Podcasts about ocd treatment

Is OCD holding you back? On this episode of Create with Franz, we're tackling the complex world of Obsessive-Compulsive Disorder with expert Dr. Avigail Lev. We'll explore the science behind compulsions, the different faces of OCD, and why early intervention is key. Dr. Lev shares her insights on schema and somatic therapy, and introduces NeuroImmerse, a revolutionary approach combining neuroscience and immersive sound.  Get ready to understand your brain better, break free from anxiety, and discover powerful tools for healing. Plus, access free guided exercises to experience the transformative power of NeuroImmerse! Topic covered: OCD, OCD symptoms, OCD treatment, OCD anxiety, types of OCD, compulsions, obsessions, CBT for OCD, schema therapy OCD, somatic therapy OCD, NeuroImmerse, binaural beats OCD, exposure therapy OCD, OCD recovery, anxiety relief, mental health podcast, neuroscience podcast, mindset transformation, emotional healing, overcoming anxiety   Find Avigail Here: https://valuesbasedcoaching.com/our-team/ Work with Franz on your mindset!   Did you enjoy this episode and would like to share some love?  

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 

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

This is the final part of our two-part chat with Chrissie Hodges. In the last episode, Chrissie shared her early experiences with OCD before embracing the challenges of OCD peer support and advocacy work. In this episode, Chrissie reflects on her experiences with OCD treatments and what clinicians can and should be doing better. She also emphasises the importance of acknowledging the impacts of different OCD themes on the individual and how some themes might result in more trauma and stigma than others. Resources and links: Chrissie Hodges’ website Chrissie Hodges on YouTube Chrissie Hodges on Instagram OCD Gamechangers website Webinars, books, and training by Melbourne Wellbeing Group OCD training workshops by Dr Celin Gelgec OCD focused supervision for healthcare professionals with Dr Celin Gelgec 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.

A decade ago, finding effective OCD treatment was an uphill battle —misdiagnosis, stigma, and inaccessibility left many struggling alone. But change is happening. OCD advocate Chrissie Hodges and Stephen Smith, co-founder and CEO of NOCD, share their personal and professional journeys in reshaping the landscape of OCD care. From grassroots advocacy to groundbreaking digital therapy, they explore how far treatment has come, but also the obstacles that still prevent people from getting help.Despite big progress, stigma and misinformation continue to delay diagnosis and treatment, especially for those facing the most distressing OCD themes. Chrissie and Stephen cover why awareness is the final frontier and how the next decade can bring true accessibility, understanding, and support for those who need it most.NOCD is proud to treat OCD with expert care. Our therapists are specialty-trained in ERP therapy — the leading treatment against OCD. Book a free 15-minute call to learn more about specialized care at https://learn.nocd.com/podcastFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

Titans of Science continues, where we talk to some of the major movers and shakers leading the way in their respective fields. This time we're hearing from Cambridge neuroscientist, and expert on obsessive compulsive disorder - OCD - Trevor Robbins... Like this podcast? Please help us by supporting the Naked Scientists

Join your host, Nicole Morris, LMFT and Mental Health Correspondent, as she reviews an overview of evidence-based therapies and emerging protocols with help from some of her prior podcast guests. Nicole amasses highlights of ERP, I-CBT, MCT, Medication Support, TMS and Deep Brain Stimulation. Additionally, Nicole highlights 4 emerging protocols worth our time and attention, including the developing landscape for I-CBT with kids, Rumination-Focused ERP, the Mastery Approach and the Upside of OCD. So whether you're already aware of most of these and curious to hear more, or new to the OCD Family Community and desperate for hope, we've got you with highlights from OCD researchers, psychiatrists, trainers and OCD treatment experts, oh my!

Make 2025 the year you take control of your OCD with insights from Brenna Posey, NOCD's Client Success Senior Manager. Brenna brings a unique perspective as both an expert in OCD care and someone who has personally experienced and managed her own OCD.In this episode of the Get to Know OCD podcast, Brenna dives into the questions many are asking as they consider treatment in the new year. Take 10 minutes of your time as she answers three key questions to help you approach OCD treatment with confidence and make this your year of progress.Start 2025 by booking a free 15-minute consultation with one of our experts. Visit https://learn.nocd.com/podcast to pick your appointment. Follow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

In this episode, Dr. David Puder dives deep into the world of Obsessive-Compulsive Disorder (OCD) with renowned expert Dr. Fred Penzel, who brings over 43 years of experience to the table. Together, they explore groundbreaking approaches to treating OCD, including Exposure and Response Prevention (ERP), cognitive restructuring, and embracing uncertainty. Dr. Penzel shares fascinating insights into the neurobiology of OCD, the cycle of intrusive thoughts and compulsions, and effective strategies for lasting recovery. Whether you're a clinician seeking best practices or someone navigating OCD, this episode offers a wealth of practical tools, compelling stories, and hope. Uncover why OCD is called the "doubting disease" and how evidence-based methods can break its grip. This is more than a podcast—it's a roadmap to understanding and overcoming one of the most challenging mental health conditions.

Send us a textI just had an eye-opening conversation with OCD specialist Amanda Petrik-Gardner that I can't wait to share with you.Most of us think we understand OCD – neat freaks who love cleaning, right? WRONG. Amanda completely shattered those myths and revealed how complex and misunderstood this disorder really is.

Stanford researcher Dr. Carolyn Rodriguez is at the forefront of OCD treatment and care. In this episode of the Get to Know Podcast, Dr. Rodriguez gives us a look at new treatments for OCD. She tells us what's still the gold-standard treatment but also new research areas to treat OCD, including improv and psychedelics. If you want a look into the future of OCD treatment, you're in the right place!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 Intro1:14 Carolyn's background 2:11 What Carolyn' superpower is4:07 Being a role model for others6:40 Helping those with OCD is Carolyn's passion9:25 Could MDMA help with OCD?12:29 Mentors paved the path for Carolyn15:20 Latest psychedelics research on OCD19:50 What Patrick learned from a comedy class21:19 What's next for Carolyn's lab and research24:51 Surgical therapy for OCD25:43 Overlap between OCD and hoarding disorder30:02 What Carolyn wants her legacy to be31:10 Treatment resistance34:35 Medication for OCD35:31 Advice from Carolyn Follow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

OCD-specialized treatment can make all the difference in recovery, but these days, the word "specialized" gets tossed around way too often. In this special episode of the Get to Know OCD podcast, we sit down with OCD researcher Uma Chatterjee and NOCD's Tia Wilson to dig into what truly counts as specialized care — and what doesn't. Hear their candid convo as both share their personal experiences with effective and ineffective treatments for their OCD. This is an eye-opening conversation you won't want to miss.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 Intro2:03 Treatments that didn't work8:53 What is specialized treatment13:14 First line treatment for OCD21:25 Treatment resistance28:15 The proven link between OCD and the brain34:59 Therapist red flags42:56 Therapist green flag45:45 What makes the OCD community so unique 54:11 Remembering why you became an advocate 59:54 Favorite therapists1:11:48 Uma's message about hope Follow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

Paul Peterson is a Licensed Clinical Social Worker and the CEO of the OCD and Anxiety Treatment Center. His practice involves mainly working with Anxiety, OCD, Hoarding, and Trichotillomania. He also works with patients suffering from comorbid issues. His practice evolved from his early years of marriage, where he realized his wife and son were living with OCD.  After using the by-the-book methods to treat his son, he realized treatment could be better. Today, he has cultivated methods of treating OCD by learning from different experts in the field and applying what he sees fitting best with each individual patient. In this episode we talk about:  ◾️Peter's personal history in treating OCD ◾️ A deeper dive into OCD treatments ◾️ Finding the right method for your OCD Find Paul here: theocdandanxietytreatmentcenter.com Find Zach here: zachwesterbeck.com/ocd-coaching @zach_westerbeck Discover the transformative power of my Concierge OCD Coaching program, where personalized support meets proven strategies to help you overcome intrusive thoughts and reclaim your life. Experience up to two one-on-one coaching sessions each week, tailored resources designed specifically for your journey, and a customized roadmap that guides you every step of the way. Plus, enjoy text support between sessions to keep you on track and motivated. This isn't just coaching; it's a life-changing opportunity to unlock your potential and embrace a calmer, happier existence. Don't wait—take the first step toward your transformation and apply now:  Disclaimer: Nothing here is medical advice. Please do your own research. The information above is just for informational and educational purposes. If you require assistance with any mental health or medical issue, please contact your healthcare provider for any medical care or medical advice.

Penny Moodie grew up consumed by catastrophic thoughts and developed habits to try to ward off impending doom. It turned out she had been living with obsessive-compulsive disorder (R)

Did you know there is a psychological approach to treating OCD that DOESN'T focus on preventing compulsions?To mark OCD Awareness Week, I am joined by Amanda Petrik-Gardner, a licensed clinical professional counsellor specializing in inference-based CBT (iCBT). We discuss the principles of iCBT, which differs from the traditional exposure and response prevention (ERP) approach. Instead, iCBT focuses on the reasoning process behind obsessional doubts rather than stopping compulsions. Our conversation highlights the concept of inferential confusion and the feared possible self, aiming to restore trust in the individual's real self. The conversation provides insights into the practical aspects of iCBT therapy, valuable insights into this purely cognitive approach that seeks to resolve the roots of obsessive doubt.  Highlights of the episode include:03:10 What is iCBT?04:02 Core Concepts of iCBT07:30 Research and Evidence for iCBT09:03 Inferential Confusion Explained12:39 Components Leading to Inferential Confusion18:34 The Feared Possible SelfThis week's guest:Amanda Petrik-Gardner, LCPC, LPC, LIMHP specialises in the treatment of Obsessive Compulsive and Related Disorders. Amanda is the creator of the OCD Exposure Colouring Books and The Compulsive Reassurance Workbook. Amanda currWhat did you think of this episode?More free downloads and resources to support your mental health and wellbeing: https://www.harleyclinical.co.uk/free-mental-health-downloadable-guidesJoin our email list for more mental health tips: https://mailchi.mp/harleyclinical/newsletter-sign-upFor private psychology services and therapy in person (London/Hertfordshire) or online, please visit Harley Clinical Psychology.*****************Subscribe to Dr Liz's YouTube channelFollow Harley Clinical on InstagramFollow Dr Liz White on InstagramFollow Dr Liz White on TikTok*****************DISCLAIMER - The Hello Therapy podcast and the information provided by Dr Liz White (DClinPsy, CPsychol, AFBPsS, CSci, HCPC reg.), is solely intended for informational and educational purposes and does not constitute personalised advice. Please reach out to your GP or a mental health professional if you need support.

OCD doesn't live in a bubble; it lives in our home. It lives in our families. It is not an isolated disorder. It involves the whole family system.That is why family involvement is key to a child's OCD long term success. Often this is the missing component, even when a child is being treated for OCD.In this week's AT Parenting Survival Podcast I explore how OCD involves the family and what parents can do to leverage their support.

Inspired by a suggestion from our listener Ashley, today Carrie is diving into how being a Highly Sensitive Person (HSP) affects OCD treatment. She explores why sensitivity matters and how it can shape your therapeutic journey.Episode Highlights: What it means to be a Highly Sensitive Person and how it impacts daily life.How being an HSP can influence the approach to treating OCD.Carrie shares her own experiences with sensitivity and how she manages it.Adjustments therapists can make to accommodate highly sensitive individuals in OCD treatment.Subscribe to our newsletter: https://hopeforanxietyandocd.com/free Explore our courses: https://hopeforanxietyandocd.podia.com/Follow us on Instagram: https://www.instagram.com/hopeforanxietyandocdpodcast and like our Facebook page: https://www.facebook.com/hopeforanxietyandocd for the latest updates and sneak peeks.

Chris opines about the future of mental healthcare in general and OCD treatment in particular. Given the slow but steady, technological development of healthcare delivery in the past 20 to 30 years, it's only a matter of time. Soon AI human-like robots (like Max Headroom from the 80s) will serve as treatment experts, and patients will get themselves better with the use of highly developed and widely accessible, therapeutic applications. Feel free to reach out with any questions you might have to chris@KentuckyOCD.com. If you've found OCD Straight Talk helpful, consider giving us a 5-star rating/review and subscribing to the podcast for more structured help with you anxiety or OCD symptoms.

SPP 176: Anxiety and OCD Treatment #psychedpodcast is excited for a great episode! Please join us as we chat with Natasha Daniels https://www.anxioustoddlers.com/https://hillchildcounseling.com/

Dr. Teri Bullis is the founder of Behavior Solutions for Children and Families. Her specialty in therapy lies in treating children of ages 3 to 12 and parents with ADHD, aggression, oppositionality, ASD-related social skills deficit, sleeping issues, and more. For patients with OCD, she collaborates with the patient in crafting effective ERP exercises to help them confront their intrusions in manageable steps. She believes in the close involvement of parents when it comes to treating their kids who face behavioral challenges.  In this episode we talk about:  ◾️ OCD in 3-12 year olds ◾️  Setting up a rewards system to aid in the child's recovery ◾️ Helping parents participate in their children's recovery journey Find Teri here: drterib@gmail.com behaviorsolutionsvt.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.

Perfectionism. It's a complicated trait that shows up a lot when working with OCD. It can present in a range of ways and can look like self-loathing, anger, people-pleasing, or even a strong sense of doubt and uncertainty in clients. In this skills episode, we dig into how perfectionism can manifest in a client, how it might present in a session, and how to address it when it does.   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.

Join us in our latest 'Among Therapists: Practical Tips' episode where we delve into mindfulness exercises for OCD. Discover engaging and effective techniques like the bubble wand exercise, designed to help clients observe their thoughts in a new, non-judgmental light. Learn about mindful action, a method for transforming daily routines into moments of deepened awareness. These practices are tailored to enhance presence and mindfulness, offering valuable skills for those managing OCD. Tune in to explore these transformative exercises and integrate them into your therapeutic toolkit.   Faculty: Kate Morrison, Ph.D. Host: Jessica Díaz, M.D. Script Editor: Anderson Garcia, Ph.D.   Learn more about: ACT Training Pathway:ACT Training Pathway: Bridging Foundations with Practical Applications Prefer to read? Here's a text version: Mindfulness Exercises for OCD

Imagine carrying a relentless storm of anxiety, compelled by thoughts that clash with your core values—a reality for many living with Obsessive-Compulsive Disorder. Joined by Stephen Smith, CEO and Co-Founder of NoCD, we confront the cold truth about OCD, unmasking the fears and secretive struggles that countless individuals endure. Gone are the misconceptions and casual stigmas; instead, our conversation serves as a beacon of understanding and a call to action for heightened awareness and empathy. This episode offers firsthand narratives and expert insights into the labyrinth of OCD subtypes, from harm-based to relationship OCD. We discuss the transformative effect of specialized treatment, particularly exposure response prevention (ERP), and how it stands as a testament to hope for those grappling with this disorder. Stephen's journey with NoCD shines a light on the importance of immediate, accessible support, detailing how ERP is revolutionizing care by meeting people where they are, amidst their deepest fears. Follow nOCD @treatmyocd Follow Chase @chase_chewning ----- In this episode we discuss... (00:00) Understanding OCD (12:18) Understanding and Treating Different OCD Subtypes (18:54) Understanding OCD and Effective Treatment (26:51) OCD Treatment and Co-Morbid Conditions (34:38) Improving Access to OCD Treatment (39:45) Accessing OCD Treatment With NoCD (48:43) Access NoCD Resources for Mental Health ----- Episode resources: This episode is sponsored by nOCD, to learn more about their treatment options visit TreatMyOCD.com Watch and subscribe on YouTube

Join host, Nicole Morris, LMFT and Mental Health Correspondent, as she welcomes Dr. Michael J. Greenberg to our family table! Explore how this integrative treatment shifts from traditional Exposure & Response Prevention (ERP) therapy to support OCD warriors in gaining freedom from OCD. This conversation covers a vast array of CBT and psychoanalytic strategies for stopping rumination. Also, we discuss disgust based OCD, value driven language and it's impact on treatment, Misophonia and more! So join the conversation, because we're opening our stance to a new horizon of possibilities!

