find solace in movement of their body, like exercise, walking or doing something with their hands, like artwork or crafts.  The key is to allow yourself to feel the emotion, as scary as it can be.  Only when you truly allow yourself to feel that emotion, can you then confront the afflicting component of it.  

• Know you do not have to go through anything alone. If you find yourself confronting huge mountains of emotions that appear too overwhelming, it can help to have support on your journey climbing.  Social supports are wonderful to have to turn to when you need a little extra encouragement.  Counselors can also be added as support, as a nonjudgmental perspective.  Speaking for myself, as a counselor who also sees a therapist, there is solace in learning you do not have to walk on your journey alone. If you'd like to talk with one of our providers, call at (630) 570-0050 or email us at Contact.OH@oakheartcenter.com to schedule an appointment. 

We are all doing our best given the current state of our environment.  The above tips are designed to help you identify if your difficult emotions are being coped with or not addressed.  This is all subjective too! The beauty of human nature is there are many factors that influence our thoughts, emotions and behaviors.  The goal is to bring awareness to the unique behaviors being used when our thoughts and emotions are distressing.  The practice of using coping skills over avoidance may create some discomfort in the short term but it is allowing you more regulation of your emotions in the long term.   

Stay safe, and know you are enough.  



 

​

Written by Katie Sheehan, MSW

Across Illinois, many schools are beginning, or have begun their first few weeks of full remote instruction. With this, comes the potential for overwhelming uncertainty. Will they adjust? What is my role as a parent? Am I doing too little? Am I doing too much? Below are a few suggestions to ease the possible uncertainty as we move forward.

1. Maintain normalcy in the areas that you can. 

If back to school usually means school supply shopping or a new outfit, it can still mean that! Work to change the definition of a school supply. Get creative! Maybe this means blue light filtering glasses, new ear buds, or a back support pillow. 

2. Weekends still should = FUN. 
​
Across the country people have been reporting the phenomenon of days running together or time not feeling concrete. It has become increasingly difficult to tell weekdays from weekends. But weekends are a necessary time for rest, relaxation, and most importantly, fun. Try to encourage activities such as socially distanced gatherings, renting the latest movies to your living room, or family game night.

3. Monitor for changes in mood or behavior. 

Things to look out for may include irritability, changes in sleep or appetite, lower energy levels, isolating from friends or family, or loss of pleasure in interests or hobbies. While one or two of these changes occurring infrequently, may be a typical response, more severe changes may indicate difficulty adjusting, and an increased need for support. If you're concerned, and would like more information regarding depression and anxiety disorders that may be triggered or exacerbated by the beginning of this unique school year, get more information on our website by following the highlighted links above. 

4. Validate their feelings. 

Many students may hyper-focus on the unfairness of the situation. Especially those who are missing out on milestone years, such as their freshman year, or their senior year. They may be feeling a profound sense of loss for an experience that they have looked forward to, or fantasized about for years. It may be difficult for them to verbalize in ways other than “It’s just not fair.” Steer away from accidental invalidations such as “at least we’re healthy,” or “it could be worse.” While true, this is not helpful for someone navigating emotional pain. Practice leaning into their feelings and trying out something like “I know this is unfair, and I’m so proud of your resilience.” If you're needing a little more guidance take a look at our previous blog on supporting someone when they're struggling. 

5. Practice patience and compassion.

Grades may slip. Pajama pants may replace jeans. Suppress the urge to come down hard on them. Try to solve the problem collaboratively. Remember that in 10 years your child will look back and remember this time full of fear and uncertainty. They will remember how hard it was to go from classroom instruction and seeing their friends in-person everyday, to their worlds existing through a screen. This is your opportunity to show them grace, understanding, patience, and compassion.

If you are still finding that you or your children are struggling with the adjustment to the changes that this new school year is bringing, I encourage you to reach out for help. You can schedule an appointment with on of our clinicians at OakHeart by calling (630) 570-0050 or by emailing Contact.OH@OakHeartCenter.com.

​

Written by Dr. Kat Harris 
​
Finding the right therapist is not always as easy as it should be. I’ve talked with many people looking for a therapist who feel overwhelmed at the prospect and don’t know where to start. Or they have already started but their searches have provided an overwhelming array of options. Or alternatively, very few options that fit their needs. Then they find someone who seems like a good fit, call or email the therapist to set up an appointment, only to find out that the therapist either doesn’t accept their insurance, doesn’t have availability that matches, or isn’t accepting new clients at all. 

