Living with OCD: Tips and Strategies for Daily Management

If you follow the Washington Commanders, you might’ve seen kicker Zane Gonzalez’s game-winning playoff field goal last season in the wild card round—and maybe you noticed the routine that went viral afterward. The precise way he tapped his helmet, adjusted his socks, fixed his hair. Over and over, the same sequence, with each kick.

Some people joked about it. Others just chalked it up to athlete superstition. But Gonzalez later shared that his routine wasn’t about luck—it was part of how he manages life with OCD.

That story stayed with me. Because in therapy, I often hear the other side of that routine: the private, internal struggle that rituals like this can represent. For many people living with OCD, the urge to get something “just right” isn’t quirky or amusing—it’s intense, exhausting, and often invisible.

Whether your compulsions are physical or entirely in your head, whether you’ve had a diagnosis for years or are just beginning to wonder—this post is for you. You’re not alone in this, and there are ways to live with OCD that don’t require you to fight so hard every day.

Let’s talk about what it actually looks like—and what might help.

What Makes Daily Life with OCD So Challenging

OCD affects more than your thoughts. It impacts how you move through the world, how you make decisions, and how much energy it takes to get through your day. Some common experiences include:

• Time-consuming rituals: Whether it's handwashing, checking, repeating actions, or seeking reassurance, compulsions can eat up hours of your time.

• Mental exhaustion: The internal dialogue that OCD creates—What if I missed something? Should I check again? What does it mean that I thought that?—can be relentless.

• Fear of being misunderstood: Many people with OCD hide their compulsions out of shame or fear of judgment, especially when they involve taboo or intrusive thoughts.

• Invisible struggles: Mental compulsions like reviewing conversations, neutralizing thoughts, or counting in your head often go unnoticed by others—making it even harder to explain what you’re going through.

Tips and Strategies for Managing OCD Day-to-Day

There’s no quick fix for OCD, but there are daily practices that can reduce its grip over time. These strategies aren’t about eliminating thoughts—they’re about changing how you relate to them.

1. Structure Your Day Where You Can

OCD thrives on uncertainty and decision overload. Creating predictable routines can help reduce the cognitive load that fuels obsessions. Keep in mind this isn’t about rigidity—it’s about supporting your nervous system and reducing unnecessary stress.

2. Name It: “This Is an OCD Thought”

A key skill in managing OCD is learning to recognize your thoughts as part of the disorder. Labeling a thought as “an OCD thought” creates a bit of space—just enough to make a different choice. The goal isn’t to argue with the thought or prove it wrong, but to notice it and step back.

3. Practice Small Acts of Response Prevention

You don’t have to tackle your biggest compulsion first. Start with something small, like delaying a ritual by 30 seconds or resisting the urge to ask for reassurance once a day. These tiny moments build tolerance and gradually rewire your response to anxiety.

4. Watch Out for Mental Compulsions

Some compulsions happen in your head—like analyzing, mentally checking, or trying to “neutralize” a bad thought. These are just as much a part of OCD as external rituals, and recognizing them is key. When you catch yourself doing a mental compulsion, gently remind yourself that it’s part of the loop, and try returning to the present.

5. Be Kind to Yourself

Living with OCD is exhausting. Progress often isn’t linear. There will be days you feel strong and days when the compulsions win. That doesn’t mean you’ve failed. Practicing self-compassion can prevent the guilt spiral that OCD loves to hijack. A helpful phrase: “I’m working on this—and I don’t have to be perfect.”

6. Track Triggers and Patterns

Keeping a journal can help you spot patterns and identify high-anxiety situations. You might notice certain times of day, stressors, or environments that amplify compulsions. Awareness helps you prepare and respond more skillfully over time.

When to Seek Support

OCD can be deeply isolating—but it doesn’t have to be something you manage alone. If your symptoms are interfering with your daily functioning, relationships, or mental health, working with a therapist who understands OCD can be life-changing.

Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) remain the most well-supported, evidence-based treatments for OCD. They help retrain how you respond to obsessive thoughts by reducing avoidance and breaking the compulsion cycle.

Acceptance and Commitment Therapy (ACT) also plays an important role, especially in helping people move away from fighting thoughts and toward building a life rooted in values—even when anxiety is present. ACT emphasizes willingness and psychological flexibility over symptom control, which many clients find empowering.

Accelerated Experiential Dynamic Psychotherapy (AEDP) is not a first-line treatment for OCD, but it can be a powerful complement—especially for clients whose OCD symptoms are shaped by trauma, shame, or attachment wounds. AEDP helps people access and process emotions that may have been buried under fear, perfectionism, or the urge to control. When OCD is part of a larger emotional survival strategy, AEDP can create a safe space for that deeper healing to begin.

A therapist can help you:

• Build a personalized hierarchy for facing compulsions

• Develop a non-reactive stance toward intrusive thoughts

• Reconnect with emotional resilience through embodied, compassionate exploration

• Stay accountable when avoidance starts to creep back in

OCD is treatable. And therapy can help you not only reduce symptoms—but begin living with more clarity, flexibility, and self-trust.

Final Thoughts

Living with OCD requires resilience, patience, and self-compassion. It’s a daily practice of noticing when the old patterns show up—and choosing, again and again, not to feed them. Some days you’ll feel like you’re making real progress. Other days will feel stuck. That’s part of the process.

Learning to live with OCD isn’t easy—but it is possible. And you don’t have to do it perfectly to make real progress.

Learn more about how OCD therapy can help.

Beyond Sadness: Understanding Emotional Numbness in Depression

When people think of depression, they often picture overwhelming sadness, crying, or despair. And while that can be true, depression doesn’t always look or feel that way. In fact, for many people, the emotional landscape of depression is defined not by sadness—but by emptiness.

This often-missed experience is called emotional numbness. Rather than feeling low, some people with depression feel… nothing at all.

What Is Emotional Numbness?

Emotional numbness is a state where you feel disconnected from your feelings, your body, or the people around you. You might go through the motions of daily life without fully engaging. Things that once brought joy now feel flat. Conversations feel distant. Even pain may not register fully.

This kind of disconnection is one of the lesser-known depression symptoms, but it’s incredibly common—and incredibly isolating. You might find yourself thinking:

• “I should be upset, but I don’t feel anything.”

