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.

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.

The Why People Participate in Therapy 

Therapy can be difficult, upsetting, fun, confusing, sad, overwhelming, empowering, and everything in between. Arguably, no matter if this is your first time participating in therapy or your twentieth, each therapeutic experience will feel different. Sometimes, someone is looking for help processing a loss of a person, pet, or opportunity, while others are seeking support in understanding more about themselves, their thoughts, and emotions. There is also no rulebook for why anyone would want to go to therapy. The journey of therapy is extremely personal and it is one of the few times you can be selfish without negative judgment or consequences.

The Benefits of Participating in Therapy 

As mentioned before, there are many reasons as to why someone chooses to come to therapy, but oftentimes, the benefits of therapy are not always as openly discussed. While I do not want to blindly say that therapy will cure all, I do believe it can help you live a more zestful and authentic life. Many times in our lives there are moments in which we wish we could openly “think out loud” without any of the negative consequences like offending a loved one with something we said or did.

Therapy is a non-judgmental space in which you may be challenged to grow emotionally but you will be supported, validated, and provided safety throughout the process. The relationship between a therapist and client is unlike any other relationship because very rarely do we have relationships where we can always be the center of the conversation. Ultimately, you will learn to better understand your thoughts and emotions and develop ways to better manage stress and to face your problems. Another benefit of participating in therapy is that, through the process of understanding yourself more, you can also have healthier relationships in your life by learning how to set boundaries, advocate for your needs, and better articulate your thoughts and feelings to others. 

Participating in Therapy with Me 

It is my hope that working with me through therapy will be restorative, healing, and empowering as you begin to remind yourself of your own strength. I utilize several modalities with a stronger emphasis on Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Emotion Focused Therapy (CFT). I believe no one approach is best, and encourage all of my clients to actively participate and advocate for their needs in therapy to truly individualize my treatment approach and your participation in treatment.

I also emphasize the importance of self-compassion and self-care. I often believe these are two sides of the same coin because to engage in self-care is to be compassionate to yourself. Most people have been taught to be kind to others, put others before themselves, and to make others feel important and listened to, but rarely are we ever encouraged to do that for ourselves. Dr. Kristin Neff (2025) defines self-compassion on her website as, “...simply the process of turning compassion inward. We’re kind and understanding rather than harshly self-critical when we fail, make mistakes, or feel inadequate. We give ourselves support and encouragement rather than being cold or judgmental when challenges and difficulties arise in our lives” (Neff, 2025). I encourage all of my clients to redefine and reimagine what a world could look like where they have boundaries, they prioritize themselves, and they feel in control of their lives. 

Concerns I treat in Therapy 

While broad, I treat mental health concerns ranging from depression, anxiety, relationship/interpersonal communication concerns, to complex trauma, LGBTQIA+ support, obsessive-compulsive disorder , attention-deficit/hyperactivity disorder, and life transitions to name a few. Regardless of what brings you to therapy, you will find a supportive and healing experience to improve your mood and quality of life. 

References

Neff, S. (2025). Self-Compassion by Kristin Neff: Join the Community Now. https://self-compassion.org/

​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.

It is important to know the types of abuse that one can experience so that they can know the warning signs of an unhealthy relationship dynamic. According to the National Domestic Violence Hotline, the common types of abuse that can be seen in domestic violence include physical abuse, sexual abuse, emotional/verbal abuse, and financial abuse.

Physical abuse

• Physical abuse is the type of abuse that most people commonly think of when someone refers to domestic violence. Physical abuse is defined as any form of repeated, unwanted, and purposeful behavior that is directed toward someone’s body with the intention of causing bodily harm.
• Examples of this can include choking, kicking, scratching, punching, biting, pulling of hair, pushing, strangling, and more. This can also include threatening or injuring someone with a physical object, such as a knife or gun. Physical abuse does not have to include severe injury to be considered abuse.
• Physical abuse perpetuates the power and control dynamic because it makes an individual fearful for their physical safety in the relationship, as well as if they were to leave a relationship. There are often threats of killing or seriously harming the person or their loved ones if they leave.

