It's Never Going To Be Perfect, So Just Get It Done

There’s nothing wrong with wanting to do well. We all want the proverbial ‘A’. But some of us struggle to know when to stop. That elusive ’point of diminishing returns’ can be hard to spot and many of us don’t see the line until we’ve crossed it. We’re generally better served by compromising on the unrealistic goal of perfection and instead, allowing ourselves to spread our efforts around to other, more useful tasks.

I have four young kids and place a lot of value in being a good dad. However, if I wanted to be a ‘perfect’ dad, I’d need to do a whole lot more. I’d need to spend every waking moment with them. I’d need to create fun crafts and cook wholesome, homemade meals. I’d stay up each night writing sweet songs to them. I could do all of this… but I’d be an awful husband, friend, and therapist. I’d have to quit my job. I couldn’t have any hobbies or get any exercise. Even though being a good dad is really important to me, I have to compromise. There are other things that are also important to me. And let’s be honest, I’m a better dad because I nourish these other parts of my life. We cannot give 100% to any one facet of our lives; that’s not how this works! We have 100% to give and we have to choose how to spread it around. If we truly want to optimize how we spend our time, we can prioritize by spending it in ways that are consistent with our values… all of them!

Graduate School Can Have Terrible Effects on People's Mental Health

In a surprise to no one, a recent study found that graduate students are disproportionately affected by mental health problems. Harvard researchers have found increased risk of anxiety, depression, and suicidal ideation among graduate students. Academic pressure, mounting student debt, insufficient stipends, and dodgy job prospects all likely contribute. This article from The Atlantic sums up the findings.

Fighting mental health stigma with...ESPN?

There are many ways to whittle away at mental health stigma.  By and large, our culture seems to be moving in a positive direction, but sometimes it can feel like it's happening at a glacial pace.  ESPN took a big step this week, as it has released a five-part series of articles, written by Jackie MacMullan, highlighting mental health within the NBA. She's discussed OCD, depression, anxiety, PTSD, ADHD, medication, and even looked at the intersection of race and mental health.  And not only that, but she's named names - big names.  Stars like Paul Pierce, Chris Bosh, Kevin Love, Shane Larkin, Channing Frye, and Jalen Rose. She talked to coaches (Brad Stevens, Doc Rivers) GMs (Danny Ainge), and owners (Jeanie Buss).  It is so incredibly important to talk about these issues.  As long as mental health remains taboo, stigma will follow.  But when we see these larger-than-life athletes talk openly about their struggles, it goes a long way in breaking down that stigma.  

IOCDF 2018

A mural brought to the conference by the Peace of Mind Foundation

A mural brought to the conference by the Peace of Mind Foundation

Another year, another amazing IOCDF conference!  I am so thankful for this wonderful organization and everything that it provides.  Every year I emerge from the conference reminded of just how brave and supportive this community can be.  I am reminded of the importance of educating therapists and getting life-saving treatment to sufferers quickly.  I am also reminded of just how meaningful it can be for individuals with OCD to connect with peers who also have OCD.  So many people suffer in silence, without ever having the experience of connecting with someone else who knows what it's like to be in their shoes.  I can give you a PowerPoint or lecture about OCD for hours, I can tell you about a time when I was scared or anxious; but that is not the same as connecting with another person who truly knows the struggle that is OCD.  

See you in Austin 2019!

Why Your Brain Tricks You Into Doing Less Important Tasks

Cognitive distortions can play a big role in anxiety, as these skewed perceptions lead us towards inaccurate beliefs about the world and its risks.  There is no shortage of ways in which our brains trick us into acting against our own interest.  As noted in this article in today's New York Times, these cognitive biases can lead us towards making decisions that do not align with our values or priorities.  The "urgency effect" leads us towards tasks that are easily completable, without regard for their usefulness or importance.  The rubric above is a great way to help us to make choices which truly reflect our values and prioritize our goals effectively.  

OCD Conference 2018

Click the image above for the conference webpage.

Click the image above for the conference webpage.

The annual International OCD Foundation Conference will be taking place in Washington D.C. the weekend of July 27-29, 2018.  This is an amazing conference and, with the conference set to take place in Austin, TX and Seattle, WA in 2019 and 2020, this is a great opportunity to attend the conference while it's within driving distance of North Carolina.

As I've done for the past several years, I'm excited to be facilitating a support group for parents of adult children with OCD.  It will take place on Thursday, June 28, 2018 at 6:30pm.

Caution: Falling Thoughts!


When it comes to anxiety, many of us are guilty of treating our thoughts like they are real and dangerous.  We become fused with them and take their warnings at face value.  It's easy to forget that anxiety is not a confirmation of danger, but rather, a warning sign that there might be danger.  Unfortunately, our brain gets this wrong all of the time. It means well.  It's trying to protect us.  But in doing so, it often overestimates risk.  It sets off that warning sign - anxiety - even when there is minimal risk.

I often think about those 'Falling Rock' signs that we've all seen on the highway.  We all notice them and acknowledge them... and then blow right by them.  We understand that it's possible that a rock may fall on us, but we keep going, because we know that the sign itself is not dangerous.  It's just a warning.  If ever we encounter a giant boulder on the road, well, that will be a good time to stop.  This is how we should be treating our thoughts - we can notice them and even acknowledge them, but we should not mistake them for danger.  Our thoughts are the sign, not the boulder.  These kinds of thoughts are just warnings - often misguided or overzealous warnings - that do not require action.  We can choose to blow right by them and keep going.   

