Podcasts about response prevention

For years, movies and TV shaped how people understood OCD — and for a long time, the portrayals got it ALL wrong. In this video, therapist Dr. Patrick McGrath sits down to watch some of the most well-known OCD scenes on screen. What he finds is a mix of half-truths, stereotypes, and the occasional glimpse of what real OCD actually feels like. Join Dr. McGrath on this watch-along featuring actors like Leo Dicaprio, Jack Nicholson, and more!Want to treat OCD? At NOCD, we specialize in Exposure and Response Prevention therapy, the most proven way to treat OCD. Book a free 15-minute call with us at https://learn.nocd.com/YTFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd Hosted on Acast. See acast.com/privacy for more information.

In this powerful and candid episode of the OCD Whisperer Podcast, host Kristina Orlova sits down with Hussain Al Abdullah, the founder of The Struggling Warrior, a platform dedicated to raising awareness and educating people about OCD. With over a decade of personal experience, Hussain shares his journey from the onset of his OCD at a young age to his eventual path to therapy and recovery.   Hussain opens up about the challenges of dealing with intrusive thoughts, compulsions, and the isolation that came with his OCD. He discusses his struggles through college, how his OCD affected his academic life, and the turning point when he finally reached out for help. In this conversation, Kristina and Hussain explore how therapy, ERP (Exposure and Response Prevention), and medication ultimately helped him regain control of his life.   Additionally, Hussain shares his passion for supporting others living with OCD and his mission behind creating his platform and writing his book, Listen Up: OCD is Talking. He discusses his book's unique approach, personalizing OCD, and offering readers insights into how OCD functions, its tricks, and ways to challenge it.   Whether you're on your own OCD journey or seeking inspiration and guidance, this episode offers hope, vulnerability, and practical advice. The 3 things you'll learn in  today's episode: How OCD can evolve and worsen over time, and the importance of seeking help before hitting rock bottom Why finding the right therapist is crucial for recovery and the impact of a supportive, understanding relationship Hussain's innovative approach to understanding OCD through his book Listen Up: OCD is Talking and his Unbound OCD Toolkit In This Episode [00:03] Introduction and guest introduction [01:08] Hussain's early experiences with OCD and intrusive thoughts [03:42] The development of compulsive behaviors and the impact on his school life [06:07] Hitting rock bottom during college and the decision to reach out for help [08:21] The turning point: reaching out to his family and seeking therapy [09:24] The struggles with stigma and the mental health system [12:05] Medication changes and how his OCD evolved [14:52] Finding the right therapist and the introduction of ERP [16:22] How Hussain's book and resources aim to help others living with OCD [20:47] Conclusion and how to reach out to Hussain and access his resources Our Guest   Hussain Al Abdullah  is the founder of The Struggling Warrior, a platform aimed at educating and raising awareness about OCD. With over a decade of personal experience, he is dedicated to breaking the stigma surrounding mental health and offering practical tools for managing OCD. Hussain is also the author of Listen Up: OCD is Talking and the creator of the Unbound OCD Toolkit. Resources & Links   Kristina Orlova, LMFT Instagram  YouTube  OCD CBT Journal Tracker and Planner  Website   Hussain Al Abdullah Website Listen Up: OCD is Talking  Unbound OCD Toolkit Instagram LinkedIn Mentioned Cognitive Therapy for OCD I-CBT Training Online Sneaky Rituals with Jenna Overbaugh  ICBT with Kristina Orlova and Christina Ennabe Please note, while our host is a licensed marriage and family therapist specializing in OCD and anxiety disorders in the state of California, this podcast is for educational purposes only and should not be considered a substitute for therapy.   Stay tuned for weekly episodes filled with valuable insights and tips for managing OCD and anxiety. And remember, keep going in the meantime. See you in the next episode!

In this Pride Edition of the Water Cooler Chat series, join Nicole as she explores how justice-based ERP (Exposure and Response Prevention) can respectfully and effectively target core fears in OCD—especially within LGBTQIA+ contexts. Three examples are covered: SO-OCD (Sexual Orientation OCD), Relationship OCD, and Moral Scrupulosity tied to queer identity. The episode emphasizes that treatment should honor identity, not erase it, and provides value-driven, identity-affirming interventions that align with dignity and justice. Whether you're queer, questioning, or an ally, this episode offers empowering insights for recovery.

Manifesting. Cleanses. The Law of Attraction. Jaclyn Steinmann tried it all, believing that if she could just control her thoughts — keep them positive and “high vibration” — she could finally quiet the chaos in her mind. But the more she chased perfect thinking, the worse her OCD got.In this interview, Jaclyn shares how popular self-help and spiritual practices didn't just fail to help — they fed her OCD. Real change didn't begin until she let go of those ideas and started evidence-based treatment like ERP. This is her journey, and what she's learned through trial, error, and research.If you feel you've tried everything and nothing's worked, you're not alone. Like Jaclyn, many people with OCD don't see real progress until they start evidence-based treatment. At NOCD, our therapists specialize in Exposure and Response Prevention, the gold standard for OCD care. To learn more, book a free 15-minute call at https://learn.nocd.com/YTResources Jaclyn mentioned on the episode:https://www.sciencedirect.com/science/article/abs/pii/S187620182400248Xhttps://michaelshermer.com/sciam-columns/quantum-quackery/https://www.amazon.com/Toxic-Positivity-Keeping-World-Obsessed-ebook/dp/B094VCFSZW?dplnkId=13f82e2f-da33-4ef5-9199-bdc566458a38&nodl=1https://www.tandfonline.com/doi/full/10.1080/09505431.2013.768222?scroll=top&needAccess=true Hosted on Acast. See acast.com/privacy for more information.

Alix Behar remembers the day everything almost collapsed. OCD had taken over her relationship, flooding her with intrusive thoughts, compulsive confessions, and endless reassurance-seeking. One morning, a single text nearly ended it all — her boyfriend said he couldn't take it anymore. It felt like OCD was winning, again. But that breaking point became the start of something new. In this powerful story, Alix shares how Exposure and Response Prevention therapy helped her take her life back — and saved her relationship. Struggling with OCD? NOCD therapists are specialized to treat OCD themes of all kinds. To book a free 15-minute call, visit us at https://learn.nocd.com/podcastFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd Hosted on Acast. See acast.com/privacy for more information.

Tracie Ibrahim knows firsthand how OCD can quietly wreck a person's day. In college, reading meant going forward, then backward, then forward again — just to feel “right.” As a mom, grocery trips were derailed by terrifying, intrusive thoughts. At work, simple emails turned into obsessive loops of rewriting and rereading. In this video, she shares what untreated OCD did to her focus, her routines, and her sense of control — and how Exposure and Response Prevention therapy helped her reclaim her time.If you're struggling with OCD, our NOCD therapists might be able to help. They are specially trained in ERP therapy — the most effective treatment against OCD. To learn about treatment options, book a free 15-minute call at https://learn.nocd.com/podcastFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd Hosted on Acast. See acast.com/privacy for more information.

