Podcasts about international ocd foundation

Sometimes, you are so consumed by caring for a loved one with a serious mental illness, like schizophrenia or bipolar disorder, that taking a moment for yourself feels like a betrayal. In this episode, host Gabe Howard and Dr. C. Alec Pollard reveal the hidden crisis of caregiver burnout in the world of serious mental illness. They dismantle the myth that self-care is selfish, showing how neglecting your own needs can worsen stress and strain the very relationships you cherish. Dr. Pollard dives into the toxic beliefs that trap caregivers—those who support individuals with schizophrenia, bipolar disorder, and other severe conditions—into a cycle of resentment and exhaustion. With breakthrough strategies and compassionate advice, this episode offers a wake-up call for anyone feeling overwhelmed by the relentless demands of caregiving. Learn how nurturing yourself not only protects your well-being but also empowers you to care more effectively for your loved one. Funding for this episode was provided by Evernorth Health Services. “If you can do no good, at least do no harm. A lot of the, the things that families don't understand and caregivers is that they're actually doing things that not only they know it doesn't work okay. When they're doing these things, these naggings and lectures and all that, they know it's not working. But what they may not appreciate is it's actually making things worse over time.” ~C. Alec Pollard, PhD Our guest, C. Alec Pollard, Ph.D., is Founding Director of the Center for OCD and Anxiety-Related Disorders at Saint Louis Behavioral Medicine Institute and Professor Emeritus of Family and Community Medicine at Saint Louis University School of Medicine. He is a licensed psychologist who works with a range of obsessive-compulsive and anxiety-related disorders, with a special interest in obstacles that might inhibit the pursuit of recovery or interfere with effective participation in treatment. He is on the Scientific and Clinical Advisory Board of the International OCD Foundation and chairs the organization's Training Subcommittee, including a national training initiative called the Behavior Therapy Training Institute.  Dr. Pollard is former chair of the Clinical Advisory Board of the Anxiety and Depression Association of America and has authored over 100 publications, including 3 books – “The Agoraphobia Workbook, Dying of Embarrassment: Help for Social Anxiety & Phobia,” and “When a Loved One Won't Seek Mental Health Treatment: How to Promote Recovery and Reclaim Your Family's Well-Being.” Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can't imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

Marisa T. Mazza, PsyD, author of The ACT Workbook for OCD, joins us to discuss mindfulness, acceptance, and exposure skills to live well with OCD. Marisa is a clinical psychologist and founder of choicetherapy psychological services, inc. She has utilized evidence-based treatments to help people with obsessive-compulsive disorder (OCD) and anxiety for over fifteen years. She created and operates an individual therapy practice and intensive outpatient program in San Francisco, CA. Mazza and her team integrate evidence-based treatments—such as acceptance and commitment therapy (ACT), exposure response and prevention (ERP), and compassion-focused therapy (CFT)—to assist adults and adolescents in changing their relationship with obsessions and compulsions in order to live vitally. She is on the board of OCD SF Bay Area (the International OCD Foundation's local affiliate), president of the San Francisco Bay Area Association for Contextual Behavioral Science, and faculty in the department of education at the University of San Francisco. Visit our website at www.newharbinger.com and use coupon code 'Podcast25' to receive 25% off your entire order. Buy the Book: New Harbinger - https://bit.ly/4i5UjvT Amazon - https://a.co/d/2ttXgPX Barnes & Noble - https://www.barnesandnoble.com/w/1133990332 Bookshop.org - https://bit.ly/4hITbyA If you have ideas for future episodes, thoughts, or questions, we'd love to hear from you! Send us an email at podcast@newharbinger.com 

Send Lauren a text! In this episode, I focus on how parents can find qualified therapists who treat OCD in children and teens, understand ERP therapy (the gold standard in OCD treatment) and support their child's recovery journey.✨ What's Bringing Me More ZenTune in till the end of the episode to discover my new favorite protein-packed snack that helps me through mid-day energy slumps! Click here to see where you can buy this snack for yourself 

Send Lauren a text! In this episode, I explore the key differences between OCD and anxiety in tweens and teens. Learn how to recognize the signs and identify when your child might need specialized support. ✨ What's Bringing Me More ZenTune in till the end of the episode to discover my favorite free meditation app! I'll tell you how it's been keeping me accountable to meditate on a daily basis. And how I'm noticing positive differences from staying consistent. 

The 2025 IOCDF Conference — starting July 10 in Chicago — is set to bring together clinicians, researchers, and individuals with OCD for a weekend focused on education, advocacy, and community. In this episode, Rebecca Deusser, Executive Director of the International OCD Foundation, talks with Dr. Patrick McGrath about what makes this event unique and why it has become such an important gathering for the OCD community. They discuss new initiatives for this year's conference, including expanded virtual access, increased programming for families, and a stronger emphasis on global outreach.Beyond the conference, Rebecca shares the IOCDF's long-term goals, from pushing for more research funding to improving access to treatment worldwide. With OCD still widely misunderstood and effective care difficult to find, the need for advocacy has never been greater. This conversation dives into how the conference plays a key role in breaking stigma, equipping clinicians with better training, and giving those affected by OCD the resources they need.For more information about the conference, please visit: https://iocdf.org/programs/conferences/Follow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocdFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

Book your free session directly, visit: www.robertjamescoaching.com Welcome to episode 452 of the OCD and Anxiety Podcast. In this enlightening discussion, host Robert James is joined by Dr. Marisa Mazza, a distinguished clinical psychologist and author of "The ACT Workbook for OCD." Together, they delve into the transformative power of Acceptance and Commitment Therapy (ACT) combined with Exposure and Response Prevention (ERP) for those struggling with OCD and anxiety. Dr. Mazza shares her personal journey into the world of OCD treatment, offering listeners valuable insights into evidence-based strategies that help disrupt the cycle of anxiety and compulsions. The conversation is rich with practical advice, compassion, and inspiring stories that emphasize finding meaning and purpose in life beyond the confines of OCD. Listeners will explore the vital ACT principles of acceptance, mindfulness, and value-based living, as well as learn effective techniques for managing compulsions and overcoming perfectionism. This episode is a must-listen for anyone navigating OCD or supporting a loved one, providing a pathway to resilience and recovery Marisa T. Mazza, Psy.D., is a licensed psychologist, supervisor, and founder of choicetherapy, a renowned group practice specializing in evidence-based treatments for OCD and Anxiety. Passionate about guiding individuals beyond their fears, she facilitates empowering workshops and provides consultation to therapists seeking genuine connections with clients. Dr. Mazza's expertise is widely recognized, as she serves as faculty at the Behavioral Therapy Training Institute of the International OCD Foundation. Her book, "The ACT Workbook for OCD," published by New Harbinger, showcases her exceptional knowledge and insights on mindfulness, acceptance, and exposure skills for living well with OCD. Links https://www.choicetherapy.net/team Disclaimer: Robert James Pizey (of Robert James Coaching) is not a medical professional and is also not providing therapy or medical treatment. Robert James Pizey recommends that anyone experiencing anxiety or OCD to seek professional medical help straight away to get a medical opinion and rule out other conditions or illnesses. The comments and opinions as written on this site are simply that and are not to be taken as professional medical opinions. Robert James Pizey provides coaching, education, accountability and peer support around Anxiety through his own personal experiences.      

S5 E5 Understanding PANDAS with Dr. Sarah O'DorIn this episode, we discuss a rare pediatric condition known as PANDAS - Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. PANDAS is a phenomenon when a child has a spontaneous manifestation of psychiatric issues following a strep infection. The field has only recently started to research and understand this condition over the past few decades. Obsessive Compulsive Disorder (OCD) is a core feature of PANDAS, among others such as vocal or motor tics, that comes on suddenly and has a strong impact on the child's life.Dr. Sarah O'Dor is an Instructor in Psychiatry at Harvard Medical School and the Director of Research at the Pediatric Neuropsychiatry and Immunology Program at Massachusetts General Hospital, otherwise known as the “PANDAS Clinic.” Dr. O'Dor's research seeks to identify the underlying biological causes, treatments, and mediating factors for recovery in childhood mental disorders. For the past 7 years, her work has focused on pediatric neuropsychiatric disorders, including Obsessive-Compulsive Disorder (OCD), mood disorders, and PANDAS. Her findings have resulted in several peer-reviewed journal articles and book chapters about childhood mental disorders. Dr. O'Dor contributions to the field of psychology and psychiatry have been recognized by organizations such as the American Psychological Foundation, the Anxiety and Depression Association of America, and the International OCD Foundation. Dr. O'Dor is also a Licensed Clinical Psychologist and has a private practice in the Boston suburbs specializing in psychological and neuropsychological assessments for children through young adults.Be curious. Be Open. Be well.The ReidConnect-Ed Podcast is hosted by Alexis Reid and Dr. Gerald Reid, produced by Cybersound Recording Studios and original music is written and recorded by Gerald Reid.*Please note that different practitioners may have different opinions- this is our perspective and is intended to educate you on what may be possible.Follow us on Instagram @ReidConnectEdPodcast and Twitter @ReidConnectEdShow notes & Transcripts: https://reidconnect.com/reid-connect-ed-podcast

Psychiatrist Dr. Dora-Linda Wang joins us to explore what Obsessive-Compulsive Disorder (OCD) is, its prevalence, symptoms, and rationality. The discussion provides valuable insights into effective treatment methods, including the use of higher doses of SSRIs and Exposure Response Prevention (ERP) therapy. We discuss techniques for managing OCD, such as refocusing and postponing rituals, and valuable resources like Jeffrey Schwartz's 'Brain Lock' and the International OCD Foundation. Learn more about OCD

OCD is often misunderstood and can manifest in many forms from a variety of experiences that create associations with a compulsion and an outcome. In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, are joined by Aiden Reis, a trans, Autistic therapist who specializes in OCD, anxiety, phobias, and panic. They discuss practical strategies for effectively managing OCD through Exposure and Response Prevention (ERP) therapy using a value-driven and neurodivergent-affirming approach. Top 3 reasons to listen to the entire episode: Learn practical strategies for rebuilding self-trust after anxiety-inducing experiences, drawing from Aiden Reis's invaluable insights into Exposure and Response Prevention (ERP) therapy adapted for neurodivergent individuals. Discover the importance of accommodating sensory needs in therapy without reinforcing anxiety, and understand how to effectively differentiate between sensory sensitivities and anxiety responses. Gain a richer appreciation of how addressing "what if" scenarios and unhooking from distressing thoughts can lead to profound empowerment and emotional resilience, helping you live a good life despite potential challenges. OCD can be challenging, but there are ways to manage it, and ERP, when done using a neurodivergent-affirming approach, can be an effective tool in managing OCD for neurodivergent individuals. More about Aiden: Aiden is a trans and autistic, private practice therapist based in Massachusetts. Working with Autistic and ADHDer clients, he is passionate about providing neurodivergent-affirming and LGBT-positive therapy. He specializes in OCD, anxiety, phobias, and panic. Aiden is a member of the International OCD Foundation. Website: www.divergecounseling.com ————————————————————————————————

Is your four-year old lining up toys? Do they love washing their hands over and over? Does your child get frustrated if routines are broken? Obsessive-compulsive disorder (OCD) is a diagnosis we see, but not all behaviors are considered OCD. In honor of OCD Awareness Week, I welcome Michelle Massi who is a mom and a therapist (LMFT) specializing in working with kids, families and adults who struggle with anxiety, OCD and OC related disorders. She joins me to discuss:  The definition and characteristics of OCD If an “inflexible” toddler is a sign of OCD Misconceptions surrounding OCD Management strategies for OCD To connect with Michelle Massi follow her on Instagram @anxietytherapyla, check out all her resources at https://anxietytherapyla.com/. Visit the International OCD Foundation at https://iocdf.org/ for additional resources.  Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk TV. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Is your four-year old lining up toys? Do they love washing their hands over and over? Does your child get frustrated if routines are broken? Obsessive-compulsive disorder (OCD) is a diagnosis we see, but not all behaviors are considered OCD. In honor of OCD Awareness Week, I welcome Michelle Massi who is a mom and a therapist (LMFT) specializing in working with kids, families and adults who struggle with anxiety, OCD and OC related disorders. She joins me to discuss:  The definition and characteristics of OCD If an “inflexible” toddler is a sign of OCD Misconceptions surrounding OCD Management strategies for OCD To connect with Michelle Massi follow her on Instagram @anxietytherapyla, check out all her resources at https://anxietytherapyla.com/. Visit the International OCD Foundation at https://iocdf.org/ for additional resources.  Our podcasts are also now on YouTube. If you prefer a video podcast with closed captioning, check us out there and subscribe to PedsDocTalk TV. We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on the PedsDocTalk Podcast Sponsorships page of the website.  Learn more about your ad choices. Visit megaphone.fm/adchoices

OCD Awareness Month is here, and we're excited to join forces with the International OCD Foundation to shine a light on what it really means to live with Obsessive Compulsive Disorder. In this video, we dive into the myths, the struggles, and the toll OCD takes on people's lives — and why it's so important to break the stigma. This month, let's take the first step together and support those affected by OCD in finding the help they need.If you or a loved one is struggling with OCD, know there is help. Visit ⁠⁠https://learn.nocd.com/podcast⁠⁠ to learn more.Show notes:0:00 Raising awareness for OCD1:27 OCD myths3:06 Media portrayals of OCD are wrong4:27 OCD treatment is available5:37 Lets break the stigma6:08 Gold standard of treatment for OCD6:36 Take the first step7:24 How do you "get rid" of OCD?7:54 Join us this monthFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

Understanding OCD and Anxiety: Navigating Intimacy with Sarah Hazleton In this episode we dive into the intricacies of OCD and anxiety, particularly focusing on how they affect intimacy and relationships, with guest Sarah Hazleton, a licensed clinical social worker. Sarah explains how OCD manifests through intrusive thoughts and compulsions, its impact on relationships, and the different subtypes of OCD including relationship OCD and Pure O. We discuss the importance of appropriate therapeutic approaches, like Exposure Response Prevention (ERP), and resources for those seeking help. The conversation touches on the stigma and shame surrounding OCD, particularly when it involves sexual and intimate thoughts. Practical advice is provided for those seeking therapy, including how to find qualified therapists through reliable sources. This episode is released in recognition of mental health awareness, emphasizing the significance of understanding and accepting diverse mental health challenges. Sarah is a Licensed Independent Clinical Social Worker specializing in treatment of OCD and anxiety related disorders. She completed her master’s degree at University of New England in 2007 and spent the early part of her career as a clinician working with children, adolescents, and families experiencing severe and persistent mental health challenges. Over recent years, Sarah has focused her therapy practice on the treatment of OCD and anxiety disorders using Exposure Response Prevention and Acceptance and Commitment Therapy as primary treatment modalities. Intimacy, gender, and sexuality are often interwoven in a client's obsessive and anxious thoughts, yet are often not identified by clients as a treatment issue. Sarah hopes to improve awareness of some of the "unspoken and taboo" thoughts and worries people experience. She wants to decrease the stigma felt by people whose OCD and/or anxiety is affecting their relationships, intimacy, and identity. You can find Sarah at www.hazeltoncounseling.com The article mentioned at the beginning - https://www.verywellmind.com/impact-of-ocd-on-sex-life-5086811 The International OCD Foundation - https://iocdf.org/ Here are some books recommended by Sarah and the IODCF. Buying them through these links will help support What Excites Us! Thank you! The Anti-Anxiety Program: A Workbook of Proven Strategies to Overcome Worry, Panic, and Phobias - Peter J. Norton (Author), Martin M. Antony (Author) - https://amzn.to/4eZWGyL Coping With OCD: Practical Strategies for Living Well With Obsessive-Compulsive Disorder - Bruce Hyman, PhD with Troy Dufrene - https://amzn.to/3zR8ch7 The OCD Answer Book: Professional Answers to More Than 250 Top Questions About Obsessive-Compulsive Disorderby Patrick B. McGrath, PhD - https://amzn.to/4eFf5kK "It'll be Okay:" How I Kept Obsessive-Compulsive Disorder (OCD) from Ruining My Lifeby Shannon Shy - https://amzn.to/3XZQ6S5 Overcoming Unwanted Intrusive Thoughts: A CBT-Based Guide to Getting Over Frightening, Obsessive or Disturbing Thoughts - by Sally Winston, PsyD & Martin Seif, PhD - https://amzn.to/3zVtlGQ Chapters: 00:00 Introduction and Content Warning 03:05 Understanding OCD and Anxiety 12:16 Types of OCD 17:22 OCD's Impact on Relationships 21:24 Compulsions During Intimacy 25:09 Relationship OCD 32:43 Challenges Faced by Teens with OCD 36:35 Exposure Response Prevention (ERP) Explained 47:52 Resources for OCD Support 53:27 Finding the Right Therapist56:53 Conclusion and Final Thoughts

Dr. Greg Chasson, clinical psychologist and researcher, speaks broadly about his work helping people and organizations who manage perfectionists.  Dr. Chasson's book - Flawed : Why Perfectionism is a Challenge for Management - is a highly regarded contribution to the fields  of psychology and business management. Dr. Gregory S. Chasson, a distinguished licensed and board-certified clinical psychologist, Associate Professor, and the Director of Behavioral Interventions of the Obsessive-Compulsive and Related Disorders Clinic within the Department of Psychiatry and Behavioral Neuroscience at the University of Chicago.With a rich academic background, Dr. Chasson earned his BA in psychology from the University of California, Santa Barbara, and later obtained his Ph.D. in Clinical Psychology from the University of Houston. His professional journey led him through three transformative years at Harvard Medical School, including a prestigious internship at McLean Hospital and postdoctoral Clinical and Research Fellowship at Massachusetts General Hospital.Before joining the faculty at the University of Chicago, Dr. Chasson made significant contributions as an Assistant Professor at Towson University and later as an Associate Professor at the Illinois Institute of Technology. For the latter, his impactful leadership extended to a four-year tenure as the Director of Clinical Training for the accredited Clinical Psychology Ph.D. program.Dr. Chasson's expertise lies in obsessive-compulsive and related disorders, encompassing conditions such as obsessive-compulsive disorder (OCD), hoarding disorder, body dysmorphic disorder, body-focused repetitive behaviors, and tics/Tourettes, alongside anxiety disorders. His commitment to evidence-based treatment is exemplified by his ownership and operation of two specialized practices—CBT Solutions of Baltimore (2010-2016) and Obsessive-Compulsive Solutions of Chicago (2016-2022).An accomplished and award-winning educator, Dr. Chasson has accumulated thousands of hours of teaching experience, leaving an indelible mark on students at various academic levels. His international reputation as a sought-after professional trainer is evidenced by workshops delivered in China on the nature and treatment of OCD for the Chinese Psychology Society and the China Mental Health Association. The International OCD Foundation recognizes his expertise, inviting him to lead trainings and serve as an expert consultant.As a prolific scholar, Dr. Chasson has authored over 70 scientific publications (Google Scholar Profile) and spearheaded grant-funded research projects in the field of OCD and related disorders. His commitment to advancing the field is reflected in his recent co-authorship of a book on cognitive-behavioral therapy for hoarding. Dr. Chasson's editorial contributions extend to multiple journal boards, and he has notably served as the Program Chair for the 2021 annual conference for the Association of Behavioral and Cognitive Therapies. Currently, he is the editor of the Behavior Therapist, solidifying his status as a leading authority in the field.Dr. Chasson's wealth of clinical experience, a dedication to education, and  prolific research portfolio, enables him to offer unparalleled insights and expertise to those seeking speaking engagements, media involvement, and a deeper understanding of OCD and related disorders.

We all experience thoughts that can feel distressing and sometimes pull us away from how we want to be living our life. For people living with OCD, this experience is amplified.  This week, Bryan talks to Dr. Marisa Mazza who is helping people living with OCD maneuver the noise of their mind and lean into what's most important to them. She talks about disengaging from our thoughts, rooting into our values, and her definition of what it means to "live well". Dr. Mazza is a licensed psychologist, and founder of choicetherapy, a group practice specializing in evidence-based treatments for OCD and anxiety. She is also faculty at the International OCD Foundation's Behavioral Therapy Training Institute, and author of "The ACT Workbook for OCD: Mindfulness, Acceptance, and Exposure Skills to Live Well with Obsessive-Compulsive Disorder". As always, take what serves you - and leave the rest. Click here to set up a free 15-minute phone consultation with Bryan if you are interested in working with him.  (This podcast is not meant to replace therapy. If you feel you need it, we encourage you to reach out to a licensed mental health professional)

If worry is your constant companion, take heart—you're in good company. Let's clear something up: worrying is as human as breathing. Everyone does it, and sometimes it even helps. But when worry transforms into a monster that steals your sleep, scrambles your thoughts, and holds your decisions hostage, that's when we've got a problem. If this sounds familiar, you'll want to hear this conversation with Ben Eckstein where we unpack his book, Worrying Is Optional: Break the Cycle of Anxiety and Rumination That Keeps You Stuck. Tune in to learn how to navigate the cycle of worry and find a balanced approach to life's uncertainties. Listen and Learn:  The fundamental distinction between "worry" and "worrying"  How did worrying become part of our human operating system, and when does it stop being helpful? Why don't our brains dismiss anxiety and focus solely on problem-solving, instead of reinforcing fear patterns? How to master the skills to coexist with anxiety and thrive despite it Unexpected insights from "Legend of Zelda" to explain the nuanced approach needed to treat anxiety The importance of having compassion for the future version of you Resources:  Worrying Is Optional: Break the Cycle of Anxiety and Rumination That Keeps You Stuck Website: www.bullcityanxiety.com Instagram: @bullcityanxiety Facebook: https://www.facebook.com/bullcityanxiety About Ben Eckstein Ben Eckstein, LCSW is a therapist specializing in the treatment of OCD, Anxiety, and OC-Related Disorders. Ben honed his specialty in OCD while working at McLean Hospital's OCD Institute in Boston. He's now the owner and director of Bull City Anxiety & OCD Treatment Center in Durham, North Carolina. Ben is the vice president of OCD North Carolina, the NC state affiliate of the International OCD Foundation. In addition to his clinical work, Ben is a speaker, trainer, and author. His first book, Worrying is Optional: Break the Cycle of Anxiety and Rumination That Keeps You Stuck, was published in 2023. Related Episodes 313. ACT-Informed Exposure for Anxiety with Brian Pilecki and Brian Thompson 250. Anxiety and Perfectionism with Clarissa Ong 212. Stuff That's Loud: OCD and Anxiety with Lisa Coyne and Ben Sedley 188. Unwinding Anxiety with Judson Brewer 121. Be Mighty: An Episode for Stressed Out, Worried Women with Jill Stoddard 77. Acceptance and Commitment Therapy with Jill Stoddard Learn more about your ad choices. Visit megaphone.fm/adchoices

My guest this week is Dr. Marla Deibler, a clinical psychologist who specializes in treating anxiety. We discussed her excellent new book, The BFRB Recovery Workbook (affiliate link). Check out the publisher's website where you can download many free worksheets and resources. Topics we discussed included: When a body-focused repetitive behavior becomes a diagnosable disorder Common physical consequences of BFRBs Behaviors associated with the hair-pulling of trichotillomania, a type of BFRB The buildup of hair in the digestive system (trichobezoar) from ingesting hair What makes BFRBs so hard to stop The rewarding feeling that often accompanies BFRBs Fixing something with a BFRB that doesn't feel quite right Why willpower alone is usually not enough to stop BFRBs Ambivalence in the process of change: wanting to change and not wanting to change The importance of a functional analysis to understand what drives behaviors Wanting to jump to fixing a problematic behavior before understanding it The importance of awareness for treatment Practicing incompatible responses to interrupt the habit of BFRBs The relation of BFRBs to OCD and other types of compulsive behaviors The important role of acceptance and Acceptance and Commitment Therapy (ACT) The problems of using punishment to shape behavior Marla W. Deibler, PsyD, ABPP, is a Licensed Clinical Psychologist, Board-Certified in Behavioral and Cognitive Psychology, and Founder/Executive Director of The Center for Emotional Health of Greater Philadelphia. Marla serves on the Faculty of the Behavior Therapy Training Institute (BTTI) of the International OCD Foundation. She serves as President of the Board of Directors of OCD NJ, the NJ affiliate of the IOCDF, Consultant for the New Jersey Center for Tourette Syndrome, Visiting Clinical Supervisor at the Rutgers University Psychological Services Clinic, and Executive Council member of the ACBS OCD SIG. She is co-author of The BFRB Recovery Workbook: A Step-By-Step Guide to Effective Recovery from Hair Pulling, Skin Picking, Nail Biting, and Other Body-Focused Repetitive Behaviors. Find Marla online at her website.

Hey everyone, it's Jennie Dildine here with another episode of the LDS Mission Podcast. Today I have a really insightful discussion about religious OCD and scrupulosity. I talk with Claire Breedlove, a licensed clinical social worker who has a lot of experience treating OCD, especially when it comes to religious themes. We discuss what scrupulosity is, how it can impact missionaries and young adults, and tips for managing anxiety. Claire also shares about effective treatment options like exposure therapy. If you or someone you know struggles with religious OCD, I hope you find this conversation helpful. Be sure to check out the resources mentioned in the show notes. Thanks for listening!   Claire Breedlove is a licensed clinical social worker who specializes in providing evidence-based treatment for religious OCD, also known as scrupulosity, in members of the Church of Jesus Christ of Latter-day Saints. Claireis an active member of the International OCD Foundation and has completed the IOCDF's Pediatric Behavior Therapy Training Institute. Claire currently serves on the Board of Directors of the Mormon Mental Health Association and is licensed to practice in California, Utah, Idaho, Texas, Louisiana and Florida. Claire holds masters degrees from Johns Hopkins University and the Tulane University School of Social Work.    More information about Claire's practice is available at www.mountainhomeocd.com.   Also check out th International OCD Foundation website: https://iocdf.org/   Learn more from Jennie:   Website | Instagram | Facebook   Get the Full Show Notes HERE   Free PDF Download:  Preparing Missionary Cheat Sheet   My Free Training for Preparing Missionaries:  Change Your Mission with this One Tool   RM Transition Free Video Series:  3 Tools to Help RMs in Their Transition Home   Free Guide:  5 Tips to Help Any Returning Missionary   Schedule a Free Strategy Call:   Click Here

Amanda Petrik-Gardner, LPC, author of The Compulsive Reassurance Seeking Workbook, joins us to discuss compulsive reassurance seeking. Amanda is an obsessive-compulsive disorder (OCD) and body-focused repetitive behavior (BFRB) specialist, licensed in multiple states. She is a member of the International OCD Foundation, the TLC Foundation for BFRBs, and the Anxiety and Depression Association of America. Amanda serves on the board of OCD Kansas, a state affiliate of the International OCD Foundation, and is author of An OCD Exposure Coloring Book. She is from Topeka, KS.  Visit our website at www.newharbinger.com and use coupon code 'Podcast25' to receive 25% off your entire order.  Buy the Book:  New Harbinger - https://bit.ly/3W8JOjS  Amazon - https://a.co/d/hVzCM6v  Barnes & Noble - https://www.barnesandnoble.com/w/1143733054  Bookshop.org - https://bit.ly/3xRyhel  If you have ideas for future episodes, thoughts, or questions, we'd love to hear from you! Send us an email at podcast@newharbinger.com 

Paul Krauss MA LPC and Stephen Whiteside PhD, LP speak about how parents and caregivers can learn to play an important role in helping decrease anxiety and OCD symptoms in children. Stephen Whiteside has authored a new book entitled "Anxiety Coach: A Parent's Guide to Treating Childhood Anxiety and OCD."  Dr. Whiteside's book gives parents and caregivers an entire outline of what constitutes clinical levels of anxiety and OCD and what is normal in childhood development. He then explains many different types of treatments that are available and especially the current research on exposure therapy. Through reading this book, parents and caregivers can not only locate the most appropriate care of their child, they can also learn to assist their child in gaining confidence and possibly lowering their symptoms as well. Stephen P. Whiteside, PhD, LP is a Board-Certified Clinical Psychologist, Professor of Psychology in the Mayo Clinic College of Medicine and Science, and Director of the Pediatric Anxiety Disorders Program at Mayo Clinic in Rochester, MN. He received a BA in Psychology from Northwestern University and Ph.D. in Clinical Psychology from the University of Kentucky before completing a pre-doctoral internship in Pediatric Psychology at the Geisinger Medical Center and a post-doctoral fellowship in Child and Family Medical Psychology at the Mayo Clinic. His research focuses on improving access to evidence-based care for pediatric anxiety disorders and obsessive-compulsive disorder through the development of effective and efficient treatments facilitated by technology. He has received research funding from the National Institutes of Health, the Agency for Healthcare Research and Quality, the International OCD Foundation, and the Mayo Clinic Center for Innovation. He has published over 80 scientific articles, co-authored the books Exposure Therapy for Child and Adolescent Anxiety and OCD, Exposure Therapy for Anxiety: Principles and Practice (2nd Ed), and Mayo Clinic Anxiety Coach: A Parent's Guide to Treating Childhood Anxiety and OCD. Get involved with the National Violence Prevention Hotline: 501(c)(3) Donate / Share with your network Write your congressperson / Sign the Petition Looking for excellent medical billing services? Check out Therapist Billing Services. A behavioral and mental health billing service developed by therapists for therapists. Preview an Online Video Course for the Parents of Young Adults (Parenting Issues) Paul Krauss MA LPC is the Clinical Director of Health for Life Counseling Grand Rapids, home of The Trauma-Informed Counseling Center of Grand Rapids. Paul is also a Private Practice Psychotherapist, an Approved EMDRIA Consultant , host of the Intentional Clinician podcast, Behavioral Health Consultant, Clinical Trainer, and Counseling Supervisor. Paul is now offering consulting for a few individuals and organizations. Paul is the creator of the National Violence Prevention Hotline (in progress) as well as the Intentional Clinician Training Program for Counselors. You can find Paul on Insight Timer. Paul has been quoted in the Washington Post, NBC News, Wired Magazine, and Counseling Today. Questions? Call the office at 616-200-4433.  If you are looking for EMDRIA consulting groups, Paul Krauss MA LPC is now hosting weekly online and in-person groups.  For details, click here. For general behavioral and mental health consulting for you or your organization. Follow Health for Life Counseling- Grand Rapids: Instagram   |   Facebook     |     Youtube  Original Music: ”Alright" from the forthcoming album Mystic by PAWL (Spotify) "Adrifting" from Casio Jazz by Kelley Stoltz (Bandcamp)

Dr. Monnica Williams is a professor at the University of Ottawa, where she holds the Canada Research Chair in mental health disparities. Her research is focused on mental health, race, racism and novel approaches to treatment. In this conversation, she is sharing about her research and tips for healing racial trauma based on the latest research.She also offers a call to action for players in the psychedelic space to improve diversity at all levels. We also discuss what a culturally informed psychedelic experience looks like, and what to look for in a guide if you're looking to heal racial trauma. This conversation offers support and hope for those who have been harmed by racial trauma. It also offers insights and language for those who aspire to be allies.Dr. Monnica T. Williams is a board-certified licensed clinical psychologist and Professor at the University of Ottawa in the School of Psychology, where she is the Canada Research Chair in Mental Health Disparities. She is also the Clinical Director of the Behavioral Wellness Clinics in Connecticut and Ottawa, where she provides supervision and training to clinicians for empirically-supported treatments. Prior to her move to Canada, Dr. Williams was on the faculty of the University of Pennsylvania Medical School (2007-2011); the University of Louisville in Psychological and Brain Sciences (2011-2016), where she served as the Director of the Center for Mental Health Disparities; and the University of Connecticut (2016-2019), where she had appointments in both Psychological Science and Psychiatry. Dr. Williams' research focuses on BIPOC mental health, culture, and psychopathology, and she has published over 200 scientific articles on these topics. Current projects include the assessment of race-based trauma, barriers to treatment in OCD, improving cultural competence in the delivery of mental health care services, and interventions to reduce racism. This includes prior work as a PI in a multisite study of MDMA-assisted psychotherapy for PTSD for people of color. She also gives diversity trainings nationally for clinical psychology programs, scientific conferences, and community organizations.Through the Kentucky Psychological Association (KPA), Dr. Williams served as the diversity delegate to Washington DC for the American Psychological Association (APA) State Leadership Conference for two consecutive years. She has served as the African American SIG leader for Association of Behavioral and Cognitive Therapies (ABCT), and currently is Chair of their Academic Training & Education Standards (ATES). She serves as an Associate Editor of Behavior Therapy. She also serves on the editorial board of Cognitive Behaviour Therapy, Canadian Psychology, International Journal of Mental Health, Journal of Psychedelic Studies, the Journal of Obsessive Compulsive and Related Disorders and the Cognitive Behavioural Therapist. She is a member of the Scientific Advisory Board of the International OCD Foundation and co-founded their Diversity Council. Her work has been featured in all major US and Canadian media outlets, including NPR, CBS, CTV, Huffington Post, and the New York Times.Topics Covered:What is racial trauma?Tools and research approaches that are applied to understand racial traumaTreatments developed for racial trauma by Dr. Williams, including psychedelicsCommunity and group work versus individual treatment for racial traumaDr. Williams' psychedelics for racial trauma research findingsIdeal set and setting when using psychedelics for healing racial traumaHow to vet your psychedelic guide for this workA culturally informed psychedelic experienceIntegrating a psychedelic experience when healing racial traumaIntentional steps the psychedelic space can take to diversifyShow Links:Apply for 1:1 Coaching with LanaWhere to find Dr. Monnica Williams:https://www.instagram.com/drmonnica/www.monnicawilliams.comDeliberate Practice in Psychedelic Assisted Therapy [book]Support Dr. Williams' research at mentalhealthdisparities.org Want more Modern Psychedelics?Instagram | YouTube | Web | Facebook Inspired to transform your life from the inside out, and integrate higher consciousness in your day to day life?Explore 1:1 Coaching with Lana or Apply Now This episode was produced in collaboration with FWI Media. Check out their beautiful work! Please support the show and leave a review if this episode sparked something within. FREEBIES to support your journey DISCLAIMER: Modern Psychedelics does not endorse or support the illegal consumption of any substances. This show is meant for entertainment purposes only. Modern Psychedelics does not sell or promote the sale of any illegal substances. The thoughts, views and opinions on this show should not be taken as life advice, medicinal advice, or therapeutic guidance.

