COGNITIVE BEHAVIORAL THERAPY (CBT)

For Obsessive-Compulsive Disorder (OCD) and related disorders

IN CALIFORNIA & NEW YORK

Yellow puffball flowers

Helping you break free from OCD so you can redirect your energy to what matters most.

DOES THIS SOUND FAMILIAR?

You want to make sure that things go well for yourself and those you care about. You try to make the best possible decisions. You go to great lengths to avoid negative consequences. You may have even accomplished a great deal because of these traits. But you have paid a steep price in the form of recurring unwanted thoughts, images, doubts, or impulses. They intrude on your awareness and take your attention away from the people you care about and the things you would rather be doing. They leave you feeling anxious, exhausted, and ashamed.

Intrusive thoughts, images, and impulses are called obsessions. They may fall into different categories. Some people are concerned about becoming contaminated by germs, chemicals, or dirt. Others struggle with doubts and uncertainty and have difficulty making decisions. Some feel anxious if things are not symmetrical or organized in a certain way. Others fear "unlucky" numbers, objects, or themes. Some are terrified by thoughts of losing control and harming themselves or others. Some feel embarrassed by thoughts of doing something inappropriate in public. Others are disturbed by unpleasant thoughts or images related to morality, sexuality, or religion. People may also obsess about their appearance or health or any other topic and worry if their obsessions will ever stop.

If you are like most people dealing with obsessions, you may try to avoid situations, objects, and thoughts that make you anxious. You do this to feel better and prevent anything bad from happening. Whenever you can’t avoid or escape, you feel the need to perform specific actions or think special thoughts to reduce your distress. These rituals are called compulsions. Common compulsions include excessive cleaning, checking and re-checking, counting, organizing, adhering to strict routines, repeating specific words or actions, striving for perfection, and seeking a lot of reassurance from others. Some people have mental compulsions, like thinking special thoughts to counteract negative ones. Unfortunately, giving in to compulsions only gives temporary relief and continues the obsessive-compulsive disorder (OCD) cycle. Over the long term, OCD steals your time and energy from the people and things you genuinely care about.

With Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and Mindful Self-Compassion (MSC), I’ll teach you how to break the OCD cycle. I can also help with OCD-related disorders such as orthorexia, body dysmorphic disorder (BDD), and body-focused repetitive behaviors (BFRBs), including skin picking (excoriation/dermatillomania) and hair pulling (trichotillomania).

Dr. Regina Lazarovich sitting on a white wicker bench

MEET YOUR THERAPIST

Hi, I’m Dr. Regina Lazarovich, PhD

Clinical Psychologist specializing in OCD, BDD, & BFRBs in CA & NY

I can help you pursue your goals, maintain your relationships, and be more present in your life.

To disrupt the OCD cycle, I use Exposure and Response Prevention (ERP), a specialized form of Cognitive Behavioral Therapy (CBT). ERP has more scientific evidence behind it than any other treatment for OCD. For this reason, ERP is the “gold standard” treatment for OCD. In our work together, I'll help you take small, manageable steps to face your fears. I will also teach you response prevention strategies so you can resist your compulsions. This will help you reduce your fear and reclaim your life from OCD.

In addition to ERP, I incorporate several mindfulness-based approaches.

With Acceptance and Commitment Therapy (ACT), you will learn to step back from your automatic thoughts and impulses. In turn, you will gain the freedom to align your actions with your authentic values instead of OCD’s demands.

With Mindful Self-Compassion (MSC), you will learn to be kinder and more compassionate to yourself, even when things don't go according to plan. In turn, you will become more resilient and comfortable with uncertainty.

I can also help with anxiety, phobias, panic attacks, disordered eating and negative body image.

How It Works

STEP ONE

Click Request an Appointment and let me know what you're struggling with. We begin with a free 20-minute consultation to determine whether we're a good fit to work together.

STEP TWO

If we’re a good fit, we’ll schedule an intake session. The initial 50-minute session will focus on getting to know you and gathering information. We'll set goals based on your values and priorities. I'll create a treatment plan to help you reach them.

STEP THREE

We'll meet weekly for 50-minute sessions. While this frequency allows us to build momentum, we can discuss the session frequency that best suits your needs. Together, we will work on helping you feel better and more engaged in what matters most to you.