Send us a textEver double-checked that your door was locked, even though you knew it was? That momentary doubt is normal—but what happens when these urges become overwhelming and constant? Drawing distinct lines between everyday quirks and clinical conditions, we untangle the often confused Obsessive-Compulsive Disorder (OCD) and Obsessive-Compulsive Personality Disorder (OCPD).The key distinction is profound: OCD manifests as intrusive, unwanted thoughts triggering repetitive behaviors to reduce anxiety. These thoughts feel foreign to the person experiencing them—what psychologists call "ego-dystonic." Despite recognizing their irrationality, people with OCD feel powerless to stop the cycle that consumes at least an hour daily. Most shocking is the 11-year average delay between symptom onset and treatment, largely due to shame and misdiagnosis.By contrast, OCPD represents a pervasive personality pattern centered on orderliness, perfectionism, and control. Unlike OCD, people with OCPD typically view their traits as rational or even virtuous—they're "ego-syntonic." This fundamentally different self-perception drives treatment differences: while OCD responds well to Exposure and Response Prevention therapy and medication, OCPD requires longer-term approaches focused on building flexibility and self-awareness.We examine how cultural context complicates recognition of OCPD, as traits like diligence and meticulousness often receive positive reinforcement. Someone might excel professionally while struggling significantly in relationships due to rigidity and control needs. Consider how our society's emphasis on productivity and perfection might blur the line between dedication and disorder—when do high standards become harmful?Whether you're a mental health professional seeking clarity or someone trying to understand these conditions better, this episode provides the framework to distinguish between unwanted symptoms and ingrained personality traits, guiding the path toward appropriate support and treatment. Want to know if you're ready for your Licensing Exam. Take our free exam today!If you need to study for your national licensing exam, try the free samplers at: LicensureExamsThis podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Montana thought he understood OCD — until he got married. His wife, Mackenzie, had been living with obsessive-compulsive disorder since she was a teenager, but it wasn't until they built a life together that he began to see the full impact. From hidden rituals to overwhelming fear, contamination spirals, and constant anxiety, OCD slowly took over their home. With two young kids, military life, and cross-country moves in the mix, their marriage was pushed to the edge.In this raw and honest conversation, Mackenzie and Montana share how OCD strained their relationship, reshaped their parenting, and nearly tore their family apart. It wasn't until everything felt like it was falling apart that therapy — specifically Exposure and Response Prevention — gave them the tools to rebuild. Together, they show what it really looks like to fight OCD as a team and how getting the right help can truly save a relationship and a family.Want to try ERP therapy like Mackenzie? NOCD offers proven, specialized treatment for OCD. Start your journey by visiting https://learn.nocd.com/podcastFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

Uma Chatterjee is a neuroscientist who studies the brain circuitry behind OCD — and she's also someone who lived with the disorder at its most severe. In this talk, she breaks down the actual biology behind intrusive thoughts and compulsions, from overactive brain regions like the orbitofrontal cortex to the role of neurotransmitters like serotonin, dopamine, glutamate, and GABA. She explains how genetics and stress can prime the brain for OCD, why certain thoughts feel so “sticky,” and what's really happening when the brain misfires and flags harmless ideas as dangerous.But this isn't just science for science's sake — it's about hope. Uma shares how Exposure and Response Prevention therapy (ERP) can actually retrain the brain's alarm system through neuroplasticity, helping people tolerate anxiety without relying on compulsions. For the most up-to-date science on OCD and its treatment, this video is must watch.To learn more about science-backed OCD treatment and to find an OCD-specialized therapist, visit us at NOCD: https://learn.nocd.com/podcastWatch Uma's interview on the Get to know OCD podcast: https://youtu.be/1NaxMoYhXZ4You can follow Uma's latest research here: ⁠https://umarchatterjee.com/research/⁠She also hosts her own podcast: ⁠https://podcasters.spotify.com/pod/show/umarchatterjeeFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

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 

Anxiety doesn't just affect your mind—it impacts your body and even your ability to stay consistent with fitness. In this episode we take a deep dive into the world of Mental Health with Cali Werner, Licensed Clinical Social Worker and fellow podcaster of Anxiety Society! Some of the subjects we cover are: Pre-performance anxiety: How it sabotages your progress and how to stay present.Imposter syndrome: Why comparison leads to spiraling and how to reframe negative thoughts.Boundaries and asking for help: Breaking free from toxic traits like avoiding support.Intrusive thoughts & OCD: How exposure therapy and reframing can lead to clarity.Mental illness stigma in fitness: Why it's time to embrace emotions (good and bad) and move forward.

Obsessive-Compulsive Disorder (OCD) presents in a wide range of subtypes and intensities—and effective treatment requires skill, sensitivity, and a deep understanding of the underlying mechanisms. In this compelling Podcourse, I'm joined by Dr. Johann D'Souza, a clinical psychologist and OCD specialist, to explore the science and art of Exposure and Response Prevention (ERP) therapy through the lens of traditional values. This episode contains hypothetical scenarios and examples that some listeners may find explicit or sensitive. These discussions are for illustrative purposes only and not intended to offend or shock. Listener discretion is advised. Purchase this Podcourse here! Check out my Coping with Political Stress Ebook Workbook Dr. D'Souza offers a comprehensive and practical breakdown of how ERP works, how to tailor it to the individual client, and how to apply it across various OCD subtypes—including contamination, harm, scrupulosity, and taboo fears. He also shares how integrating a values-based framework into ERP can build trust with clients and support long-term recovery. This episode will equip mental health professionals with an in-depth understanding of how to design ERP hierarchies, conduct imaginal exposures ethically and effectively, and overcome treatment barriers like poor insight, family accommodation, and avoidance. You'll also learn how to use storytelling, mindfulness, and exposure mapping to optimize outcomes and empower clients to become their own therapists. If you're a clinician looking to expand your OCD treatment toolkit and appreciate the importance of aligning therapy with client values, this Podcourse is for you. By listening to this episode, you'll be able to: Develop client-centered exposure and response prevention (ERP) exercises for at least four OCD subtypes, design response prevention strategies for common compulsions, and create effective ERP hierarchies to guide treatment progression. Apply principles of graduated exposure and response prevention to optimize client outcomes, while evaluating factors that contribute to less effective treatment, such as family accommodation and overvalued ideation. Differentiate between OCD subtypes and assess how ERP can be tailored to address specific obsessional fears, while demonstrating strategies to enhance client adherence and long-term success. Need continuing education contact hours? If so, then be sure to check out my $5 Podcourses. Check out the other CE courses - Holistic Counseling Bundle, the Art of Breathwork and How to Resolve the Parent Trap!  Learn more about Dr. Johann D'Souza and his work at Values First Therapy. Please note that The Therapy Show with Lisa Mustard is for informational and entertainment purposes only and not a substitute for professional medical or mental health advice. Always consult with your therapist, doctor, or physician before implementing any suggestions from this show. Lisa Mustard, a licensed marriage and family therapist, provides insights that should not replace medical or psychiatric advice. Your unique situation requires personalized attention from a healthcare professional.