1 Million Steps 4 OCD Walk

The annual 1 Million Steps 4 OCD Walk will be taking place the first and second week of June 2018.  OCD North Carolina is organizing four separate walks - Durham, Greensboro, Asheville, and Wilmington.  Registration opens today!  If you raise $25, you'll receive a free walk t-shirt!  The Durham walk will be taking place on Saturday, June 9, 2018.  Check out the links below to register for your nearest walk location:

Asheville Walk

Durham Walk

Greensboro Walk

Wilmington Walk



Admit It: You're a Badass!


Fear is a useful emotion.  It keeps us safe and prepares us to take action when we're in danger.  Fear has been an integral part of our survival as a species - we all feel it.  We generally start to label fear as 'anxiety' when it is disproportionate to actual risk; when our brains activate our 'fear system' without the presence of an actual threat.  Every individual is different - we all have unique cues and triggers which set off this system, but make no mistake: we all have it and we all feel it, regardless of the actual presence or absence of a threat.

Most of us have the luxury of being able to avoid our fears.  If I have a fear of sharks, for instance, I can live a full and meaningful life without ever having to confront that fear.  Provided I didn't have any ambitions of being a sailor or professional surfer, I can probably live my day-to-day life without ever seeing any repercussions of my shark fear.  

Individuals with OCD do not have this luxury.  Obsessions are pervasive and all-encompassing.  For someone with OCD, living a life in which you avoid your fears would be incredibly limiting and even debilitating.  These individuals have no choice but to confront their fears.  

Sometimes individuals with OCD can feel shame about their exposures. The thought of "I should be able to do this" can be hard to shake.  I recently worked with an individual who needed to perform counting rituals when tying her shoes - the prospect of resisting these rituals was daunting and she felt a great deal of embarrassment that this simple task was so difficult for her.  I reminded her that her brain does not discriminate between rational and irrational fear when it sets off her fear system.  Fear is fear, whether rational or irrational.  It's the same internal experience; the same system activated by your brain.  If we saw someone with a shark phobia decide to confront their fears and get into a shark cage, we'd say "Wow!  That's incredible!", and yet, with OCD, we often forget these experiences are the same.  Resisting counting rituals while tying your shoes can evoke the same internal experience as someone face-to-face with a shark.  It's important that we acknowledge just how badass exposure therapy is.  ERP is not a therapy for the weak or timid; it's for courageous individuals who choose to confront their fears.  While most people are coasting through life without ever having to confront their greatest fears, individuals with OCD are facing these challenges head-on, every day.  That's badass.    

Olympic Thought Suppression

The Haunting of Lindsey Jacobellis, published in today's New York Times, touches on a principle instantly familiar to anyone who has struggled with obsessive bad thoughts: thought suppression does not work.  Lindsey Jacobellis, an Olympic snow boarder most noted for a blunder which cost her a gold medal in 2006, has finally adopted a new approach to unwanted thoughts - accept them.  Rather than trying to escape the constant reminders of past performance mistakes, she makes room for the thoughts and embraces the fear that comes with them.  Believe it or not, this approach is an outlier for many performance coaches, who often encourage athletes to focus on good thoughts, rather than acknowledging the bad.  

OCD Family Support Group Schedule

The remaining 2018 schedule for the OCD Family Support Group is listed below.  The group takes place in my office on the first Monday of each month at 6:30pm.  In September, the first Monday of the month is Labor Day, so the group will take place on the second Monday for that month only.  The dates are below:

March 5, 2018

April 2, 2018

May 7, 2018

June 4, 2018

July 2, 2018

August 6, 2018

September 10, 2018

October 1, 2018

November 5, 2018

December 3, 2018

Why Are More Teenagers Than Ever Suffering From Severe Anxiety?

This New York Times article discusses the increasing prevalence of anxiety disorders, particularly among adolescents and young adults.  It paints a vivid picture of how debilitating these illnesses can be and of what good therapy can look like.  It also offers some speculation about what may be driving this increased prevalence, addressing concerns such as technology, perfectionism, and "trigger-warnings".

Post-Partum OCD

"Maternal Instinct, or O.C.D?"  by Kelly Kautz in The New York Times

"Maternal Instinct, or O.C.D?" by Kelly Kautz in The New York Times

Thankfully, we've seen many advances in awareness and screening for Post-Partum Depression.  The "baby blues" are widely recognized and every new mom gets a screening upon leaving the hospital and at subsequent follow-ups.  Unfortunately, Post-Partum OCD is still relatively misunderstood.  This article from the New York Times does its part to dispel some of the taboo around this really common problem.

Post-Partum OCD is something near and dear to my heart.  As the father of three young children, it feels like it's been years since there wasn't a baby in my home.  OCD can be masterful at sniffing out points of leverage; it wants to find things that are important and meaningful, so that it can twist that significance into a rationale to do compulsions.  And what better leverage than a sweet, innocent, helpless little new-born baby?  What could be more horrific than some harm coming to that adorable cherub?  

It should come as no surprise that just about every new parent has thoughts of harm regarding their new-born.  For those with OCD, these intrusive thoughts can grow into obsession, transforming that precious infancy into a nightmare of unwanted thoughts and worries.  Sadly, many people do not recognize these thoughts as OCD.  Rightfully so, there is a certain taboo when it comes to hurting babies.  Many people are ashamed or embarrassed to have had these thoughts; they hide them and bury them so that no one ever finds out.  It is incredibly important to bring attention to this subset of OCD, as the stigma and lack of awareness take such a toll on parents and prevent many people from seeking the care that they need.