Glossary of Terms
J K L Q U W X Z
A
Accommodation - When others (family, coworkers, friends, etc.) help a person with OCD to ritualize (for example, by purchasing toilet paper and paper towels, by completing , or by waiting while s/he ritualizes, etc.). Accommodation, although usually well-intended, actually makes a person's OCD worse. Family members can be helped by a therapist to learn different ways of being supportive without helping an individual to ritualize.
Automatic Thoughts - Thoughts that "pop" into one's mind during a certain situation. These thoughts, although sometimes very simple, can represent attitudes or beliefs that fuel feelings. See also '.'
Avoidance Behavior - Any behavior that is done with the intention of avoiding a in order to avoid anxiety. Avoidance behaviors are treated as a .
B
Behavior Therapist - The therapist (or or ) who is in charge of one's treatment plan for OCD using behavior therapy, most often .
Behavior Therapy - A type of therapy that applies learning theory principles to current problem behaviors that one wishes to change. As the name implies, the point of intervention is at the behavioral level.
Body Dysmorphic Disorder (BDD) - about a body part being deformed in some way, resulting in repeated rituals involving checking, mirror checking, excessive grooming, inability to dress oneself, and . Sometimes individuals with BDD have plastic surgeries relating to their imagined defects, but the relief (if there is any) is short-lived, and soon the individual begins worrying again, or the focus of his/her BDD can change to a different body part.
C
Checking Compulsions - Repetitive checking behaviors in order to reduce the probability that someone will be harmed, or to reduce the probability that one might make a mistake. The checking can be behavioral (i.e. physically returning to a room to check if an appliance is turned off) or it can take the form of a mental ritual (i.e. a mental review in which a person imagines in detail each step he/she took to complete a task).
Competing Alternative Behaviors - When one is trying to stop a bad habit, one can engage in a competing alternative behavior, which is an activity that inhibits the ability of the person with OCD to engage in the habit that s/he is trying to break. For example, if one is knitting, one is unable to simultaneously pull one's hair. See also '.'
Compulsions - Compulsions, also known as , are repetitive behaviors or thoughts that conform to rigid rules as far as number, order, etc. that function as an attempt to reduce anxiety brought on by intrusive thoughts.
Contamination Compulsions - These are washing and cleaning behaviors in a particular order or frequency in an attempt to reduce chronic worry about being exposed to germs or becoming ill. This can also be done for , in which a person washes and cleans in order to reduce the chances of taking on the characteristics of another person.
Contamination Obsessions - Excessive worries about germs, bodily functions, and illness. The risk is overestimated, given the chances of actually getting sick.
D
Distraction - A strategy used primarily outside to enhance one's ability to resist . One does another activity (for example, playing a board game, watching TV, taking a walk, etc.) while triggered in order to cope with anxiety without ritualizing.
E
Emotional Contamination Obsessions - Worry that one will be contaminated by the characteristics of another person. The worrier believes that the risk of "catching" the other person's personality is much like when one is exposed to germs. The spread of the "emotional germs" can be through touching, or can even be airborne. This usually includes magical thinking and . For more on Emotional Contamination, click .
Exposure and Response Prevention (ERP) - The behavioral treatment of choice for OCD during which a person with OCD purposefully an and blocks his/her rituals in order to create . ERP is initially done with a behavioral coach, who assists the person with OCD to resist rituals. Eventually the coaching is faded, as the person with OCD becomes more able to resist rituals without help.
Extinction - The process by which is withheld in order to decrease or eliminate a target behavior. It is common to have an initially, which is an increase of the target behavior when the extinction process is started.
Extinction Burst - An initial increase in behavior (can be or ) when one first stops reinforcing a behavior. When you start a new and more difficult , you should not be surprised if initially you feel more ritualistic and the urge to ritualize feels stronger.
F
Fading the Prompt - Once a positive behavior is successfully initiated, the behavioral coach will stop giving the verbal or behavioral cue out loud, so the individual with OCD can practice the new behavior without help. See also '.'
Functional Analysis - The therapist and the individual with OCD study the behaviors and thoughts that occur before and after a target behavior occurs.
G
Generalization - The transfer of learning from one environment to another, or from one stimulus to a broader range of stimuli in the same category.
