Evidence-Based Health Solutions

By Alex Rebmann

Who I Am

I am a licensed therapist in Virginia who helps people who feel stuck in cycles of anxiety, overthinking, and emotional overwhelm—especially when they’re navigating transitions that feel bigger than they are prepared for. Many of my clients are high-functioning on the outside but internally feel exhausted, uncertain, or disconnected from themselves.

I also work with people who experience OCD or intrusive thoughts, including the confusion and distress that can come from trying to “think their way out” of anxiety. Together, we focus on understanding what’s happening in the mind and body, so symptoms feel less frightening and more manageable.

My approach is grounded in evidence-based practices, including Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and Internal Family Systems (IFS). I tailor treatment to each person's unique needs, goals, and experiences.

A lot of the people I support are in periods of change—starting or ending relationships, shifting careers, moving through identity changes, or trying to figure out what comes next. Even when these changes are positive, they can bring up anxiety, self-doubt, and a sense of instability.

In my work, I slow things down enough to understand what you’re experiencing, build practical skills for regulation and coping, and reconnect you with your own sense of agency. I see therapy as a collaborative process—you are the expert on your life, and my role is to help you make sense of what you’re carrying and support you in responding to it in a way that feels grounded and aligned with who you are.

How I Work

My approach is collaborative and grounded in the belief that you are the expert on your own life. In sessions, I combine a supportive therapeutic relationship with psychoeducation, DBT-informed skills, and nervous system awareness to help you better understand and work with what you’re experiencing. I look at patterns like anxiety, intrusive thoughts, or overwhelm with curiosity rather than judgment, and focus on building practical ways to feel more regulated and steady. I move at a pace that respects your autonomy, readiness, and lived experience.

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a form of psychotherapy developed by psychologist Marsha Linehan (1993). It is designed to help individuals better understand and manage intense emotions that can sometimes feel overwhelming.

When emotions become very strong, they can influence behaviors in ways that may not align with a person’s values or how they want to show up in the world. DBT helps people build skills to regulate emotions, calm the nervous system, and respond to challenges more effectively. Over time, this can support healthier coping strategies and more stable, fulfilling relationships.

DBT is used to treat a range of mental health concerns, including anxiety, depression, eating disorders, substance use disorders, self-harm and suicidal behaviors, and post-traumatic stress disorder (PTSD). DBT supports individuals in building skills to regulate emotions, calm the nervous system, and respond more effectively to stress, which can ultimately lead to healthier coping strategies and more stable relationships (Corliss, 2024).

The four main skill areas in DBT include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness:

Mindfulness:

Mindfulness involves paying attention to the present moment without judgement. It also helps reduce impulsive reactions and increase awareness. This skill helps individuals notice thoughts, emotions, and sensations as they arise, rather than reacting automatically, which can reduce impulsive or emotionally driven behaviors.

Distress Tolerance:

Distress tolerance involves managing crises and painful emotions without making things worse. Instead of trying to immediately fix or avoid discomfort, individuals learn healthy ways to get through painful moments using grounding techniques, self-soothing skills, and other short-term coping tools. 

Emotion Regulation:

Emotion regulation involves understanding and managing strong emotions and learning how emotions work. This includes identifying emotional triggers, increasing positive emotional experiences, and developing skills to shift or manage intense emotional states more effectively. Learning how emotions work reduces emotional vulnerability.

Interpersonal Effectiveness:

Interpersonal effectiveness involves communicating needs clearly, setting boundaries, and handling conflict while maintaining self-respect and relationships. This skill helps individuals communicate their needs clearly and assertively while maintaining respect for themselves and others.

Together, these four core skill areas help individuals stay present, manage crises without worsening situations, better understand and modulate emotions, and communicate needs while maintaining healthy relationships (Linehan, 1993).

Sources:

Corliss, J. (2024, January 22). Dialectical behavior therapy: What is it and who can it help? Harvard Health Publishing. https://www.health.harvard.edu/blog/dialectical-behavior-therapy-what-is-it-and-who-can-it-help-202401223009 

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. 

What is OCD?

Obsessive Compulsive Disorder (OCD):

Obsessive-Compulsive Disorder is a mental health condition where a person experiences unwanted, repetitive thoughts and/or feels driven to perform repetitive behaviors or mental rituals to reduce anxiety or prevent something feared from happening (International OCD Foundation, n.d.).

OCD creates a cycle:

  1. Obsession (intrusive thought)

  2. Anxiety

  3. Compulsion (behavior to reduce anxiety)

  4. Temporary relief

  5. Stronger OCD over time

OCD can become debilitating. It can become a relentless obsession-compulsion loop, consume time with compulsions and mental rituals that can take hours, contribute to avoidance, and cause mental exhaustion. OCD becomes debilitating when it shifts from occasional intrusive thoughts (which most people have) to a rigid, self-reinforcing system of anxiety and rituals that consumes time, narrows life, and undermines functioning (Stanford Medicine, n.d.).

OCD can attach itself to almost anything that a person values, fears, or feels responsible for. While every person’s experience is unique, there are several common OCD themes, including:

  • Contamination OCD

  • Harm OCD

  • Relationship OCD (ROCD)

  • Sexual Orientation OCD (SO-OCD)

  • Scrupulosity (Religious or Moral OCD)

  • Symmetry, Order, and “Just Right” OCD

  • Health OCD

  • Responsibility OCD

  • Existential OCD

  • Pure O (“Purely Obsessional”) OCD

Common triggers across OCD Types:

What is Exposure Response Prevention?

Exposure and Response Prevention (ERP):

Exposure and Response Prevention (ERP) is a type of therapy that is used to treat Obsessive Compulsive Disorder (OCD) and other anxiety-related conditions. “Exposure” refers to gradually facing the things that trigger your anxiety or obsessive thoughts (called triggers). “Response prevention” refers to the ability to resist the urge to do one’s usual coping behavior (called compulsions) (Cleveland Clinic, 2025).

How ERP Works:

Normally, OCD creates a cycle of an intrusive thought, anxiety, compulsion, temporary relief, and stronger OCD over time. ERP breaks this cycle by letting you experience some anxiety without escaping it. Over time, this teaches your brain that the feared outcome doesn’t happen, which helps anxiety naturally decrease over time (Cleveland Clinic, 2025).


Sources

Cleveland Clinic. (2025, October 29). Exposure and response prevention (ERP) therapy: What it is. https://my.clevelandclinic.org/health/treatments/erp-therapy 

International OCD Foundation. (n.d.). About OCD. https://iocdf.org/about-ocd/ 

Stanford Medicine. (n.d.). History. Obsessive-Compulsive and Related Disorders Program. https://med.stanford.edu/ocd/treatment/history.html