Daily panic attacks. Anxiety so crippling he could barely function. The fear that if he told anyone what was happening in his mind, they'd think he was crazy. That was Sean Patton's reality growing up. OCD wasn't just about organizing things or washing hands — it was a relentless loop of intrusive thoughts and compulsions that dictated his life. It got so bad he dropped out of high school, avoided doorways, people, places, and conversations that might expose his struggles. But what Sean didn't realize at the time was that the very thing causing his pain would eventually become the foundation of his greatest strength.Comedy became Sean's way of fighting back. What started as a defense mechanism— using humor to mask the chaos inside — turned into a career where he could be unapologetically honest about his experiences. On stage, he found power in telling the stories he once tried to hide, turning his most terrifying thoughts into punchlines that resonated with audiences who had their own hidden battles. In this sit-down interview, Sean opens up about his journey with OCD, the misconceptions about mental health, and how laughter became his therapy. Chapters:0:00 Intro2:05 Meet Sean Patton4:03 How OCD affected Sean early in his life9:42 How Sean dealt with his OCD11:08 Is psychedelics good for OCD?16:25 Misrepresentation of OCD in movies and shows20:45 Is OCD beneficial?23:15 Sean's comedic act about OCD26:47 Fear that OCD will evolve27:50 “It's Okay”29:36 OCD ebbs and flows32:13 Why Sean talks about OCD in his comedy39:21 Facing OCD fears head-on42:39 The best compliment Patrick gets46:26 Destigmatize OCD and other mental health struggles49:21 Sean's comedic act about OCD superstitions54:09 Why does OCD have to feel so real?58:05 How to find SeanStruggling with OCD? NOCD may be able to help. We specialize in Exposure and Response Prevention therapy — the gold standard in OCD care. To learn about treatment,  book a free 15-minute call at https://learn.nocd.com/podcastFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

When we try to control every thought that enters our mind, we unknowingly give it more power. The harder we fight intrusive thoughts or uncomfortable feelings, the more they seem to persist. Brenna Posey, a member of NOCD, shares how this cycle kept her stuck and how she learned — through therapy and experience — that true freedom comes from allowing thoughts to come and go without reacting to them.Learning to sit with uncertainty is one of the most challenging but life-changing skills for managing OCD. In this video, Brenna explains why resisting anxiety only fuels it and how changing your response can break the cycle. She also offers practical strategies to help you step away from compulsions and regain control —not over your thoughts, but over how you respond to them.Exposure and Response Prevention therapy helped Brenna manage her OCD, and it might do the same for you. If you want to explore treatment options with our team, book a free 15-minute call at  https://learn.nocd.com/podcastFollow us on social media:https://www.instagram.com/treatmyocd/https://twitter.com/treatmyocdhttps://www.tiktok.com/@treatmyocd

Chrissy Cammarata is a pediatric psychologist who has worked in academic medical centers, and now in a private practice catering to kids, teens and young adults for the past 15 years. Her specialty focused on the overlap between anxiety and eating disorders. Her practice conducts evidence-based assessments before and during treatments to assess symptom severity and progress. Her approach to recovery involves a combination of Exposure and Response Prevention and other Cognitive Behavioral strategies, as well as Acceptance and Commitment Therapy.   In this episode we talk about:   ◾️ How eating disorders can be confused with anxiety and OCD ◾️ Avoidant restrictive food intake disorder (ARFID) vs. Anorexia ◾️ Facing fears & phobias in everyday life   Find Chrissy here:   brandywinepsych.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.

In episode 459 I chat with Nicole Morris, LMFT. Nicole is a therapist and host of the OCD Family podcast.  We discuss her therapy story, her view of OCD, Inference-Based CBT (I-CBT), Exposure and Response Prevention Therapy (ERP), her podcast and favourite guests, words of hope and much more. Hope it helps. Show notes: https://theocdstories.com/episode/nicole-459  The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Join many other listeners getting our weekly emails. Never miss a podcast episode or update: https://theocdstories.com/newsletter   Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

Today, I'm going to talk about living ERP (Exposure and Response Prevention) and how this isn't just a one-and-done thing. You can't just dip in and get out. Many people think of ERP as a specific exercise or a series of tasks that you need to complete and then you're done. But the truth is, ERP is so much more than that. It's not just a series of moments; it's really a lifestyle change. Here's a little preview of what we'll cover: What is ERP (Exposure and Response Prevention)? A practical example of living with ERP

The post 304: Co-Morbidity With Eating Disorders and ERP (Exposure and Response Prevention) with Dr. Brad Smith appeared first on Seven Health: Eating Disorder Recovery and Anti Diet Nutritionist.

In episode 442 therapist Jonny Say interviews myself, Stuart, about my work as a therapist with children and adolescents.  We discuss how I adapt Exposure and Response Prevention therapy (ERP) and Acceptance and Commitment Therapy (ACT) for children and teens with OCD, the other therapies I integrate, self-compassion, how parents can help their children with OCD, what I would tell my younger self, and much more. Hope it helps.  Show notes: https://theocdstories.com/episode/stuart-442 The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

In episode 441 I chat with Madina Alam. Madina is a licensed mental health therapist, and director of therapist engagement at NOCD.  We discuss her therapy journey, Exposure and Response Prevention therapy (ERP) as a tool for life, explaining ERP, working for NOCD, coming up with exposure ideas in session, homework, when ERP works really well what she notices, experiences of being on the TV show the Bachelor and dealing with the pressure, and much more. Hope it helps.  Show notes: https://theocdstories.com/episode/madina-441 The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

In episode 440 I chat with Jack who has kindly agreed to share his OCD story with us.  We discuss his OCD story, an early parental loss, he shares themes of harm OCD, sexual orientation OCD, and peadophile themed OCD. Jack talks about substance use to mask the pain, how numbers played a part in his compulsions, being in an abusive relationship, he mentions suicide, attending The OCD Camp, doing Acceptance & Commitment Therapy (ACT) and Exposure and Response Prevention therapy (ERP). Jack discusses secondary spikes, what else helps him, self-compassion and much more. Hope it helps.   Show notes: https://theocdstories.com/episode/jack-440  The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

Dr. Tatyana Mestechkina is a licensed clinical psychologist practicing in New York, New Jersey, and Florida. She is the founder and clinical director of Cognitive Behavioral Therapy for Better Living, which is also the approach she uses in treating patients, together with Acceptance and Commitment Therapy. She specializes in treating OCD, even in the purely obsessional subtype (Pure-O), and anxiety disorders such as generalized, social, panic, health, and phobias. Her clients are often ones that face concerns related to perfectionism, body-image, mood challenges, and postpartum/perinatal issues. In this episode we talk about:  ◾️ Processing thoughts and feelings when facing compulsions ◾️ Positively changing your relationship with your brain   ◾️ Reframing emotions when resisting compulsions Find Tatyana here: @ocdanxietyexpert cbtforbetterliving.com Find Zach here: zachwesterbeck.com @zach_westerbeck Use promo code: ZACH  https://www.restoredminds.com/offers/SrL78mUq?coupon_code=ZACH 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.

