Obsessive Compulsive Disorder (OCD) is a mental health disorder in which individuals experience recurring, unwanted (and often disturbing) thoughts, images, sensations or feelings (obsessions) that make them feel driven to do something repetitively (compulsions). The compulsions can manifest in an outward behavior or an inward, mental compulsion. The aim of the compulsion is to neutralize the obsession or is an attempt to prevent something bad from happening. Examples of compulsions include, excessive hand washing, excessive reassurance seeking, ritualized prayers or thinking a good thought to neutralize a bad thought. OCD can significantly interfere with a person’s daily activities and social interactions.

For individuals with social anxiety disorder, everyday social interactions can create severe anticipatory anxiety, self-consciousness and fear of embarrassment. Symptoms may include excess fear of situations in which one may be judged, worry about embarrassment or humiliation or concern about offending someone.

Generalized Anxiety Disorder (GAD) is an anxiety disorder characterized by persistent and excessive worry about a number of different things. People with GAD may anticipate disaster and may be overly concerned about money, health, family, work, or other issues. Individuals with GAD find it difficult to control their worry. They may worry more than seems warranted about actual events or may expect the worst even when there is no apparent reason for concern.

People with specific phobias, or strong irrational fear reactions, work hard to avoid common places, situations, or objects even though they know there's no threat or danger. The fear may not make any sense, but they feel powerless to stop it. People who experience these seemingly excessive and unreasonable fears in the presence of, or in anticipation of, a specific object, place, or situation have a specific phobia. Common phobias include, Claustrophobia (fear of confined spaces), Emetophobia (fear of vomiting) , Trypanophobia (fear of needles) and Acrophobia (fear of heights).

Panic disorder is an anxiety disorder in which individuals experience spontaneous, seemingly out-of-the-blue, panic attacks and often become overly preoccupied with the fear of a recurring attack. Panic disorder usually begins in adulthood (after age 20), but children can also have panic disorder and many children experience panic-like symptoms (“fearful spells”). Symptoms may include, a racing heartbeat, feeling faint or dizzy, sweating, nausea, chest pain, shortness of breath, trembling, hot flashes or chills, shaky limbs, a choking sensation, numbness or pins and needles, dry mouth, a feeling of dread or a fear of dying and/or a feeling like you're not connected to your body.

Health anxiety, which was once called hypochondriasis; now includes somatic symptom disorder and illness anxiety disorder. It involves a preoccupation with the belief that one has, or is in danger of developing, a serious illness. Many people with health anxiety are often unable to function or enjoy life due to their fears and preoccupations.

The term body-focused repetitive behavior (BFRB) represents a group of related disorders including hair pulling, skin picking, and nail-biting. Other body-focused repetitive behaviors include cheek and lip biting, nail picking, scab picking/eating, knuckle cracking, and tooth grinding.

Excoriation disorder is also known as skin picking disorder or Dermatillomania. It's characterized by the repetitive picking of one's skin, including touching, rubbing, scratching, and digging into the skin. Picking can result in tissue damage, discoloration, and/or scarring. Research shows that 2-5% of the population picks their skin to the point of noticeable tissue damage, with 75% of those people being females.

Trichotillomania is also known as hair pulling disorder and is characterized by the action of repeatedly pulling one's hair (including scalp hair, eyelashes, eyebrows, arm/leg hair, pubic hair, chest hair, and facial hair). According to research, 1-2 in 50 people experience trichotillomania in their lifetime and the average age that people begin pulling is around age 12. People with trichotillomania experience bald patches and hair loss due to the severity of hair pulling.

Acceptance and Commitment Therapy (ACT) focuses on accepting unwanted experiences which are out of our personal control and making committed actions towards living a valued life. The goal of ACT is to increase psychological flexibility, or the ability to contact the present moment and the psychological reactions it produces, as a fully conscious human being, and based on the situation, to persist with or change behavior for valued ends.

Cognitive Behavioral Therapy is based on the idea that mood disruptions stem from irrational thoughts and that identifying and changing these distorted thought patterns can improve emotional symptoms. In cognitive-behavioral therapy, this theory is combined with the principles of behavioral therapy, which is aimed primarily at modifying specific problematic or unwanted behaviors. CBT is a short-term, solution-focused therapy that is focused on the present and involves simple, structured exercises to change distorted thoughts and inappropriate behaviors; it also includes "homework" assignments so that clients can practice and reinforce what they have learned in their everyday lives.

The “gold standard” treatment approach for OCD. Exposure & Response Prevention (E/RP) is a behavioral intervention proven to be effective for treating OCD and specific phobias. E/RP focuses on exposing oneself to particular thoughts, images and situations that trigger distress, while also changing and/or preventing maladaptive responses or compulsions. Through E/RP, clients learn how to relate to the stimulus or trigger in a different way and retrain their brains to no longer experience the trigger as dangerous or threatening.

Habit reversal training (HRT) is an evidence-based behavioral therapy for people with body focused repetitive behaviors (BFRBs). HRT works on behaviors such as: hair pulling, nail biting and skin picking. In this treatment, therapy focuses on building awareness of patterns of picking or pulling, identifies the behaviors that bring on the picking or pulling, and then works on developing competing responses to block the maladaptive habit. For instance, when feeling high levels of anxiety a hair puller can knit or type on a computer, which keeps both hands occupied and keeps the individual engaged in an activity when s/he is at a high risk to pull.

The comprehensive behavioral (ComB) model, developed by Dr. Charles Mansueto and his colleagues, is based on the assumption that a person engages in their BFRB because it meets one or more need in the individual (e.g., helping to relax, to fall asleep, or to feel like a goal was accomplished). This model focuses on understanding why, where and how a person engages in their BFRB so that individualized interventions can be selected to help the person achieve what they want to achieve without engaging in the BFRB. The ComB model consists of four components: Assessment, Identify and Target Modalities, Identify and Choose Strategies, and Evaluation. It focuses on understanding five domains: Sensory, Cognitive, Affective, Motor, and Place (SCAMP).

Source: The TLC Foundation for Body Focused Repetitive Behaviors

A focus on intentional observation and awareness of experiences in-the moment. Present-moment awareness involves compassion, curiosity, and acceptance and fosters development of self-awareness and discovery. This is a skill that takes a considerable amount of practice.