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 has nothing to do with neatness or liking things organized. 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)?
Understanding how obsessional doubt is built
Inference-Based Cognitive Behavioral Therapy (I-CBT) examines the reasoning process that makes imagined possibilities feel like credible threats.
Sessions are often less structured and focus on understanding how OCD creates doubt. We examine when imagination has taken priority over direct evidence and practice responding from what you actually know.
Where I usually start: I typically begin OCD treatment with I-CBT, then introduce more structured ERP-focused sessions when useful.
What is ERP (Exposure and Response Prevention)?
Structured exposure and response prevention
Exposure and Response Prevention (ERP) is a well-studied, first-line behavioral treatment for OCD. It uses planned exposure to situations that trigger obsessive thoughts while helping you reduce compulsive responses.
ERP gives you repeated practice allowing anxiety and uncertainty to be present without relying on rituals, avoidance, or reassurance seeking.
How it is structured: We create an exposure hierarchy, choose planned exercises, and review what happens between sessions. The plan changes as your response to treatment changes.
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.
OCD-Specific Questions
How do I know if I have OCD?
OCD involves two key components: obsessions (intrusive, unwanted thoughts that cause distress) and compulsions (repetitive behaviors or mental acts you feel driven to perform to reduce that distress).
Key signs include:
- Spending significant time each day on obsessive thoughts or rituals
- Recognizing your fears may be irrational but being unable to stop
- Avoiding situations that trigger obsessions
- Repeatedly seeking reassurance from others
OCD is different from general anxiety because the distress is driven by specific obsessive themes and you feel compelled to perform specific rituals in response. If you suspect you have OCD, a therapist trained in OCD can help clarify the diagnosis.
What types of OCD are there?
OCD can attach to virtually any theme. Common presentations include:
Regardless of the theme, the underlying mechanism is the same, and evidence-based treatments like I-CBT and ERP are effective across all subtypes.
What is the difference between I-CBT and ERP for OCD?
I-CBT examines the reasoning process that makes obsessional doubts feel believable. ERP uses planned exposure and response prevention to reduce compulsive patterns.
I typically begin with less structured I-CBT sessions, then introduce a more structured ERP treatment plan when useful. Some clients spend more time in I-CBT; others lean more heavily into ERP-focused work. Learn more about OCD treatment approaches →
Can OCD be cured?
OCD is considered a chronic condition, but it is treatable. I-CBT and ERP address different parts of the OCD cycle, and outcomes vary by person. Treatment focuses on reducing the time, distress, and interference caused by obsessions and compulsions.
Treatment helps you develop a new relationship with intrusive thoughts so they lose their power over your behavior. The key is getting the right kind of treatment from a therapist specifically trained in OCD.
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 (LCSWA), I provide evidence-based psychotherapy. If medication might be helpful, I can coordinate with psychiatrists or your primary care provider.
Do you offer virtual therapy across North Carolina?
Yes. In-person sessions are available at my Asheville office at 29 North Market Street. Virtual sessions are available to clients who live anywhere in North Carolina.
What insurance do you accept?
I'm in network with Aetna and BlueCross BlueShield (BCBS). If you're covered by one of those plans, sessions can be billed to your insurance.
If you have a different plan, self-pay is available to all clients, and I can provide a superbill for out-of-network reimbursement. I accept Visa, Mastercard, Amex, Venmo, Zelle, and check.
How much does therapy cost if I pay out of pocket?
Self-pay rates are $150 for a 50-minute individual session and $250 for a 50-minute couple session.
If you're paying for sessions yourself, or you're not using insurance, you have the right to a Good Faith Estimate explaining what your care will cost. Ask for one before you schedule or at any point during treatment, and you'll get a written estimate. See full fee and insurance details →
What if you're out of network with my insurance?
You can still work with me on a self-pay basis. I provide a superbill, an itemized receipt you can submit to your insurance company for out-of-network reimbursement.
Reimbursement amounts are set by your insurer, so check your out-of-network benefits with them before you start.
Still Have Questions?
I offer a free 15-minute consultation to answer your questions and see if we're a good fit.