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Why Worry Can Be So Hard to Stop

6/28/2026

 
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Why Worry Can be So Hard to Stop

Written by: Kat Harris, PhD, LCP

Most people I see for worry have already tried to stop on their own. They have read about it, tried apps, and made real attempts to reason themselves out of their fears. The worry comes back anyway. Worry in Generalized Anxiety Disorder (GAD) can be self-sustaining. It is maintained by a set of beliefs and behaviors that are understandable from the inside and that keep the cycle going.

Positive Beliefs About Worry
Worry does not always feel entirely negative to the person doing it. For many of my clients it can instead feel like the responsible thing to do or like preparation. The implicit assumption is that thinking through everything that could go wrong will keep them ready, keep the people they love safe, or at least prevent them from being caught off guard. In some instances, clients will even believe that worrying about something will reduce the actual likelihood of what they fear coming true. These are called positive beliefs about worry, and they are common in GAD (Borkovec, Hazlett-Stevens, & Diaz, 1999). 

The difficulty is that most of what people worry about does not happen, or resolves differently than feared. When the feared outcome does not occur, worry gets the credit, and a behavior that provides no actual protection is reinforced anyway. Worry is also a largely verbal process rather than a sensory or image-based one, and that verbal quality appears to suppress the physical experience of fear in the moment (Borkovec, Alcaine, & Behar, 2004). For that reason, worry functions in part as avoidance. It feels like engaging with a problem while actually keeping the emotional core of the fear at a distance, which is one reason it is so persistent.

Negative Beliefs About Worry
A second factor is what the person comes to believe about the worry itself. Wells, in the metacognitive model of GAD, distinguished ordinary worry about external problems from worry about worrying (Wells, 1995). Two beliefs carry most of the weight. The first is that the worry is uncontrollable, that once it begins the person has no influence over whether it continues. The second is that the worry is dangerous, that it will harm their health or eventually cause them to break down. Both raise the stakes of an ordinary worried thought. If worry is believed to be both unstoppable and harmful, each instance becomes something to manage urgently, and the person responds with more monitoring and more attempts to suppress it. The belief that worry cannot be controlled tends to confirm itself, since deliberate attempts not to think about something reliably produce more of the thought.​

Safety Behaviors
People with GAD work hard to manage their fear, and the strategies are understandable. They seek reassurance from themselves and others, check, search symptoms online, contact loved ones to confirm they are safe, over-prepare, keep extensive lists, and rehearse conversations in advance. Some delay the thing they are dreading, and some avoid it completely. Each of these produces brief relief, and the relief is the problem. It teaches the brain that the situation was in fact dangerous and was narrowly managed, so the original estimate of threat is never revised. Most of these behaviors rest on a low tolerance for uncertainty, a difficulty remaining in a state of not knowing how something will turn out (Dugas, Gagnon, Ladouceur, & Freeston, 1998). Safety behaviors are attempts to produce certainty, and because certainty is not available, the behaviors do not end.

What Changes Worry
If worry is maintained by beliefs and behaviors, those are what treatment addresses. This matters, because the intuitive strategy, arguing with each worry until the anxiety settles, generally does not work. A process whose function is to generate the next "what if" cannot be reasoned with directly. The more effective approach is to test the beliefs rather than accept them, for example by setting up situations to see whether worry is genuinely uncontrollable or whether uncertainty can be tolerated longer than expected; to reduce reassurance, checking, and over-preparation so the brain can gather evidence of safety without them; and to allow a thought to remain a thought rather than a directive to act. It also means approaching the feared outcome directly instead of circling it in words. Because worry keeps fear at a verbal distance, treatment often uses imaginal exposure, in which the person deliberately holds the feared outcome in mind, in image form, and stays with it long enough for the emotional response to rise and settle on its own. This allows the fear to be processed emotionally rather than only verbally, which is precisely the processing that worry has been preventing (Borkovec, Alcaine, & Behar, 2004). Cognitive behavioral therapy does this in a structured way, and the evidence for its effectiveness in GAD is strong (Cuijpers, Sijbrandij, Koole, Huibers, Berking, & Andersson, 2014).

This does not mean the worries are unreasonable or that what a person cares about does not matter. The aim is not to care less about health, work, or family. It is to reduce the cost that chronic worry adds on top of those concerns and to recover the time and attention it consumes. When worry reaches the point of organizing a person's day, it is treatable. If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.​

Panic Disorder and Your Health: Why We Always Recommend a Medical Checkup

4/19/2026

 
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Panic Disorder and Your Health: Why We Always Recommend a Medical Checkup

If you have been experiencing panic attacks, you are likely already familiar with just how physical they feel. Your heart races. Your chest tightens. You feel short of breath, dizzy, or like your hands and feet have gone numb. A wave of fear washes over you that can be genuinely terrifying. And then, often just as suddenly as it started, it passes.

Panic attacks are real, they are intensely physical, but they are not dangerous. For the vast majority of people who experience them, there is no underlying medical condition driving the symptoms. But as part of responsible, thorough care, we always recommend that clients have a medical evaluation alongside their mental health treatment. Not because we expect to find something wrong, but because ruling out medical contributors is simply good clinical practice and because in most cases it provides meaningful reassurance that your body is healthy and allows you to move forward with treatment with confidence.

This blog is meant to be informational and educational, not a substitute for medical advice. If you are experiencing symptoms that concern you, please reach out to your doctor.

What Panic Attacks Feel Like
According to the DSM-5, a panic attack is a sudden surge of intense fear or discomfort that peaks within minutes and includes at least four of the following: a racing or pounding heart, sweating, trembling or shaking, shortness of breath or a feeling of being smothered, chest pain or discomfort, nausea or stomach distress, dizziness or lightheadedness, chills or hot flashes, numbness or tingling sensations, a sense of unreality or feeling detached from yourself, fear of losing control, and fear of dying.

That is a striking list of symptoms, and you can immediately see why panic attacks feel so alarming in the moment. These same symptoms can occasionally have a medical origin, which is one of the reasons a medical evaluation is a meaningful part of the process and important to rule out. In most cases, that evaluation comes back normal and simply confirms what was already suspected. Occasionally it identifies something that needs its own attention. Either way, having that information is valuable.

To learn more about Panic Disorder, click here. 

Why a Medical Evaluation Is Part of Good Care
Responsible mental health care includes ruling out medical contributors before or alongside a mental health diagnosis. This is not unique to panic disorder. It is simply good clinical practice. A thorough evaluation by your primary care physician typically includes a physical exam, routine blood work, and a review of your symptoms and their patterns over time. In many cases, everything comes back normal and the picture becomes much clearer. In some cases, a medical condition is identified that needs its own treatment, or that helps explain part of what you have been experiencing.

The relationship between physical health and anxiety is genuinely complex. Medical conditions can trigger anxiety and panic. Anxiety can worsen physical symptoms. And both can exist at the same time. Having a medical provider and a mental health provider working in coordination is often the most effective approach.

Medical Conditions Worth Discussing With Your Doctor
The following conditions are among those that clinicians typically consider when evaluating someone with panic-like symptoms. This list is not meant to send you down a rabbit hole of worry. It is simply meant to help you understand what your doctor may be looking for and why that conversation is worthwhile.

