On Monday March 13, 2017, Allen Weg, Ed.D. presented at the quarterly meeting of OCDNJ. Dr. Weg is a New Jersey Licensed Psychologist. He is Founder and Director of Stress and Anxiety Services of New Jersey, an independent multi-clinician practice with offices in East Brunswick and Springfield, specializing in cognitive behavioral treatment of OCD spectrum disorders, PTSD, and anxiety disorders in children, adolescents, and adults. Dr. Weg is also co-founder and President on the Board of Directors of OCDNJ and is on the Clinical and Scientific Advisory Board of the IOCDF. He has received certifications for the treatment of compulsive hair pulling and skin picking from The Professional Training Institute (PTI) of The Trichotillomania Learning Center (TLC) Foundation, and for the treatment of OCD from the IOCDF's Behavioral Therapy Training Institute (BTTI).
Dr. Weg began by explaining tonight's talk is about facing the fears, exposure and response prevention (ERP) therapy, and "not doing what the OCD tells you to do." ERP treatment is a "hard sell" because it is "counterintuitive and not what you expect."
A paradox is "off centered and confusion," with something being true and not true at the same time. Paradoxical intention is the deliberate practice of a habit or thought which is undertaken to identify and remove it. A counterintuitive proposition is one that does not seem likely to be true when assessed using intuition. For example, to get one's finger free from a finger trap toy, one has to push them together to get out of it.
Dr. Weg provided the audience with several stories that he uses in therapy to illustrate the terms above. The bee trap story shows how the bee has to "fly into the darkness" and move toward the thing you want to get away from in order to be free. Another paradox is the harder you try to fall asleep, the harder it is to fall asleep.
ERP is likewise paradoxical and counterintuitive, and understanding this is the key to recovery for OCD. For instance, when is it ok to leave someone's house that feels contaminated? Dr. Weg explained that "as long as you feel like you need to leave, you need to stay. As soon as you feel like you can stay, then you can leave."
This is important not only behaviorally, but also mentally (e.g., "I need to think on purpose that something bad is going to happen because I didn't engage in a ritual.") For instance, after one does not go back to check if he/she hit someone with the car, he/ she should purposely think, "I did hit someone. I'll be jailed and humiliated forever." Dr. Weg discussed anthropomorphizing the OCD to personify it as a living, breathing entity. OCD is the bully that lives only to control you, and it's helpful to use the anger of how OCD "manipulates and robs you of your life" against it in treatment. Paradoxically, a person with anxiety will gain control by letting go of the need to be in control. It is important to embrace the uncertainty.
Dr. Weg concluded the talk with the following encouragement: 1) In the war against OCD, surrender in order to win. 2) Embrace the anxiety. 3) If you want to think about it less, think about it more. 4) Do on purpose what you are afraid to do by accident. 5) Prescribe the symptom. 6) Fly into the darkness.
DVDs of this presentation are available through the OCDNJ website.
Dr. Rachel Strohl is a licensed psychologist at Stress and Anxiety Services of NJ in East Brunswick. She is on the Board of Directors at OCD New Jersey. She may be reached at 732-390-6694.