• “It’s like I’m watching life happen from behind a wall.”

• “I’m not sad. I’m just... blank.”

These experiences are real. And they are just as valid—and just as serious—as classic symptoms like sadness or hopelessness.

Depression Without Sadness

The idea of depression without sadness may sound contradictory, but it’s a reality for many people. For some, the nervous system doesn’t register sadness—it shuts down to protect against it. This survival mechanism can leave people feeling emotionally frozen rather than overwhelmed.

In fact, feeling numb may be the only thing you feel.

Rather than asking, “Why am I so sad?” you may be wondering, “Why don’t I feel anything at all?” This is still depression. It’s not a lesser form—it’s just a different face of the same condition.

Why Does Emotional Numbness Happen?

Sometimes, emotional numbness is the body’s way of saying, “It’s too much.” When the nervous system is overwhelmed—by trauma, loss, chronic stress, or burnout—it may protect itself by shutting down. You’re not weak. Your body is simply doing what it knows to do: survive.

Therapists often talk about something called the Window of Tolerance—a way to describe the range of emotional arousal we can handle before feeling overwhelmed. When you’re within your window, you’re able to feel and process emotions in a way that feels manageable. But when life becomes too much for too long, your system may flip outside of that window.

Sometimes it flips upward into a state of hyperarousal—anxiety, panic, racing thoughts. Other times, it drops downward into hypoarousal—a state of freeze, collapse, and emotional shutdown. This is often when emotional numbness shows up. You don’t feel sad or angry or afraid—you feel nothing. That numbness can be confusing or even frightening, but it’s your nervous system trying to keep you safe.

Medication, particularly certain antidepressants, can also contribute to emotional blunting—a reduction in both emotional highs and lows. If that’s part of your experience, it’s worth discussing with your provider, but it doesn’t mean you’re broken. It means your system may need care, regulation, and gentle reconnection.

What Therapy Can Do

You may be wondering: If I feel nothing, how can therapy even help? The truth is, therapy isn’t about forcing emotions to come back. It’s about gently creating space where emotions can return when you’re ready.

Therapy can help you:

• Explore the underlying causes of your emotional numbness—whether it's past trauma, ongoing stress, or a nervous system stuck in survival mode.

• Begin to safely reconnect with your emotional world through grounding, mindfulness, and body-based approaches.

• Identify and challenge beliefs like “There’s something wrong with me for not feeling,” replacing shame with understanding.

• Learn strategies for regulating your nervous system so that your body no longer needs to shut down just to get through the day.

This work can take time. But many people find that—gradually—they begin to notice small shifts. A flicker of emotion. A tear they didn’t expect. A laugh that feels real. These are signs that your system is thawing. That healing is happening.

Final Thoughts

Depression doesn’t always look like sadness. Sometimes, it looks like emptiness, flatness, or silence. Sometimes it feels like watching life happen from far away. If you’re feeling numb, that doesn’t mean your experience is less valid. It means your system may be overwhelmed—and trying to protect you the best way it can.

The good news is, you don’t have to stay frozen. With support, it's possible to reconnect with your emotional life and reclaim a sense of vitality.

Learn more about how depression therapy can help.

How to Stop Reassurance-Seeking and Start Trusting Yourself

It starts with a question.
“Are you sure it’s okay?”
“You think they’re mad at me?”
“What if I made a mistake and didn’t realize it?”

If you live with anxiety, you might recognize the urge to double-check, seek a second opinion, or scroll through online forums for that one piece of information that will finally quiet your fears. This is reassurance-seeking—a coping strategy that offers short-term relief but can quietly reinforce anxiety over time.

You’re not alone in this. In fact, the only surprising thing about these questions is how many of my clients believe they’re the only ones asking them. So many people imagine they’re the lone anxious one in a world where everyone else seems calm and confident—as if they’re a child pretending to function in a room full of capable adults. The truth is, these doubts are far more common—and far more human—than they appear on the surface.

Why We Seek Reassurance

Anxiety thrives on uncertainty. When the mind senses something might be wrong—even if there's no clear evidence—it responds as if there’s danger. Reassurance becomes a way to do something in response to that perceived threat. You might:

• Ask a friend if they’re upset with you (again).

• Re-read a work email to make sure you didn’t say the wrong thing.

• Google health symptoms late into the night.

• Apologize for something you already apologized for.

These are understandable behaviors. Your brain is trying to create safety, reduce doubt, and regain a sense of control. But reassurance is a temporary fix—it soothes the anxiety for a moment, only for the doubt to return later, often stronger.

How Reassurance Becomes a Habit

Each time you seek reassurance and feel a brief wave of relief, your brain takes note: That helped. But because the root fear remains unresolved, the anxiety creeps back in—and the cycle starts again:

Anxious thought → Seek reassurance → Temporary relief → Doubt returns → More reassurance

Over time, your brain learns to associate uncertainty with danger and relief with external validation. The more often you reach outward for certainty, the harder it becomes to feel confident in your own judgment or memories.

The Hidden Cost of Reassurance-Seeking

Reassurance-seeking can seem harmless—or even necessary—but over time, it takes a toll:

• Erodes self-trust: You stop believing in your ability to cope, decide, or tolerate discomfort without someone else’s input.

• Strains relationships: Partners, friends, and family may feel pressure to respond perfectly—or may become frustrated, confused, or emotionally fatigued.

• Increases anxiety: The more you rely on reassurance, the more doubt your brain produces. It becomes harder to tell what’s true and what’s anxiety.

It can quietly start running your life. You may second-guess decisions, hesitate to take risks, or feel like you need constant permission to feel okay. You might begin avoiding situations that trigger uncertainty altogether, shrinking your world bit by bit. And all of it can happen so gradually that you don’t notice until you’re exhausted.

How to Break the Cycle and Build Self-Trust

Self-trust doesn’t mean ignoring anxiety. It means building the internal capacity to respond to fear without always needing to be rescued from it.

Here’s how to start shifting the pattern:

1. Pause before reaching out

When the urge for reassurance strikes, take a breath. Ask yourself:

What am I afraid of? What would I be saying to myself if I weren’t texting/calling/searching right now?

This helps you slow down and engage with the feeling before acting on it.

