OC Spectrum Disorders

     The Obsessive Compulsive Spectrum Disorders are a cluster of disorders that are similar to OCD in terms of either their symptom profile, or their treatment, or both. The spectrum disorders that respond well to Cognitive Behavior Therapy are  Body Dysmorphic Disorder, Trichotillomania and Skin Picking.




Body Dysmorphic Disorder

     The person with Body Dysmorphic Disorder has a painful preoccupation with a perceived defect in their appearance. This preoccupation and the stress associated with it becomes so extreme that it causes significant impairment in functioning. Obviously it can affect social and work functioning, but it may also affect a person's focus and concentration and other important areas of functioning. The person with Body Dysmorphic Disorder is very certain that they are hideous and deformed and that everyone can see their ugliness. As a result this person will spend an inordinate amount of time checking their apparent deformity in the mirror (or the opposite, they may go to extreme lengths to avoid mirrors and reflective surfaces). They may spend large sums of money on lotions and potions to hide or disguise the perceived deformity. They may even resort to cosmetic surgeries to correct the deformity.


     The treatment of Body Dysmorphic Disorder (BDD) involves helping the person come to terms  with their apparent deformity. Rather than engaging in lengthy, unhelpful discussions on whether or not the deformity is real, treatment will focus on helping this person to better appreciate how much their BDD has impacted their life and prevented them from achieving the things that are most important to them. Therapy will help the person with BDD to gradually start engaging in activities that they have commonly avoided because they felt too self conscious. They also  learn to resist the behaviors that only serve to reinforce their conviction that they have a deformity, such as excessive mirror checking or  doctor shopping. Over time, the person with BDD will learn how to participate more fully in their life despite the apparent deformity until such time that they find themsleves not so consumed by thoughts about their deformity.


If you are interested in an initial evaluation

feel free to call 310 285 2280 or send an e-mail.


     Trichotillomania occurs when a person pulls out their hair, strand by strand, resulting in noticeable hair loss. Common sites for hair pulling are the scalp, eyebrows and eyelashes, but any region of the body where hair grows may also be a target for hair pulling, such as legs, under arms and pubic areas.

Once a hair is pulled, it is not uncommon that the person with trichotillomania will then inspect the hair, or feel it by running it through their fingers, even chew it or eat it. 

     The act of hair pulling typically occurs under  2 conditions. The first is when a person pulls their hair in response to a negative event or emotion. This is called focussed pulling. The second condition is known as automatic pulling, and occurs outside of a person's awareness. Most people with trichotillomania will experience both types of pulling. A feeling of relief or gratification is experienced upon pulling the hair.

The noticeable bald patches that result from extensive pulling will frequently lead to the person trying to hide the affected the area. Or they may avoid social situations out of shame or embarrasement.

     Treatment of Trichotillomania involves several types of Cognitive Behavior Therapy known as Habit Reversal and Stimulus Control. Habit Reversal involves first becoming aware of the urge to pull, and then implementing a behavior that competes with the act of pulling - a competing response. Stimulus Control refers to behaviors that make pulling more difficult.The person with Trichotillomania tries to identify other, healthier ways of relieving the tension they experience prior to pulling their hair. Ultimately, the person with trichotillomania will be able to tolerate the negative emotions that serve to trigger the urge to pull. They begin to see these emotions and urges as less threatening and less demanding. 


If you are interested in an initial evaluation

feel free to call;

Karron at 310 285 2280 or send an e-mail