If you're looking for an alternative treatment for your persistent OCD, it might be worth exploring ketamine IV therapy from Chrysalis Ketamine (888-836-4334), now serving patients near Agoura Hills, CA. Learn more at https://chrysalisketamine.com/ocd-treatment-thousand-oaks-ca/ Chrysalis Ketamine City: Thousand Oaks Address: 430 E Avenida De Los Arboles Suite 205 Website: https://www.chrysalisketamine.com Phone: +1-888-836-4334 Email: hkarpanian@gmail.com

Tired of dealing with OCD or other mental health symptoms and ready to move forward with your life? Calusa Recovery (+1 866 939 6292) offers mental health treatment programs, with inclusive, holistic modalities. Visit https://calusarecovery.com/mental-health-treatment for more details. Calusa Recovery City: Fort Myers Address: 15611 New Hampshire Ct Website: https://www.calusarecovery.com Phone: +1-866-798-3232 Email: info@calusarecovery.com

Obsessive-Compulsive Disorder (OCD) is a challenging condition, but the good news is that it's highly treatable. The key to effective management and recovery lies in understanding the condition, embracing the right treatment approaches, and adopting a supportive mindset. This article distills essential guidance and expert insights, aiming to empower those affected by OCD with knowledge and strategies for their treatment journey. YOU ARE BRAVE FOR STARTING OCD TREATMENT Taking the first step towards seeking help for OCD is a significant and brave decision. Acknowledging the courage it takes to confront one's fears and commit to treatment is crucial. Remember, showing up for therapy or seeking help is a commendable act of bravery. YOU CAN GET BETTER WITH OCD TREATMENT OCD treatment, particularly through methods like Exposure and Response Prevention (ERP) and Cognitive Behavioral Therapy (CBT), has shown considerable success. These evidence-based approaches are supported by extensive research, indicating significant potential for individuals to reclaim their lives from OCD's grasp. The path may not lead to a complete eradication of symptoms, but substantial improvement and regained control over one's life are highly achievable. OCD TREATMENT IS NOT TALK THERAPY OCD therapy extends beyond the realms of conventional talk therapy, involving specific exercises, homework, and practical worksheets designed to confront and manage OCD symptoms directly. These tools are integral to the treatment process, allowing individuals to actively engage with their treatment both within and outside therapy sessions. THERE IS NO SUCH THING AS “BAD” THOUGHTS A pivotal aspect of OCD treatment involves changing how individuals perceive their thoughts and their control over them. It's essential to recognize that thoughts, regardless of their nature, do not define a person. Attempting to control or suppress thoughts often exacerbates them, which is why therapy focuses on techniques that allow individuals to accept their thoughts without judgment and reduce their impact. YOU CAN NOT CONTROL YOUR THOUGHTS, BUT YOU CAN CONTROL YOUR BEHAVIORS You will have intrusive thoughts and feelings. This is a part of being human, and it is not in your control. However, you can learn to pivot and change your reactions to these intrusive thoughts, feelings, sensations, urges, and images.  YOU HAVE MANY OCD TREATMENT OPTIONS While medication can be a valuable part of OCD treatment, particularly when combined with therapy, it's not mandatory. Decisions regarding medication should be made based on personal circumstances, preferences, and professional advice, acknowledging that progress is still possible without it. In addition to ERP and CBT, other therapies such as Acceptance and Commitment Therapy (ACT), mindfulness, and self-compassion practices have emerged as beneficial complements to OCD treatment. These approaches can offer additional strategies to cope with symptoms and improve overall well-being. The accessibility of OCD treatment has expanded significantly with the advent of online therapy and self-led courses. These digital resources provide valuable support, particularly for those unable to access traditional therapy, enabling individuals to engage with treatment tools and strategies remotely. For those without access to a therapist, self-led OCD courses and resources can offer guidance and structure. Engaging with these materials can empower individuals to take active steps towards managing their OCD, underscoring the importance of self-directed learning in the recovery process. TREATMENT WILL NEVER INVOLVE YOU DOING THINGS YOU DO NOT WANT TO DO I am usually very clear with my patients. Here are some key points I share I will never ask you to do something I do not want you to do I will never ask you to do something that I myself would not do  I will never ask you to do something that goes against your values. RECOVERY IS NOT LINEAR Recovery from OCD is not a linear process; it involves ups and downs, successes and setbacks. Embracing discomfort and challenges as part of the journey is essential. Adopting a mindset that views discomfort as an opportunity for growth can greatly enhance one's resilience and progress in treatment. There will be good days and hard days. This is normal for OCD recovery.  There will be days when you feel like you are making no progress, but you are. Keep going at it and be as gentle as you can SETTING CLEAR TREATMENT GOALS Clarifying treatment goals is crucial for a focused and effective therapy experience. Whether it's reducing compulsions, living according to one's values, or tackling specific fears, clear goals provide direction and motivation throughout the treatment process. BE HONEST WITH YOUR THERAPIST The success of OCD treatment is significantly influenced by the honesty and openness of the individual undergoing therapy. Without reservation, sharing one's thoughts, fears, and experiences allows for more tailored and effective therapeutic interventions. IT IS A BEAUTIFUL DAY TO DO HARD THINGS.  No question. You can do hard things!  OCD is a complex but treatable condition. By understanding the essentials of effective treatment, including the importance of evidence-based therapies, the role of mindset, and the value of self-directed learning, individuals can embark on a journey towards recovery with confidence. Remember, every step taken towards confronting OCD is a step towards reclaiming control over one's life and living according to one's values and aspirations. TRANSCRIPT There is so much bad advice out there about OCD treatment. So today, I wanted to share with you the 11 things I specifically tell my patients on their first day of OCD therapy.  Hello, my name is Kimberley Quinlan. I'm an OCD specialist. I specialize in cognitive behavioral therapy, and I have helped hundreds of people with OCD over the course of the 10, 15 years I have been in practice.  Now, whether you have an OCD therapist or not, my goal is to help you feel confident and feel prepared when addressing your OCD treatment and symptoms, whether you have an OCD therapist or not. That is the big goal here at CBTSchool.com and Your Anxiety Toolkit podcast.  Make sure you stick around until the end because I will also be sharing specific things that you can remember if you don't have a therapist, because I know a lot of you don't. And I'll be sharing what you need to know so that you don't feel like you're doing it alone.  Now, if you're watching this here on YouTube, or you follow me on social media at Your Anxiety Toolkit, let me know if there's anything I've missed or anything that you were told on your first session that was particularly helpful, because I'm sure your knowledge can help someone else or another person with OCD who is in need of support and care and advice. So let's go. Here are the 11 things that I tell my patients on their first day of OCD therapy. Number one, I congratulate them for showing up, because showing up for OCD treatment is probably one of the most brave things you can do. I really make sure I validate them that this is scary, and I'm really glad they're here. And I'm pretty impressed with the fact that they showed up, even though it's scary.  The second thing I tell them is that OCD treatment is successful. You can come a long way and make massive changes in your life by going through the steps of OCD treatment, showing up, being willing to take a look at what's going on in your life, and making appropriate changes so that you can get your life back, do things you want to do, spend more time with your family, your friends, the things you love to do, like hobbies, and that OCD treatment can be very effective. We're very lucky that OCD is a very treatable condition. It doesn't mean it'll go away completely, but you can have absolute success in getting your life back.  Now, one thing to know here is, how do we know this? Well, OCD treatment research and OCD treatment articles. If you go onto Google Scholar, you will find a lot of articles that show a meta-analysis of the OCD treatments available, where it shows that ERP and cognitive behavioral therapy are the gold standard of treatment. And using a meta-analysis, that basically means that they've surveyed all of the large, well-done research articles and found which one shows the most results and shows that they have the most repeated results over periods of time. And that's why it is so important that you do follow the research because there is a lot of bad information out there, absolutely.  Now, the third thing I tell my patients on their first day of therapy is that OCD treatment is not talk therapy. It's not just talking, that it requires OCD therapy exercises and homework and lots of worksheets. I have a packet that we give our patients at the center that I own in Calabasas, California. Everyone gets a welcome manual. And in the welcome manual, it's got worksheets on identifying obsessions and compulsions. It's got mindfulness worksheets. It's got logging worksheets. And I will send you home with those to do for homework. You'll come back. Let me know what worked, what didn't work, what was helpful, what wasn't. And you will be doing a lot of this work on your own.  Now, again, as I mentioned at the beginning, if you do not have access to OCD therapy or you don't have the resources to get that, we have an online course called ERP School. It is a course specifically for people with OCD, where I walk you through the specific steps that I take my patients through. And all of those worksheets are there. They have worksheets on identifying your obsessions, identifying your compulsions, mindfulness, self-compassion worksheets, things that can remind you and prompt you in the direction of setting up a plan so that you can get moving and make the steps on your own. The fourth thing that you need to know on the first day of your therapy is that there is no such thing as bad thoughts. Let's just sit with that for a second. There is no such thing as bad thoughts. Your thoughts do not define you, nor do your behaviors, that you might have these thoughts that you think are going to really freak you out. You might have this idea, these thoughts, these intrusive, repetitive, scary thoughts, and you might think, “Well, I can't even tell Kimberley about them yet.” I will often tell my patients like there is nothing these walls haven't heard, and you probably won't shock me because I haven't been shocked in many, many, many years working as an OCD therapist. I've heard it all. I've heard the most, what people perceive as the grossest thoughts. It's a normal part of the work that we do. And your thoughts are neither good nor bad and they do not define you. And I really make that point made because, as we move forward, I want you to know that I've seen a lot of cases and that “your thoughts aren't special” in that they're not something that I would be alarmed by.  The fifth thing that I would tell my patients is that you cannot control your thoughts. And I bet you believe it because you've probably tried over and over again, and all you found is the more you try and control it, the more thoughts you have. The more you try to suppress your thoughts, the more thoughts you have. There are, as we've already discussed, OCD treatment options that will really solidify this concept. Now, the most important one is exposure and response prevention, which is the type of treatment that we use for OCD and is the type of treatment that all of those research articles I discussed before show and direct to as a really successful treatment for OCD.  Now, in addition, there are other OCD treatment options. One of those treatment options is OCD treatment with medication. Now, again, when you do that meta-analysis, we have found that a combination of CBT and ERP with medication is the most successful. Now, that doesn't mean you have to take medication, though. I'm never going to tell my patients that they have to take medication.  So we can have OCD treatment with medication. We can have OCD treatment without medication. In fact, some of my most difficult cases, the clients, for medical reasons or for personal values reasons, chose not to go on medication. You can still get better. It might make it a little more difficult. You may want to speak with your therapist, or if you're doing this alone, you might need to put in a little extra homework, have a team of support, and people who are really there holding you accountable. Absolutely. But medication is another treatment option that you may want to consider as you move through this process. Now there are also new treatments for OCD recovery. They might include acceptance and commitment therapy, mindfulness practices, self-compassion. We even have some research around dialectical behavioral therapy as other OCD treatment interventions. I will be implementing those as we go, depending on what roadblocks show up. And again, if you're doing this on your own, there are amazing resources that can also help you, and I'll share about those here in a bit. Again, as we've talked about, there is also OCD treatment online. Since COVID-19, we've done a lot of growing in terms of being able to utilize CBT via the internet, via our computers, via our smartphones. A lot of people come to us because they've looked for OCD treatment in Los Angeles, which is where we are. And even though they only live a few miles down the street, they're still doing sessions online because it's so convenient. They can do it at home between sessions with their work or between getting their kids to school. So, OCD treatment online has become a very popular way to also access treatment. And I give these to my clients as we go, because sometimes they're going to need a little extra help.  Now, as I've mentioned to you earlier in there, if you don't have access to OCD treatment, there are tons of self-led OCD courses. Again, one of the ones that we offer is ERP School. Now you can go to CBTSchool.com, or you can click the link below in the show notes, where we have all of these courses for OCD and other anxiety disorders. But there are others as well—other amazing therapists who have created similar products.  When we're really looking at treatment depending on your age, the treatment does look very similar for OCD treatment for adults and OCD treatment for children. They are very, very similar. With children, we might play more games, have more rewards, use those strategies, but to be honest with you, adults are just big kids in adult bodies. So I really believe that we want to make this as fun as we can. Have rewards. Have there be something that you're working towards. Make it fun. Make it a part of a game. I use a lot of games in treatment and a lot of ERP games because why do we want to make everything boring all the time? Why not make it a little bit fun if we can? Number seven, the main thing I'm going to tell you here, and this is really, really important, is I will not ask you to do something that you don't want to do. I have this in our welcome manual. We don't ask people to do things that go against their values, and we don't ask people to do things that I myself would not do. There are a lot of TV shows that sort of use ERP and exposure work as sort of like doing your worst, worst, worst, worst, worst case. And that's fine. But often we're not doing that. We're doing exposures, we're facing your fears so that you can get back to functioning, so you can get back to doing the things you want to do. So again, I'm not going to have you do anything you don't want to do. You're in charge. If you're taking ERP School, we do the same thing. You create your own plan. You create a hierarchy of what you want to start with, and we work our way up. And we do the same thing in therapy as well.  Now the eighth thing that I will tell you, and by then you're probably getting a little tired and overwhelmed. We might take a little tea break really quick, but I would tell you that recovery is not linear. While we do have effective treatment for OCD, it will be an up-and-down process. You'll have really good days, and you'll have some hard days. And those hard days don't mean that you're doing anything wrong. It doesn't mean that your treatment's not successful. It just means we have to take a look here and see what's going well, what's not going well, what do we need to tweak, do we need to make a pivot here. Or do we need to reassess something and maybe apply some additional tools—mindfulness tools again, self-compassion skills, some distress tolerance skills, maybe? But just remember, your recovery will not be linear, and that is okay.  Now the ninth thing I'm going to tell you is that your OCD treatment goals must be clear. You are going to get really clear on why you're here, what you want to do, why you're doing this treatment because it is hard work. Again, there's homework. I'm going to be giving you some things to do at home, and they're going to be a little bit difficult. They're going to cause you to feel some feelings that maybe you don't want to feel, some sensations you don't want to feel.  And so, really again, I will ask them, like, what are your goals for treatment? Now, some common OCD goals for OCD therapy is to reduce compulsions. “I want to be able to not be doing these compulsions for hours and hours.” Other people say, “I want to live my life according to my values. I don't want to let fear constantly be telling me what to do.” Other people will say, “I want to learn how to tolerate this discomfort and this uncertainty because every time I try and run away from it, it just gets worse. It makes it worse. And now I'm stuck in this cycle.” So it's important that you get really clear.  Sometimes people will come in and they'll say, “I've never been to Paris. I want to be able to go to Paris with my family. And so, that's the goal.” That's fine too. You could have a large goal like that, or you could have a really simple goal like, “I just want to have more space in my life to paint,” or “I don't want to feel like I'm on edge all the time, like the scariest thing is going to happen all the time.” And that's fine too.  Now, the 10th thing that you're going to need to know and need to remember is, our recovery is really dependent on how open and honest you are. As I said at the beginning, some people don't feel yet like they can trust to tell me the depth of their intrusive thoughts, and that's okay. But throughout therapy, I'm going to need you to be really honest with me and really honest with yourself, because if you're not disclosing what's going on and the thoughts you're having, we can't actually apply the skills to it. And then it puts a wrench in the success of your treatment.  So we want you to be as open, honest as you can. And I often will say to them, there is nothing I haven't heard. In fact, if you have taken ERP School already—a lot of you have—we actually play a couple of games where we play a game called One Up, which is where no matter what thought you have, you make it a little worse or little more scary. And I give some demonstrations and show like I'm not afraid to go there. I will go to the scary, yucky place just to show you that that's what I want you to do as well. Again, it doesn't have to be all serious. We're allowed to play games, and we do that in therapy as well.  Often people will ask like, how do I tell my therapist about these horrible thoughts I'm having? Like, how do I share? If you're having a specific type of thought that you feel is particularly taboo or very scary to share, or you're afraid of the consequences of sharing, what I would encourage you to do is do a very quick Google search. There are some amazing websites and articles online of your obsession. Print it out and bring it to your therapist, and say, “Hey, this is what I'm dealing with. I'm too scared or I'm too vulnerable to share. It's so horrendous in my mind, but this is what I'm going through.” And chances are, again, the therapist, if they're a trained OCD specialist, will go, “Ah, thank you for letting me know. I've treated that before. I'm good to go.” Again, if they're a newer therapist, it's still okay because they're getting the education about really common obsessions that happen a lot in our practice.  Okay. Here we go—drum roll to the last one. And I know you guys are probably already guessing what it is. It's something I say to my patients and to you guys all the time, and it's this: It's a beautiful day to do hard things.  We have been taught that life should be easy, shouldn't be scary, shouldn't be hard, and that you should be Instagram-ready all the time. But the truth is, life is hard. And today is a beautiful day to do those hard things. I have found that those who recover the fastest and the most successful over time are the ones who see discomfort as a challenge, something that they're willing to have. They'll say, “Bring it on, let's go. Bring my shoulders back. I know it's going to be here.” And they're really gentle with themselves when they have this discomfort. And I want you to really walk away feeling empowered that you too can handle some pretty uncomfortable things because you already are. So again, it's a beautiful day to do hard things.  All right, let's round it out because I know I promised you some extra things here. Now, what have we covered? We've covered the mindset shifts that you need for OCD therapy, behavioral changes that you're going to need to make. We've talked about complementary tools, the most important being self-compassion. And also, guys, you can also follow Your Anxiety Toolkit because we have over 380 episodes of tools and core concepts, and everything like that.  Now, for treatment, just so that you get an idea of what this would look like, I share with my patients what treatment looks like. So usually, once I've told them all of this, I send them home with their welcome manual, and I'll say, “The next two to three sessions, I'm going to be training you for this treatment. And a lot of that is going to involve psychoeducation, me giving you tools, giving you strategies, putting a plan together.” And again, for those of you who don't have therapy, we do exactly that in ERP School. So if you feel like you need some structure, you can go to CBTSchool.com and access ERP School. We can go through that.  Now, for those of you, again, who don't have an OCD therapist, does OCD therapy and treatment work for you too? Yes. We actually have some early research to show that self-led programs can be very successful for people with OCD and with other anxiety disorders. So, if you don't have access to therapy, you could take ERP School. You could buy some workbooks that you buy from Amazon or your local bookstore. There are a ton of workbooks out there. Shameless plug, I also wrote one called The Self-Compassion Workbook for OCD. You can get it wherever you buy books. There are also online groups. I'm a huge, huge proponent of online groups. So if there are support groups in your area, by all means, use those because just knowing other people who are struggling, what you're struggling with can be so validating and inspiring because you're seeing them do the hard thing as well.  But either way, treatment requires a lot of homework. So, as I say to patients, showing up here once a week isn't going to get you better. You're going to have to practice the skills. And if you don't have a therapist, you're going to be doing that anyway. So I want to really hope that you leave here with a sense of inspiration and hope that you can get better even if you don't have OCD therapy at this time. So there you go, guys. There are the 11 things I tell my patients on the very first session. I will usually end the session by encouraging them and, again, congratulating them for coming in and doing this work with me. Let them know I'm so excited for them.  I hope that this was helpful for you, and my hope is that you too will then go on to learn all the tools that you need in your tool belt and go on to live the life that you want to live because that's the whole mission here at Your Anxiety Toolkit.  Have a wonderful day, everybody, and I'll talk to you next week.