Dr. Reid Wilson is a licensed psychologist who has spent over 30 years in the field of self-help for anxiety disorders and OCD. He is the Director of the Anxiety Disorders Treatment Center and an author of several self-help books catering to anxiety disorders. He is also Clinical Associate Professor of Psychiatry at the University of North Carolina School of Medicine. In 2014, he was honored with the highest award given by the Anxiety and Depression Association of America, and was presented the Service Award by the International OCD Foundation in 2019.  In this episode we talk about:  ◾️ A deep dive into anxiety and OCD ◾️ Deciding whether tools or medication are fit for your recovery ◾️ How OCD and anxiety treatment has evolved through the years Find Dr. Reid here: anxieties.com Find Zach here: zachwesterbeck.com @zach_westerbeck This podcast is made possible by NOCD. NOCD offers effective, affordable, and convenient OCD therapy. NOCD therapists are trained in Exposure Response Prevention, or ERP, therapy, the gold standard treatment for OCD. With NOCD, you can do virtual, live face-to-face video sessions with one of their licensed, specialty-trained therapists, and they accept most major insurance plans. If your insurance isn't covered, mention discount code ZACH100 for a special $100 rate for the next two months. To find out more about NOCD, visit zachwesterbeck.com/virtual-ocd-therapy/ to book a free 15-minute call. Zach Westerbeck is not a licensed medical professional. Zach Westerbeck is not trained in diagnosing psychological or medical conditions. Zach Westerbeck is not a substitute for medical care or medical advice. If you require assistance with any mental health or medical issue, please contact your health care provider for any medical care or medical advice. Zach Westerbeck makes no guarantees of any kind that the information or services provided by Zach Westerbeck will improve the client's situation. This podcast should not be considered medical advice. Please seek professional assistance from a licensed professional. Zach Westerbeck (https://zachwesterbeck.com/virtual-ocd-therapy/) Virtual OCD Therapy - Zach Westerbeck I've partnered with NOCD to bring you effective, affordable and convenient OCD therapy.

Jeff talks to Dr. Jeff Szymanski about hoarding disorder, its warning signs, and options for treatment. They also discuss the evolution of the diagnosis, how it started as a subtype of OCD, and its current diagnostic criteria. Additionally, Dr. Szymanski shares resources, organizations, and researchers doing work in the field today.Jeff Szymanski, PhD, served as the executive director of the International OCD Foundation for 15 years following his role as the director of psychological services at McLean's OCD Institute. Dr. Szymanski is a lecturer on psychology at Harvard Medical School and the author of the book “The Perfectionist's Handbook.”RELEVANT CONTENT:– More about the episode: https://mclean.link/6nn– Read the episode transcript: https://mclean.link/i5j- - -The McLean Hospital podcast Mindful Things is intended to provide general information and to help listeners learn about mental health, educational opportunities, and research initiatives. This podcast is not an attempt to practice medicine or to provide specific medical advice.© 2024 McLean Hospital. All Rights Reserved.

Have you ever considered the profound impact of justice-oriented treatment in the context of OCD, particularly when it intersects with sensitive issues like race-based OCD? How do we create an environment where individuals, especially those from BIPOC communities, feel safe to openly discuss their fears and intrusive thoughts without the burden of judgment or dismissiveness? In today's episode of The OCD Whisperer Podcast, we are delighted to welcome Bianca Simmons and Erin Nghe from ERP Kaleidoscope to discuss justice-oriented OCD treatment. They explore how to support BIPOC clinicians and individuals with OCD, emphasizing the need for a safe, empowering environment. The co-founders share insights on incorporating justice into ERP therapy and tackling race-based OCD. They advocate for diversity, clinician empowerment, and education on sensitive OCD themes, providing practical advice for therapists to effectively address these issues in their practice. In This Episode [00:03]Introduction to Bianca Simmons and Erin Nghe [02:39] Explanation of the name ERP Kaleidoscope [05:28] The concept of justice-oriented OCD treatment [07:57]Strategies to support BIPOC clinicians [10:17] Concrete example of justice-oriented ERP [11:47] Client's race-based OCD [13:56] Empowerment and advocacy for clinicians [15:46] Tangible exposures for clients [18:00] The importance of understanding core fears [19:41] Intersectionality in OCD treatment [23:04] Educating clinicians on cultural awareness [24:08] Impact on access and quality of care [25:58] Contact information for further support   Notable Quotes [03:04] “ERP kaleidoscope is all about uplifting the voices of BIPOC clinicians who specialize in OCD as well as the individuals.”- Bianca  [04:25] “Oftentimes when people think about OCD, they think about the suffering, and it's really hard to see the beauty. And so we really wanted to highlight how ERP brings out that beauty.”- Erin  [06:58] “BIPOC clinicians have to be able to feel safe because that's the only way that they can not only do good work with BIPOC individuals living with OCD but all individuals that have OCD.” -Erin [17:12] “Some clinicians of color have no idea that there is this theme that also latches on to race and so that can be very blindsiding.”- Erin  [20:42] “What we're trying to do at ERP kaleidoscope as well, building those safe spaces in terms of healing circles, and just allowing that time for clinicians to be able to heal.”- Bianca     Our Guests Bianca Simmons, an OCD specialist, co-founded ERP Kaleidoscope and owns Bianca Simmons LLC, a mental health private practice in Texas. With extensive experience in severe OCD treatment, she transitioned from managing a residential facility to providing outpatient therapy. Committed to accessibility, she focuses on supporting individuals from underrepresented communities and minority populations, ensuring they have access to the quality mental health assistance they need and deserve. Erin Nghe is a licensed clinical social worker, psychotherapist, and co-founder of ERP Kaleidoscope, a network association supporting Bipoc individuals with OCD and therapists interested in OCD treatment. With 15+ years of experience, she's also the owner and Clinical Director of OCD Set Free, training therapists along the East Coast in Ethical OCD Treatment. Erin advocates for OCD awareness, serving on the Diversity, Equity, and Inclusion Action Council of the International OCD Foundation and as a faculty member for their Behavioral Therapy Training Institute.   Resources & Links Kristina Orlova, LMFT https://www.instagram.com/ocdwhisperer/ https://www.youtube.com/c/OCDWhispererChannel https://www.korresults.com/ https://www.onlineocdacademy.com Bianca Simmons https://www.biancasimmonslpc.com/ https://www.linkedin.com/in/kimberly-bianca-simmons/ https://www.instagram.com/therapywithbianca https://www.facebook.com/profile.php?id=100064234050479 Erin Nghe https://www.linkedin.com/in/erinnghe/ https://www.ocdsetfree.com/ https://www.instagram.com/ocdsetfree/   **Disclaimer** Please note, while our host is a licensed marriage and family therapist specializing in OCD and anxiety disorders in the state of California, this podcast is for educational purposes only and should not be considered a substitute for therapy. Stay tuned for bi-weekly episodes filled with valuable insights and tips for managing OCD and anxiety. And remember, keep going in the meantime. See you in the next episode!

Bio Stephen P. H. Whiteside, Ph.D. is a Board-Certified Clinical Psychologist, Professor of Psychology in the Mayo Clinic College of Medicine and Science, and Director of the Pediatric Anxiety Disorders Program at Mayo Clinic in Rochester, MN. He received a BA in Psychology from Northwestern University and Ph.D. in Clinical Psychology from the University of Kentucky before completing a pre-doctoral internship in Pediatric Psychology at the Geisinger Medical Center and a postdoctoral fellowship in Child and Family Medical Psychology at the Mayo Clinic. His research focuses on improving access to evidence-based care for pediatric anxiety disorders and obsessive-compulsive disorder through the development of effective and efficient treatments facilitated by technology. He has received research funding from the National Institutes of Health, the Agency for Healthcare Research and Quality, the International OCD Foundation, and the Mayo Clinic Center for Innovation. He has published over 80 scientific articles, co-authored the books Exposure Therapy for Child and Adolescent Anxiety and OCD, Exposure Therapy for Anxiety: Principles and Practice (2nd Ed), and Anxiety Coach: A Parent's Guide to Treating Childhood Anxiety and OCD. Sign up for 10% off of Shrink Rap Radio CE credits at the Zur Institute

Charlene Colwell is a Licensed Clinical Social Worker based in Minnesota. Her private practice focuses on treating patients who suffer OCD and general anxiety. She has grown a passion for helping people who suffer said mental illnesses because she too experienced the same things growing up. She has dedicated her time the past 11 years to helping her patients change their relationship with OCD through evidence based treatments. Today, she continues her training through Rogers Behavioral Health, and education training through the Cognitive Behavior Institute Center for Education and the International OCD Foundation.  In this episode we talk about:  ◾️ Internal Family Systems (IFS) ◾️ Changing perspectives and the relationship with OCD ◾️ How this perspective shift can aid living with OCD Find Charlene here: restoringwaterscounseling.com Find Zach here: zachwesterbeck.com @zach_westerbeck This podcast is made possible by NOCD. NOCD offers effective, affordable, and convenient OCD therapy. NOCD therapists are trained in Exposure Response Prevention, or ERP, therapy, the gold standard treatment for OCD. With NOCD, you can do virtual, live face-to-face video sessions with one of their licensed, specialty-trained therapists, and they accept most major insurance plans. If your insurance isn't covered, mention discount code ZACH100 for a special $100 rate for the next two months. To find out more about NOCD, visit zachwesterbeck.com/virtual-ocd-therapy/ to book a free 15-minute call. Zach Westerbeck is not a licensed medical professional. Zach Westerbeck is not trained in diagnosing psychological or medical conditions. Zach Westerbeck is not a substitute for medical care or medical advice. If you require assistance with any mental health or medical issue, please contact your health care provider for any medical care or medical advice. Zach Westerbeck makes no guarantees of any kind that the information or services provided by Zach Westerbeck will improve the client's situation. This podcast should not be considered medical advice. Please seek professional assistance from a licensed professional. Zach Westerbeck (https://zachwesterbeck.com/virtual-ocd-therapy/) Virtual OCD Therapy - Zach Westerbeck I've partnered with NOCD to bring you effective, affordable and convenient OCD therapy.

Many people with OCD experience obsessions related to God, spirituality, and their faith. Reverend Katie O'Dunn is helping bridge the gap between spiritual traditions and effective treatment for OCD.  In this episode, Bryan talks to Katie about religious and moral scrupulosity and how it can manifest for some people living with OCD. She also talks about how she is reframing effective OCD treatment as a spiritual practice, and how she's seen therapy help people deepen their relationship with God. Katie also shares her own personal journey of living with OCD.  Katie is an ordained minister and interfaith chaplain. She is also the Founder and Director of "Stick with the Ick", and lead advocate for the International OCD Foundation. Katie shares that running is a spiritual practice for her and - as an endurance athlete - she is working towards running an ultra marathon in every state to raise awareness about OCD.  Follow Katie on Instagram: @revkrunsbeyondocd Visit her website here.  As always - take what serves you, and leave the rest.  (This podcast is not meant to replace therapy. If you feel you need it, we encourage you to reach out to a licensed mental health professional)

If you want to know the 5 Most Common Recovery Roadblocks with Chris Tronsdon (an incredible anxiety and OCD therapist), you are in the right place. Today Chris and I will go over the 5 Most common anxiety, depression, & OCD roadblocks and give you 6 highly effective treatment strategies you can use today.  Kimberley: Welcome everybody. We have the amazing Chris Trondsen here with us today. Thank you for coming, Chris. Chris: Yes, Kim, thanks for having me. I'm super excited about being here today and just about this topic. Kimberley: Yes. So, for those of you who haven't attended one of the IOCDF Southern California conferences, we had them in Southern California. We have presented on this exact topic, and it was so well received that we wanted to make sure that we were spreading it out to all the folks that couldn't come.  You and I spoke about the five most common anxiety & OCD treatment roadblocks, and then we gave six strategic solutions. But today, we're actually broadening it because it applies to so many people. We're talking about the five most common anxiety treatment roadblocks, with still six solutions and six strategies they can use. Thank you for coming on because it was such a powerful presentation. Chris: No, I agree. I mean, we had standing room only, and people really came up to us afterwards and just said how impactful it was. And then we actually redid it at the International OCD Foundation, and it was one of the best-attended talks at the event. And then we got a lot of good feedback, and people kept messaging me like, “I want to hear it. I couldn't go to the conference.” I'd play clips for my group, and they're like, “When is it going to be a podcast?” I was like, “I'll ask Kim.” I'm glad you said yes because I do believe for anybody going through any mental health condition, this list is bound, and I think the solutions will really be something that can be a game changer in their recovery. Kimberley: Absolutely, absolutely. I love it mostly because, and we're going to get straight into these five roadblocks, they're really about mindset and going into recovery. I think it's something we're not talking about a lot. We're talking about a lot of treatment, a lot of skills, and tools, but the strategies and understanding those roadblocks can be so important. Chris: Yeah. I did a talk for a support group. They had asked me to come and speak, and I just got this idea to talk about mindset. I did this presentation on mindset, and people were like, “Nobody's talking about it.” In the back of my head, I'm like, “Kim and I did.” But we're the only ones. Because I do think so many people get the tools, right? The CBT tools, they get the ERP tools, the mindfulness edition, and people really find the tools that work for them. But when I really think of my own personal recovery with multiple mental health diagnoses, it was always about mindset. And that's what I like about our talk today. It's universal for anyone going through any mental health condition, anxiety base, and it's that mindset that I think leads to recovery. It shouldn't be the other way around. The tools are great, but the mindset needs to be there. Kimberley: Yeah. We are specifically speaking to the folks who are burnt out, feeling overwhelmed, feeling a lack of hope of recovery. They really need a kickstart, because that was actually the big title of the presentation. It was really addressing those who are just exhausted with the process and need a little bit of a strategy and mindset shift. Chris: Yeah. I don't want to compare, but I broke my ankle when I was hiking in Hawaii, and I have two autoimmune diseases. Although those ailments have caused problems, especially the autoimmune, when I think back to my mental health journey, that always wore me out more because it's with you all the time, 24/7. It's your mental health. When my autoimmune diseases act up, I'm exhausted, I'm burnt out, but it's temporary. Or my ankle, when it acts up, I have heating pads, I have things I can do, but your brain is with you 24/7. I do believe that's why a lot of people resonate with this messaging—they are exhausted. They're busting their butt in treatment, but they're tired and hitting roadblocks. And that's why this talk really came about. Kimberley: Yeah, exactly. All right, let's get into it here in a second. I just want to give one metaphor with that. I once had a client many years ago give the metaphor. She said, “I feel like I'm running a marathon and my whole family are standing on the out, like on the sidelines, and they're all clapping, but I'm just like faceplant down in the middle of the road.” She's like, “I'm trying to get up, I'm trying to get up, and everyone's telling me, ‘Come on, you can do it.' It's so hard because you're so exhausted and you've already run a whole bunch of miles.” And so I really think about that kind of metaphor for today. If people are feeling that way, hopefully they can take away some amazing nuggets of information.  Chris: Absolutely. That's a good visual. Faceplant. Kimberley: It was such a great and powerful visual because then I understood this client's experience. Like, “Oh, okay. You're really tired. You're really exhausted.” ROADBLOCK #1: YOU BEAT YOURSELF UP! Okay, let's get into it. So, I'm going to go first because the number one roadblock we talked about, not that these are in any particular order, but the one we came up first was that you beat yourself up. This is a major roadblock to recovery for so many disorders. You beat yourself up for having the disorder. You beat yourself up for not coping with it as well as you could. You beat yourself up if you have OCD for having these intrusive thoughts that you would never want to have. Or you're beating yourself up because you don't have motivation because you have, let's say, some coexisting depression.  The important thing to know there is, while beating yourself up feels productive, it might feel like you're motivating yourself, or you may feel like you deserve it. It actually only makes it harder. It only makes it feel like you've got this additional thing. Again, a lot of my patients—let's use the marathon example—might yell at themselves the whole way through the marathon, but it's not a really great experience if you're doing that, and it takes a lot of energy.  SOLUTION #1: SELF-COMPASSION So what we offered here as a strategic solution is self-compassion—trying to motivate and encourage yourself using kindness. If you're going through a hard day, maybe, just if you've never tried this before, trial what it would be like to encourage yourself with kind words or asking for support, asking for help so that you're not burning all that extra energy, making it so much harder on yourself, increasing your suffering. Because I often say to patients, the more you suffer, the more you actually deserve self-compassion. It's not the other way around. It's not that the more you suffer, the less you deserve it. Do you have any thoughts on that, Chris? Chris: Oh yeah. I would say I see that across the board with my clients, this harshness, and there's this good intention behind it, this idea that if I can just bully myself into recovery. I always try to remind clients that anxiety-based disorders, it's a part of our bodies as well. Our brain is a part of our body, just like our arm, our tibia, our leg, all these other bones, but there's a lack of self-empathy that we have for ourselves, as if it's something that we're choosing to do. Someone with a broken leg doesn't wake up in the morning and get mad at themselves that their leg is still broken. They have understanding, and they're working on their exercises to heal. It's the same with these disorders.  So, the reason I love self-compassion is when we go and step in to help one of our friends, we use a certain tone, we use certain words, we tap into their strengths, we use encouragement because we know that method is going to be what boosts them up and helps them get through that rough patch. But for some reason, when it's ourselves, we completely abandon everything we know that's supportive, and we talk to ourselves in a way that I almost picture like a really negative boot camp instructor, like in the military, just yelling and screaming into submission. The other thing is when we're beating ourselves up like that, we're more likely to tap into our unhelpful habits. We're more likely to shut down and isolate, which we see a lot in BDD, social anxiety, et cetera. But that self-compassion isn't like a fake pop culture support. It's really tapping into meeting yourself where you're at, giving yourself some understanding, and tapping into the strategies that have worked in the past when you're in a low moment.  I know sometimes people are like, “I don't know how to do that,” but you're doing it to everybody else in your life. Now it's time to give yourself that same self-compassion that you've been giving to everybody important to you. Kimberley: Yeah, and we actually have a few episodes on Your Anxiety Toolkit on exactly how to embrace self-compassion, like how that might actually look. So, if people are really needing more information there, I can add in the show notes some links to some resources there as well.  ROADBLOCK #2: THERE WILL BE HARD DAYS  Okay. Now, Chris, can you tell us about the second most common or another common anxiety roadblock around this idea that there will be hard days? Chris: There's always these great images if you Google about what people think recovery will look like versus what recovery looks like. I love those images because there is this idea. We see a lot of perfectionism in anxiety disorders. In OCD, we see perfectionism. So, this idea of, like, I should be here and I should easily scoot to the end. It's not going to be like that; it's bumpy, it's ups and downs. We know so much factors into or impact how our mental health disorder shows up. We can't always control our triggers. Sometimes if we haven't slept well or there's a lot of change in our life, we could have more anxiety. So, it's going to ebb and flow.  So, when we have this fixed mindset of like, it has to be perfect, there has to be absolutely no bumps on the road, no turbulence, we're going to set ourselves up for failure because the day we have a hard day, we want to completely shut down. So I really believe, in this case, the solution is thinking bigger. If you're thinking day to day, sometimes if you're too in it, you're dealing with depression, you're really feeling bad, you skipped school because you have a presentation, social anxiety is acting up. You think bigger picture. Why am I here? Why am I doing this? Why have I sought out treatment? Listen to this podcast. What am I trying to accomplish?  SOLUTION #2: KNOW YOUR WHY I know for me in my own recovery, knowing my why was so important. There were certain things in my life that I found important to achieve, and I kept that as the figurative carrot in front of the mule to get me to go. So, that way, if I had a rough day, I thought bigger picture. What do I need to do today to make sure that I meet my goals? And so, I believe everybody needs to know their why.  Now, it doesn't have to be grandiose. Some people want to build a school and teach kids in underprivileged countries. Amazing why. But other people are sometimes like, “I just want to be able to make my own choices today and not feel like I base them out of anxiety.” There's no right or wrong why, but if you can know what beacon you're going to, it really helps you get through those hard days.  What about for you? When we talk about this, what comes up for you? Kimberley: Well, I think that for me personally, the why is a really important mindset shift because often I can get to this sort of, like you said, perfectionistic why. Like, the goal is to have no anxiety, or the goal is to have no bad days. We see on social media these very relaxed people who just seem to go with the flow, and that's your goal. But I have to often with myself do a little reality check and go, “Okay, are you doing recovery to get there? Because that goal might be setting you up for constant disappointment and failure. That mightn't be your genetic makeup.”  I'm never going to be like the go-with-the-flow Kimberley. That's just not who I am. But if I can instead shift it to the why of like, what do I value? What are the things I want to be able to do despite having anxiety in my life? Or, despite having a hard day, like you said, how do I want that to look? And once I can get to that imagery, then I have a really clear picture. So, when I do have a bad day, it doesn't feel so defeating, like what's the point I give up, because the goal was realistic. Chris: For me, a big part of my why in recovery, once I started getting into a place where I was managing the disorders I was dealing with—OCD, body dysmorphic disorder, I had a lot of generalized anxiety, and major depressive disorder—I was like, “I need to give back. There's not people my age talking about this. There's not enough treatment providers.” There was somewhere, like in the middle of my treatment, that I was like, “I don't know how I'm going to advocate. I don't know what that's going to look like, but I have to give back.” And so, on those hard days when I would normally want to just like, “Well, I don't care that it's noon, I'm shutting it down, I'm going into my bed, I'm just going to sleep the rest of the day,” reminding myself like there's people out there suffering that can't find providers, that can't find treatment, may not even know they have these disorders. I have to be one of the voices in the community that really advocates and gets people education and resources. And so, I didn't let myself get in bed. I looked at the day as quarters. Okay, the morning and the afternoon's a little rough, but I still have evening and night. Let me turn it around. I have to go because I have this big goal, this ambitious dream. I really want to do it. So that bigger why kept me just on track to push through hard days. ROADBLOCK #3: YOU RUN OUT OF STAMINA Kimberley: Amazing. I love that so much. All right. The third roadblock that we see is that people run out of stamina. I actually think this is one that really ties into what we were just talking about. Imagine we're running a marathon. If you're sprinting for the first 20 miles, you probably won't finish the race. Or even if you sprint the first two miles, you probably won't finish the marathon.  One of the things is—and actually, I'll go straight to the strategy and the thing we want you to practice—we have to learn to pace ourselves throughout recovery. As I said, if you sprint the first few miles, you will fall flat on your face. You're already dealing with so much. As you said, having a mental health struggle is the most exhausting thing that I've ever been through. It requires such of your attention. It requires such restraint from not engaging in it and doing the treatment and using the tools. It's a lot of work, and I encourage and congratulate anyone who's trying. The fact that you're trying and you're experimenting with what works and what doesn't, and you're following your homework of your clinician or the workbook that you've used—that's huge. But pacing yourself is so important. So, what might that look like? Often, people, students of mine from CBT School, will say, “I go all out. I do a whole day of exposures and I practice response prevention, and I just go so hard that the next day I am wiped. I can't get out of bed. I don't want to do it anymore. It was way too much. I flooded myself with anxiety.” So, that's one way I think that it shows up. I'll often say, “Okay, let's not beat yourself up for that.” We'll just use that as data that that pace didn't work. We want to find a rhythm and a pace that allow you to recover. It's sort of like this teeter-totter. We call it in Australia a seesaw. You want to do the work, but not to the degree where you faceplant down on the concrete. We want to find that balance.  I know for me, when I was recovering from postural orthostatic tachycardic syndrome, which is a chronic illness that I had, it was so hard because the steps to recovery was exercise, but it was like literally walking to the corner and back first, and then walking half a block, and then walking three-quarters of a block, and then having my husband pick me up, then walking one block. And that's all I was able to do without completely faceplanting the next day, literally and figuratively.  My mind kept saying to me, “You should be able to go faster. Everybody else is going faster. Everyone else can walk a mile or a block. So you should be able to.” And so, I would push myself too hard, and then I'd have to start all over again because I was comparing myself to someone who was not in my position.  SOLUTION #3: PACE YOURSELF So, try to find a pace that works for you, and do not compare your pace with me or Chris or someone in your support group, or someone you see on social media. You have to find and test a pace that works for you. Do you have any thoughts, Chris? Chris: Yeah. I would say in this one, and you alluded to it, that comparison, that is going to get you in this roadblock because you're going to be looking to your left and your right. Why is that person my age working and I'm not? It's not always comparing yourself. Sometimes, like you said, it is people in your support group. It's people that you see advocating for the disorder you may have. But sometimes people even look at celebrities or they'll look at friends from college, and can I do that? The comparison never motivates you, it never boosts you; it just makes you feel less than. That's why one of my favorite quotes is, “Chase the dream, not the competition.” It's really finding a timeline that works best for you.  I get why people have this roadblock. As somebody who's lived through multiple mental health disorder diagnoses, it's like, once we find the treatment, we want to escalate to the finish line, and we'll push ourselves in treatment sometimes too much. And then we have one of those days where we can't even get out of bed because we're just beat up, we're exhausted, and it's counterproductive.  I wanted to add one thing too. The recovery part may not even be what you're doing with your clinician in a session that you are not pacing yourself with. My biggest pacing problem was after recovery, not that the disorders magically went away, they were in remission, I was working on doing great, but it was like, I went to martial arts, tennis, learned Spanish, started volunteering at an animal shelter, went back to school, got a job, started dating. It was so much. Because I felt like I was behind, I needed to push myself.  The problem that started to happen was I was focusing less on the enjoyable process of dating or getting a job, or going back to school. I was so fixated on the finish line. “I need to be there, I need to be there. What's next? What's next?” I got burnt out from that, and I was not enjoying anything I was doing.  So, I would say even after you're managing your disorder, be careful about not pacing yourself, even in that recovery process of getting back into the lifestyle that you want. Kimberley: Yeah, absolutely. I would add too, just as a side point, anyone who is managing a mental health issue or an anxiety disorder, we do also have to fill our cup with the things that fill our hearts. I know that sounds very cliche and silly, but in order to pace ourselves and to have the motivation and to use the skills, we do have to find a balance of not just doing all the hard things, but making sure you schedule time to rest and eat and drink and see friends if that fills your cup, or read if that fills your cup. So, I think it's also finding a rhythm and a balance of the things that fill your cup and identifying that, yes, recovery is hard. It will deplete your stores of energy. So, finding things that fill that cup for you is important.   Chris: Well, you just made a good point too. In my recovery, all those things you mentioned, I thought of those as like weakness, like I just wasted an hour reading. Sometimes even with friends. That one, not as much, because I saw value in friendship. But if I just watched a movie or relaxed, or even just hung out with friends, it felt like a waste. I'm like, “How dare I am behind everybody else? I should be working. I should be this. I should move up.” A lot of should statements, a lot of perfectionist expectations of myself.  So, the goal for me or the treatment for me wasn't to then go to the other extreme and just give up everything; it was really to ask myself, like you said, how can I fill my cup in ways that are important and see value and getting a breakfast burrito with a friend and talking for three hours and not thinking like, “Oh, I should have been this because I got to get my degree.” I'm glad that you brought that up. I always think of like we're overflowing our cup with mental health conditions. We have to be able to have those offsets that drain the cup so we have a healthy balance. So, a great point. ROADBLOCK #4: NOT OWNING YOUR RECOVERY Kimberley: I agree. So important. Would you tell us about owning your recovery? Because you have a really great story with this. Chris: Yeah. People ask me all the time how I got better. A lot of people with body dysmorphic disorder struggle to get better. Obviously, we know that with obsessive-compulsive disorder, major depressive disorder, et cetera. So, a lot of people will ask sometimes, and I always say to them, if I had to come up with one thing, it was because I made my mental health recovery number one. I felt that it was like the platform that I was building my whole life on. I'm so bad with the-- what is it? The house, the-- I'm not a builder.  Kimberley: Like the foundation. Chris: Thank you. Clearly, I'm not going to be making tools tomorrow or making things with tools. But yeah, like a house has to have a nice foundation. You would never build a house on a rocky side of the mountain. And so, I had to give up a lot, like most of us do, as we start to get worse. I became housebound and I dropped out of college, and I gave up a job. I was working in the entertainment industry, and I really enjoyed it. I was going to film school, and I was happy. I had to give all that up because I couldn't even leave my house because of the disorder.  SOLUTION #5: MAKE YOUR RECOVERY THE MOST IMPORTANT THING So, when I was going to treatment and I was really starting to see it work, I was clear to that finish line of what I needed to do. So I made it the most important thing. It wasn't just me; it was my support system. My treatment was about a four-hour round trip from my house, so my mom and I would meet up every day. We drive up to LA. I go to my OCD therapist, and I'd go to my psychiatrist and then my BDD therapist and support group, and then come home. There's times I was exhausted, I wanted to give up, I was over it, but I never ever, ever put it to number two or three. I almost had this top three list in my head, and number one was always my recovery. My mom too, I mean, when she talks, she'll always say it's the most important thing. If my job was going to fire me because I couldn't come in because I had to take my kid on Wednesdays to treatment, I was going to get fired and find a new job. We just had to make this important.   As I was getting better, there were certain opportunities that came back to me from my jobs or from school. My therapist and I and my mom just decided, “Let's hold off on this. Let's really, really put effort into the treatment. You're doing so well.” One of the things that I see all the time, my mom and I run a very successful family and loved ones group. A lot of times, the parents aren't really making it the priority for their kids or the kids, or the people with the disorders aren't really making it a priority. It's totally understandable if there's things like finances and things, barriers. But that's not what I'm talking about. I'm talking about when people have access to those things, they're just not owning it. Sometimes they're not owning it because they're not taking it seriously or not making it important. Or other times, people are expecting someone else to get them better.  I loved having a team. I didn't have a big team. I came from nothing. It was a very small team. I probably needed residential or something bigger. I only really had my mom's support, but we all leaned on each other. But I always knew it was me in the driver's seat. At the end of the day, my therapist couldn't save me, my mom couldn't save me, they couldn't come to my house and pull me out of bed or do an exposure for me, or have me go out in public during the daytime because of BDD. I had to be the one to do it. I could lean on them as support systems and therapists are there for, but at the end of the day, it was my choice. I had to do it. When my head hit the pillow, I had to make sure that I did everything I possibly could that day to recover.  When I took ownership, it actually gave me freedom. I wasn't waiting for someone to come along. I wasn't focusing on other things. I made it priority number one. I truly believe that that was the thing that got me better. Once again, didn't have a lot of resources, leaned a lot on self-help books and stuff because I needed a higher level of care, but there was none and we couldn't afford it. I don't want anyone to hear this podcast and think, “Well, I can't find treatment in my area.” That's not what I'm saying. I'm just saying, whatever you have access to, own it, make it a priority, and definitely be in that leader's seat because that's going to be what's going to get you better. Kimberley: Yeah, for sure. I think too when I used to work as a personal trainer, I would say to them, “You can come to training once a week, but that once a week isn't going to be what crosses you across that finish line.” You know what I mean? It is the work you do in the other 23 hours of that day and the other seven days of the week. I think that is true. If you're doing and you're dabbling in treatment, but it's not the main priority, that is a big reason that can hold you back. I think it's hard because it's not fair that you have to make it priority number one, but it's so necessary that you do.  I really want to be compassionate and empathize with how unfair it is that you have to make this thing a priority when you see other people, again, making their social life their priority or their hobby their priority. It sucks. But this mindset shift, this recalibration of this has to be at the top. When it gets to being at the top, I do notice, as a clinician, that's when people really soar in their recovery. Chris: Yeah. We had a very honest conversation with my BDD therapist, my OCD therapist, and my psychiatrist, and they're like, “You need a higher level of care. We understand you can't afford it. There's also a lot of waiting lists.” They're like, “You're really going to have to put in the work in between sessions. You're supposed to be in therapy every day.” We just couldn't. All we can afford is once a week. They said, “Look, when you're not in our session, you need to be the one.”  So, for instance, with depression, my psychiatrist is like, “Okay, you're obviously taking the medication, but you need to get up at the same time every day. Open up all your blinds, go upstairs, eat breakfast on the balcony, get ready, leave the house from nine to five.” I didn't have a job. “But you need to be out of the house. You need to be in nature. You need to do all these things.” I never wanted to, but I did it. Or with my OCD and BDD recovery, I didn't want to go out in public. I felt like it looked horrendous. I felt like people were judging me, but I did. Instead of going to the grocery store at 2:00 in the morning, I was going at noon. When everyone's there for OCD, it was like, I didn't want to sit in public places. I didn't want to be around people that I felt I could potentially harm.  My point is like every single day, I was doing work, I was tracking it, I was keeping track, and I had to do that because I needed to do that in order to get better based on the setup that I had.  I do want to also say a caveat. I always have the biggest empathy for people or sympathy for people that are a CEO of a company or like a parent and have a lot of children, or it's like you're busy working all day and you're trying to balance stuff. I mean, the only good thing that came from being housebound is I didn't have a lot of responsibilities. I didn't have a family. I wasn't running a company. I wasn't working. So, I did have the free time to do the treatment. So, I have such sympathy for people that are parents or working at a company, or trying to start their own small business and trying to do treatment too. But I promise you, you don't have to put your recovery first forever. Really dive into it, get to that place where you're really, really stable. It'll still be a priority, but then you will be a better parent, a better employee, a better friend once you've really got your mental health to a level that you can start to support others. You may need to support yourself first, like the analogy with a mask on the plane. ROADBLOCK #5: YOU HAVE A FIXED MINDSET Kimberley: Agreed. That's such an important point. All right, we're moving on to roadblock number five. This is yours again, Chris. Tell us about the importance of specific mindsets, particularly a fixed mindset being the biggest roadblock. Chris: One of the things that makes me the most sad about people having a mental health condition because of how insidious they are is it starts to have people lose their sense of identity. It has them start to almost re-identify who they are, and it becomes a very fixed mindset. So, if you have social anxiety or social phobia, it's like, “Oh, I'm somebody that's not good around people. I say embarrassing things. I never know what kind of conversation to lead with. I should probably just not be around people.” Or, let's say generalized anxiety. “Deadlines really caused me too much strain. I can't really go back to school.” BDD. “I'm an unattractive person. Nobody wants to date me. I'm unlovable.”   We get into these fixed mindsets and we start to identify with them, and inevitably, that person's life becomes smaller and smaller and smaller. So, the more they identify with it, the more that they become isolated from others, and they have this very fixed mindset. I think of like OCD, for instance, isn't really about guidelines; it's all about rules. This is how things are supposed to be. What happens is when I work with a client specifically, somebody that's pretty severe, it's trying to get them to see the value in treatment and to even tap into their own personal values is really difficult. It's like, “Treatment doesn't work. I've tried all the medications. I don't know what I'm going to do. I'm just not somebody that can get better.” SOLUTION #5: GROWTH MINDSET What I tell clients instead is, “Let's be open. Let's be curious. Let's move into a growth mindset. Let's focus on learning, obtaining education, being open to new concepts. Look, when you were younger and the OCD didn't really attack you, or when you were younger and you didn't deal with social anxiety, you were having friends, you had birthday parties, you were going to school, and everything. Maybe that's the real you, and it's not that you lost it. You just have this disorder that's blocked you from it.” And so, when clients become open and curious and willing to learn, willing to try new things, and to get out of their comfort zone, that's where the growth really happens.  If you're listening to this podcast or watching it right now and you're determined like, “This isn't working; nothing can help me,” that fixed mindset is never something that's going to get you from where you are to where you want to be. You have to have that growth, that learning, that trying new things, expanding.  I always tell clients, “If you try something with your therapist and it doesn't work, awesome. That's one other thing that doesn't work. Move on to something else.” That openness. What I always love after treatment is people are like, “I am social. I do love to be around people. I am somebody who likes animals. I just was avoiding animals because of harm thoughts.” People start to get back into who they really are as soon as they start to be more open to recovery. Kimberley: Yeah, for sure. The biggest fixed mindset thought that I hear is, “I can't handle it.” That thought alone gets in the way of recovery so many times. We go to do an exposure, “I can't handle this.” Or, “What if I have a panic attack? I cannot handle panic attacks.” It's so fixed. So I often agree with you. I will often say, this work, this mental health work, or this human work that we do is shifting the way we see ourselves and life as an experiment. We always have these black-and-white beliefs like “I can't handle this” or “I can't do this. I can't get in an elevator. I can't speak public speaking,” or whatever it might be. But let's be curious. Like you said, let's use it as an experiment. Let's try, and we'll see. Maybe it doesn't go great. That's okay, like you said, but then we know we have data, and then we have information on what got in the way, and we have some information.  I think that even just being able to identify when you're in a fixed mindset can be all you need just to be like, “Oh, okay, I'm having a very black-and-white fixed mindset.” Learning how to laugh and giggle at the way our brain just gets so determined and black-and-white, like you can't do this, as you said, I think is so important because, like you said, once you get to recovery, then you go on to live your life and actually do the things that you dream, the dream that you're talking about. It might be you want to get a master's degree or you might want to go for a job, or you want to go on a date. You're going to be able to use that strong mindset for any situation in life. It applies to anything that you're going to conquer.  I always say to clients, if you've done treatment for mental health, you are so much more prepared than every student in college because they haven't gone through, they haven't had to learn those skills. Chris: Yeah, no, exactly. I remember like my open mindset was one of the assets I had in recovery. I remember going to therapy and being like, “I'm just going to listen. These people clearly know what they're doing. They've helped people like me. Why would it be any different?” And I was open. I can see the difference with clients that have a more growth mindset. They come in, they're scared. They're worried. They've been doing something for 10, 15, 16 years, and they're like, “Why is this guy going to tell me to try to do different things or to think different or have different thinking patterns?” But they're open. I always see those people hit that finish line first. It's the clients that come and shut down. The family system has been supporting this like learned helplessness. Nobody really wants to rock the boat. Everything shut down and closed. It's like prying it open, as most of the work. And then we finally get to the work, but we could have gotten there quicker. Everybody's at their own pace, but I really hope that people hear this, though, are focused on that openness. You were talking about like people thinking they can't handle it. The other thing I hear sometimes is people just don't think they deserve it. “I just don't even deserve to get better.” You do. You do. That's what I love about my job the most. Everybody that comes into my office, and I'm like, “You deserve a better life than you're living. Whatever it is you want to do. You want to be a vet. How many animals are you going to save just by getting into being a vet? You got to do it.” My heart breaks a little bit when people have been dealing with mental health for long enough that they start to believe they don't even deserve to get better.  SOLUTION #6: IT'S A BEAUTIFUL DAY TO DO HARD THINGS Kimberley: I love that. So, we had five roadblocks, and we've covered it, but we promised six strategies. I want to be the one to deliver the last one, which everyone who listens already knows what I'm going to say, but I'm going to say it for the sake that it's so important for your recovery, which is, it's a beautiful day to do hard things. It is so important that you shift, as we talked about in the roadblock number one, you shift your mindset away from “I can't do hard things” to “It's okay to do hard things.” It doesn't mean you've failed. Life can be hard.  I say to all my patients, life is 50/50 for everybody. It's 50% easy and 50% hard. I think some people have it harder than others. But the ones who seem to do really well and have that grit and that survivor's mindset are the ones who aren't destroyed by the day when it is hard. They're willing to do the hard thing. They're okay to march into uncertainty. They're willing to do the hard thing for the payoff. They're willing to take a short-term discomfort for the long-term relief or the long-term payout. I think that mindset can change the game for people, particularly if you think of it like a marathon. Like, I just have to be able to finish this marathon, I'm going to do the hard thing, and think of it that way. There'll be hills, there'll be valleys, there'll be times where you want to give up, but can I just do one hard thing and then the next hard thing, and then the next hard thing? Do you have any thoughts on that? Chris: I'm glad that this is the message that you put out there. I'd say, obviously, when I think of Kim Quinlan as a friend, I think of other things and all the fun we've had together. But as a colleague, I always think of both. Obviously, self-compassion. But this idea of it's a beautiful day to do hard things, I like it because we've always talked about doing hard things as this negative thing before you came along, and by adding this idea of it's a beautiful day. When I look at all the hard things I did in my own recovery, or I see clients do hard things, there's this feeling of accomplishment, there's this feeling of growth, there's this feeling of greatness that we get. Just like you were saying, beyond the mental health conditions that I dealt with, when I start getting into real life after the mental health conditions now are more in recovery, every time I choose to do hard things, there's always such a good payoff. I was convinced I would never be able to get through school and get a degree and become a licensed therapist because I struggled with school with my perfectionism. It was difficult for me to get back in there and to humble myself and say, “Hey, you may flop and fail.” But now I'm a licensed therapist because of that willingness to do hard things.  I could give a plethora of examples, but I want people to hear that doing hard things is your way of saying, “I believe in myself. I trust myself that I can accomplish things, and I'm going to tap into my support system if I need to, but I am determined, determined, determined to push myself to a level that I may not think I can.” I love when clients do that, and they always come in, they're like, “I'm so proud of myself, I can't wait to tell you what I did this weekend.” I love that. So, always remember hard things come with beautiful, beautiful, beautiful outcomes and accomplishments. Kimberley: Yeah. I think the empowerment piece, when clients do scary, hard things, or they feel their hard feelings, or they do an exposure, they'll often come in and be like, “I felt like I could do anything. I had no idea about the empowerment that comes from doing hard things.” I think we've been trained to think that if we just avoid it, we then will feel confident and strong, but it's actually the opposite. The most empowered you'll ever feel is right after you've done a really, really hard thing, even if it doesn't go perfectly. Chris: Yeah, and so much learning comes out of it. That's why I always tell clients too, going back to one of our first roadblocks, beating yourself up prevents the learning. Let's say you try something and it doesn't go well. I was talking to a colleague of ours who I really, really like. She was telling me how her first treatment center failed. Now she's doing really well for herself down in San Diego. She's like, “I just didn't know things, and I just did things wrong, and I learned from it, and now I'm doing well.”  It's like, whenever we look at something not going the way we'd like as an opportunity to learn and collect data, it just makes us that much better when we try it the other time. A lot of times these anxiety disorders were originally before treatment, hopefully trying to find ways to avoid our way through life—tough words—and trying to figure out, like, how can I always be small and avoid and still get to where I want to be? When people hear this from your podcast—it's a beautiful day to do hard things—I hope that they recognize that you don't have to live an avoidant lifestyle, an isolated lifestyle anymore. Really challenging yourself and doing hard things is actually going to be so rewarding. It's incredible what outcomes come with it. Kimberley: Amazing. Well, Chris, thank you so much for doing this with me again. We finally stamped it into the podcast, which makes me so happy. Tell us where people can hear about you, get in contact with you, and learn more about what you do. Chris: I am really active in the International OCD Foundation. I'm one of their board members. I also am one of their lead advocates, just meeting as somebody with the disorder. I speak on it. Then I lead some of their special interest groups. The Body Dysmorphic Disorder Special Interest Group is one of them, but I lead about four of them. One of their affiliates, OCD Southern California, I am Vice President of OCD SoCal and a board member. We do a lot of events here locally that Kim is part of, but also some virtual events that you could be a part of. And then, as a clinician, I'm a licensed clinician in Costa Mesa, California. I currently work at The Gateway Institute. You can find me either by email at my name, which is never easy to spell. So, ChrisTrondsen@GatewayOCD.com, or the best thing is on social media, whether it's Instagram, Facebook, or X, I guess we're calling it now. Just @christrondsen. You could DM me. I always like to hear from people and get people's support, and anything I can do to support people. I always love it. Kimberley: Oh my gosh, you're such a light in the community, truly. A light of hope and a light of wisdom and knowledge. I want to say, because I don't tell you this enough as your friend and as your colleague, thank you, thank you for the hope that you put out there and the information you put out there. It is so incredibly helpful for people. So, thank you. Chris: I appreciate that. I forgot to say one thing real quick. Every first, third, and fourth Wednesday of the month at 9 a.m. Pacific Standard Time on the IOCDF, all of their platforms, including iocdf.org/live, I do a free live stream with Dr. Liz McIngvale from Texas, and we have great guests like Kim Quinlan on, so please listen. But thank you for saying that. I always try to put as much of myself in the community, and you never know if people are receiving it well. I want to throw the same thing to you. I mean, this podcast has been incredible for so many. I always play some of this stuff for my clients. A lot of clients are looking for podcasts. So, thanks for all that you do. I'm really excited about this episode because I think it's something that we touch so many people. So, now to share it on a bigger scale, I'm excited about it. But thank you for your kind words. You're amazing. It's all mutual. Kimberley: Thank you. You're welcome back anytime. Chris: And we're going to get Greek food soon. It's funny [inaudible] I'm telling you. It's life-changing. Thanks, Kim. Listen to other episodes. Kimberley: Thank you.