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Two things are true: 1) I am unqualified to speak on ERP and OCD and 2) I am sharing my thoughts about ERP for those that still want to hear them even though I am unqualified. What is ERP (Exposure & Response Prevention)? How helpful is it for those with relationship anxiety? What are its strengths and limitations? In this episode, I'll share my thoughts on this treatment. Join me for Both Feet In - Abridged: https://www.anxiouslovecoach.com/both-feet-in-abridged If you need immediate support, write me a Wisio. I'll make you a 7-10 minute custom video response. Here: https://wisio.com/anxiouslovecoach We will be bumping up to 2 calls a month on Patreon when we hit 250 patrons — one for Q&A and one for meditation practice! Our next call is Sunday, February 11th at 8am PST/11am EST. https://patreon.com/anxiouslovecoach   Who we are: Natalie Kennedy @Anxiouslovecoach   Time Stamps: 5:04 What is ERP (exposure response therapy)? 9:34  The dangers of disassociating 13:00  What is polarity work? 20:00 Compassionate self-inquiry

"Now the Lord is the Spirit, and where the Spirit of the Lord is, there is freedom."~ 2 Corinthians 3:17How often do we hear that someone is "obsessed" with a new show or that they keep a clean home because they're "a little OCD"? The reality is that the burden of OCD weighs heavily on millions of people who suffer with this disorder, and on those who love them. How can we understand OCD and its effects on faith? And, even more importantly, how can we support those who are working on healing from OCD - or seek help and support ourselves?In Episode 39 of "This Whole Life," Kenna welcomes Dr. Katherine Posch, a licensed clinical psychologist specializing in Obsessive Compulsive Disorder (OCD) and anxiety disorders. They tackle the complexities of OCD and its terrible cycle. Dr. Posch emphasizes evidence-based treatments, including Exposure and Response Prevention therapy, and offers a hope-filled way forward for those struggling with religious OCD or scrupulosity. Through personal experiences and professional expertise, the episode offers hope, understanding, and practical guidance for those impacted by OCD - and for all of us who can be stuck in a place of fear and anxiety. Freedom is real and possible!Katherine Posch, Psy.D., LP is a licensed clinical psychologist at  Renew Behavioral Health in Minneapolis, Minnesota. She is a graduate of the University of Texas at Austin and earned her Doctor of Psychology in Clinical Psychology from Baylor University. She completed a clinical internship at George E. Wahlen Veterans Hospital in Salt Lake City, Utah and a Postdoctoral Fellowship in PCBH/Health Psychology at Hennepin Healthcare Medical Center in Minneapolis, Minnesota. Find out more about Katherine's work at renewbehavioralmn.com.Episode 39 Show NotesThe International OCD Foundation & their provider directoryChapters:0:00: Introduction and Highs & Hards15:17: What is OCD?26:15: Treating OCD & discovering hope39:19: Approaching OCD related to faith & religious practice47:51: Supporting a loved one struggling with OCD53:45: Challenge By ChoiceThank you for listening! Visit us online at thiswholelifepodcast.com, and send us an email with your thoughts, questions, or ideas.Check us out on Instagram & FacebookInterested in more faith-filled mental health resources? Check out the Martin Center for IntegrationMusic: "You're Not Alone" by Marie Miller. Used with permission.

When OCD Paws at Your Love for Pets: A Dive into ERP & ACT In this episode, I discuss how OCD and anxiety can sometimes latch onto our pets. I talk about ... Examples of obsessions people with OCD might have regarding pets Examples of how to incorporate Exposure and Response Prevention when you have pets Examples of how to practice Acceptance and Commitment Therapy Strategies when you have pets Check out The OCD & Anxiety Recovery Blueprint HERE!

Cari Stubbs is a trauma-informed therapist with her master's in Clinical Mental Health Counseling. As a counselor, she is passionate about working with individuals and couples in their journey toward healing from trauma, depression, anxiety, life-changes, and other mental health barriers. Her desire is to empower others to unearth their authentic and whole self through curiosity, awareness, and action. Cari typically pulls from an integrated approach with traditional talk therapy, trauma-informed therapy, person-centered, and strength-based approaches as my foundations. She is trained in both EMDR and ERP (Exposure and Response Prevention therapy), the gold standard for OCD. Her husband, Trey Stubbs, was my very first guest on this show! In this episode, Cari and I discuss the concepts of EMDR, a trauma-informed therapy: what it is, what is involved, and how it can be a healing treatment for those affected by trauma. We discuss some of the complexities of validation with trauma and how we can best support others who have experienced trauma in their lives. We define some basic terms and Cari shares about what she does to take care of herself when working in a highly emotionally-charged career. For more information about Cari or if you are interested in scheduling a session with her, you can email her at cari@sojourncounselingco.com or visit her website at sojourncounselingco.com/cari. Follow me @joshkorac on TikTok, Instawgram, and YouTube for video clips, podcast previews, and more mental health content! If you are in a mental health crisis, please call 988 or go to your nearest emergency room. If you are from Colorado and are interested in scheduling a session, please reach out at sojourncounselingco.com/josh or josh@sojourncounselingco.com. New episodes every Wednesday (with exceptions!) while the show is in season!

Think about this: have you ever tried to find peace and meaning through your spiritual practices, like meditation or prayer, only to have nagging, bothersome thoughts and habits that just won't leave you alone? This is the intersection of OCD and spirituality, and it's a complex place where your quest for spiritual connection and the constant demands of OCD come together. In today's episode of The OCD Whisperer Podcast, I'm joined by Lucy Grantz. Lucy is a licensed marriage and family therapist who specializes in therapy for teens and adults struggling with OCD. During our conversation, we discussed the intersection of OCD and spirituality. We share personal experiences of how spiritual practices can become compulsions for individuals with OCD, such as over-reliance on tarot card readings or healers. We emphasize the importance of distinguishing between engaging in spiritual practices for connection and joy versus using them as compulsions to alleviate anxiety. Our conversation also touches on the rigidity of OCD and the need for grounding.   In This Episode [01:17] The relationship between OCD and spiritual practices [04:09] Compulsive behaviors related to tarot cards and astrology [07:09] The impact of OCD on manifestation and law of attraction [08:03] How spiritual practices can become compulsions for individuals with OCD [08:57] How OCD can affect the practice of meditation [09:46] Thoughts as manifestations [17:29] Recognizing the pattern of OCD [21:11] Finding flexibility in spiritual practices [22:43] Compulsions and over-reliance on spiritual practices [23:38] Compulsive over-processing and fixation on the problem [24:11] Finding a balance between helpful practices and compulsions   Notable Quotes [03:11] “I don't want to make it sound like anything I think is bad about any of these spiritual practices, but when OCD latches on, it can start to be compulsive, and that's what we want to avoid, but that's what happened to me for a long time trying to solve my own OCD before I knew I had OCD.” - Lucy [18:54] “With the law of attraction, that whole thing was like, well, I'm not manifesting what I want. So what's wrong with how I'm thinking about it? Or like I have this one bad thought and what will that mean for what I manifest?” - Lucy [24:53] “I think it's not black and white, you know. I think with this whole thing we're trying to get back to that life is gray. OCD wants it to be one or the other but there are no rights and wrongs. Everything can be helpful and it's about us finding our own path and who we really are and our own grounding versus being in a compulsion.” - Lucy   Our Guest Lucy Grantz is a Licensed Marriage and Family Therapist in Minnesota, specializing in helping teens and adults overcome Obsessive Compulsive Disorder and Anxiety. Drawing from her own experience with OCD, she is dedicated to supporting others through their struggles. Lucy specializes in mental compulsions, using Inference-Based Cognitive Behavioral Therapy, and collaborates with renowned expert Frederick Aardema. Her background in Buddhism and mindfulness adds a unique dimension to her therapy, and she is well-versed in Exposure and Response Prevention as well as rumination-focused CBT.   Resources & Links Kristina Orlova, LMFT https://www.instagram.com/ocdwhisperer/ https://www.youtube.com/c/OCDWhispererChannel https://www.korresults.com/ https://www.onlineocdacademy.com Lucy Grantz https://www.linkedin.com/in/lucy-grantz-80110626/ https://www.pivotpsychmn.com/about   **Disclaimer** Please note, while our host is a licensed marriage and family therapist specializing in OCD and anxiety disorders in the state of California, this podcast is for educational purposes only and should not be considered a substitute for therapy. Stay tuned for bi-weekly episodes filled with valuable insights and tips for managing OCD and anxiety. And remember, keep going in the meantime. See you in the next episode!