In this episode, I talk to OCD and anxiety advocate, Elysse Lescarbeau, about techniques typically reserved for OCD and anxiety are actually beneficial for everyone. We also discuss.. Her "Stay PUT" method of managing anxiety in the moment Our 5 strategies typically reserved for OCD/anxiety that can be helpful for all individuals Why and how ERP is absolutely necessary for OCD and anxiety recovery Elysse Lescarbeau (@ocd.or.just.me) has A LOT of lived experience with mental health issues with diagnoses. Elysse had been struggling in silence due to a lack of OCD awareness - she thought her obsessive thoughts and mental only compulsions were “just her”. A year after being hospitalized for SI, with a long overdue OCD diagnosis and treatment under her belt, she hopes to offer others the knowledge she wished she'd had - how OCD can present very differently from common media portrayals, why gold standard therapy techniques for OCD can go beyond treating acute symptoms, and how recovery and a less anxious life IS possible.  Follow her on Instagram @ocd.or.just.me and check out her free resource - the Values in Action Digital Workbook (https://stan.store/ocdorjustme/p/free-find-my-values-worksheet) - for her tried and true techniques to take value-driven action everyday, even while anxious. 

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)

In our last episode, Associate Professor of Psychology and convenor of the clinical psychology program at the University of Melbourne, Dr Brett Deacon, explained the concept of safety behaviours and how to manage them in OCD treatment. In this episode, Brett dives into the data behind safety behaviours and accommodations. He expands on how making more accommodations can impact treatment and how clinician accommodations can be as limiting as parental or familial accommodations.   Resources and links: Purchase ‘Exposure Therapy for Anxiety: Principles and Practice' here Dr Brett Deacon at the University of Melbourne Dr Brett Deacon on LinkedIn   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.

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. 

On the next Corner, host Steve Martorano welcomes Dr. Jonathan Beatty, founder of Wave Treatment Centers, to explore the advancements in treating Obsessive-Compulsive Disorder (OCD) using Transcranial Magnetic Stimulation (TMS). Their discussion sheds light on the clinical significance of these developments, offering hope and new possibilities for individuals struggling with OCD.-------------------------------The Behavioral Corner is produced in partnership with Retreat Behavioral Health -- where healing happens.

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

In this midweek special episode I chat with licensed psychologists Dr Michele Bechor and Dr Ciana Mickolus of the Neurobehavioral Institute (NBI) in Florida.  We discuss their stories, a team approach to OCD treatment, what's it like working in a big multidisciplinary team, the benefits for clients and for staff, a day in the life at NBI, and much more. Hope it helps.   Show notes: https://theocdstories.com/episode/nbi-7  The midweek special episodes which go out at the end of the month on a Wednesday are made possible by and in partnership with the Neurobehavioral Institute (NBI) in Florida. I will be interviewing different members of their clinical team on a range of topics. NBI specialise in treatment and programs for anxiety, OCD, comorbidities, and complex cases. They also offer an intensive outpatient program, and a residential program called the NBI Ranch: A supportive living experience that complements intensive treatment for Anxiety and Obsessive-Compulsive Related Disorders. To find out more about their intensive outpatient services, or the NBI ranch, as well as to read some of their free information online about OCD via their blog, click here to find out more: https://www.nbiweston.com/

This week, licensed therapists Christa Overson and Brett Cushing speak with Emily Conery, a licensed therapist at the Nystrom Hugo Clinic, who specializes in the treatment of Obsessive Compulsive Disorder- (OCD). Together, they discuss what OCD is and how to treat it. Brett and Christa talk with Emily about how OCD can sometimes be misunderstood and that it is actually an extreme form of anxiety -- from which recovery IS possible!Do you have feedback or topic requests? Email us at:podcast@nystromcounseling.comWe'd love to hear from you!Follow alongInstagramFacebookNystrom & Associates

In this episode, I'm joined by Juliet Gustafson, a therapist who specializes in OCD treatment. We focused on relationship OCD and how to bring your partner into OCD treatment. We discuss.. - an overview of relationship OCD - ways in which relationship OCD can impact your partner - ways to bring your partner into treatment - resources for your partner to help cope and feel supported during this time Juliet Gustafson is a licensed master social worker located in Michigan.  She received her bachelor's and master's degrees in social work from Wayne State University.  She has worked in child welfare, community mental health where she provided in-home trauma-focused therapy to children and families, a group practice where she worked with adolescents and adults with anxiety, OCD, PTSD, and chronic pain, and she recently opened a private practice dedicated to treatment of OCD, OC-Spectrum Disorders, and anxiety! Juliet has received advanced training and supervision in OCD treatments such as ERP, CBT, ACT, and Habit Reversal Training. In addition to her training, Juliet has lived with OCD since she was a young child. Juliet is a proud member of the LGBTQ+ community and a reality TV enthusiast,  You can find her on instagram at https://z-p3.www.instagram.com/ocd_therapist_juliet/  Head to my website at ⁠www.jennaoverbaughlpc.com⁠ to sign up for my free e-mail newsletter, grab your free "Imagine Your Recovered Life" PDF, and download your free “5 Must Know Strategies for Managing Anxiety and Intrusive Thoughts” video + access expertly crafted masterclasses just for you.  Course and more coming soon! Remember: this podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as mental health or medical advice. The information and education provided here is not intended or implied to supplement or replace professional advice of your own professional mental health or medical treatment, advice, and/or diagnosis. Always check with your own physician or medical or mental health professional before trying or implementing any information read here. Copyright 2023 Jenna Overbaugh, LLC

OCD sufferers and advocates say it's nearly impossible to get treatment for the disorder in the public sector unless there's 'blood on the floor'. For one mother it took eight months and calling the police for her son to be seen, and another says she had to sell her possessions to pay for a private psychologist for her kids. Luka Forman has more.

In this episode, we delve into the potential outcomes after the first SSRI trial for OCD. With SSRIs being a first-line treatment, understanding response patterns is crucial. What course of action should be taken when patients exhibit significant symptom improvement, partial relief, or no response? Discover when to discontinue, switch, or augment treatment. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Algorithm for the Pharmacotherapy of Obsessive-Compulsive Disorder Node 2: Potential Outcomes After the First Trial

In this episode, we share insights into the comorbidities and other considerations that can impact the treatment algorithm for OCD. From the risks of medication use in pregnant women, to the challenges of treating OCD in patients with comorbid bipolar disorder, this episode provides valuable clinical pearls for clinicians looking to improve their approach to treating OCD. Faculty: David Osser, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: Algorithm for the Pharmacotherapy of Obsessive-Compulsive Disorder OCD Comorbidities and Other Circumstances: Variations in the Treatment Algorithm

When we are raising kids with OCD it is important that we fully understand the therapeutic approaches our kids are being taught in therapy. Ultimately we will want our kids to be able to utilize those tools throughout their life.The use of imaginal scripts can be an effective tool in their OCD toolbox. In this episode of the AT Parenting Survival Podcast I explore what imaginal scripts are, how to write an effective one and the most common pitfalls that make them less effective.Click here to listen.Want some extra support?

In this midweek special episode I chat with Dr Jonathan Hoffman and Dr Katia Moritz of the Neurobehavioral Institute (NBI) in Florida.  In this episode we discuss what goes on behind the scenes of an OCD treatment centre, how the NBI team work together, what an average day looks like, how the clinic operates, and much more. Hope it helps.   Show notes: https://theocdstories.com/episode/nbi-3 The midweek special episodes which go out at the end of the month on a Wednesday are made possible by and in partnership with the Neurobehavioral Institute (NBI) in Florida. I will be interviewing different members of their clinical team on a range of topics. NBI specialise in treatment and programs for anxiety, OCD, comorbidities, and complex cases. They also offer an intensive outpatient program, and a residential program called the NBI Ranch: A supportive living experience that complements intensive treatment for Anxiety and Obsessive-Compulsive Related Disorders. To find out more about their intensive outpatient services, or the NBI ranch, as well as to read some of their free information online about OCD via their blog, click here to find out more: https://www.nbiweston.com/

Sam Greenblatt is a psychologist who specializes in the treatment of OCD. He accidentally started on his path by realizing he had OCD himself. Sam loves working with those who struggle with OCD, especially those who have been treatment-resistant.   In this episode, we talk about: ◾️The new versus the old model of exposure and response prevention therapy. ◾️Changing our relationship with our thoughts for longevity. ◾️Helpful helplessness.   Find Sam here: drsamgreenblatt.com sam@drsamgreenblatt.com @ocd.is.treatable   Find Zach here: zachwesterbeck.com @zach_westerbeck

Dealing with OCD isn't like dealing with a cold. It isn't cured and then we move on. It can help to shift our perspective to focus on how to live and, more importantly, thrive with OCD. In this week's AT Parenting Survival Podcast I talk about how to shift our kids from a victim to an empowerment mentality (and us as well)! We also dive into how to create a lifestyle that acknowledges and works on OCD organically within the home environment.To learn about the OCD Workshop series click here.Youtube video on How OCD is Like an Octopus.****This podcast episode is sponsored by NOCD. NOCD provides online OCD therapy in the US, UK, Australia and Canada. To schedule your free 15 minute consultation to see if NOCD is a right fit for you and your child, go tohttps://go.treatmyocd.com/at_parentingThis podcast is for informational purposes only and should not be used to replace the guidance of a qualified professional.To join the AT Parenting Community go to: www.ATparentingcommunity.comVisit my website at www.ATparentingSurvival.comSign up for my weekly email newsletter:https://pages.convertkit.com/740ba8cd83/92109b7172Take one of my online classes:To view the entire online school library, go to:http://www.ATparentingSurvivalSchool.comClasses include:How to Crush Social Anxietyhttp://www.ATparentingsurvivalschool.com/p/crush-social-anxietyParenting Kids with OCD http://www.ATparentingsurvivalschool.com/p/child-ocdCrush Moral OCD in Kidshttp://www.ATparentingsurvivalschool.com/p/moral-ocd Hosted on Acast. See acast.com/privacy for more information.