Sexual abuse

• There is a common misconception that a person in a committed relationship cannot experience sexual abuse. Oftentimes, sexual abuse comes from someone who the person knows. Sexual abuse is defined by behavior that pressures, coerces, or forces someone to do a sexual act that they do not want to do.
• Examples of this can include threatening or pressuring someone to have sex or perform sexual acts, unwelcomed touching or kissing, unwelcomed sexual activity, taking a condom off during sex without consent, and sexual insults directed towards a partner. Sexual abuse can maintain power and control because using force to control someone to do something they do not want to do makes a person feel powerless.
• Typically, sexual abuse causes significant fear. People will often think or be told it is “their fault” that something happened. The person who experienced sexual abuse is NEVER at fault.

Emotional/Verbal Abuse

• Abuse does not have to be physical to be considered abuse. Emotional abuse is defined by any form of non-physical behaviors that are intended to cause psychological harm to a person.
• Examples of this can include threatening, demanding, belittling, humiliating, isolating one from family and friends, and stalking. A common form of emotional abuse includes gaslighting, which is a form of manipulation. This includes persistent efforts to attempt to alter someone’s reality, which causes an individual to be unsure of their feelings or recollection of events.
• These events perpetuate power and control because a person perpetrating abuse creates a dynamic where a person is often questioning their reality or even their confidence. The person experiencing abuse can begin to believe that they are unworthy of love or an emotionally safe relationship.

Financial abuse

• This type of abuse is defined by a person limiting or restricting someone’s access to financial independence. This includes various levels of control.
• Examples of this can include not allowing someone to have a job, getting someone fired by constant harassment at the workplace, restricting access to bank accounts, hiding or stealing finances, and restricting someone's ability to have transportation or necessary work items to sustain a job.
• The way that financial abuse perpetuates the power and control dynamic is because if a person is unable to gain independence from someone who perpetuates abuse, they then can find themselves relying on the person to provide food, shelter, and water, which are all necessary for survival.

What is moral injury? “The lasting psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” (Litz et al., 2009, p. 697; as cited in Bryant, 2021). In other words, a moral injury takes place when one’s conduct is not perceived as moral or ethical or when one’s experience does not align with one’s moral viewpoint (Bryant, 2021). 

How does this look for my clients who suffer from moral injuries? It appears to be a chronic, internal agony… A voice that starts off quiet but gets louder with time. It typically starts with a “If only I had done X,” but quickly evolves into a “I should have known, how did I not know? I am a failure. I am a terrible person.” I have seen Veterans sob, overwhelmed by the guilt and shame of the commands they were given and chose to follow through with. I have seen firefighters heartbroken over the car seat in the back of the burning car. I have seen nurses tormented by the question, “is there anything else I could have done to save them?” I have seen mothers sick with guilt because they think they could have prevented a catastrophic outcome related to their child. Many people in the helping fields, such as nurses, firefighters, and police officers, suffer from a moral injury when they are not able to save a member of a vulnerable population, such as a child. I have also seen that the impact of moral injuries worsen over time. This makes sense because the impact of PTSD generally increases the longer the PTSD remains untreated; in other words, time does not heal a wound that continues being opened by shame, guilt, and negative and harsh internal dialogue.

So how can treatment help someone with moral-injury related PTSD? First, addressing shame, guilt, and self-blame is a critical component of the treatment of PTSD, especially when a moral injury has contributed to the development of the disorder. Therefore I see my role in treating your moral injury as helping you to understand that you did the best you could with the information you had at the time. If you had other information, you would have done something else. That is what many of the brave and courageous humans I treat who serve others don’t see. We are not perfect. We cannot be perfect, especially when having to make life altering decisions every day at work. The path that you chose was the path you believed would have the highest likelihood of success or you would not have chosen it. 

