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Trouble Getting Started

8/25/2021

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Research by Edna Foa PhD

​“If you find yourself hesitating or balking, think of me saying to you:

“I’m sorry to see that you’re having trouble deciding to do this. I’ll support you as much as I can during the exposure if you become upset by doing it.”
 
“Remember that this is the next step we agreed on, and I will be doing you a disservice to reinforce your tendency to avoid. If you really don’t feel you can do it at this very moment, we will stop for now and resume a little later in the session when you feel ready.
 
Rarely people actively try to conceal from the therapist ritual activity. Think of me saying this to you:
 
“I understand that you’ve been having difficulty not checking the front door several times before leaving the house. For the treatment to work well for you, it’s important to adhere to the ritual prevention component. If you’re having a hard time not doing the ritual, please make sure to let me know or your designated support person though, so we can help you overcome the urge to do a ritual.”
 
We are a team and we know how to win. We can overcome this best by working together.
 
“If you’re struggling to follow the rules on a regular basis, imagine me saying this to you: “It seems that right now you are unable to stop ritualization as agreed-upon at the outset. For the treatment to be effective, it’s essential that you do so during treatment. Every time you relieve your discomfort by ritualizing -by washing, checking , repeating, you prevent yourself from learning that anxiety would have declined eventually on its own without rituals and that you are able to tolerate the anxiety until it declinesand you don’t fall apart. Doing exposures to feared situations -without stopping the rituals -is not helpful.” 
 
How can we work together to help you follow the “no rituals “rule?
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    Don Boice
    Don Boice, LCSW-R, specializes in gender communication with couples in conflict.  

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