2. Try uncertainty on purpose

Let yourself sit with not knowing for just a few minutes. Gradually increase that window. You're training your nervous system to learn that discomfort isn't danger.

3. Journal your resilience

Track moments when you resisted the urge and things turned out okay. These small wins help your brain remember that you can handle discomfort.

4. Talk to yourself compassionately

Something like:

“This feels scary, but I’ve handled similar things before. I can ride this out.”

Kind, supportive inner dialogue begins to replace the need for outside confirmation.

5. Reframe the discomfort

Instead of seeing anxiety as something to eliminate, view it as an invitation to practice courage and build self-trust.

These practices take time. You’re not trying to be perfect—you’re trying to build something stronger and steadier inside of you.

How Therapy Helps You Build a New Relationship with Anxiety

True safety doesn’t always come from being certain. It comes from knowing that—even when you feel uncertain—you can support yourself through it. That you can ride the wave of anxiety without letting it dictate your every move.

This is where therapy can make a real difference. If you’re stuck in cycles of doubt and reassurance, therapy offers a space to slow down and understand what’s happening beneath the surface.

Often, these patterns aren’t just about the immediate fear—What if I said something wrong?—but about deeper emotional themes, like fear of rejection, not feeling good enough, or needing to be perfect to feel safe. In therapy, we begin to explore the roots of these beliefs and how they’ve shaped your relationship with anxiety.

You might discover that reassurance was how you coped with unpredictability in childhood—or how you tried to earn safety in relationships that felt unstable or overly demanding. Exploring these layers can be deeply clarifying and healing.

Along the way, therapy helps you:

• Recognize your reassurance patterns with clarity and self-compassion.

• Understand the emotional history behind your anxiety.

• Learn tools for managing uncertainty and distress.

• Build internal confidence and a more stable sense of self.

• Practice new ways of relating to your thoughts and feelings—ways that reduce suffering, not amplify it.

You’re not just talking—you’re learning new emotional habits. The work involves insight, but also practice: rewiring how you respond to fear, how you talk to yourself, and how you anchor your sense of safety.

What It Feels Like to Start Trusting Yourself

As you begin to put these tools into practice, something subtle but meaningful shifts. You start making decisions with more ease, even when you don’t have every answer. You notice yourself checking less, doubting less, needing less input from others. You still feel anxious sometimes—but now you have a way to meet that anxiety with steadiness instead of panic.

Confidence begins to replace compulsive questioning. You trust not that things will always go right, but that you’ll be okay even when they don’t.

This is the deeper work of anxiety therapy—not fixing you, but helping you reconnect with the part of you that exists beneath the doubt, the shrinking, and the powerlessness—the part that’s capable, steady, and whole. Over time, you begin to relate to your thoughts, feelings, and fears in a new way—one rooted in curiosity, self-compassion, and trust. And from that place, real change becomes possible.

When Anxiety Is a Trauma Response: 8 Signs to Look For

Anxiety and trauma are deeply connected, yet many people don’t recognize when their anxious behaviors are actually rooted in past trauma. What may seem like generalized anxiety—difficulty relaxing, overthinking, or avoiding certain situations—can sometimes be a trauma response, shaped by the body and brain’s attempts to protect against further harm.

Understanding these patterns is essential because trauma-based anxiety is not just about nervousness or worry; it’s about survival strategies that were once necessary but may no longer serve you. Unlike generalized anxiety, which often stems from persistent worry about future uncertainties, trauma-based anxiety is typically triggered by reminders of past experiences, causing the nervous system to react as if the danger is still present. Here are some common anxious behaviors that might actually be trauma responses, along with ways to begin shifting them.

1. Over-Apologizing and People-Pleasing

Constantly saying “sorry” or going out of your way to avoid conflict can be a sign of trauma rather than simple politeness. If you grew up in an unpredictable or unsafe environment, you might have learned that pleasing others and minimizing your own needs kept you safe. This response, sometimes called fawning, is a survival strategy where people try to appease others to prevent conflict or rejection.

How to Shift This Pattern: Practice pausing before apologizing and ask yourself, “Did I actually do something wrong, or am I apologizing out of habit?” For example, if a coworker bumps into you and you instinctively say “sorry,” try reframing it to “Oh, excuse me,” to acknowledge the interaction without assuming blame. Start small by asserting your needs in safe situations.

2. Hypervigilance: Always Being on Edge

Feeling like you have to be alert at all times—scanning for danger, overanalyzing people’s tone of voice, or assuming the worst—can be a trauma response rather than typical anxiety. Hypervigilance is common in people with post-traumatic stress, as their nervous system remains in a heightened state of awareness, even when there’s no actual threat.

How to Shift This Pattern: Grounding techniques like deep breathing, mindfulness, or focusing on physical sensations (e.g., rubbing a textured object, focusing on the way your foot feels when you walk) can help signal to your body that you are safe.

3. Difficulty Making Decisions

Trauma can disrupt the brain’s ability to assess risk and trust itself. If you find yourself paralyzed over small decisions or seeking excessive reassurance from others, it may be because past experiences taught you that the wrong choice could lead to serious consequences. This is especially true for those who grew up in environments where mistakes were harshly punished.

How to Shift This Pattern: Remind yourself that most decisions are not permanent. Try setting a time limit to decide, and trust that you can adjust if needed.

4. Avoiding Certain Situations or People

While avoidance is often seen as an anxious behavior, it can also be a trauma response. If certain places, sounds, or even types of interactions trigger intense discomfort, your brain may be trying to protect you from reliving past pain. This can show up as avoiding social events, skipping difficult conversations, or even procrastinating on tasks that feel overwhelming.

How to Shift This Pattern: Identify whether avoidance is protecting you from a real threat or reinforcing fear. Slowly expose yourself to safe situations while using self-soothing strategies.

5. Shutting Down or Dissociating Under Stress

Some forms of dissociation can be mild, such as spacing out or feeling emotionally numb, while others can be more severe, like losing time or feeling disconnected from your body. Recognizing the different ways dissociation manifests can help in understanding and addressing it.
Some people respond to stress not with visible anxiety but by emotionally shutting down. If you find yourself zoning out, feeling detached from your surroundings, or struggling to remember what happened during stressful moments, this could be dissociation, a trauma response where the brain disconnects from overwhelming emotions to protect itself.

