Stepping Out for OCD

On June 9th, 2018, friends, family and mental health professionals gathered with those experiencing obsessive compulsive disorder (OCD) to walk in solidarity and raise awareness of OCD. The One Million Steps 4 OCD walk, coordinated by the International OCD Foundation (IOCDF), is now in its sixth year as a national event. This is the second year the Asheville chapter has participated. Under the shade trees of the French Broad River Park, the group enjoyed snacks and conversation before starting the approximately three mile walk. Dr. Haley Elder opened the event welcoming participants and telling the story of the origins of the walk. 

The event, sponsored by the CBT Center of WNC, included signs along the route with facts about OCD. The beautiful warm weather drew a large crowd of outdoors enthusiasts to the public park who were able to learn about the disorder as they enjoyed their picnics, jogging, and walking their dogs.

Each year as more grassroots chapters organize awareness walks, the generous contributions from participants goes to support research and availability of effective care for OCD across the country. To learn more about OCD or to make a contribution, click here.

Photos by Katie Kelleher.





The Anxious Mind

Racing heart. Knots in the stomach. Trouble focusing. Sweaty palms. Regardless of the cause, these symptoms of anxiety are a nearly universal part of life. Almost everyone can relate to feeling this way at some point, but why? What is the purpose of anxiety, aside from making us uncomfortable?

Like all parts of human anatomy and behavior, the experience of anxiety is a product of evolution. Imagine our ancient ancestors, hunter-gatherers living in small tribes and family groups. They lived their lives almost exclusively outdoors without the protection of walls, doors, or modern weapons. If a larger, stronger predator attacked, the risk was high that a human caught off guard would not win the fight.

In this vulnerable setting, a keen sense of awareness of surroundings was crucial for survival. If someone heard rustling in the leaves, it could be a wolf or a mountain lion hunting for prey, or it could be a harmless squirrel. Those who survived were the ones who assumed it was a fierce predator and responded accordingly. Humans have been bred to be anxious.

Our bodies still hold the genetic predisposition toward anxiety despite the threats having changed drastically over the years. Unless you are an outdoorsman, you are unlikely to have anxiety about being hunted by a mountain lion, but you may become anxious when you get a phone call from a certain person, or if you have to drive during rush hour. When we look closely at the reasons why certain things make us anxious, we can usually trace it back to some type of fear for our safety. It may be perfectly reasonable to be anxious if we get a phone call from someone who has hurt us in the past. The alertness that we experience with anxiety might help keep us safe from other drivers.

If we can see anxiety as friend and protector, we can work toward making peace with the discomfort that anxiety causes. Granted, there are times when anxiety is unreasonable and can cause more harm than good. In a future post, we will explore how to tell the difference and what to do when anxiety gets the best of us.

Mind Reading: Three ways we guess wrong

“I know what you’re thinking!”

Are you sure?

We’ve probably all been on both the giving and receiving end of this common flaw in logic. Sometimes it’s easier to notice it when others direct it toward us. Starting a sentence with, “You must think…” is an almost guaranteed way to get someone to disagree with us. The reality is that we have no idea what anyone else is thinking, yet we so frequently try to impose those guesses on others.

In this article, we look at specific ways we find ourselves in this all too familiar trap:

    1. Reading too much into text. So much of our communication is text-based now. Depending on our mood, we could view a message of “Thanks, you’re so helpful” as a genuine compliment, or a sarcastic insult. Communication is far more complicated than simply the words we convey. Tone, volume, and body language speak just as much, if not more meaning than the words. When these cues are absent, our minds are prone to fill in those gaps and assume additional meaning. Frustratingly, we often get it wrong, which can result in tension and hurt feelings.
    2. Assuming it’s all about us. “Why did my friend ignore my text? Is he mad at me? I must have said something to upset him.” Sometimes a missed text is just a missed text. The mind dislikes gaps in information. Our desire to understand why people behave the way they do can lead us down dark paths if we are not cautious. We assign meaning – and often blame – in the interest of filling in gaps in meaning, but be careful with this. Until the other person has confirmed your assumptions, you may not be in as much trouble as you thought. Maybe their actions have nothing to do with you.
    3. Acting like we’re right. If I assume a person dislikes me, I’m going to behave differently around them than if I assume they like me. This leads to the trap of the self-fulfilling prophecy. If I ignore a person because I assume they don’t like me, they’re not going to like me because I’m ignoring them. By acting this way, I’m making myself very unlikable.


So now what? Once we catch ourselves mind reading, what do we do about it?


  1. Don’t take it personally. If you feel tempted to blame yourself for your friend’s mysterious absence recently, or a family member’s failure to return a call, take a step back. What else might be going on in this person’s life that could explain their behavior? True, there are times when we might have actually done something wrong and they are in fact avoiding us. Why start with that assumption, though? There’s just as much of a chance that we were wrong as there is that we were right.
  2. Test your theory. There are many ways to do this. My favorite is perhaps the simplest: Ask. Approaching someone with kindness, honesty, and a genuine sense of curiosity has rarely steered me wrong. “Hey, I haven’t heard back from you after I texted you the other day. Just checking in. Is everything ok?”
  3. Remember that sometimes the mind lies to us. Simply second-guessing our thoughts is a powerful ability. Just because we have a thought doesn’t mean we have to believe it or agree with it. We have the power to choose which of our thoughts we hold onto, and which we let go. Letting go of the questions, the insecurities, and accepting the ambiguity of not really knowing can bring a calmness to our lives that we rarely find when we buy into the pressure to solve all of the mysteries.