Today we are happy to have Cristina Chua, MSW on The Essential Oil Revolution. Cristina is an expert in helping people reclaim their life from OCD and anxiety. Her technique is grounded in trauma and neuroscience informed care, emotional regulation and mindful self compassion. She loves incorporating aromatherapy into her personal practice and work with her patients. What You Will Learn: What inspired Cristina to start working as a therapist and coach for people with OCD?  The problems with “gold standard” treatments, especially when they don't work. What is OCD and how does it manifest?  The different types of OCD and what various themes of them are. What goes on in the brain of someone with OCD and how the amygdala hijacks one's executive functioning.  What are the Havening Techniques and how Cristina uses them in her work with OCD.  How Cristina incorporates aromatherapy into her work with OCD clients. The difference between training the brain to tolerate uncertainty and using coping strategies to live life with less fear. How Cristina's approach is different from the “gold standard” treatment for OCD, ERP (Exposure and Response Prevention) and how her approach with this new emerging tool is viewed by conventional psychiatry. The importance of the emerging science on the Havening Technique and essential oils. Closing questions: What Cristina does for daily self-care and what she feels we should ditch and replace with instead to have a more nourishing or healthier life. Essential Oil Hacks: How Cristina incorporates essential oils in her personal life and for everyday use. Cristina Chua, MSW Bio:In addition to being a coach, Cristina is a Licensed Clinical Social Worker who earned her MSW from Silberman School of Social Work and a BA in International Relations from Brown University. She has worked in family counseling, as a trauma therapist, as a social worker in a youth empowerment program for immigrant youth, and as a trainer. Cristina brings her knowledge of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) into her coaching work. She is also a Certified Havening Techniques® Practitioner. This is a gentle, neuroscience-based approach that helps people heal from trauma, anxiety, and stressful life circumstances. Furthermore, Cristina is a mindfulness and yin yoga practitioner who has been inspired by the teachings of Tenzin Wangyal Rinpoche, Thich Nhat Hahn, and Jon Kabit-Zinn (the founder of Mindfulness Based Stress Reduction-MBSR). As a dancer, Cristina has continued to be interested in how the creative process can be used for transformation and healing. She studied voice, breathing and the Alexander Technique with the wonderful Jean McClelland. She enjoys combining her knowledge of mindfulness techniques and the creative process to support her clients in getting unblocked and into the flow of their lives. Where to Find Cristina and Learn More About Her Work: Cristina's Website Listen to Cristina Explain “What is a Compulsion?"  More Information and the Science of the Havening Technique My Post on the Science of the Havening Technique An Introduction to the Havening Technique  Havening website CPR for the Amygdala Handout Healing in Your Hands Book  Videos on the Havening Technique Intro to the Havening Touch  Intro to CPR for the Amygdala  How the Amygdala Designs our Days Daily Resilient Brain Care Program Learn more about your ad choices. Visit megaphone.fm/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Today we are happy to have Cristina Chua, MSW on The Essential Oil Revolution. Cristina is an expert in helping people reclaim their life from OCD and anxiety. Her technique is grounded in trauma and neuroscience informed care, emotional regulation and mindful self compassion. She loves incorporating aromatherapy into her personal practice and work with her patients. What You Will Learn: What inspired Cristina to start working as a therapist and coach for people with OCD?  The problems with “gold standard” treatments, especially when they don't work. What is OCD and how does it manifest?  The different types of OCD and what various themes of them are. What goes on in the brain of someone with OCD and how the amygdala hijacks one's executive functioning.  What are the Havening Techniques and how Cristina uses them in her work with OCD.  How Cristina incorporates aromatherapy into her work with OCD clients. The difference between training the brain to tolerate uncertainty and using coping strategies to live life with less fear. How Cristina's approach is different from the “gold standard” treatment for OCD, ERP (Exposure and Response Prevention) and how her approach with this new emerging tool is viewed by conventional psychiatry. The importance of the emerging science on the Havening Technique and essential oils. Closing questions: What Cristina does for daily self-care and what she feels we should ditch and replace with instead to have a more nourishing or healthier life. Essential Oil Hacks: How Cristina incorporates essential oils in her personal life and for everyday use. Cristina Chua, MSW Bio: In addition to being a coach, Cristina is a Licensed Clinical Social Worker who earned her MSW from Silberman School of Social Work and a BA in International Relations from Brown University. She has worked in family counseling, as a trauma therapist, as a social worker in a youth empowerment program for immigrant youth, and as a trainer.  Cristina brings her knowledge of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) into her coaching work. She is also a Certified Havening Techniques® Practitioner. This is a gentle, neuroscience-based approach that helps people heal from trauma, anxiety, and stressful life circumstances. Furthermore, Cristina is a mindfulness and yin yoga practitioner who has been inspired by the teachings of Tenzin Wangyal Rinpoche, Thich Nhat Hahn, and Jon Kabit-Zinn (the founder of Mindfulness Based Stress Reduction-MBSR).  As a dancer, Cristina has continued to be interested in how the creative process can be used for transformation and healing. She studied voice, breathing and the Alexander Technique with the wonderful Jean McClelland. She enjoys combining her knowledge of mindfulness techniques and the creative process to support her clients in getting unblocked and into the flow of their lives.  Where to Find Cristina and Learn More About Her Work: Cristina's Website Listen to Cristina Explain “What is a Compulsion?"   More Information and the Science of the Havening Technique My Post on the Science of the Havening Technique An Introduction to the Havening Technique  Havening website CPR for the Amygdala Handout Healing in Your Hands Book   Videos on the Havening Technique Intro to the Havening Touch  Intro to CPR for the Amygdala  How the Amygdala Designs our Days Daily Resilient Brain Care Program Learn more about your ad choices. Visit megaphone.fm/adchoices

Join host, Nicole Morris, LMFT and Mental Health Correspondent, as she welcomes back Psychiatrist and OCD Specialist, Dr. Ryan Vidrine, MD. for Part II of our medication conversation. Ryan graciously shares his thoughts on some hot topics, including differential diagnostic considerations for psychosis and other mental health disorders, as well as sharing the emerging research around psychedelics in the treatment of different mental health disorders. Additionally, Nicole and Ryan share in a discussion around other treatments that quench for OCD, including Inference-Based CBT and Exposure and Response Prevention. So join us for Part II, fam, because there's always a seat at the table for you.

