• OCD • ANXIETY • TICS • PTSD • SPECIALIZED VIRTUAL TREATMENT
Obsessive-Compulsive & Related Disorders
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
Obsessions that are intrusive, unwanted thoughts/images/urges. There are attempts to achieve perfect thoughts/behaviors to prevent harm, wrongdoing, or discomfort with unhelpful coping (compulsions, avoidances), only for perpetual doubt or discomfort to return. Sudden onset can also occur for adults around the arrival of a baby or for c
Obsessions that are intrusive, unwanted thoughts/images/urges. There are attempts to achieve perfect thoughts/behaviors to prevent harm, wrongdoing, or discomfort with unhelpful coping (compulsions, avoidances), only for perpetual doubt or discomfort to return. Sudden onset can also occur for adults around the arrival of a baby or for children upon infection by an autoimmune condition (PANDAS/PANS). Common themes: harm, sex, sexuality, contamination, religious or moral scrupulosity, exactness/just right feeling, and health.
Body Dysmorphic Disorder
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder
Distressing thoughts about a particular aspect of one's appearance, and responding to them with mental or behavioral compulsions or mental and behavioral avoidances. Common beliefs surround: flaws, color, size, and symmetry. Common bodily areas: face, skin, hair, and build.
Olfactory Reference Syndrome
Obsessive-Compulsive Disorder
Olfactory Reference Syndrome
A persistent belief that one is emitting an offensive odor. Some actually perceive an odor. The person does not have an odor. Believed odors may include natural, body scents, food scents, etc. This condition often manifests as OCD or BDD. Cognitive distortions are made when interpreting others‘ expressions and behaviors as a reaction to t
A persistent belief that one is emitting an offensive odor. Some actually perceive an odor. The person does not have an odor. Believed odors may include natural, body scents, food scents, etc. This condition often manifests as OCD or BDD. Cognitive distortions are made when interpreting others‘ expressions and behaviors as a reaction to the odor. The individual typically engages in avoidant behaviors (e.g. not going out of the house) or compulsions (e.g. cleansing, checking/smelling, reassurance seeking and medical interventions).
Phobias
Agoraphobia
Specific Phobias
Specific Phobias
Excessive fear of not being able to escape particular situations (e.g. public transportation, open spaces, enclosed spaces, crowds, or being home alone). Avoidance or significant distress are the primary responses.
Specific Phobias
Specific Phobias
Specific Phobias
An excessive and persistent fear that causes an individual to have significant anxiety or to engage in avoidance when thinking about or confronted with the feared object. Common themes: animals, nature and environment, blood-injection-injury, specific situations, etc.
Emetophobia
Specific Phobias
Emetophobia
An excessive and persistent fear that causes an individual to have significant anxiety or to engage in avoidance when thinking about or confronted with vomiting. This may manifest in rules around food and eating and/or avoiding people, places, things, events, and experiences where one might be susceptible to nausea or vomiting.
Anxiety Disorders
Social Anxiety Disorder
Separation Anxiety Disorder
Illness Anxiety Disorder
Excessive and persistent fear of being evaluated or judged during a social interaction (one-to-one or group) and being humiliated. This causes an individual to have significant anxiety or to engage in avoidance. Common themes: conversations over the phone or in person, initiating conversation, engaging in "small talk," public speaking, and performance situations.
Illness Anxiety Disorder
Separation Anxiety Disorder
Illness Anxiety Disorder
Preoccupation with becoming ill or being ill despite lack of or mild symptomatology; if one does have an illness, the associated stress is excessive. Responses often include hypervigilance, self-monitoring, and avoidance.
Separation Anxiety Disorder
Separation Anxiety Disorder
Separation Anxiety Disorder
Extraordinary distress at the idea or experience of being separated from an attachment figure for fear of something bad happening to them. This occurs in children and adults. Symptoms may also entail a fear of being alone, sleeping separate, and/or physical complaints.
Tic & Tourette's Disorders
Tic & Tourette's Disorders
The conditions in this category vary in severity and length of time; however as a whole, entail a single or multiple motor or vocal tics. The tics are sudden and recurrent movements or vocalizations. Common motor tics: eyes, neck, shoulders, extremities, and obscene gestures. Common vocal tics; abrupt sounds and obscenities.
Comorbid Symptoms Requiring Additional Support or Referral
OCPD
Dr. Curiel does not treat Obsessive-Compulsive Personality Disorder (see slide show on the Home page regarding OCD v. OCPD), but can provide a specific referral for you. The latest treatment for OCPD is Radically-Open DBT (RO-DBT) which addresses over-control by working towards increasing flexibility.
ERP is the gold-standard treatment for OCD and should always be the primary intervention; however, if an individual struggled to complete ERP due to rigidity then RO-DBT could be a helpful intervention to improve flexibility and then return for ERP.
Active Self-Harm (Internally-Directed Emotion Dysregulation)
If an individual is currently engaging in a form of self-harm (e.g. hitting, biting, cutting, burning), their safety takes precedent; this needs to be addressed prior to exposure therapy. The best treatment for this type of coping (under-control) is Dialectical Behavior Therapy (DBT). Dr. Curiel recommends inquiring with a DBT specialist, particularly about the distress tolerance and emotion regulation modules. A specific referral can be provided for you. If it is found that a person is self-harming during treatment, a referral will be made for DBT as the primary treatment (pausing ERP).
Escalated Anger (Externally-Directed Emotion Dysregulation)
If an individual has significant difficulty managing uncomfortable emotions when upset (e.g. hurt, sad, angry) resulting in lashing out at others, throwing fits, destroying property, slamming doors, etc.; this will need to be addressed before exposure therapy. Interpersonal interactions are often intense, misperceived, and entail poor communication. The best treatment for this intensity of emotional expression (under-control) is Dialectical Behavior Therapy (DBT). Dr. Curiel recommends inquiring with a DBT specialist, particularly about the distress tolerance, emotion regulation, and interpersonal effectiveness modules. A specific referral can be provided for you. Because these cognitions, emotions, and behaviors can be treatment interfering (in-office & at home), a referral will be made for DBT as the primary treatment (pausing ERP).