How to Shift This Pattern: Try grounding exercises, such as naming five things you see or holding something cold, to bring yourself back into the present moment.

6. Feeling Anxious in Safe Relationships

If you’ve experienced betrayal or emotional neglect, even safe relationships can feel unsettling. You might constantly worry about being abandoned, doubt people’s kindness, or struggle to let your guard down. This pattern is often linked to attachment trauma, where past relationships shaped your ability to trust and feel secure with others.

How to Shift This Pattern: Therapy can be particularly helpful in navigating attachment wounds. Practicing open communication and noticing when your fears are based on past experiences rather than present reality can also help.

7. Perfectionism and Harsh Self-Criticism

Striving for perfection can sometimes be less about ambition and more about preventing failure at all costs. If you grew up in an environment where mistakes led to rejection or punishment, you may have developed perfectionism as a survival strategy. The inner critic that fuels this can be a trauma-based response, trying to keep you safe from past patterns of disapproval or harm.

How to Shift This Pattern: Challenge self-critical thoughts by asking, “Would I speak to a friend this way?” and practice celebrating small successes, even when they’re imperfect.

8. Startling Easily and Feeling Jumpy

If loud noises, sudden movements, or unexpected touch make you react strongly, your nervous system may be stuck in a fight-or-flight response. This exaggerated startle reflex is common in people with trauma histories, especially if they have experienced violence, abuse, or accidents.

How to Shift This Pattern: Therapies that engage the body, such as somatic experiencing, Internal Family Systems, and experiential psychodynamic therapies, can help regulate the nervous system over time.

Trauma Responses Can Shift with Awareness and Support

Healing from trauma-based anxiety doesn’t happen overnight. Small, incremental changes—such as practicing self-compassion, gently challenging avoidance patterns, or seeking support—can make a meaningful difference over time. With awareness, self-compassion, and support, it’s possible to reshape these patterns in a way that allows for more ease and emotional flexibility.
If you see yourself in these patterns, know that you’re not “overreacting” or “too sensitive.” These responses developed as a way to keep you safe in the past, but they don’t have to control your present. With awareness, self-compassion, and support, it’s possible to reshape these patterns in a way that allows for more ease and emotional flexibility. If you’re ready to explore how trauma-informed therapy can support your healing, reach out today.

The Past is Always Present: How Psychodynamic Therapy Unlocks Change

““A man with no memory is a man with no foresight.””

— Eleanor Catton, The Luminaries

Clients sometimes ask: Does my past really matter? It’s a fair question. When people seek therapy, they often want immediate relief from their current struggles, not a deep dive into childhood memories or long-buried emotions. However, understanding how past experiences shape present thoughts, emotions, and behaviors is an invaluable tool for healing and change. At the same time, therapy also equips you with practical coping skills that provide comfort and stability in the present.

Imagine walking into a doctor’s office with severe stomach pain, and instead of asking when it started or what might be triggering it, the doctor simply prescribes medication. While the treatment might offer some relief, it wouldn’t address what’s causing the pain in the first place. In fact, treating the symptoms without understanding the root cause could be ineffective or even harmful. Therapy works similarly—by looking at past experiences, we gain insight into present struggles, making it easier to find lasting solutions.

How the Past Influences the Present

The patterns we repeat in relationships, the emotional responses we have to certain situations, and even the ways we view ourselves are often rooted in past experiences. These experiences, particularly those from early life, create internal working models—unconscious blueprints that influence how we interpret and respond to the world.

For example, someone who grew up with inconsistent or critical caregivers may develop an internal belief that they are not “good enough” or that others will ultimately let them down. Even if they are unaware of these early dynamics, these beliefs can unconsciously shape their relationships, leading to patterns of self-doubt, avoidance, or emotional withdrawal.

In psychodynamic therapy, exploring these origins isn’t about dwelling on the past for its own sake—it’s about shining a light on and understanding why certain patterns exist so that new, more adaptive ways of thinking, feeling, and behaving can emerge.

The Role of Unconscious Emotional Conflict

Many struggles people face—anxiety, depression, difficulties in relationships—are rooted in unconscious emotional conflicts. When emotions are not fully acknowledged or processed, they don’t disappear; they often manifest in other ways, such as chronic worry, self-criticism, or physical symptoms.

For instance, someone who was taught to suppress anger might experience frequent muscle tension, headaches, or even gastrointestinal distress, without consciously linking these symptoms to unresolved emotional conflicts. Psychodynamic therapy, including modern approaches like Intensive Short-Term Dynamic Psychotherapy (ISTDP), helps bring these connections to light by fostering deep emotional awareness and allowing clients to process emotions that may have been buried for years.

To see how these unconscious patterns play out in real life, let’s look at an example.

A Case Example: When the Past Shapes the Present

Jason had grown up in a home where expressing emotions—especially negative ones—was silently discouraged. When conflicts arose, they were never addressed directly; instead, a tense silence filled the home until everyone simply pretended the disagreement never happened. Over time, Jason internalized the belief that conflict led to disconnection and that expressing his emotions might push people away.

As an adult, Jason struggled in relationships. Things started off well, but as soon as disagreements or tension arose, he instinctively withdrew. Without realizing it, he equated conflict with disconnection and rejection. Because he had never learned how to engage in healthy emotional expression or repair ruptures, his partners interpreted his emotional withdrawal as disinterest or detachment. As a result, his relationships gradually deteriorated.

One pivotal moment came when a partner said, "I feel like I don’t really know you. Every time there’s tension, you shut me out." That statement resonated deeply, and in therapy, Jason began to uncover a pattern—his emotional withdrawal was not just a present-day behavior but a deeply ingrained response from his past.

Through therapy, Jason recognized and addressed his discomfort with emotional vulnerability. He realized that avoiding conflict wasn’t protecting his relationships—it was eroding them. Over time, he learned to express his feelings openly, engage in honest conversations, and repair conflicts rather than retreat from them. By confronting his past conditioning, he gained greater foresight—understanding how his past influenced his present allowed him to make intentional, healthier choices moving forward. His journey in therapy not only helped his relationships but also improved his confidence at work, where he started asserting himself in ways he had previously avoided.