Obsessive compulsive disorder (OCD) is said to be one of the most challenging mental health conditions to treat because it is treatment resistant.To better understand what's going on with kids struggling with OCD, we must first know how to provide them help, and how to get the best treatment. I'm here to help you dispel common myths and misconceptions about OCD.Obsessive compulsive disorder is often misdiagnosed The first and common reason as to why obsessive compulsive disorder is treatment resistant is misdiagnosis. Obviously, if your kid's condition is misdiagnosed, they won't be able to get the right treatment. In line with this, having the wrong treatment also causes the resistance of your kid to treatments.Oftentimes, people with OCD opt for cognitive behavioral therapy or talk therapy. However, the best recommendation for treatment which has been proven to be effective is Exposure and Response Prevention which will be discussed in another episode. The more we form a habit, the more likely it is to stay.The first thing we need to do is to make sure that we have a proper diagnosis for our kids. Like what we've said, proper diagnosis is important in getting the right treatment.When we don't get that right diagnosis, we end up feeding the barking dog. Parents inadvertently accommodate their kids' constant questioning. But we have to remember that the more we form a habit, the more likely it is to stay. It's similar to your sleeping patterns becoming a habit. We get used to the things we usually do. In this case, if we keep accommodating our kids, their actions will just get reinforced every time. With OCD, we have something called negative reinforcement. It's the same thing as the rich get richer and the poor get poorer. The more we do something, the more likely it will happen. Conversely, the less we do it, the less likely it's going to happen. The more you read, the better you get rid of your OCD ways. The same way that the more we engage in the obsessive thinking, intrusive thoughts, compulsions, and rituals, the more likely it's going to happen. If you can visualize you have an intrusive thought, what happens?Intrusive thoughts make it difficult for people with OCD to function in their daily lives. They can visualize these thoughts. Case in point, a kid keeps on asking his mom if it's going to rain because he's worried he'll be struck by lightning. That's what an intrusive thought is like for kids.Once the kid's mother confirms that it's going to rain, the kid does everything in his power to avoid the lightning strike. There's this high level anxiety prior to the confirmation of his mom. Then, the anxiety shoots down once the kid visualizes that intrusive thought.What happens every time the mother confirms the kid's question, the baseline goes up. And so, there's a need for more reinforcement for the baseline to go down to the point of extinguishment or until it gets into a normal range. Exposure and response prevention is the key.Reinforcement requires persistence to unlearn old habits and learn new healthy habits. This is best done through exposure response prevention. When you're able to do it, what happens is that the brain has this recognition of whether or not something is going to happen or not. And so, the brain begins to relax once it's reassured. As we've previously discussed in other episodes, the best way to calm the brain is through neurofeedback or PEMF.Most people waste so much time on medication, but then there's no progress with their condition. I highly recommend the exposure response prevention as it is the most effective treatment out there. But we have to always take into consideration proper diagnosis to ensure proper treatment because once your...

