Self Injury Disorder

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Self-injury, also known as self-harm, self-mutilation, or self-abuse occurs when someone intentionally and repeatedly harms herself/himself in a way that is impulsive and not intended to be lethal.

Personality Disorder

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A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people.

Impulse Control Disorder

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Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, an impulse, or the inability to not speak on a thought.

Anger Management

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Anger management is the process of learning to recognize signs that you're becoming angry, and taking action to calm down and deal with the situation in a productive way.

Stress Management

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Stress management is a wide spectrum of techniques and psychotherapies aimed at controlling a person's level of stress, especially chronic stress, usually for the purpose of improving everyday functioning.

Insomnia/Sleep Disorders

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Insomnia is a sleep disorder that is characterized by difficulty falling and/or staying asleep. People with insomnia have one or more of the following symptoms: Difficulty falling asleep. Waking up often during the night and having trouble going back to sleep.

Olfactory Reference Syndrome

What is Olfactory Reference Syndrome (ORS)?

People suffering from Olfactory Reference Syndrome (ORS) are overwhelmingly preoccupied with the false belief that they are giving off an offensive body odor (BO) and will be perceived negatively because of it. ORS is often accompanied by depression, shame, anxiety, and embarrassment. Avoidance of social situations, school, or work is very common. It is important to emphasize that individuals with ORS do not give off an odor, but rather it is the false belief and fear that they do.

ORS is under recognized and understudied, in addition it has similarities to Social Anxiety, Body Dysmorphic Disorder (BDD), and Obsessive Compulsive Disorder (OCD), which can make it even more difficult to differentiate between symptoms. According to the DSM-V, although ORS is not considered as a distinct diagnosis, it can be classified as an “Other Specified Obsessive Compulsive and Related Disorder.”

Most common BO preoccupations:

  • Flatulence (who cut the cheese?)
  • Fecal or anal odors
  • General BO (i.e. sweat, armpit, under breast)
  • Halitosis or Bad Breath
  • Genital odors
  • Semen
  • Urine
  • Smelly hands and feet

And sometimes people suffering from ORS report a preoccupation with unsavory smells other than BO such as ammonia, detergents, rotten onions, candles, burned rags, etc. (you get the point).


Who does it effect? 


Actually, it might be even more common than you think (and often goes undiagnosed). It has been reported around the world in places like Africa, Japan, Europe, South America, Canada, and the Middle East, for over a century. Most people begin experiencing symptoms in their mid 20s or later; some might even report it as early as their teens. It appears to be more common in women on this side of the hemisphere (Western) and is reported more often in men in the East. 


Do I have it?  What are some of the signs to look for? 


Experts believe ORS sufferers can continue to experience symptoms for years (even decades) and when left untreated tend to worsen over time. Recognizing ORS can sometimes be very difficult! People often hide their symptoms because they are embarrassed by them.Here are some things to keep an eye out for:

  • Persistent false belief of giving off BO (and belief that other people can smell it too)
  • Time consuming: preoccupation lasts for at least an hour a day
  • “Safety” and avoidance behaviors cause significant distress or impairment seen in social, school or the workplace
    • Excessive showering or washing
    • Excessive use of perfumes or body care products (soap, body washes, deodorant)
    • Using gum/mints and mouthwash throughout the day
    • Changing clothes frequently
    • Hiding oneself when interacting with others, such as turning away, covering face, sitting away from others
    • Excessive checking or masking of supposed BO
    • Avoid social activities, intimate relationships, traveling
    • Change jobs frequently
    • Become housebound (or even move to another town altogether)
    • Excessive “cure seeking” non-psychiatric doctor visits i.e. dentists, surgeons, ENT specialists, proctologist, or gastroenterologists
    • “Referential thinking” – a belief that others are talking or noticing me.

    Individuals with ORS may struggle with co-occurring symptoms and psychological conditions, such as depression (85%), social phobia (65%), and use of drugs and alcohol (50%). A high percentage of individuals with ORS struggle significantly leading to suicidal thoughts, suicidal attempts, and hospitalizations. 


    What kind of help is out there for it? 


    Cognitive behavioral therapy (CBT) can be very effective in treating ORS. Initial treatment includes conducting a thorough assessment, strengthening motivation and readiness for change, targeting depression and/or suicidal thoughts, and thoroughly educating the patient about the treatment. Cognitive therapy consists of challenging the faulty beliefs associated with ORS, such as “I smell so awful that no one will want to be around me, I know others stay away from me because of the way I smell etc.” Behavioral therapy can consist of targeting the avoidance behaviors by guiding the patient to gradually face the situations frequently avoided while decreasing safety and checking behaviors (such as excessive showering or washing and the use of beauty/body products). Mindfulness-based cognitive therapy (MBCT) is another useful approach that focuses on increasing awareness of the present and not giving importance to negative and  maladaptive beliefs.  After all, these are not “fixed realities or reflections of truth;” essentially reducing reacting to such false beliefs. MBCT has been seen to be effective in treating persistent depression which is a common co-occurring condition for ORS sufferers. Effective medication therapy is limited however, Selective Serotonin Reuptake Inhibitors (SSRIs), a class of antidepressants have been seen to be the most helpful. All therapeutic medications should be prescribed and monitored by a trained licensed medical professional.

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Family/Marital problems

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With today's hectic pace, couples and families often experience high levels of stress. As a result, tension and conflict cause difficulty in communication. Solutions that previously worked may not seem to work now. When families experience high levels of stress, children often develop problems in school or behave in inappropriate ways.


Marital Conflict


Couples, regardless of their lifestyle, experience a wide range of pressures and challenges - earning a living, dealing with an extended family, raising children, as well as dealing with loss and change. The impact of these issues on a relationship can be overwhelming and difficult to manage without help. If you and your partner are experiencing any of the following problems or situations, professional help would be beneficial:

  • High levels of conflict or tension
  • Difficulty in making decisions both partners can support
  • Mixed feelings about continuing in the relationship
  • Loss of employment
  • Financial problems and difficulty agreeing about finances
  • Dealing with the problems a child may be having
  • Sexual dissatisfaction
  • An extra-marital affair
  • Depression or other emotional problems of one or both partners
  • Problems with the extended family
  • A pending divorce or separation
  • The need to plan for shared custody of children

Family Problems


Family problems can cause significant difficulties at work, in school and in relationships with others. When the level of stress becomes unmanageable, families may need help finding more creative ways to meet daily challenges or cope with crises. If your family is experiencing any of the following problems or situations, professional help would be beneficial:

  • A child’s problems in school
  • Difficulty setting limits for children
  • Caring for a child with special needs
  • Siblings whose difficulty getting along disturbs the family’s functioning
  • The illness of a family member
  • Supporting elderly family members
  • The death of a family member or loved one
  • Addiction of a family member
  • Divorce or separation