In this episode, we discuss understanding OCD through an IFS lens. We explore particular challenges in treating OCD that arise from the interplay of the neurological and psychological factors that underly the condition. We also discuss how IFS integrates effective elements of other empirically validated treatments for OCD, and why IFS enhances the effectiveness of these interventions.  Melissa Mose, LMFT, has been in private practice for 30 years and has specialized in working with OCD for roughly half of that. She is currently the president of OCD Southern California, an affiliate of the International OCD Foundation and she is an international speaker and educator on Obsessive Compulsive disorder. As a Level 3 trained and certified Internal Family Systems therapist and an IFSI-approved professional consultant, Melissa is committed to developing a more compassionate, IFS-informed approach to evidence-based treatment for OCD. She is currently working on several projects designed to raise awareness, improve early identification and a wider range of treatment options for individuals with OCD. 

In this episode, we discuss understanding OCD through an IFS lens. We explore particular challenges in treating OCD that arise from the interplay of the neurological and psychological factors that underly the condition. We also discuss how IFS integrates effective elements of other empirically validated treatments for OCD, and why IFS enhances the effectiveness of these interventions.  Melissa Mose, LMFT, has been in private practice for 30 years and has specialized in working with OCD for roughly half of that. She is currently the president of OCD Southern California, an affiliate of the International OCD Foundation and she is an international speaker and educator on Obsessive Compulsive disorder. As a Level 3 trained and certified Internal Family Systems therapist and an IFSI-approved professional consultant, Melissa is committed to developing a more compassionate, IFS-informed approach to evidence-based treatment for OCD. She is currently working on several projects designed to raise awareness, improve early identification and a wider range of treatment options for individuals with OCD. 

ERP is widely considered the gold standard treatment for OCD. Unfortunately, very few people with OCD receive this type of therapy due to many external factors. It can take up to 17 years for someone with OCD symptoms to receive any treatment let alone the best one. Also, many people with OCD are unaware of ERP's existence or how it even works.  We explain what OCD is and is not and address some common reasons people don't seek help for OCD.  Join us as our host, Gabe Howard, speaks with Dr. Patrick McGrath, the clinical director of NOCD.com, an app-based platform that specializes in bringing ERP to those who need it. Special thanks to NOCD for graciously sponsoring this episode. Learn more at treatmyocd.com. To read the transcript or see show notes, please visit the official episode page. Our guest, Dr. Patrick B. McGrath serves as the Chief Clinical Officer for NOCD, an app-based platform for the treatment of OCD, leading their teletherapy services across the world. He opened Intensive Outpatient, Partial Hospital, and Residential Treatment Programs for Anxiety Disorders, School Refusal, and OCD. He is also a member of the Scientific Advisory Board of the International OCD Foundation. He is a Fellow of the Association for Behavioral and Cognitive Therapies. He authored “Don't Try Harder, Try Different,” and “The OCD Answer Book.” He was featured on Discovery Health Channel's, “Panic” and on three episodes of TLC's “Hoarding; Buried Alive.” Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can't imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

Katharine Phillips, M.D., is Professor of Psychiatry, DeWitt Wallace Senior Scholar, and Residency Research Director at Weill Cornell Medical College, and Attending Psychiatrist at New York-Presbyterian Hospital in New York City. Dr. Phillips is internationally recognized for her expertise in body dysmorphic disorder (BDD). She has been conducting research studies and treating patients with BDD for more than30 years. Her studies have included investigation of BDD's symptoms, prevalence, morbidity, course of illness, and relationship to other disorders such as OCD. Because no BDD-specific measures were available, she developed and tested BDD screening, diagnostic, severity, and insight measures. She has also conducted and published most of the medication studies of BDD, and she has co-developed and tested CBT for BDD. Her scientific studies on BDD were continuously funded by the National Institute of Mental Health for more than 20 years. Dr. Phillips led the effort to include the new chapter of Obsessive Compulsive and Related Disorders in DSM-5. She has published more than 350 articles and chapters in scientific journals and books, and she has authored or edited 11 books, including multiple books on BDD. She has given more than 600 presentations around the world and more than 500 media interviews. Dr. Phillips has received many honors and awards for her research, clinical work, and other academic contributions. Her awards for herresearch studies on BDD include a Special Presidential Commendation from the American Psychiatric Association and the Outstanding Career Achievement Award from the International OCD Foundation.

I am so excited to finally share this incredible conversation with the amazing Annabella Hagen. In episode #10, she: Describes her background & passion for this work (3:20) Defines OCD/Scrupulosity (5:02) Talks about OCD in the LDS Community (6:51) Discusses  the OCD treatment journey (14:02) Offers a connection between faith & treatment (21:39) Explores self-compassion through a faith lens (32:38) Shares her “scoop on scrup” (35:48) Annabella Hagen is the clinical director and founder of Mindset Family Therapy in Provo, Utah. Her focus is working with clients who suffer from anxiety, OCD, and OC-spectrum disorders. She is passionate about helping her clients progress as they fully engage in their treatment and experience the journey back to living a values-centered life. Annabella obtained her MSW degree from Brigham Young University. She is a member of the International OCD Foundation and the Association for Contextual Behavioral Science.  Annabella is the author of “Imperfectly Good, Navigating Religious and Moral Anxiety to Release Fear and Find Peace” and “Let Go of Anxiety, Climb Life's Mountains with Peace, Purpose, and Resilience.”  She enjoys walking, classical music, reading, yoga, and finding new adventures when she travels. Her favorite pastime is spending time with her 15 grandkids. Instagram: @imperfectlygood_scrupulosity Website: ⁠https://mindsetfamilytherapy.com/  Resources: https://mindsetfamilytherapy.com/books/downloads