OCD TREATMENT OPTIONS  Today, we have Elizabeth McIngvale and we are talking all about different OCD treatment options.  Elizabeth (Liz) McIngvale is the Director of the McLean OCDI Houston. She has an active clinical and research and leadership role there. McLean OCDI is a treatment center for people with OCD and she talks extensively about different OCD treatment options in this episode. She's the perfect one to talk to in this episode about knowing when you need a higher level of care, particularly related to OCD.  In this episode, we walk through the different levels of care from self-help all the way through to inpatient facilities. Elizabeth spoke so beautifully about how to know when you're ready for the next step of care, what to look out for, what you should be interested in, and questions you should ask. This is such an important episode. I'm actually blown away that I haven't addressed it yet, but I'm so grateful we got to talk about it today. Elizabeth McIngvale is also a lecturer at Harvard Medical School. She treats obsessive-compulsive disorders, anxiety disorders. She's got a special interest in mental health stigma and access to mental health care. It was actually such an educational episode and I felt like it actually made me a better supervisor to my staff and a better educator as well. You're going to love this episode if you're really wanting to understand and take the stigma out of increasing your care if that's something that you need.  That being said, I'm going to let you listen to Elizabeth's amazing words, and I hope you enjoy this episode just as much as I did. Have a great day, everybody. Kimberley Quinlan:  Well, welcome, Liz McIngvale. I'm so excited to have you on for two reasons. Number one, I really want to talk about giving people information about OCD treatment options, but I also understand that you can also bring in a personal experience here. Anytime, someone can share their personal experience, just lights me up. So thank you for being here. Elizabeth McIngvale: Thank you for having me. I'm so excited to be here and yeah, I hope that both my personal but also professional kind of background in this arena might help guide. Some individuals who are kind of wondering what treatment do they need right now and and what does treatment for them look like Kimberley Quinlan: Wonderful. Do you want to share a little bit about your history with OCD and your story as much as you want to share? Elizabeth McIngvale: For sure. Yeah, I'll try to not take up too much time but you know, basically, I grew up here in Houston, Texas, where I'm from, and was diagnosed with OCD right around 12. I started showing lots of different symptoms prior on and off, but nothing that was disruptive nothing. That really would have warranted a diagnosis. I would do things like track the weather, or every time I read a book, I would start at page one because I didn't like the feeling if I picked up in between and things like that… Elizabeth McIngvale: but nothing was really out of the norm normal in the sense that I was still doing okay. And academically you know, Relationship-wise and I was functioning well until I wasn't, you know, until my intrusive thoughts, got louder and the disruption became more and more severe. Here in Houston, we have the largest medical center in the world and we are known for our healthcare and so you would think access to good care would be really accessible, but unfortunately, it just wasn't and granted, this was a long time ago, almost 20 years ago but we really started searching for treatment here in Houston and, you know, I was lucky enough that pretty early on I got  a diagnosis and for most of us in the OCD world, we know that that's rare for it to happen that soon. So that was great. That was a huge blessing for me, however we couldn't find good treatment. Every provider would say things like we've never seen a case like this. We don't know how to treat this and there's not help available. You guys should assume that Liz live in a mental health hospital, the rest of her life. And so my parents were just really struggling with What do I do and How do I help my child. And so they kept researching and kept trying to figure it out and actually they got lucky enough that they stumbled across the newspaper article and in that newspaper article talked about an inpatient treatment center at the time which was called the Meninger Clinic and how they had an OCD program. There was a little bitty excerpt and immediately my dad, called my mom, they ended up calling Meninger and learning more and I ended up going to the Meninger clinic when I was 15. I went three days after my 15th birthday, I'll never forget and I talk about this a lot because my treatment stay at Meninger was the first step to my life being changed. It was the first step to me getting appropriate treatment. It didn't cure me, you know, I want to be honest about that. I think sometimes we think, okay, we go do that. We either like get cured or We don't. And, for those of us who live with OCD, we understand that management of our illnesses different than a cure, right? It was a lot of work, but it was also the beginning of a journey where I had to learn to do my own treatment and I had to learn to become my own therapist. And as much as the treatment was super successful for me, I was there for three months and my life changed. I went from being suicidal being hopeless, and not being able to function at all six to eight hour showers and completely, homebound completely riddled by rituals, to being a kid who could fully function. I was able to go back to school. Take five minute showers, do things I never thought I could do again. At the same time, I didn't realize that I had to still take ownership of my illness, I think I thought Oh like the ownership is, I did treatment and that's what it meant. Not that I needed to keep engaging in treatment. And I talk about that because I did relapse later, I ended up going… I ended up doing some outpatient in between and then back to impatient again. And for me, I had to kind of learn what level of care works for me? What does that look like? And how do I manage my illness? And to this day, I still go to outpatient therapy. It's still a big part of my life. Am I actively doing OCD work every week? No I'm doing other stuff right? Family system and boundary setting and things that are important in my life that are tough. But it's been a journey even for myself personally, to know what level of care do I need and at what point. And I think what's really interesting is that when I was 15 I would have told you I'm not going to treatment. My parents had to take me involuntarily and it was a pretty awful day the day they took me to treatment. And, you know, I say this because a lot of times when people hear my story they think Oh, well, y'all did everything right and like, it was just this, like, beautiful path to recovery. That's like, no. It was really messy and it is messy and that's okay. There is no perfect way for us to get treatment in a way that can change our life. And so I really want us to think more about the outcome and what treatment might mean to us versus being super close-minded about the process,… 00:05:00 Kimberley Quinlan:  Right. Elizabeth McIngvale: because I think a lot of times we have so much anxiety around I want to go to intensive treatment. I don't want to leave my life. I don't want to put things on hold I don't want to go to this hospital like setting if that's where I'm going and really, it's not about that. It's about what might it give us in the long run,  right? Kimberley Quinlan: Right. Elizabeth McIngvale: And just that chance at freedom that maybe outpatient care can no longer do. Kimberley Quinlan: Right? So for the folks who are new here and if just new to us let's sort of just because I feel like I really want to cover this as as much as we can. When you went to Meninger what was the correct OCD treatment in which you received like was it,… Elizabeth McIngvale: Yeah. Totally. Kimberley Quinlan: can you kind of give us a little bit of a view of what that looks like? Elizabeth McIngvale: Yeah. So before Meninger I had gone to outpatient providers and… Elizabeth McIngvale: I remember playing the  board game life with a therapist once and I crossed the bridge and I remember her saying Liz, how does that feel? And I was like Well I don't know. Like How does it feel to you? Like what? I remember going to my mom and I was young, right? I was adolescent. I said Mom like this isn't working like we're playing the  board game life, I'm not getting better, like this is not therapy and my mom was just like, well, I don't know, she didn't know, she didn't know what she should be doing or not. And so I got to Meninger and I remember there were three things that really put things in perspective for me upon arriving. The first was I met someone else like myself. I met a young girl named Amy who struggled with an eating disorder and OCD and I remember I was crying. I was vomiting. I was so sick. That was so anxious about being there and all she said to me is it's okay. I cried too. And it was the first time in my life. I met someone else like me. And for those of you who know, you know, the the value I believe advocacy has in the OCD world is because we need to feel part of a community, even when we're struggling, And so I got that but it was the first time in my life. I remember, I sat down with my therapists in this conference room and you know, I didn't believe in therapy, candidly. I had gotten really bad therapy for a long time and I just continued to get worse. So I didn't think therapy could help me. I didn't think I could get better and I really was starting to accept that I would just live a life with bad OCD forever and then I would just live in this basically, in the state of misery. And I remember I sat down and for the first time My provider starts asking me all these questions, and he doesn't seem scared. He's like, Oh yeah, no problem. Okay, tell me about this. Tell me about that. And there was this like, not egotistical like this, very humble confidence that. Oh, yeah. Like I know how to treat you, and I was just like, what? And I remember, He said, Yeah, we're gonna do Exposure & Response Prevention (ERP)  I've done this before. You're not the worst case. I've seen, you know, I know how to treat this. I've done all in, It was the first time I realized, Oh my gosh, someone actually knows how to help me. Elizabeth McIngvale:  And so my entire treatment was based on exposure and response prevention and you know I think ERPs come a long way as somebody who now works in this field and runs a program doing, you know, runs at the same program. We don't do ERP the same way we did when I did it. Right. When I did ERP, it was an older school model. It was a very habituation model. I remember holding contaminated sweaters and just sitting there for an hour or two, right? We don't do that anymore, but there's something about the basis, right? The core of the treatment hasn't changed and it's it's what changed my life and it's it's really important that I will say, I can't imagine what it had been like if I would have gone to an impatient or a residential setting that wasn't OCD specific and that wasn't doing evidence-based care. I would have believed in treatment even last and I would have been even more helpless. Kimberley Quinlan: Yeah, there is so much beauty to being with someone who's like, Oh yeah, I've had a worst case than you like. I've had so many clients say like that is the best thing anyone has ever said to me. Elizabeth McIngvale: Yeah. Yeah. Like okay not like Oh like I mean literally providers would say to me in Houston like we've never seen a case of severe. We don't know how to help you and it's like, Well what? So like What do I do? Kimberley Quinlan: Right. Elizabeth McIngvale: You know, Can you try and they're like, we don't know, we don't know how to try. Kimberley Quinlan: Right, right? I'm so grateful that you had that experience. This amazing. So, Let's sort of fast forward to now. You of course are an OCD specialist, we know this an amazing one. I first want to look at the term outpatient For some people, they don't know what that means. So what does OCD outpatient treatment look like? Elizabeth McIngvale: Yeah. OCD TREATMENT ONLINE Kimberley Quinlan: And would you also speak to now since covid? We also have like an online version of that so you want to elaborate on OCD treatment online?  Elizabeth McIngvale: Yeah, there's so many. So actually, let's have you start first by describing self-help because I think it's. So I think it's really important When we think about levels of care to think about the continuum, right? I look at it as like,… Kimberley Quinlan: Right. Yep. OCD SELF HELP Elizabeth McIngvale: there's self-help options, there's outpatient options and then there's intensive option. Elizabeth McIngvale:  Yeah. 00:10:00 Kimberley Quinlan: Beautiful, yeah. Like thats the epitome of me, like even with this podcast, right? How can we provide free or not one one one treat metn for people or in the case of CBT School, how can we  help you to do it on your own?  RIght, so there are sort of self lead courses  or we have the self-compassion workbook for OCD, which is ultimately me as a clinician saying, If I was with a client, this is the steps I would take. So, that's the first step and we offer that all the time. And and I think I don't really actually think we've got that much research on it yet. I think we're in the early stages of that, but that is being really helpful for people who sort of want to become educated, want to understand what's going on and they feel motivated and able to do that on their own. So that's that's the self-help model, then what would we use? Elizabeth McIngvale: Well in one of the things, I want to back up for a second to just and I know you've done so many podcasts on this but for those who've skipped over this one, right, what's really most important is that you're engaging in evidence-based treatment and what we mean by that is that we want to make sure you're getting access to treatment that's been researched and that we know works for OCD. And so there's self-help that is not evidence-based for OCD and they're self-help that is evidence-based for OCD. And one of the beauties of self-help is that you don't have to look at it as a soul intervention, right? Do it while you can, you can do these workbooks, you can do these self-help, you know, in different modalities while you're going to an outpatient therapist. And then one of the things that's really beautiful is that if you live in an area where there isn't OCD providers or OCD specialists your clinicians can actually also use it as a guiding tool in treatment, right? And so again it's allows there to be this rubric of good treatment, all right? This kind of like guide book to,… Kimberley Quinlan: Yeah. Elizabeth McIngvale: you know, or handbook to say. And so Always think of that as kind of our least, invasive level of care and… Kimberley Quinlan:  Right. Elizabeth McIngvale: it's a level of care. That's my goal that everyone ends up at right that you're able to get to a place… Kimberley Quinlan:  Yeah. Elizabeth McIngvale: where like, yes, you're still actively engaged in a treatment community whether that's through self-help workbooks or podcasts or different ways that you connect because that's really helpful, but that you may not need one-to-one anymore, right? I go to one-to-one therapy because it's important for my soul. I don't need it and… Kimberley Quinlan:  Right. Elizabeth McIngvale: that's very different, right? I'm at a place where I can engage the tools inependently, using some resources with and when I need them. And so then the next level is outpatient therapy and traditional outpatient therapy would be oftentimes once a week 45 to 50 minutes session with an OCD specialist in person, one to one in the past three years, that's totally shifted right actually, I would say more commonly it's virtual than it is in person and you know, there's pros and cons. I think most of us Most of us still think in person is better,  right? That just if it's feasible, But from a scheduling perspective and feasibilities perspective online is so much easier, right? So most of us, myself included, I do my therapy online because it's, I don't have to schedule the time to drive and get to my clinician and drive back. And so, that's really important. The second piece that's really important to think about is, I would rather you 100 times over be doing virtual sessions with someone who specializes in OCD and knows how to treat OCD then do in person with someone who doesn't. Elizabeth McIngvale: Right, so really, when we think about therapy and interventions, we want to make sure and this is important because a lot of times people will say, Oh well I've tried out patient therapy, It doesn't work for me but they haven't necessarily tried it with an OCD specialist and they haven't been appropriate evidence-based treatment and really we want you to do that first before you start thinking about next level of care or you know some people will want to do like a medication trial and it's like Well you don't get in the research study in a trial if we haven't tried evidence based stuff first, right? So that's really important. With that being said, outpatient can be a continuum, Some outpatient providers can offer two to three sessions a week for 45 minutes, you know? So they can do kind of what we would call like intensive outpatient and that they may make in their own program, but traditionally most clinicians who carry an outpatient case. Load would see someone once a week for 45 minutes session. Kimberley Quinlan: Yeah and I think that's for our center as well once maybe twice if there's more of a crisis but that's the level of care that we that's the kind of clients that we have and that's the level of care that we do provide. So I think and I will say going back to your online is quite a few of the people who take ERP school have therapists, right? It's like 55% of the people who take ERP School are therapist. So therapists are, you know, even though that might be their specialty, Let's say they're the only person in their neighborhood. That is what they're doing, right? They're just doing the best, they can learning whatever skills they can. So that's very positive in my mind. Elizabeth McIngvale: That's right. Yeah, and want people to have a good sound background in ERP but have to mean that they only treat OCD,… Kimberley Quinlan:  Right. Elizabeth McIngvale: you know, and I think it's important that you can get really great progress right on an outpatient basis with someone who's knowledgeable and ERP. If you are at a place where outpatient level of care is warranted and important to think about, 00:15:00 Kimberley Quinlan:  Right, and that brings me to my next question, how would someone know if they needed a higher level of care for OCD? What would be some symptoms or signs that would be showing up for them? Elizabeth McIngvale: And so the first thing I want you to think about is, Are you seeing somebody who does evidence-based care and are you not getting better, right? That's really the first like thing we need to look at is, Are you going to therapy and have you given in a good therapeutic dose, right? So we're talking, you know, at least a couple months. You don't expect that in two sessions, right? We're like better. Because often it may get worse than better. But at least, you know, maybe a couple weeks to a month or two. Are you on your own saying, I'm not seeing the results that I want, right? That this is, this is not getting me where I want to be. The second question is what level of functioning has your OCD impacted? Elizabeth McIngvale: Traditionally most of our patients in residential care are not working full-time. So their OCD is really impacting their functioning on a level that's disruptive so whether that's either their family life or their job or their school or their career, right? Something is pretty significantly disrupted from their OCD. That once a week may not be enough, right? It again the level of disruption is a little bit too high and then the third thing to really think about is what your provider telling you A good OCD clinician should not be trying to make some sort of a program for you that they don't typically do to keep you on their caseload. Kimberley Quinlan: Right. OCD INTENSIVE TREATMENT Elizabeth McIngvale: They should willing to say to you, You know I think I think you need more right now. And this is what more might look like. And the reality is that you're going to get to go back to them, right? As long as they're doing good ERP and evidence based care, right? You're gonna be encouragedto go back to that outpatient provider but it's about stepping up the level of intensity, right? If we have a medical diagnosis and we're going to our doctor but it starts to warrant the level of hospitalization or certain you know more intensive treatment, we don't want our outpatient doctor to keep seeing us in their private practice, right? We want them to send us to the hospital so that it can get managed and we can get more intensive treatment until we can return back to an outpatient level of management. We cannot treat the brain differently. Elizabeth McIngvale: You know, and I hear people all the time. Well Liz, you know, I don't really want to go to treatment for four six weeks and my answer is like, well, what's 4 6? 12 18. However, many weeks you're at a treatment center if it gives you the rest of your life. Kimberley Quinlan: Right. Elizabeth McIngvale: Right? When we are talking about meeting this level of care, the disruption is not minimal the disruption is significant, right? We know that for patients with OCD, OCD impacts all aspects of your quality of life, right? All facets of it. I'm looking at our data yesterday and all like our 2022 outcomes data. We see significant statistically, significant decrease in OCD scores in phq-9. Kimberley Quinlan: Right. Elizabeth McIngvale: But then also in disability scores, right? Because we want you to be able to get back to functioning and get back to the life, you love, or you deserve, or you're excited about that OCD is taking away from you and so, I always want, I always want you to think about that and often with that means is that you typically can't do the homework, you're being assigned,… Kimberley Quinlan:  Yeah. Elizabeth McIngvale: you know, being assigned homework, and you're trying to do it, you're trying to engage in it, but you're struggling and you find that you're you're not able to do that homework independently. And so often times patients in our level of care, need extra support. They need support in the evenings. They need support outside of their behavioral therapy sessions to be able to do this ERP They need extra coaching, they need extra support. They need extra motivation. Kimberley Quinlan: Right. And and recently, we had Micah Howe on the podcast. I was sharing with you before and he was really saying… He said, I went to inpatient thinking that it would be like a new kind of therapy and he's like, it was actually good to see, it's the same therapy, but more, right? Like just so much more. Elizabeth McIngvale:  That's right. Yeah, if you're with a good therapist, right? It's same, if you're with someone who's doing evidence-based care, it's the same therapy but more and maybe maybe it's implemented a little bit differently, right? I do believe that we use some different language. We try to get things to stick in different ways, right? That sort of thing, but the model of treatment shouldn't change. OCD INPATIENT TREATMENT  Kimberley Quinlan: Okay, so this is all beautiful and I think it all of those points that you made are so important. The homework piece the therapist feeling like that's what they're recommendation is. What would be the next step up from outpatient? OCD treatment, in your opinion? Elizabeth McIngvale: Yeah. So you know I can't speak for all the programs but what I can tell you is that here at the OCD Institute in Houston, Right? Houston Ocdi. We really focus on a super detailed admission process. And so what I mean by that is Kim,… 00:20:00 Elizabeth McIngvale: if you call tomorrow and said Hey I have sever OCD, I need to come to your program. We don't say great, here's our next opening,  that's not how it works at all. So for us we require a provider referral form a family referral form. You have to complete intake forms and then we do a one hour zoom session with you And during that zoom session we want to gather information. We want to understand your current symptoms. We want to make sure two things A: You're a good fit for our program and B: that we think this level of cares appropriate for you, you know, just because sometimes people have really bad OCD but they're actually not right yet for this level here. I run my program with this super strong whatever we want to call it…but deep rooted ethical means because it's happened to me in different ways and I'll never do it is I want to make sure that if someone is coming here and using certain resources that aren't you know, They run out. I want to make sure they're having the best chance of Elizabeth McIngvale:  Managing their symptoms being able to return and live return to their life or live their life. And so, what I mean by that is that I don't take a patient if they want to come here, but we don't think they're good fit and ethically, I'm never gonna do that, right? I want you to get the right treatment and go to the right providers and the same thing happens when you come here. I think a lot of times people think, Oh, if I go to intensive treatment, I just, you know, they're gonna take my money and hopefully I get better. Absolutely not. You should run from a program that you feel like that programs should be reassessing