Many cognitive patterns contribute to the maintenance of the guilt and shame found in moral injuries. For example, research suggests that first responders have a tendency to believe that they should always be able to successfully save or help others, and that they therefore perceive it to be a failure when they can’t do so (as cited in Bryant, 2021). This assumption is another way that guilt and shame can be perpetuated. Additionally, during a moral injury, fundamental assumptions can be shattered. For example, if someone believes that good things happen to good people, and bad things happen to bad people, otherwise referred to as the “Just World Belief” (Resick et al., 2017), then they may not know how to interpret certain unfair tragedies, such as the death of a toddler.  

Therefore, treatment of moral-injury related PTSD typically entails challenging unhelpful thinking patterns and related beliefs. For example, an exercise that I encourage is thinking about what else could have happened? You could have made a different decision, sure. But how do you know the outcome would be better or different? For a healthcare worker, how do you know that a person would have lived if you provided different care? For a firefighter, how do you know that child would have survived the fire if you arrived sooner? You don’t. We do not get access to these unknown answers. I provide a treatment called Cognitive Processing Therapy to guide these exercises and thought challenging strategies, an evidence-based treatment for PTSD and moral injury-related PTSD (Litz et al., 2021). Treatment suggestions also include the following: Processing memories of the moral transgression, integrating corrective information that allows for a more evidence-based perspective, and self-forgiveness strategies, such as values-driven and reparative behavior (as cited in Litz et al., 2021). 

In my experience helping patients with moral-injury related PTSD, I have witnessed the effectiveness of these treatment strategies and watched my patients forgive themselves for the circumstances they could not control. I encourage you to reach out if you would like help healing from your moral injury. 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

Bryant, R. A. (2021). Treating PTSD in First Responders: A guide for serving those who serve. American Psychological Association. 

Litz, B. T., Stein, N., Delaney, E., Lebowitz, L., Nash, W. P., Silva., C., & Maguen, S. (2009). Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clinical Psychological Review. 29(8), 695-706. https://doi.org.10.1016/j.cpr.2009.07.003

Litz, B. T., Rusowicz-Orazem, L., Doros, G., Grunthal, B., Gray, M., Nash, W. & Lang., A. J. (2021). Adaptive disclosure, a combat-specific PTSD treatment, versus cognitive-processing therapy, in deployed marines and sailors: A randomized controlled non-inferiority trial. Psychiatry Research, 297, 113761, https://doi.org.10.1016/j.psychres.2021.113761

Resick, P. A., Monson, C. M., & Chard, K. M. (2017). Cognitive Processing Therapy for PTSD. The Guilford Press.

Stress is a normal part of life — but when it starts to feel overwhelming or unmanageable, or when someone experiences chronic stress, it can take a serious toll on your mental and physical health. At OakHeart, Center for Counseling, we often see clients who are juggling demanding jobs, caregiving responsibilities, financial pressures, and/or major life transitions. If you’re feeling stressed, know this: you’re not alone, and there are tools that can help.

What Is Stress?

Stress is your body’s natural response to a challenge or demand. In small doses, stress can be helpful — it can motivate you to meet deadlines or avoid danger. But chronic or intense stress can lead to anxiety, trouble sleeping, irritability, fatigue, and even health problems like headaches, digestive issues, or high blood pressure.

Signs You May Be Experiencing Too Much Stress

• Feeling overwhelmed or constantly anxious
• Changes in appetite or sleep patterns
• Difficulty concentrating or making decisions
• Frequent headaches or muscle tension
• Irritability or mood swings
• Withdrawing from friends or activities you enjoy or an increase in conflict in relationships
• New or worsening medical conditions

How to Manage Stress: 6 Therapist-Backed Strategies

Here are six evidence-based ways to manage stress that we often recommend to our clients:

Practice Mindful Breathing

4-2-6 Breathing: Slowing down your breath tells your nervous system you’re safe. Try this simple exercise: Inhale for 4 seconds, hold for 2, exhale for 6. Repeat for 2–3 minutes. It’s a small practice with a big impact.

Move Your Body
Exercise reduces stress hormones and boosts feel-good chemicals like endorphins. You don’t need an intense workout — even a 10-minute walk can help clear your mind and reset your mood.

Set Healthy Boundaries
Stress often creeps in when we say yes to too much or when we consistently self-sacrifice. It’s okay to say no, reschedule, or delegate. Healthy boundaries protect your time, energy, and mental health. 