Thyroid Conditions
The thyroid gland helps regulate heart rate, metabolism, and energy. When it becomes overactive, a condition called hyperthyroidism, it can produce a racing heart, sweating, trembling, heat intolerance, and a persistent sense of being keyed up that can look a great deal like anxiety or panic. The good news is that thyroid function is easy to check with a routine blood test, and treatment is straightforward when a thyroid condition is identified.

Heart Rhythm Irregularities
Certain irregularities in heart rhythm can produce sudden episodes of a pounding or racing heart, chest discomfort, and lightheadedness, symptoms that are also among the most common features of panic attacks. An EKG or other cardiac evaluation can help a physician assess whether a heart rhythm issue may be contributing to what you are experiencing. This is one of the most common reasons people end up in the emergency room during a first panic attack, and having a cardiac evaluation can provide meaningful reassurance as well as ruling out a medical contributor.
​
Blood Sugar Fluctuations
Low blood sugar, known as hypoglycemia, can produce a sudden onset of heart pounding, sweating, shakiness, dizziness, and a sense that something is wrong, symptoms that overlap considerably with panic. This is particularly worth discussing with your doctor if your symptoms tend to occur when you have not eaten in a while, or if you have any history of diabetes or blood sugar regulation concerns.

Autonomic Nervous System Conditions
Postural Orthostatic Tachycardia Syndrome, more commonly known as POTS, is a condition in which the heart rate spikes significantly when moving from lying down to standing up. This can produce dizziness, a racing heart, lightheadedness, brain fog, and fatigue that can resemble panic. A notable feature of POTS is that symptoms tend to be triggered by or worsen with positional changes and may improve when lying down, a pattern that differs from typical panic. POTS is often underdiagnosed, and many people with POTS have been told their symptoms are anxiety-related before a correct diagnosis is made. If your symptoms consistently relate to changes in position or standing up, it is worth mentioning this to your doctor.

Vestibular and Inner Ear Conditions
The vestibular system governs balance and spatial orientation. When it is not functioning as it should, it can produce dizziness, vertigo, a sense of unsteadiness, and nausea that can be quite frightening and can overlap with panic symptoms. Some vestibular conditions involve structural problems in the inner ear itself. These include benign paroxysmal positional vertigo (BPPV), vestibular neuritis, and Meniere's disease, all of which are considered peripheral vestibular disorders and are typically evaluated by an ear, nose, and throat specialist or vestibular specialist.
​
Persistent Postural-Perceptual Dizziness, known as PPPD, is a different kind of vestibular condition and worth knowing about separately. Rather than involving a structural problem in the inner ear, PPPD is classified as a chronic functional vestibular disorder, meaning it involves the way the brain processes balance and spatial information rather than a problem with the ear itself. PPPD produces chronic dizziness, unsteadiness, and a sense of non-spinning vertigo that persists on most days and is worsened by upright posture, movement, and visually complex environments. It frequently develops following an acute vestibular event, a medical illness, or a period of significant psychological stress, and anxiety is closely intertwined with its development and maintenance. Because of this, PPPD can closely resemble or co-occur with panic disorder, and the two can reinforce one another in a cycle that can be difficult to untangle without proper evaluation. Treatment for PPPD typically involves vestibular rehabilitation, medication, and cognitive behavioral therapy, making collaboration between medical and mental health providers especially valuable.

Respiratory Conditions
Difficulty breathing is one of the most distressing symptoms of a panic attack, and it is also a feature of several respiratory conditions including asthma. The relationship between respiratory conditions and anxiety is well established and genuinely bidirectional -- each can worsen the other. If you experience episodes of shortness of breath, chest tightness, or a feeling of being unable to get a full breath, it is worth discussing with your doctor whether a respiratory evaluation makes sense.

A Note on Less Common Conditions
There are some less common conditions that clinicians may also consider in certain presentations, including neurological conditions and adrenal conditions such as Addison's disease, in which insufficient production of cortisol can produce episodes of fatigue, dizziness, and feeling acutely unwell that may resemble anxiety or panic. Your doctor is the right person to determine which evaluations are appropriate for your specific situation. The goal is not to work through an exhaustive checklist of everything that could possibly be wrong. The goal is a thoughtful, individualized evaluation that helps paint a clear and complete picture.

What This Means for You
If you have been experiencing panic attacks, seeing your primary care physician is a meaningful first step alongside pursuing mental health support. Share your symptoms openly, describe when they happen and how long they last, and ask whether any medical evaluation is warranted. In most cases, a medical workup provides reassurance that your body is physically healthy and helps you move forward with treatment with more confidence and clarity.

Panic disorder is highly treatable. The research on Cognitive Behavioral Therapy and Panic Control Treatment is robust and genuinely encouraging, and most people who engage in evidence-based treatment see significant improvement. Getting there starts with making sure you have an accurate, complete picture of what is going on -- and that is something your medical provider and mental health provider can work on together.

If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Tunnell, N. C., Corner, S. E., Roque, A. D., Kroll, J. L., Ritz, T., & Meuret, A. E. (2024). Biobehavioral approach to distinguishing panic symptoms from medical illness. Frontiers in Psychiatry, 15, 1296569. https://doi.org/10.3389/fpsyt.2024.1296569

Recognizing the Early Warning Signs of a Mood Episode in Bipolar Disorder

4/16/2026

 
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Recognizing the Early Warning Signs of a Mood Episode in Bipolar Disorder

​One of the most powerful tools available to individuals living with bipolar disorder is also one of the most underutilized: the ability to recognize when a mood episode is beginning before it fully takes hold. Early warning signs, sometimes called prodromal symptoms, are the subtle shifts in mood, thinking, behavior, sleep, and energy that often precede a full manic, hypomanic, or depressive episode. Learning to identify your personal early warning signs, and knowing what to do when they appear, is a cornerstone of effective bipolar disorder management and a central component of Cognitive Behavioral Therapy (CBT) for bipolar disorder.

Why Early Warning Signs Matter
Mood episodes in bipolar disorder do not typically appear out of nowhere. In most cases, there is a window of time, sometimes days, sometimes weeks, during which early signs are present and intervention is possible. Research consistently supports the value of early intervention in bipolar disorder. Catching an emerging episode early can mean the difference between a brief period of increased symptoms and a full-blown episode that significantly disrupts your life, relationships, and functioning.

The challenge is that early warning signs can be subtle, easy to rationalize, and can even feel good at first. This is why developing awareness of your personal pattern is so important. What triggers your episodes? What are your first signs? How long is your typical warning window? These are questions worth exploring with your therapist.

Early Warning Signs of a Manic or Hypomanic Episode
While early warning signs vary from person to person, some of the most commonly reported signs that a manic or hypomanic episode may be emerging include:

Changes in sleep: Needing less sleep than usual without feeling tired is one of the most reliable early warning signs of an emerging manic or hypomanic episode. You may find yourself waking up earlier than usual feeling energized, or staying up later without experiencing the fatigue you normally would. It is worth noting that sleep disruption is not just a symptom of mania, it can also trigger and accelerate a manic episode. The relationship between sleep and mood in bipolar disorder is bidirectional, interconnected, and critically important.

Increased energy or activity: Feeling unusually energized, productive, or motivated, particularly in ways that feel out of proportion to your circumstances, can be an early sign. You may notice yourself taking on more projects, making ambitious plans, or feeling like you can accomplish more than usual.