every week. We have team meeting every day, we have rounds and we're talking about, Is this the right fit? Are we helping move the needle? Is the patient getting better? And so just because you start, somewhere, doesn't always mean you're gonna end somewhere. Sometimes we learn a lot about a patient. And example might be You come here with strong with with really high level OCD. But as you start doing intensive, work we realize. Wow you you're really struggling with emotion regulation and we actually think you need to go get some DBT work first before you're going to be able to effectively engage in ERP. And so we may encourage a patient to discharge,… Elizabeth McIngvale: go do DBT and come back to us so that there's a chance at us being successful. I never want to patient to stay in my level of care and not be successful because it wasn't the right time or they needed to do something else first because then guess what they think treatment doesn't work for them and they think they can't get better when that's not the case. I talked about this with John Abramowitz the other day on a webinar with Chris Johnson and then we were talking about ERP and I said Guys for all intents and purposes there's years if not decades a decade in my life where I could have said to you ERP doesn't work for me. But it's not that ERP didn't work for me. Kimberley Quinlan: Mmm. Elizabeth McIngvale: It's that I wasn't accepting ERP and I wasn't engaging in ERP. I was doing it with one foot in one foot out. And the good news with intensive treatment is, we're going to try to help you get both feet in, right? We're gonna try to increase your motivation, increase your willingness, and we can support you 24 hours a day in that process, which is what outpatient therapy cannot do. An outpatient therapist does not have the capacity to offer that level of support… Elizabeth McIngvale: where we can and we do. At the same time, If we're trying and you're not able to do that right now, we're not going to keep trying the same thing. We're not gonna keep saying Well let's just keep doing ERP because guess what ERP isn't gonna work for you right now, but it's not that ERP doesn't work. It's because we need to get you ready to do ERP even at an intensive level. And so we should be thinking about that as well. And so my point is that it's not a one size fits all model. And if you're looking for intensive or residential programs, be cautious of that, be cautious of programs that, you know, require you to stay a certain amount of time and take all your money up front and they're not going to, you know, customize a plan, you know, that sort of thing. Kimberley Quinlan: Mmm. I love that. I love that. So, just for the sake of people understanding and I actually will even admit, like, I really want to know this too because I've only ever been an outpatient provider. I've never been an inpatient or a residential provider. So could you share Maybe the differences between OCD intensive, outpatient therapy, right? With OCD inpatient treatment or residential treatment. What, what would the day look like? And how would that be different for the person with OCD? Elizabeth McIngvale: Yeah, it's a great question and let's actually walk through. There's a couple levels of care, so there's IOP, which is intensive outpatient, which is often three to five hours a day. Three to five days a week. There's PHP, which is partial hospitalization, which is often five days a week about eight hours a day. And then there's residential level of care, which is 24 hours, a day, 7 days a week. And then there's inpatient level of care, which is also 24 hours a day, seven days a week, but impatient is a little bit different than like what we have here at the Houston OCDI where we're residential. Inpatient can take patients with a higher level of acuity. So impatient is often a locked unit. That's a hospital setting. So they may be able to take patients that are active safety risk, you know, harm of hurting themselves that sort of thing, where residential program like ours, we don't, we don't accept those patients because we can't maintain that level of acuity for them. We are not a facility that can help keep patients safe. And what I mean by that is that while our program operates 24 hours a day. We are a non-locked unit. We have a full kitchen, we've got washer dryers, we get for all intents and purposes, like You're living in a beautiful residential home and you have access to knives, you can leave whenever you want. You can go off site, you can go to the Astros game if you're here in Houston. And we want you to do that. Actually, we want you to start to reintegrate into life, while you're in treatment with us. 00:25:00 Elizabeth McIngvale: And so, the reality is that, we need patients to be at a certain level of acuity right? So they have to be safe, and they have to not be a risk or harm to themselves for us to feel comfortable that they can engage in our level of care safely. And so, the difference between let's say IOP is that often times, we're talking about three to five hours a day, three days a week and so you're doing intensive sessions together, right? Imagine you're going to your therapist and for three hours a day, you're doing some, you know, individual or even group stuff, but you're working together, you're doing exposures and you're getting three hours of support versus 45 minutes. Elizabeth McIngvale: Residential however, is 24 hours a day. And so, for our residential patients, there's programming from 8:45 to 4 pm Monday through Friday, 8:45 to 3 pm on weekends. But there's residential counselors here 24 hours a day, which means that when we do outings with our patients, Wednesday and Saturday night our RCs are going with you. They're encouraging you. They're helping you. They're supporting you. Because for all all of our patients actually with OCD, there's exposures built into outings you know, to going off, site to going and doing enjoyable things. And so you have that support 24 hours. If you need support in the shower, you have that support. If you need support cooking a meal, you have that support doing your laundry, you have that support in a residential setting. So really, if you need extra support around activities of daily living, we want you to be thinking about a residential level of care, compared to more of an outpatient level of care. Even if it's intensive outpatient or PHP, you're gonna go home in the evenings and you're gonna be expected to be able to engage in those activities on your own. Kimberley Quinlan: Right. Right. So just because I'm thinking of the listeners and I'm wondering if they're wondering, Does that mean that when they come into your Houston residential program that, let's say, if they're someone who showers for, let's say, two or three hours, that you're immediately, your therapist on staff are going to be cutting them dance for like down right away. Or What does that look like? Is it gradual? Like How would that like, That's just an example… Elizabeth McIngvale: Oh yeah. Kimberley Quinlan: But what would that look like in the residential format? Elizabeth McIngvale:  It's a great question, right? So I can tell you up front, if someone is coming with contamination OCD and they have, Let's just say a two to three hour shower. My goal is definitely gonna be that we're cutting that down, right? And the goal is that you're not going to be engaging in that long of a shower, by the time you leave and that's not your goal, right? Or you wouldn't be coming, but everything is done slowly and systematically and it's done effectively. So, what I mean by that is that we're not gonna push you to do exposures, if you can't engage in response prevention yet. We know, that's not useful. And so, what you would expect really weeks one and two are getting to know our model. You're starting to, you know, engage in readings and videos. And, you know, you have some small exposures. We're starting to do and you're building trust and repor, but you're starting where you want to start. Some of our patients might show up with the two-hour shower, but that's actually not their most distressing compulsion, something else is and that's what they want to work on first and that's where we're gonna meet them, right? We're not gonna start with a place you don't want to start and so we slowly work up to things and we get there together and we do like monitors in the shower and in our staff room so that we can have coached showers. So we might say things. Like If you set a goal of you know I want to be done with shampooing my hair within a five minute period or this, right? We're telling you the time we're communicating with you throughout we're asking you if you need a different level of support, we're talking to you about the amount of supplies you take into the shower prior. So we're doing a lot of planning, a lot of prepping. But I have a lot of rules. For exposures as an OCD clinician and certainly as the program director here. Number one is exposure should never be a surprise? We never throw exposures on someone, right? We talk about it with you. We're all on board. It's not an unplanned exposure by just, you know, say Hey today you're doing this or I just purposely contaminate you. The second is exposures should be agreed upon mutually right? You should be wanting to do it. You should be agreeing to do it. It shouldn't be something that I think makes sense. It should be what you think makes sense. And of course the last is that it should always be something I'm willing to do, right? I'm never ask someone to do an exposure that I'm not willing to do and so that doesn't shift in the residential process, right? Yes. In a residential program, I might be able to push patients a little bit more because I, I know they're gonna have support. I know that we can help them or you're with four hours of activity or people blocks a day compared to you know, 20 minutes within my 45 minute outpatient session. So sure we may be able to push a little bit more or a vote higher levels of distress when we're doing er, 00:30:00 Elizabeth McIngvale:  Than what would be comfortable with on an outpatient level but across the board motivation. Willingness that's on the patient, not on us, and it shouldn't be Kimberley Quinlan: And I'm just curious because I don't, this is so wonderful and thank you for sharing all that. Because I think that's true for outpatient and… Elizabeth McIngvale:  forced, or Kimberley Quinlan: for residential, but I think is so beautiful in that setting and I'm mainly just curious because I haven't been able to visit your center is,… Elizabeth McIngvale:  Yes. Kimberley Quinlan: are they as everyone bunked in rooms together? Like, What does that look like? I know that in and of itself may be scary for people going in, right? Like, Do I have to sleep with somebody because I have compulsions around sleep and I'm afraid I won't sleep like, so, what does that look like? Elizabeth McIngvale: I know it's a great question and it's it's interesting because when I so I actually went to the Meninger clinic when I went impatient at 15 and it was a locked unit, it was a much, lover, level higher, level of acuity. And so it was this like, sterile hospital, like setting, you know, and I remember feeling super upset and anxious and away from my home and One of the things that I don't love about those sort of settings for OCD treatment perspective, is that like, we had a housekeeper there, for example, like there was an access to a washer dryer to a kitchen. So like meals were prepared for you and what laundry was done. And while that's fine or good, actually, for some of us with OCD. It's not good for OCD, right? Because we want patients to actually practice those skills. And so, However, before I jump into what our programs like I do want to say, I still got better. Elizabeth McIngvale: And I will tell you that, if the cost is being in an uncomfortable, sterile hospital setting, but it was me getting my life back. I do it all over again and so I really want us to think about that. Kimberley Quinlan: That's really interesting. Elizabeth McIngvale: You know that I think sometimes we we get so hung up on like, am I gonna be comfortable? What does it look like? What if I have a roommate and at the end of the day, you're getting your life back? So those sort of things are not what's more important, that should not override if it's an OCD specialty program, if you're going to be with other patients with anxiety or OCD, that's more important to me. I want When you're, if you're looking for a higher level of care, you need to be asking questions, like Are all the patients Patients with anxiety OCD are related disorders, is the treatment program specific to that, right? You don't want to be at a program with, you know, people with 20 diagnoses and there's just generalist modalities for groups or generalists, you know, groups and whatnot. You want there to be effective evidence-based care, being taught to you for anxiety and OCD. Elizabeth McIngvale:  And so our program is actually so different. So our program is, in a beautiful Mediterranean, you know, 6,000 square foot, beautiful home and with the brand new kitchen, and it's got, you know, two washers too. Dryers and we have 11 beds total. So, six of our I'm sorry, we have six bedrooms, five of the bedrooms, have double beds. So, two queens and those rooms and then one has a single bed, that's our ada room, all of our bedrooms have their own bathroom and it's a really a home like home like experience. I think all of our patients would tell you, I hear this, I do it. Check out with every patient that comes through a program, I run groups and with them all the time, they always say that the entire experience was completely different than what they expected. You know, they were thinking this hospital setting this kind of rigid treatment where it was really instead it's like, hey, you come here and we help together create a supportive environment to get you back to the things you want to be doing in your life. Kimberley Quinlan: Yeah, I love it. I mean, when I used to work in the eating disorder community, it's like a big family. Like and and I think for me from my experience of clients, going through residential programs is, I think they had this idea of What the other people would be like only to find out. Like, these are my people, like, these are my people and and I want to encourage people listening. I know it's scary, the idea of increasing your, at the level of care. But usually, when you increase the level of care, you meet more of your people which is like the silver lining, I don't know, that was just being my experience of people and… Elizabeth McIngvale: I couldn't agree more,… Kimberley Quinlan: what they've said, Elizabeth McIngvale: you know, and we we see our patients and they leave. And we do this mentor support group where they can come back and run them into our group to the newer patients, or the patients currently in the program and it's so great to see. But I cannot tell you how many of our patients are great friends now and they go to the conference together and… Kimberley Quinlan: Yeah. Elizabeth McIngvale: they, you know, connect together and they run a support group for each other outside of when they leave here to keep and hold each other accountable. But you know one of the beauties is that in our home like setting you get to truly practice everything, right? And so you practice, the things you're gonna have to be doing at home, from cooking a meal doing your laundry, cleaning your room, right? All these sort of things that are important skills. We don't want to isolate and create this sterile environment. We want it to feel and to mimic your home. And so, there is so many memories and so much connection that's made when you're cooking together with your residence or when you're sitting in the living room together and watching them a movie, or going out to dinner in the community together and those are some of the most Important impactful and meaningful experiences and treatment, right? Not only because you make peers and connections, but you also get to encourage each other in the treatment process together. 00:35:00 Kimberley Quinlan: Mmm, I love that. Okay. So we've worked our way to the higher level of care. You've done the higher level of care. Let's make sure we finish this story. Well, right? It's like, it's like a movie plot to, the right is, How do we come down the level of care, right? So what does it look like for somebody who's done higher levels of care? What what is like you said at the beginning? It's not just like a one and done, you can sort of dust yourself off and maybe you can, I don't know. What is your experience? What's your suggestions in terms of reducing the level of care, Elizabeth McIngvale: Yeah. So our goal from treatment is that anytime someone discharges from our program, their discharging to an outpatient level of care and at some times for some of our patients, they're going to discharge back to their outpatient provider and they may see them two or three days a week, a first couple weeks and then two days a week and then, you know, to kind of taper back down to traditional outpatient or whatever, their therapist has available. And so that's the goal. But getting there looks different for everyone. So some of our patients will do residential the whole time, they're with us 12 to 16 weeks. However, long, they're in treatment and go straight back to their outpatient level of care, especially if they live out of state, different things that may make the most sense for them, but some of our patients may actually discharge to our day program. So they may, you know, spend eight weeks with us in the residential. And then discharge to our day program, for the last four weeks, especially if they're local, but even if they're not, they may get an airbnb and discharge to that level of care because it might actually be recommended and warranted for them to really practice independent things outside of the treatment day without 24 hours support Elizabeth McIngvale:  And then again be able to tailor or taper back down to an outpatient level of care. So for us that is always our goal. One of the questions I get a lot is like Well when will I know if I'm ready to leave Liz and What will that look like? And my response is always the same is that I don't expect or actually want patients to leave here without any OCD. If you're leaving here without any triggers or any anxiety or OCD, then we probably kept you too long, right? Because it's important to remember that. You only should be in this level of care for as long as it's warranted. We should not be keeping you and charging you and having you stay. If you're ready to go to an outpatient level of care at that point. And so, my response is always, I'm, I, I want people to discharge when they're at a place where the treatment team and the patient feels confident that they're going to be able to maintain their progress on an outpatient level. And so the goal is that you've gotten all the tools, you've got the skills, you understand the concepts, you know, the difference between feeding your OCD and fighting your OCD and what that looks Elizabeth McIngvale:  Like, you've changed your relationship with anxiety and OCD and now you're ready to keep doing that on your own. And so for a lot of our patients, we recommend and have them do what's called a therapeutic absence. This is typically about three fourths through treatment. We'll ask you to go home for about three to five days. Practice your skills. See how you do, see where you got stuck? Come back. We'll tweak things will help kind of read those final things before you leave, but the goal is that you're gonna discharge to outpatient care and you're gonna discharge to a functioning structured schedule. So this is really important, right? I want you at discharge to have a clear plan for what you're going to be doing, we don't want you to go home without a plan and to, you know, potentially revert back to sleeping in staying in your room, right? Those sort of things we want you to go back to a schedule because one of the benefits of being in our program is how scheduled and structured. It is Kimberley Quinlan: And I love this because as a treatment provider, anytime a client of mine has come back from residential or some kind of intensive treatment, the therapist that they were working with gives me this plan right? Or the The client brings me the plan and so I'm I hit the, what's The saying? Hit the ground running. Like I know what the plan is that we already have it. Elizabeth McIngvale: Yep. Kimberley Quinlan: It's not like we have to go and create a whole nother treatment plan. It's usually coming handed off really beautifully, which makes that process like so easy. Elizabeth McIngvale:  that's, Kimberley Quinlan: For an outpatient provider to to take that client back. Elizabeth McIngvale: Our goal, right? Our goal is that if you referred someone to meet him, I'm gonna be talking to you before I start working with them and I'm certainly going to be talking to you as we're getting close to discharge and around the time of discharge to transition that care. Right? Seamless,… Kimberley Quinlan: Right. Elizabeth McIngvale: we want it to be smooth and we want the patient to feel like there's not an interruption in their treatment. Kimberley Quinlan:  Right. Oh my gosh. So, good. Is there anything we've missed? Do you feel? Elizabeth McIngvale: Not really, you know, I think I get this question a lot, you know, across the board everything we've talked about just because I've personally experienced this, I do this myself professionally and Here's what I'll tell you guys. Treatment is fair is scary No matter what. It doesn't matter if we're doing on outpatient level or an intensive level, right? We're being asked to face our fears or being asked to do things that terrify us I know and many of our listeners know that treatment can and will save your life. And so if you're questioning if you're ready, if it makes sense, you may not ever feel ready and it may not ever make sense. But what I can promise you is that if you put forth the work,… 00:40:00 Kimberley Quinlan: If? Elizabeth McIngvale: the outcome is incredible. And I am someone who sits right here as Elizabeth McIngvale: Someone who really believes in full circle moments. Because the program that I attended when I was 15 is the program. I now get to run every day. Kimberley Quinlan:  It makes me want to cry. Elizabeth McIngvale: And it is, it is I can tell you. I I love my job and every person at our team here at the Houston OCD Institute. We are driven by the opportunity to help individuals change their own life through treatment and it works. I wouldn't you know Kim those of us with lived experiences even if it's different we wouldn't be doing the work that we do. If we didn't know it worked What a friend,… Kimberley Quinlan:  All right. Elizabeth McIngvale: what a horrible life if I had to be a fraud every day pretending for didn't, you know, I couldn't but we do this, we make a career out of it and and we get to keep changing lives and keep hopefully doing for others. What some people did for us when we really needed it. And I'm very grateful that I have the opportunity to be at a… Kimberley Quinlan: So beautiful. Elizabeth McIngvale: where I can now help other people. And what I can promise you is that with the right treatment, you can be at a place where you can be doing, whatever it is. You're meant to be doing not what OCD wants you to be doing. Kimberley Quinlan: So beautiful. My curiosity is killing me here. So I'm just gonna have to ask you one more question, is it the same location? Elizabeth McIngvale: It is not. So when I was a patient it was impatient actually at the Meninger clinic. So it was in that hospital setting and they closed their program in 2008 and then it became an offset. And so it's now we're our own facility and a beautiful house. And we're in a beautiful neighborhood in the Heights that you can walk around in Houston. Kimberley Quinlan: Yeah. Elizabeth McIngvale: So it is not a hospital setting but it is the same program for all intensive purposes. Kimberley Quinlan:  Right? That is so cool. I am so grateful for you. Thank you so much now um I know you've shared a little bit but do you want to tell us where people can get a hold of you, any social media websites, and so forth. Elizabeth McIngvale: Yes. Yes, please feel free to reach out anytime y'all want my instagram and handle is Dr. Liz OCD. So you can always reach out there or find resources and support but for our website you can go to Houston OCDI.ORG or you can give us a call at 713-526-5055. And what I'll tell you is that I'm always available to help answer questions offer support and that doesn't mean you have to choose our program, but I would love to give good insight into what you should look for. And what I will say is, I know, can you talk about us all the time? You want to make sure the program that you're attending engages in evidence-based care so for OCD that's going to be ERP and often a combination of medication and that they really specialize in treating solely anxiety and OCD and OCD related disorders at the intens Or you want to be cautious? Not to go to a program. That's a really mixed program that says, they can also treat OCD. I don't think that'll be the same experience. Kimberley Quinlan: Agreed agreed, So grateful for you. This I feel like this has been so beautifully. Put like in terms of like explaining the whole step, their questions. I will be I'll be referring patients to this episode all the time because these are common questions we get asked. So thank you so much for coming on.Elizabeth McIngvale:  Well, thank you for having me. Anything I can never offer. Please never hesitate to reach out, and thank you for all that you do in the awareness and education you spread in our field.