Prioritize Sleep
Lack of sleep can make stress feel 10 times worse. Aim for 7–9 hours of quality rest. Try creating a calming bedtime routine and keeping screens out of the bedroom. Engaging in healthy sleep hygiene habits is crucial. 

Connect with Others
Talking to someone you trust — a friend, family member, or therapist — can help process pent-up emotions and give you a fresh perspective. Simply connecting with others is an incredibly effective anti-depressant and anti-stress activity. 

Limit Stimulants and Substance Use
Caffeine, sugar, and alcohol can all contribute to anxiety and sleep problems. Pay attention to how these affect your stress levels and consider cutting back.

When to Seek Professional Help
If you’ve tried managing stress on your own but still feel stuck or overwhelmed, it may be time to speak with a mental health professional. Therapy can help you get to the root of your stress, develop healthy coping skills, and make lasting changes in your life.

You Don’t Have to Do This Alone
Stress may be common, but that doesn’t mean you have to carry it by yourself. Our team of licensed therapists is here to support you. Whether you’re navigating a major life change, work burnout, or just feeling emotionally drained, we’re ready to help you feel more grounded and in control.

​If you are interested in counseling for insomnia, 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.

​To anyone reading this who has intrusive thoughts about harming others, I would like to remind you that you are not a monster. I treat many clients who experience these debilitating fears of harming others (and/ or themselves), often referred to as harm OCD (Hershfield, 2019). These thoughts, of course, are incredibly difficult for my clients to tolerate because they find these thoughts to be horrible and unforgivable. They experience tremendous fear that they will act on their intrusions some day or even worse, that they already have. Because these thoughts so strongly contradict their moral compass, they attend to them and monitor them closely to ensure that “the monster” does not take over and harm innocent bystanders. However, I would like to share that my clients with harm OCD tend to be some of the most conscientious and kind people I have ever met. I would trust them more than the general population to not cause intentional or unintentional harm on others. Why is this? Because their top values are protecting others and remaining conscientious of the impact of their behavior. They also typically find topics like murder or rape to be so morally incomprehensible and deplorable, that even the thought of one of these topics makes them feel guilt, shame, and dread that some day they could do something awful. Due to the harsh inner voice that often comes with harm intrusions, Jon Hershfield (2018), the director of the Center for OCD and Anxiety at Sheppard Pratt in Towson, Maryland and author of Overcoming Harm OCD: Mindfulness and CBT Tools for Coping with Unwanted Violent Thoughts, emphasizes the need for self-compassion when managing these unyielding harm intrusions. 

Before examining why self-compassion is so critical for overcoming harm OCD, it is important to further define harm OCD. Many of my clients, as described by Hershfield (2019), report both intrusive thoughts and images involving harming others, ranging from intrusive images of running someone over while driving, to “urges” to pick up a knife and stab someone, to thoughts of dropping a baby. However, as described by Hershfield (2019), these urges are not actually urges. Instead, they are intrusive feelings (or intrusive thoughts paired with a “sensation in the body,” (Hershfield, 2019, p. 13)), such as feeling like your hand may want to grab the knife in the kitchen. However, these “urges” to cause harm go against all authentic desires in someone with harm OCD. In fact, someone with harm OCD feels like such an intrusive feeling is morally repulsive and is entirely inconsistent with their values. Therefore, it is not actually an urge; it is just an intrusive feeling. Hershfield (2018) labels these thoughts, images, and intrusive feelings as ego-dystonic, or not representative of self-concept.  