Expanding Awareness: From Understanding to Action

Once unconscious patterns and emotions become conscious, they lose their grip and we find more adaptive ways to relate to the people in our lives. Recognizing these past influences allows us to respond in new, healthier ways. Modern psychodynamic approaches emphasize not just uncovering these patterns but also actively working through them. ISTDP, for example, helps clients build emotional resilience by engaging directly with these unconscious conflicts in a focused, transformative way. Rather than repeating old patterns automatically, they develop the freedom to choose new, healthier ways of relating to themselves and others.

For example, someone who has always feared rejection may realize that their avoidance of close relationships is an unconscious way of protecting themselves from past pain. With this awareness and newfound capacity to face challenging emotions, they can begin experimenting with new ways of connecting, building relationships based on reality rather than old fears.

Therapy as a Collaborative Process

While exploring the past can be invaluable, therapy is never about forcing someone to go somewhere they do not wish to go. Some people may not be ready or willing to look at the past, and that is entirely their choice. The goal of therapy is always to work collaboratively, honoring each person’s unique needs, pace, and readiness.

If you’ve ever wondered why certain struggles keep resurfacing in your life, therapy may provide the clarity and relief you seek. The past may shape us, but it does not have to define us. By making the unconscious conscious, therapy empowers you to step out of old patterns and move toward a future shaped by clarity, confidence, and intentionality.

Chronic Illness and Anxiety: Understanding the Connection and Finding Relief

Living with a chronic illness presents daily challenges that extend beyond physical symptoms. The uncertainty of fluctuating health, the emotional toll of ongoing medical concerns, and the disruption of daily life can lead to significant anxiety. Many individuals find themselves caught in a cycle of worry—fearful of worsening symptoms, struggling with medical uncertainty, and grappling with changes in identity and lifestyle. The psychological impact of chronic illness can be just as overwhelming as the physical, and without proper support, anxiety can become a persistent and exhausting companion.

At the same time, anxiety itself can contribute to chronic illness. Persistent stress and worry activate the body's stress response, leading to increased inflammation, disrupted sleep, and heightened physical tension—all of which can exacerbate existing health conditions or even contribute to the development of new ones. Over time, chronic anxiety can weaken the immune system, intensify pain sensitivity, and lead to cycles of physical and emotional distress that are difficult to escape. Addressing this bidirectional relationship between anxiety and chronic illness is key to ameliorating symptoms and fostering both physical and emotional well-being.

How Anxiety Fuels Chronic Symptoms

Anxiety manifests in different channels—cognitive, muscular, and autonomic (e.g., heart rate changes, gastrointestinal distress). When anxiety is chronically high, the body remains in a heightened state of stress, exacerbating symptoms of chronic illness. This cycle can include:

• Increased inflammation and worsening of symptoms.

• Hypervigilance about physical sensations, leading to excessive symptom monitoring.

• Avoidance of emotions, which keeps unresolved conflicts buried and intensifies distress.

Finding Hope Through Emotional Processing

Rather than focusing solely on symptom management, therapy helps to uncover and process core emotional conflicts that drive anxiety. Some key approaches include:

1. Building Awareness of Emotional Conflicts

Through therapy, individuals learn to recognize when anxiety spikes and trace it back to underlying emotions. This process creates an opportunity to consciously engage with feelings instead of repressing them.

2. Regulating Anxiety in the Body

Identifying whether anxiety is expressed through voluntary muscle tension (think fidgety arms, hands, and legs), smooth muscle discharge (like GI distress or migraines), or cognitive/perceptual disruption (think ringing ears, tunnel vision, difficulty thinking) allows for targeted interventions. Strategies like deep breathing, grounding exercises, and progressive muscle relaxation can help regulate anxiety.

3. Unlocking and Processing Repressed Emotions

Many chronic illness sufferers carry unprocessed emotions related to past traumas, medical experiences, or relational conflicts. Therapy provides a structured way to process these emotions, reducing their impact on physical and mental well-being.

4. Addressing Maladaptive Defense Mechanisms

Common defenses like avoidance, intellectualization, or self-shaming prevent individuals from fully experiencing and resolving their emotions, and contribute to increased emotional and physical symptoms. Therapy helps identify these patterns and replace them with healthier emotional processing strategies.

5. Reconnecting with Inner Strength

When individuals learn to experience emotions fully and without overwhelming anxiety, they gain greater resilience in coping with both illness and life’s uncertainties. By facing feelings instead of avoiding them, they often find a renewed sense of empowerment.

Melissa's Story: Understanding the Mind-Body Connection

Melissa had been waking up each morning with stomach pain, cramping, nausea, and an urgent need to use the bathroom — symptoms that worsened throughout the day, especially at work. She constantly worried about how they would impact her ability to focus, which only made them worse. Despite medical tests, no clear physical cause was identified, and the cycle continued.

Through therapy, Melissa explored her feelings about work and realized that her anxiety spiked most when interacting with a difficult colleague. Yet in those moments, she was not aware of experiencing any emotions and noticed only her anxiety. Her therapist helped her recognize that she had long struggled to acknowledge anger toward others. Before she was even aware of it, her anger was repressed and expressed physically, leading to chronic GI distress.

As therapy progressed, Melissa became more aware of this emotional pattern and her tendency to suppress anger. She began to recognize anger as a natural response rather than something to avoid. While the process was not immediate or linear, with practice, she became better at identifying and working through these emotions. Over time, her symptoms became less frequent and intense. She also realized that her colleague reminded her of past experiences where interactions had left her feeling defeated and ashamed. Along with anger, she uncovered grief about how those past encounters had shaped her self-perception.

By recognizing these patterns, Melissa learned to engage with her emotions in a healthier way. As she allowed herself to acknowledge and process her feelings, her symptoms eased, and she felt more confident. Rather than feeling guilty about her anger and repressing it as anxiety, she began asserting boundaries with others, leading to a stronger sense of autonomy, safety, and well-being.

Finding Hope Through Emotional Processing

While chronic illness and anxiety often reinforce each other, they do not have to define one’s life. Anxiety therapy provides a pathway to understand and resolve the unconscious emotional conflicts that drive anxiety and exacerbate physical symptoms. Healing does not necessarily mean eliminating illness or anxiety, but rather developing the capacity to engage with emotions in a way that promotes resilience, self-compassion, and a fuller sense of well-being.