Zach Westerbeck is a mental health advocate, national speaker, Mental Health Coach and author of the mental health book, “You're Not Alone”, who was diagnosed with an anxiety disorder in 2016. During that time period he experienced severe anxiety, deep depression and thoughts of suicide. After hitting his rock bottom moment, he sought help and started to recover.Through his recovery process he became Mental Health First Aid certified and now travels the country educating thousands of students and organizations on the fundamentals of mental health.https://zachwesterbeck.com/

SUMMARY:  How to include family members in ocd treatment Supporting siblings during ocd treatment  How to apply the “be seen” model Ocd family therapy: including siblings as “assistant coaches”  Developing empathy during ocd treatment Links To Things I Talk About: ERP School https://peaceofmind.com/for-siblings/ OCD Stories (with Jessica Serber) https://theocdstories.com/episode/dr-michelle-witkin-siblings-and-ocd/ https://www.amazon.com/When-Family-Member-Has-Obsessive-Compulsive/dp/1626252467 When a Family Member has OCD https://www.anxioustoddlers.com/psp-050-explaining-ocd/#.Y2Lc2S1h2Tc Krista's webpage Instagram: @anxiouslybalanced 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 Kimberley Quinlan: Well, welcome Krista Reid. I am so excited to number one connect with you, but to talk about a topic that I don't talk a lot about which is something that I'm excited to really talk about with you today. A Peaceful Balance Wichita: Yes, thank you so much for having me. Kimberley Quinlan: So welcome. A Peaceful Balance Wichita: I'm excited. Kimberley Quinlan:  Yeah. Look at you. You're all the people who don't see, you're like everything's bright and it's so happy. It makes me so joyful just to see you. A Peaceful Balance Wichita: Thank you, anybody. That has met me. Will get it. I'm a very colorful person. Thank you. Kimberley Quinlan: I love that that we need more of you in the world. Kimberley Quinlan: I really feel Yeah, good thing. I made children that sort of created more of me, right? That's the best I can do. A Peaceful Balance Wichita: I we need more of you. A Peaceful Balance Wichita:  You go. There you go. Kimberley Quinlan: All right, let's talk about supportive siblings. Let's talk about… A Peaceful Balance Wichita:  Yeah. SIBLINGS AND OCD Kimberley Quinlan: how the family can play a role in recovery. I kind of want you to take the lead here and tell me everything, you know. So tell me a little bit about why this subject is important to you and how you used it in clinical and in the field of OCD. A Peaceful Balance Wichita: Yeah, absolutely. And so I'll give you just a little bit of background. I always have been interested in sibling dynamics, and in fact, when I was in grad school completing my thesis, I even consulted the director of the program. I said, Are there any theories about siblings? And he's like, well, you know, there's the one by Alf or Alfred Adler on birth order. But really outside of that, no and that has just always been so entirely profound. Because when we think about family work, if you're looking at family theories, if you're looking at different types of family interventions and models, a lot of them really focus on parent child. And when you're dealing specifically with a child who has an, I'll go into the physical medical side as well, because I don't think this is exclusively just OCD or just mental illness. Kimberley Quinlan: Mmm. A Peaceful Balance Wichita: when we're seeing that a lot of times, the model is fixated on the child with the medical issue and the parent And what I was finding was that siblings. They kind of get othered In this. It's full process and the definition of other. It is essentially, you know, being excluded from meetings being excluded from family sessions being excluded in some way, shape or form. Now I could see how potential listeners will say, Well, isn't it that child with the OCD the child with the medical issues othered Yes, I'm not debating that at all, I'm saying, primarily within the family unit, that the sibling themselves can get very other and siblings struggle when their sibling has a disorder. You… Kimberley Quinlan: Mmm. A Peaceful Balance Wichita: they can struggle emotionally, they can struggle behaviorally. You know, just looking at the construct of OCD, they could struggle with the with the grief. Of their sibling having OCD, the moods that may come with the disorder. And oftentimes, this can lead to resentment within the sibling relationship, or even guilt or shame. And I I have siblings, and I think this potentially might be even where a lot of my work is very important because I am very close to my siblings. I am super close. Like I I feel like I'm very fortunate. I have, I have amazing relationships with my siblings and so it absolutely breaks my heart when you see a child. A Peaceful Balance Wichita:  Who who has this? Some type of distance within their sibling relationship either because they themselves have the disorder or their sibling has the disorder. And so, I started finding different ways to incorporate siblings and to the therapeutic model. I'm really big into family work. I don't understand how special when you're working pediatrics pediatrics. And that's primarily what I'm going to focus on today is a pediatric work. I don't understand how when you're working with pediatrics? How you you can't have the family involved? To me, that doesn't make any sense because we're seeing, especially in the outpatient world, we're seeing these kids an hour a week, so tops four hours a month. Pretty sure there with their families, a lot more than just four hours a month. and then thinking about, A Peaceful Balance Wichita:  The siblings. What can we do to make them feel like they're not being other? How can they also not be parentified? Because that's sometimes happens within the disorder. World is the siblings may feel that they have to have some type of responsibility for their siblings medical issues. And that is Absolutely. I don't want any sibling to have that. I want them to have a childhood. I want them to be kids, but how can we incorporate them without parentifying them and without othering them and also bringing in the family as a whole and tackling this beast together whether that's OCD or whatever? That beast might be. 00:05:00 Kimberley Quinlan: That's so interesting because as someone who treats OCD but also treats eating disorders, I have found that, you know, you'll treat the one child who has the primary disorder. We get them better. And then a year or two later, the other kid that didn't have the the diagnosis starts to suffer and all this emotion comes out and they start to really acknowledge how painful it was for them and and it all comes out later. A Peaceful Balance Wichita: Okay. Kimberley Quinlan: But I know that there are other cases where it comes out during and you've got multiple things happening at once. So, that is why I think this is so important is Kimberley Quinlan: In my early days of treating you would be like, no, that the siblings. Fine. Look at how well they're doing. They're they're doing well in school and it's quite a miracle,… A Peaceful Balance Wichita:  Yeah. INCLUDING THE WHOLE FAMILY IN OCD TREATMENT Kimberley Quinlan: isn't it? But then Yeah, it all comes out, right? It all comes out. So I love that you're talking about this, right? So you you And number number one, before we move on. Is this true of not just siblings, Would we say? This is true of partners of OCD or eating disorders or depression as well. Like Does this spread to that or… A Peaceful Balance Wichita: Yeah. I I agree a hundred percent,… Kimberley Quinlan: What are your thoughts? A Peaceful Balance Wichita: you know, this, I hate to call it curriculum because that makes it sound so sterile. A Peaceful Balance Wichita: Process I guess I'll call it and I feel that this process is and as as you know aforementioned it's not just about OCD. I can see this being across the board for any medical issue. Absolutely. It could be for Let's a roommate. Let's not even like let's let's take out the family part. Kimberley Quinlan: um, And here. A Peaceful Balance Wichita: You know what, working with a college. I college student, who has a roommate that, maybe they're pretty close with. Absolutely. I if they're willing to bring that person in, How can we incorporate them? Because doesn't that client win? That's what we're wanting… Kimberley Quinlan:  Yeah. A Peaceful Balance Wichita: because we know that no matter what your medical diagnosis might be relationships, struggle, and… Kimberley Quinlan:  Mm-hmm. A Peaceful Balance Wichita: that absolute last thing I would wish upon anybody. Kimberley Quinlan: yeah, I'm even thinking of me as someone with a chronic illness On how I think it even like you said it stretches to medical to like that. You know, I know I look back until tell a quick story. I look back to when I was really sick and really sick. And I even remember seeing my children, Starting to play a parental role on me. Like, What do you need today? Mom, instead of like, No, I'm supposed to be asking you that Hun. Like, I think that it's,… A Peaceful Balance Wichita: Yeah. Kimberley Quinlan: it can spread. So I I think that this is that's again why? I think this is so important. So I'm gonna skip to my main sort of questions here. Now, it's like you talk about what is called a coach Like an OCD coach. I know I've watched one of your presentations like Do you want to share with us What this model may look like? BE SEEN MODEL A Peaceful Balance Wichita: Yeah. Absolutely. So before I even talk about the OCD coach, because that's not like, I'm not reinventing the wheel, this isn't something that I think a lot of your listeners are going to say, Oh like that's that's a new thing. No, it's not a new thing especially when working pediatrics. That's a pretty common term because that's what we really want these parents, or caretakers to be of these kids. As we want them, to be able to learn how to do what we are doing with their kids. So they don't have to be in therapy forever. So, I developed this process and I call it BE SEEN  seen as an acronym, because why not us medical professionals. We love our acronyms. So let's make another acronym. And also it's really easy to just to remember Kimberley Quinlan:  Right. A Peaceful Balance Wichita:  And I chose this specific, acronym one. It fits the letters, really nicely of what I was hoping to explain throughout this process but also for a couple different reasons. One I have OCD and I struggled as a child and adolescent and one of the primary factors in my own recovery, that was so A profound was I realized I did not want to be seen. I did not want people to note because I felt I felt bad, You know that shame just smothers you like a blanket and it just it it was embarrassing. And then I was thinking about it from the other side of siblings. 00:10:00 A Peaceful Balance Wichita: When you have a child who has a chronic illness, you think about how often, are they going into doctors appointments? How often are they going into whatever type of treatment facility? They may they may be utilizing. The sibling is often and they can get hidden. They can get hidden. And if I in fact, I think it was Chris Baer who did unstuck who actually called the sibling, the forgotten child. and I,… Kimberley Quinlan: Such a crisp, man. A Peaceful Balance Wichita: I absolutely, I'm gonna, I'm gonna get to how that whole thing. Actually, kind of birthed this idea here in a bit. A Peaceful Balance Wichita: But thinking about just how profound it could be for the sibling to be seen. And as I mentioned before,… Kimberley Quinlan:  Hmm. SUPPORTING SIBLINGS DURING OCD TREATMENT  A Peaceful Balance Wichita: I don't want them to be responsible for their siblings treatment. That is so incredibly inappropriate. And I want them to have a childhood, but I also want them to participate and have a relationship with their sibling. So when I think of an OCD coach essentially, how I define an OCD coach, is going to be that's going to be the adult figure. So that is going to be the person that is going to take the the child to therapy to treatments. That's going to be the main one, utilizing, exposure and response prevention therapy. They're going to be kind of the one overhead and I like using the word coach. A Peaceful Balance Wichita:  Because one, I really like sports and I just think that there's something kind of neat about a coach because a coach is going to be, they're gonna be tough. They're gonna be fair. And at the end of the day, all they want is for you to win. I just think that's such a cool concept and when you tell that to a parent, a parent, a lot of times can say, Okay, so I get that because I could say, I want you to be the parent to the kid but also think about a coach because when you have your child on a team, OCD FAMILY THERAPY: INCLUDING SIBLINGS AS “ASSISTANT COACHES”  A Peaceful Balance Wichita:  In OCD Family Therapy, that coach is going to be tough. And I'm not trying to take the emotions out at all because we know coaches can be incredibly empathetic. The coaches are probably going to push your child a little bit more than you would put child. And so putting yourself into that role and thinking about this is for a win, I know my child might be hurting, I know my child because they're doing the exposures because you're not allowing them to have the OCD accommodated, you're pushing them to grow. So, Putting yourself into the coaches role versus only solely. The parents' role can be such a powerful metaphor for parents and I just really, really love that. So when I'm looking at the siblings, I call those the assistant coaches, those are the ones that can assist and help out. The players. A Peaceful Balance Wichita:  So the child that is in OCD  therapy or in treatment or whatever necessarily it might be and so be seen. So each letter of scene represents something s is supportive. How can you support the child? And I've actually created Worksheets, that are age appropriate for the sibling and the child with OCD, which again, it really could be any kind of medical thing because the acronym really doesn't exclusively cover OCD. They can do this together and so s is supportive finding different ways to support and A Peaceful Balance Wichita:  With the worksheets that I've developed with ages five to 10. I just love this. It's it's an art activity and the kids together get to draw them slaying. I mean I'm using quotation marks slaying the OCD monster or making a can of like OCD away spray and so it's just a really, really cute. A activity to do and again because it's ages five to ten, that's such a level of mastery and explorative and, you know, they, they like to draw in color and play at that time. So, even if their sibling with OCD, it's a lot older. Think about what an amazing bonding experience that could be, you have a five year old sibling, and a 12 year old with OCD, that's a pretty cool, a situation able to put those two together to talk about it. A Peaceful Balance Wichita: Because then that five year old. I mean, how empowering and beautiful that is is like, okay, so you know, sibling older sibling, I'm going to draw a can of a way spray, and this is what it's going to do, and it's gonna get it's gonna help get rid of this and this. And we know that children think so highly a metaphors. That, that could be such a really cool way for them to interpret that. And to be able to understand that because we also don't want little kids to well, it's not, we don't want to, it's they just simply don't have the cognitive abilities to understand OCD comprehensively So let's find age appropriate manners to be able to do that. 00:15:00 Kimberley Quinlan: Yeah. DEVELOPING EMPATHY DURING OCD TREATMENT A Peaceful Balance Wichita: And then the next one is developing empathy during OCD treatment. I'm not gonna lie doing an empathy exercise with kids can be a little bit challenging and I think I think that because the Emotions are so complex. In situations are so complex. And so I was trying to find a way to be able to put this in a manner that A five-year-old is going to comprehend and yet also like a 15 year old is not going to think is to babyish. Kimberley Quinlan:  Yeah. A Peaceful Balance Wichita: Per se. So it's a it's another worksheet because they're all worksheets it's another worksheet where the siblings can work alongside each other and it really can go either way. It usually works better if the child with OCD goes first. And so the child with OCD can share a so, for instance, I feel disgusted. When I'm around a bad food, I'm just gonna say something super blanketed and then the child the sibling with who does not have OCD could say, Okay? So let's talk about disgust. When do you feel disgusted? And they might say I feel disgusted when my parents make me eat broccoli. And so that's just a really cool and simple way for them to see that this is, you know, we can we can relate on emotions. A Peaceful Balance Wichita: And we don't have to agree on your, on your emotional reaction, but we can all we can realize that we all have these emotions and this is how we can bond. And for a young young child,… Kimberley Quinlan:  Hmm. A Peaceful Balance Wichita: This could also be a really cool lesson in emotional intelligence, because they may not necessarily understand or comprehend. All these different kinds of emotions I'm not gonna lie. I think this might be my favorite one because I think this really encompasses a lot of different things. I love empathy exercises, I'm sure you like being big. Kimberley Quinlan: Well, I think it builds on that common humanity, doesn't it? A Peaceful Balance Wichita: But it really does. And that's the whole point is, you know, going back to what I mentioned about being seen, we're all humans and we're flawed and we don't want anybody to feel like they have to be perfect in this process and we don't want anybody to feel like they have to be all knowing, because there's such a beautiful way to which is actually Um, I was gonna go back to support. I've already talked about supportive, but it's a really cool way to support each other. and also not feel like you have to be an expert or Creating them per say,… Kimberley Quinlan:  Yeah. Yeah. Yeah. A Peaceful Balance Wichita: all right. So then the next one. The next E is encourage this one and the worksheets is make a sign. So like if you were at because again, these are assistant coaches and I'm kind of using the metaphor of sports or games or like, if you're running along a marathon, what sign would you hold for your sibling? And so, then they get to make a sign for older kids. It could be a Post-it notes, have Post-it notes, and then put it like in your siblings lunch or on the bathroom mirror, draw a picture of them, make a card for them, You know, finding different ways to encourage your sibling with out feeding and to the OCD. That could be a really big part of it. Because let's say, for instance, you have a sibling. A Peaceful Balance Wichita: Who their OCD attaches on to the color? Black black is death. Black is some. Well, you know what, we're just not going to draw with the color black because it's not the siblings responsibility to do the exposures. Unless that is something that has been discussed actually in the therapy session, because, again, I can't say it enough that I do not want the sibling, to ever be in charge of treatment, or exposures or anything along the lines of that, of course, without actually working with a therapist beforehand. Kimberley Quinlan: Right, right? Can I ask you a question really quite just to clarify Tim? A Peaceful Balance Wichita: And yeah. Absolutely. Kimberley Quinlan: So that parent is the coach. Right? And… A Peaceful Balance Wichita:  Yes. Yes. Kimberley Quinlan: then the child is the assistant coach, you mentioned. Do they get assigned that or… A Peaceful Balance Wichita:  Correct. Kimberley Quinlan: Do we just call them that? Do they know they're the coach? Do we use those words? Do we assign them? That? What are your thoughts? A Peaceful Balance Wichita: I think that could really be up to a parent. Those are just terms that I've used you. 00:20:00 Kimberley Quinlan: They're like,… Kimberley Quinlan: conceptualizations. Okay. A Peaceful Balance Wichita: Exactly it… A Peaceful Balance Wichita: because children work, so highly with metaphors and they can use whatever, I had a child. Once say, a lot of want to be a coach, I want to be a cheerleader. Cool. Then you could cheerlead we really kind of whatever it's like… Kimberley Quinlan:  Okay. Kimberley Quinlan:  Right. A Peaceful Balance Wichita: if they want to be the waterboy, I mean I don't care as long as they whatever they can conceptualize it as and we can still kind of follow this supportive method fine. Kimberley Quinlan: Yeah. Okay, thank… Kimberley Quinlan: I just want to clarify that. So okay,… A Peaceful Balance Wichita: Yep. Right. Kimberley Quinlan: we're up to we're up to N. A Peaceful Balance Wichita: That's just great. I say in is non-judgment. And this is the part that we really, really, really like to push that OCD is not your siblings fault. Absolutely did not ask to have OCD. They're not doing this on purpose to despise you or for whatever reason. And also realizing that as the sibling, the way the sibling with OCD behaves is not the siblings fault. This can be a part where you have some psycho education and learning more about what OCD is and what OCD is not. And finding different ways to be able to talk about that. Because that itself can be very difficult and… Kimberley Quinlan: Mmm. Right. A Peaceful Balance Wichita: I have, I do a lot of OCD psychoeducation when I work with families. And this is where I was going to bring unstuck back. I think that even before going through this process with families unstuck in my opinion I I'm sure other professionals you know, have their own ways of doing it but I find it to be one of the most profound psycho education methods to use for families. Because, and I'm, I do you work with kids as well. Okay, I'm sure you can, you can relate that when you're having that Psychoed session with a kid, it gets lost. They're done. They're bored. They're just like, well can I just do something else? When you have a which I love that, it's like 20 minutes, it was so made for kids the unstuck documentaries. It was beautiful. And kids talking about OCD to kids. A Peaceful Balance Wichita: I mean I I don't know how it it is more impactful than that. Because a long treatment, it's funny enough, my clients will actually refer to the kids in the movie. Like oh, okay. Well, that one boy. Um, he was able to wear Hulk mask or that one, that one girl was able to hug a tree. Oh, that one. She ripped out pages of the Bible and they'll actually refer to that and they see that as being incredibly empowering. what that also does is it lets the parents know that here are some kids… Kimberley Quinlan: You. A Peaceful Balance Wichita: who I mean, you hear their stories, you know that those were pretty severe cases These are kids who came out the other side and are in recovery. and they're talking about these challenges, they're talking about How difficult it was for them. And so when parents are learning about ERP for the first time, it's it's very scary, it's very and so I think it's not only powerful for the children with OCD and their siblings but also their parents to be able to see this documentary, I can't speak highly enough about it, but that's not why we're here. Kim, we're not here to talk about this documentary. Kimberley Quinlan: No, but I think I mean that's the beauty of the community, right? Is we all bring little pieces to what's so important. As you're talking, I'm thinking like A Peaceful Balance Wichita: That. Kimberley Quinlan: He sees that movie because that's the impact it's having. I mean I've seen it and I loved it it's so it's when we can't miss the siblings, right? Like that's some important piece. So I love that you're talking about that and I do think you're right. Question totally off topic. A Peaceful Balance Wichita:  Yeah. Kimberley Quinlan: But on topic is, when you're with a client, do you? Encourage them to watch on stock. Do you bring the family in and do this training with them? What kind how do you apply these concepts in session or Are you know, for someone who doesn't have therapy, what might they do? A Peaceful Balance Wichita: Oh, okay, I'm gonna answer that. Someone who doesn't have therapy. Might what they do. I'll go. The therapeutic route to begin with, of course, after you solidify the diagnosis? Which again, for kids can be boy, that can be a challenge that can be such a challenge. So, this is after diagnosis, This is just part of the therapy. I do I, I will say, Okay, so bring in the family and I would say, I would love to have siblings here and they'll say, Well, the sibling is five or six, is that? Okay, absolutely, because you will be surprised at how aware the young sibling is going to be their older sibling. 00:25:00 A Peaceful Balance Wichita: And all time, you will also be surprised at how much accommodation the young child might be doing because they might see that as being. Well, that's just my older sibling. My only can't cut food. Kimberley Quinlan: Yeah, right. A Peaceful Balance Wichita: My older sibling doesn't walk down this one hallway. That's just how they are. Well, we also want to teach them that, you know, this is this, This has a name and here's some ways that you can be encouraging for your sibling. And so I have an entire session where I invite the entire family in and we watch the movie and then we process it together. and from there,… Kimberley Quinlan:  Right. A Peaceful Balance Wichita: We go on to. A Peaceful Balance Wichita: Week, We go on to just write right away going on into the bc model and figuring out different ways how the sibling can be involved. Not other not excluded and then we'll go into more of kind of like, the clinical stuff, the Y box, exposure, higher and… Kimberley Quinlan:  Yeah. A Peaceful Balance Wichita: and so forth. But you ask, how can people that don't have therapy being able to utilize this. Honestly, it's on silly. I I'm probably the. Okay, there's two ways. I'm very competitive but I'm not competitive. When it comes to This this work, I post these worksheets for free on my website because this is something that I'm not here to make a profit off of it. I'm not here to, I'm not even gonna copyright it because at the end of the day, if we can help one sibling feel heard, Cool. That's it. That's that's amazing. No, no amount of money or… Kimberley Quinlan:  Right. And A Peaceful Balance Wichita: anything could ever be better than that? Kimberley Quinlan: We can link the links to these worksheets in the show notes. You're comfortable with that. That would be amazing. Yeah. Okay,… A Peaceful Balance Wichita:  Absolutely. Kimberley Quinlan: that is so cool and so people can kind of work through them on their own. Okay. A Peaceful Balance Wichita:  Mm-hmm. And in fact, there there was a family that I worked with whose younger sibling had had some special needs. And what I did with the parents, is I just kind of briefly explained this to them and because they know their kid better than, I know, their child and they know How how their child is going to be able to kind of understand process. This, they were able to take the information they did and that they needed to be able to help out the sibling who now helps out. That the sibling with OCD. Kimberley Quinlan:  Yeah, yeah. Okay. So a couple of quick questions that I want to ask is so and it's a sort of going off of some past cases that I had. So what about the the sibling, Who's just really angry. Kimberley Quinlan: the situation at how the, you know OCD has made their family, very For treatment before they were getting resources. Do, do they There's those children who have a lot of resistance to this idea of being a coach. You work with that. Is it through the empathy? Do you have any thoughts? A Peaceful Balance Wichita: Door. And that's a fantastic question. Because we can't, we can't force. We can't force anybody to do anything. And I kind of view it like the child with OCD, If the child with OCD does not want to do the treatment. Well, then my job as a clinician is to meet that child while they're at and… Kimberley Quinlan: Yeah. A Peaceful Balance Wichita: that very much with the sibling, you know, of the child with Ocds, I'm gonna have to meet that sibling where they're at, if they don't want anything to do with this, if they want nothing to do with any of this process at all. I'll do one of a couple things one. I, I might refer the sibling on to a therapist who doesn't necessarily like they don't necessarily have to treat OCD but they can understand OCD comprehend OCD. Well enough to be able to have a conversation. And sometimes the sibling is like, Well, I'm not the one with the problem. I don't need to go into therapy, so I'll do my best. I can to coach the parents and help them to support that sibling as well. Kimberley Quinlan: Right. Right, so. Okay and just conceptually. So the parents are using the parent. Coaches are using the bc model the children. A Peaceful Balance Wichita:  Yeah. Kimberley Quinlan: If they're ready and willing, they're using the bc model. And the person with the disorder or the medical condition is also using the bc model. Be seen model for the sibling and the family correct. A Peaceful Balance Wichita:  Yeah, I mean this this doesn't have to just be with OCD, In fact, you know, as as I'm looking at just the the acronym of seeing, I don't know if you just has to just reach the medical stuff. Because at the end of the day, don't we generally want to be supportive and empathetic and encouraging and non-judgmental humans. I think just kind of a neat model just to teach our children in general. 00:30:00 Kimberley Quinlan: Mmm. Yeah. Kimberley Quinlan:  That's what I was thinking. business sort of, like, 101 Training to be a nice. and like, A Peaceful Balance Wichita: It really is it really? Like I said, I'm not reinventing the wheel, you know, I was able to use some different strategies that I've learned with. So originally as a therapist, I was on the way to becoming a play therapist. And a lot and also dealing with Dr. Bruce Perry's neurossequential model of. Oh My Gosh. Oh my gosh. Why can't I think what it is? It's his nurse sequential model for trauma. That's what it is. Oh wow. And then just just pulling different plate therapy, text me techniques. And I kind of just establish this thick this and… Kimberley Quinlan: Yeah. A Peaceful Balance Wichita: you're right. This is basically just Yeah, I like how you said 101. Be a nice person. Kimberley Quinlan: Yeah, but the truth is and that's why I think it's so important is we all are nice people. We all want to be but when we get hit by a disorder, It's easy to go into reactivity as a parent. I know for myself or as I've seen, you know, siblings it's easy to go reactive. So these are sort of basic tools to come back to the basics and and recalibrate,… A Peaceful Balance Wichita:  Exact. Kimberley Quinlan: which is why I love it. Okay. So no,… A Peaceful Balance Wichita:  Ly. Yeah. Kimberley Quinlan: I love this so much is before we finish up. Is there anything that we haven't touched on that? You want to make sure we address here and we're talking about Supporting the siblings, but supporting the person with the disorder, any I've missed. A Peaceful Balance Wichita: Um, can I list some resources? Oh, okay. Kimberley Quinlan:  And please. A Peaceful Balance Wichita: There's really not a ton of information out there about how can the sibling be involved with any medical treatment to be honest with you and I'll focus specifically on the OCD portion. Of course, John Hirschfield's amazing book in regards to family at the,… Kimberley Quinlan: On a family,… A Peaceful Balance Wichita: Yes at the very tail,… Kimberley Quinlan: I see. A Peaceful Balance Wichita: and he talks about different ways, family members can can be helpful. Natasha Daniels on her YouTube channel, she's so great. They're all great everybody. I'm listing is like All Stars. She specifically has a video about how to talk about OCD with young children and I think there's actually even more specific video about how to talk with siblings. Dr. Areeen Wagner on the Peace of Mind Foundation website. There is a whole slew of stuff about how to talk with siblings and I think the Bear Family is even involved in some of those presentations as well. And then this is gonna sound silly because I'm gonna shout out another podcast. Is that okay? A Peaceful Balance Wichita: Okay, there's a couple on the OCD stories that they talk about siblings. Jessica, Surber rested. Kimberley Quinlan:  Yes. A Peaceful Balance Wichita: One about her own experiences being a sibling. And then, this is an older one. Maybe two, three years ago. Dr. Michelle Witkins. She does a lot of advocacy for siblings and so she has an amazing podcast on there where she talks about that work. Kimberley Quinlan: Right? No, I will link to Eyes and you know I'm a massive stew fan so don't wait. Don't worry about it. No, I he's been on our show. I've been on his show a bunch of times. We are very much in Communic. A Peaceful Balance Wichita:  I figured, I don't think there was a feud going on. Kimberley Quinlan: Around food at all. No, that's that's so good that you have those and I will list those in the show notes for All as resources to use. I love. Thank you so much for sharing all those and we will have links to your sheets as well. A Peaceful Balance Wichita: ah, Kimberley Quinlan: You can An excellent resources. A Peaceful Balance Wichita:  oh, you're sweet. Thank you. Kimberley Quinlan:  Well, I am so grateful for you to come on and talk about this. I think it's really, really important that we talk about siblings, you know, address the whole family because it is a family condition, right? Thank you. I'm so just overjoyed to have you on the show. A Peaceful Balance Wichita:  Well, thank you. I'm overjoyed to be here. Kimberley Quinlan: Where can people hear from you or get information about you? A Peaceful Balance Wichita: So my website, so my practice name is a peaceful balance, Wichita Kansas, and my website is a PB wichita.com. and really, to be honest with you, probably the easiest way to To contact me is on Instagram. I'm probably on their way more often than I'd like to admit and… Kimberley Quinlan:  Yeah. 00:35:00 A Peaceful Balance Wichita: my handle is at anxiously balanced. Kimberley Quinlan: Love it and you put some amazing exposure lists and movies. It's so good. You but no it's so it's such a huge resource. A Peaceful Balance Wichita: I think I have way too much fun with those. Kimberley Quinlan: If you're looking for specific movies, documentaries songs, I think you do a great job of listing exposures. A Peaceful Balance Wichita:  Thank you.Kimberley Quinlan: Thank you so much.