Making the decision to see a therapist is a brave one, and it’s unfortunate that the task can sometimes be daunting. My hope is to outline a few considerations to help make the task easier. Finding the “right” therapist can be so rewarding in so many ways and worth the work to find one. 

License Types and Degree Types

What are all of those letters after a person’s name? In short, the letters often indicate one of three things: degree type, license type, and additional certifications. For example, someone with the letters MA, LCPC, CADC after their name is someone with a Master of Arts degree (MA), licensed as a Licensed Clinical Professional Counselor (LCPC) and are certified as a Certified Alcohol and Drug Counselor. There are many types of degrees in the field of mental health (e.g., PhD, PsyD, MA, MSW) in various areas of study (e.g,. Psychology, Counseling, Social Work, Marriage and Family Therapy). And there are many different licenses (e.g., Licenced Clinical Psychologists, Licensed Clinical Social Worker, Licenced Professional Counselor) that vary across states, with some denoting full licensure and some denoting partial licensure (still requiring supervision). And there are even more kinds of certifications, some that come with additional letters after the person’s name, and some that don't. 

At the end of the day, what I believe is most important is not so much the letters after someone’s name, but what the therapist’s competency level is in the areas which they claim to treat, their professional value system, and the therapist-client relationship. 

Where to Start Looking

Where to even start? Here are some ideas:

Therapist directories specifically designed to help consumer’s find counselors. Examples of these include Psychology Today, Theravive, and Good Therapy to name a few. Most of these directories allow you to filter out options to best match your needs such as finding a therapist who accepts your insurance or who claims to specialize in what you need help with. 

Specific mental health organizations also have their own internal therapist directories that can be an excellent way of finding therapists who specialize in treating your symptoms. For example, the International OCD Foundation and the Anxiety and Depression Association of America both have therapist directories to help people with symptoms of OCD and Anxiety ind specialists. 

If you have insurance, you can also contact your insurance provider or go on your insurance provider finder website page to obtain a list of providers in your area who accept your insurance.

Asking a friend or family member for counselor’s whom they would recommend is another great place to start. 

Navigating Insurance and/or Affordable Therapy

Navigating insurance alone can feel like you need a direction manual. Here are some basic things to consider:

If you have insurance, you will likely want to find a therapist who is “in-network” with your insurance company. This means that they officially contract with that insurance company and have negotiated rates with that insurance company. That way you can pay “in-network” rates for co-insurance/co-pays/deductibles rather than out-of-network co-insurance/co-pays/deductibles which can often be significantly more expensive. Check your personal contract with your insurance provider to determine what your in-network and out-of-network responsibilities are as the client. 

A co-pay means you are paying a set amount (e.g., $20) per session and the insurance company is paying the rest of what your therapist bills. A co-insurance means you pay a certain percentage (e.g., 20%) of the contracted rate for a therapy session and the insurance company pays for the rest. A deductible refers to the amount of money you have to pay out-of-pocket before your co-pays/co-insurance kicks in. Deductibles can range greatly and can be anywhere from $0 to thousands of dollars. Until your deductible is met, you have to pay 100% of the therapist’s session fees. 

Not all therapist’s will be in-network with all kinds of insurance companies. In fact, some therapist’s choose to only be in network with one or two companies. 

PPO’s do not usually require a physician’s referral for therapy sessions to be covered but may require pre-authorization depending on the service. Most therapist’s are in network with PPO’s. 

HMO’s require a physician’s referral for therapy sessions and fewer outpatient therapists tend to be in network with HMO’s. If you have an HMO it would likely be easiest to contact your insurance company and ask for a list of therapist’s in your area whom they will cover. 

If you don’t have insurance, community organizations such as community mental health centers, and sometimes private practices, have sliding scale options. Training clinics are also a good place to try because they often offer sliding scale fees. Open Path is an organization that can be a good start to find a therapist if you need a sliding scale as well.

Finding a Specialist

Do I need a specialist? In short, it depends on a number of factors. These factors include severity of symptoms, symptom presentation, and prevalence of the disorder. For example, I would recommend that someone with OCD find someone who specializes in the treatment of OCD. Particularly using a form of therapy called Exposure and Response Prevention. Why? Because research has demonstrated that this is the gold-standard treatment for this disorder and not all therapists have training in this treatment or in treating OCD. Someone with mild depression on the other hand may not need to find a specialist because the majority of therapists have training and experience treating at least mild to moderate depression. 