Every time I tell Joanna Hardis how much her book, Just Do Nothing: A Paradoxical Guide to Getting Out of Your Way, has impacted me, her jaw drops. She truly can't seem to believe how deeply her unique approach and perspective to getting out of one's way is resonating with readers.Join us for this episode of the Write the Damn Book Already podcast as Joanna shares her incredible journey from self-doubt to powerful author. Discover how her unique perspective on overcoming obstacles can inspire you to write your own damn book. Plus, learn from her experiences as a therapist-turned-author, and find out how she tackles the challenges of writing and marketing with wisdom and insight that will resonate with every aspiring writer.  ABOUT JOANNA Joanna Hardis, LISW-S, is a cognitive behavioral therapist based in Cleveland, Ohio. Committed to using evidence-based treatments, Joanna helps people get “unstuck.” Through her private practice as well as virtual workshops on distress tolerance, Joanna shows people how to respond to being uncomfortable by giving them the knowledge and tools they need to move forward. She may drop a favorite Yiddish word (or two) during a session, and her goal is always for her clients not to need her anymore. She has been quoted in The Today Show, Self, and Well and Good magazines. She received her B.S. at Cornell University and her M.S.S.A. at Case Western Reserve University. She earned her certification from the Cleveland Center for Cognitive Therapy in 2000, SPACE (Supportive Counseling for Anxious Childhood Emotions) Certification in 2016, and she's one of a handful of clinicians with the highest training in Exposure and Response Prevention for OCD in Northeast Ohio.  In her spare time, Joanna enjoys powerlifting, doing anything with her three kids, traveling, and getting sucked into bad Reality TV.   WHAT JOANNA'S READINGOutline by Rachel CuskThe Guest by Emma Cline  CONNECT WITH JOANNAInstagram: instagram.com/joannahardisWebsite: joannahardis.comBook: Just Do Nothing: A Paradoxical Guide to Getting Out of Your Way RESOURCES MENTIONEDBook Outlines Made Simple: A Pay-What-You-Can WorkshopThe Anxious Truth Podcast episode Joanna recently appeared on (Episode 272)Thanks so much for listening! If you enjoyed this episode, don't forget to subscribe and leave a review!To see all the ways we can work together to get your book written, published, and launched, visit publishaprofitablebook.com/work-with-elizabeth

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On this week's episode, we are joined by licensed marriage and family therapist Lauren Rosen, who specializes in OCD, anxiety and eating disorders. Lauren shares her personal experience with OCD and how it led her to pursue a career helping others with the disorder. She discusses various manifestations of OCD beyond the stereotypical cleanliness obsession and how it impacts people's daily lives through mental compulsions, reassurance seeking and avoidance. Lauren provides advice on how friends and family can better support those with OCD by validating their feelings rather than trying to fix their uncertainty. More about Lauren:Lauren Rosen, LMFT, is a psychotherapist and the director of The Center for the Obsessive Mind, an outpatient clinic serving individuals in California, Florida, Utah, Nevada and Oregon. Lauren specializes in treating OCD, Anxiety Disorders & Eating Disorders and supports people using Mindfulness-Based Cognitive Behavioral Therapy, Exposure & Response Prevention and Acceptance and Commitment Therapy. Lauren has her BA and MA in Psychology from UCLA and Antioch university. She trained at the OCD Center of LA and is a certified Intuitive Eating Counselor. In addition to her work as a therapist, Lauren co-hosts the Purely OCD Podcast and does social media advocacy.Connect with Lauren!Instagram: @theobsessivemindWebsite: https://theobsessivemind.com/Podcast: https://purelyocd.com/Connect with Brianna!Instagram: @mombossinaustinLinkedIn: linkedin.com/in/briannademikeFollow the Podcast on Instagram: @badassbasicbitchLove the podcast? We would love if you would leave a review!Thank you to this week's sponsor, Factor! Head to factormeals.com/bbb50 and use code bbb50 to get 50% off.

It's my pleasure to bring on Alex Bishop, a registered counsellor and IFS (Internal Family Systems) therapist, onto the podcast today. Alex has struggled with Relationship OCD/Relationship Anxiety, and disorganized attachment, and can speak deeply on the experience of pushing a partner away. In this episode, we discuss his story with overcoming ROCD, how parts work relates to relationship anxiety, the IFS model for overcoming doubts, fears, and "the ick" associated with ROCD, and some of the limitations of ERP therapy for overcoming ROCD specifically. If you have been feeling stuck, this episode will be SO validating for you, and can help you get on the path to free yourself from the overwhelming shame and anxiety! Find Alex over at @forloveweheal on Instagram.   Links:  PATREON CALL w/ live Q+A: August 3rd at 10AM PST https://www.patreon.com/AnxiousLoveCoach   Time Stamps: 3:00 - Alex's experience with ROCD 16:42 - The importance of knowing your patterns when you have relationship anxiety 19:00 - How Alex used parts work/CBT 23:00 - How psychedelics can help with relationship anxiety 26:12 - Creating aliveness for yourself in your relationship 31:00 -Therapeutic routes to help with ROCD 42:50 - The causes of attraction obsessions 56:10 - Having different experiences that we label the same thing 57:50 - The limitation of ERP: Exposure and Response Prevention

In this episode, I talk about how and why Exposure and Response Prevention works.  I discuss..  - an overview of Exposure and Response Prevention (ERP) - the Habituation model - the Inhibitory Learning model - enhancing the effectiveness of ERP - and so much more  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. Jenna Overbaugh, LPC

In this episode, I talk about the ways in which OCD and anxiety can make us misinterpret our thoughts as being significant.  I discuss..  - specific ways we can misinterpret thoughts in OCD and anxiety - common cognitive distortions in OCD and anxiety - how to practice mindfulness, acceptance, and general Exposure and Response Prevention related to these issues - overcoming fear and uncertainty  - and so much more  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. Jenna Overbaugh, LPC

In this episode, I talk about the difference between courage and confidence, as well as how to apply it to Exposure and Response Prevention for OCD and anxiety. I discuss..  - basic definitions of courage and confidence and highlights of their distinctions - Exposure and Response Prevention and how courage + confidence relate to facing fears - how to balance courage and confidence in OCD and anxiety recovery  - overcoming challenges and building resilience - and so much more  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. Jenna Overbaugh, LPC

In episode 385 I chat with Madelaine Sanfilippo. Madelaine is a licensed Marriage and Family therapist in the state of California and Head of Groups at The Center for Anxiety and OCD. We discuss her OCD story, what is a group, how does group therapy differ from individual therapy, the benefits of group therapy, when is group therapy right for you, the flow and process of group therapy, Exposure and Response Prevention therapy (ERP) within a group therapy setting, who wouldn't be suitable for group therapy, and much more. Hope it helps.   Show notes: https://theocdstories.com/episode/madelaine-385  The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Thanks to all our patrons for supporting our work. This podcast episode is available as a video recording on our Patreon. To sign up to our Patreon and to check out the other benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

