Obsessive Compulsive Disorder, or OCD, affects about 3% of the population and can cause very significant distress for sufferers and their families. The primary symptoms of OCD are obsessions, compulsions, and avoidance. Obsessions are very uncomfortable and unwanted thoughts, usually doubts, that cause anxiety or guilt. Often the doubts are about contamination, mistakes, or causing harm.  The distress created by these doubts often leads their person to feel compelled to engage in repetitive behaviors or thoughts (compulsions) such as checking, washing, or seeking reassurance, that temporarily ease their suffering. Or, OCD sufferers may begin avoiding everyday situations because their symptoms are provoked. However, OCD sufferers usually seek therapy because these behaviors don’t work for long, and because they put significant strain on themselves and on the people in their lives. Fortunately there is an effective and evidence based treatment for OCD- exposure and response prevention.


PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. While it remains somewhat controversial in the psychiatric community, PANDAS is characterized by the sudden onset (24-48 hours) of OCD symptoms in children, which are associated with certain types of strep infections.  The psychotherapy that is used for PANDAS is the same as other forms of OCD- exposure and response prevention.

Body Dysmorphic Disorder

BDD, or Body Dysmorphic Disorder, describes an excessive and harmful anxiety regarding aspects of one’s appearance. Unhelpful behaviors range from excessive mirror checking to, in some cases, seeking out repeated cosmetic surgeries. Exposure and response prevention combined with Acceptance and Commitment Therapy (ACT) are evidence based treatments for BDD.


Tic Disorders, including Tourette’s Syndrome, involve sudden, repetitive, and involuntary movements or vocalizations.   CBIT is the primary evidence based treatment for tics.


Trichotillomania describes repetitive and highly habitual hair pulling. In many cases this leads to bald spots.

Excoriation Disorder / Dermatillomania

Excoriation Disorder/ Dermatillomania is repetitive and habitual skin picking, often leading to bleeding and scarring in the affected area.  Both Trichotillomania and Dermatillomania are treated with HRT, or Habit Reversal Training, as well as ACT.


OCPD (Obsessive Compulsive Personality Disorder) is similar to OCD in that it involves pervasive patterns of rigidity and unhelpful perfectionism. They are different in that people  with OCD find their thoughts intrusive and unwanted, whereas those with OCPD tend to view their high standards as appropriate. Nonetheless, people with OCPD often seek help when they begin to find their high standards are resulting in interpersonal conflict, overworking, procrastination, or chronic sense of failure.