Exercise for Depression: How Much is Enough?

When it comes to managing depression, exercise is one of the most accessible and effective tools available. But how much exercise is needed to make a real difference? While everyone’s experience with depression and exercise is unique, research provides some valuable guidelines that can help you tailor a routine to improve your mental health.

What the Research Says

Numerous studies indicate that regular exercise can significantly reduce symptoms of depression. The most commonly recommended frequency and duration are:

• 3 to 5 sessions per week of moderate to vigorous exercise.

• 30 to 45 minutes per session for maximum benefit.

However, even smaller amounts of physical activity can have a positive impact. For example, research shows that just 15 minutes of vigorous activity per day or an hour of moderate activity per week can reduce the risk of depression.

Both aerobic activities, such as walking, jogging, or cycling, and resistance training, like weightlifting or bodyweight exercises, have shown to be effective. The key is consistency over intensity—you don’t need to exhaust yourself to reap the mental health benefits.

Why Does Exercise Work?

Exercise positively affects the brain and body in several ways, making it a powerful tool for improving mood and reducing depressive symptoms. Here are some of the primary mechanisms:

Biological Benefits

• Increased Endorphins: Physical activity stimulates the release of endorphins, often referred to as “feel-good” hormones, which can lift your mood.

• Enhanced Serotonin Levels: Exercise boosts serotonin and other neurotransmitters involved in regulating mood.

• Reduced Cortisol Levels: Exercise helps decrease cortisol, a stress hormone often elevated in individuals with depression.

Psychological Benefits

• Improved Self-Esteem: Achieving exercise goals can boost your confidence and sense of accomplishment.

• Distraction from Negative Thoughts: Physical activity shifts your focus away from ruminative thoughts, providing mental relief.

Social Benefits

• Increased Connection: Joining a group class or walking with a friend can foster a sense of community, combating the isolation often associated with depression.

Starting Small: Overcoming Barriers to Exercise

For many people with depression, starting an exercise routine can feel overwhelming. Fatigue, lack of motivation, and feelings of hopelessness can make it difficult to take that first step. Here are some strategies to overcome these challenges:

• Set Manageable Goals: Start with as little as 5 to 10 minutes of walking or stretching. Every bit counts.

• Focus on Enjoyment: Choose activities you genuinely enjoy, whether that’s dancing, yoga, swimming, or gardening.

• Pair Exercise with Existing Habits: Build your routine around something you already do, like walking the dog or listening to your favorite podcast.

• Celebrate Small Wins: Acknowledge every effort, no matter how small. Completing a 10-minute walk is a victory worth celebrating.

Practical Advice for Building an Exercise Routine

Consistency is key when it comes to seeing the mental health benefits of exercise. Here are some tips to help you create and sustain a routine:

1. Start Slow: If you’re new to exercise, begin with light activities like walking or gentle yoga and gradually increase the intensity.

2. Set a Schedule: Aim to exercise at the same time each day to build a habit.

3. Be Flexible: Life happens—if you miss a session, don’t let it derail your efforts. Start again when you can.

4. Track Your Progress: Use a journal or app to note how you feel before and after exercise. Seeing patterns of improvement can reinforce the habit.

5. Mix It Up: Prevent boredom by trying different activities, such as hiking, swimming, or strength training.

When Can You Expect Results?

The mental health benefits of exercise can begin to appear within the first few weeks of consistent effort. Many people report feeling a boost in mood immediately after exercise, while longer-term improvements, such as reduced symptoms of depression, tend to become noticeable after 4 to 6 weeks.

Final Thoughts

Exercise is not a cure for depression, but it is a powerful and natural way to improve mood, increase energy, and foster resilience. Whether you’re walking around the block or hitting the gym five times a week, every step you take is a step toward better mental health. Start small, stay consistent, and remember that even the smallest effort can have a meaningful impact. Learn more about how depression therapy can support you alongside other approaches to improve mental health.

Bend Like Bamboo: ACT for Anxiety

For today’s blog post, I am returning again to wisdom from the Tao Te Ching:

“The bamboo that bends is stronger than the oak that resists.”

— Lao Tzu

This ancient insight captures a fundamental truth about human resilience—true strength comes from flexibility, not rigidity. In the context of anxiety, this idea is especially relevant. The more we try to resist or control anxious thoughts and feelings, the more entrenched they become. But when we learn to bend, adapt, and move with our emotions, we can navigate anxiety with greater ease and effectiveness.

This is the essence of psychological flexibility, a core principle in Acceptance and Commitment Therapy (ACT), which offers a powerful approach to managing anxiety.

What is Psychological Flexibility?

Psychological flexibility is the ability to stay open and present, even in the face of discomfort, and to take action guided by what truly matters. It’s about being able to experience difficult thoughts and emotions without getting stuck or overwhelmed by them. Unlike rigid control strategies—where we try to avoid or eliminate anxiety—flexibility allows us to acknowledge these experiences while continuing to move toward our goals and values.

In ACT, the goal isn’t to eliminate anxiety, but to develop the flexibility to live fully with it. This approach contrasts with traditional methods that focus on symptom reduction. Instead, ACT empowers individuals to respond to anxiety in a way that aligns with their values, leading to greater psychological well-being.

The Problem with Psychological Rigidity

When anxiety strikes, our instinct is often to resist it—much like the oak tree that stands firm against the storm, trying to stay rooted in place. We might try to control our anxious thoughts, avoid uncomfortable situations, or endlessly ruminate in an attempt to “solve” our worries. But this psychological rigidity can actually make anxiety worse. The more we resist or try to avoid discomfort, the more it seems to grow, leaving us feeling stuck or overwhelmed.

ACT teaches us that rigidity leads to suffering because it traps us in a cycle of avoidance and control, where the focus is on pushing anxiety away rather than living a meaningful life despite it.

How Could Accepting Anxiety Possibly Help?

A common reaction to hearing about “accepting anxiety” is confusion. After all, isn’t the goal to get rid of anxiety? It’s natural to want to push away anxious feelings, and many people believe that fighting anxiety or avoiding what triggers it is the best way to cope. However, this approach often leads to more anxiety over time. Trying to control or eliminate anxiety is like trying to hold back a wave—it’s exhausting and rarely works for long.

