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Rumination in the context of OCD, anxiety & depression is often conceptualized as an automatic & intrusive psychological experience for which there is little relief beyond distraction, mindfulness etc.  Dr. Michael Greenberg, clinical psychologist and Director of OCD Associates, has re-framed rumination as a compulsion which is amenable to treatment via a number of specific techniques.  In this conversation we cover:

• how Dr. Greenberg's conceptualization of OCD differs from traditional conceptualizations of OCD
• the unique contribution and value that psychodynamic models can bring to the conceptualization and treatment of OCD
• the concept of the "core-fear" in OCD
• why rumination is so often thought of as an intrusive thought and the case for re-conceptualizing rumination as a compulsion
• the importance of differentiating between awareness and attention with respect to mental events
• a brief summary of Dr. Greenberg's critiques of Acceptance & Commitment Therapy (ACT), particularly in the context of OCD
• the form and function of rumination for most clients and the principles that need to be taught to clients in order to teach them to stop ruminating
• differentiating between constant intrusive, automatic thoughts & rumination
• a consideration of whether rumination in OCD is functionally or qualitatively different than in depression, generalized anxiety disorder etc. 
• reflective pondering vs. brooding in the context of effective problem solving
• examples of response prevention in the context of rumination and Dr. Greenberg's conceptualization of ERP more generally 
• integration of core belief work/psychodynamic principles for examining stuck points in OCD therapy.

Comments or Feedback?  Email the show: [email protected]

Host note: We will be offering a 6 week essentials of CBT workshop that I will be facilitating beginning March 24, 2023.  For more information and registration, please visit: https://www.ottawacbt.ca/news. 

Dr. Michael Greenberg is a licensed clinical psychologist and the director of OCD Associates, a national telehealth practice specializing in Rumination-Focused ERP.  He holds a PhD in clinical psychology from Fairleigh Dickinson University, where he trained in both Cognitive-Behavioral Therapy (CBT) and psychodynamic psychotherapy. He completed specialized training in CBT for anxiety disorders and OCD at Mount Sinai Hospital, and in the treatment of personality disorders and serious mental illness at Nassau University Medical Center. He completed post-doctoral training at Terrap, one of the oldest and best established CBT centers on Long Island. He is licensed in New York, California, and Virginia.

https://drmichaeljgreenberg.com/ocdassociates/