Welcome back, everybody. Thank you for joining me again this week. I'm actually really excited to dive into another topic that I really felt was important that we address. For those of you who are new, this actually might be a very steep learning curve because we are specifically talking about a treatment skill or a tool that we commonly use in CBT (Cognitive Behavioral Therapy) and even more specifically, Exposure and Response Prevention. And that is the use of imaginals or what we otherwise call scripts. Some people also use flooding.  We are going to talk about this because there are a couple of reasons. Number one, for those of you who don't know, I have an online course called ERP School. In ERP School, it's for people with OCD, and we talk about how to really get an ERP plan for yourself. It's not therapy; it's a course that I created for those who don't have access to therapy or are not yet ready to dive into therapy, where they can really learn how to understand the cycle of OCD, how to get themselves out of it, and gives you a bunch of skills that you can go and try. Very commonly, we have questions about how to use imaginals and scripts, when to use them, how often to use them, when to stop using them, when they become compulsive and so forth.  In addition to that, as many of you may not know, I have nine highly skilled licensed therapists who work for me in the state of California and Arizona, where we treat face-to-face clients. We're actually in Los Angeles. We treat patients with anxiety disorders. I also notice that during my supervision when I'm with my staff, they have questions about how to use imaginals and scripts with the specific clients. Instead of just teaching them and teaching my students, I thought this was another wonderful opportunity to help teach you as well how to use imaginals and why some people misuse imaginals or how they misuse it. I think even in the OCD community, there has been a little bit of a bad rap on using scripts and imaginals, and I have found using scripts and imaginals to be one of the most helpful tools for clients and give them really great success with their anxiety and uncertainty and their intrusive thoughts.  Here we are today, it is again a start of another very short series. This is just a three-week series, talking about different ways we can approach imaginals and scripts and how you can use it to help manage your intrusive thoughts, and how you can use it to reduce your compulsions.  It is going to be three weeks, as I said. Today, we are starting off with the amazing Krista Reed. She's been on the show before and she was actually the one who inspired this after we did the last episode together. She said, “I would love to talk more about imaginals and scripts.” I was like, “Actually, I would too, and I actually would love to get some different perspectives.” Today, we're talking with Krista Reed. Next week, we have the amazing Shala Nicely. You guys already know about Shala Nicely. I'm so happy to have her very individual approach, which I use all the time as well. And then finally, we have Dr. Jon Grayson coming in, talking about acceptance with imaginals and scripts. He does a lot of work with imaginals and scripts using acceptance, and I wanted to make sure we rounded it out with his perspective.  One thing I want you to think about as we move into this series or three-part episode of the podcast is these are approaches that you should try and experiment with and take what you need. I have found that some scripts work really well with some clients and others don't work so well with other clients. I have found that some scripts do really well with one specific obsession, and that doesn't do a lot of impact on another obsession that they may have. I want you just to be curious and open and be ready to learn and take what works for you because I think all of these approaches are incredibly powerful.  Again, in ERP School, we have specific training on how to do three different types of scripts. One is an uncertainty script, one is a worst-case scenario script, and the last is an acceptance script. If you're really wanting to learn a very structured way of doing these, head on over to CBTSchool.com and you can sign up for ERP School there. But I hope this gets you familiar with it and helps really answer any questions that you may have.  Alright, let's get over to the show. Here is Krista Reed. Kimberley: Welcome back, Krista Reed. I am so happy to have you back on the show. Krista: Thank you. I am elated to be able to chat with you again. This is going to be great. Kimberley: Yeah. The cool thing is you are the inspiration for this series. Krista: Which is so flattering. Thank you.  IMAGINAL OR SCRIPT? Kimberley: After our last episode, Krista and I were having a whole conversation and you were saying how much you love this topic. I was like, “Light bulb, this is what we need to do,” because I think the beautiful piece of this is there are different ways in which you can do imaginals, and I wanted to have some people come on and just share how they're doing it. You can compare and contrast and see what works for you. That being said, number one, do you call it an imaginal, do you call it a script, do you think they're the same thing, or do you consider them different? Krista: I do consider them differently because when I think about script, I mean, just the word script is it's writing, it's handwriting in my opinion. I mean, scripture is spoken. That's something a little bit different, but scripting is writing. When I think of an imaginal, that is your imagination. I know that I already shared with you how much I love imaginals because in reality, humans communicate through stories. When we can, using our own imagination, create a story to combat something as challenging as OCD, what a powerful concept. That's exactly why I just simply love imaginals. Kimberley: I can feel it and I do too. There's such an important piece of ERP or OCD recovery or anxiety recovery where it fills in some gaps, right? Krista: Yes, because imaginals, the whole point, as we know, it's to imagine the feared object or situation. It could evoke distress, anxiety, disgust. Yet, by us telling those stories, we're poking the bear of OCD. We're getting to some of that nitty gritty. Of course, as we know that, not every obsession we can have a real-life or an in vivo exposure. We just simply can't because of the laws of science, or let's be real, it might be illegal. But imaginals are also nice for some people that the real-life exposure maybe is too intense and they need a little bit of a warmup or a buy-in to be able to do the in vivo exposure. Imaginal, man, I freaking love them. They're great.  Kimberley: They're the bomb.  Krista: They really are.  HOW TO DO IMAGINALS FOR OCD Kimberley: You inspired this. You had said, “I love to walk your listeners through how to do them effectively. I think I remember you saying, but correct me if I'm wrong, that you had seen some people do them very incorrectly. That you were very passionate because of the fact that some people weren't being trained well in this. Is that true or did I get that wrong? Krista: No, you absolutely got it right. Correct and incorrect, I think maybe that is opinion. I'll say that in my way, I don't do it that way. That's a preference. But this is an inception. We're not putting stories into our clients' minds. The OCD is putting these stories into our clients' minds. If you already have a written-out idea of a script, of like fill in the blanks, you are working on some kind of inception, in my opinion. You are saying that this is how your story is supposed to be. That's so silly. I'm not going to tell you how your story is supposed to be. I don't know how your imagination works. When we think of just imagination, there's so many different levels of imagination.  Let's say for instance, if I have somebody who comes into my office who is by trade a creative writer, that imaginal is probably going to be very descriptive, have a lot of heavy adjectives. Just the way it's going to be put together is going to be probably like an art in itself because this is what that person does. If you have somebody who comes in and creativity is not something that is part of a personality trait, and then I have a written fill-in-the-blank thing for them, it's not going to be authentic for their experience. They're going to potentially want to do what I, the therapist, might want them to do. It's not for me to decide how creative or how deep that person is to go. They need to recognize within themselves, is this the most challenging? Is this the best way that you could actually describe that situation? If that answer is yes, it's my job as a therapist to just say okay. Kimberley: How would one know if it's the most descriptive they could be? Is it by just listening to what OCD has to say and letting OCD write the story, but not in a compulsive way? Share with me your thoughts.  Krista: I think that that's almost like a double-edged sword because that of itself can almost go meta. How do I know that my story is intense enough? Well, on the surface we can say, “Is it a hard thing to say.” They might say yes, and then we can work through. But if I'm really assessing like, “Is it hard enough, is it hard enough,” and almost begging for them to provide some type of self-reassurance, they might get stuck in that cycle of, is this good enough? Is this good enough? Can it be even more challenging?  