Frequently Asked Questions
Understanding therapy concepts and what to expect
What Is the Inner Critic?
The inner critic is that persistent voice inside your head that judges, criticizes, and doubts you. It's the part of you that says "you're not good enough," "you should have done better," or "what's wrong with you?" While everyone has some form of inner dialogue, for many people this voice becomes overwhelming, harsh, and relentless.
Common Signs of an Overactive Inner Critic
- Constant self-doubt and second-guessing
- Harsh self-judgment after mistakes
- Perfectionism that's never satisfied
- Comparing yourself unfavorably to others
- Difficulty accepting compliments
- Fear of being "found out" as inadequate
The inner critic often develops early in life as a way to protect us. Maybe you grew up with critical parents, faced difficult experiences, or absorbed harsh messages from society. At some point, this voice may have helped you avoid pain or meet expectations. Over time, though, it can become counterproductive and contribute to anxiety, depression, and low self-esteem.
How Therapy Helps
Through therapy, we work to calm the inner critic. The goal isn't to silence it completely. Instead, we focus on understanding where it comes from, developing a healthier relationship with it, and building a more compassionate inner voice. Using approaches like Internal Family Systems (IFS) and Cognitive Behavioral Therapy (CBT), you can learn to recognize when the critic is speaking, question its messages, and respond with self-compassion.
Understanding OCD Treatment
What is OCD, really?
Obsessive-Compulsive Disorder (OCD) is often misunderstood. Despite what you might see in movies or on TV, OCD isn't about being neat or liking things organized a certain way. It's a condition where intrusive, unwanted thoughts (obsessions) cause significant distress, leading to repetitive behaviors or mental rituals (compulsions) that you feel compelled to do to reduce that distress.
OCD can attach itself to anything you care about: your health, relationships, morality, identity, or safety of loved ones. The thoughts feel urgent and real, even when part of you knows they don't make sense.
Common themes include contamination fears, harm obsessions, religious scrupulosity, "just right" feelings, and relationship doubts. These are just some examples; OCD can show up in many different ways.
What is I-CBT (Inference-Based CBT)?
A newer, highly effective approach to OCD treatment
Inference-Based Cognitive Behavioral Therapy (I-CBT) is a cutting-edge treatment that targets the root of OCD: the inferential confusion that makes obsessive thoughts feel so real and compelling.
I-CBT takes a different approach than traditional anxiety management. It helps you understand why you're giving credibility to thoughts that don't deserve it. We examine the faulty reasoning process that leads you to distrust what your senses are telling you and instead trust what your imagination is generating.
Key insight: OCD convinces you that "what if" possibilities deserve the same weight as actual evidence. I-CBT helps you reconnect with reality and trust your direct experience again.
What is ERP (Exposure and Response Prevention)?
The gold-standard behavioral treatment for OCD
Exposure and Response Prevention (ERP) is considered the most effective behavioral treatment for OCD. It works by gradually exposing you to situations that trigger obsessive thoughts while helping you resist performing compulsions.
Through this process, you learn something important: anxiety naturally decreases on its own, even without performing rituals. You also discover that you can tolerate uncertainty better than you thought. Over time, the obsessions lose their power.
Important: ERP is always done collaboratively and at your pace. We work together to create a hierarchy of challenges, starting with manageable steps and building up gradually.
Understanding Therapy Approaches
What is Internal Family Systems (IFS)?
Internal Family Systems (IFS) is a therapeutic approach that views the mind as naturally having many different "parts." Each part has its own perspective, feelings, and role in your life.
You might recognize parts like the inner critic, the perfectionist, the people-pleaser, or the part that wants to avoid difficult feelings. IFS helps you approach these parts with curiosity and compassion. When we stop fighting our parts and start understanding them, real change becomes possible.
The goal is to access your core Self, a calm and compassionate center from which you can lead your life and help heal wounded parts that are stuck in the past.
What is Cognitive Behavioral Therapy (CBT)?
Cognitive Behavioral Therapy (CBT) is one of the most researched and effective forms of therapy. It's based on the idea that our thoughts, feelings, and behaviors are all connected to each other. When we change unhelpful thought patterns, we often see shifts in how we feel and act as well.
CBT is practical and skill-based. You'll learn to identify cognitive distortions (like catastrophizing or black-and-white thinking), challenge unhelpful beliefs, and develop healthier ways of responding to difficult situations.
What is Dialectical Behavior Therapy (DBT)?
Dialectical Behavior Therapy (DBT) was developed to help people who experience emotions very intensely. It combines CBT techniques with mindfulness and acceptance strategies.
DBT teaches four core skill sets:
- Mindfulness: Being present and aware without judgment
- Distress Tolerance: Surviving crisis moments without making things worse
- Emotion Regulation: Understanding and managing intense emotions
- Interpersonal Effectiveness: Navigating relationships while maintaining self-respect
What is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy (ACT) focuses on learning to make room for difficult thoughts and feelings instead of getting caught up in battling them. At the same time, it helps you commit to actions that align with what you truly value.
ACT recognizes that pain is a normal part of life. Much of our suffering comes from how hard we fight against that pain. By practicing psychological flexibility (being present, staying open, and doing what matters to you), you can live a rich and meaningful life even when difficult thoughts and feelings show up.
Common Questions About Therapy
How do I know if therapy is right for me?
Therapy can help if you're struggling with persistent difficult feelings, unhelpful patterns, or relationship challenges. It's also valuable if you simply want to understand yourself better. You don't need to be in crisis to benefit from therapy. Many people use it for personal growth and self-understanding. If something in your life isn't working the way you'd like, therapy might be worth exploring.
What happens in the first session?
The first session is about getting to know each other and understanding what brings you to therapy. We'll discuss your history, current challenges, and goals. It's also an opportunity for you to ask questions and see if we're a good fit. There's no pressure to share everything at once. We move at whatever pace feels right for you.
How long does therapy take?
This varies greatly depending on your goals, the issues you're working on, and other factors. Some people find significant improvement in 8-12 sessions, while others benefit from longer-term work. For OCD treatment specifically, a typical course of ERP or I-CBT might be 12-20 sessions, though this varies. We'll regularly check in about your progress and adjust as needed.
Is what I share confidential?
Yes, confidentiality is a cornerstone of therapy. What you share stays between us, with very limited exceptions required by law (such as imminent risk of harm to yourself or others, or suspected abuse of a child or vulnerable adult). We'll discuss these limits in detail during our first session so you know exactly what to expect.
What's the difference between a therapist, psychologist, and psychiatrist?
Therapists (like LCSWs, LPCs, and LMFTs) provide talk therapy and are trained in various therapeutic approaches. Psychologists have doctoral degrees and can provide therapy and psychological testing. Psychiatrists are medical doctors who can prescribe medication and sometimes provide therapy.
As a Licensed Clinical Social Worker Associate (LCSW-A), I provide evidence-based psychotherapy. If medication might be helpful, I can coordinate with psychiatrists or your primary care provider.
Do you offer online therapy?
Yes! I offer both in-person sessions at my Asheville office and secure video sessions for clients throughout North Carolina. Online therapy can be just as effective as in-person work for many issues, and it offers flexibility and convenience. We can discuss which format works best for you.
Still Have Questions?
I offer a free 15-minute consultation to answer your questions and see if we're a good fit.