Hershfield (2019) outlines many recommendations in his book, Overcoming Harm OCD, including exposure and response prevention therapy (ERP, see https://www.oakheartcenter.com/exposure-and-response-prevention.html) and self-compassion work. I have found that incorporating self-compassion and self-love techniques into ERP is critical for successful treatment of harm OCD. For those reading this with harm OCD, you may be asking, how could I possibly love myself when I am having these atrocious thoughts and feelings? Well the answer is simple: Everyone has these thoughts from time to time. So if you are “sick or defected” (Hershfield, 2018, p. 82), then we are all sick and defected. It is part of the human experience to have intrusive thoughts, including violent and sexual intrusions. However, most people do not even really register these thoughts; instead, they just call them odd and continue on with their day. They brush them off and do not bother to analyze them further or to talk about them with others. However, someone with OCD has an intense reaction to such intrusions and often asks “why am I having that awful thought, what does that mean, does this mean I want to be having that thought? That would be terrible. I must be a monster for having that thought…I must want to act on that thought. Do I want to do that?” This intense fear reaction then further intensifies the fear. Self-compassion is a critical step to stopping this cycle. The fact that you are so alarmed by this thought and so attuned to it clearly means it is not a thought that you want to be having. So instead of calling yourself a monster, I am asking that you start calling yourself human and focusing on three core elements of self-compassion described by compassion researcher, Kristin Neff (as cited in Hershfield, 2018). 
​

• Mindfulness: Observe your thoughts without judgment, as they are, not as OCD makes them out to be. For instance, I am having a harm intrusion and I fear it means I am bad. vs. I am an awful human being for having these thoughts (Hershfield, 2018). 
• Common Humanity: Intrusive, taboo thoughts are normal. Take a moment to remind yourself that you are a human being (Hershfield, 2018). 
• Self-Kindness: Treat “yourself as you would treat anyone else you cared about who was suffering” (Hershfield, 2018, p. 60). Remind yourself that you are doing the best you can and are trying to be the best person you can be. 

Instead of listening to the critical voice of shame, I encourage you to make room for these three elements of self-compassion and generally for self-love when having intrusive thoughts. Despite feeling that these thoughts make you a monster, I am here to remind you that they reflect quite the opposite of that. The fact that you are so deeply bothered by these intrusions means that you have incredibly high moral integrity, means you would never harm someone else on purpose, and means that it is likely that your odds of causing accidental harm is generally lower because you are so vigilant of this possibility. So please stop calling yourself a monster. It is not accurate or kind and will only intensify your intrusions and fears. To anyone suffering with harm OCD, I encourage you to seek out exposure and response prevention therapy which incorporates self-compassion work so that you can start believing in your moral compass and true intentions again. 

​If you would like help overcoming your reaction to your intrusive thoughts, 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

Hershfield, J. (2019, May 2). Overcoming harm OCD. https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/overcoming-harm-ocd

Hershfield, J. (2018). Overcoming Harm OCD. New Harbinger Publications, Inc. 

Most individuals with OCD have strict criteria for rituals to ensure their fears do not come true, despite the rituals or compulsions often seeming illogical to someone without OCD. I talk to my clients about how OCD is far from logical and, as you know, if you are reading this and have OCD, rituals do not rationally or logically reduce the level of threat. This appears to be true for most OCD presentations, from fears of contaminating self or others to fears of seriously harming self or others. For example, circling the block repeatedly to ensure you did not run someone over does not decrease the likelihood that you already ran someone over. Instead, it actually might increase the likelihood of subsequently hitting someone because you will be less focused while checking for pedestrians on the side of the road. 

So if OCD is not logical, one strategy that I have seen to be helpful for my clients is to use the phrase “it’s already done.” In other words, if you really did run someone over, it is already done and there is nothing you can do now. If you accidentally poisoned your cat via Chocolate, it will already be done and you will have to deal with the ramifications after. If you accidentally contracted a deadly disease in the Target bathroom, no amount of showers will help reduce the odds of that already happening. It’s already done. 

This ‘it’s already done’ strategy can be a helpful tool in exposure and response prevention, which aims to assist with tolerating uncertainty. One great reason for striving to tolerate uncertainty is because we can’t turn back the clock to prevent mistakes. Mistakes might happen and we will be made aware of them if they do. Your cat will either get sick or they won’t get sick but you will not know without the passing of time, and it must be accepted that the chocolate has already been consumed and there is nothing that can be done about it (and luckily you will know quickly if they did eat it, as they will become very clearly ill!). At the same time, it is highly unlikely that your cat ate the chocolate without your knowledge, especially if this is something you are very mindful of. However, in the very slim chance that your eyes have deceived you, It’s already done. We can’t go back in time. If some awful thing has already happened, then we will have to deal with the consequences which will become apparent to you at some point. Although sitting with this uncertainty feels awful for both people with and without OCD, it is a fact that all of us could accidentally make some awful mistake. Exposure and response prevention therapy aims to assist you with learning to tolerate this strategy, alongside many others, to help you overcome your OCD. 

