SERVICES OFFERED
Individual Adult Therapy
Individual Adolescent and Child Therapy
Evaluation and Diagnosis
Parent Sessions
AREAS OF SPECIALTY
Cognitive Behavioral Therapy (Exposure Response Prevention ERP, Acceptance Commitment Therapy ACT, Dialectical Behavioral Therapy DBT)
Body-Focused Repetitive Behaviors (BFRBs, trichotillomania- hair pulling, excoriation – skin picking)
Anxiety Disorders (GAD, Social Anxiety, Panic, Specific Phobias, Health Anxiety, PTSD)
RELATED SYMPTOMS AND CONDITIONS
OCD and anxiety often exist with other issues. Lilah has experience treating:
Executive dysfunction
Depersonalization Derealization Disorder
Sleep difficulties
Trauma
Grief and Loss
Depressive symptoms
Interpersonal challenges, relationship difficulties, emotional regulation
Cognitive Behavioral Therapy (CBT)
Evidence-based Cognitive Behavioral Therapy has become the “gold standard” for treating OCD and anxiety disorders. CBT makes connections between how your thoughts, beliefs and attitudes affect your feelings and actions. It teaches skills that help people have a greater awareness of thoughts and better manage negative emotions and challenging behaviors. CBT is action oriented, time limited and can be tailored to meet specific needs.
Obsessive Compulsive Disorder (OCD)
Treatment for OCD
I am extensively trained in Exposure Response Prevention (ERP) therapy, which is accepted as the most effective treatment for OCD. It frees people from the cycle of obsession and compulsion. ERP gradually exposes people to obsessive fears in a safe environment and then teaches them to not engage in compulsions. The key to successful ERP is building a trusting relationship in therapy that provides a safe space to address some content that can feel very overwhelming. People often have not shared their obsessions with friends and family before coming into therapy and express a huge sense of relief knowing that they are not alone with their OCD.
ERP provides lasting tools to manage OCD in the long term, beyond therapy sessions. I have found that Acceptance Commitment Therapy (ACT) is a true complement to ERP. The concepts and skills in ACT help people identify values and move towards a more fulfilling, balanced life.
What is OCD?
OCD is a mental health disorder that affects an estimated 2-3% of the population. A person with OCD gets caught in cycles of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, urges or images that trigger intensely distressing feelings. Compulsions are behaviors an individual performs to try to decrease distress or get rid of obsessions. Compulsions can be outward behaviors or internal.
What are obsessions?
Everyone has unwanted thoughts, but for people with OCD those thoughts occur repeatedly and become extremely disturbing. They are time consuming and get in the way of everyday life. Obsessive thoughts are often accompanied by intense feelings of fear, guilt or shame.
Common obsessions
Obsessions can be about a wide variety of themes. These thoughts do not align with a person’s moral values and create a fear cycle.
Common obsession themes are:
Fear of contamination
Unwanted sexual thoughts: Am I secretly a pedophile?
Violent or “harm” thoughts: What if I stab my partner?
Relationship related obsessions
Symmetry or exactness
Feeling that something is “Just Right”
Religious scrupulosity and morality
Perfectionism
Fear of being responsible for something terrible happening: Fire or a car accident, confusion between real and false memory
Common compulsions
Washing and cleaning
Checking
Repeating
Counting
Ordering/Arranging
Reassurance seeking
Mental review
Body Dysmorphic Disorder (BDD)
Body Focused Repetitive Behaviors (BFRB’s) including:
Trichotillomania (hair pulling)
Excoriation (skin picking)
I use the ComB Comprehensive Behavioral Model to treat trichotillomania and skin picking. This model goes beyond Habit Reversal Training, taking a more in depth look at triggers, vulnerabilities and the role of thoughts and emotions in treatment. Each case of BFRB’s is unique. Sometimes anxiety, OCD or ADHD are playing a role in continuing hair pulling or skin picking. Often shame develops around these behaviors. I use Acceptance Commitment Therapy (ACT) and Dialectical Behavioral Therapy (DBT) in conjunction with ComB to create lasting progress. Along with reducing or ending behaviors, therapy for BFRB’s helps treat the whole individual to make positive change.
