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Anxiety is a beast, let’s tame it!

11/02/2026

Have you ever spent so much time trying to make the right decision that you end up making no decision at all?

Maybe you’ve researched every possible option, read the reviews, asked for opinions, and somehow feel less certain than when you started.

Or maybe you already know what you want, but you’re worried about disappointing someone else.

Sometimes the problem isn’t knowing what you want. It’s figuring out how to compare your options, prioritize what’s important, or organize all the information in front of you.

And sometimes you’re faced with two genuinely good choices. You want both, but choosing one means giving up something you value about the other.

Then there’s the person who has learned that making the wrong decision can lead to criticism, punishment, or someone else’s unpredictable reaction. Of course making decisions might feel difficult when you’ve had those experiences.

But here’s something I see a lot in OCD.

Someone makes a decision. They move forward. And then the reviewing starts.

Did I make the right choice? What if I overlooked something? What if I regret this later?

They might replay the decision, research the alternatives, or ask someone else what they would have done.

The decision has already been made, but the uncertainty hasn’t gone away.

Not everyone who struggles with decisions needs more confidence, better organizational skills, or another list of pros and cons.

Sometimes the work is learning to make a choice without knowing how it will turn out.

Sometimes it’s learning to tolerate the possibility of disappointing someone.

And sometimes it’s recognizing that two options can both be meaningful, and choosing one will naturally involve giving something up.

A difficult decision isn’t necessarily a problem to solve. And feeling uncertain afterward doesn’t mean you made the wrong one.

10/27/2026

Have you ever put something off for days, even though you know you’ll feel better once it’s done?

Maybe you’re worried about making a mistake. What if you overlook something important? What if there are consequences you can’t undo?

Or maybe you’re dreading someone else’s reaction. The criticism, judgment, or disappointment you anticipate makes it easier to put the whole thing off.

Sometimes you genuinely want to get started, but figuring out where to begin feels overwhelming. You sit down to work, get distracted, and suddenly an hour has passed.

Other times, you’re just exhausted. Even the simplest tasks feel like they require energy you don’t have.

And sometimes? The task is just boring. You know exactly what needs to be done, but almost anything else sounds more interesting.

I’ve worked with people who spend hours worrying about a task they’re avoiding. I’ve also worked with people who aren’t particularly anxious about it. They just struggle to get started.

From the outside, both look like procrastination.

But the distinction matters.

If you’re putting something off because you’re afraid of making a mistake, breaking it into smaller steps might help you get organized without addressing the fear that’s keeping you stuck.

If you’re struggling with task initiation, telling yourself to tolerate uncertainty may not address the difficulty either.

And if the task is simply unpleasant, sometimes the work is learning to do something boring because it matters to you, even when something more enjoyable is available.

Of course, several of these things can happen at once.

One thing I wish more people understood about procrastination is that knowing what you need to do doesn’t necessarily mean you can easily get yourself to do it.

And figuring out why you’re stuck is often more useful than another lecture about discipline.

10/26/2026

Have you ever spent hours working on something that probably could have been finished a long time ago?

Maybe you genuinely enjoy the details. You take pride in your work, and refining it is satisfying.

But maybe you’re still working because you’re afraid of making a mistake.

What if you overlooked something important? What if someone gets hurt? What if you’re responsible?

Or maybe you’ve learned that mistakes come with consequences. Criticism, punishment, disappointment, or someone’s
unpredictable reaction.

Sometimes it’s about how other people might see you. You don’t want to look incompetent or feel embarrassed.

And sometimes there’s no particular consequence you’re trying to prevent. Something just doesn’t feel right yet. You keep adjusting or checking until that uncomfortable feeling settles.

Then there’s getting so absorbed in the details that you lose track of time. You might even be enjoying yourself, but shifting your attention feels incredibly difficult.

All of these experiences can look like perfectionism from the outside.

But they’re not necessarily driven by the same thing.

This is especially important when we talk about OCD and ADHD. Spending hours refining something doesn’t automatically mean someone is afraid of making a mistake. And enjoying the process doesn’t necessarily mean it’s easy to stop.

I’ve also worked with people who don’t particularly care whether something is perfect. They just can’t tolerate the feeling of leaving it unfinished.

This matters when we’re deciding how to help.

High standards aren’t necessarily the problem. But when you lose the ability to decide when something is good enough, it’s worth understanding what’s keeping you there.

10/22/2026

“Are you upset with me?”

It’s a pretty ordinary question in a relationship, but not always straightforward on why someone asks..

Maybe you’re worried you said something hurtful or morally wrong, and you need to know you haven’t caused harm.

Maybe you’ve learned that a change in someone’s mood can mean conflict or punishment, so you’re checking whether you’re safe.

Maybe you’re feeling disconnected and want to know where you stand.

Or maybe your partner just seems upset, and you’re trying to understand what’s going on.

The question all sound the same, but what happens next can tell us a lot more.

For someone with OCD, an answer might bring relief for a few minutes before another doubt appears. They may replay the conversation, ask again, or look for a more convincing answer.

For someone else, the question might open a conversation that helps them reconnect.

And sometimes several of these things are happening at once.

If you’re the partner being asked, this distinction also matters. Repeatedly answering questions meant to resolve OCD-related doubt can keep the cycle going, even when you’re trying to help.

That doesn’t mean withholding affection or refusing to communicate. It means finding ways to offer support without repeatedly providing certainty, ideally through a plan you’ve discussed together.

And if reading this makes you want to analyze every time you’ve asked for reassurance, that’s worth noticing. You don’t need to classify every question.