​If you would like help overcoming your reaction to your intrusive thoughts, 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.

Around 2-3% of the population meets criteria for Obsessive-Compulsive Disorder (OCD) (about 1 in every 40 people). That means, between those who have the disorder, and the loved ones that are impacted, many many people are impacted by the oftentimes devastating consequences of the disorder. How can loved ones support their loved ones with OCD?

Get a better understanding of the disorder and how it works. 

Here are some blogs and resources that can help shed some light:

https://www.oakheartcenter.com/obsessive-compulsive-disorder-ocd.html
What to Expect in CBT Treatment Series: Obsessive Compulsive Disorder (OCD)
​OCD and “Unacceptable” Intrusive Thoughts : You are Not Alone
Thinking Errors in Obsessive Compulsive Disorder
Thought-Action Fusion in OCD
Exposure and Response Prevention for OCD
​The Role of Avoidance Learning in the Development of Anxiety-Based Disorders, OCD, and PTSD
Challenging Shame in Obsessive Compulsive Disorder

Briefly, OCD is a disorder characterized by obsessions and compulsions. Obsessions are persistent unwanted thoughts, images, impulses, or doubts that are intrusive and distressing. People with OCD interpret these internal experiences as being dangerous, intolerable, or shameful, and therefore do not want to have them and try to resist them. In other words, they interpret normally occurring and benign internal experiences as being potential signs of threat/danger and as therefore important and in need of monitoring, pushing away, confessing, etc. These obsessions then tend to elicit feelings of anxiety, fear, disgust, uncertainty, and frustration. Obsessions can revolve around essentially any content area, but most of the time, obsessions involve thoughts/images specific to making mistakes, contamination, violence, sex, religion, morality, and the possibility of being responsible for or causing har (either by losing control or negligence). 

Unfortunately, obsessions usually take the form of a content area that actually represents what matters most to the individual. If an individual values kindness, compassion, and taking care of others, then they may be more likely to be alarmed in response to a random, non-sensical, ego-dystonic thought about potentially harming someone. Or a new mother who is elated to have a baby and wants nothing more than to love and protect that baby, may be extremely afraid in response to an intrusive thought about something horrible happening to the baby. Because the intrusive thought is interpreted as being dangerous, the thought ends up taking on a life of its own and becoming more repetitive.

In response to these obsessions, individuals with OCD employ compulsions. Compulsions are strong urges to engage in a behavior and/or mental act to try to reduce the frequency of, or distress associated with, the obsessions and/or to try to keep a specific feared outcome(s) from happening. Compulsions can be overt (e.g., washing hands repeatedly, checking to make sure a mistake hasn’t been made, asking a loved one for reassurance) or covert (e.g., completely avoiding triggers, mental rituals such as saying a specific phrase in one’s head, praying to oneself, or suppressing thoughts). The problem with compulsions is that engaging in them does not allow the individual with OCD to re-assess their beliefs and learn that they are in fact safe, that their thoughts are not dangerous, that what they are afraid of is unlikely to happen, and that they can handle feelings of anxiety and uncertainty. 

How Are Loved Ones Affected by OCD

There are many ways that loved ones are affected by OCD. The stress and distress caused by the disorder may impact the quality of relationships in many ways. Watching someone whom you love experience immense turmoil may be painful to watch and create feelings of helplessness and hopelessness. 

