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  • Dr. Dug

Case Study of BZ and OCD: Session #1

In our first appointment, BZ and I talked about her background and history of OCD. With BZ's background and insights shared through pre-session paperwork, we delved into her past experiences and the strategies she employed to manage OCD.

Understanding the Past

I summarized my understanding of BZ's background, outlining the various strategies she had attempted to wrestle control from OCD's grip. These strategies included distraction tactics (e.g., I’ll talk with someone on the phone while leaving home), self-shaming (e.g., “what is wrong with you stop this stupid behavior, you’re ruining your life), and the rigid pursuit of control over her compulsions (e.g., “I will not check anything today”).

The ACT Approach: A Paradigm Shift

To set the stage for our therapeutic journey, I introduced BZ to Acceptance and Commitment Therapy (ACT), a framework that emphasizes mindfulness, acceptance, and values-based living. I explained that my practice incorporates Virtual Reality Exposure Therapy (VRET), uniquely informed by ACT principles.

ACT teaches us that rather than constantly avoiding or attempting to change pain and discomfort, we can redirect our energy towards what truly matters in life – our values and aspirations. To make this shift, one must cultivate the willingness to confront discomfort head-on, a fundamental aspect of our path towards a meaningful life.

ACT vs. Traditional Exposure Therapy

We discussed how ACT differs from traditional forms of Exposure Therapy, which often focus solely on extinguishing or desensitizing fear or pain. I highlighted the potential downsides of a treatment approach solely aimed at eliminating something – it can inadvertently perpetuate fear and avoidance, even when the source of distress is no longer present. ACT, in contrast, aims not to subtract from life but to add to it.

Charting a New Course

Together, BZ and I recognized that what she needed to reintegrate into her life was a recapturing of her true self – a person characterized by confidence, optimism, and a relentless pursuit of meaningful goals. In essence, BZ aspired to transition from a life dictated by the fear of pain to one governed by her deeply held values.

The Treatment Plan

In collaboration, we constructed an 8-week treatment plan tailored to BZ's unique journey. We explored the core principles of Virtual Reality Exposure Therapy (VRET), a pivotal component of her treatment.

Starting with Mindfulness

Our session culminated in BZ's initiation into mindfulness. I explained the benefits of mindfulness and its instrumental role in grounding individuals and fostering self-awareness, a cornerstone of our therapeutic process.


To empower BZ on her path towards recovery, I equipped her with resources for her transformation. This included reading materials to deepen her understanding of ACT, a Values homework to connect with her core beliefs, a daily mindfulness homework to cultivate self-awareness, and the simple yet important task of purchasing inexpensive VR goggles – a gateway to the immersive world of VRET.

As BZ takes her first steps on this transformative journey, we eagerly anticipate the evolution of her story and the remarkable progress that lies ahead. Stay tuned for Session #2 of BZ's pursuit of a life filled with purpose and driven by values.

Case studies provide readers with an opportunity to become familiar with Virtual Reality Exposure Therapy. Each case study will unfold over multiple articles. Future case studies will explore a variety of problems. Leave a comment if there is a specific problem or disorder of which you would like to see a case study.

Wishing everyone well! #DrDug #LittleThingsFromDrDug

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