Racing or sped-up thinking: Thoughts that feel faster than normal, jumping quickly from one idea to the next, or difficulty slowing your mind down can be an early indicator of an emerging elevated episode.

Increased talkativeness: Talking more than usual, feeling like your words can not keep up with your thoughts, or others commenting that you seem more talkative or difficult to interrupt are worth paying attention to.

Elevated or irritable mood: Feeling unusually elated, confident, or "on top of the world," or conversely, feeling more easily irritated or agitated than usual, can both signal an emerging manic or hypomanic episode. It is important to recognize that mania does not always feel good. Irritable mania is a real and common presentation.

Increased impulsivity or risk-taking: Making impulsive decisions, spending money more freely than usual, engaging in uncharacteristic risk-taking behavior, or feeling unusually uninhibited socially are all worth noting.

Decreased need for food: Some individuals notice changes in appetite or a decreased interest in eating as an early sign of an elevated episode, often related to increased energy and activity.

Heightened sensory experience: Some individuals report that colors seem brighter, music sounds better, or the world generally feels more vivid or intense in the early stages of an elevated episode.

Early Warning Signs of a Depressive Episode
Just as important, and often more difficult to catch early because the changes are quieter and more gradual, are the early warning signs of an emerging depressive episode. These may include:

Changes in sleep: In contrast to manic episodes, emerging depression often brings increased sleep, difficulty getting out of bed, or hypersomnia. Some individuals experience insomnia during depressive episodes as well.

Withdrawal and isolation: Pulling away from friends, family, or activities you normally enjoy, even in subtle ways, like responding to fewer texts or skipping social plans, can be an early sign.

Decreased motivation or energy: Feeling more fatigued than usual, procrastinating on tasks that are normally manageable, or noticing a drop in your overall drive and initiative.

Slowed thinking: Thoughts that feel heavier, slower, or harder to organize than usual. Difficulty making decisions that are normally straightforward.

Increased negativity or hopelessness
: A subtle shift in your overall outlook, things feeling harder, less enjoyable, or less worthwhile, even before full depressive symptoms set in.

Changes in appetite: Eating more or less than usual, or losing interest in foods you normally enjoy.

Increased irritability: Like manic episodes, depressive episodes can also present with irritability, feeling more easily frustrated, short-tempered, or emotionally reactive than your baseline.

Your Warning Signs Are Personal
It is worth emphasizing that early warning signs are highly individual. While the list above covers commonly reported signs, your personal pattern may look different. Some individuals have very reliable, consistent warning signs that appear in the same order every time. Others have more variable patterns. Part of the work of therapy is helping you develop an individualized understanding of your own mood episode patterns, including your triggers, your early warning signs, your typical timeline, and the interventions most likely to help at each stage.

What to Do When You Notice Early Warning Signs

Noticing early warning signs is only half of the equation. Having a plan for what to do when they appear is equally important. Some evidence-based strategies to discuss with your therapist include:

Contact your treatment providers. If you notice early warning signs, reaching out to your therapist and/or medication provider promptly gives your treatment team the opportunity to intervene before a full episode develops. Do not wait until things feel out of control.

Prioritize sleep. Given the bidirectional relationship between sleep and mood in bipolar disorder, protecting your sleep is one of the most important behavioral interventions available. If sleep is being disrupted, addressing it quickly is a priority.

Reduce stimulation and stress. During the early stages of an elevated episode, reducing your exposure to stimulating environments, decreasing your commitments, and building in rest can help slow the momentum of an emerging episode.

Engage your support system. Trusted friends, family members, or partners who are educated about your warning signs can be invaluable. They may notice changes before you do, and having someone you trust who can gently flag what they are observing can be an important safety net.

Use your coping plan. If you have developed a mood episode action plan with your therapist, which is a standard component of CBT for bipolar disorder,  this is the time to put it into action. Do not wait for certainty that an episode is coming. Acting on early warning signs, even if it turns out to be a false alarm, is always the right call.

Avoid alcohol and recreational substances. Substance use can accelerate and worsen mood episodes and significantly undermine the effectiveness of your medications. This is particularly important during periods of elevated warning signs.

Building Your Personal Warning Signs Profile
One of the most valuable things you can do, ideally in collaboration with your therapist, is to develop a written personal warning signs profile. This is a document that outlines your specific early warning signs for both manic and depressive episodes, your known triggers, your typical timeline from first warning sign to full episode, and your personalized action plan for each stage. Having this document in place before an episode begins means you are not trying to create a plan when your judgment may already be compromised.

Some individuals also find it helpful to involve a trusted person in their life in this process, sharing your warning signs profile with a partner, family member, or close friend so that they can serve as an additional layer of awareness and support.

The Bottom Line
Early warning sign recognition is not about living in fear of the next episode or constantly monitoring yourself for signs of instability. It is about developing the self-awareness and the tools to respond quickly and effectively when your mood begins to shift, so that you spend less time in episodes and more time living your life.

If you are living with bipolar disorder and would like support in developing your personal early warning signs profile and mood management plan, we are here to help. At OakHeart, Center for Counseling, our team of licensed psychologists, counselors, and social workers in North Aurora and Sycamore, Illinois provides evidence-based treatment for bipolar disorder to clients throughout Kane County, DeKalb County, DuPage County, and the surrounding Chicago suburbs. We also offer telehealth services throughout Illinois.

References


American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

National Institute of Mental Health. (2023). Bipolar disorder. https://www.nimh.nih.gov/health/topics/bipolar-disorder

Existential OCD

4/15/2026

 
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Existential OCD: When Your Brain Won't Stop Asking "Why?"

Written by: Kat Harris, PhD, LCP

Most people are familiar with the more commonly depicted presentations of Obsessive Compulsive Disorder (OCD) — hand washing, checking locks, needing things to be symmetrical or "just right." What is far less talked about, and often misunderstood, is a presentation of OCD that targets some of the biggest questions humans have ever grappled with: Why am I here? Does any of this matter? Is any of this even real? This is Existential OCD.

What is Existential OCD?
Existential OCD involves intrusive, repetitive, and distressing obsessions centered on philosophical questions about existence, reality, meaning, and purpose. Obsessions can also involve obsessions about one's own existence. The questions that are posed are inherently unanswerable with certainty.

Common obsessions include thoughts such as:

  • What is the point of doing anything if we are all going to die eventually?
  • How do I know that anything is real?
  • What if life has no meaning?
  • Do I actually exist, or is this all an illusion?
  • What if I am living in a simulation?
  • What is consciousness, and how do I know I am truly conscious?
  • Why does anything exist at all?
  • What happens after death?
  • What if I am the only one that is real?
  • What if I get stuck trying to answer these questions and lose my mind?
  • What if even small decisions I make change the course of my life in drastic or negative ways?

It is important to note that these questions are not unique to people with OCD. Most humans have pondered existential questions at some point in their lives. The difference is that individuals without OCD are generally able to sit with the uncertainty these questions produce, shrug, and move on. For individuals with Existential OCD, these thoughts and doubts become stuck. They are intrusive, unrelenting, and produce significant distress and anxiety. The person feels compelled to figure out the answer, even though, by the very nature of existential questions, no definitive answer exists. They search for certainty and answers that never come. 