Anxiety Disorders
Anxiety is a normal part of the human experience. At times, anxiety can motivate you to achieve or keep you safe. However, unhealthy levels of anxiety can be overwhelming. It can be triggered by a variety of stressful life events or seemingly come out of nowhere. High anxiety can lead to feeling stuck, extremely stressed and impair functioning across many areas of life including relationships, work and home. Your racing thoughts and sleep disruption may be exhausting. Constant worry may keep you from feeling present in your life. The good news is that there are highly effective therapies for overactive anxiety that can help you re-engage with your life. You do not need to continue suffering with intense anxiety symptoms.
What type of Anxiety do you treat?
I treat the spectrum of anxiety disorders with current, research based therapy tailored to the individual. Specialized treatments include Acceptance Commitment Therapy (ACT), Exposure Therapy, Cognitive Behavioral Therapy (CBT), Prolonged Exposure (PE) and Dialectical Behavioral Therapy (DBT).
Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder
Health Anxiety
Panic Disorder - Panic Attacks
Specific Phobias and Agoraphobia
Post-Traumatic Stress Disorder (PTSD)
Common symptoms of unhealthy anxiety
Thoughts
Constant worry and rumination
High levels of nervousness
Brain fog and difficulty concentrating
Sleep difficulties due to racing thoughts
Physical
Shaking, trembling or excessive sweating
Racing heart and accelerated breathing
Gastrointestinal issues, dizziness, nausea
Tension or not being able to relax
Emotional
Irritability or anger
Feeling overwhelmed by emotions
Existential questioning
Feeling of dread
Avoidance plays a sizable role in keeping the cycle of anxiety going. It can cause your world to become smaller. The more you avoid, the more stuck you become. Therapy can help you break this cycle.
Related symptoms and conditions
Secondary issues are often present with OCD and anxiety and I consider the whole person. Other areas I treat:
Attention deficit hyperactivity disorder (ADHD)
Executive dysfunction
Depersonalization Derealization Disorder
Trauma
Grief and Loss
Depressive symptoms
Interpersonal challenges, relationship difficulties, emotional regulation
ADHD
Attention deficit hyperactivity disorder is a neurological disorder that affects the parts of the brain that help you plan, focus on, and complete tasks. The three subtypes of ADHD are inattentive, hyperactive or combined. ADHD impacts your individual well being, relationships and can affect work and school life. I spend time getting to know your unique situation and how ADHD is getting in the way.
I use Cognitive Behavioral Therapy (CBT), an effective, evidence-based treatment for children and adults with ADHD. CBT helps executive functioning difficulties related to ADHD/ADD (e.g., time management, managing distractions), as well as the emotional difficulties related to ADHD (e.g., depression, anxiety). A typical session for ADHD will focus on identifying the situations in which the client has disorganization, poor time management, poor planning, and the struggles in their day-to-day life. Dialectical Behavioral Therapy is used to address interpersonal and emotional regulation challenges that are common with ADHD. Addressing these issues has been known to lead to higher self-esteem, an increase in productivity, and overall happiness in clients with ADHD.
Symptoms of ADHD in adults
Difficulty staying organized
Frequent procrastination
Ongoing relationship conflict
Low frustration tolerance, difficulty with emotional regulation
Difficulty focusing attention and easily distracted
Impulsivity
Mental or physical restlessness
Trouble maintaining employment
Being overwhelmed by daily tasks
Low self esteem
Struggles with motivation
Symptoms of ADHD in adolescents and children
Children may have symptoms of both inattentiveness and hyperactivity and impulsiveness, or they may have symptoms of just 1 of these types.
Inattentiveness (difficulty concentrating and focusing)
The main signs of inattentiveness are:
having a short attention span and being easily distracted
making careless mistakes – for example, in schoolwork
appearing forgetful or losing things
being unable to stick to tasks that are tedious or time-consuming
appearing to be unable to listen to or carry out instructions
constantly changing activity or task
having difficulty organizing tasks
Hyperactivity and impulsiveness
Hyperactivity and impulsiveness are:
being unable to sit still, especially in calm or quiet surroundings
constantly fidgeting
being unable to concentrate on tasks
excessive physical movement
excessive talking
being unable to wait their turn
acting without thinking
interrupting conversations
little or no sense of danger