Acceptance, as understood in ACT, isn’t about giving up or resigning yourself to feeling anxious forever. Instead, it’s about allowing the feeling to exist without fighting it, acknowledging its presence, and making space for it, so it no longer has as much control over your actions. By accepting anxiety, you take away its power to dictate your life.

Imagine anxiety as a passenger in your car. If you keep wrestling with it to push it out, you’ll spend all your energy fighting, and you'll lose focus on driving. Acceptance means allowing anxiety to sit there—knowing it’s present—but keeping your hands on the wheel and your eyes on the road.

What Does "Accepting Anxiety" Really Mean?

Acceptance doesn’t mean liking or wanting anxiety; it’s about acknowledging its presence and no longer struggling against it. Here’s what that might look like in practice:

• Acknowledging Your Anxiety: When anxiety arises, notice it without immediately trying to fix or avoid it. You might say to yourself, “I’m feeling anxious right now, and that’s okay. I don’t need to change it or run from it.”

• Breathing Through It: Instead of tensing up, try to take a few deep breaths and allow the sensations of anxiety to exist. Pay attention to how it feels in your body—tight chest, racing heart—without judgment. This creates a space where you can observe anxiety rather than react to it.

• Mindfully Sitting with Discomfort: Acceptance often involves sitting with discomfort rather than acting impulsively to get rid of it. For example, imagine walking up to a podium to speak in front of hundreds of people. Your heart is pounding, your palms are sweaty, and your mind is racing. Resisting the anxiety might look like saying to yourself, “Oh no, I’m anxious!! What’s wrong with me?! I need to get it together. Stop being anxious. Now!” This reaction often intensifies anxiety, as it adds self-criticism and pressure to suppress natural feelings.

  By contrast, accepting anxiety might look like acknowledging it instead: “I’m anxious right now, and that’s okay. I can still do this, even with anxiety here.” With this approach, you allow yourself to feel the anxiety without letting it dictate your actions. You might focus on taking slow, steady breaths as you start speaking, allowing the anxiety to be present while still moving forward.

The surprising effect of acceptance is that when you stop struggling against anxiety, it often becomes less overwhelming. By letting it in, you might find that the fear of anxiety is worse than the anxiety itself.

How ACT Builds Psychological Flexibility

ACT offers six core processes that cultivate psychological flexibility and help us navigate anxiety:

1. Acceptance: Rather than fighting or avoiding anxious feelings, ACT encourages us to “make space” for them. Acceptance doesn’t mean liking or wanting anxiety, but acknowledging its presence without trying to change it.

2. Cognitive Defusion: This involves stepping back from our thoughts, seeing them for what they are—just thoughts, not truths. By distancing ourselves from anxious thoughts, we reduce their power over us.

3. Being Present: Mindfulness practices help us stay grounded in the present moment, rather than being consumed by worries about the future or regrets from the past.

4. Self-as-Context: ACT teaches us to view ourselves as the observer of our experiences, rather than being defined by our thoughts and feelings. This helps create a sense of distance from the anxiety and to see ourselves with clarity.

5. Values: Clarifying what truly matters in life helps guide our actions, even when anxiety is present. Values provide direction and purpose, making it easier to act despite discomfort.

6. Committed Action: Once we’ve identified our values, ACT encourages us to take steps toward those values, even in the face of anxiety. This involves making choices based on what we care about, not on what we fear.

Bending with Anxiety, Not Breaking

Lao Tzu’s metaphor of the bamboo teaches us that flexibility leads to resilience. When we bend with anxiety—accepting it, making space for it, and allowing it to exist without letting it dictate our actions—we become stronger. Psychological flexibility helps us live in alignment with our values, moving forward even when anxiety is present. Like bamboo swaying in the wind, we adapt to life’s challenges rather than breaking under their weight.

Practical Steps to Cultivate Flexibility

If you’re looking to apply these concepts in your life, here are a few practical strategies from ACT:

1. Mindfulness: Practice observing your anxious thoughts and feelings without judgment. Notice them, but don’t try to change them. Simply allow them to be, like leaves floating down a stream.

2. Identify Your Values: Spend some time reflecting on what truly matters to you. Is it connection, creativity, adventure, or kindness? Use these values to guide your actions, especially when anxiety tries to hold you back.

3. Take Action: Once you’ve clarified your values, commit to taking small steps in that direction, even if anxiety is present. The more you take action guided by your values, the less control anxiety will have over your life.

The path to managing anxiety isn’t about becoming unbreakable—it’s about learning to bend. Through the practice of psychological flexibility, as taught in ACT, you can face your anxiety with openness and resilience, rather than resistance. By embracing the discomfort of anxiety and taking meaningful action, you’ll find that you are not only stronger but also more capable of living the life you desire. .

5 Signs of Depression in Men

Depression affects millions of people every year, but it doesn't always look the same for everyone—especially for men. Men are often taught to be “strong,” “self-reliant,” and emotionally reserved, which can make it difficult for them to recognize or admit when they are struggling with their mental health. Thus, depression can manifest differently in men, and it may show up in ways that aren’t always associated with sadness. Understanding the signs can help men, and those who care about them, take the steps needed to get support.

Here are five common signs of depression in men that are often overlooked:

1. Anger or Irritability

While depression is often linked with sadness or hopelessness, many men express their depression through irritability or anger. This anger can be directed outward at friends, family, or coworkers, or even inward through harsh self-criticism. In a society where men are often taught that showing vulnerability is a weakness, they might feel more comfortable expressing frustration rather than admitting feelings of sadness or despair. This anger is sometimes accompanied by a sense of restlessness, impatience, or an inability to relax.

Without recognizing it as a symptom of depression, this irritability can strain relationships and increase feelings of isolation. Ironically, in their efforts to remain "strong" and avoid vulnerability, men may find themselves feeling isolated and drained, weakening their capacity to cope.

2. Withdrawing from Social Activities

Men experiencing depression may begin to withdraw from the people and activities that once brought them joy. This withdrawal can manifest in several ways—avoiding friends, skipping social events, or losing interest in hobbies that were once enjoyable. For some men, this retreat is a coping mechanism. They may feel emotionally drained, overwhelmed, or embarrassed about their struggles and prefer to avoid interactions that require energy or explanation.