Loved ones are also often pulled into compulsions/rituals. When loved ones give in and do what the OCD wants them to do, this is called accommodation. For example, an individual with OCD might have intense fears of being contaminated with germs. As a result, they may start showering every time they come home from being anywhere public. They may change out of their “outside” clothes and immediately wash their clothes in a very specific ritualized way. They may not be able to touch certain objects in the house. Eventually, the individual with OCD may ask their loved one to start doing these compulsions too since they may believe that their loved ones are contaminated as well. The loved one may initially object, but as a consequence, the individual with OCD may deteriorate and express intense displeasure or despair. So the loved one may acquiesce and agree to also shower when they return home, change out of their “outside” clothes and avoid touching certain objects in the house. 

This accommodation is motivated to “help” the individual with OCD to not feel so distressed. However, the loved ones must realize that compulsions (and accommodations to compulsions) are in the long run perpetuating the OCD and creating more distress in the long run. In fact, research suggests that accommodation can actually feed the severity of OCD symptoms and reduce the likelihood that an individual with OCD will be motivated to change and participate in treatment. Accommodations can also create a lot of stress on the loved ones resulting in conflict and resentment.

Support your loved one in obtaining mental health treatment with a provider who specializes in OCD

Exposure and Response Prevention (ERP) is a first-line, highly effective treatment for OCD. It is a form of Cognitive-Behavioral Therapy specifically designed to support people with OCD and their loved ones. In ERP, the individual with OCD is taught to confront/sit-with the thoughts/images/doubts/urges (exposure) and to not engage in the compulsions (response preventions) so that they can retrain their brain and fight/flight/freeze system. 

Here are some resources for finding good treatment options for your loved one with OCD (or suspected OCD):

How To Find The Right Therapist For You
Levels of Care in Mental Health Care
International OCD Foundation (IOCDF) including their IOCDF Provider Directory

Attend sessions with your loved one to learn more about OCD and partake in treatment planning and response prevention

OCD treatment often includes loved ones/support systems when appropriate so that their loved ones can learn how to support without accommodating. Parents specifically will learn how to assist with ERP implementation and practice to set their children up for success (being a cheerleader). Loved ones will learn what behaviors are specially accommodating behaviors and which are not (e.g., reasonable reassurance giving versus problematic reassuring giving), the best way to start eliminating those behaviors (e.g., identifying a start date and plan of action) and communication around response prevention (e.g., statements and phrases that may be helpful if asked to participate in a compulsion), and how to troubleshoot when situations arise that can be difficult for all involved to navigate (e.g., how to respond if the individual with OCD becomes extremely distressed or starts to bargain when told no to accommodations). For parents, the therapist may help provide training around reinforcement systems to reward/motivate their child’s participation in exposure work. 

Engage in self-care

Having a loved one with OCD can be an incredibly difficult experience to go through for many reasons and may warrant separate individual therapy. For example, a loved one of an individual with OCD may feel like their life has been taken over by accommodating compulsions/avoidance. They may feel that their time for self-care or their own responsibilities has dwindled significantly. The loved one may feel that conflict and high-stress interactions have changed their relationship with their partner/child/family member. Part of self-care is learning to communicate effectively and set healthy boundaries. Setting healthy boundaries, especially around accommodation, will be imperative to best support your loved one. 

Loved ones of individuals with OCD are incredibly powerful sources of support, engagement, and motivation and can make a big difference in the trajectory of an individual with 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.

Finding a therapist who is well-informed about gender, gender-affirming care, and the infinite varieties in gender experience and expression can be difficult. Progress has been made over the years in terms of education about and acceptance of transgender (trans) and gender non-conforming people. However, it can still be daunting to find a therapist who you can feel safe with being honest about your gender. And, even when you are able to find a therapist that you might feel safe with as a trans or gender non/conforming person, not knowing what to expect in therapy with a gender-affirming therapist may be scary. My hope through this blog post is to explain some of the things you may see in your work with a gender-affirming therapist, and share a little bit about the way that I practice as one of these therapists. 

What to Expect at the Beginning of Treatment

When you begin therapy, you will likely be asked to fill out what is often referred to as an “intake form”. Typically, in these forms, you are asked to share a little bit about yourself, what brings you to therapy, and other relevant information. (Of note: the specific questions included on these forms can vary between practices.) Sometimes, these forms ask you for the sex you were assigned at birth and/or what your current legal sex is, how you refer to your gender currently, and what pronouns you use. As a therapist who has worked with the queer and trans community for several years, there are various things that I prioritize at the beginning of treatment with my trans clients. 