Kimberley: Welcome back, Ethan Smith. I love you. Tell me how you are. First, tell me who you are. For those who haven't heard of your brilliance, tell us who you are. Ethan: I love you. My name is Ethan Smith, and I'm a national advocate for the International OCD Foundation and just an all-around warrior for OCD, letting people know that there's help and there's hope. That's what I've dedicated my life to doing. Kimberley: You have done a very good job. I'm very, very impressed. Ethan: I appreciate that. It's a work in progress. Kimberley: Well, that's the whole point of today, right? It is a work in progress. For those of you who don't know, we have several episodes with Ethan. This is a part two, almost part three, episode, just catching up on where you're at. The last time we spoke, you were sharing about the journey of self-compassion that you're on and your recovery in many areas. Do you want to briefly catch us up on where you're at and what it's been like since we met last? Ethan: Yeah, for sure. We'll do a quick recap, like the first three minutes of a TV show where they're like, “So, you're here, and what happened before?”  Kimberley: Previously on. Ethan: Yeah, previously, on real Ethans of Coweta County, which sounds super country and rural. The last time we spoke, I was actually really vulnerable. I don't mean that as touting myself, but I said for the first time publicly about a diagnosis of bipolar. At that time, when we spoke, I had really hit a low—a new low that came from a very hypomanic episode, and it was not related to OCD. I found myself in a really icky spot. Part of the reason for coming or reaching that bottom was when I got better from OCD into recovery and maintenance, navigating life for the first time, really for the first time as an adult man in Los Angeles, which isn't an easy city, navigating the industry, which isn't the nicest place, and having been born with OCD and really that comprising the majority of my life. The next 10 years were really about me growing and learning how to live. But I don't know that I knew that at the time. I really thought it was about, okay, now we're going to succeed, and I'm going to make money, live all my dreams, meet my partner, and stuff's going to happen because OCD is not in the way. That isn't to say that that can't happen, and that wasn't necessary. I had some amazing life experiences. It wasn't like I had a horrible nine years. There were some wonderful things. But one of the things that I learned coming to this diagnosis and this conclusion was how hard I was being on myself by not “achieving” all the goals and the dreams that I set out to do for myself. It was the first time in a long time, really in my entire life, that I saw myself as a failure and that I didn't have a mental illness to blame for that failure. I looked at the past nine years, and I went, “Okay, I worked so hard to get here, and I didn't do it. I worked so hard to get here in a personal relationship, and I didn't get there. I worked so hard to get here financially, and I didn't even come close." In the past, I could always say, “Oh, OCD anxiety.” I couldn't do it. I couldn't finish it. I dropped out. That was always in the way. It was the first time I went, “Oh wow, okay, this is on Ethan. This is on me. I must not be creative enough, smart enough, good enough, strong enough, or brave enough.” That line of thinking really sent me down a really dark rabbit hole into a really tough state of depression and hypomania and just engaging in unhealthy activities and things like that until I just came crashing down. When we connected, I think I had just moved from Los Angeles to Atlanta and was resetting in a way. At that time, it very much felt like I was taking a step back. I had left Los Angeles. It just wasn't a healthy place for me at that time. My living situation was difficult because of my upstairs neighbor, and it was just very complicated. So, I ended up moving back to Georgia for work, and I ended up moving back in with my parents. I don't remember if we talked about that or not, but it was a good opportunity to reset. At that time, it very much looked and felt like I was going backwards. I just lived for 10 years on my own in Los Angeles, pursuing my dreams and goals. I was living at home when I was sick. What does this mean? I'm not ready to move. I'm not ready to leave. I haven't given up on my dream. What am I doing? I think if we skip the next three years from 2019 on, in retrospect, it wasn't taking a step back; it was taking a step forward. It was just choosing a different path that I didn't realize because that decision led to some of the healthiest, most profound experiences in my life that I'm currently living. I can look back at that moment and see, “Oh, I failed. I've given up.” This is backwards. In reality, it was such a beautiful stepping stone, and I was willing to step back to move forward, to remove myself from a situation, and then reinsert myself in something. Where I am now is I'm engaged, to be married. I guess that's what engaged means. I guess I'm not engaged with a lawyer. I'm engaged, and that's really exciting. Kimberley: Your phone isn't engaged. Ethan: Yeah, for sure, to an amazing human being. I have a thriving business. I'm legitimately doing so many things that I never thought I would do in life ever, whether it had to do with bipolar or more prominently in my life, OCD, where I spent age 20 to 31, accepting that I was home-ish bound and that was going to be my life forever and that I'm “disabled” or “handicapped,” and that's just my normal. I had that conversation with my parents. That was just something that I was going to have to live with and accept. I'm doing lots of things that I never expected to do. But what I've noticed with OCD is, as the stakes seem raised because you're engaging yourself in so many things that are value-driven and that you care about, the stakes seem higher. You have more to lose. When you're at the bottom, it's like, okay, so what? I'm already like all these things. Nothing can go wrong now because I'm about to get married to my soulmate, and my business is doing really well. I have amazing friends, and I love my OCD community. The thoughts and the feelings are much more intense again because I feel like I have a lot more to lose. Whereas I was dismissing thoughts before, now they carry a little bit more weight and importance to me because I'm afraid of losing the things that I care about more. There's other people in my life. It's not just about me. With that mindset came not a disregard but almost forgetting how to be self-compassionate with myself. One of the things that came out of that bipolar diagnosis in my moving forward was the implementation of active work around self-compassion. I did workbooks, I worked very closely with my therapist, and we proactively did tons and tons of work in self-compassion. You can interrupt me at any time, because I'll keep babbling. So, please feel free to interrupt. I realized that I was not practicing self-compassion in my life at all. I don't know that I ever had. Learning self-compassion was like learning Japanese backwards. It was the most confusing thing in the world. The analogy that I always said: my therapist, who I've been with for 13 years, would say to me, “You just need to accept where you are and embrace where you are right now. It's okay to be there. Give yourself grace.” She would say all these things.  I always subscribe to the likes of, “You have to work harder. You can't lift yourself off the hook. Drive, drive, drive, drive.” That was what I knew. I tried to fight her on her logic. I said, “If there's a basketball team and they're in the finals and it's halftime and they're down by 10, does the coach go to the basketball team and say, ‘Hey guys, let's just appreciate where we are right now; let's just be in this moment and recognize that we're down by 10 and be okay with that.'” I'm like, “No, of course not. He doesn't go in there and say that. He goes, ‘You better get it together and all this stuff.'” I remember my therapist goes, “Yeah, but they're getting out of bed.” I'm like, “Oh, okay, that's the difference.” They're actually living their life. I'm completely paralyzed because I'm just beating myself down.  But what I've learned in the last three or four years is that self-compassion is a continuous work in progress for me and has to be like a conscious, intentional practice. I found myself in the last year really not giving myself a lot of self-compassion. There's a myriad of reasons why, but I really wanted to come on and talk about it with you and just share some of my own experiences, pitfalls, and things that I've been dealing with.  I will say the last two years have probably been the hardest couple of years and the most beautiful simultaneously, but hard in terms of OCD, thoughts and triggers, anxiety, and just my overall baseline comfort level being raised because, again, there's so many beautiful things happening. That terrifies me. I mean, we know OCD is triggered by good stress or bad stress. So, this is definitely one of those circumstances where the stakes seem higher. They seem raised, so I need more certainty. I need it. I have to have more certainty. I don't, really. I'm okay with uncertainty, but part of that component is the amount of self-compassion that I give myself. I haven't been the best at it the last couple of years, especially in the last six months. I haven't been so good. Kimberley: I think this is very validating for people, myself included, in that when you are functioning, it doesn't seem like it's needed. But when we're not functioning, it also doesn't feel like it's needed. So, I want to catch myself on that. What are some roadblocks that you faced in the implementation of this journey of self-compassion or the practice of self-compassion? What gets in the way for you? Ethan: I will give you a specific example. It's part of my two-year journey. In the last year and a half, I started working with a nutritionist. Physical health has become more important to me. It may not look like that, but getting there, a work in progress. But the reality of it is, and this is just true, I'm marrying a woman who's 12 years younger than me. I want to be a dad. I can't wait to have children. The reality of my life—which I'm very accepting of my current reality, which was something I wasn't, and we were probably talking about that before—was like, I wanted to be younger. I hated that everything was happening now. I wasn't embracing where I was and who I was in that reality. I'm very at peace with where I am, but the reality of my reality is that I will be an older father. So, a value-driven thing for me to do is get healthier physically because I want to be able to run around and play catch in 10 years with my kid. I would be 55 or 60 and be able to be in their lives for as long as I possibly could. I started working with a nutritionist, and for me, weight has always been an issue. Always. It has been a lifelong struggle for me. I've always yo-yoed. It's always been about emotional eating. It's always been a coping mechanism for me. I started working with a nutritionist. She's become a really good friend, an influence in my life, and an accountability partner. I'm not on a diet or lifestyle change. There's no food off the table. I track and I journal. But in doing this, I told her from the beginning, "In the first three months, I will be the best client you've ever had,” because that's what I do—I start perfectly. Then something happens, and I get derailed. I was like, my goal is to come back on when I get derailed. That is the goal for me. And that's exactly what happened. I was the star student for three months. I didn't miss a beat. I lost 15 pounds. The goal wasn't weight loss, mind you; it was just eating healthier and making more intentional choices. Then I had some OCD pipe up, my emotions were dysregulated, and I really struggled with the nutrition piece. I did get back on track.  Over the last year, I gained about seven pounds doing this nutrition. Over the last six months, I was so angry at myself for looking at my year's journey. This is just an example of multiple things with self-compassion, but this is the most concrete and tangible I can think of at the moment. But looking at my year and looking at it with that black-and-white OCD brain and saying, “I failed. I'm a piece of crap. I'm not where I want to be on my journey. I've had all of the support I could possibly have. I have all the impetus. I want to be thinner for my wedding. I want to look my best at my wedding. What is wrong with me? In these vulnerable emotional states or these moments of struggle, why did I give in?” In the last couple of months, I literally refused to give myself any compassion or grace around food, screw-ups, mess-ups, and any of that. I refused. My partner Katie would tell me, “Ethan, you have to love--” I'm like, “No, I do not deserve it.” I'm squandering this opportunity. I just wholeheartedly refused to give myself compassion. Because it's always been an issue, I'm like, “What's it going to take?” Well, compassion can't be the answer. I need tough love for myself.  I think I did this in a lot of areas of my life because, for me, I don't know, there's a stigma around self-compassion. Sometimes, even though I understand what it is on paper-- and I've read your workbook and studied a lot of Kristin Neff, who's an amazing self-compassion expert. On paper, I can know what it is, which is simply embracing where you are in the moment without judgment and still wanting better for yourself and giving yourself that grace and compassion, regardless of where it is.  I felt like I couldn't do that anymore because I wasn't supposed to. I wasn't allowed. I suddenly reframed self-compassion as a weakness and as an excuse rather than-- it was very much how I thought about it before I even learned anything about self-compassion, and I found myself just not a very loving person myself. My internal self-talk was really horrible and probably the worst. If somebody was talking to me like this, you always try to make it external and be like, “Oh, if somebody talked to you like this, would they be your friend? Would you listen to them?” I was calling myself names. I gave myself a room. It was almost in every facet of my life, and it was really, really eating at me. It took a significant-- yeah, go ahead. Kimberley: When I'm with clients and we're talking about behaviors, we always talk about the complex outcomes of them, like the consequences that you were being hard on yourself, that it still wasn't working, and so forth. But then we always spend some time looking at, let's say, somebody is drinking excessively or doing any behavior that's not helpful to them. We also look at why it was helping them, because we don't do things unless we think they're helping. What was the reason you engaged in the criticism piece? How did that serve you in those moments? Ethan: It didn't, in retrospect. In the moment, I think behaving in that way feels much like grabbing a spear and putting on armor. I don't know if it's stigma or male stigma. I mean, I've always had no problem being sensitive, being open to sensitivity, and being who I am as an individual. But with all of this good in my life, my emotions are more intense. My thoughts are more intense. My OCD is more intense. I felt like I needed to put on-- I basically defaulted to my original state of thinking before I even learned about self-compassion, which is head down, bull horns out, and I'm just going to charge through all of this because it's the only way. It's just like losing insight. When you're struggling with OCD, it's like you lose insight, you lose objectivity. It's like there's only one way through this.  I think it's important to note, in addition to the self-compassion piece, this year especially, there's been some physical things and some somatic symptoms that I've gotten really stuck on. I'm really grateful that-- and I love to talk about it with advocacy. It's like, advocates, all of us, just because we're speaking doesn't mean that we have an OCD-free life or a struggle-free life. That's just not it. I always live by the mantra: more good days than bad. That is my jam. I'm pleased to report that in the last 13 years, I've still had more good days than bad, but it doesn't mean that I don't have a tough month.  I think that in the last couple of years, I've definitely been challenged in a new way because there's been some things that have come up that are valid. I have a lot of health anxiety, and they've been actual physical things that have manifested, that are legitimate things. Of course, my catastrophic brain grabs onto them. You Google once, and it's over. I have three and a half minutes to live for a brown toenail, and-- Kimberley: You died already. Ethan: I'm already dead. I think it all comes back around to this idea of self-stigma, that even if you know all this stuff like, I'm not allowed to struggle, I'm not allowed to suffer, I have to be a rock, I have to be all things to all people—it's all these very black and white rules that are impossible for a human being to live by because that's just not reality. I mean, I think that's why the tough exterior came back because it was like, “All right, life is more challenging.” The beautiful thing about recovery is, for the most part, it didn't affect my functioning, which was amazing. I could still look at every day and go, “I was 70% present,” or “I was 60% present and 40% in my head, but still being mindful and still doing work and still showing up and still traveling.” From somebody that was completely shut down, different people respond in different ways to OCD. From somebody who came from completely shutting down and being bedridden, this was a huge win. But for me, it wasn't a huge win in my head. It was a massive failing on my part. What was I doing wrong? How was it?  Just as much as I would talk every week on my live streams and talk about, it's a disease, not a decision, it's a disorder. I can say that all day long, but there are times when it tricks me, and I stigmatize myself around it.  It's been very much that in the last year, for sure. It's been extremely challenging facing this new baseline for myself. Because, let's face it, I'm engaging in things that I've never experienced before. I've never been in a three-year relationship with a woman. I've never been engaged. I've never bought a house. Outside of acting, I've never owned a business or been a businessperson. I mean, these are all really big commitments in life, and I'm doing them for the first time.  If I have insight now and it's like, I can have this conversation and say, “Yeah, I have every reason to be self-compassionate with myself.” These are all brand new things with no instruction manual. But it's very easy to lose sight of that insight and objectivity and to sit there and say-- we do a lot of comparing, so it's very easy to go, “Well, these are normal human things. Everybody gets married. Everybody works. This should be easy.” You talk about, like, never compare struggles, ever. If somebody walks to the mailbox and you can't, never compare struggles. But that's me going, “Well, this is normal life stuff. It's hard. Well, what's wrong with me?” Kimberley: Right. I think, for me, when I'm thinking about when you're talking, I go in and out of beating myself up for my parenting, because, gosh, I can't seem to perfect this parenting gig. I just can't. I have to figure it out. What's so interesting is when I start beating myself up and if I catch myself, I often ask myself, what would I have to feel if I had to accept that I'm not great at this? I actually suck at this. It's usually that I don't want to feel that. I will beat myself up to avoid having to feel the feelings that I'm not doing it right. That has been a gateway for me, like a little way to access the self-compassion piece. It's usually because I don't want to feel something. And that, for me, has been really helpful.  I think that when you're talking about this perceived failure—because that's what it is. It's a perceived failure, like we're all a failure compared to the person who's a little bit further ahead of us—what is it that you don't want to feel? Ethan: It's a tough question. You've caught me speechless, which is rare for me. I'm glad you're doing video because otherwise, this would be a very boring section of the podcast. For me, the failing piece isn't as much of an issue. It was before. I don't feel like I've failed. In fact, I feel like I'm living more into where I'm supposed to be in my values. I think for me, the discomfort falls around being vulnerable and not in control. I think those are two areas that I really struggle with. I always say, sometimes I feel like I'm naked in a sandstorm. That's how I feel. That's the last thing you want to be. Well, you don't want to be in a sandstorm—not naked, but naked in a sandstorm—you don't want to see me naked at all. That's the bottom line. No nudity from Ethan. But regardless, you're probably alone in the sandstorm. You feel the stinging and all of that. No, I'm just saying that's what I picture it feels like.  Kimberley: Yeah, it's an ouch. That feels like an ouch. Ethan: It feels like a big ouch. I think that vulnerability, for me, is scary. I'm not good at showing vulnerability. Meaning, I have no problem within our community. I'll talk about it all day long. I'll talk about what happened yesterday or the day before. I'll be vulnerable. But for people who don't know me, I struggle with it.  Kimberley: Me too. Ethan: Yeah. We all have our public faces. But vulnerability scares me in terms of being a human being, being fallible, and not being able to live up to expectations. What if I have to say I can't today? Or I'm just not there right now and not in control of things that scare me. Those feelings, I think, have really thrown me a bit more than usual, again. I keep saying this because things feel more at stake, and they're not, but I feel like I have so much more to live for. That's not saying that I didn't feel like I didn't have a reason to live before. That's not what I'm saying at all. I'm simply saying, dreams come true, and how lucky am I? But when dreams come true with OCD, it latches onto the things we care about most and then says, “That's going to be taken away from you. Here are all the things you have to do to protect that thing.” I think it'd been a long time since I'd really faced that.  To answer your question in short, I think, for me, vulnerability and uncertainty around what I can't control, impacting the things that I care about most, are scary. Kimberley: I resonate so much with what you're saying. I always explain to my eating disorder clients, “When you have an eating disorder and you hit your goal weight, you would think we would celebrate and be like, ‘Okay, I hit it. I'm good now.'” But now there's the anxiety that you're going to go backwards. Even though you've hit this ridiculous goal, this unhealthy goal, the anxiety is as high as it ever was because the fear of losing what you've got is terrifying. I think that's so true for so many people. And I do agree with you. I think that we do engage in a lot of self-criticism because it feels safer than the vulnerability, the loss of control, or whatever that we have to feel. What has been helpful for you in moving back towards compassion? I know you said it's like an up-and-down journey, and we're all figuring this out as we go. What's been helpful for you? Ethan: A couple of things. I think it's worth talking about, or at least bringing up this idea of core fear. I've done some recent core fear work, just trying to determine, at the root of everything, what is my core fear? For me, it comes down to suffering. I'm afraid of suffering. I'm not afraid of dying; I'm afraid of suffering. I'm afraid of my entire life having to be focused on health and disease because that's what living with OCD when I was really sick was about. It's all I focused on. So, I'm so terrified of my life suddenly being refocused on that.  Even if I did come down with something awful, it doesn't mean that my life has to solely focus on that thing. But in my mind, my core fear is, what if I have to move away from these values that I'm looking at right now and face something different? That scares the crap out of me.  The first thing around that core fear is the willingness to let that be there and give myself compassion and grace, and what does that look like, which is a lot of things. This fear—this new fear and anxiety—hasn't stopped me from moving forward in any way, but it sure has made it a little bit more uncomfortable and taken a little bit of the joy out of it. That's where I felt like I needed to put on a second warrior helmet and fight instead of not resisting, opening myself up, and being willing to be naked in a sandstorm.  One of the things that I've learned most about is, as a business owner yourself, and if you're a workaholic, setting boundaries in self-care is really hard. I didn't really connect until this year the connection, the correlation between self-care and self-compassion. If I don't have self-compassion, I won't allow myself to give myself self-care. I won't. I won't do it because I don't deserve it. There's a very big difference between time off, not working, sleeping, but then actually taking care of yourself. It's three different things. There's working, there's not working, and then there's self-care. I didn't know that either. It was like, “Well, I didn't work tonight.” Well, that's not necessarily self-care. You just weren't in a meeting, or you weren't working on something. Self-care is proactive. It's purposeful. It's intentional.  Giving myself permission to say no to things, even at the risk of my own reputation, because I feel like saying no is a big bad word, because that shows that I can't handle everything at once, Kim. I can't do it all. And that is a no-no for me. Like, no, no, no, everybody needs to believe that you can do everything everywhere all at once, which was a movie. That's the biggest piece of it.  Recently, I was able to employ some self-care where it was needed at the risk of the optic seeming. I felt like, "Here I am, world. I'm weak, and I can't handle it anymore." That's what I feel like is on the other end.  I was sick, and I had been traveling every week since the end of March. I don't sleep very well. I just don't. When I'm going from bed to bed, I really don't sleep well. I had been in seven or eight cities in seven or eight weeks. I had been home for 24 hours. This was only three weeks ago, and I was about to head out on my last trip, and the meeting that I was going for, the primary reason, got canceled, not by me. I was still going to meet with people that I love and enjoy. I woke up the day before I was traveling, and I was sick. I was like, “Oh man, do I still go?” The big reason was off the table, but there were still many important reasons to go, but I was exhausted. I was tired. I was sick. My body was saying, “Enough.” I had enough insight to say, I'm not avoiding this. This isn't anxiety. This is like straight up.  When I texted the team—this is around work and things that I value—I was like, “I'm not coming.” I said, “I'm not coming.” They responded, “We totally understand. Take care of yourself.” And what I read was, “You weak ass bastard. You should suck it up and come here, because that's what I would have done. Why are you being so lame and lazy?” That is what I read. This is just an instance of what I generally feel if I can't live up to an expectation. I always put these non-human pressures on myself.  But making this choice, within two days, I was able to reset intentionally. This doesn't mean I'm going to go to bed and avoid life. I rested for a day because I needed to sleep to get better. But the next few days were filled with value-driven decisions and choices and walks and exercising and getting back on nutrition and drinking lots of water and spending quality time with people that I care about, and my body and brain just saying, “You need a moment.” Within a couple of days, everything changed. My OCD quickly dropped back down to baseline. My anxiety quickly dropped back down. I had insight and objectivity.  When I went back to work later that week—I work from home—I was way more effective and efficient. But I wouldn't have been able to do that. It was very, very hard to give myself self-compassion around making that simple decision that everybody was okay with. Kimberley: I always say my favorite saying is, “I'm sorry, but I'm at capacity right now.” That has changed my life because it's true. It's not even a lie. I'm constantly at capacity, and I find that people do really get it. But for me to say that once upon a time, I feel this. When I was sick, the same thing. I'm going to think I'm a total nutcase if I keep saying no to these people. But that is my go-to sentence, “I'm at capacity right now,” and it's been so helpful.  Ethan: In max bandwidth.  Kimberley: Yes. What I think is interesting too is I think for those who have been through recovery and have learned not to do avoidant behaviors and have learned not to do compulsions, saying “I need a break” feels like you've broken the rules of ERP. They're different things. Ethan: You hit them down. I was literally going to say that. It also felt when I made that decision that it felt old history to me, like old Ethan, pre-getting better. I make the joke. It was true. I killed my grandfather like 20 times while he was still alive. Grandpa died. I can't come to the thing. I can't travel. I can't do the thing. This was early 2000s, but I had a fake obituary that I put into Photoshop. I would just change the date so I can email it to them later and be like, it really happened. I would do this. It's like, here was a reason. It was 100% valid. Nobody questioned it. It was not based on OCD. It was a value-driven decision, and it felt so icky. My body felt like I might as well have sent a fake obituary to these people about the fake death of my grandfather. It felt like that. So, I wholeheartedly agree with you. Kimberley: I think it's so important that we acknowledge that post-recovery or during recovery is that saying acts of compassion sometimes will feel like and sound like they're compulsions when they're actually not.  Ethan: That's such a great point. I totally agree with you. Kimberley: They're actually like, I am actually at capacity. Or the expectation was so large, which for you, it sounds like it is for me too—the expectation was so large, I can't meet that either. That sucks. It's not fun.  Ethan: No, it's not. It's not because, I mean, there's just these scales that we weigh ourselves on and what we think we can account for. I mean, the pressure that we put on ourselves. And that's why, like the constant practice of self-compassion, the constant practice of being mindful and mindfulness, this constant idea of-- I mean, I always forget the exact thing, but you always say, I strive to be a B- or C+. I can never remember if it's a B- or C+, but-- Kimberley: B-. Ethan: B-. Okay, cool.  Kimberley: C+ if you really need it. Ethan: Yeah. To this day, I heard that 10 years ago, and I still struggle with that saying because I'm like, I don't even know that I can verbally say it. Like, I want to be a B... okay, that's good enough. Because it sounds terrifying. It's like, “No, I want to be an A+ at everything I do.”  I know we're closing in on time. One of the things I just wanted to say is thank you not only for being an amazing human being, an amazing advocate, an amazing clinician, and an okay mom, as we talked about. Kimberley: Facts. #facts. Ethan: But part of the reason I love advocating is I really didn't come on here to share a specific point or get something across that I felt was important. I think it's important as an advocate figure for somebody who doesn't like transparency or vulnerability to be as transparent and vulnerable as possible and let people see a window into somebody that they may look at and go, “That person doesn't struggle ever. I want to be like that. I see him every week on whatever, and he's got it taken care of. Even when it's hard, it isn't that hard.”  For me, being able to come on and give a window into Ethan in the last six months is so crucial and important. I want to thank you for letting me be here and share a little bit about my own life and where I met the goods and the bads. I wouldn't trade any of it, but I appreciate you. Kimberley: No, thank you. I so appreciate that because it is an up-and-down journey and we're all figuring it out, myself included. You could have interviewed me and I could have done similar things. Like here are the ways that I suck and really struggle with self-compassion. Here are the times where I've completely forgotten about it as a skill until my therapist is like, “Uh, you wrote this book about this thing that you might want to practice a little more of.” I think that it's validating to hear that learning it once is not all you need; it is a constant practice. Ethan: Yeah, it definitely is. Self-compassion is, to me, one of the most important skills and tools that we have at our disposal. It doesn't matter if you have a mental health issue or not. It's just an amazing way of life. I think I'll always be a student of it. It still feels like Japanese backwards sometimes. But I'm a lot better at putting my hand-- well, my heart's on that side, but putting my hand in my heart, and letting myself feel and be there for myself. I never mind. I'm a huge, staunch advocate of silver linings. I've said this a million times, and I'll always say, having been on the sidelines of life and not being able to participate, when life gets hard and stressful, deep down, I still have gratitude toward it because that means I'm actually living and participating. Even when things feel crappy or whatever, I know there'll be a lesson from it. I know good things will come of it. I try to think of those things as they're happening. It's meaningful to me because it gives me insight and lets me know that there'll be a lesson down the road. I don't know if it'll pay itself back tomorrow or in 10 years, but someday I'll be able to look at that and be like, “Well, I got to reintroduce myself to self-compassion. I got to go on Kim Quinlan's podcast, Your Anxiety Toolkit, and be able to talk to folks about my experience.” While I didn't quite enjoy it, it was a life experience, and it was totally worth it for these reasons. Now I get to turn my pain into my purpose. I think that's really cool. Kimberley: Yeah, I do too. I loved how you said before that moving home felt like it was going backwards, but it was actually going completely forward. I think that is the reality of life. You just don't know until later what it's all about. I'm so grateful for you being on the show. Thank you so much for coming on again. Ethan: Well, thanks for having me, and we'll do one in another 200 episodes. Kimberley: Yes, let's do it. Ethan: Okay.

My guest today is Ben Eckstein, LCSW. Ben is a therapist specializing in the treatment of OCD, Anxiety, and OC-Spectrum Disorders. He is the owner and director of Bull City Anxiety & OCD Treatment Center in Durham, North Carolina. In addition to his clinical work, Ben is also an accomplished speaker, trainer, and is the author of the new book, Worrying is Optional: Break the Cycle of Anxiety and Rumination That Keeps You Stuck. He also serves on the board of OCD North Carolina, the state affiliate of the International OCD Foundation.Some of the topics we explore in this episode include: - How Ben ended up writing Worrying is Optional- The overlap between Generalized Anxiety Disorder and Obsessive-Compulsive Disorder - How worrying can get in the way of other areas of life that are more important - Understanding the habitual nature of worry- The power of choosing what not to do- The role of Acceptance and Commitment Therapy (ACT) in addressing worry and rumination- Ben's background working in residential treatment for OCD—————————————————————————Worrying Is Optional: https://a.co/d/aE4FjqKBen's practice: https://www.bullcityanxiety.com/Instagram: @bullcityanxiety—————————————————————————Thank you all for checking out the episode! Here are some ways to help support Mentally Flexible:You can help cover some of the costs of running the podcast by donating a cup of coffee! www.buymeacoffee.com/mentallyflexiblePlease subscribe and leave a review on Apple Podcasts. It only takes 30 seconds and plays an important role in being able to get new guests.https://podcasts.apple.com/us/podcast/mentally-flexible/id1539933988Follow the show on Instagram: https://www.instagram.com/mentallyflexible/Check out my song “Glimpse at Truth” that you hear in the intro/outro of every episode: https://tomparkes.bandcamp.com/track/glimpse-at-truth

Amy Diener is an artist that specializes in dot paintings. She had been struggling with OCD since her high school years, but has been utilizing her art to heal and deal with her mental health. She finds peace and zen in making her paintings made of dots and solely relied on art as an avenue for healing, but as she grew older, she learned of the many other ways to aid in her healing from OCD, such as ERP. She now has a deeper understanding of the mental illness and has developed to live without fear of having OCD. Today, she continues her passion for art and even donates a portion of proceeds in supporting the International OCD Foundation.   In this episode we talk about:  ◾️ Amy's personal journey with OCD ◾️ Her art and how it helped her with navigating her thoughts ◾️ Therapy, medication, and other technicalities of OCD Find Amy here:  amydiener.com Find Zach here : zachwesterbeck.com @zach_westerbeck This podcast is made possible by NOCD. NOCD offers effective, affordable, and convenient OCD therapy. NOCD therapists are trained in Exposure Response Prevention, or ERP, therapy, the gold standard treatment for OCD. With NOCD, you can do virtual, live face-to-face video sessions with one of their licensed, specialty-trained therapists, and they accept most major insurance plans. If your insurance isn't covered, mention discount code ZACH100 for a special $100 rate for the next two months. To find out more about NOCD, visit zachwesterbeck.com/virtual-ocd-therapy/ to book a free 15-minute call.

Penny Moodie first shared her OCD story on The Imperfects in 2020. Since then, we and she have been flooded with incredible feedback from OCD sufferers who finally felt seen. Now Penny is back because she's written an incredible book about OCD called The Joy Thief and it's out now (link below).In this beautifully moving episode, Penny talks openly with Hugh, Ryan and Josh about some of the confronting moments from her book. The reason Penny calls OCD ‘the joy thief' is because it attempts to steal so much of the joy from your life. In Penny's case, it almost stole her blossoming relationship with Hugh in the early days, and as a child it tried to take the one thing she held most sacred - the safety of her mother.This may be a b-b-b-bonus episode, but it's also a v-v-v-very special one.To purchase Penny's book, The Joy Thief, follow this link: https://bit.ly/3RkMTuCTo learn more about OCD and to access resources to assist with getting help and how to manage it, follow these links:  So OCD - https://soocd.com.au/ This Way Up - https://thiswayup.org.au/ The International OCD Foundation: https://iocdf.org/ The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice, treatment or assessment. The advice given in this episode is general in nature, but if you're struggling, please see a healthcare professional, or call lifeline on 13 11 14.See omnystudio.com/listener for privacy information.

In episode #5, we are honored to have Rabbi Noah Tile on the podcast, where he: Describes his background & passion for this work (1:21) Defines OCD/Scrupulosity (11:59) Discusses treatment for OCD (20:00) Explores how treatment can be connected to faith (24:26) Shares about OCD in the Jewish community & his new support group beginning September 12 (38:45) Shares his “scoop on scrup” (40:41) Noah is a Registered Psychotherapist, academic coach, Rabbi and Co-Founder of a Canadian student mental health company called Resolvve (www.resolvve.ca). Resolvve is a low-cost, student-focused therapy platform, that provides integrative support for mental health, academic success, and personal growth. The platform also offers educational and social-emotional learning (SEL) tools, while building community through its support groups for students, parents, and educators. In private practice, Noah specializes in the treatment of OCD and ADHD. In addition, Noah is passionate about integrating spirituality with mental health and is a part of the International OCD Foundation's (IOCDF) faith and OCD task force to create positive change, working alongside both Jewish and non-Jewish faith leaders and practitioners across the world.  Website - www.resolvve.ca Instagram - @resolvvementalhealth Jewish OCD Support Group led by Rabbi Noah - Sign Up Here

On episode 21 of A Chat with Uma, I speak with Kimberley Quinlan, LMFT! Kimberley is a Licensed Marriage and Family Therapist (LMFT) and public speaker who is the host of Your Anxiety Toolkit podcast, founder of CBT School, and owner of Kimberley Quinlan (A Marriage and Family Therapy Corporation) in Los Angeles, CA.  She is passionate about the treatment of Obsessive-Compulsive Disorder and related disorders, Eating Disorders and Body-Focused Repetitive Behaviors, and provides one-on-one treatment and online courses for those who are struggling in these areas. Advocating for those with mental health disorders is also a huge part of her life mission, and she serves as a global advocate for the International OCD Foundation. She is also the founder of CBTSchool, an online psychoeducation platform where she offers support and research-based educational products to those who cannot access correct care. CBTSchool offers low-cost online courses and FREE resources for OCD, anxiety and BFRB's. She is also the best-selling author of 'The Self-Compassion Workbook for OCD: Lean into Your Fear, Manage Difficult Emotions, and Focus On Recovery' (2021). In this episode, we discuss the following topics (+ timestamps): (00:00:00) Introduction of episode & Kimberley Quinlan, LMFT (00:04:35) How Kimberley became an OCD-specialized therapist (00:10:39) How Kimberley's lived experience with anxiety, eating disorders, and being a personal trainer led her to becoming a mental health therapist; Being an OCD therapist without having OCD (00:13:59): All about self-compassion The events that led to Kimberley's interest & specialization in self-compassion Referenced clinician: Tara Brach Operational definition of self-compassion What self-compassion is & is not How anybody can access self-compassion Research on efficacy of self-compassion in treatment Role of self-compassion in recovery (00:30:22) About Kimberley's book: The Self-Compassion Workbook for OCD: Lean into Your Fear, Manage Difficult Emotions, and Focus On Recovery' (2021) (00:40:57) How Kimberley has made evidence-based OCD treatment education widely accessible through CBT School (00:47:55) Discussion: does an OCD treatment provider need to have lived experience of OCD to provide the best therapeutic care? (00:53:39): Kimberley's experience with chronic illness & having a disability Her journey to a POTS diagnosis How she had to radically change her life & way of operating Acceptance of disabilities & limitations The lessons she's learned from her chronic illness experience Full story on her podcast: episode 124, episode 307 Recommended book: How To Be Sick by Toni Bernhard (01:10:20): Navigating boundaries and finding balance in life Kimberley's experience with developing boundaries How to (attempt to) strike balance amongst incredible busyness Fielding judgment and criticism from social media & large-scale public creation Kimberley's family and children Kimberley's strategies for time management Referenced course: Time Management for Optimum Mental Health (01:20:03) Kimberley's experience as an Australian immigrant; Navigating the grief + anxiety of living across the world from her family (01:23:23) DEEP rapid-fire final questions with Kimberley, and closing out the episode! Connect with Kimberley: Website: https://kimberleyquinlan.com/ Listen To Her Podcast: Your Anxiety Toolkit - all podcast platforms CBT School: Find all courses here Instagram: @YourAnxietyToolkit Book: The Self-Compassion Workbook for OCD: Lean into Your Fear, Manage Difficult Emotions, and Focus On Recovery Kimberley's Clinical Practice: info here Connect with me! My website⁠: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠umarchatterjee.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠Instagram:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@UmaRChatterjee⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@UmaRChatterjee⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ TikTok:⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@UmaRChatterjee⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠hello@umarchatterjee.com⁠⁠⁠⁠⁠ Have a guest you want on the show? Fill out the ⁠⁠⁠⁠Guest Suggestion Form!⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/umarchatterjee/message

