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.

When it comes to building and maintaining a healthy, long-lasting relationship, few theories are as insightful and research-based as Dr. John Gottman’s “Sound Relationship House.” Developed by Dr. Gottman, a renowned psychologist and relationship expert, the Sound Relationship House is a practical model designed to help couples build strong, resilient relationships. When I begin work with couples, one of the first places I start is by assessing their current dynamic and discussing this foundational theory with the goal of helping them with strengthening their own “ sound house.” In this blog, I will explore the Sound Relationship House and how its principles can serve as a guide for couples looking to create a stable, thriving partnership.

What is the Sound Relationship House?

The Sound Relationship House is a metaphor that illustrates the key elements necessary for a stable and loving relationship. Dr. Gottman’s research identified that successful relationships are built on specific, foundational principles. These principles are represented by various "levels" of a house, each of which contributes to the overall strength of the relationship. Each level of the Sound Relationship House has its own set of strategies and skills that couples can develop to build trust, intimacy, and connection. Let’s break down these levels and explore their significance.

The Levels of the Sound Relationship House

1) Build Love Maps

Foundation: Knowing Each Other Deeply
The first level of the Sound Relationship House is building love maps. In this context, "love maps" refer to the mental framework you have of your partner’s world—their likes, dislikes, dreams, worries, and life history. The more detailed your love map, the more you can navigate your partner’s inner world and respond to their emotional needs. This helps partners feel seen and known deeply. 

Key Tips:

• Ask open-ended questions to understand your partner's thoughts and feelings.
• Regularly check in with your partner about their life and experiences.
• Update your knowledge about their evolving interests and challenges.

2) Share Fondness and Admiration

Strengthening Positive Feelings
This level emphasizes the importance of expressing fondness and admiration toward each other. Research shows that couples who express appreciation and respect for one another have a greater chance of staying together and weathering difficult times. Positive interactions must outweigh negative ones, with a ratio of at least 5:1 (five positive interactions for every negative one).

Key Tips:

• Compliment your partner often, focusing on both small and big things.
• Reflect on the qualities you admire in your partner.
• Make a habit of expressing gratitude for their actions and support.

3) Turn Toward Each Other Instead of Away

Creating Emotional Support and Safety
Turning toward each other means responding to your partner’s emotional bids for connection. These bids can be as simple as asking for help, seeking attention, or expressing a need for comfort. Couples who turn toward each other in these moments create emotional security and strengthen their bond. Ignoring or dismissing these bids can erode trust and emotional connection.

Key Tips:

• Recognize and respond to your partner’s bids for connection.
• Engage in conversations where both partners feel heard and validated.
• Show empathy when your partner expresses vulnerability or needs.

4) The Positive Perspective

Viewing Each Other in a Positive Light
The positive perspective level is about cultivating a positive view of your partner, even when facing conflict. It's about assuming the best intentions rather than jumping to conclusions or making negative attributions. Couples who maintain a positive perspective are more likely to repair conflicts and handle challenges with understanding and patience.

Key Tips:

• Look for the good in your partner, especially during tough times.
• Practice gratitude for their efforts and actions.
• Give them the benefit of the doubt instead of assuming the worst.

5) Manage Conflict

Handling Disagreements Constructively
Conflict is a natural part of any relationship; what matters is how couples handle it. The Gottmans emphasize the importance of managing conflict in a healthy way, rather than avoiding it or allowing it to escalate into destructive arguments. Successful couples use effective communication skills, such as softening their start-up (avoiding harsh, critical language), accepting influence from one another, and working together to solve problems.

Key Tips:

• Use "I" statements to express feelings and avoid blaming.
• Seek compromise, and be willing to adjust your expectations.
• Learn to self-soothe during tense moments (taking a walk or taking deep breaths).

6) Make Life Dreams Come True

Supporting Each Other’s Aspirations
It is important for partners to support each other’s dreams and life goals, whether they’re big or small. Couples who take the time to nurture each other’s personal dreams, as well as their shared vision for the future, are more likely to feel fulfilled and connected. This level focuses on exploring goals and casting a vision for the future.