First, if you filled out this intake form prior to your actual intake appointment, I will likely confirm this information with you by asking the pronouns that you use, as well as ask you to describe, in your own words, why you’re coming into therapy. I will likely share the pronouns that I use (which are she/they!) as well. I may also ask you if you have any other names that you like to be referred to as, whether they are related to your birth/legal name or not. I will never refer to you by your birth name (sometimes referred to as a dead name if you no longer use it) unless you request me to. One thing to note, however, is that if you are using your insurance benefits to help pay for sessions, it will be necessary to provide your legal name and sex in order for us to submit insurance claims. This is an unfortunate and unavoidable part of the process if your legal name and sex are not what you would like them to be, but know that this is one of the only times this would be a consideration. 

Throughout Treatment

When working with minors, I often collaborate with their parents to a certain extent to ensure that lessons and strategies learned in treatment are implemented outside of session at home, but I never share details of our sessions unless it becomes absolutely necessary. An example of this may be if the minor reports to me that they have been engaging in self-harm or are having active suicidal ideation. Of course, if it ever gets to a point where I feel this is necessary to communicate to the caregiver(s), I try my best to have a conversation about this with the minor before doing so. 

There are some things I keep in mind when working with minors who identify as trans/gender-nonconforming. One of the most important things is that I will have a conversation with the minor at the beginning of treatment to make sure I’m referring to the client how they would like to be referred to when I speak with their caregivers. This is especially important if the minor is not out to (i.e. hasn’t shared their trans identity with) their caregivers. Additionally, part of doing therapy with trans minors is providing education to caregivers about their child’s trans identity, how to support their trans child, and more, and I will always discuss this with the child beforehand to make sure I’m doing my best to have conversations with their caregivers that they are okay with. 

When working with clients who identify as trans, I sometimes support clients with identifying any gender-affirming care goals they may have. This may include things like hormone replacement therapy, gender-affirming surgeries, voice training and more. These interventions would require medical professional oversight, but I am happy to play a role in providing referrals and collaborating with providers throughout the process (with consent, of course). We may also talk about gender affirmation without medical intervention, such as exploring how clothing, body modification (such as piercings and tattoos), binding, tucking tools, and more may be incorporated into your life to express yourself and your experience of your gender. These conversations often include myself pulling from elements of Narrative Therapy and Solution-Focused Therapy as you discover more about yourself. I always approach these conversations with enthusiastic curiosity, supporting clients on their journeys to discover what makes them feel most at home in their bodies. 

When Looking for a Gender-Affirming Therapist

There are many things to keep in mind when you look for a gender-affirming therapist, and these can vary widely based on a person’s preferences. However, there are some things to keep in mind that a gender-affirming therapist will never do. One thing that a gender-affirming therapist will never do is force you to use your birth/dead name if you don’t want to. If I am aware of a trans client’s dead name, such as in cases where their chosen name is not their legal name, I do my best to ignore that information as much as possible and only use their chosen name unless otherwise specified by the client. (Again, it’s important to note that legal names do need to be used to file insurance claims.) Additionally, a gender-affirming therapist will never tell you that you need to change who you are, how you should express yourself, or how you should refer to yourself. Therapists, especially those who are trans themselves, may provide suggestions at times, such as potential ways to manage gender dysphoria. That being said, these suggestions should never be made in an attempt to tell you how you should experience your identity or express yourself, but rather to offer alternative options and resources. The process of discovering yourself can be a sensitive one, and it should be approached and discussed with care, acceptance, and support. 

Final Thoughts

Ultimately, it is up to each individual person to decide what is best for them and their goals when choosing a therapist. It sometimes takes people a few tries with more than one therapist to find the one that they feel comfortable with, and although this can be a frustrating process, know that it is not out of the ordinary. You deserve to work with a therapist that you connect with, who sees you for who you are, and who is committed to supporting you in working towards your goals. 

​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.