Kimberley: Welcome. This conversation is actually so near and close to my heart. I am so honored to have Jessie Birnbaum and Sandy Robinson here talking about Managing the anxiety of chronic illness and disability. Welcome and thank you both for being here. Sandy: Thank you for having us. Kimberley: For those of you who are listening on audio, we are three here today. We're going to be talking back and forth. I'll do my best to let you know who's talking, but if anything, you can look at the transcripts of the show if you're wondering who's saying what. But I am so happy to have you guys here. You're obviously doing some amazing work bringing awareness to those who have an anxiety disorder, specifically health anxiety OCD, panic disorder. These are all very common disorders to have alongside a chronic illness and disability. Jessie, will you go first in just telling us a little bit about your experience of managing these things?  Jessie: Yeah, of course. I've had OCD since I was a little kid but wasn't diagnosed until around age 14, so it took a little while to get that diagnosis. And then was totally fine, didn't have any physical limitations, played a lot of sports. And then in 2020, which seems like it would coincide with the pandemic (I don't think it did), I started getting really physically sick. I started out with these severe headaches and has continued on and morphed into new symptoms, and has been identified as a general chronic illness. I'm still searching for an overall diagnosis, but I've seen a lot of different ways in which my OCD has made my chronic illness worse. And then my chronic illness has made my OCD worse, which is really why Sandy and I are so passionate about this topic. Kimberley: Thank you. Sandy, can you share a little about your experience? Sandy: Yeah. Just briefly, I was born really prematurely at about 14 weeks early, which was a lot. And then I was born chronically ill with a bowel condition and I also have a physical disability called [02:31 inaudible] palsy. And then I wasn't diagnosed with OCD until I was 24, but looking back now, knowing what I do about OCD, I think I would say my OCD probably started around age three or something. So, quite young as well. Kimberley: You guys are talking about illnesses or medical conditions that create a lot of uncertainty in your life, which is so much of the work of managing OCD. Let's start with you Jessie again. How do you manage the uncertainty of not having a diagnosis or trying to figure that out? Has that been a difficult process for you, or how have you managed that? Jessie: It has been such a difficult process because that's what OCD latches onto, the uncertainty of things. That's been really challenging with not having a specific diagnosis. I can't say, “Oh, I have Crohn's disease or Lyme disease,” or something that gives it a name and validates the experience. I feel like I have a lot of intrusive thoughts and my OCD will latch onto not having that diagnosis. So, I'll have a lot of intrusive thoughts that maybe I'm making it up because if the blood work is coming back normal, then what is it? I'll have to often fight off those intrusive thoughts and really practice mindfulness and do a lot of ERP surrounding that to really validate my experience and not let those get in the way. Kimberley: Sandy—I can only imagine, for both of you, that is the case as well—how has your anxiety impacted your ability to manage the medical side of your symptoms? Sandy: I think that's an interesting question because I think both my OCD and my medical symptoms are linked. I think when I get really stressed and have prolonged periods of stress, my bowel condition especially gets a lot worse, so that's tricky. But I think as I've gone through ERP, and I'm now in OCD recovery, that a lot of the skills I've learned from being chronically ill and disabled my whole life, like planning, being a good self-advocate at the doctors or at the hospital and that flexibility, I think those tools really helped me to cope with the challenges of having additional anxiety on top of those medical challenges. Kimberley: Right. Of course, and I believe this to be from my own experience of having a chronic illness, the condition itself creates anxiety even for people who don't have an anxiety disorder. How have you managed that additional anxiety that you're experiencing? Is there a specific tool or skill that you want to share with people? And then I'll let Jessie chime in as well. Sandy: Yeah. I think the biggest thing is, it was realizing that my journey is my journey and it might be a little slower than other people's because of all the complicating factors, but it's still a good journey. It's my journey, so I can't really wish myself into someone else's shoes. I'm in my own shoes. I guess the biggest thing is realizing like my OCD isn't special because I have these complicating factors, even though I myself am special. My OCD is just run-of-the-mill OCD and can still be treated by ERP despite those medical issues as well. Kimberley: Right. How about you Jessie? What's your experience of that?  Jessie: I'd like to add to what Sandy had said too about the skills from ERP really helping. One of the things I feel like I've gone through is there's so much waiting in chronic illness. You're waiting for the doctors to get back to you, you're waiting for test results, you're waiting for the phone schedulers to answer the phone. I feel like I've memorized the music for the waiting of all the different doctors. But there's a lot of waiting, and that's really frustrating because the waiting is uncertain. You're just waiting to get an answer, which typically in my case and probably Sandy's and yours as well, then just adds more uncertainty anyways.  But I remember one of the tools that's really helped me is staying in the present, which I'm not great at. But I remember I had to get an MRI where you literally can't move. There's only the present. You're there with your thoughts, your arms are in, you can't move at all. It was really long. It was like 45 minutes long. I remember just thinking the colors. What do I see? I see blue, I see red. I thought I had to think of things because then my eyes were closed and I was thinking of different shapes of like, “Oh, in the room before, I saw there was a cylinder shape and there was a cube.” That's really helped me to stay in the present, especially with those really long waiting periods Kimberley: For sure. The dreaded MRI machine, I can totally resonate with what you're saying. It's all mindfulness. It's either mindfulness or you go down a spiral, right? Jessie: Exactly. Kimberley: You guys are talking about skills. Because I think there's the anxiety of having this chronic illness or a disability or a medical condition. What about how you manage the emotions of it and what kind of emotions show up for you in living with these difficult things that you experience? Sandy, do you want to share a little about the emotional side of having a chronic illness or a disability? Sandy: Yeah. I think the first thing that shows up for me emotion-wise, or did at least when I started to process the idea that I have a disability and I have these chronic illnesses and it's going to be a lifelong thing, was I was in my undergraduate university and I really hadn't thought much about what it's like to-- I had thought about having a disability, but I hadn't thought about the fact that I needed to process that this is a lifelong thing and it's going to be challenging my whole life. I think when I started to process that, the grief really showed up because I had to grieve this life that I thought I should have of being able-bodied or medically healthy or mentally well, I guess. I had to really grieve that. But I think that grief shows up sometimes unexpectedly for me too because sometimes I feel like I moved past this thing that happened. But then because it's an ongoing process to navigate chronic illness and disability, the grief shows up again at unexpected times.  I think the other thing too I've navigated was a lot of shame around the idea that I should be “normal.” But of course, I can't really control how I was born and the difficulties I've had. I think something that really helps me there is bringing in the self-compassion. I do think that compassion really is an antidote to shame because when you bring something out to the forefront and say, “This is something that I've experienced, it was challenging,” but I can still move forward, I think that really helps or at least it helps me.  Kimberley: Yeah, I agree. Jessie, what are your experiences? Jessie: I would say the first two words I thought of were frustration and loneliness. I think there's a lot of frustration in two different ways. The first way being like, why is this happening? First, I had OCD, and then now I have this other thing that I have to deal with. As Sandy was saying before, there's a lot of self-advocacy that has to happen when you're chronically ill, or at least that I've experienced, where you have to stand up for yourself, you have to finagle your way into doctor's appointments to get the treatment that you deserve. But there's also the frustration that both OCD and my chronic illness, I guess, are invisible. I look totally fine. I look like someone else walking down the street who might be completely healthy. I often feel frustrated that as a 23-year-old, a person who is a young adult, I'm having to constantly go to these doctor's appointments and advocate for myself and practice ERP, which is not always the most fun thing to do. It's frustrating to constantly have to explain it because you don't see it. And then that goes together with the loneliness of being a young adult and being pretty much the only person in the doctor's offices and waiting rooms who isn't an older adult or who isn't elderly. And then they get confused and then I get confused. My OCD will then attack that like, “Everyone else is older. What are you doing here?” I would definitely say loneliness, and I just forgot the other thing. Loneliness and frustration.  Kimberley: I resonate with what you're saying. I agree with everything both of you are saying. For me too, I had to really get used to feeling judged. I had to get good at feeling judged, even though I didn't even know if they were judging me. But that feeling that I was being judged, maybe it's more magical thinking and so forth. But that someone will say like I have to explain to someone why I can't do something. As I'm explaining it, I have a whole story of what they're thinking about me, and that was a really difficult part to get through at the beginning of like, “You're going to have to let them have their opinions about you. Who knows what they're thinking?” That was a really hard piece for me as well. I love that you both brought in the frustration and the loneliness because I think that's there. I love that we also bring in the grief, and I agree, Sandy. Jessie, do you agree in terms of that grief wave just comes at the most random times?  Jessie: Absolutely. Kimberley: It can be so, so painful. Let's keep moving forward. Let's go back to talking about how this interlocking web of how anxiety causes the chronic illness to get worse sometimes, the chronic illness causes anxiety to get worse sometimes. Sandy, have you found any way that you've been able to have a better awareness of what's happening? How do you work to pull them apart or do you not worry about pulling them apart?  Sandy: Oh, that's an interesting question. I think I have a few strategies. I do try to write everything down. I make notes upon notes upon notes of, this day I had these symptoms. I do automate a lot of tasks in the fact that I have a medication reminder on my phone, so it reminds me to take my pills instead of just having to remember it off the top of my head. Something that really helps is trying to remember that things that work for other people might actually also work for me too, because it's like, yeah sure, maybe me as a person, I'm unique and my medical situation is interesting or different or whatever. But a lot of good advice for other people, especially for mental health works for me too, like getting outside. Even if I feel really not great and I'm really tired or in a lot of pain, just like getting outside. Anytime I have my shoes on and I'm just outside even for five minutes, I count that as a win. Drinking a lot of water, for me, helps us too. Of course, I'm wary of saying all this because a lot of people might just say, “Oh well, Jessie and Sandy, they just need to do more yoga and that'll just cure them.” Of course, it's not that simple. It's not a cure at all. But at the same time, I try to remember that at least for me, I have common medical issues that a lot of different people have so I can pull on literature and different things that I've worked for other people with my conditions. Maybe other people haven't had this exact constellation that I do, but I can still pull on the support and resources from other people too. Kimberley: How about you, Jessie? Jessie: If I could add there, I'm not as good as differentiating. I can tell, like I know when things are starting to get compulsive, which I actually appreciate that I had had so much ERP training before I got sick because I really know what's a compulsion, what's an obsession and I can tease that out. But a lot of my treatment has also been really understanding, like maybe I don't need to know if this is my chronic illness or if this is my OCD because then that gets compulsive. I've had to sit in that uncertainty of maybe it is one, maybe it is the other, but I'm not going to figure it out. Kimberley: You read my mind because as you were both talking, I was thinking the most difficult part for many people that I see in my practice is trying to figure out and balance between advocating going to the doctor when you need, but also not doing it from a place of being compulsive because health anxiety and OCD can have you into the doctor surgery every second day or every second hour. How are you guys navigating that of advocating, but at the same time, keeping an eye on that compulsivity that can show up? Sandy, do you want to go first?  Sandy: Yeah. I honestly haven't figured out the perfect formula between trying to figure out like, is this anxiety around the potential that I might be getting sick again and compulsively trying to get things checked out, and the idea that I might have something actually medically going wrong that needs to be addressed. I find it still challenging to tease those things apart. But I think something that does help is trying to remind myself like, not what is normal, because I don't think normal really exists but what is in the service of my recovery. I can't have recovery from my disability or my chronic illnesses, but I can't have OCD recovery. I'm always still trying to think to myself, how can I move forward in a way that both aligns with my values and allows me to move forwards towards my recovery? Kimberley: How about you, Jessie? Jessie: It's so hard to follow that, Sandy. I love that. I would say, I think it's tough because a symptom that I have is like, I was never really a big compulsive Googler. But I know in OCD world, it's like, “Don't go to Google for medical issues. Google is not your friend.” But for my chronic illness recovery or chronic illness journey, Google's been important. I've had to do a lot of research on what is it that I possibly have. And that really helps me advocate my case to the doctors because I've had some great doctors, but they're not spending hours reading medical journals and trying to figure it out to the extent that I care about it because it's my situation and I want to figure stuff out. Googling has actually helped me a lot in that regard and joining different Facebook groups and actually hearing from other people what their experiences have been.  I know Sandy and I started a special interest group, which hopefully we'll talk about a little later, but someone in the group had mentioned that something that really helps them is the community of their doctors and their therapists working together of, oh, I'm going to wait two days if I have this symptom and if it's still a symptom that's really bothering me and my therapist thinks it should be checked out, then I'm going to go to the doctor. Having those people who are experts guiding you and helping you with making sure, no, this isn't compulsive, this is a real medical thing that needs to be checked out—I thought that was really smart and seemed to work for her, so I'd imagine it would work for other people as well. Sandy: I guess if I can add-- Kimberley: I have a question about that. Yes, please. Sandy: Oh, sorry. If I can add one more thing, it would just be that, while there's so many experts on OCD and ERP and your chronic medical issues or your disability or whatever it is for you, you are the only frontline expert in your own experience of your mind and your body and you are the only one who knows what it's like to exactly be in that, I guess, space. While I 100% think therapy is important, evidence-based treatments are important, I do also think like remembering when you think like, “Oh, this is really hard,” or “I can't cope,” actually, you can cope, you're capable and you know yourself best. I think that's challenging because I know sometimes in ERP, for people who maybe don't have other complicated medical challenges, they would say, “Don't Google.” But I think, as just Jessie has explained, sometimes because we have other chronic stuff going on, we do need to do things to help ourself holistically too. Kimberley: I love that. I'll speak from my own experience and if you guys want to weigh in, please do. I had to always do a little intention check before I went down into Google like, okay, am I doing this because anxiety wants me to do it, or am I doing it because this will actually move me towards being more informed, or will this actually allow me to ask better questions to the doctor and so forth? It is a tricky line because Google is the algorithm and the websites are set to sometimes freak you out. There's always that piece at the bottom that says, “It could be this, this, or this,” or “It could be cancer.” That always used to freak me out because that was something that the doctors were concerned about as well. This might be beyond just Googling, but in terms of many areas, how did you make the decision on whether it was compulsive or not? Jessie? Jessie: It's tough too because then you're down the rabbit hole. You've already been Googling it and it's like, “Or this,” and I'm like, “Well, I have to figure out what that is.” Sometimes it does get a little compulsive and then the self-compassion, and also realizing it like, okay, now it's getting compulsive and I'm going to stop and go about my day. But another thing that I've struggled with is the relationship with doctors. Sandy and I have talked about this before with wanting to be the “perfect” patient. I worry that I'm messaging them too much or I'll often now avoid messaging them because then I don't want to be too annoying of a patient. I can't be the perfect patient if I'm messaging them all the time. It really is, like you said, the intention. Am I messaging them because I want to move forward with this and I want an answer, or am I messaging them because there's a reason to message them and I need their medical advice? There's just so much gray in it. Again, not necessarily having that specific answer, it can be very tricky. Kimberley: It truly can. How about you, Sandy? Sandy: I think the biggest thing for me, and I'm still trying to figure out the right balance for this, is weighing how urgent is this medical symptom. Am I-- I don't know, I don't want to say something that would put someone into a tailspin, but do I have a medical symptom going on right now that needs urgent attention? If so, maybe I should go to my doctors or the ER. Or is the urgency more mental health related, feeling like an OCD need to get that reassurance or need to know, and just separating the urgency of the medical issue that's going on right this second versus the urgency in my head.  Kimberley: Amazing. You guys have created a special interest group and I'd like to know a little more about that. I know you have more wisdom to tell and I want to get into that here a little bit more. But before you do, share with us how important that part of creating this special interest group is, how has that benefited, what's your goals with that? Tell us a little bit about it, whoever wants to go first. Jessie: Sandy and I actually met in an online OCD support group, and I found those online groups to be really helpful for my OCD recovery and mostly with feeling less shame and stigma. Met some amazing people clearly. And then I remember Sandy had mentioned in one of the different groups that she had a chronic illness. When I was going through my chronic illness journey, I felt really alone. As I was saying before, the loneliness is one of the biggest emotions that I had to deal with. I looked online, and now online support groups are my thing. Let's just Google chronic illness support groups. I thought it would be as easy as OCD support groups, and it wasn't. It was very challenging and it was really hard to find one.  I found one that was state-based. For my state, it was me and three women. I think one was in their eighties, the other two were in their nineties, and they were very sweet. But we were at very different lifestyle changes. We were going through very different experiences. I remember I reached out to Sandy and I said, “Do you have any chronic illness support groups that you've been attending?” Even in that group with the elderly women, there were so many things that they were saying that helped them with their chronic illness and my OCD would totally have latched onto all of it. I was like, “I can't do that with my OCD.” There's so much overlap that it just seemed like there needed to be this dual chronic illness and OCD. Sandy had said she had the same issue, like it was really hard to find these groups.  I think we're really lucky that the International OCD Foundation was such a good partner for us and they were so kind in helping us get this special interest group started. I'm interested to hear what Sandy says, but it's been so helpful for me to see that there are other people who deal with a lot of these challenges. Of course, I wouldn't want anyone else to have these experiences, but being able to talk about it, being able to share has just been so helpful. I was really quite amazed to see the outreach we had and how many people struggled with this and that there really weren't any resources. It's been pretty amazing for me and I'm really lucky that we've been able to have this experience. Kimberley: Amazing. Sandy? Sandy: Similar to Jessie, I had found some resources for OCD support groups both locally to me in Ontario and online, and that was great. The sense of community really helped my OCD recovery. But then when it came to the chronic illness disability part, there was just a gap. As Jessie said, we started this special interest group and I think it's called—Jessie, correct me if I'm wrong—Chronic Illness/Disability Plus OCD is our official title. Basically, it's for anyone who has a chronic illness or disability and OCD, or is a clinician who's interested in learning more. Our goals really are to create a community, but also create resources for the wider OCD community to help people who are struggling with chronic illness or disability and OCD or clinicians.  The sense of community has been great. I think for my own recovery OCD-wise, it's been really motivating to be able to help found and facilitate this group because it's showed me that I really don't have to be in this perfect state of recovery to have something valuable to contribute. I just have to show up in an imperfect way and do my best and that is enough in itself, and that the fact that I don't have to get an A+ in recovery because that's not even a thing you can get. I just have to keep trying every single day and try to live my values. I think this SIG's been a great opportunity to embody those values as well of community and advocacy. It's just been great. Kimberley: Oh, I love it so much and it is such an important piece. I actually find the more I felt like I was in community, that in and of itself managed my anxiety. It was very interesting how just being like, “Oh, I'm not alone.” For some reason, my anxiety hated this idea that I was alone in this struggle. I totally just love that you're getting this group and I'll make sure that all of the links are in the show notes so people can actually access you guys and get connected.  I have one extra question before I want to round this out. How do you guys manage the—I'm going to use the word “ridiculous”— “ridiculous” advice you get from people who haven't been what you've been going through? Because I've found it actually in some cases to be quite even hilarious, the suggestions I get offered. Again, I know patients and clients have had a really difficult time because they might have been suggested an option, and then their anxiety attaches to like, “Well, you should do that,” and so forth. Sandy, do you want to go first in sharing your experience with “ridiculous” advice? Sandy: I guess to give a brief example, a practitioner who I've worked with for quite a while, who I think is great and a wonderful person and wonderful practitioner, had in the last couple months suggested that maybe I should just try essential oils to manage my bowel condition. What actually was needed was hospitalization and surgery. It's that kind of advice from both well-meaning practitioners or just people in my life that can be not what you need to hear and maybe not as supportive as they're hoping it would be. I guess for me, I manage it mostly by saying, “Thank you, that's a great idea,” even when it's not really a great idea. I just say to myself or maybe to a support person later, “That was not the best advice.” Just debriefing it with someone I think is really helpful, someone that I trust.  Jessie: Kimberley, I love this. I think, Sandy, our next SIG, we should ask this and hear all the ridiculous advice that people have been given because it's true. There's so many things that are so ridiculous. I'm going to shout out my mom here who I love more than anything in the world, but even my mom who lives with me some of the time and sees what I go through, one time she called me (she's going to kill me) and she said, “I heard there's a half-moon at 10:30 AM your time and if you stand outside, it will heal some of your rear rash.” I was like, “What? That's absurd.” She was like, “I know, I think it's absurd too, but you need to do this for me.” With that, you see she just wants me to get better. As Sandy was saying, people really want to help and this is a way they think they can help. I've also been told like, “Oh, if you mash up garlic and then you put--” it was like this weird recipe, then you want to had it. Just ridiculous things. But people are really well-meaning and they want to help. Unfortunately, those often don't really help. But now I can laugh about it and now text my mom and be like, “You'll never guess what so-and-so said,” or text Sandy and we could have a good laugh about it. But that's what's nice about community. You're like, “Wait, should I do this essential oil thing?” And then you realize from others, “No, that's probably not the best route to go.” Kimberley: For me, with anxiety, self-doubt is a big piece of the puzzle. Self-doubt is one of the loudest voices. When someone would suggest that, I would have a voice that would say, “It's not going to hurt you to try.” And then I would feel this immense degree of self-doubt like, “Should I? Should I not? What do you think?” “You could try. You should try.” I'm like, “But I literally don't have time to go and stand in the sun and do the thing,” or in your example. I would get in my head back and forth on decision-making like, “Should I or shouldn't I?” “It wouldn't hurt.” “It sounds ridiculous, but maybe I should.” And that was such a compulsive piece of it that would get me stuck for quite a while. It's often when it would be from a medical professional because it really would make you question yourself, so I fully resonate with that. Sometimes I wish I could do a hilarious Instagram post on all of the amazing advice I've been given throughout the time of having POTS. Some of it's been ridiculous.  Let me ask you finally, what advice would you give somebody who has an anxiety disorder and is at first in the beginning stages of not having these symptoms and not knowing what they are? Jessie, will you go first? Jessie: Yeah. I would say a big thing, as we've been talking about, is finding that community whether that be reaching out to us with the SIG or whether that be finding a Facebook group or online group or whatever it may be, because it has helped me so much to reach out and be in a community with others who really understand. There's nothing like people who truly get it. And then I would say to validate like, this is really tough. Having OCD is tough. Having a chronic illness or disability is tough, and having both is very, very tough. Validate those symptoms too because I think there's a lot of people that will say, “Oh, you have an anxiety disorder, you're probably making that up,” and that comes up a lot. Just validating that and really trying to find other people who are going through it because I think that's just irreplaceable. Kimberley: Sandy? Sandy: I think the biggest thing to echo Jessie would be try to find community. I think for me, for my OCD recovery journey, Instagram has particularly been great because there's so many wonderful OCD advocates or clinicians on Instagram. It's really a hub for the OCD community. I would say check out Instagram and once you follow a couple of people from the OCD community, the algorithm will show you more so it's nice that way. I think the other thing is that being disabled or having a chronic illness can really chip away your confidence. Just reminding yourself that you're doing the best you can in a really hard situation, and it may be a long-term situation, but just because your life is different than other people doesn't mean that it's not going to be a great life. Kimberley: I'm actually going to shift because I wanted to round it out then, but I actually have another question. Recently, we had Dr. Ashley Smith on talking about how to be happy during adversity. I'm curious, I'll go with you, Sandy, first because you just said, how do you create a wonderful, joyful life while managing not only an anxiety disorder, but also chronic illness or disability? What have you found to be helpful in that concoction per se? Sandy: I listened to that episode with Dr. Smith and that was a wonderful episode. If people haven't listened to it, I recommend it. I listened to it twice because I just wanted to go back and pick out the really interesting parts. But I think for me, the combination of finding things that are both meaningful from a values and an acceptance and commitment therapy (ACT) perspective, meaningfulness, finding those things that matter to me, but also finding the things that challenge me. If I'm having a really bad pain day or fatigue day, the things that challenge me might just be getting out of bed, or maybe I'm really depressed and that's why I can't get out of bed. Either or, your experience is valid, and just validating your own experience and bringing in that self-compassion and saying, what is something that can challenge me today and bring me a little closer to recovery? Even if it's going to be a long journey, what's this one small thing I can do, and break it down for yourself. Kimberley: Amazing. I love that. What about you, Jessie?  Jessie: I would say I've been able to find new hobbies. I'm still the same person. I'm still doing other things that I found meaningful and this doesn't. Well, it is a big part of my life. It's not my entire life. I'm still working and hanging out with friends and doing things that regularly bring me happiness. But just a small example, I said before, I used to play sports and love being really active and that gets a little harder now. But something I found that I really love is paint by numbers because they're so easy. They're fun, they're easy, you don't have to be super artistic, which is great for me. I'm able to just sit down and do the paint by numbers. Even recently I had friends over and it was like a rainy day and we all did a craft. Even though it was a really high-pain day for me, I was in a flare of medical symptoms, I was still able to engage with things that I find meaningful and live my life. Kimberley: I love that. Thank you. That's so important, isn't it? To round your life out around the disability or the chronic illness or your anxiety. I love that. We talked about those early stages of diagnosis, any other thing that you feel we absolutely have to mention before we finish up? Sandy? Sandy: I guess to quote someone you've had on the podcast before, Rev. Katie, I find her content amazing and she's just a lovely person. But she always says, you are a special person, but your OCD is not special. Your OCD isn't fundamentally different or it's never going to get better. You got to remember that you are the special person and your OCD doesn't want you to recognize that you are the thing that's special, not it. Just be able to separate yourself from your anxiety disorder or your chronic illness or your disability, saying, “I'm still me and I'm still awesome, and these things are just one part of me.” Kimberley: So true. I'm such a massive Katie fan. That's excellent advice. Jessie? Jessie: To go the other route, I think you said right with people who are first going through this. I would say we recently did a survey of our SIG, so people who have chronic illness and OCD. We haven't done all the data yet, but the thing that really stood out was we asked the question like, have you ever felt invalidated by a medical professional or mental health professional, and every single person said yes and then explained. Some people had a lot to say too. I think I've really learned in this process that you have to be a self-advocate. It's very challenging to be an advocate when you're going through a mental disorder, a physical disability, and/or both. It's required. Really standing up for yourself because it's going to be a tough journey and there's so much light in the journey too. There's so many positive things and so much “happiness” from the episode before, but there's also a lot of difficulties that can come from being in the medical world as well as the mental health world and really trying to navigate both of them and putting them together. Really try to advocate for yourself or find someone who could help you advocate for yourself and your case because I think that'll be really helpful. Kimberley: So true. You guys are so amazing. Jessie, why don't you go first, tell us where people can get resources or get in touch with you or the SIG, and then Sandy if you would follow. Jessie: We have an Instagram account where we'll post-- we're experiencing with Canva. We're really working on Canva and getting some graphics out there about the different things that come up when you have both of these conditions. And then that's where we post our updates for the special interest group. Sandy, correct me if I'm wrong. @chronically.courageous is our Instagram handle. And then in there, the link is in our bio to sign up for the special interest group. You get put on our email list and then you'll get all the emails we send with the Zoom links and everything. And then you could also go to the International OCD Foundation's website and look at the special interest groups there and you'd find ours there. Sandy: The other thing is we meet twice a month. We meet quite frequently and we'd love to have you. So, please check out our Instagram or get at our email list and we would love you to join. Kimberley: You guys, you make me so happy. Thank you for coming on the show. I'm so grateful we're having this conversation. I feel like it's way overdue, but thank you for doing the work that you're doing. Thank you so much. Jessie: Thank you. Sandy: Thanks for having us.