The same words don’t always mean the same thing. And the response that helps one person may keep another stuck.

10/22/2026

What started as a cute behavior has turned into me figuring out how to reduce my own accommodation for Fig.

He spends his days pretending to be a therapist, watching clients on Zoom, barking and lunging at animals on TV and watching music videos.

He even checks the office computer before bed to make sure he’s not missing anything.

He’s recently discovered the washing machine and watches that too.

Apparently, being a behavior therapist doesn’t make you immune to reinforcing your dog’s behavior 😂

10/21/2026

Avoidance is one of those behaviors we tend to think we understand just by looking at it.

Take four people avoiding the same difficult conversation.

One is afraid they’ll say something harmful or morally wrong.

Another has learned through experience that conflict can lead to punishment or danger.

A third worries that expressing their needs will push someone away.

And the fourth… Having that conversation might create more emotional closeness than they’re comfortable with.

It’s the same conversation and the avoidance all looks the same… but very different things are happening for each of them..

And here’s where it gets interesting….Someone else might keep putting off that conversation because getting started is difficult. They’re not afraid of the conversation or what might happen afterward.

We see these patterns across many contexts, to include: OCD, trauma, social anxiety, attachment-related experiences, ADHD. And sometimes it’s not straight forward and several processes are operating at once.

But here’s what matters clinically: we can’t determine the function of a behavior just by looking at it. And even when someone can explain why they’re avoiding something, that doesn’t necessarily tell us what’s keeping the pattern going.

If we treat all avoidance the same way, we’re going to miss important differences.

Because helping someone who fears causing harm isn’t necessarily the same as helping someone who has learned that speaking up leads to punishment.

Understanding the maintaining behavior helps us figure out what actually needs to change.

10/20/2026

Hair pulling, skin picking, nail biting, and other body-focused repetitive behaviors (BFRBs) aren’t always driven by anxiety.

Sometimes they happen when we’re bored, concentrating, overwhelmed, or understimulated.

Sometimes there’s a sensory experience involved. A hair that feels different, a rough spot on your skin, or an urge to smooth or even it out.

And sometimes we’re not even aware we’re doing it until we’ve been doing it for a while.

The same behavior can serve different functions at different times, even for the same person.

For example, someone might pick their skin automatically while watching TV but engage in more focused picking when they notice an imperfection.

Sometimes picking or pulling can be part of OCD. A person might pick at their skin because they believe it’s contaminated and feel compelled to remove the contamination, or pull a hair because they’re afraid something bad will happen if they don’t.

In those situations, the behavior may function as an OCD compulsion rather than a BFRB.

The behavior can look the same, but what maintains it may be very different.

This is why understanding when, where, and how a behavior happens is so important.

Treatment isn’t just about trying harder to stop. It’s about identifying the patterns, understanding what maintains it, and developing strategies that address the specific functions.

10/20/2026

These behaviors can serve many different functions. They can show up in OCD, trauma responses, social anxiety, or simply as learned ways of navigating relationships. Doing them doesn’t mean you have OCD. But the question becomes, what function do they serve?

Sometimes, when we look at the bigger picture, these behaviors are attempts to prevent an OCD core fear from coming true.

Maybe you avoid expressing disagreement because you’re afraid it means you’re a bad person.

Maybe you take responsibility for someone else’s feelings because you’re afraid of causing harm.

Maybe you over-explain because you can’t sit with the possibility of being misunderstood.

Maybe you repeatedly seek reassurance because you can’t tolerate not knowing whether you’ve done something wrong.

And maybe you struggle to maintain boundaries because you’re afraid of becoming the bad guy in someone else’s story.

The problem isn’t necessarily the behavior itself. It’s what happens when fear starts making those decisions for you.

Over time, are your choices being shaped more by what matters to you or by what you’re trying to prevent?

Recovery isn’t just about reducing compulsions. It’s about having more freedom to participate in your life and relationships in ways that reflect your values, even when uncertainty comes along for the ride.

10/14/2026

Fig is a little obsessed with his role as co-therapist. He takes a very personal interest in everyone’s business 😂

10/08/2026

When OCD Recruits the World Around It: Recognizing Accommodation- Free training

OCD doesn't just affect the person experiencing it. It can gradually recruit the people and systems around them, including parents, partners, siblings, teachers, and even therapists.
Often, the people trying hardest to help are unknowingly participating in the OCD cycle.

In recognition of OCD Awareness Week, Dr. Michelle Matzke, PsyD, and I are offering a FREE, two-hour training on recognizing accommodation and understanding how our responses can unintentionally maintain OCD.

We'll explore:
• How to recognize common and subtle forms of accommodation.
• Why understanding the function of a behavior matters more than the behavior itself.
• How accommodation can show up at home, in schools, and even in therapy.
• How to distinguish OCD accommodation from legitimate supports, particularly when ADHD, autism, or other needs coexist.
• How well-intentioned responses can reinforce the OCD cycle.

We'll also work through a case vignette to practice identifying accommodation, recognizing appropriate supports, and determining what additional information we need before making clinical decisions.

Tuesday, October 27, 2026
5:30–7:30 PM Mountain Time
Live via Zoom | FREE
2 Montana Board of Behavioral Health CEUs

This training is open to mental health professionals, educators, families, and anyone interested in better understanding OCD.

Recognizing accommodation isn't always straightforward. The same behavior can be helpful support in one situation and reinforce OCD in another.

Register through The Anxiety Break's Clinicians Corner:
https://theanxietybreak.com/clinicanscorner

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Tuesday	8am - 5pm
Wednesday	8am - 5pm
Thursday	8am - 5pm

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