Key Tips:

• Take time to talk about each other’s life dreams and aspirations.
• Offer emotional and practical support to help each other achieve these dreams.
• Work together to create a vision for your future as a couple.

7) Create Shared Meaning

Building a Meaningful Partnership
The final level of the Sound Relationship House is about creating shared meaning—building rituals, traditions, and a sense of purpose together that express who you are as a team. This can involve defining the meaning behind your relationship, creating shared experiences, and developing a sense of spirituality, whether that’s through family traditions, shared hobbies, or a common life philosophy.

Key Tips:

• Engage in meaningful activities that are significant to both of you.
• Create shared rituals (like date nights or family traditions).
• Discuss what you both want your relationship to stand for and how to achieve that.

Building Your Sound Relationship House

I encourage my clients to remember that The Sound Relationship House is not a one-time project; it’s an ongoing process. Like a house, it requires maintenance, care, and attention. Even if some levels feel stronger than others, it’s important to remember that one can always work on strengthening their relationship by returning to these foundational principles.

Here are a few final tips for building your Sound Relationship House:

• Consistency is Key: Regularly check in with each other and reinforce the positive habits that build trust, intimacy, and communication.
• Prioritize Quality Time: Spend time together regularly, focusing on deepening your emotional connection.
• Be Patient: Building a strong relationship takes time, effort, and understanding. Don’t expect perfection, but keep working toward mutual respect and emotional security.

Resource

The Seven Principles for Making Marriage Work by John M Gottman, PhD

​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.

A key tool in improving communication within a couples relationship is providing opportunities for healthy conflict. In John Gottman’s research examining thousands of couples, he found that some couples were masters at having difficult conversations around issues that distressed them. The common thread was these couples sought to understand and validate their partner before problem-solving the issue. Regardless of whether the couple ultimately found a solution that worked for both parties, the ability to let the other person feel heard and understood was valuable to the relationship’s overall success.

He created a structured conversation for couples nicknamed the “State of the Union" where couples would spend one hour per week discussing difficult topics in a way that allowed both parties to feel understood and valued. When couples followed this structure, they were more likely to have a successful discussion of the issues in their relationship rather than an intense conflict. This is how he suggests conducting your own State of the Union meeting.

The Preparation Stage
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It’s crucial to find a time where both parties will show up fully present and able to engage with the conversation. Try to find a time that can work on a weekly basis and doesn’t need to be moved from week to week. Remaining consistent is key to making the State of the Union conversations work. Both parties know that it’s a time where they will be heard and they can confront more difficult aspects of the relationship so it’s important to treat that time as sacred.

Before starting, make sure each partner has paper and a pen to take notes while they are being the active listener. You want to find an hour of the day that will be uninterrupted by outside intrusions (no cell phones!) and where your partner has your full attention.

The opening remarks should be focused on what has been going well in the relationship over the past week. Gottman found that 5 positive interactions balanced out every 1 negative interaction within the relationship. So try coming up with 5 examples of positive
things your partner has done for you or the family over the last week. Be as specific as possible! Starting off on a positive note sets the tone for the entire conversation. 

Sometimes couples will come to the meeting with a conflict that occurred earlier in the week that they wish to discuss in greater depth. Otherwise, it’s important to determine what issues are open for discussion so the other partner doesn’t feel blindsided or defensive. Once everyone is on the same page, it’s time to get started!

The Main Discussion

Each partner will get an opportunity as the speaker and the active listener. Typically, the first speaker is the one who is bringing up the issue that needs to be addressed. The speaker’s goal is simply to communicate their emotional experience to the other party. Not to ask for solutions or cast blame but to explain to their partner what it feels like to experience this issue from their perspective. Gottman recommends using a softened start-up which centers “I feel” statements rather than “You did” statements. Here are some examples:

I feel overwhelmed lately by the amount of housework and I really need more support.

I feel so lonely with how little we’ve been spending time together and I need us to prioritize more date nights.

I feel hurt when we end up shouting at each other over money and I want to find a better way to have these discussions.

Focusing on what the experience feels like for the speaker might seem unnatural at first. Most people hear statements like these and immediately jump into problem solving but allowing space for your partner’s discomfort is a key component of emotional validation. The active listener is encouraged to take notes so they can accurately report back what they heard the speaker explaining about their perspective.