Kimberley: My tummy already hurts from laughing too much. I'm so excited to have you guys on. Today, we are talking about thriving in relationships with OCD and we have Rev. Katie O'Dunne and Ethan Smith. I'd love for you both to do a quick intro. Katie, will you go first? Katie: Yeah, absolutely. My name is Reverend Katie O'Dunne. I always like to tell folks that I always have Reverend in my title because I want individuals to know that ordained ministers and chaplains can in fact have OCD. But I am super informal and really just go by Katie. I am an individual who works at the intersection between faith and OCD, helping folks navigate what's religious scrupulosity versus what is true authentic faith. I'm also an OCD advocate on my own journey, helping individuals try to figure out what it looks like for them to move towards their values when things are really, really tough. Outside of being a chaplain and faith in OCD specialist and advocate, I'm also an ultramarathon runner, tackling 50 ultramarathons in 50 states for OCD. As we get into stuff with Ethan today, Ethan is my biggest cheerleader throughout all of those races. I'm sure we'll talk all about that too, running towards our values together. Ethan: My name is Ethan Smith. Katie is my fiancé. I'm a national advocate for the International OCD Foundation, a filmmaker by trade, and a staunch advocate of all things OCD-related disorders. Definitely, my most important role is loving Katie and being her biggest cheerleader. Katie: Since you said that, one of my things too, I am the fiancé of Ethan Smith. Sorry. Ethan: Please note that this is an afterthought. It's totally fine. Kimberley: No, she knew you were coming in with it. She knew. Ethan: Yeah, I was coming in hot. Yup, all good. WHAT IS IT LIKE BEING IN A  RELATIONSHIP WITH SOMEONE WITH OCD? Kimberley: Thank you both for being on. I think that you are going to offer an opportunity for people to, number one, thriving in Relationships with OCD, but you may also bring some insight on how we can help educate our partners even if they don't have OCD and how they may be able to manage and navigate having a partner with OCD. I'm so excited to have you guys here. Thank you for being on. Can you first share, is it easier or harder to be in a relationship with someone with OCD? For you having OCD? Ethan: I'll let Katie start and then I'll end. Katie: Yes. No, I think it's both. I think there are pros and cons where I think for so long being in relationships with individuals who didn't have OCD, I desperately wanted someone to understand the things that I was going through, the things that I was experiencing, the intensity of my intrusive thoughts. I was in so many relationships where individuals felt like, well, you can just stop thinking about this, or you can just stop engaging in compulsions. That's not how it works. It has been so helpful to have a partner through my journey who understands what I'm going through that can really say, “I actually get it and I'm here with you in the midst of that.” But I always like to be honest that that can also be really, really challenging where there are sometimes points, at least for me, having OCD with a partner with OCD, where if we are having a tough point at the same time, that can be really tough. It can also be really tough on a different level when I see Ethan struggling, not reassuring him even more so because I know how painful it is and I want so badly to take that away. There are times that that can feed into my own journey with OCD when I see him struggling, that my OCD latches onto his content, vice versa. There's this amazing supportive aspect, but then there's also this piece I think that we have to really be mindful of OCD feeding off of each other.  Ethan: I was just making notes as you were-- no, go ahead.  Kimberley: No, go ahead, Ethan. I'm curious to know your thoughts. Ethan: Katie made all great points, and I agree. I mean, on the surface, it makes a lot of sense and it seems like it's fantastic that we both can understand each other and support each other in really meaningful and value-driven ways. I always like to say that we met because of OCD, but it by no means defines our relationship or is at the heart of our relationship. It's not why we work. It's not what holds us together. I think Katie brings up two good points. First of all, when I would speak and advocate with parents and significant others and things like that, and they would say, “I'm having a really hard time not reassuring and not enabling,” I'd be like, “Just don't, you're making them sicker. Just say what you got to say and be tough about it.” Then I got in a serious relationship with Katie and she was suffering and hurting, and I was like, “Oh my God, I can't say hard things to her.” I became that person. I suddenly understood how hard it is to not engage OCD and to say things that aren't going to make her comfortable. I struggle with that. I struggle with standing my ground after a certain amount of time and wanting to desperately give in and just make her feel better. I just want her to feel better.  For me personally, I lived alone for 10 years prior to meeting Katie, and those 10 years followed my successful treatment and recovery from OCD. For me, my mother was my safe person. I learned during treatment and therapy that you don't talk about your OCD around your parents anymore. You just don't. That's not a conversation you have. I found myself, other than within therapy, not ever talking about my OCD. I mean, advocacy, yes, but my own thoughts, I never talked about it.  Starting to start a relationship with Katie, I suddenly had someone that understood, which was wonderful, but it also opened up an opportunity for OCD to seek reassurance. I'm an indirect reassurance seeker. I don't ask for it as a question; I simply state what's on my mind, and just putting it out there is reassuring enough for me. For instance, like, “Oh, this food tastes funny.” Whether she says it does or it doesn't, I really don't care. I just want her to know that I think that it does, and it could be bad. I think this is bad. I'm not saying, “Do you think it's bad?” I'm like, “I think it's bad. I think there's something wrong with this.” I've had to really work and catch myself vocalizing my OCD symptoms because having a partner that understands has given my OCD permission to vocalize and want to talk about it. That honestly has been the biggest challenge for me in this relationship. NAVIGATING OCD REASSURANCE SEEKING IN RELATIONSHIPS Kimberley: So interesting how OCD can work its way in, isn't it? And it is true. I mean, I think about in my own marriage, at the end of the day, you do want to share with someone like, “This was hard for me today.” You know what I mean? That makes it very complicated in that if you're unable to do that. That's really interesting. Let's jump straight to that reassurance seeking piece. How do you guys navigate, or do you guys create rules for the relationship? How are you thriving in Relationships with OCD related to reassurance seeking or any compulsion for that matter? Katie: A couple different things. I think part of it for us, and we by no means do this perfectly, I'd have to have conversations about it even-- yes, Ethan, you might do it perfectly, but even in the last week, we've had conversations about this where what Ethan responds well to is very different from what I respond well to. I think that is really important to note, especially when there's two partners with OCD, that it's not one size fits all. It's not because I understand OCD that I know exactly how to respond to him. It's still a conversation. For me, I respond really well if I'm seeking reassurance or I'm struggling to a lot of compassion where he doesn't respond to the content, but tells me, “I know that this is really hard. This sounds a lot like OCD right now, but let's sit with it together. I know that it sucks, but we can be in the midst of this. We aren't going to talk about it anymore, but I love you. We're going to watch a show. We're going to do whatever it is we're going to do, we're going to be in it together.” I respond really well to that.  Ethan, on the other hand, does not respond quite as well to that and actually responds better to me being like, “Hey, stop talking about that. We are not going to talk about this right now. I have heard this from you so many times today. No, no, no, no.” He responds in a harsher tone. That's really hard for me because that is not naturally what comes out of me, nor what is helpful for me. Sometimes the compassion that I offer to Ethan becomes inherently reassuring and is just not something that's helpful for him, so we have to have these conversations. Vice versa, sometimes when I'm really struggling, he'll forget the compassion piece works for me and is like, “Hey, Katie, no. Stop doing that.” I'm like, “Seriously? This is really hard.” Being able to have those conversations.  Kimberley: How do those conversations look, Ethan? Can you share whatever you're comfortable sharing? Ethan: Yeah. Katie hit over the head, first of all. We are definitely products of our therapists when we're struggling. For those of you that may or may not know, Katia Moritz, she is hardcore, like here's what it is, and I'm a product of that. There's like, “Nope, we're not going to do it. We're not going to have it. OCD is black and white, don't compulse, period. End of story.” Katie is like, “Let's take a moment.” My natural instinct on how I respond to her is very different to what she needs and vice versa. We've learned that. I would say that the rule in our household is we're a no-content household. I'm not saying we succeed at that all the time, but the general rule is we're not a content household. We don't want a no content. You can say that you're struggling. You can say that you're having a hard day. You can say that OCD is really loud today. Those are all okay things. But I don't want to hear, and Katie doesn't want to hear the details because that inevitably is reassuring and compulsy and all of those things. That's our general rule. I'll talk for me, and I don't know, Katie, I'll ask you ahead of time if it's okay to share an example of our conversation, but my stuff, like I said, it's covert reassurance seeking and she does it too. We're both very covert. We're like well-therapized and we know how to-- Katie: It's really funny because I can tell when he's sneaky OCD reassurance-seeking. Nobody else in my life has ever been able to tell when I'm secretly seeking reassurance. It's actually frustrating because he can call me on it because he's really good at it too. There's some level of accountability with that. Ethan: For sure. For me, I'll get stuck on something and I'll just start verbalizing it. That's really the biggest thing I think, unless Katie has some other insight, and she may. But for me, verbalization of my thoughts, not specifically asking for a specific answer and simply saying, “Oh, my chest feels weird. I'm sure I'm dying. My heart is about to give out.” How are you going to respond to that? What are you going to say right now? And that's my system. She'll be like, “Okay, yup. You may.” To be honest, I'll call Katie out, she really struggles with giving me-- she's like, “Ethan, I'm sure you're fine.” I'm like, “Why did you say that?” She does. She really struggles with-- Katie: It's interesting because I work with folks with OCD all the time and I don't reassure them, but it's so interesting because it feels so different with my partner knowing how much he's struggling and I just want to be like, “You know what this is, it's fine.” But yeah, working on that Kimberley: If he's struggling, then you said sometimes you will struggle, it makes sense that in that moment you're like, “You're fine, you're fine.” You don't want them to have a struggle because you know it might even impact you, I'm guessing. Katie: Well, yeah. It's funny, all of Ethan's stuff is around bad things happening to him. All of my stuff is around bad things happening to other people. If Ethan's worried something bad's going to happen to him, I'm like, “No. I can't handle that. I don't want to worry that you're going to die. Let's not put that on the table.” Ethan: We discovered it was true love when my OCD was worried about her. She's like, “Baby, it's about me. It's not about you.” It's true love. No question. Katie: He had never had obsessions about someone else before. I was so excited. He was like, “Am I going to kill you in your sleep? Is that going to happen?” I was like, “Oh my gosh, you do love me. So sweet.” Ethan: But to answer your question, conversely, when Katie is struggling, she gets loopy and she directly asks for reassurance. I can definitely get frustrated at it at a certain point. I always feel like one time is appropriate. “Do you have a question or concern? Do you think blah, blah, blah?” “No, I don't think so. I think that's totally appropriate.” And then the second time, “Yeah, but do you...” I was like, okay, now we're starting to move into OCD land and I stay compassionate up to a certain point and then I'll get frustrated because it will be so obvious to me. As she said, myself is so obvious to her. I just want to be like, “Katie, can you see this makes no sense at all?” But when she's really struggling, not just the superficial high-level or low-level OCD hierarchy stuff, when she's really, really deeply struggling, it's challenging. I really struggle with not giving her the reassurance that her OCD craves because I can't stand to see her suffer. Sometimes I wish that I didn't know as much about OCD as I do because I actively know that I'm helping OCD, but giving her that instant relief in the moment, it just pains me.  We've definitely changed our relationship style as we've gotten to know each other and been able to say things like, “I know this doesn't feel good. I don't want to say these things to you, but I really, really don't want to help OCD and hurt you. I really, really want to help you get better in this moment and hurt OCD and just put it to bed, so I'm not going to answer that.” We've had to have those communicative conversations to be able to address it when it does cross the line.  I will say we're pretty well., we do pretty good, but that's not to say that there aren't times where we can both get in a rabbit hole. To Katie's point and to your point, it gets sticky sometimes. I literally never checked an oven in my entire life till I moved in with Katie. And then now she'll mention it or I'll be closing up the lights and I'll be like, I've never looked and thought about it. But Katie talks about it and that's one of her things, and like, “It latched on. I'll take it,” and like, “No, no, no. Ethan. Everything's going to burn down.” Yes, moving on. Katie: Likewise, I've never checked my pills multiple times to make sure that I didn't take too many or worried that there was glass inside of my glass from hitting it. I mean, there's things that were Ethan's that I now think about. It's really interesting because I think we actively work to not give into those things, but that's definitely a process to you where they were things that I never would've gotten stuck on before. We have these conversations too of being able to call each other out. Well, actually, comedy is a really big thing in our house too, so we also like to call it out in a way of like, “Hey, you're stealing my themes. Stop it. That's mine. Come on, let me have that stomach bug thing.” Kimberley: Isn't that so interesting, though? We constantly get asked what causes OCD, and we never can really answer the question. We say it's a combo of nature and nurture and you guys are touching on the nurture piece in that, yes, we are genetically predisposed to it, but that other people's anxiety around things can create anxiety for us. I actually feel the same way. There are so many things my husband is anxious about, or my kids. Now I'm hyper-vigilant about it. That's so interesting that you guys are seeing that in real life.  HOW TO SUPPORT A LOVED ONE WITH OCD  Ethan: Yeah, for sure. And then Katie brought up a great point, which is, I think the most challenging times, and they don't happen often, is when we're both struggling simultaneously. How do you support each other in that moment? First of all, what's very funny is we like to joke we both have OCD and we're both only children. It's one of those households. Literally, we'll cook a frozen pizza and we'll sit there and size up the half to figure out which one's bigger and then be like, “Are you sure you want that one? I want that.” It's a thing.  When we're both struggling, it's like, “No, you need to listen to me.” “No, no, no, no. You need to listen. It's my thing. It's my thing.” It's been few and far between where we've both really been significantly struggling simultaneously, but we've managed it. We learn how to be able to struggle and listen and support. It's no different than advocating when you're not feeling your best. You can still be compassionate and sympathetic and offer advice that is rooted in modalities of treatment and still be struggling at the same time. We may not get the empathy that we want because maybe we're just not in a place or we're pouring from an empty cup or whatever, but fortunately, those times aren't that frequent. But when they do happen, we've navigated and managed really well, I think.   Katie: And even just-- oh, sorry.  Kimberley: No, please, Katie. Go ahead.  Katie: I was going to say, even with that, having conversations around it, I think, has been really helpful. We've had moments of being really honest. Particularly earlier this year, I had some tough stuff that happened and I was in a place of grief and then also OCD was coming into that. Ethan, it lined up at some points with some difficult points that you had. There were some times that you were honest about saying, “I am just not in a place to respond to this right now in this moment in a healthy way.” I think that's actually one of the best things that we can do too. Of course, OCD sometimes gets frustrated at that, “Hey, why can't you talk about it right now?” But I think having those honest conversations as a couple too so that we can both offer care to ourselves and to one another in the midst of those times that we're struggling is really, really important. SETTING BOUNDARIES IN RELATIONSHIPS WITH OCD Kimberley: You answered actually exactly what I was going to say. There are times when we can't be there for our partner. When that is the case, do you guys then go to your own therapist or to a loved one? Not to get reassurance or do compulsions, but just have a sense of containment and safety. Or are you more working towards just working through that on your own? How do you guys navigate thriving in Relationships with OCD when your partner is tapped out?   Katie: We both have our own therapist and that's really, really helpful. We both actually have conversations together with the other person's therapist. Ethan will meet with his therapist and we've had times when he's struggling where I'll come in for a half session to talk about, hey, what's the best way to respond to him and vice versa. I'll meet with my therapist separately, but we might bring him in for 20 or 30 minutes for him to learn, hey, what's the best way to respond to Katie right now? We both have those separate spaces to go and talk about both what we're navigating and what we need, but also how to respond to our partner and then collaborate with one another's therapist. I mean, that has been so helpful for me because there have been points where I don't know how to respond to what Ethan's navigating. To hear directly from his provider as opposed to feeling like I have to take on that role is so crucial. And then, Ethan, you meeting with my therapist earlier this year, oh my goodness, was so helpful because she had given me all this insight that I just wasn't in a place to be able to share because I was struggling. For you to hear that directly from her and what she thought that I needed I think was a huge step forward for us. Ethan: Yeah. It's nuanced. It's not a one size fits all. Yes, it's all ERP or ACT or DBT or whatever. But it's all specific to what we're all going through. I will say it's funny because as we're talking, I'm like, “I didn't ask Katie if these things I could say or not.” Katie: I'm afraid to say that. You can literally say anything. I pretty much talk all the time about all this. Ethan: For sure. I think one of the things that really, really helped our relationship in terms of navigating this is, when I first met Katie and we started dating, she wasn't seeing a therapist actively. It was challenging because as someone that is well-versed in OCD, we would constantly talk about things and she would divulge a lot of information to me. I started to feel like I didn't want to take on an advocate or therapist's role with her. I wanted to be her boyfriend. I was really struggling because I really wanted to support her and I really wanted to be. That was never a question, it was not supporting her. But for the same reason that we tell parents like, “Don't police your kids, be their parents,” and hear how that can backfire, it was really challenging to navigate being a significant other and also supporting her, but not becoming that person that her OCD goes to.  I think her finally landing on a therapist that was right for her and good for her where she can get that objectivity that she needs and I can too learn what she needs from me as a partner, not that there was anything wrong with our relationship, but really allowed our relationship to grow and really allowed us to focus on what we should be focusing on, which is each other and who we are to each other and what's important to our lives and our family. Our therapists can handle our OCD. That doesn't mean that OCD doesn't get involved. It does. But for the most part, that was really where our relationship really got to level up. We both were able to turn to our therapists, but also include each other in treatment so we can have open and honest conversations about what's going on.  DO I TELL MY PARTNER ABOUT MY OCD OBSESSIONS? The other thing I'll say is, we have no secrets. We literally have no secrets. As a first timer to a long-term relationship, because my OCD Obsessions wouldn't let me have a long-term relationship any longer than four or five months, as a first-timer in the three-year club on May 9th, I really feel like that is such a crucial piece to our relationship. We watch reality shows and it's like, “You went through my phone,” and it's like, “Well, I don't care. She knows my passwords. I have nothing to hide.”  I always say that individuals with OCD would make the worst thieves. Could you imagine? I put myself in a position of robbing a house. There's no way I wouldn't worry that one piece of DNA was not left in that house. I find hair on my pillow all the time. There's no possible way I could ever burglarize anyone and not think I would be caught. We're not transparent because we know that that will alleviate our OCD. We're transparent because I think honesty is really important in a relationship and so is communication. We always advocate that having therapy and having access to treatment shouldn't be an exception at all. That should be the standard. It should be accessible, should be affordable, should be effective. Absolutely, no question there. But with that being said, Katie and I were both fortunate enough to have really good treatment and I think our relationship reflects that. Not to say that we're perfect all the time, but I think we're too highly therapized individuals that began our relationship with honesty and communication and have continued that through and through. I think that has enabled us to not only grow as a couple but also helped us manage our own OCD and the OCD of each other and how we interrelate. HOW TO ENCOURAGE SOMEONE WITH OCD  Kimberley: Right. I think that is so true. As you're talking, I'm thinking of people who are at the very beginning stages. They didn't have any idea about OCD and they've been giving reassurance, they've been asking for reassurance, and there's tantrums because the person isn't giving the right reassurance. What would you encourage couples to do if they're newly to treatment, newly to their diagnosis, and their goal is to be thriving in Relationships with OCD? Katie: There's so many different things, and I know this is different for every person, but even if they're new to that process, getting their partner involved in therapy, meeting with their therapist, having them learn about OCD, again, Ethan talked about, not from a space of the partner becoming the therapist, but having an understanding of what the person is going through so that they're not reassuring, so that they're not accommodating. But I say this to folks all the time, again, so that you're not also being so hard and so rigid so that you can still be the person's partner in the midst of that. I think being able to understand what their triggers are, what their symptoms are, what's coming up, so that you can say, “Hey, I'm your partner. I love you. I can't answer that, but I'm here.”  I think figuring out what that looks like with the provider, but also with the partner is just so beyond important to have an effective relationship, one, so that you're not just closing it off so that you can't talk about it, but two, so that, as Ethan said, you don't become the therapist because that's not healthy either. I think we have in our relationship almost tried both extremes at different points of, “Hey, we're not going to talk about it at all,” or “Oh, we're going to talk about everything and we're going to totally support each other through every aspect.” I think with each person, it's finding that balance of how we can be a couple with open and honest communication, but we're actually still each other's partners and not each other's therapists. Kimberley: Yeah. Do you have any thoughts, Ethan? Ethan: I was just thinking. I mean, she nailed it. I don't know that I have anything to add to that, whether you both have OCD or one of you has OCD. I was actually thinking earlier on in the relationship, and about divulging your OCD and when it's appropriate. We get so many questions from so many people about, when I'm dating, when am I supposed to let them know? When am I supposed to talk about it? I have very aggressive feelings about OCD and dating, and as amazing as somebody may look and be like, “Oh my God, I would love to be in a relationship with a partner that has OCD because then I don't have to explain anything.” I did not date to specifically find somebody with OCD. When I met Katie, we were friends long before we were together.  Katie: We always say that, like he was my best friend that I happened to meet through the OCD community, that we fell in love during COVID because he was my best friend, and because we had so much that connected us beyond OCD. I know you said this earlier, Ethan, but we get the question all the time, “Oh, if I just had a partner with OCD...” and that is not. If all we had in common was our OCD, this would not work out because it actually can make it even more challenging. But it's what's beyond that. I always think we shouldn't be in a relationship or not in a relationship based on our diagnosis. It's about who the person is and how we can support them for who they are. Ethan: Yeah, for sure. You actually raised a good point. I was going to talk about, and we can maybe come back to it, when to talk about your OCD to your partner, when it's appropriate, when you feel it's appropriate, this difference between wanting to confess about your own OCD and feeling like they need to know right now that I have OCD so I'm not dishonest with them and I don't hit them with the big secret down the road. We can talk about that. But you raised-- wow, it was a really interesting point that I totally forgot. Katie, what did you just say? Go ahead. Katie: No, I was just talking about not being in a relationship because of the OCD and really having--  Ethan: I remember. Katie: Okay, go ahead. You got it.   HOW TO HELP YOUR LOVED ONE UNDERSTAND WHAT IT'S LIKE TO HAVE OCD Ethan: Yeah. I'd be curious to Kim's thoughts. But I think with OCD individuals, whether it's a significant other or family and friends, and I've been talking about this a lot lately, we've talked about, okay, how do I get someone to understand what OCD is? How do I help them understand what I'm going through? We did a town hall on family dynamics last week for the IOCDF and we've had multiple conversations about this. I'd be curious to Kim's thoughts. I think there's a difference between having a partner or a family member, whatever, being able to support you in an effective, healthy, communicative way, and fully understanding what you're going through. I think those are two different things. I don't think that an individual needs to know and feel exactly what you're experiencing going through to be able to understand and support you. I think as individuals with OCD, we have this inherent need for our partners or people that we care about to know exactly how we feel and exactly what we're going through. “You need to know my pain to understand me.” I think that is a big misnomer.  I think honestly, that's a potential impossible trap for a relationship when you're dating someone or with someone that doesn't have OCD. The likelihood of that individual, while you can give them examples, the likelihood of them actually truly understanding your own OCD experience is unlikely. Just like if Katie had had cancer and went through treatment, I'll never know what that's like. But that doesn't mean that I can't be sympathetic and empathetic and support her and learn about the disease state and be able to be a really, really wonderful partner to her. I think for individuals that are in relationships with individuals that don't have OCD, if you resonate with this, being able to release this idea of like, they need to know exactly what I've gone through. Really the real thing they need to know is, how can I be a supportive partner? How can I support you in a meaningful, healthy, value-driven way so we can have the best possible relationship? I don't know if I ever said that, but Kim, I'd be open to your thoughts.  Kimberley: No, I agree. Because the facts are, they won't get it. No matter how much you want them to get it, they will get it, but they won't have experienced something similar to you. But I think like anything, there's a degree of common humanity in that they can relate without completely having to go through it. They can relate in that I too know what it's like to be uncertain or I too know what it's like to have high levels of anxiety. Or even if they don't, I too can understand your need for certainty in this moment or whatever it may be.  I think the other thing to know too is often when someone needs to be understood and they insist on it, that's usually a shame response. There's a degree of shame that by being understood, that may actually resolve some of that shame. If that's the case, they can take that shame to therapy and work through that and get some skills to manage that, because shame does come with mental illness. Often I find some of the biggest fights between couples were triggered by a shame emotion. They felt shame or they felt embarrassed or humiliated, or they felt less than in some way, or the boxing gloves are on. How do you handle, in this case, conflict around-- I don't know whether you have any conflict, but has conflict came up around this and how do you handle it? SHAME + GUILT IN RELATIONSHIPS WITH OCD Katie: One piece with the last component, and then I'll shift into this. I think as you were talking, the shame piece resonates with me so much. I'm definitely someone that even through the OCD experience, guilt and shame are much heavier for me than anxiety or fear or anything else, that feeling really challenging. I think that the biggest piece that helped to combat that actually had to do with my relationship with Ethan, not specifically because he knew every ounce of my themes or what I was going through, but simply because of the empathy that he showed me. I talk often about how because of shame in my OCD journey, one of the reasons I struggled to get better for a long time was I didn't feel like I deserved it. I didn't feel like I was good enough because of my intrusive thoughts. I didn't like myself very much. I hated myself actually. Ethan, by loving me, gave me (I'm going to get emotional) permission to love myself for the first time. It wasn't because he specifically knew the ins and outs of my themes, but simply because he offered empathy and loved me as a human being, and showed me that I could do that for myself. That was a huge step forward for me. I think every partner can do that.  I used to talk with my students when I was in education about empathy, and I would always say you don't have to experience the exact same thing that your friend experienced to say, “Oh, I can put myself in your shoes.” To your point, Kim, I know what sadness feels like. I know what this feels like. I know what that feels like. I think just showing empathy to your partner, but also showing them that they truly do deserve love in the midst of whatever they're experiencing with their OCD can be such a healing component. I just wanted to say that, and now I've forgotten the other part of your question.  Ethan: Well, wait, before she asks it, can I piggyback?  Kimberley: Yeah.  Ethan: I'm going to just offer to Katie. Katie's shared that story before and it's really special. Always, I was just being me and seeing something beautiful in her and wanting it to shine. But something that I don't think I've ever talked about ever is what she did for me in that same context. I always saw myself as a really shiny car, and if you saw me surface, I was really desirable. I knew my first impressions were really solid. But if you got in me and started driving, I got a little less shiny as the deeper you went. It was really hard to get close to Katie and let her in. Katie and I haven't talked about this in a while, but when we started getting intimate, I would never take my shirt off with the light on. I would hold my shirt over my stomach because I was embarrassed about my body. She's an athlete. I'm not an athlete. When we would walk and I would get out of breath, the level of embarrassment and shame, I would feel like, how could this person love me? Now I'm going to get emotional, but it took me a long time to be able to-- this morning, I was downstairs making breakfast without a shirt. I didn't think about it. She taught me that the parts of myself that I thought were the ugliest could actually be loved. I had never experienced that beyond my parents. But even beyond that, I don't know that they had seen pieces of my OCD, pieces of me as a human being, as an individual. Katie taught me about unconditional pure love and that even what I deemed the most disgusting, grossest parts of myself, even seeing those.  My biggest fear with Katie was her seeing me. I don't panic often, like have major panic freakouts, but there are a few things that I do. My biggest fear was her seeing me. I kept saying, “Just wait. Wait till you see this, Ethan.” It comes out every now and again. “You won't love that person.” Early on, I had a thing that I panicked and she was nothing but love and didn't change anything. For weeks, I was like, “How can you still love me?”  It doesn't necessarily relate to your question, but I wanted to share that because I think that for so many that really see themselves as broken or cracked, I think it's real easy to look really good on the surface. But I think that being willing to be vulnerable and honest and truthful-- and Katie's the first woman I've ever done that with, where I was literally willing to go there despite what my OCD told me, despite what my head told me and my brain told me. I just think that's also created a really solid foundation for our relationship. I just wanted to share that. Kimberley: That full vulnerability is like the exposure of all exposures. To actually really let your partner see you in your perceived ugliness, not that there's ever any ugliness, but that perceived, that's the exposure of all exposures in my mind. You have to really use your skills and be willing to ride that wave, and that can be really painful. I love that you guys shared that. Thank you for sharing that, because I think that that's true for even any relationship. That is truly thriving in Relationships with OCD! Katie: Absolutely. SEEING BEYOND OCD  Ethan: Yeah, for sure. OCD can definitely get sticky even with that. It'll start to question, well, does she still love me because of that? She says she does, but does she really-- even my brain now goes, “She can't possibly love my body. That doesn't make sense. That doesn't make sense.” So funny thing about Katie, we were early on in our dating, we were struggling. She's laying on me. She's like, “You're the most comfortable boyfriend I've ever had.” I was like, “Yeah.” And then I started thinking like all she'd ever dated before me were triathletes, like washboard dudes. I was like, “Huh, thank you?” She's like, “No, no, it's a good thing. It's a good thing.” I'm like, “Okay. Yeah.” It's very funny, but I also loved it. Katie: I do the same thing with you. I mean, all the time, everything's still. Three years in, we're getting married in September, stuff will come up and it's like, “Wait, you saw this, this part of myself that I think is really ugly. You still love me?” Like, what? It gives me permission every time to love myself. Ethan: That's such an interesting relationship dichotomy between the two of us. I don't mean to venture away from your question, Kim, but it's so interesting. I don't see any of the things that she sees in herself. She could freak out for a week and I would still see her as this perfect individual who I couldn't love more. She feels the same about me. It's so weird because we see each other in the same light, but we don't see ourselves in that light. It is amazing and I feel a little selfish here to have a partner to be able to remind me of how I should see myself. I hope that I give Katie that same reminder and reassurance, but it really is amazing to be able to see that within our partner because I'll do something and I'll be like, “Wow.” She's like, “Yeah, that didn't change anything for me.” I'm like, “Really?” Because that's how I feel like, “Oh, okay.” Because that's how I feel when you do. “Okay, we're on the same page.” Kimberley: Let's just delete the last question because I want to follow this. I love this so much. It actually makes me a bit teary too, so we might as well just cry together. What would you say to do for those who don't understand OCD and maybe perceive it as “ugliness”? I'm sure there are those listening who are thinking, “I wish my partner could see beyond my anxiety and how I cope.” What advice would you give to them?  Katie: Ethan, you go first. Ethan: It's a hard question. It's a hard question to answer. It's thundering and you get it twice since we're in the same house. I think one thing I was going to say before, and maybe this will get tight, and this doesn't answer your question directly, Kim, but I'm hoping we can get to it, is when somebody asks me like, “I have OCD and I want to date and get in a relationship, well, how do I do that?” I have very strong feelings about that particular question because I don't want to dive into acceptance and commitment therapy and this whole concept of being able to do both things simultaneously, which is very value driven and we're going to feel the feels and have the ick and we don't have to wait for the perfect moment. But I've always believed that if your OCD at that time is so severe that it's going to heavily impact your relationship, and the reason that you have to tell the person that you're interested in all about your OCD is because you have expectations of that person to reassure and enable, and you're going to need that from that person, I would always say, you might not want to get in a relationship right now. That may not be the best timing for you to get in a relationship.  I always would want somebody to ask themselves like, if you're in therapy and you're in treatment or wherever you are in your process and you know that you shouldn't be seeking things from somebody and reassurance, enabling and so forth and so on, then that's a different conversation. But I think at first, being honest and true to ourselves about why we're divulging, why we want them to know about our OCD, and what we're going to get out of this relationship—doing that from the beginning, I think, then trickles over into your question, Kim, about like, what if they don't understand? What if they don't get it? Because going into a relationship with this idea of, “Well, they need to know so they can keep my OCD comfortable,” is very different than my OCD doesn't necessarily play a prominent role in my life, or maybe it does, but I'm in treatment and I need them to know and then they may not understand. I think that that's like a different path and trajectory. Katie? Yeah, go ahead.  Katie: I think that's such an important component. It's interesting. I heard a very different side of the question. I was thinking about maybe someone who is already in, whether it's a romantic relationship or-- Ethan: No, that was the question. I didn't know what to say yet, so I was being like, “Well...” Yeah, no, that was the question. You heard that right. YOU ARE WORTHY & LOVABLE WITH OCD Katie: It was really important too. This might sound really simplistic, but I think it's so important. Just based on, oh my goodness, my experiences with feeling for such a long time, I was defined by my OCD or defined by my intrusive thoughts, or, oh, how could anybody love me in the midst of all of this? I want everybody to hear that regardless of how your OCD is making you feel right now, or how you're feeling, you are not defined by your OCD. You are not defined by your intrusive thoughts. You are not defined by your disorder. You are an amazing human being that is worthy of love in all of its forms, and you're worthy of love from yourself. You're also worthy of love from a partner. I think sometimes there's this feeling of, well, I don't deserve love because of my OCD, or I don't deserve someone to be nice to me or to treat me well. I've also seen folks fall into that trap. I've been in relationships that weren't particularly healthy because I felt like I didn't deserve someone to be kind to me because of my OCD, or like, oh, well, I'm just too much of a pain because of my obsessions or my compulsions, so of course, I don't deserve anything good in this sense.  I want you to hear that wherever you are in your journey, you do deserve love and respect in all of its forms, and that the people that are around you, that truly love you, yes, there are moments that are hard just like they are for me and Ethan, where sometimes there might be frustrations. But those people that truly love you authentically, I really believe will be with you in the midst of all of those highs and lows, and continue to offer you love and respect and help you to offer yourself that same love and respect that you so deeply deserve. Kimberley: I love that. I think that that speaks to relationships in general in that they're bumpy and they're hard. I think sometimes OCD and anxiety can make us think they're supposed to be perfect too, and we forget that it's hard work. Relationships are work and it takes a lot of diligence and value-based actions. I think that that is a huge piece of what you're bringing to the table. I want to be respectful of your time. Closing out, is there anything that you feel like you want the listeners to hear in regards to relationships and yourself in a relationship? Do you want to go first, Ethan? Ethan: Sure. Yeah, I agree. Let Katie close out. She's amazing. I just want to echo, honestly, the last thing that Katie said was perfect, and I wholeheartedly agree. What would I want to bring into a relationship? I want to bring in my OCD or myself, what is going to be my contribution to a relationship, a romantic relationship. I definitely would want to bring me into it. I want to bring Ethan and not Ethan's OCD. That doesn't mean that Ethan's OCD won't tag along for the ride, but I definitely don't want Katie to be initially dating my OCD. I wanted her to date Ethan.  I think what Katie said about that directly relates in the sense that love yourself, value yourself, realize your worth, know your worth. It's so hard with OCD, the shame and the stigma and just feeling like your brain is broken and you don't deserve these things, and you don't deserve love. What's wrong? It's so hard. I mean, I say it humbly. When I say go into a relationship with these things, I know it's not that simple. But I think that if you can find that place where you know what you have to offer as a human being and you know who you are and what you have to give, and it doesn't have to be specific. You don't have to figure yourself out of your life out, simply just who your heart is and what you have to give like, I don't know who I am entirely; I just know that I have a lot of love to give and I want to give it to as many people as possible—own that and don't be afraid to leave crappy relationships that are good, that because it's feels safe or comfortable, it's the devil you know in terms of how it relates to your OCD. You're not broken. You're not bad. You shouldn't feel shame. OCD is a disorder. It's a disease, and you deserve, as Katie said, a meaningful, beautiful love relationship with whomever you want that with. You deserve that for yourself. Stay true to who you are. Stay true to your values. If that's where you are now, or if it isn't where you are now, be willing to take a risk to be able to find that big, as Katie says, beautiful life that you deserve. It's out there and it's there.  To Kim's point, I'm sorry, this is a very long last statement, so I apologize. But to Kim's point, relationships are hard and life is hard. I really believed when I got better from OCD that in six months, I was going to meet my soulmate, make a million dollars, and everything would be perfect. Life did not happen like that at all. It's 15 years later. But at a certain point, I was like, “I'm never meeting my person. OCD is not even in the way right now, and I'm never meeting my person. I'm never going to fall in love. I'm never going to get married.” Now we're four months away from my wedding to being married to the most amazing human being. I truly believe that that exists for everyone out there in this community. Living a life that is doing things that I never would imagine in a million years. Please know that it's there and it's out there. If you put in the work, whether it happens the next day, the next year, or the next decade, it's possible and it's beautiful. Embrace it and run towards it.  Kimberley: Beautiful. Katie? Katie: I feel like there isn't much I can add to that. I'm going to get teary listening to that. I think I'll just close similar to what I was sharing before for anyone listening, whether it is someone with OCD or a partner or a family member, whomever that is, that you deserve love and compassion from yourself and from every single person around you. You are not defined by your OCD. It is okay, especially if you're a partner, if you don't respond perfectly around OCD all the time, because you know what, we are in the midst of a perfectly imperfect journey, especially when it comes to romantic relationships. But if you continue to lead with love, with empathy, and with compassion, and with trusting who you are, not who the OCD says you are, I truly believe that you'll be able to continue to move towards your personal values, but also towards your relationship values, and that you so deeply deserve that. Kimberley: Oh, I feel like I got a big hug right now. Thank you, guys, for being here. I'm so grateful for you both taking the time to talk with me about this. Most of the time when someone comes to see me and we talk about like, why would you ever face your fear? Why would you ever do these scary hard things? They always say, “Because I've got this person I love,” or “I want this relationship to work,” or “I want to be there for my child.” I do think that is what Thriving in Relationships with OCD is all about. Thank you so much for coming on the show.  Katie: Thank you for having us.Ethan: Thank you for having us.

Join your host, Nicole Morris, LMFT and Mental Health Correspondent, as she unpacks this year's IOCDF Annual Conference. She is joined by special guest and handsome hubs, Patrick Morris. Patrick attended his first ever OCD conference, and he shares some of the highs and lows from their recent trip. So join the conversation, fam, and learn how this recap turned into re-crap on our return home.