Common Questions About OCD and Related Disorders

  • According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms of obsessive-compulsive disorder (OCD) include:

    • The presence of obsessions, compulsions, or both.

      • Obsessions are defined as recurrent, persistent, and intrusive thoughts, images, or urges that cause high anxiety or distress. Obsessions are accompanied by attempts to ignore or suppress the distressing thoughts, images, or urges or to neutralize them with another thought or action (i.e., performing a compulsion).

      • Compulsions are defined as repetitive behaviors or mental acts that one feels driven to perform in response to an obsession or in accordance with rigid rules. While compulsions are aimed at preventing or reducing anxiety or distress or preventing a dreaded outcome, they are excessive in nature and usually not connected in a realistic way with what they are designed to prevent.

    • The obsessions or compulsions are time consuming and disrupt important areas of life such as relationships or career.

    • The obsessions or compulsions cannot be attributed to a medication, drug, medical condition or another mental health condition.

  • OCD is biopsychosocial in nature. It is caused by the interaction of learning and biology.

    • Biology: research suggests that a biological vulnerability to OCD must exist for someone to develop OCD. According to the serotonergic theory, while OCD sufferers have enough serotonin, it is not as available as it needs to be for certain brain communications to take place. As a result, people with OCD may have a lower threshold for feeling anxious in response to uncertainty and don’t experience the feeling of completion after completing an action as easily as non-sufferers.

    • Learning: The specific ways in which obsessions and compulsions manifest for each person with OCD are a result of a complex mix of their cultural background, personal history, environment, and state of mind at the onset of OCD symptoms. Due to this learned component of OCD, the symptoms can look very different from person to person.

  • While the specific content of obsessions and compulsions differs among OCD sufferers, there are some common ways that OCD can show up:

    • Cleaning (contamination obsessions and cleaning compulsions)

    • Symmetry (symmetry obsessions and repeating, ordering, and counting compulsions)

    • Forbidden or taboo thoughts (sexual, aggressive, or religious obsessions and related compulsions)

    • Harm (fears of harm to oneself or others and related checking compulsions)

  • According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms of body dysmorphic disorder (BDD) include:

    • Feeling preoccupied with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.

    • At some point during the course of BDD one had to have engaged in repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing one's own appearance to those of others) in response to the appearance concerns.

    • The preoccupation with appearance disrupts important areas of life such as relationships or career.

    • The preoccupation cannot be attributed to a medication, drug, medical condition or another mental health condition.Cleaning (contamination obsessions and cleaning compulsions)

  • While orthorexia is not included in the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is increasingly being recognised by mental health professionals. Orthorexia is defined as an obsession with healthy or clean eating. Common signs and symptoms of orthorexia include:

    • Excessive worry about the healthfulness, cleanliness, or purity of different foods and ingredients.

    • Avoidance of foods perceived to be unhealthy, harmful, or impure.

    • Compulsive checking of ingredient lists and nutritional labels.

    • Cutting out an increasing number of food groups (all sugar, all carbs, all dairy, etc…).

    • Spending hours per day thinking about what food might be served at upcoming events.

    • Experiencing a lot of distress when "safe" or "healthy" foods are not available.

    • Obsessive following of food and “healthy lifestyle” blogs on social media.

    • Paying a lot of attention to what others are eating.

    • Body image concerns may or may not be present.

  • While anxiety disorders and obsessive-compulsive disorder (OCD) can have symptoms in common, such as recurrent thoughts, avoidance behaviors, and reassurance-seeking behaviors, there are some key differences between them as well.

    • Generalized anxiety disorder (GAD) vs. OCD: the recurrent worry thoughts present in GAD are typically focused on real-life concerns, whereas OCD obsessions can sometimes include seemingly magical content. Furthermore, compulsions are often present in OCD but not in GAD.

    • Social anxiety disorder (social phobia) vs. OCD: In OCD, obsessions and compulsions are present in several domains. In social anxiety disorder, the feared objects or situations are limited to social interactions, as are the avoidance and reassurance-seeking behaviors.

    • Specific phobia vs. OCD: Like OCD, phobias include a fear reaction to a particular object or situation. Unlike OCD, people with specific phobias do not engage in rituals.

Have more questions? Read my General FAQ here.