Sally Winston, Martin N. Seif – Treating the Reassurance Junkie

Outline

Recognize covert and subtle compulsive reassurance seeking in a clinical setting. Recognize covert and subtle compulsive reassurance seeking in a clinical setting.

• We will describe productive and unproductive reassurance types, including hidden, implicit, deduced and empty subtypes as well as checking compulsions. We will describe productive and unproductive reassurance types, including hidden, implicit, deduced and empty subtypes as well as checking compulsions.
• We will illustrate how reassurance junkies present in the clinical setting, often as “neurotic”, or with generalized anxiety, We will illustrate how reassurance junkies present in the clinical setting, often as “neurotic”, or with generalized anxiety, depressiondepression, low self-esteem or poor confidence, needy or dependent with case vignettes., low self-esteem or poor confidence, needy or dependent with case vignettes.

Distinguish responses that reinforce obsessive worry from those that reduce it. Distinguish responses that reinforce obsessive worry from those that reduce it.

• We will show how reassurance can serve as negative reinforcement, driving the OCD cycle and maintaining obsessive worries. We will show how reassurance can serve as negative reinforcement, driving the OCD cycle and maintaining obsessive worries.
• We will introduce a detailed classification system for reassurance traps, including Do No Harm, Always Do Right, Guarantees Forever and Banish All Doubts. We will introduce a detailed classification system for reassurance traps, including Do No Harm, Always Do Right, Guarantees Forever and Banish All Doubts.
• We will discuss and define the three voices of the mind.We will discuss and define the three voices of the mind.

Implement evidence-informed treatment strategies which avoid inadvertent empty or unproductive reassurance. Implement evidence-informed treatment strategies which avoid inadvertent empty or unproductive reassurance.

• We will show how a meta-cognitive and acceptance-based approach interferes with the “addictive” cycle of reassurance seeking. We will show how a meta-cognitive and acceptance-based approach interferes with the “addictive” cycle of reassurance seeking.
• We will demonstrate how to implement exposure and response prevention interventions which withdraw the patient from unproductive reassurance. We will demonstrate how to implement exposure and response prevention interventions which withdraw the patient from unproductive reassurance.

Apply strategies to increase tolerance for uncertainty. Apply strategies to increase tolerance for uncertainty.

• We will supply metaphors and stories that communicate the attitude of mindful acceptance that is an essential component of recovery. We will supply metaphors and stories that communicate the attitude of mindful acceptance that is an essential component of recovery.
• We will offer ways to withhold reassurance without sacrificing compassion. We will offer ways to withhold reassurance without sacrificing compassion.

Increase mindful awareness of unproductive self-talk which masquerades as self-comfort, rational refutation and problem-solving. Increase mindful awareness of unproductive self-talk which masquerades as self-comfort, rational refutation and problem-solving.

• We will show, using descriptions of internal dialogues, how many typical self-help and cognitive behavioral interventions can simply perpetuate the worry cycle by promoting paradoxical effort, entanglement with content and further reassurance-seeking. We will show, using descriptions of internal dialogues, how many typical self-help and cognitive behavioral interventions can simply perpetuate the worry cycle by promoting paradoxical effort, entanglement with content and further reassurance-seeking.