What makes a specialist? I have always suggested that what makes a specialist is someone who has the following four pillars of specialty practice: Formal Training, Supervision and/or Intensive Consultation, Experience, and Continued Education. Formal training can include graduate school training, internship or postdoctoral training, trainings at conferences and other intensive trainings. Supervision and/or Intensive Consultation means that the person has received supervision or consultation from another professional who is already a specialist in the area. Experience means that the therapist has seen a large enough number of cases to have had the opportunity to refine skills, learn from their experiences (preferably under supervision or consultation), and develop nuanced approaches for a variety of presentations. Finally, continued education means that the therapist is passionate enough about their speciality that they want to continue to learn and grow. This may mean that they seek out up-to-date research, regularly attend conferences and trainings, are members of speciality interest groups, etc. We're grateful at OakHeart to have specialists in several areas including OCD, Panic Disorder and Agoraphobia, Substance Abuse, Eating Disorders, Grief and Bereavement, Trauma, LGBTQ Related Issues, and many more. 

It is impossible for a therapist to specialize in everything. Therapists who list 20 “specialties” under their profiles or in their bios are likely not specialists in all they claim to be. 

It’s 100% OK to reach out to a prospective therapist by email or phone and ask a few questions to ascertain whether they would be a good match for you, including whether they meet some basic qualifications for claiming to be a specialist in a given area. If a therapist makes you feel badly for asking questions then they might not be the best match for you in the first place. Here is an example list of questions for someone interested in finding an OCD therapist authored by the International OCD Foundation: https://iocdf.org/ocd-finding-help/how-to-find-the-right-therapist/ 

Levels of Care

Another consideration is that there are varying levels of care. Many people think of two things when they think of therapy: traditional outpatient therapy, where you meet one-on-one with a therapist, or inpatient therapy where you are locked on the unit for safety reasons. However, there are actually several in-between options that may be a good match for your needs depending on the “dose” of treatment you need. The more severe the symptoms, the more likely a higher level of care will be indicated to best help you get better. 

Outpatient: This is the most traditional level of care and will fit most people’s needs. Usually in this setting you see a therapist once or twice a week for between 40-53 minutes. 

Intensive Outpatient Programs (IOP): At this level of care, client’s would attend a therapy program anywhere between 3-4 hours a day. The therapy program might include group therapy, psychoeducation presentations, meetings with an individual therapy, meetings with a psychiatrist, and an experiential component (e.g, music therapy). At this level of care you go home at the end of the day and your participation is voluntary. 

Partial Hospital Programs (PHP): This level of care is very similar to an IOP settings (and most of the time client’s start in a PHP and then “step down” to an IOP setting within the same location and program. With this level of care a client might attend anywhere between 5 and 6 hours a day and have additional components such as family therapy. At this level of care you go home at the end of the day and your participation is voluntary. 

Residential Treatment: This level of care is similar to PHP programming; however, the client’s sleep on a unit in the program and programming might last a little longer throughout the day. At this level of care you don’t go home at the end of the day and your participation is voluntary. 

Inpatient: This level of care is reserved for situations where a client’s symptoms are severe enough that the person’s safety or ability to function are at risk, and therefore the person needs to be closely monitored. This is a short-term treatment, and the person is usually “stepped down” to a PHP/IOP program as soon as possible. At this level of care you don’t go home at the end of the day and a person's ability to end treatment is sometimes partially determined by the attending physicians.

Final Thoughts

It might be helpful to be open to the possibility that you might need to meet with more than one therapist before finding a good match. My heart breaks when I meet a client for the first time and they inform me that they tried finding help a decade ago but gave up after a meeting with a therapist didn’t go as they had hoped (and there can be many reasons for this). I think of the decade lost and what could have been if they had met the “right” therapist for their needs. There are many factors that go into whether a therapist is a good match, but some of the ones that stand out most to me are whether you feel safe, whether you feel understood and heard, and whether the therapist demonstrates some level of competence in diagnosing and treating your symptoms. 
Finding a therapist in some areas of the county can be considerably more difficult than other areas. Especially if someone is looking for a particular specialist or another important variable. Telehealth might be a good option for individuals with limited options in their communities. 

There is a therapist for you! And there are treatments that work! Best wishes on your journey! For more information on the therapeutic services that OakHeart offers, call and speak with her intake specialist at (630) 570-0050 or email us at Contact.OH@OakHeartCenter.com.