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Q.  My nineteen-year-old son quit therapy with his OCD counselor because he was uncomfortable that the therapist wasn’t Catholic. When he was asked to move up the ladder and face the higher challenges of ERP [exposure and response prevention], he didn’t because he felt it was blasphemy. So my question is, do you ever counsel people with scrupulosity via Skype?
I think we could really use your help. 

A. As painful as it might be to hear this, the uncomfortable truth is that your son will not be persuaded by me any more than he would by a professional. His excuse not to progress in his therapy because it is “blasphemy”—and it is an excuse—is a manifestation of his obsessive-compulsive disorder/scrupulosity. It’s quite common. It indicates that the therapist was on the right track and making progress. I encourage him to return to the therapist who was making him uncomfortable. Your son might be on the verge of real progress and management, if not healing.

Q. Are we required to make and keep New Year’s promises? It seems to me such a waste of time and effort, and more than anything else it triggers a great source of anxiety. 

A.  No, you’re not required to do so. In fact, for a scrupulous person the making of any kind of promise is fraught with difficulty and is seldom, if ever, helpful. Leave the making of promises to others. Put your energy into the management of your condition. That’s a much better use of your time and energy. 

Published inSA Mailbox