Written by: Erin Shadle, LCSW


1 Million Steps 4 OCD

Asheville’s first annual walk, 2017

I’ve heard the argument that obsessive compulsive disorder (OCD) is one of the most difficult mental illnesses to live with. Imagine feeling intense anxiety over things that most people never think about, then believing you have to go to extreme lengths to make that feeling go away. Now imagine doing that while knowing that the fear is irrational to begin with, and even if you make the feeling go away, it will return soon.

I’ve also heard it said that OCD is probably one of the most misunderstood of the mental illnesses, often portrayed in the movies as a funny quirk that offers comic relief, or limited to excessive hand washing. We hear phrases like, “I’m so obsessed with this band!” or “My books have to be a certain way on my shelf. I’m pretty OCD about it.” The way OCD has woven its way into our vernacular almost always misrepresents the true experience.

To demystify the disorder, one organization is rallying groups across the country for the sixth year in a row to participate in the 1 Million Steps 4 OCD Walk. Chapters nationwide will walk together to raise awareness of OCD, and contribute financial support to the International Obsessive Compulsive Disorder Foundation (IOCDF).

The Cognitive Behavioral Therapy Center will be participating in Asheville, NC for the second year in a row. The following is an interview with organizer and OCD specialist Dr. Haley Elder:

What is the 1 Million Steps 4 OCD Walk all about?

In 2012, a father named Denis Asselin walked over 500 miles (which is roughly one million steps) from his home in Cheney, PA to Boston, MA in memory of his son Nathaniel. Nathaniel took his own life at the age of 24 after a long battle with OCD and Body Dysmorphic Disorder (BDD). His father Denis walked to both honor his son and raise awareness about OCD and BDD. At the end of his walk, Denis was greeted in Boston on June 5, 2012 by the staff of the IOCDF, friends, family, and members of the OCD community at a rally honoring Denis and supporting OCD and BDD awareness. The next year the first 1 Million Steps 4 OCD Walk took place in Boston with the goal of raising awareness, money, and hope for this illness.

Each year since, more and more cities have participated. As the walks have expanded, smaller grassroots virtual walks have started to pop up around the country and this year we are having the second organized one in Asheville, which we hope will continue to grow in size each year.

Why is it so important to raise awareness about OCD?

Our best estimate is that OCD affects roughly 2-3 million adults and approximately 500,000 children and adolescents in the United States alone. By building awareness of this disorder, it is the foundation’s hope that worldwide mental health professionals will become better educated about evidence-based treatments, the general public will gain access to information about treatments for OCD, and the stigma surrounding OCD and mental illness in general will be reduced.


How can I get involved?

OCD-NC, an official affiliate of the IOCDF, will be hosting a grassroots 1 Million Steps 4 OCD Walk in Asheville on Saturday, June 9, 2018. It will take place at French Broad River Park, 508 Riverview Drive, Asheville, NC 28806. Check-in for the walk will be at 9:15 am, with the walk commencing at 10 am. To register to attend or donate, please visit:

I think I may have OCD, or I know someone who does. Where can I go to learn more or seek treatment?

The Cognitive Behavioral Therapy Center offers comprehensive treatment of OCD, including individual therapy, an intensive outpatient program, medication options, and a support group. Please contact us to learn more. You can also visit the IOCDF website at for more information about OCD and its treatment.

Photos by: Katie Kelleher


Introducing: the Behavioral Sleep Solutions Program

Over the years as a cognitive behavioral therapist, I’ve worked with numerous clients who are struggling with sleep. At first they start the conversation with, “I’m really upset about an argument with my spouse,” or “I’m here because I want to stop being so anxious.” Sleep is not the first thing on their mind when they walk into my office, but it probably is by the time they leave.

Insomnia is an epidemic that receives far too little attention. It is estimated that 60 million Americans struggle with insomnia at any given time. That equates to about one of every five adults, and that number tends to rise with age.

Sometime during 2013, a colleague handed me a book called Cognitive Behavioral Treatment of Insomnia. I was hooked. It amazed me how straight-forward the treatment of insomnia could be, and how effective the method is. Word got out, and before I knew what was happening, I was inundated with clients who wanted to see me exclusively for sleep problems. The waiting list was upwards of three months long. It was time to expand on this untapped need.

On May 1st, 2018, the Behavioral Sleep Solutions program will launch. The ultimate goal of this program is to be able to provide effective evidence-based treatment of insomnia to the greatest number of clients in need. Accomplishing this will take a combination of individual sessions, groups, and the assistance of well-educated and supervised student interns.

With a treatment protocol that is as rigorously tested and effective as CBT for insomnia, there is no reason anyone should continue to suffer through sleepless nights. For more information about the Behavioral Sleep Solutions program, please see the Behavioral Sleep Solutions page.

Written by: Erin Shadle, LCSW