H
Habit Reversal Treatment - This is the behavioral treatment of choice for . In this treatment the patient becomes more aware of patterns of picking or pulling, identifies the behaviors that bring on the picking or pulling, and then works on developing to block the destructive habit. For instance, when feeling high levels of anxiety a hair puller can knit, which keeps both hands occupied and keeps the individual engaged in a relaxing activity when s/he is at a high risk to pull.
Habituation - The process during which a person stops responding to a stimulus because it is no longer new. For example, after jumping into a cold swimming pool, one might initially feel that the water is too cold; however, after splashing around for a few minutes, the water begins to feel warmer (even though the water temperature has not changed at all) because the swimmer has gotten used to the water temperature. An example of this in OCD would be when someone who worries about germs touches a doorknob without a barrier for at least 1.5 hours. As time passes without the person ritualizing, the person can no longer maintain an anxious response.
Harm Obsessions - Excessive worries that one will be harmed, or that others will be harmed, due to intentional or accidental behavior on the part of the person with OCD.
Hierarchy - A list of situations or triggers that are ranked in order from easier tasks to more difficult tasks according to the patient's estimated ratings. Consider the hierarchy as a map or outline of future .
Hoarding Compulsions - Saving unreasonable amounts of an item "in case someone else might need it," even though one no longer has space to keep belongings. Objects are saved even when they are a health hazard.
Hoarding Obsessions - Worry that one must save more than is necessary in order to feel secure. The hoarder is not as disturbed by his/her saving and accumulation patterns as those around him/her.
Hot Cognitions - that generate strong or intense affect.
I
Insight - For someone with OCD, this is the understanding (when not triggered by an ) that one's worry is not realistic, nor does the logic applied to the person's make any sense. Usually when one is triggered or experiencing high anxiety about an obsession, the level of insight decreases dramatically.
M
Mental Ritual - A mental act, done in response to an unwanted , that is completed in order to reduce anxiety. Often a mental ritual must be repeated multiple times. It can be a prayer, a repeated phrase, a review of steps taken, a , etc. Often a mental ritual is repeated so often that the individual barely has any awareness of the thought.
Mindfulness - A focus on the present. This is a skill that takes a considerable amount of practice.
N
Negative Reinforcement - When a is removed, the behavior increases. When a person's headache is eased after taking an aspirin, that experience will increase the likelihood that the person will take an aspirin the next time he has a headache.
Neutralization - Refers to when an individual with OCD "undoes" a behavior or thought that is believed to be "dangerous" by neutralizing it with another behavior or thought. This behavior is also considered a .
O
Obsessions - Obsessions are repetitive intrusive thoughts or images that dramatically increase anxiety. The obsessions are so unpleasant that the person with OCD tries to control or suppress the fear. The more the person attempts to suppress the fear, the more entrenched and ever-present it becomes.
Obsessive Compulsive Disorder (OCD) - People diagnosed with OCD spend over one hour daily struggling with repetitive intrusive thoughts, impulses and/or behavioral urges that increase their anxiety. They try to control their with compulsive behaviors () that function as an attempt to reduce their anxiety. Over time, the rituals become less and less effective in controlling the obsessions.
Overvalued Ideation - When the person with OCD has great difficulty understanding that his/her worry is senseless.
P
Perfectionism - Unrealistically high expectations about one's performance on any task. Failure is catastrophic and unbearable. Anything less than 100% perfection is considered a failure. Consequently, perfectionists are paralyzed and sometimes unable to begin a task until the last minute, or are sometimes unable to complete a task. For more on perfectionism, click .
Positive Reinforcement - An action or behavior is applied and the consequence is that the frequency of the behavior will increase. For example, when a teacher praises a student for raising his/her hand in class before speaking, the likelihood of the student's behavior of raising his/her hand before speaking will increase.
Praying Compulsions - This can include repetitive praying for forgiveness or asking God to protect a person perceived to be at risk, reading the Bible or watching religious TV programming for hours daily, and repeated confessing for possible sins.
Psychiatric Nurse - This mental health professional has a Bachelor's degree in nursing with a special emphasis on psychiatry and working with mentally ill populations.
Psychiatrist - This mental health professional has completed medical school and has specialized in psychiatry and mental illness. S/he can do therapy and prescribe medicine.
Psychologist - This mental health professional holds a doctorate in either clinical or counseling psychology. This individual can have a Ph.D., which is a research degree, or a Psy.D., which has a clinical focus.
Psychopharmacologist - This mental health professional prescribes psychiatric medicines and is an expert in how these medicines work together.