How is Existential OCD Different from Normal Philosophical Thinking or Depression?
This is an important distinction, and one that is often missed. Existential OCD can be confused with:

General philosophical curiosity: Many people enjoy contemplating the big questions of life. The key difference is that philosophical curiosity is generally experienced as interesting or stimulating, while Existential OCD is experienced as distressing, intrusive, and impossible to turn off. Philosophical curiosity may temporarily elicit some anxiety or dread, but people without OCD can tolerate that discomfort and move on. In addition, if someone with philosophical curiosity is engaging in thought exploration, they can be interrupted or stop without significant distress. 

Depression: Individuals experiencing depression may also ruminate on themes of meaninglessness and hopelessness. However, in depression, these thoughts tend to be mood-congruent and tied to a generally negative emotional state. In Existential OCD, the thoughts are ego-dystonic, meaning they feel intrusive and inconsistent with how the individual wants to be thinking. The distress comes from having the thought, not from a pervasive low mood.

Generalized Anxiety Disorder (GAD): Because of the worry-like quality of existential obsessions, Existential OCD is sometimes misunderstood to be GAD. However, there are some important distinguishing features. With OCD presentations, the thoughts themselves often triggers distress, which drives compulsive, repetitive, or ritualistic behavior aimed at reducing the distress or obtaining certainty. In GAD, the worry themes tend to center around worries that most people have such as finances, health, or concern for the safety of loved ones. In OCD, the themes tend to focus on highly specific content that the individual finds intrusive, unacceptable, or deeply threatening; content that often feels inconsistent with who they are and what they value. Additionally, in GAD, worry is typically experienced as an attempt to problem-solve or prepare, whereas in OCD, the obsessive thought feels uncontrollable and is followed by a compulsive urge to neutralize, undo, or resolve the distress.

The OCD Cycle in Existential OCD

Like all presentations of OCD, Existential OCD operates within a well-established cycle. An intrusive existential thought triggers significant anxiety and distress. The individual then engages in compulsions in an attempt to neutralize the thought, reduce the distress, or obtain a sense of certainty. These compulsions may include:

  • Mental reviewing and ruminating: going over and over the question in one's mind in an attempt to "figure it out" or reviewing the past to try and prove one's existence
  • Reassurance seeking: asking others what they think, looking for validation that life has meaning, asking other's what the answers are
  • Researching: reading philosophy, science, or religious texts in an attempt to find an answer
  • Testing reality: engaging in repeated mental or physical checking behaviors to confirm that the world, one's experience, or one's own existence is real (e.g., touching or interacting with objects to confirm they are solid, staring in the mirror to verify one's own existence, or repeatedly checking whether one's own thoughts and feelings feel 'authentic' or 'real'
  • Avoidance: avoiding movies, books, conversations, or topics that trigger the obsessions
  • Thought suppression: trying to push the thoughts out of one's mind

Unfortunately, as is the case with all OCD compulsions, these behaviors provide only temporary relief. Over time, they actually reinforce the cycle, teaching the brain that the thought is dangerous and must be dealt with, which makes the thoughts more frequent and more distressing.

Why is Existential OCD Particularly Challenging?
One of the things that makes Existential OCD especially difficult is the nature of the obsessions themselves. Existential questions are, by definition, unanswerable with certainty. There is no fact, study, or expert that can provide the 100% certainty OCD demands. This makes the compulsive drive to "figure it out" an endless urgent loop. Every answer generates a new doubt. Every reassurance eventually wears off. This is a hallmark feature of OCD that I discuss in my blog on Thinking Errors in OCD; specifically, Intolerance of Uncertainty. OCD demands certainty that simply does not exist, and existential questions are perhaps the most unanswerable questions humans have ever asked.

Treatment for Existential OCD
The good news is that Existential OCD responds to the same gold-standard treatment as all other presentations of OCD: Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy (CBT).

In ERP, the goal is not to find the answer to the existential question. It is to build tolerance for the uncertainty and distress that the question produces, and to break the compulsive cycle that is maintaining the OCD. This involves:

Exposures: deliberately and gradually confronting the existential thoughts, rather than avoiding or neutralizing them. This might include reading or listening to content that triggers the existential thoughts, writing out the feared thoughts, or deliberately sitting with the uncertainty without engaging in compulsive responses.

Response Prevention: resisting the urge to mentally review, research, seek reassurance, or otherwise compulse in response to the obsession.

ACT components: Acceptance and Commitment Therapy (ACT) can be a particularly useful complement to ERP for Existential OCD. ACT encourages individuals to accept the presence of uncertainty and uncomfortable thoughts without needing to resolve them, and to move toward a valued life even in the face of unanswered questions.

The goal of treatment is not to convince the individual that life has meaning, or to answer the unanswerable. It is to help the individual develop a different relationship with the uncertainty itself. To be able to have the thought, feel the discomfort, and choose not to engage with it compulsively.

You Do Not Have to Suffer
If you find yourself spending significant time each day consumed by existential questions, if these thoughts feel intrusive and distressing rather than intellectually stimulating, and if you notice yourself engaging in mental reviewing, reassurance seeking, or avoidance in response to them, it may be worth speaking with a clinician who specializes in OCD.

If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Penzel, F. (2013). To be or not to be, that is the obsession: Existential and philosophical OCD. International OCD Foundation. https://iocdf.org/expert-opinions/to-be-or-not-to-be-that-is-the-obsession-existential-and-philosophical-ocd/

How SMART Goals can provide a roadmap for change

4/8/2026

 
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How SMART Goals Can Provide a Roadmap for Change!

​Written by: Lee Ann Heathcoat, MSEd, LCPC

Spring is upon us, and as the season changes, this may be a good time to stop and check in with how a New Year's resolution is progressing (is the motivation where it was in January), or is this an opportunity to set a new personal goal? Utilizing SMART Goals can be a skill to help provide the structure needed for implementing long-term change while breaking up the process into more manageable pieces.

What are SMART Goals?
The SMART acronym is a roadmap to help change turn into concrete actions.

S - Specific: Clearly define what you want to achieve. Instead of "I want to be less stressed," try "I want to stop screaming when I become angry".

M - Measurable: Find a way to track your progress. How will you know you are making progress? (e.g., using a mood tracker, counting the number of social interactions, or rating anger on a 1-10 scale).

A - Achievable: Set realistic expectations. Goals should challenge you but not lead to burnout. If you haven't journaled in years, aiming for daily journaling might fail. Start with a few times a week.

R - Relevant: Ensure the goal aligns with your core values and overall mental health needs. Is this goal truly important to you right now?

T - Time-bound: Set a deadline or timeline to create a sense of urgency. For instance, "I will learn two deep-breathing techniques by the end of this month."

Why SMART Goals Matter.
They Provide Direction and Focus: Rather than wandering through emotions, SMART goals give you a concrete map for where to focus your energy to work on implementing change.

They Boost Motivation: When you can tangibly see that you've accomplished a small goal, it increases your motivation to keep going, preventing discouragement.

They Enhance Accountability: Regularly reviewing your SMART goals helps you stay on track and allows for adjustments if life changes.
They Prevent Overwhelm: Breaking large issues into small steps makes the process feel manageable.

Guiding clients to learn and implement SMART goals to help them achieve change is only one way I support my clients. If reading the information provided above resonated with you and you may be a good fit for one of my specializations, reach out. I'd like to connect and find out more about how I can support you on your journey.