In this episode, I explain the biology and psychology of obsessive-compulsive disorder (OCD)—a prevalent and debilitating condition. I also discuss the efficacy and mechanisms behind OCD treatments—both behavioral and pharmacologic as well as holistic and combination treatments and new emerging treatments, including directed brain stimulation. I explain the neural circuitry underlying repetitive “thought-action loops” and why in OCD, the compulsive actions merely make the obsessions even stronger. I review cognitive-behavioral therapies like exposure therapy and SSRIs, holistic approaches, and nutraceuticals, detailing the efficacy of each approach and what science says about how to combine and sequence treatments. I describe an often effective approach for treating OCD where clinicians use cognitive behavioral therapy (CBT) to deliberately bring patients into states of high anxiety while encouraging them to suppress compulsive actions in order to help them learn to overcome repetitious thought/action cycles. This episode should interest anyone with OCD, anyone who knows someone with OCD or OCPD, and more generally, those interested in how the brain works to control thoughts and actions, whether those thoughts are intrusive or not. Thank you to our sponsors AG1 (Athletic Greens): https://athleticgreens.com/huberman Thesis: https://takethesis.com/huberman Eight Sleep: https://www.eightsleep.com/huberman Supplements from Momentous https://www.livemomentous.com/huberman. For the full show notes, visit hubermanlab.com. Timestamps (00:00:00) Obsessive-Compulsive Disorder (OCD) (00:03:01) Momentous Supplements, AG1 (Athletic Greens), Thesis, Eight Sleep (00:08:28) What is OCD and Obsessive-Compulsive Personality Disorder? (00:11:18) OCD: Major Incidence & Severity (00:15:10) Categories of OCD (00:21:33) Anxiety: Linking Obsessions & Compulsions (00:27:33) OCD & Familial Heredity (00:29:10) Biological Mechanisms of OCD, Cortico-Striatal-Thalamic Loops (00:39:36) Cortico-Striatal-Thalamic Loop & OCD (00:46:39) Clinical OCD Diagnosis, Y-BOCS Index (00:51:38) OCD & Fear, Cognitive Behavioral Therapy (CBT) & Exposure Therapy (01:01:56) Unique Characteristics of CBT/Exposure Therapy in OCD Treatment (01:10:18) CBT/Exposure Therapy & Selective Serotonin Reuptake Inhibitors (SSRIs) (01:22:30) Considerations with SSRIs & Prescription Drug Treatments (01:25:17) Serotonin & Cognitive Flexibility, Psilocybin Studies (01:31:50) Neuroleptics & Neuromodulators (01:36:09) OCD & Cannabis, THC & CBD (01:39:29) Ketamine Treatment (01:41:43) Transcranial Magnetic Stimulation (TMS) (01:46:22) Cannabis CBD & Focus (01:47:50) Thoughts Are Not Actions (01:51:27) Hormones, Cortisol, DHEA, Testosterone & GABA (02:00:55) Holistic Treatments: Mindfulness Meditation & OCD (02:03:28) Nutraceuticals & Supplements: Myo-Inositol, Glycine (02:09:45) OCD vs. Obsessive-Compulsive Personality Disorder (02:20:53) Superstitions, Compulsions & Obsessions (02:31:00) Zero-Cost Support, YouTube Feedback, Spotify & Apple Reviews, Sponsors, Momentous Supplements, Instagram, Twitter, Neural Network Newsletter Title Card Photo Credit: Mike Blabac Disclaimer

In episode 333 I chat with Jonny Say. Jonny is a UK based psychotherapist.  We discuss how he's doing, Jonny's mental health and how he practices self-compassion daily, we discuss shame around intrusive thoughts and in doing compulsions, the inner critic, self-compassion and how it can help, building up psychological flexibility skills before exposure and response prevention therapy (ERP), values based exposure, dropping anchor, a compassionate approach to ERP, and much more. Hope it helps.   Show notes: https://theocdstories.com/episode/jonny-say-334  The podcast is made possible by NOCD. NOCD offers affordable, effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans, if they currently take your insurance, or to download their free app, head over to https://go.treatmyocd.com/theocdstories