Approximately 1-4% of people throughout the world experience obsessive-compulsive disorder (OCD). Individuals with OCD are more likely than those without OCD to engage in nonsuicidal self-injury (NSSI), and recent research has shown that, among those who self-injure, having a diagnosis of OCD predicts more severe self-injury.In this episode, licensed clinical social worker and OCD expert Nathan Peterson explains how he differentiates nonsuicidal self-injury (NSSI) from Self-Harm OCD, which is just one of many subtypes of OCD and one in which a person experiences intrusive thoughts or mental images of violence toward oneself. He then walks us through how he uses Exposure and Response Prevention (ERP) for Self-Harm OCD in therapy. Learn more about Nathan and his therapy practice OCD and Anxiety Counseling here. He has nearly 100k subscribers on YouTube (@ocdandanxiety) where his videos receive thousands and thousands of views. You can also follow him on Instagram (@ocdandanxietyonline), Twitter (@ocdandanxiety1), and Facebook.  Click here to take his online "Do I Have Harm OCD? Test." Below are additional resources about OCD and/or NSSI:Browning, M. E., Lloyd-Richardson, E. E., Schneider, R. L., Faro, A. L., Muehlenkamp, J. J., & Claudio-Hernandez, A. (2022). Obsessive compulsive disorder and co-occurring nonsuicidal self-injury: Evidence-based treatments and future research directions. The Behavior Therapist, 45(6), 199-208.International OCD Foundation at https://iocdf.org/.Winston, S. M., & Seif, M. N. ( 2017). Overcoming unwanted intrusive thoughts: A CBT-based guide to getting over frightening, obsessive, or disturbing thoughts. New Harbinger.Baer, L. (2012). Getting control: Overcoming your obsessions and compulsions (3rd ed.). Plume.To learn more about how medication can help address OCD (most often in tandem with ERP but not discussed in this episode), click here. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS).The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their "20 Best Clinical Psychology Podcasts" and also featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it's a good fit.

Dr. Witkin is a licensed psychologist in private practice in Valencia, California, with more than 30 years of experience. She specializes in treating children, teens, and adults with obsessive compulsive disorder and other anxiety-related disorders. She's been a featured speaker on podcasts and radio shows, including the OCD Stories, Moms Without Worry, and Tell Me What You're Proud Of. She's a regular presenter at national conferences, including the International OCD Foundation, IOCDF, and the Anxiety and Depression Association of America. Dr. Witkin is a graduate of the International OCD Foundation's General and Pediatric Behavior Therapy Training Institute, and is a clinical fellow of the Anxiety and Depression Association of America.  In this episode we talk about:  ◾️ Supporting someone who supports somebody with OCD ◾️ Approaching different angles of supporting someone with mental illness ◾️ Communities and groups of support for people suffering OCD Find Michelle here: drmichellewitkin.com Find Zach here: zachwesterbeck.com @zach_westerbeck

For back to back Mid-Acts teachings, download the FREE mobile App @ https://www.TruthTimeRadio.com/wttr and listen to our NEW radio station: WTTR - Celebrating the Word of Reconciliation & Songs of Grace. This channel is one of the few that can teach you how to Rightly Divide the word of truth: (2 Timothy 2:15) Once you learn to do so, the confusion will disappear and the scriptures will come alive like never before! On today's podcast we speak with a caller concerning her Religious OCD. The International OCD Foundation defines Scrupulosity as "a subtype of obsessive compulsive disorder (OCD) involving religious or moral obsessions. Scrupulous individuals are overly concerned that something they thought or did might be a sin or other violation of religious or moral doctrine. They may worry about what their thoughts or behavior mean about who they are as a person." Also listed on their website are the following common symptoms: ●Fear of committing blasphemy, or offending/angering God ●Fear of having committed a sin ●Behaving overly morally ●Excessively striving for purity ●Fear of going to hell or being punished by God ●Fear of being possessed ●Fear of death ●Fear of the loss of impulse control ●Doubting what you truly believe or feel ●Needing to acquire certainty about religious beliefs Today you will hear Misti, talk about her experience with Scrupulosity/Religious OCD and how coming to understand the Grace of God is helping to set her free from the bondage of religion. The symptoms which fuel this type of OCD, should be relatable for anyone from a religious background - whether they end up leading to behavioral compulsions or not. Misti believes that the anxiety causing her Scrupulosity came from her never having heard the good news of what actually happened on the cross. How that it was there when God stopped charging the world with their sins! (2 Corinthians 5:19) In NOT ONE of the churches she attended had she ever heard this good news!!! - But only that she was a dirty rotten sinner on her way to hell if she didn't stop sinning. But praise be to God: Misti now knows what happened to her sins as a result of the finished work of Christ. She has believed the gospel unto salvation, and in doing so, is learning to find peace in her circumstances. Religious Legalism is damaging but Grace is the answer. Anxiety is defeated by the peace that comes from being secure in Christ. Please keep Misti in your prayers, as she still struggles from time to time, but continues to grow in God's grace, learning more about who she is in Christ. We pray that her brave testimony of what Christ has already done for her, (helping her realize that Christ already defeated the battles in her mind) will be a blessing to all who listen. Like us on Facebook @ https://www.facebook.com/truthtimeradio Visit https://TruthTimeRadio.com to subscribe to our Podcast & Blog. For Bible questions call 1-888-988-9562. --- Send in a voice message: https://podcasters.spotify.com/pod/show/truthtimeradio/message

Anita is no stranger to anxiety, but her spirals are mostly short lived. In this episode she meets folks who often get caught in loops of extreme worry and compulsions with little relief. A married couple shares how OCD put them in survival mode and a woman whose OCD symptoms began in kindergarten talks about learning how to open up about her experience in friendships and dating. Meet the guests: - Mike and Nicole Comforto, writers who published a Modern Love essay about how Mike's OCD impacted their marriage, share their story and talk about what led to Mike's diagnosis, what the experience was like for both of them and how Mike's OCD impacts other relationships in his life - H.T., a writer who wants to remain anonymous for personal and medical privacy, explains how her OCD symptoms first showed up as a young girl, how she navigated getting an OCD diagnosis and how she discloses her OCD to those she is close to Read the transcript | Review the podcast Follow Embodied on Twitter and Instagram Leave us a message for an upcoming episode here! Here's a link to the International OCD Foundation, where you can find an OCD specialist near you.

Navigating the process of supporting loved ones in treatment can feel like walking through a minefield. It's easy to question if it's appropriate to involve yourself in the treatment process, where the boundaries lie, and how to even begin. These questions can feel overwhelming and often lead to us doing nothing at all. In this skills episode, we discuss how clinicians can expand their treatment plans to include a client's family and friends, while still maintaining appropriate boundaries. We'll also emphasise the importance of accessing knowledge, practising self-care, communicating, and holding space for grief for those who are supporting a loved one in treatment.   Resources and links: International OCD Foundation website  So OCD website Natasha Daniels - YouTube An OCD Kids Movie  Obsessive-Compulsive Disorder | Made of Millions Foundation 'Daring to Challenge OCD' by Joan Davidson 'The Family Guide to Getting Over OCD' by Jonathan Abramowitz   Connect: https://www.melbournewellbeinggroup.com.au/ http://www.drcelingelgec.com.au/ This show is produced in collaboration with Wavelength Creative. Visit wavelengthcreative.com for more information.

At 12 years old, Dr. Elizabeth McIngvale was diagnosed with obsessive-compulsive disorder (OCD). By age 17, she found success in evidence-based treatment and became a national spokesperson for patients. Now, 20 years later, she treats OCD patients of her own, while still advocating to end stigma and misconceptions about OCD and perfectionism.  Dive into this episode of The Menninger Clinic's Mind Dive Podcast with hosts Dr. Kerry Horrell and Dr. Bob Boland for an expert's insider journey of OCD. Also explored are the contrasts of OCD and obsessive compulsive personality disorder (OCPD) and how doctors can improve patient treatment by recognizing and acknowledging the differences.  Elizabeth McIngvale, PhD, LCSW, is the director of McLean OCD Institute at Houston. She currently serves on the faculty at Harvard Medical School and has founded the Peace of Mind Foundation and OCDChallenge.com, both now within the International OCD Foundation. “My message to patients is that we are going to get them back to functioning, but we should really be fighting for freedom from their illness,” said Dr. McIngvale. “We are fighting to get them to a life where they can make decisions for themselves and live by their values, not their diagnosis.” Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to never miss an episode of Mind Dive. To submit a topic for discussion, email podcast@menninger.edu. Visit www.menningerclinic.org to learn more about The Menninger Clinic's research and leadership role in mental health. Listen to Episode 26: Bridging Faith & Mental Health Care with Dr. Marcy VerduinResources mentioned in this episode: Episode 21: OCD From the Front Lines with Dr. Wayne Goodman, Dr. Eric Storch Episode 14: The Measurement of Wisdom with Dr. Dilip Jeste Peace of Mind FoundationMcClean OCD Institute OCDchallenge.com International OCD Foundation 

In this episode, we are talking about the emotional toll of OCD.  Kim: Welcome back, everybody. This week is going to include three of some of my most favorite people on this entire planet. We have the amazing Chris Trondsen, Alegra Kastens, and Jessica Serber—all dear friends of mine—on the podcast. This is the first time I've done an episode with more than one guest.  Now, this was actually a presentation that the four of us did at multiple IOCDF conferences. It was a highly requested topic. We were talking a lot about trauma and OCD, shame and OCD, the stigma of OCD, guilt and OCD, and the depression and grief that goes with OCD. After we presented it, it actually got accepted to multiple different conferences, so we all agreed, after doing it multiple times and having such an amazing turnout, that we should re-record the entire conversation and have it on the podcast. I'm so grateful for the three of them. They all actually join me on Super Bowl Sunday—I might add—to record this episode. I am going to really encourage you to drop down into your vulnerable self and listen to what they have to say, and note the validation and acknowledgment that they give throughout the episode. It is a deep breath. That's what this episode is.  Before we get into this show, let me just remind you again that we are recording live the Overcoming Depression course this weekend. On March 11th, March 18th, and March 25th, at 9:00 AM Pacific Standard Time, I will be recording the Overcoming Depression course. I am doing it live this time. If you're interested in coming on live as I record it, you can ask your questions, you can work along with me. There'll be workbooks. I'll be giving you a lot of strategies and a lot of tools to help you overcome depression.  If you're interested, go to CBTSchool.com/depression. We will be meeting again, three dates in March, starting tomorrow, the 11th of March, at 9:00 AM Pacific Time. You will need to sign up ahead of time. But if for any reason you miss one of them, you can watch the replay. The replays will be uploaded. You'll have unlimited on-demand access to any of them. You'll get to hear me answering people's questions. This is the first time I've ever recorded a course live. I really felt it was so important to do it live because I knew people would have questions and I wanted to address them step by step in a manageable, bite-sized way. Again, CBTSchool.com/depression, and I will see you there. Let's get over to this incredible episode.  Again, thank you, Chris Trondsen. Thank you, Alegra Kastens. Thank you, Jessica Serber. It is an honor to call you my friend and my colleague. Enjoy everybody.  Kim: Welcome. This has been long, long. I've been waiting so long to do this and I'm so thrilled. This is my first time having multiple guests at once. I have three amazing guests. I'm going to let them introduce themselves. Jessica, would you like to go first? Jessica: I'm Jessica Serber. I'm a licensed marriage and family therapist, and I have a practice specializing in the treatment of OCD and related anxiety and obsessive-compulsive spectrum disorders in Los Angeles. I'm super passionate about working with OCD because my sister has OCD and I saw her get her life back through treatment. So, I have so much hope for everyone in this treatment process. Kim: Fantastic. So happy to have you. Chris? Chris: Hi everyone. My name is Chris Trondsen. I am also a licensed marriage family therapist here in Orange County, California at a private group practice. Besides being a therapist, I also have OCD myself and body dysmorphic disorder, both of which I specialize in treatment. Because of that, I'm passionate about advocacy. I am one of the lead advocates for the International OCD Foundation, as well as on their board and the board of OCD Southern California, as well as some leadership on some of their special interest groups. Kind of full circle for me, have OCD and now treat it. Kim: Amazing. Alegra? Alegra: My name is Alegra Kastens and I am a licensed therapist in the states of California and New York. I'm the founder of the Center for OCD, Anxiety and Eating Disorders. Like Chris, I have lived experience with OCD, anxiety, eating disorders, and basically everything, so I'm very passionate. We got a lot going on up here. I'm really passionate about treating OCD, educating, advocating for the disorder, and that is what propelled me to pursue a career as a therapist and then also to build my online platform, @obsessivelyeverafter on Instagram. GRIEF AND OCD Kim: Amazing. We have done this presentation before, actually, multiple times over the years. I feel like an area that I want to drop into as deeply as we can today to really look at the emotional toll of having and experiencing and recovering from OCD. We're going to have a real conversation style here. But first, we'll follow the format that we've used in the past. Let's first talk about grief and OCD because I think that that seems to be a lot of the reason we all came together to present on this. Alegra, would you talk specifically about some of the losses that result from having OCD? I know this actually was inspired by an Instagram post that you had put out on Instagram, so do you want to share a little bit about what those emotional losses are?  Alegra: For sure. I think that number one, what a lot of people with OCD experience is what feels like a loss of identity. When OCD really attacks your values, attacks your core as a human being, whether it's pedophile obsession, sexual orientation obsessions, harm obsessions, you really start to grieve the person that you once thought you were. Of course, nothing has actually changed about you, but because of OCD, it really feels like it has. In addition to identity, there's lost relationships, there's lost time, lost experiences. For me, I dropped out of my bachelor's degree and I didn't get the four years of undergrad that a lot of people experienced. I mean, living with OCD is one of the most debilitating, difficult things to do. And that means, if you're fighting this battle and trying to survive, you probably are missing out on life and developmental milestones. Kim: Right. Was that the case for you too, Chris? Chris: Yeah. I actually host a free support group for families and one of the persons with OCD was speaking yesterday talking about how having OCD was single-handedly the most negatively impactful experience in his life. He is dealt with a lot of loss. I feel the same way. It's just not something you could shake off and recover from in the sense of just pretending nothing happened. I know for me, the grief was hard. I mean, I had mapped out what I thought my life was going to look like. I think my first stage of grief, because I think it became two stages, my first, like Alegra said, was about the loss. I always wanted to go to college and be around people in my senior year, like make friends and things like that. It's just my life became smaller and smaller. I became housebound. I missed out on normal activities, and six years of my life were pretty much spent alone.  I think what Alegra also alluded to, which was the second layer of grief, was less about the things that I lost, but who I became. I didn't recognize myself in those years with OCD. I think it's hard to explain to somebody else what it's like to literally not live as yourself. I let things happen to me or I did things that I would never do in the mind state that I am in now. I was always such a brave and go-for-it kind of person and confident and I just became a shell of myself. I grieve a lot of the years lost, a lot of the things I always wanted to do, and places I wanted to go. And then I grieve the person I became because it was nothing I ever thought I could become. Kim: Jessica, will you speak also to just the events that people miss out on? I don't know if you want to speak about what you see with your clients or even with your sibling, like just the milestones that they missed and the events they missed. Jessica: Yeah, absolutely. My sister was really struggling the most with her OCD during middle school and high school. Those are such formative years, to begin with. I would say, she was on the fortunate end of the spectrum of being diagnosed relatively early on in her life. I mean, she definitely had symptoms from a very, very young age, but still, getting that diagnosis in middle school is so much before a lot of people get that. I mean, I work with people who aren't diagnosed until their twenties, thirties, and sometimes even later. Different things that most adolescents would go through she didn't.  Speaking to the identity piece that Alegra brought up, a big part of her identity was being a sports fan. She was a diehard Clippers fan, and that's how everyone knew her. It was like her claim to fame. She didn't even want to go to Clippers games. My dad was trying to get tickets to try to get her excited about something to get out of the house. She missed certain events in high school because it was too anxiety-provoking to go and it was more comforting to know she could stay in the safety of the home. Their experiences all throughout the lifespan, I think that can be impacted. Even if you're not missing out on them entirely, a lot of people talk about remembering those experiences as tainted by the memories of OCD, even if they got to go experience them. Kim: Right. For me, as a clinician, I often hear two things. One is the client will say something to the likes of, “I've lost my way. I was going in this direction and I've completely lost the path I was supposed to go on.” I think that is a full grief process. I think we've associated grief with the death of people, but it's not. It's deeper than that and it's about like you're talking about, identity and events and occasions.  The other thing that I hear is—actually, we can go totally off script here in terms of we've talked about this in the past separately—people think that once they're recovered, they will live a really happy life and that they'll feel happy now. Like, “Oh, the relief is here, I've recovered.”  But I think there is a whole stage of grief that follows during recovery and then after recovery. Do you have any thoughts on that, anybody?  Alegra: Well, yeah. I think it reminds me a lot of even my own experience, but my client's experiences of when you recover, there tends to be grief about life before OCD. If I'm being perfectly honest, my life will just never be what it was before OCD, and it's different and wonderful in so many ways that maybe it wouldn't be if I didn't have OCD. But I'm laughing because when you were like, “I'm going to mark my calendar in July because you're probably going to have a relapse,” then I have to deal with it every six months. My brain just goes off for like two weeks. I don't know why it happens. It's just my OCD brain, and there's grief associated with that. I can go for six months and I have some intrusive thoughts, but it doesn't really do anything to me to write back in it for two weeks. That's something I have to deal with and I have to get to that acceptance place in the grieving process. I'm not going to have the brain that I did before OCD when I didn't have a single unwanted sexual thought. That just isn't happening. I think we think that we're going to get to this place after recovery, and it's like game over, I forget everything that happened in the past, but we have to remember that OCD can be traumatizing for people. Trauma is stored in the body. The brain is impacted and I think that we can carry that with us afterwards. Kim: Right. Chris: Yeah. I mean, everything that Alegra was saying—I'll never forget. I always joke, but I thought when treatment was done, rainbows were going to shoot out and butterflies. I was going to jump on my very own unicorn and ride off to the sunset. But it was like a bomb had gone off and I had survived the blast, but everything around me was completely pulverized. I just remember thinking, what do I do now? I remember going on social media to look up some of my friends from high school because my OCD got really, really bad after high school. I just remember everybody was starting to date or marry or travel and move on and I'm like, “Great, I live in my grandma's basement. I don't have anything on my calendar. I'm not dating, I don't have any friends. What do I do?” I was just completely like, “Okay, I don't even know where to begin.” I felt so lost. Anything I did just didn't feel right. Like Alegra said, there was so much aftermath that I had to deal with. I had to deal with the fact that I was lost and confused and I was angry and I had all these emotions. I had these memories of just driving around.  As part of my OCD, I had multiple subtypes—sexual intrusive thoughts, harm thoughts. I remember contamination, stores around me would get dirty, so I'd be driving hours to buy products from non-dirty stores at 4:00 or 5:00 in the morning, crying outside of a store because they were closed or didn't have the product I need, getting home and then my checking would kick in. You left something at the store, driving back. You just put yourself through all these different things that are just not what you would ever experience.  I see it with my clients. One client sticks in mind who was in his eighties and after treatment, getting better. He wasn't happy and he is like, “I'm so happy, Chris. You helped me put OCD in remission. But I now realize that I never got married because I was scared of change. I never left the house that I hated in the city I didn't really like because I was afraid of what would happen if I moved.” He's like, “I basically lived my OCD according to OCD'S rules and I'm just really depressed about that.” I know we're going to talk about the positive sides and how to heal in the second half, but this is just really what OCD can ravish on our lives. Kim: Right.  Jessica: If I can add one thing too really quickly, something I really think is a common experience too is that once healing happens, even if people do get certain parts of their lives back and feel like they can function again in the ways that they want to, there's always this sense of foreboding joy, that it feels good and I'm happy, but I'm just waiting for the other shoe to drop all the time. Or what if I go back to how I was and I lose all my progress? Even when there are those periods of joy and happiness and fulfillment, they might also be accompanied with some anxiety and some what-ifs. Of course, we can work on that and should work on that in treatment too because we want to maximize those periods of joy as much as we can. But that's something that I commonly see, that the anxiety sticks around just in different ways. OCD, SHAME, & GUILT Kim: Yeah, for sure. I see that very commonly too. Let's talk now about OCD, shame, and guilt. I'll actually go straight to you, Jessica, because I remember you speaking about this beautifully. Can you explain the difference between shame and guilt specifically related to how it may show up with OCD?  Jessica: Yeah. I mean, they're definitely related feelings but they are different. I think the simplest way to define the difference is guilt says, “I did something bad,” whereas shame says, “I am bad.” Shame is really an identity-based emotion and we see a lot of shame with any theme of OCD. It can show up in lots of different ways, but definitely with some of the themes that are typically classified as Pure O—the sexual intrusive thoughts or unwanted harm thoughts, scrupulosity, blasphemous thoughts. There can be a lot of shame around a person really identifying with their thoughts and what it means about them. Attaching that, meaning about what it means about them. And then of course, there can also be guilt, which I think feels terrible as well, but it's like a shame light where it's like, “I did something wrong by having this thought,” or just guilt for maybe something that they've thought or a compulsion that they've done because of their OCD.  Kim: Yeah. I've actually also experienced a lot of clients saying they feel guilty because of the impact their OCD has had on their loved ones too. They're suffering to the biggest degree, but they're also carrying the guilt of like, “I've caused suffering to my family,” or “I'm a financial burden to my parents with the therapy and the psychiatrist.” I think that there's that secondary guilt that shows up for a lot of people as well, which we can clump in as an outcome or a consequence or an experience of having OCD. Chris: Yeah. I mean, right before you said this, Kim, I was thinking for me personally, that was literally what I was going to say. I have a younger sister. She's a couple of years younger than me and I just put her through hell. She was one of the first people that just felt the OCD's wrath because I was so stressed out. She and I shared a lot of the same spaces in the home, so we'd have a lot of fights. Also, when I was younger, because she looks nothing like me—she actually looks more like you, Kim, blonde hair, blue eyes—people didn't know we were related. People would always say things like, “Oh, is that your girlfriend?” So then I'd have a lot of ancestral intrusive thoughts that caused a lot of harm to me, so I'd get mad at her. Because I was young, I didn't know better. And then just the hell I put my mom through.  I always think about just like, wow, once again, that's not who Chris is. I would jump in front of eight bullets for both my mom and my sister. I remember one time I needed something because I felt dirty, and my mom hit our spending money so that if there was an emergency. My sister knew where it was and she wouldn't give it to me. I remember taking a lighter and lighting it and being like, “I'll burn your hair if you don't give me the money,” because I was so desperate to buy it because that's how intense the OCD was. I remember she and I talking about that and it just feels like a different human. Once again, it's more than just guilt. It's shame of who I had become because of it and not even recognizing the boy I was now compared to the man I am now, way than man now. OCD AND ANGER Kim: One thing we haven't talked a lot about, but Chris, you just spoke to it, and I've actually been thinking about this a lot. Let's talk about OCD and anger because I think that is another emotional toll of OCD. A lot of clients I've had—even just recently, I've been thinking about this a lot—sometimes instead of doing compulsions, they have an anger outburst or maybe as well as compulsions. Does anyone want to speak to those waves of frustration and anger that go around these thoughts that we have or intrusive whatever obsessions in any way, but in addition, the compulsions you feel you have to do when you have OCD? Alegra: I feel like sometimes there can be maybe a deeper, more painful emotion that's underneath that anger, which can be shame or it can be guilt, but it feels like anger is maybe easier to express. But also, there just is inherent anger that comes up with having to live with this. I remember one time in my own personal therapy, my therapist was trying to relate and she pulled out this picture that she had like an, I don't know, eight-year-old client with OCD and was like, “She taps herself a lot.” I screamed at her at that moment. I was like, “Put that fucking picture away, and don't ever show that to me again. I do not want to be compared to an eight-year-old who taps himself, like I will tap myself all day fucking long, so long as I don't have these sexually unwanted thoughts about children.” I was so angry at that moment because it just felt like what I was dealing with was so much more taboo and shameful. I was angry a lot of the time. I don't think we can answer the question of, why? Why did I have to experience this? Why did someone else not have to experience this? And that anger is valid.  The other thing that I want to add is that anger does not necessarily mean that we are now going to act on our obsessions because I think clients get very afraid of that. I remember one time I was so fucking pissed at my coworker. He was obnoxious when I worked in PR, and I was so mad at him, I had to walk outside and regulate. And then instantly, of course, my brain went, “You want his kid to die?” or whatever it was. I felt like, oh my God, I must really want this to happen because I'm mad at him. In terms of anger, we can both feel angry and not align with unwanted thoughts that arise. CAN OCD CAUSE ANGER ISSUES?  Kim: Right. OCD can attack the emotions that you experience, like turn it back on you. It's funny, I was doing a little bit of research for this and I typed in ‘OCD in anger.' I was looking to see what was out there. What was so fascinating to me is, you know when you type something in on Google, it shows all of the other things that are commonly typed in. At the very top was ‘Can OCD cause anger issues?' I was like, that is so interesting, that obviously, loved ones or people with OCD are searching for this because it's so normal, I think, to have a large degree of just absolute rage over what you've been through, how much you've suffered, just the torment and what's been lost, as we've already talked about. I just thought that was really fascinating to see, that that's obviously something that people are struggling with.  Chris: When you think about it, when we're struggling with OCD, the parts of our brain that are trying to protect us are on fire or on high alert. If you always think about that, I always think of a feral dog. If you're trying to get him help, then he starts to bite. That's how I honestly felt. My anger was mostly before I was diagnosed, and once again, like I said, breaking things at home, screaming, yelling at my family, intimidating them, and stuff. I know that once again, that wasn't who I am at the course. When I finally got a diagnosis, I know for me, the anger dissipated. I was still angry, but the outbursts and the rage, and I think the saddest thing I hear from a lot of my clients is they tell me, I think people think I'm this selfish and spoiled and bratty and angry person. I'm not. I just cannot get a break.  I always remind parents that as your loved one or spouses, et cetera—as your loved one gets better, that anger will subside. It won't vanish, it won't disappear, it may change into different emotions, like Alegra was saying, to guilt and to shame and loss of identity. But that rage a lot of times is because we just don't know what to do and we feel attacked constantly with OCD.  Kim: Yeah. Jessica: I also want to validate the piece that anger is a really natural and normal stage of grief. I like that you're differentiating, Chris, between the rage that a lot of people experience in it versus maybe just a different type of anger that can show up after when you recognize how—I think, Alegra, you brought up—we can't answer the question of, why did this happen to me? Or “I missed out on all these times or years of my life that I can't get back.” Anger is not a problem. It's not an issue when it shows up like that. It's actually a very healthy natural part of grief. We want to obviously process it in ways that really honor that feeling and tend to that feeling in a helpful way. I just wanted to point out that part as well. DO YOU CONSIDER HAVING OCD A TRAUMATIC EVENT?    Kim: Yeah, very, very helpful. This is for everybody and you can chime in, but I wanted to just get a poll even. Alegra spoke on this a little bit already. Do you consider having OCD a traumatic event? Alegra: A hundred thousand percent. I'm obviously not going to trauma dump on all of you all, but boy, would I love to. I have had quite a few of what's classified as big T traumas, which I even hate the differentiation of big T, sexual assault, abuse, whatever. I have had quite a bit of big T traumas and I have to say that OCD has been the most traumatizing thing I have been through and I think we'll ever go through. It bothers me how much I think gatekeeping can happen in our community. Like, no, it's only trauma if you've been assaulted, it's only trauma if X, Y, and Z. I have a lot of big T trauma and I'm here to say that OCD hands down, like I would go through all of that big T trauma 15 times over to not have OCD, 100%. I think Chris can just add cherries to the cake, whatever that phrase is. Chris: Yeah. This is actually how the title, the Emotional Toll of OCD, came about. We had really talked about this. I was really inspired mainly by Alegra talking about the trauma of OCD and I was like, finally, someone put the right word because I always felt that other words didn't really speak to my personal experience and the experience I see with clients. We had submitted it for a talk and it got denied. I remember they liked it so much that they literally had a meeting with you and I, Kim, and we're like, “We actually really love this. We just got to figure out a way to change it.” Like Alegra was saying, a lot of the people that were part of a trauma special interest group just said, “Look, we can't be using the word ‘trauma' like this.” But we had a good talk about it. It's like, I do believe it's trauma. I always feel weird talking about him because sometimes he listens to my stuff, but still, I'll say it anyways. But my dad will hopefully be the first to admit it. But there were a lot of physical altercations between he and I that were inappropriate—physical abuse, emotional abuse, yelling, screaming. Like Alegra said, I would relive that tenfold than go through the depths of my OCD again where I attempted suicide, where I isolated, where I didn't even recognize myself.  If ‘trauma' isn't the correct word, we only watered it down to emotional toll just to make DSM-5 folks happy. But if ‘trauma' isn't the word, I don't know what is, because like I said, trauma was okay to describe the pain I went through childhood, but in my personal experience, it failed in comparison to the trauma that I went through with OCD.  Alegra: I also want to add something. Maybe I'm wrong, but if I'm thinking about the DSM definition, I think it's defining post-traumatic stress disorder. I don't think it's describing trauma specifically. Maybe I'm wrong, but it's criteria for PTSD. I will be the first to say and none of you have to agree. I think that you can have PTSD from living with OCD. DSM-wise diagnostically, you can't. But I think when people are like, “Well, that's not the definition of trauma in the DSM,” no, they're defining PTSD. It's like, yeah, some people have anxiety and don't have an anxiety disorder. You can experience trauma and not have full-blown PTSD. That's my understanding of it. Kim: Yeah. It's funny because I don't have OCD, so I am an observer to it. What I think is really interesting is I can be an observer to someone who's been through, like you've talked about, a physical assault or a sexual assault and so forth, and they may report I'm having memories of the event and wake up with the physiology of my heart beating and thoughts racing. But then I'll have clients with OCD who will have these vivid memories of having to wash their hands and the absolute chaos of, “I can't touch this. Oh my God, please don't splash the water on me,” Memories of that and nightmares of that and those physiological experiences. They're remembering the events that they felt so controlled and so stuck in. That's where for me, I was, with Chris, really advocating for. These moments imprint our brain right in such a deep way. Alegra: Yeah. I'm reading this book, not to tell everyone to buy this book, but it's by Dr. Bruce Perry and he does a bunch of research on trauma and the brain. Basically, the way that he describes it is like when we experience something and it gets associated. Let's say, for instance, there are stores that I could go to and I could still feel that very visceral feeling that I did when I was suffering. Part of that is how trauma is stored in the brain. Even if you logically know I'm not in that experience now, I'm not in the war zone or I'm not in the depths of my OCD suffering, just the store, let's say, being processed through the lower part of your brain can bring up all of those associations. So, it does do something to the brain. Kim: Right.  Chris: Absolutely. I was part of a documentary and it was the first time I went back to the home that I had attempted suicide, and the police got called the hospital and all that. It was a bad choice. They didn't push me into it. It was my idea because I haven't gone back there, had no clue how I'd react and I broke down. I mean, broke down in a dry heaving way that I never knew I could and we had to stop filming and we left. Where I was at my worst of OCD was there and also at my grandma's house because that's where I moved right after the suicide attempt. I'd have people around me, and still going down to the basement area that I lived in. It is very hard. I rarely do it. So, I have a reaction. To me, it was like, if that isn't once again trauma, I don't know what is. Alegra: It is.  Chris: Exactly. I'll never forget there was a woman that was part of a support group I ran. She was in her seventies and she had gone through cancer twice. I remember her telling the group that she's like, “I'll go through cancer a third time before I'll ever go back to my worst of OCD.” Obviously, we're not downplaying these other experiences—PTSD, trauma, cancer, horrible things, abuse, et cetera. What we're saying is that OCD takes a lasting imprint and it's something that I have not been able to shake. I've done so much advocacy, so much therapy, so much as a therapist and I don't still struggle, but the havoc it has on my life, that's something I think is going to be imprinted for life. Alegra: Forever. Jessica: Also, part of the definition of trauma is having a life-threatening experience. What you're speaking to, Chris, you had a suicide attempt during that time. Suicidality is common with OCD. Suicidal ideation, it's changing your life. I think Alegra, you said, “I'll never have the life or the brain that I had before OCD.” These things that maybe it's not, well, some of them are actually about real confrontation with death, but these real life-changing, life-altering experiences that potentially also drive some people to have thoughts or feelings about wanting to not be alive anymore. I just think that element is there. Alegra: That's so brilliant, Jessica, because that is so true. If we're thinking about it being life-threatening and life-altering, it was life-threatening for me. I got to the point where I was like, “If something doesn't change, I will kill myself. I will.” That is life-threatening to a person. I would be driving on the freeway like, “Do I just turn the car? Do I just turn it now? Because I was so just fucking done with what was happening in my brain.” Kim: It feels crisis. Alegra: Yeah. Kim: It's like you're experiencing a crisis in that moment, and I think that that's absolutely valid. Alegra: It's an extended crisis. For me, it was a crisis of three to four years. I never had a break. Not when I was sleeping. I mean, never. Chris: I was just going to add that I hear in session almost daily, people are like, “If I just don't wake up tomorrow, I'm fine. I'd never do anything, but if I just don't wake up tomorrow, I'm fine.” We know this is the norm. The DSM talks about 50% of individuals with OCD have suicidal ideation, 25% will attempt. This is what people are going through as they enter treatment or before treatment. They just feel like, “If I just don't wake up or if something were to happen to me, I'd actually be at peace with it.” It's a really alarming number. THE EMOTIONAL TOLL OF OCD TREATMENT Kim: Right. Let's move. I love everything that you guys are saying and I feel like we've really acknowledged the emotional toll really, the many ways that it universally impacts a person emotionally and in all areas of their lives. I'm wondering if you guys could each, one at a time or bounce it off each other, share what you believe are some core ways in which we can manage these emotional tolls, bruises left, or scars left from having OCD? Jessica, do you want to go first?  Jessica: Sure. I guess the first thing that comes to mind is—I'll speak from the therapist perspective—if you're a therapist specializing in treating OCD, make sure you leave room to talk about these feelings that we're bringing up. Of course, doing ERP and doing all of the things to treat OCD is paramount and we want to do that first and foremost if possible. But if you're not also leaving room for your client to process this grief, process through and challenge their shame, just hold space for the anger and maybe talk about it. Let your client have that anger experience in a safe space. We're missing a huge, huge part of that person's healing if we're leaving that out. Maybe I'll piggyback on what you two say, but that's just the baseline that I wanted to put out there. Chris: I could go next. I would say the first thing is what Jess said. We have to treat the whole person. I think it's great when a client's Y-BOCS score has gone down and symptomology is not a daily impact. However, all the things that we talked about, we aren't unicorns. This is what many of our clients are going through and there has to be space for the therapist to validate, to address, and to help heal. I would say the biggest thing that I believe moves you past where we've been talking about is re-identity formation. We just don't recognize until you get better how nearly every single decision we make is based off of our OCD fears, that some way or another, what we listen to, how we speak, what direction we drive, what we buy. I mean, everything we do is, will the OCD be okay with this? Will this harm me, et cetera?  One of the things I do with all my clients before I complete treatment is I start to help them figure out who they are. I say, “Let's knock everything we know. What are the parts of yourself that you organically feel are you and you love? Let's flourish those. Let's water those. Let's help those grow. What are some other things that you would be doing if OCD hadn't completely ransacked your life? Do you spend time with family? Are you somebody that wants to give back to communities? What things do you like to do when you're alone?” I help clients and it was something I did after my own treatment, like re-fall in love and be impressed with yourself and start to rebuild. I tell clients, one of the things that helped me flip it and I try to do it with them is instead of looking at it like, “This is hard, this is tough,” look at it as an opportunity. We get to take that pause, reconnect with ourselves and start to go in a direction that is absolutely going to move as far away from the OCD selves as possible, but also to go to the direction of who we are. Obviously, for me, becoming a therapist and advocate is what's helped me heal, and not everybody will go that route. But when they're five months, six months, a year after the hard part of their treatment and they're doing the things they always picture they could do and reconnecting with the people that they love, I start to see their light grow again and the OCD starts to fade. That's really the goal.  Alegra: I think something that I'll add—again, I don't want to be the controversial one, but maybe I will be—is there might be, yes. Can I get canceled after this in the community? There might be some kind of trauma work that somebody might need to do after OCD treatment, after symptoms are managed, and this is where we need to find nuance. Obviously, treatments like EMDR are not evidence-based for OCD, but if somebody has been really traumatized by OCD, maybe there is some kind of somatic experience, some kind of EMDR, or some kind of whatever it might be to really help work on that emotional impact that might still be affecting the person. It's important of course to find a therapist who understands OCD, who isn't reassuring you and you're falling back into your symptoms. But I have had clients successfully go through trauma therapy for the emotional impact OCD had and said it was tremendously helpful. That might be something to consider as well. If you do all the behavioral work and you still feel like, “I am really in the trenches emotionally,” we might need to add something else in. Chris: I actually don't think that's controversial, Alegra. I think that what you're speaking-- Alegra: I don't either, but a lot of clinicians do. Jessica: No, I agree. I think a lot of people will, and it's been a part of my recovery. I don't talk about a lot for that very reason. But after I was done with treatment, I didn't feel like I needed an OCD therapist anymore. I was doing extremely well, but all the emotions we'd been talking about, I was still experiencing. I found a clinician nearby because I was going on a four-hour round trip for treatment. I just couldn't go back to my therapist because of that. She actually worked with a lot of people that lost their lifestyle because of gambling. I went to her and I said, “What really spoke to me is how you help people rebuild their lives. I don't need to talk about OCD. If I need to, I'll go back to my old therapist. I need to figure out how to rebuild my life.” That's really what she did. She helped me work through a lot of the trauma with my dad and even got my dad to come to a session and work through that. We worked through living in the closet for my sexual orientation for so long and how hard coming out was because I came out while I was in the midst of OCD. It was a pretty horrible coming out experience. She helped me really work through that, work through the time lost and feeling behind my peers and I felt like a whole person leaving. I decided, as a clinician, I have to do that for my clients. I can't let my clients leave like I felt I left. It was no foul to my therapist. We just didn't talk about these other things.  Now what I'll say as a clinician is, if I'm working with a client and I feel like I could be the one to help them, I'll keep them with me. I also know my limitations. Like Alegra was saying, if they had the OCD went down so other traumas came to surface and they've dealt with molestation or something like that, I know my limitations, but what I will make sure to do is refer to a clinician that I think can help them because once again, I think treating the whole client is so important.  Kim: Yeah. There's two things I'll bring up in addition because I agree with everything you're saying. I don't think it's controversial. In fact, I often will say to my staff who see a lot of my clients, we want to either be doing, like Jessica said, some of the processing as we go or really offer after ERPs. “Do you need more support in this process of going back to the person you want?” That's a second level of treatment that I think can be super beautiful. As you're going too with exposures and so forth, you're asking yourself those questions like, what do I value? Take away OCD, what would I do? A lot of times, people are like, “I have no idea. I have really no idea,” like Chris then. I think that you can do it during treatment. You can also do it after, whichever feels best for you and your clinician.  The other thing that I find shows up for my patients the most is they'll bring up the shame and the guilt, or they'll bring up the anger, they'll bring up the grief. And then there's this heavy layer of some judgment for having it. There's this heavy layer as if they don't deserve to have these emotions. Probably, the thing I say the most is, “It makes complete sense that you feel that way.” I think that we have to remember that. That every emotion that is so strong and almost dysregulating, it makes complete sense that you feel that way given what you're going through.  I would just additionally say, be super compassionate and non-judgmental for these emotional waves that you're going to have to ride. I mean, think about the grief. This is the other thing. We don't go in and then process the grief and then often you're running. It's a wave. It's a process. It's a journey. It's going to keep coming and going. I think it's this readjustment on our thinking, like this is the life goal, the long-term practice now. It's not a one-and-done. Do you guys have thoughts? Jessica: I think as clinicians, validating that these are absolutely normal experiences and you deserve to be feeling this way is important because I think that sometimes, I don't think there's ill intent, but clinicians might gaslight their clients in a certain way by saying, “This isn't traumatic. This is not trauma. You can feel sad, but it is absolutely not a trauma,” and not validating that for a person can be really painful. I think as clinicians, we need to be open to the emotional impact that OCD has on a person and validate that so we're not sitting there saying, “Sorry, you can't use that word. This is not your experience. You can be sad, you can be whatever, but it's not trauma,” because I have seen that happen. Kim: Or a clinician saying, “It's not grief because no one died.” Jessica: Yeah. It was just hard. That was it. Get over it.  Kim: Or look at how far you've come. Even that, it's a positive thing to say. It's a positive thing to say, but I think what we're all saying is, very much, it makes complete sense. What were you going to say, Jessica? Sorry. Jessica: No. I just wanted to point out this one nuance that I see come up and that I think is important to catch, which is that sometimes there can be grief or shame or all these emotions that we're talking about, but sometimes those emotions can also become the compulsion themselves at times. Shala Nicely has a really, really good article about this, about how depression itself can become a compulsion, or I've seen clients engage in what I refer to as stewing in guilt or excessive guilt or self-punishment. What we want to differentiate is, punishing yourself by stewing in guilt is actually providing some form of covert reassurance about the obsessions. Sometimes we need to process the true emotional experiences that are happening as a result of OCD, but we also want to make sure that we're on the lookout for self-punishment compulsions and things like that that can mask, or I don't know. That can come out in response to those feelings, but ultimately are feeding the OCD still. I just wanted to point out that nuance, that if someone feels like, “I'm doing all this processing of my feelings with my therapist, but I'm not getting any better or I'm actually feeling worse,” we want to look at, is there a sneaky compulsion happening there?  Chris: I was just going to quickly add two things. One, I think what you were saying, Kim, with your clients, I see all the time. “I shouldn't feel this way. It's not okay for me to feel this way. There's people out there that are going through bigger traumas.” For some reason, I feel society gives a hierarchy of like, “Oh, if you're going through this you can grieve for this much, but we're going to grief police you if you're going through this. That's much down here.” So, my clients will feel guilty. My brother lost an arm when he was younger. How dare I feel bad about the time lost with OCD? I always tell my clients, there's no such thing as grief police and your experience is yours. We don't need to compare or contrast it to others because society already does that. And then second, I'm going to throw in a little plug for Kim. I feel as a clinician, it's my responsibility to keep absorbing things that I think will help my client. Your book that really talks about the self-compassion component, I read that from cover to cover. One thing that I've used when we're dealing with this with my clients is saying like, “We got to change our internal voice. Your internal voice has been one that's been frightened, small, scared, angry for so long. We got to change that internal voice to one that roots for you that has you get up each day and tackle the day.” If a client is sitting there saying that they shouldn't feel okay, I always ask them, “What kind of voice would you use to your younger brother or sister that you feel protective about? Would you knock down their experience? No, you would hold that space for them. What if we did that for you? It may feel odd, but this is something that I feel you need at this time.” Typically, when they start using a more self-compassionate tone, they start to feel like they're healing. So, that's something that we got to make sure they're doing as well. OCD AND DEPRESSION Kim: Yeah. Thank you for saying that. One thing we haven't touched on, and I will just quickly bring it up too, is I think secondary depression is a normal part of having OCD as well and is a part of the emotional toll. Sometimes either that depression can impact your ability to recover, or once you've gone through treatment, you're still not hopeful about the future. You're still feeling hopeless and helpless about the way the world is and the way that your brain functions in certain stresses. I would say if that is the case, also don't be afraid to bring up to your clinician. Like, I actually am concerned. I might have some depression if they haven't picked up on it. Because as clinicians, we know there's an emotional toll, we forget to assess for depression. That's something else just to consider. Chris: Yeah. I'm a stats nerd and I think it's 68% of the DSM, people with OCD have a depressive disorder, and 76% have an anxiety disorder. I always wonder, how can you have OCD and not be depressed? I was extremely depressed when my OCD was going on, and I think it's because of how it ravishes your life and takes you away from the things you care about the most. And then the things that would make you happy to get you out of the depression, obviously, you can't do. I will say the nice thing is, typically, what I see, whether it's through medication or not medication, but the treatment itself—what I see is that as people get better from OCD, if their depression did come from having OCD, a lot of it lifts, especially as they start to re-engage in life. Kim: All right. I'm looking at the time and I am loving everything you say. I'd love if you could each go around, tell us where we can hear more about you. If there's any final word that you want to say, I'm more than happy for you to take the mic. Jessica? Jessica: I'll start. I think I said in the introduction, but I have a private practice in Los Angeles. It's called Mindful CBT California. My website is MindfulCBTCalifornia.com. You can find some blogs and a contact page for me there. I hope to see a lot of you at the IOCDF conference this year. I love attending those, so I'll be there. That's it for me. Kim: Chris? Alegra: Like I said, if you're in the Southern California area, make sure to check out OCD SoCal. I am on the board of that or the International OCD Foundation, I'm on the board. I'm always connected at events through that. You can find me on my social media, which is just my name, @ChrisTrondsen. I currently work at the Gateway Institute in Orange County, California, so you can definitely find me there. My email is just my name, ChrisTrondsen@GatewayOCD.com. I would say the final thought that I want to leave, first and foremost, is just what I hope you got from this podcast is that all those other mixed bags of emotions that you're experiencing are normal. We just want to normalize that for you, and make sure as you're going through your recovery journey that you and your clinician address them, because I feel much more like a whole person because I was able to address those. You're not alone. Hopefully, you got from that you're not alone. Kim: Alegra? Alegra: You can find me @obsessivelyeverafter on Instagram. I also have a website, AlegraKastens.com, where you can find my contact info. You can find my Ask Alegra workshop series that I do once a month. I also just started a podcast called Sad Girls Who Read, so you can find me there with my co-host Erin Kommor, who also has OCD. My final words would probably be, I know we talked about a lot of really dark stuff today and how painful OCD can be, but it absolutely can get so much better. I would say that I am 95% better than I was when I first started suffering. It's brilliant and it's beautiful, and I never thought that would be the case. Yes, you'll hear from me in July, Kim, but other than that, I feel like I do have a very-- Kim's like, “Oh, will I?” Kim: I've scheduled you in. Alegra: She's like, “I have seven months to prep for this.” But other than that, I would say that my life is like, I never would've dreamed that I could be here, so it is really possible. Kim: Yeah. Chris: Amen. Of that. Kim: Yeah. Thank you all so much. This has been so meaningful for me to have you guys on. I'm really grateful for your time and your advocacy. Thank you. Chris: Thanks, Kim. Thanks for having us.  Alegra: Thanks, Kim.