​If you are interested in counseling with Lee Ann or any other clinician, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

Every BODY Matters

4/2/2026

 
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Every BODY Matters

Written by Kevin Hamor, PsyD ​

What is body image?
According to Cash, 2004, “Body image is a multi-faceted psychological experience incorporating perceptions, thoughts, feelings, and behaviors related to one’s body.” Essentially, the human experience and everything involved with that can shape one’s perception of their body.

What is Body Positivity?
Body positivity spawned from the need to understand negative body image and focus on decreasing the symptoms of negative body image without focusing on increasing positive body image (Cash & Smolak, 2011; Tylka, 2011). However, Tylka et al., 2015, argue if therapists focus on reducing negative body image and do not also incorporate body positivity, treatment may only promote a neutral body image and make statements such as, “I don’t hate my body anymore. I merely tolerate it.” Technically, they argue that the lack of promoting body positivity has to be added on top of decreasing negative body image; that merely decreasing negative body image does not inherently increase body positivity. Body positivity is both a social movement and a personal practice centered on the belief that all bodies deserve respect and acceptance. It challenges cultural ideals that equate worth with physical appearance, and encourages people to reject shame and judgment about their bodies. While promoting positive sentiments and thoughts about one's body is positive, it is also not always realistic or sustainable to expect oneself to love every aspect of their body at all times.

What is Body Neutrality?
Body neutrality states that it is okay if you do not always love or even like aspects of your body, and that it can be okay. Anne Poirier, an author, defined body neutrality as, “Not supporting the hatred of our vessel or the love and adoration of our vessel” (Shaping Perspectives, 2023). Mink & Szymanski, 2022, determined that the new movement of body neutrality on social media such as TikTok, may be a protective factor against body dissatisfaction in the treatment of eating disorders (Pellizzer & Wade, 2023). Author, Jessi Kneeland of Body Neutral: A Revolutionary Guide to Overcoming Body Image Issues stated, “Neutrality gives you space for everything that previously felt like a huge problem to kind of just be… It gives you the ability to see yourself and the world clearly, which means you can take your emotional power back from the places that don’t deserve it” (Kneeland, 2023).

Social Media and Body Image
Social media has been a driving force for both good/bad and healthy/unhealthy perceptions of body image. Some of the biggest and most widespread trends in social media have been surrounding body positivity. The initial goal was to both challenge and replace negative ideals and perceptions of body image. To challenge the “ideal” body size as thin and move toward love and acceptance of all body types. On TikTok alone, #bodypositivity has accumulated over 23 billion views, and the hashtag has appeared on tens of millions of Instagram posts

In a study conducted by Davies et al.,(2020) and Fioravanti et al., (2021) compared body-positive, fitspiration, and neutral Instagram posts and found that body positive posts led to higher esteem about one’s weight, mood, and body satisfaction while posts with messages centralized around rigorous exercising and diet (fitspiration) led to poorer esteem about one’s weight and negative mood. However, Mehdi and Frazier (2021) argue that the body positivity movement has been co-opted over time, shifting away from its original focus on social equality for marginalized bodies toward a commercialized message of self-love that now primarily centers thin, able-bodied, and conventionally attractive bodies, ultimately further marginalizing the communities the movement was created to serve. 

Some research actually suggests that the effects of body positivity can be complicated. A survey of 778 undergraduate women found that exposure to body positivity content on TikTok actually worsened body dissatisfaction for some users, particularly through upward social comparison and increased body monitoring (Mink & Szymanski, 2022). Given the mixed findings in the research, it is clear that social media's impact on body image is highly individual, and that therapeutic support can play an important role in helping people develop a healthier relationship with their bodies regardless of what they encounter online.​

How Can Therapy Help?
Here at OakHeart, Center for Counseling, you will receive integrated and evidence-based approaches like cognitive behavioral therapy and acceptance and commitment, as well as emotional-focused therapy interventions. Additionally, OakHeart’s values are rooted in integrity, kindness, courage, genuineness, respect, and empathy. Equally important and relevant to body image is the Health at Every Size (HAES) model. This model focuses on developing healthy behaviors without prioritizing weight loss. In particular as stated by researchers Phelan et al., (2015), “First and foremost that health care must be accessible to people no matter their size, and no matter why they are any given size. This disproportionately affects large bodied people because our current societal norms prioritizes and normalizes slender and thin bodies. Anti-fat bias has created an environment where even in health care (where we expect people of all ability levels and health statuses to be included) equipment, gowns, and seating is not designed for all bodies.” Essentially, rather than center health around being thin, or losing weight, we create an environment free of judgement and stigma, promoting body acceptance and without exceptions (Puhl & Heuer, 2009; Association for Size Diversity and Health, 2026). 

If you are interested in counseling with Dr. Hamor or any other clinician at OakHeart, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.
References

Cash, T. F. (2004). Body image: Past, present, and future. Body image, 1(1), 1-5.
Cash, T. F., & Smolak, L. (Eds.). (2011). Body image: A handbook of science, practice, and prevention. Guilford press.
Davies, B., Turner, M., & Udell, J. (2020). Add a comment… how fitspiration and body positive captions attached to social media images influence the mood and body esteem of young female.Instagram users. Body Image, 33, 101-105.
Association for Size Diversity and Health (2026). Health at every size® principles. ASDAH. (2026). https://asdah.org/haes/ 
Fioravanti, G., Tonioni, C., & Casale, S. (2021). # Fitspiration on Instagram: The effects of fitness‐related images on women’s self‐perceived sexual attractiveness. Scandinavian Journal of Psychology, 62(5), 746-751.
Mehdi, N., & Frazier, C. (2021). Forgetting fatness: The violent co-optation of the body positivity movement. Debates in Aesthetics, 16(1), 13-28.
Mink, D. B., & Szymanski, D. M. (2022). TikTok use and body dissatisfaction: Examining direct, indirect, and moderated relations. Body Image, 43, 205-216.
Pellizzer, M. L., & Wade, T. D. (2023). Developing a definition of body neutrality and strategies
Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of
weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319-326. doi: 10.1111/obr.12266.
Puhl RM, Heuer CA. The stigma of obesity: A review and update. Obesity (Silver Spring). 2009;17(5):941-964. doi: 10.1038/oby.2008.636.
Shaping Perspectives. (2023). 5 Steps to Body Neutrality. https://shapingperspectives.com/5-steps-to-body-neutrality/.
Tylka, T. L., & Wood-Barcalow, N. L. (2015). What is and what is not positive body image? Conceptual foundations and construct definition. Body image, 14, 118-129.

Growth Mindset vs. Fixed Mindset

3/18/2026

 
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Growth Mindset vs. Fixed Mindset: Why Our Beliefs About Change Matter for Mental Health

Written by: Bridgette Koukos, MA, LCPC, NCC

In this blog post, we’re exploring a powerful concept that influences how we experience anxiety, depression, trauma, and even progress in therapy: mindset.

How we think about our ability to change can either support our growth—or keep us feeling stuck. Let’s take a closer look 👇

In mental health work, whether in therapy, recovery, or personal growth, people often ask an important question:
 
“Can I really change?” 

