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

Outline

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 illustrate how reassurance junkies present in the clinical setting, often as “neurotic”, or with generalized anxiety, depression, low self-esteem or poor confidence, needy or dependent with case vignettes.

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 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.

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 demonstrate how to implement exposure and response prevention interventions which withdraw the patient from unproductive reassurance.

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 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.

• 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.