In This Episode: The difference between Reassurance seeking vs. holding in emotions Why Reassurance seeking OCD is problematic and keeps you stuch What tools you can use to help you manage emotions with OCD Links To Things I Talk About: ERP School: https://www.cbtschool.com/erp-school-lphttps://kimberleyquinlan-lmft.com/32-reduce-reassurance-seeking-behaviorscompulsions/ Newsletter https://www.cbtschool.com/newsletter Chatter Book:https://www.amazon.com/Chatter-Voice-Head-Matters-Harness/dp/0525575235 Episode Sponsor:This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This is Your Anxiety Toolkit - Episode 306. Welcome back, everybody. We are well and truly into OCD Awareness Week, and I have been so excited to be a part of some amazing awareness projects, being an advocate for the International OCD Foundation, doing a lot of social media on self-compassion this week. It's been such a treat. This week, I actually wanted to discuss a concept that I-- actually, I say this often these days, but I get asked this question a lot in some various forms by my clients, so I wanted to address this question that I got with you. This is actually a question from one of the people in ERP School, which is our online course for OCD. If you click the link here in the bio or you can go to CBTSchool.com, we have a course called ERP School where we teach, or I teach step by steps that I take with my patients on how to set up an ERP plan so that you can slowly face your fear and reduce your compulsions and take your life back from OCD. Reassurance Vs Holding In Emotions One of the members asked a question, and there's a whole portal in there where you can ask questions to me directly, and they asked: “I have a question to you regarding reassurance seeking.” They said, “I've been trying to stop doing my compulsions and my go-to is reassurance seeking.” “What is the difference between Reassurance vs holding in emotions?” Reassurance Seeking OCD Reassurance seeking is a type of compulsion where you usually go to Google or you go to a loved one or another person and you ask for reassurance on your fear or your uncertainty. They go on to say, “One thing I do understand about is why it's bad and how it keeps the cycle going.” So, they do understand that reassurance seeking OCD is a problem. They do understand how it keeps the OCD cycle going. We talk a lot in ERP School about this OCD cycle. It's a huge component of the treatment. We have to first understand the cycle so that we can then know how to stop the cycle. And they go on to say, “I know that I have to learn to rely on myself to manage my anxiety and seeking reassurance makes me dependent on others for my relief, which can increase my anxiety when they're not around. But I've always been told by friends and family that talking about things that are bothering you is healthy because that way you get it out as opposed to bottling it in. When I don't seek reassurance, I worry that I'm bottling it in and that the only way to feel better is to let it out by talking to others. How do I join these two seemingly healthy ideas?” This is such a core component of all the work that we do. And so, I really want to go deep into this with you here in just a sec. Now, before we move on, if you aren't quite sure about reassurance seeking yet, you can go back and listen to a previous podcast we did, Number 32, which is called How to Reduce Reassurance Seeking Behaviors. It's an amazing podcast episode that really goes deep into what is a reassurance compulsion. You can click that there. But let's talk more about this specific question. Before we do that, let's quickly do the review of the week. This is from Isha.Isha and they said: “An invaluable resource. I have read many books on anxiety and OCD, and yet I am continuously surprised to learn new things with this podcast. It is thought-provoking and brings forward new, helpful, and interesting content.” She went on to say: “Kimberly, your 6 Part series on Mental Compulsions has truly been life-changing for me. Despite reading dozens of books on OCD and Anxiety, including yours, I was astounded to realize how many mental compulsions I actually have. The approaches to dealing with them, suggested by a few of the guests (thank you, Hershfield, Nicely, and Reid), have been nothing short of miraculous for me. Thank you for your hard work here! It is deeply appreciated!” Again, you guys, if you go to CBT School and you sign up for our newsletter, you will be given a gift from me, which is a link where I have put all of those six-part mental compulsion audio files together and we've thrown in a whole bunch of PDFs that will help you really strategize your own way of managing mental compulsions. So, go sign up for the newsletter. If you go to CBTSchool.com, you'll be able to get access to it there. And then one more thing before we move on, let's quickly do the “I did a hard thing” segment. It sounds like this person who asked the question is doing hard things too, but this one was so fun, I wanted to share it with you. Anonymous says: “Having OCD has made wedding planning and the wedding process in general challenging for me. But this weekend, I made it to my bridal shower and I had the best time, even despite my OCD being along for the ride. I actually took the day as an opportunity to face the disorder head-on. I left feeling empowered as F***.” Amazing, Anonymous. I'm so happy and congratulations on your bridal shower. I hope you had the most incredible time. All right, so let's look at this question. Let's break it down. Okay. So, yes, this person has already shared they understand that reassurance-seeking keeps us in the OCD cycle, keeps the fear going strong, and only makes more problems. It makes problems for the person with OCD, but it also impacts the relationship. In fact, I would go as far as to say, those who engage in reassurance-seeking behaviors tend to have a bigger impact on their family members because they're constantly going to their family members saying, “Would this happen? Could it happen? Do you think it could happen? What would happen?” And that person, because they're not trained as a clinician, they don't know how to respond. They haven't been trained. Usually, they try many different ideas and it actually ends up making the person with OCD even more confused. And then that can create conflict in the relationship. We know this. We know that reassurance-seeking can be very, very problematic and we want to slowly reduce it. It sounds like this person is doing amazing work, but they've got this dilemma in saying, “But I thought I was supposed to let things out.” Let's take a look here. Managing emotions with OCD When you have an obsession, naturally, your instincts are, “How can I make this fear go away or this discomfort or feeling go away?” You're going to want to do a compulsion. The goal of ERP is to reduce those compulsions. So, now what are you doing? So, you're reducing the compulsion, you're not trying to get reassurance, and now you're handling a large degree of anxiety and stress. Yeah, that's true. You will have to rise and fall in discomfort. Absolutely. We know that that's a part of the work. Willingly, ride the wave of discomfort. So, what I want to say to you here is you have some choices. You could ride that wave on your own. Let it go high, let it go low, let it go up and down, do what it wants, and you can practice actually allowing that discomfort and really building a resilience to that as you go. Similar to what Anonymous said in “I did a hard thing” is they left feeling empowered. When we do it on our own, we can actually feel incredibly empowered. Now, that is one option. That doesn't mean to say that when things are really hard, naturally, we do want connection. That's what human beings want. So, sometimes we do want to go to our loved one and say, “I'm having a hard time.” But there's a really big difference between going to a loved one and saying, “I'm having a hard time. Will this bad thing happen? Or do you think it will happen?” and saying to your partner, “I'm going through some stuff right now, would you sit with me?” One is very compulsive and one is not. But this is where OCD can be very, very tricky. Sometimes, just having a partner there forms reassurance. If your fear is like, “Well, what if I'm going to go harm someone?” keeping them in the room, even though you're not talking, that can still serve as a reassurance because you're like, “Okay, they're here. They'll stop me if I'm going to do something bad and I snap.” So, we want to keep an eye out for how reassurance seeking doesn't have to be just verbal, it can be physical, it could be us just looking at them to see their face and go, “Okay, they look fine, they don't look stressed. Okay, that gives me the reassurance that nothing bad is happening.” Catch the little nuances that can happen here because as we know, OCD can be very, very sneaky. Again, we can use the option and it is healthy to go to your partner and say, “Hey, I'm really dealing with something. This is really hard. I'm riding a wave of discomfort.” But you're doing that without getting any reassurance, without seeking any reassurance, without them reducing or removing your uncertainty or anxiety. So, you can do that. There are ways to do it. But the main thing to remember here is, are you doing this with urgency? Because that's usually a very good sign that you're doing something compulsive. Are you doing it in attempt to reduce or remove your discomfort? If you're able to be in conversation with them and discuss and seek support from them without seeking it in an urgent way or trying to reduce or remove your discomfort, well then that's fine. But here is what I want you to consider just to start, is I am all for support. In fact, it is a human need to have support. But what I'm going to offer you is an idea, which is, when it comes to OCD, if you're going to them for support because of this discomfort, there is a chance you're still treating the fear like it's important, and you will suffer. I get that. You're going to have a lot of emotions. But if you have the emotions and you're like, “Oh my God, I feel so bad, I just have these thoughts, or having this anxiety,” and you're giving that too much attention by saying, “I need your support, I'm really, really suffering,” sometimes that in and of itself can actually reinforce the anxiety. I guess you're still probably thinking, well, what's the balance? And there is no perfect answer. I'm sorry, I can't give you a yes or a no. What I can say is, when it comes to OCD or anxiety, I personally am always going to encourage that you do it yourself as much as you can because that's where you actually learn how much you can actually tolerate. Remember here, anxiety is always going to be sneaky and say in the back of your mind, “Kimberley, just in case, just so you know, my anxiety is high, but I can really turn it up and freak you out, so you better be careful. Do your best to avoid me.” That's what anxiety says in some way or form. So, if we still treat ourselves as if we're really fragile, we can actually reinforce that belief in that thought or intrusive thought. So, I personally am always for myself going to say, “Okay, fear is here, how can I ride this one out 100% by myself?” and this is the key point to remember. Ask yourself in that moment, because you're probably having some pretty strong reactions right now. Ask yourself in this moment if you are having a strong reaction, “What is my strong reaction to that?” Is it “it's not fair”? Is it “that's uncool, that's too much to handle”? That just shows you where our work is and here is the key point. What is it that you want them to provide you? Is it warmth? Is it compassion? Is it relief from the shame you feel? Is it to know that they won't leave you or they're not judging you? What is it that they're, this one particular person in that moment, what is it that they can provide you? And now, can you provide it for yourself? Or, is this thing you're looking for even really that helpful? So if you're like, “Oh my gosh, I just need a safe place to land right now,” I beg for you to practice being the safe place to land. Not your partner, not your family, not your friends. You be that for you. You deserve to be the safe place to land. If there's a sneaky part of this where you're like, “No, I just want them to tell me that I'm good and not a terrible human being,” well, that is in fact still reassurance. Yes, we're all allowed to get that reassurance, but you have to ask yourself, is that reassurance a healthy reassurance or is it something keeping you stuck in the cycle? You get to choose. I'm not saying what's right or wrong here because each person is different. If I'm with a patient, we will look at this and go, “Okay, let's talk about why you want your partner to provide you support. What is it that the partner support provides you?” And we pull apart whether that support is in fact benefiting their long-term resilience and success in treatment or actually slowing them down. There's nothing wrong with getting support at all, but is this an opportunity where you can show up and be your best person? Be the first person that's standing there going, “I got you.” Mindfulness & Self Compassion For Reassurance Seeking Now here is the other piece of this, which is they're talking about bottling it in. Let's say you decide, “Kimberley, I'm on with this idea and I am going to commit to 30 days or seven days or one day or 10 minutes where I'm actually going to be the support for myself. I am going to practice my self-compassion skills, my mindfulness skills, my radical acceptance skills, and I'm going to be it for myself.” That doesn't mean you're technically bottling it in. Bottling it in is when you have the emotion and you shut it down and you refuse to let it pass through you and you hold it in and you pretend it's not there and you're faking your way through it. If sometimes you need to do that, that's still fine. But this question is around saying that's a problem. Now here's what I'm going to say. There's really no scientific evidence to say that bottling things in is particularly bad, because how do we know what's bottled in really? We can't really measure what's being bottled in, but we do know that if you don't talk to people and you aren't processing stuff that, yeah, it can create some problems. So, this again is, how can we be healthy in our expression and effective in our expression of what's going on for us? Can you journal? For me, this might sound a little weird, but I am a little weird, is when I really have something I've got to get off my chest, I record an audio, I take a walk. I leave my kids and my husband and I take a walk and I record an audio of me just venting it out because, the truth is – this was particularly true during covid – me venting it out to my partner when he's got his own stuff he's working on, he's also going through some things as well. It's not helpful for me to dump it on him, so I would audio it into myself and listen back and listen for things that I could maybe work on.  So, there are ways. Another way is to practice just feeling your feelings. That's probably the most important thing I want to mention here and which is why I wanted to really report it, is feel your feelings instead of bottling them in. Now, we recently did an episode about this and how this idea of sitting with your emotions. Go back and listen to that because that's important. When we talk about feeling your feelings, it doesn't mean lashing out and having them all over the place and being really unskilled in how you manage them, and it also doesn't mean having your feelings and staring at the wall and just being like, “Oh my God, I'm just so overwhelmed with this feeling, but I'm sitting with it.” It's saying, while you go and engage with your life, you allow and embrace whatever emotions to come up. That's not bottling it in. You saying them out loud is not what's preventing you from bottling it in. They're two completely different concepts. Let's finish up by really talking about what is a healthy way to ride a wave of discomfort instead of having reassurance-seeking compulsions play out. You could journal, you could feel your feelings while you engage with your life, and use skills that you have, mindfulness skills, skills from this podcast. Go all the way back to the beginning. We've got tons of good stuff at the beginning of the podcast episodes where you can actually mindfully experience your emotions while also engaging in life. You could do those. You could also go and ask for support and say, “Hey, it's a really hard time. I just did a really hard exposure. My anxiety is really high. I don't want you to try and reduce or remove my anxiety, but your presence here is really wonderful. Thank you.” You could be the one who shows up for you radically so hard. You could be like, “Hey Kimberley, what do I need? What do you need right now? How can I show up for you? Do you need my fear support? Do you need my nurturing support? Do you need my champion support? What do you need? And I'm here for you, sister.” That's what I really want you to practice. You could also find an OCD therapist who's trained in ERP and say, “Hey, I'm working through some things. Can we talk about it in a way that doesn't provide me reassurance?” Because you trust that they understand how to not provide reassurance. And that can be a really helpful way. But there's one thing I want you to remember here at the very end. The reason I'm saying it at the very end is I think this is probably one of the most groundbreaking things that I learned just this year, and this has changed my marriage. I'm not going to lie, it's changed my marriage, which is this: At the beginning of this year, I read a book called Chatter. I will link it in the show notes. The book is-- let me pull it up really quick. The Voice in Our Head, Why It Matters, and How to Harness It by Ethan Kross. It is an amazing book. One of the things that blew my mind was the research that venting actually increases a person's distress and does not benefit them. What? That is the opposite of what I have been trained in my career. I was trained that venting is a really healthy thing. I know some of you may be like, “Well, duh, I've had issues with this in my past.” But the truth is, it really showed the data on why venting actually makes us feel worse. It actually has a negative impact and there's no benefit to venting. So, I'm going to leave you to think about that because for me, when I read that, I can be-- I'm not going to lie, one of my not-so-great traits is I can be a little bit of a ventor. A ventor? Is that a thing? I can be a person who vents and unfortunately, my husband is the one who has to hear me process stuff. I'm a real process kind of person. What I realized when I learned this is, holy moly, I've been thinking that this is important and this keeps us connected, but the truth is, it doesn't. It doesn't impact me positively. It doesn't impact him positively, even though he is the most kind, supportive man in the history of the world. This is actually not a good behavior and I got to stop it. So, what I did is I called my best friend and I called my husband and I said, “From now on, I'm going to be much more mindful around venting. There will be times when I'm really struggling where I'm actually going to choose not to share about it in that moment. You might see that I'm spiraling on something.” I'm going to say, listen, now is not the time because I now understand the science that venting is not in fact beneficial. It just makes me feel worse and works me up more. So, I use all my tools and I double down and I ride the wave and I journal and I audio in and I ride the wave on my own. So, here are some ideas you take and choose what you want, but that's the main concepts I want you to consider. And there's your answer, is this whole idea of holding it in is not the only option. You can, in a healthy way, ride your emotions and your wave of anxiety and you can do it in a way that actually is very effective that doesn't require anybody else. However, if you require somebody, no problem. That's wonderful. I hope that you have the most amazing, supportive people in your life and it's all good. So, that is it. I hope that is helpful for you guys. We did go around and around into all of the little cracks and crevices of this topic. If you've got any questions, you can always let me know. Please do leave a review because I hope this is helpful for you. I will see you next week. Next week, I'm actually doing a little bit of a personal episode, talking about a few shifts that I've had with my own chronic illness and how it's impacted my own anxiety. All fun and games. Not really. No fun and games is what I should say. All right, my loves, have a wonderful day. Please do remember it is a beautiful day to do really freaking hard things. You're not alone because I'm doing the hard things and your friends are doing the hard things and all the people listening here, thousands and thousands of people are doing the hard things too. Have a wonderful day, everybody.