Underlying this question is something psychologists call mindset: our belief about whether our abilities, emotions, and behaviors are fixed or capable of growth. These beliefs influence how we approach challenges, cope with distress, and engage in the healing process. Understanding the difference between growth mindset and fixed mindset can provide powerful insight into mental health, resilience, and recovery.
Understanding Fixed Mindset vs. Growth Mindset

The concepts of growth mindset and fixed mindset were introduced by psychologist Carol Dweck in her research on motivation and learning.

Fixed Mindset
A fixed mindset reflects the belief that core abilities, intelligence, or personality traits are largely unchangeable. Common thoughts include: 
  • “I’ve always been this way.”
  • “I’m bad at handling stress.”
  • “Nothing I do makes a difference.”
In mental health contexts, this mindset can reinforce feelings of hopelessness, shame, and avoidance.
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Growth Mindset
A growth mindset is the belief that skills, coping abilities, and emotional patterns can develop over time through learning, effort, and support. Examples include: 
  • “I’m learning how to cope with this.”
  • “This is difficult, but I can improve.”
  • “Progress takes practice.”
This perspective supports resilience, self-compassion, and motivation—all critical factors in psychological healing.
Why Mindset Matters for Mental Health

Mental health challenges such as anxiety, depression, trauma, and addiction can create powerful narratives that reinforce a fixed mindset. 
For example:
  • Depression may lead someone to believe “I’ll always feel this way.” 
  • Anxiety may create the belief “I can’t handle uncertainty.” 
  • Trauma may reinforce “I’m permanently broken.” 
When individuals begin to adopt a growth mindset, healing becomes a process rather than a permanent limitation. Research suggests growth-oriented beliefs increase resilience, persistence, and willingness to seek help.
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The Brain Science Behind Growth

The science of neuroplasticity supports the idea that psychological change is possible. Neuroplasticity refers to the brain’s ability to adapt and form new neural pathways throughout life. Research shows that experiences such as:
  • psychotherapy
  • mindfulness practices
  • learning new skills
  • physical exercise 
  • social connection
can lead to measurable changes in the brain's structure and functioning. This means that emotional responses, coping strategies, and behavioral patterns are not permanently fixed. The brain is continually learning.

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How Mindset Shows Up in Therapy

For clinicians and mental health professionals, mindset often appears subtly during sessions. Examples include:
Fixed mindset language
  • “I’ve tried everything.”
  • “This will never change.”
  • “I always mess things up.”

Growth mindset reframes
  • “I’m still figuring out what works.”
  • “I’m learning how to respond differently.”
  • “This is part of the process.”
Encouraging growth-oriented thinking does not invalidate pain or struggle. Instead, it creates space for possibility alongside compassion.

​
Real-World Examples of Growth Mindset in Mental Health

A growth mindset does not mean ignoring difficulty or expecting immediate change. Instead, it shows up in small but meaningful shifts.
For example:
  • A first responder learning new tools to regulate stress after years of hypervigilance.
  • Someone in recovery recognizes relapse as information rather than failure.
  • A person navigating infertility, learning to hold grief while still nurturing hope and self-worth.

Each example reflects a key truth: Growth is rarely linear, but it is possible.
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Practical Ways to Cultivate a Growth Mindset

Developing a growth mindset is a gradual process that can begin with small shifts in perspective.

Reframe Self-Talk

Instead of: “I’m terrible at this.”

Try: “I’m still learning how to manage this.”

Instead of: “Therapy isn’t working.”
Try: “This is hard, and I’m still showing up.” 

​Normalize the Learning Process

Growth often involves mistakes, setbacks, and discomfort. These experiences are part of building new coping skills.

Focus on Effort, Not Just Outcomes

Progress in therapy may appear as:
  • increased awareness
  • trying new strategies
  • practicing emotional regulation
  • asking for help​
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Practice Self-Compassion

Self-criticism often reinforces fixed mindset beliefs. Self-compassion encourages curiosity and patience during difficult moments.
Final Thoughts

Mental health recovery is not about “fixing” oneself. Instead, it involves learning, adapting, and growing—often in ways that take time and persistence. A growth mindset reminds us that:
  • You’re not stuck, and yes, change is possible
  • You’re not broken, the brain is capable of  adapting
  • You’re still becoming, healing is a process 

Whether you are a mental health professional supporting others or someone navigating your own challenges, embracing the possibility of growth can be one of the most powerful steps toward resilience. With that said, let's keep showing up, even when it’s hard. That is the growth.

If you're feeling like you need a little more help implementing these strategies, Call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.
References

Dweck, C. S. (2006). Mindset: The New Psychology of Success. Random House.
Dweck, C. S. (2017). Mindset: Changing the way you think to fulfil your potential. Psychological Science Agenda.
Doidge, N. (2007). The Brain That Changes Itself. Viking.
Yeager, D. S., & Dweck, C. S. (2012). Mindsets that promote resilience. Educational Psychologist, 47(4), 302–314.
Siegel, D. J. (2012). The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are. Guilford Press.

Reducing the Mental Cost of Social Media

2/25/2026

 
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Reducing the Mental Cost of Social Media: Risks and Strategies to Use Tech More Healthily

Written by Hillary Gorin, PhD, LCP

Technology is embedded in nearly every part of our lives. It is a gift in many ways, as it improves efficiency, it reduces costs for businesses, it allows for connection with family members who live across the world, it keeps us informed about current events. Social media, specifically, can be incredibly beneficial in these ways. However, technology and social media also have some risks. 

The Risks: 

Regardless of your current political affiliation, social media consumption has been painful for many of us recently. It presents vivid realities, extreme beliefs and messaging, and “facts” that have not been substantiated by research. These are many of the risks of using social media for news updates, dieting advice, financial planning, couples therapy strategies, etc. It is difficult to identify sources of information and to disentangle extreme beliefs and opinions from science. Often, extreme views of the world do not corroborate facts. 

In addition, we have a tendency to represent the very best parts of our lives on social media. Shiny realities that do not really exist are often painted: Glamorous vacations, celebrations, accomplishments, financial freedom, perfectly clean homes, and quintessential lives. Striving to create these images and lives exhaust us and can fuel social comparison and esteem issues. 

Lastly, on social media, we are rapidly bombarded with messages that can be difficult to process; it is common to feel exhausted after scrolling for hours, yet we continue seeking to activate dopamine pathways (neural circuits that regulate reward) produced by social media consumption (De et al., 2025). In a recent review of the neurological impact of social media algorithms on adolescents, research demonstrated that frequent social media consumption can even create brain pathways that are similar to addiction. Also, De and colleagues (2025) found evidence that social media use at high volumes creates changes in sensitivity to emotions and decision making abilities due to impacts on the prefrontal cortex (important for logical reasoning) and the amygdala (important for emotion processing and threat management). AI is also assisting in filtering content to viewers in systematic ways that capture attention and interest (De et al., 2025). This is enhancing the rewarding impact of social media on the brain as well. 

