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Dogs love to lick. There are ways to curb this undesirable behavior.
OCD says that a person has to avoid things that cause obsessions and do compulsions to prevent bad things from happening.
Why does my dog always lick me?
By facing obsessive fears and not doing rituals, the person stops fearing the triggers and learns that the rituals are part of the problem rather than the solution. The most powerful learning in ERP comes when the person faces the scariest OCD triggers: Nothing rewires the brain like facing our worst fears.
Sometimes in OCD treatment a person naturally will want to stop short of the most difficult exposures. The problem with not tackling the toughest items on the person's exposure "hierarchy" is that it makes relapse more likely. By way of analogy, imagine if a person had a dog phobia. In the same way, ERP is most effective when the therapist encourages the person to confront her fears as directly as possible. Hopefully you're thinking, "But that's disgusting! Nobody wants to eat from a toilet!
Why does my dog lick me?
At the same time, it's probably cleaner than eating off your desk at work. In fact, it's not actually worse than things we do all the time without thinking about it, like touching a dirty door knob between washing our hands and eating.
The truth is, we often have to take extreme measures to combat serious conditions. I should note that exposures are not deed to be extreme for the sake of being extreme.
There seems to be a bit of a trend toward a "more extreme is better" approach in OCD exposure. The point is to maximize recovery.
Yes, licking a toilet seat would be more extreme than eating food from a napkin on the seat, just like sticking your head in a dog's mouth goes beyond petting the dog; the question is whether being more extreme is necessary. For most people with OCD, stopping shy of toilet licking is still plenty to conquer the fear. Exposures at the top of the hierarchy are probably going to trigger a lot of anxietyand may lead the person to want to avoid the exposure.
The therapist has a crucial role to play in these moments. The challenge is to be compassionate without being indulgent.
Why does my dog lick me?
Compassion says, "Yes, this is a really hard one--of course there's a part of you that doesn't want to do it. You're strong enough. Here's a chance to really stick it to OCD. Therapists make a mistake to do one of these approaches without the other.
Being angrily insistent doesn't tend to be helpful, nor does throwing in the towel too quickly. When the desire to avoid is strong, that's when we know the OCD is threatened. Thus the difficulty in doing the exposure can be highlighted as a of how important it is.
If the person truly isn't willing to do the exposure, the therapist should work with the person to find a suitable substitute, with the goal of working up to the top exposure. Some days the steps forward will be small and sometimes they'll be big--the most important thing is that the person is moving forward.
My next entry in this series will address the different kinds of exposures used in ERP therapy. Seth J. Gillihan, Ph. Gillihan Ph. Think, Act, Be. Posted January 22, Share. OCD Essential Re. About the Author.
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