Isolation can be a self-reinforcing cycle, as the more disconnected someone becomes, the harder it can be to reach out for help. When a man suddenly becomes more distant, this might be a sign that he's dealing with something deeper than just a bad day.

3. Physical Symptoms

It’s not uncommon for men to experience depression through physical symptoms. Chronic pain, headaches, stomach issues, or other unexplained physical complaints can often accompany depression. These symptoms may be a result of the body’s prolonged stress response, and men might not even recognize the connection to their mental health. Instead, they might visit doctors to find the cause of their physical discomfort, but without an obvious diagnosis, they may feel frustrated or helpless.

Since physical symptoms are easier to acknowledge and treat than emotional ones, men might not connect their pain to depression, making it important to consider mental health when physical symptoms persist without a clear cause.

4. Substance Abuse

Another common sign of depression in men is an increased reliance on alcohol or drugs to cope with their emotions. Men may turn to substances to numb their feelings or escape from the overwhelming weight of depression. While this can provide temporary relief, it often leads to a dangerous cycle where the substance use worsens the depression, deepening the feelings of isolation and hopelessness.

Substance abuse can also serve as a form of avoidance. Rather than addressing the root cause of their struggles, some men may try to drown out their feelings, which delays the healing process and can have serious long-term consequences on both their mental and physical health.

5. Risky Behaviors or Overworking

Engaging in risky behaviors or throwing oneself into work are also signs of depression in men. When men feel out of control emotionally, they may seek to regain a sense of power or escape through high-risk activities like reckless driving, gambling, or even engaging in dangerous physical pursuits.

On the other hand, some men immerse themselves in work or hobbies as a way to distract themselves from their emotions. While this might seem productive on the surface, it can become unhealthy if it's done to the point of burnout or exhaustion. These behaviors are often attempts to avoid confronting their feelings, but over time, they only add to the stress and worsen the depression.

Encouraging Help-Seeking

Recognizing these signs in yourself or a loved one is the first step in addressing depression. If someone you know is showing these signs, approach the topic with care and compassion. Let them know you’re there to listen and support them without judgment. Encourage them to seek professional help, whether through therapy, counseling, or a trusted healthcare provider. You can also learn more about depression treatment here.

It’s important to remember that depression is treatable, and reaching out for help is a sign of wisdom, not weakness.

How to Stop OCD Rituals

Obsessive-Compulsive Disorder (OCD) can feel like a relentless cycle of obsessive thoughts followed by compulsive behaviors, or rituals, aimed at reducing the anxiety these thoughts generate. While rituals may provide temporary relief, they ultimately reinforce the cycle, making it harder to break free. Learning how to stop OCD rituals is crucial to regaining control, but long-term relief often involves addressing the deeper emotional issues underlying the disorder. That’s why a combination of response prevention strategies and more in-depth emotional work is key to lasting recovery.

Understanding OCD Rituals

OCD rituals are compulsive behaviors that people perform in response to obsessive thoughts. These behaviors can be mental (such as repeating specific thoughts) or physical (such as checking or cleaning). While they provide short-term relief from anxiety, they often make the compulsive cycle worse over time. For many people, these rituals are not just habits—they often serve as defenses against difficult emotions like anger, sadness or fear. While rituals offer short-term relief, they ultimately maintain the cycle of OCD by reinforcing the belief that the ritual is necessary to prevent a feared outcome.

Strategies to Stop OCD Rituals

1. Exposure and Response Prevention (ERP)

   ERP, a type of Cognitive Behavioral Therapy (CBT), involves gradually exposing yourself to the triggers that provoke your obsessions while preventing the compulsive behavior that follows. This technique reduces the anxiety associated with the obsession and helps break the cycle of rituals over time.

2. Mindfulness and Acceptance

   Mindfulness teaches you to observe your thoughts and feelings without immediately reacting to them. This can help you sit with the discomfort of obsessive thoughts and reduce the urge to perform rituals. Over time, this practice allows you to experience difficult emotions without automatically turning to compulsions for relief.

3. Delay and Disrupt the Ritual

   By delaying or disrupting a ritual, you can weaken the connection between your obsessions and the compulsions that follow. Start by postponing the ritual for a few minutes and gradually increase the delay over time. This creates space to reflect on what you're feeling and break the automatic response cycle.

4. Cognitive Restructuring

   Cognitive restructuring is another component of CBT that helps you challenge the irrational beliefs and distortions behind your OCD. By identifying the flawed logic in your thinking, you can start to question the validity of your obsessions. For example, if your OCD makes you believe that leaving the house without checking the door multiple times will lead to a break-in, cognitive restructuring will help you recognize that checking once is enough and that repeatedly checking doesn’t provide additional security.

5. Practice Self-Compassion

   OCD can be exhausting, and it’s easy to get frustrated with yourself for performing rituals. Practicing self-compassion is key. Understand that breaking the cycle of OCD takes time, and setbacks are normal. Acknowledge your progress and treat yourself with kindness throughout the process.

The Importance of Addressing Emotional Roots

While the above strategies are important for disrupting OCD rituals, it’s also critical to address the emotional roots that contribute to OCD. For many individuals, OCD rituals serve as a way to avoid or distract from uncomfortable emotions. Often, these emotions are repressed so effectively that the person is unaware of them. Over time, the rituals become habitual and seem disconnected from any emotional experiences. However, the core emotional challenges remain intact, driving the compulsions beneath the surface.

Get Professional Help for Long-Term Healing

This is where professional help becomes invaluable. While short-term coping strategies can help manage symptoms, working with a therapist allows you to dive deeper into the underlying emotional issues that fuel your OCD. By addressing repressed emotions—whether it's sadness, guilt, anger, or even joy — you can achieve long-term healing rather than just symptom management. Therapists trained in modalities like Exposure and Response Prevention (ERP), as well as deeper emotional work such as psychodynamic or experiential therapies, can guide you through this process.

Through therapy, you can gain awareness of the emotions that trigger your compulsions, allowing you to work through them rather than continue to avoid them. This dual approach—stopping the rituals and addressing the emotional drivers—creates a comprehensive plan for overcoming OCD and achieving long-term relief.

Learn more about how OCD Treatment can help you manage obsessive thoughts and break the cycle of compulsive behavior.