Strategies: 

Despite these risks, social media and technology as a whole are important parts of modern society, of communication, of freedom of expression and speech, and of efficiency. Therefore, it is important to consider healthy ways to use these tools. Below are some of our suggestions we provide at Oakheart for our clients who seek to use social media in healthier ways: 

How to consume social media in healthier ways: 

Set time limits: It is so easy to get stuck in the social media feedback loops and to lose hours of time. We suggest using built-in-tools on your phone, such as apple screen time, android digital well being, or the clock app to regulate time spent on social media.
Schedule in social media use and/ or limit when you will engage with it throughout the day. Eliminating use an hour or two before bedtime may be beneficial to reduce consumption of anxiety-provoking material. 
Consider your goals for social media. How is it helpful for you? How can you focus on consuming more helpful content or content that could contribute to growth? For example, do you want to learn a new hobby, learn about philosophy, or learn about the stock market? In other words, we encourage seeking beneficial content and intentional social media use. We also encourage you to also ask, how is social media harmful for you? Can you reduce exposure to that content by unfollowing or hiding specific content? 
Seek out balanced news sources and fact check information you see on social media. Be a scientist! Double and triple check for accuracy. 

How to manage being triggered by social media: 

Regardless of political affiliation, social media posts can easily trigger us. We encourage the following for managing related distress, catastrophic or negative thinking, anxiety, sadness, and/ or anger: 

  1. Practice decatastrophizing by asking these questions:
    • What are you afraid of? 
    • Will you survive that? 
    • If so, how will you survive it? How will you cope with this stressor? 
    • How long would it take to recover? 
  2. If you will not survive the future zombie apocalypse described on social media, then it is time to stop worrying about the apocalypse. 
  3. Challenge thinking. Extremes often do not reflect reality. Do you have evidence that this is true? Have you fact checked this post with multiple, reputable sources? 
  4. Problem solve: What can you do to contribute to a solution? Is there a small way to contribute to fixing the problem you feel stressed about? Do you have the time, financial resources, etc. to do so? Will there be any consequences or risks if you make this contribution? If the contribution will cost you too much, identify a smaller contribution. Small actions, over time, lead to big changes.  
  5. Shift focus to stability. How can you create the most stable life you can, despite the content that triggered you on social media? 
  6. Practice sitting with uncertainty. We cannot predict the future. However, we can cope with what comes. Elimination of risk cannot be our goal because our lives will become too small. 
  7. Support each other. If social media is leading to feelings of disconnection, community outreach and intentional connection may be helpful. 

If you're feeling like you need a little more help implementing these strategies, Call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

References: 

De, D., Jamal, M. E., Aydemir, E., & Khera, A. (2025). Social Media Algorithms and Teen Addiction: Neurophysiological Impact and Ethical Considerations. Cureus 17(1), e77145. https://doi.org/10.7759/cureus.77145

​Sensorimotor OCD: Understanding and Finding Relief

1/17/2026

 
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​Sensorimotor OCD: Understanding and Finding Relief

Introduction: What Is Sensorimotor OCD?
Most people don’t spend much time thinking about their breathing, blinking, or swallowing. These automatic bodily functions usually happen in the background, unnoticed. But for some, these sensations become impossible to ignore. If you find yourself constantly aware of your breathing, heartbeat, or other bodily processes—and this awareness causes you distress—you may be experiencing a lesser-known form of Obsessive-Compulsive Disorder (OCD) called Sensorimotor OCD.

Sensorimotor OCD is a condition where people become intensely focused on normal, involuntary bodily sensations. This hyperawareness can lead to anxiety, frustration, and a cycle of thoughts and behaviors that are hard to break. If this sounds familiar, know that you’re not alone—and that effective help is available.

What Does Sensorimotor OCD Feel Like?
Sensorimotor OCD (sometimes called somatic or hyperawareness OCD) is different from the more commonly known types of OCD, like Contamination OCD or Scrupulosity OCD. Instead, the focus is on the body’s automatic functions. People with Sensorimotor OCD might become preoccupied with:

Breathing (e.g., worrying about how you breathe or feeling you have to control it)
Swallowing of salivating (e.g., feeling every swallow, worrying about swallowing “correctly”)
Blinking (e.g., noticing every blink, feeling it’s abnormal, how often one is blinking)
Heartbeat or pulse (e.g., constantly feeling or checking your pulse, noticing heartbeat at night when trying to sleep)
The position or movement of your tongue
Bladder or bowel pressure
Eye contact (e.g., awareness of eye contact itself, paying attention to which eye one is looking at when interacting with another person)
Visual distractions (e.g., floaters, eye movements)

The problem isn’t the sensation itself—it’s the anxiety and intrusive thoughts that come with being unable to “turn off” your awareness of it ("obsessing about obsessing"). You might worry that you’ll never stop noticing it, that something is wrong, or that you’ll lose control of the function.

Why Does This Happen?
Sensorimotor OCD creates a vicious cycle. The more you notice a sensation, the more anxious you feel. That anxiety makes the sensation even more noticeable, which leads to more worry and more focus. Trying to stop thinking about it often makes it worse. This cycle can be exhausting and can interfere with your ability to concentrate, relax, or enjoy life.

Common Obsessions and Compulsions
Obsessions are the unwanted, intrusive thoughts or worries about bodily sensations, such as:

“What if I forget to breathe?”
“What if I can’t swallow?”
“What if my heartbeat isn’t normal?”
“Why can’t I stop noticing my blinking?”

Compulsions are the actions or mental rituals you do to try to relieve the anxiety, such as:

Checking or controlling your breathing or swallowing
Counting breaths or heartbeats
Seeking reassurance from others or online
Avoiding situations that make the sensation more noticeable
Mentally rehearsing or monitoring the sensation
Distraction away from the fixation 

These behaviors in the short-term (and therefore are highly reinforced), but they usually make the cycle stronger in the long run.

How Is Sensorimotor OCD Different from Other Conditions?
Sensorimotor OCD is not the same as health anxiety, where the worry is about having a disease. It’s also different from general anxiety which is intense or frequent worry about catastrophic outcomes related to things such as finances, safety, and work. In Sensorimotor OCD, the main focus is about the process itself—how you breathe, swallow, or blink—not about being sick. The typical feared outcome is about not being able to stop focusing on these processes.

How Can Sensorimotor OCD Be Treated?
The good news is that Sensorimotor OCD is treatable. The most effective therapies include:

Exposure and Response Prevention (ERP)
ERP is a type of cognitive-behavioral therapy (CBT) that helps you gradually face your fears and reduce compulsive behaviors. For Sensorimotor OCD, this might mean intentionally focusing on the sensation (like breathing) without trying to control it, and learning to let the anxiety pass without doing a compulsion (e.g., distraction). Imaginal exposures to feared outcomes (e.g., getting stuck focusing on the process) may be employed as well.  

Mindfulness and Acceptance
Mindfulness teaches you to notice sensations without judgment or the urge to change them. Over time, this helps you accept that these sensations are normal and not dangerous, and they can fade into the background.

Support and Education
Learning about Sensorimotor OCD and connecting with others who understand can be incredibly helpful. Support groups, educational resources, and compassionate therapy can make a big difference.

What Can I Do If I Think I Have Sensorimotor OCD?
If you recognize yourself in these descriptions, know that you’re not alone and that help is available. Sensorimotor OCD can feel isolating, but with the right support and treatment, you can learn to manage your symptoms and reclaim your life.

Steps you can take:
  • Reach out to a mental health professional who understands and specializes in OCD and its subtypes
  • Learn more about ERP and mindfulness-based therapies
  • Practice self-compassion and patience—recovery is possible, but it takes time
  • Consider joining a support group or connecting with others who share your experience

Conclusion
Sensorimotor OCD can be a challenging and confusing experience, but it is treatable. With the right approach, you can learn to let go of the constant focus on bodily sensations and find relief from anxiety. Our practice specializes in helping people with Sensorimotor OCD and other forms of OCD. If you’re ready to take the next step, contact us today to learn more or schedule a consultation.