Once the speaker has expressed their full experience, the active listener can provide validating responses like these:

I hear you saying how overwhelmed and frustrated you are by the housework. That you don’t feel supported in that area.

What I’m hearing is that you’ve been feeling lonely in our relationship. We haven’t been prioritizing time as a couple and you’d like to have more date nights.

I understand that you’re feeling hurt when we start to yell at each other during money discussions. From your perspective, we need to find a more constructive way to have those conversations.

Notice how none of the validating responses are meant to defend the listening partner or dismiss the speaking partner’s concerns as silly or trivial. Having an emotionally open conversation requires safe and non-judgmental communication. While it might seem like a minor issue to one partner, it has been causing distress for the other and improving the emotional connection requires that level of vulnerability.

The active listener can ask follow up questions like: Did I hear you correctly? Is there more you wanted to share? Have we covered all aspects of the issue? until the speaker agrees that their perspective has been understood. Then it’s time to switch roles.

It’s important to clarify that this is not an opportunity for the active listener to defend themselves or make a case for why they did something that upset the other person. This is simply the listener’s chance to share their own emotional experience with this particular issue. With the speaker now in the active listening role, their job is to take notes to understand their partner’s view of the issue. Responses might look like:

I feel frustrated that the housework has become so overwhelming for you. I’ve noticed we’re fighting a lot more lately and I didn’t know that was the reason. 

I feel helpless and scared when I hear that you’re feeling alone in this relationship and I think I have been letting my work schedule get in the way of our time together.

I feel so angry and stressed when we have conversations about money. I don’t realize how upset I am until I’m already yelling.

Sometimes, the speaker or the listener will start to get emotionally overwhelmed or “flooded” during this process. They might feel guilt and shame coming up when their partner shares what an emotional experience has been like for them. If they feel flooded, it’s important to call a time-out and take a 20 minute break. Allowing 20 minutes of self-regulation (taking a walk, having a snack, watching a funny video) takes both partners out of fight or flight and allows them to continue the conversation in a more calm manner. It also keeps the conversation from escalating into a confrontation.

It’s essential to resume the conversation after 20 minutes. Allowing an opportunity to connect and repair after a setback strengthens the outcome of the conversation. Once both parties have regulated and returned to the conversation, it’s time to ask the same clarifying questions from the new speaker then ensure both parties have been heard and their perspective validated.

Problem Solving and Finding a Compromise

Couples are often surprised that problem solving is so late in the process. Typically, we learn that to make another person feel better we must present them a list of solutions to their problem. But the solution is less important than how the conversation has created a greater sense of unity and connection. When you feel like you’re collaborating with your partner, you’re much more open to finding a compromise that feels good to both sides.

Now that the issue is fully understood, Gottman suggests making a list of areas you can be flexible and areas that are inflexible or non-negotiable. Leading with the areas in which we are willing to accommodate our partner allows them to feel special and important. This might look like:

I am not able to adjust my work schedule during the week but I can dedicate time on Saturdays to tackle some of the weekly housework so it won’t be on your to-do list.

I am able to come home early 2 nights per week so we’re able to have dinner together. Or I can plan some dates for us that work with your travel schedule for work.

We can meet with a financial planner and get a better understanding of our money situation in a neutral setting.

Following this blueprint helps the majority of couples come to a more peaceful agreement however, Gottman considers certain issues “perpetual, unsolvable problems”. While some of these problems may lead to ending the relationship (wanting kids vs wanting to be childfree, wanting to live in Hawaii vs wanting to live in Alaska),Gottman found that master couples were able to offer some flexibility and agree to temporary compromises even if it meant revisiting the issue a short time later and trying again.

After agreeing to a compromise, you’ll want to end the meeting on a high note! Try to name one or two things you’ll do to make the other person’s upcoming week better. Improving your partner’s day-to-day life makes even hard conversations like these feel less intimidating.

Making the State of the Union meeting a regular part of your weekly routine might not prevent every conflict but it’s a productive way to get ahead of challenges and maintain a sense of teamwork when tackling difficult subjects. The more you and your partner are on the same team, the more likely you are to be successful in the long-term.

​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.