If you are interested in treatment for Sensorimotor OCD at OakHeart, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

College Prep: 101

11/12/2025

 
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College Prep: 101

Written by Kevin Hamor, PsyD

Syllabus Week 
We have probably all seen the movies about how fun college can be, right? Elle Woods is crushing it in the courtroom in all pink, a group of women sing throughout college, and it is aca-mazing. However, college is not all Hollywood chalked it up to be. Whether you are attending college far from home or up the street, it is a very different experience from high school. No one is making sure you eat vegetables, go to bed before midnight, or do your homework. More often than not, there may be some challenges you experience that make you feel alone and unsupported, and even overwhelmed with all the responsibilities asked of you as a college student. Some of these challenges include dealing with roommates, difficult professors, and struggling to stay focused on studying. In this “course,” you will be presented with strategies to feel more supported, welcomed, and excited to be a college student.


Week of Welcome
Having the opportunity to have a roommate in college can be exciting: meeting a new person, doing new things together, and maybe even forming a new friendship. However, it can be a significant stressor to navigate interpersonal relational dynamics with a roommate. From my experience working with college students in a university setting for three years, challenges with roommates seem never-ending. I have heard of issues ranging from cleanliness and loud music to having a roommate move their partner in, indefinitely. The best way to navigate these challenges is to be communicative and not avoidant, as avoiding confrontation or communication will only worsen the problem(s) over time.

According to Illinois State University’s (ISU) Housing Services (2025), the best way to have an enjoyable experience navigating living dynamics with a roommate is to connect, compromise, care, and resolve conflicts. They encourage you to ask open-ended questions pertaining to rules, needs, and wishes that you both can agree upon. These can range from shared belongings, noise, and privacy needs. That then leads to communication, in which ISU encourages open communication, cooperation, collaboration, and respect, to name a few. They suggest you be honest about your safety and comfort, and also hold empathy for compromise and negotiation. That begins the third step, compromise. Boundaries change just as your needs and wants change as you grow at college. That means what worked during the beginning of the semester, as you first began school, may be different as you start the next semester. ISU then encourages you and your roommate to use care by demonstrating empathy. Lastly, the next piece of advice is to utilize care when interacting with your roommate(s). Highlighting the importance of care when managing conflict can go a long way to reinforce connection, communication, and compromise (Illinois State University, 2025).

Homecoming
A quick Google search on “adapting to college life” will show results ranging from limiting substance use to focusing on hygiene and routine building. What might be more helpful is first figuring out what challenges you are having in adjusting to college. Is it living far away from my family? Is it challenging for me to make friends? Or is it difficult to perform well academically? It may be a little bit of all of the above. Regardless, the first semester or even year of college can feel out-of-body during one period, and liberating and joyous in the other. That is because you are most likely experiencing many new things all at the same time. According to a researcher and professor, Dr. Vincent Tinto, studied the retention and departure of college students and found many compounding factors that led to a student dropping out of college. He theorized that, when students’ values and lived experiences, to name a few, are integrated in an accepting or positive manner, students are more likely to stay enrolled in their prospective school. However, a misalignment in that blend can contribute to student dropout and not feeling connected to or accepted by their prospective school. These connections can be dependent on the quality of resources provided on campus, as well as the quality of professors. Some helpful questions to ask yourself are: Do you, as a student, feel accepted by your peers and professors, and what is the quality and effectiveness of your peer-to-peer relationships outside of the classroom (Tinto, 1975).

Many universities and colleges advertise events for students to participate in to be more involved on campus. This may help strengthen your connectedness with the school as a whole, as well as increase your social support. Most schools also offer events that are free of charge and held weekly to monthly to more easily incorporate in your academic schedule.

Mid-Terms & Finals Week
As many of you are beginning to realize, grades are weighted differently in college and university than in high school. Some of your classes may only have three to four assignments for the whole course, while others may have 20 or more assignments and weekly discussion posts. Regardless, how you approach each course is probably different. Below are some helpful tips that ensure you are doing your best to succeed academically.

The general rule-of-thumb is for every credit a course is worth, you need to spend two to three hours per week studying and preparing for that course. If you are enrolled in 15 credits, that is over thirty hours a week. Now you may have already found out that some courses will require the full 3 hours a week of study and coursework, while others are a lot simpler.

One of the best ways to assist you in preparing for your courses is to get and stay organized. I am not saying you need to have everything color-coded and use five different highlighters, but having a general sense of what assignments are due, when exams are, and other major components of your courses can make a huge difference in your preparedness and overall stress. That leads me to time management. Knowing when your classes are and also showing up to them helps demonstrate to the professor that you are invested. Also, you cannot learn the material if you are not in class. You would not believe how many times a professor may say, “This specific thing will be on the exam,” and you would not have known if you were not there. Next, get to know your professor. Most, if not all, professors are required to offer some sort of office hours, and if they are truly passionate about what they teach, they may provide more individualized support. Lastly, study more effectively. What worked in high school may not work for you in college, and as mentioned above, you may need to approach how you study for each course differently, too.

Studying habits are important to form early and well when you first begin a course and semester. In college, you are most likely attending any given course once or twice a week, so if you are not reviewing any of the material in between, you are more likely to not remember it and do poorly on the exams. Setting aside a set time in your schedule dedicated to studying preemptively may be helpful so that, if you need less time, it will be easier to accommodate, rather than trying to find more time that is no longer available. In addition to setting time in your schedule to study, spacing out when you study can be helpful, too. This method is called distributed practice and helps you remember the material better (Newport, 2007).

Holiday Break
The semester is finally over! As you reflect on your first semester, do not be too discouraged if you did not do your best. Regardless of whether it is your first semester or your 8th semester, college is hard, and no two classes are the same. If you need support as you navigate college, we here at OakHeart are more than happy and equipped to help you succeed. Specifically, I recommend you reach out to get support if you are struggling with implementing organization strategies, struggling to concentrate, struggling socially, struggling with academic performance due to mental health challenges (or any of the above difficulties), or struggling with overall adjustment to the new trials and tribulations you are encountering. We are here to assist you using a variety of evidence-based strategies, including therapies called Cognitive Behavioral Therapy and Acceptance and Commitment Therapy. In such treatments provided at OakHeart Center for Counseling, we can help you with challenging thinking, assisting with organization strategies, increasing values-driven behavior, modifying coping skills, and assisting with interpersonal challenges.

​If you are interested in counseling with Dr. Hamor or any other clinician at OakHeart, call OakHeart at 630-570-0050 or 779-201-6440 or email us at [email protected]. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

References
Illinois State University (2025). Navigating roommate relationships. University Housing Services. https://housing.illinoisstate.edu/student-life/roommates/relationships/index.php

Newport, C. (2006). How to become a straight-A student: The unconventional strategies real college students use to score high while studying less. Three Rivers Press.

Tinto, V. (1975). Dropout from higher education: A theoretical synthesis of recent research. Review of Educational Research, 45(1), 89-125.
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Counseling Phone: 630-570-0050
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Email: [email protected]
North Aurora, IL Location
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phone: 630-570-0050
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Sycamore, IL 60178
phone: 779-201-6440
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