Another thing I love about imaginals is the limit doesn't exist, because the limit is just however far your imagination can take you. Let's say that I have a session with a client today and they're creating an imaginal. I'm just going to give a totally random obsession. Maybe their obsession is, “I am afraid that I'm going to murder my husband in his sleep,” harm OCD type stuff, pretty common stuff that we do with imaginals. They do the imaginal and they're able in session to work through it. It sounds like it was good. In the session, what they provided was satisfactory to treatment. And then they come back and say, “I got bored with the story,” which a lot of people think that that's a bad thing. That's actually a good thing because that's letting you know that you're not in OCD's control of that feared response and you're actually doing the work. However, they might still have the obsession. I was like, “Okay, so you were able to work through this habituate or get bored of that. Now, let's create another imaginal with this obsession.” Because it's all imagination, the stories, you can create as many as you possibly can or as you possibly want to.  I'm actually going to give you a quote. He's a current professor right now at Harvard. He is a professor of Cognitive and Educational Studies. If you look this guy up, his name is Dr. Howard Gardner—his work is brilliant. He has this fantastic quote that I think is just a bomb when it comes to imaginal stuff. His quote is: “Stories constitute the single most powerful weapon in a leader's arsenal.” Think about that. What a powerful statement that is. Isn't that just fantastic? Because we can hear that as the stories OCD tells us as being hard. Okay, cool story, bro, that is your weapon OCD, but guess what? I'm smarter than you and I brought a way bigger gun and this gun isn't imaginal and I'm going to go ahead and one up you. If I come back that next week in my therapist's office and I'm able to get bored with that, I can make a bigger gun. Kimberley: I love that. It's true, isn't it? I often will say, “That's a good story. Let me show you what I've got.” It is so powerful. Oh my gosh. Let's actually do it. Can you walk us through how you would do an imaginal? Krista: This is actually something that I created on my own taken from just multiple trainings and ERP learning about imaginals, because one of the things that I was realizing that a lot of clients were really struggling with is almost over-preparing just to do the imaginal. Sometimes they would write out the imaginal and then we would work through that. But what I was finding is sometimes clients were almost too fixated on words, reading it right, being perfect, that they were almost missing out on the fact that these are supposed to be movies in our mind. Kimberley: Yeah. They intellectualize it. Krista: Exactly. I created a super simple format. I mean, we really don't have a lot of setup here. It's basically along the lines of the Five Ws. What is your obsession and what is your compulsion? Who is going to be in your story? Who is involved? Where is your story taking place? When is your story taking place? And when is already one of those that's already set because I tell people we can't do anything in the past; the past has already existed. You really need to be as present as possible. But the thing is that you can also think. For instance, if my obsession is I'm going to murder my husband in his sleep tonight, part of that might be tonight, but part of that might also be, what is going to be my consequence? What is that bad thing that's going to happen? Because maybe the bad thing isn't necessarily right now. Maybe that bad thing is going to be I'm not going to have a relationship with my children and what if they have grandchildren? Or what if I'm going to go to hell? That might not necessarily exist in the here and now, but you're able to incorporate that in the story. When is an interesting thing, but again, never in the past, needs to start in the present, and then move forward.  And then also, I ask how. How is where I want people to be as descriptive as possible. For instance, if I say, and this is going to sound gritty, you're fearful that you're going to murder your husband tonight. Be specific. How are you going to murder your husband? Because that's one of the things that OCD might want us to do. Maybe it is just hard enough to say, “I'm going to murder my husband.” But again, we're packing an arsenal here. Do you want to just say that? Because I can almost guarantee you OCD is already telling you multiple different ways that it might happen. Which one of those seems like it might be the hardest? Well, the hardest one for me is smothering my husband with a pillow. Okay, that's going to be it. That's literally my setup. That's literally my setup, is I say that. Actually, I have one more thing that I have to include. I have all that as a setup and then I say, “Okay, at the very end, you are going to say this line, and it's, ‘All of this happened because I did not do the compulsion.'” If I were going along with the story of I murdered my husband, I suffocated him with a pillow, and in my mind, the worst thing to happen is I don't have a relationship with my kids and grandchildren, and the compulsion might be to pray—I'll just throw that out—the last line might be, “And now, I don't have a relationship with my children or grandchildren all because I decided to not pray when the thought of murdering my husband came up in my mind.” That is the entire setup.  And then I have my clients get their phones out and push record. They don't have to do a video, just an audio is perfectly fine. I know some therapists that'll do it just once, but I actually do it over and over again. Sometimes it could be a five-minute recording, it could be a 20-minute recording, it could be a 40-minute recording. The reason for that being is if we stop just after one, we might be creating accommodation for that client, because I want my clients to be in that experience. That first time they tell that story after that very brief setup, they're still piecing together the story. Honestly, it's really not until about the third or fourth time that they've repeated that exact same story that they're really in it. I am just there and every time they finish—I'll know they finish because they say, “And this happened all because da da da da da”—I say, “Okay, what's your number?” That means what's your SUDS? And they tell me they're SUDS. I might make a little bit, very, very minimal recommendations. For instance, if they say, “I murdered my husband,” I say, “Okay, so this time I want you to tell me how you murdered your husband.” Again, they say the exact same story, closing their eyes all over again, this time adding in the little bit that I asked for. We do that over and over and over again until we reach 50% habituation. Then they stop recording. That is what they use throughout the week as their homework, and you can add it in so many different ways.  Again, keeping along with this obsession of “I'm afraid I'm going to kill my husband tonight,” I want you to listen to that with, as you probably have heard this as well, just one AirPod in, earbud, whatever, keep your other ear outside to the world. This is its way to talk back to OCD. Just something along the lines of that. I want you to the “while you're getting ready for bed.” Because if the fear exists at night and your compulsions exist at night, I want you to listen to that story before you go to bed. It's already on your mind. You're already in it, you're already poking the bear of OCD. It's like, “Okay, OCD, you're going to tell me I'm going to kill my husband tonight? Well, I'm going to hear a story about me killing my husband tonight.” Guess what? The bad thing's going to happen over and over and over again.  It's such a powerful, powerful, powerful thing. Because it's recorded, you can literally listen to it in your car. You can listen to it on a plane. You can listen to it in a waiting room. I mean, there's no limit.  Kimberley: It's funny because, for those of you who are on social media, there was this really big trend not long ago where they're like what they think I'm listening to versus what I'm actually listening to, and they have this audio of like, “And then she stabbed her with the knife.” It's exactly that. Everyone thinks you're just listening to Britney Spears, but you're listening to your exposure and it's so effective. It's so, so effective. I love this. Okay, let's do it again because I want this to be as powerful as possible. You did a harm exposure. In other episodes, we've done a relationship one, we've done a pedophile one. Let's pick another one. Do you have any ideas?  Krista: What about scrupulosity? Kimberley: I was just going to say, what about scrupulosity? Krista: That one is such a common one for imaginals. We hear it very frequently, “I'm going to go to hell,” or even thinking about different other religions like, “Maybe I'm not going to be reincarnated into something that has meaning,” or “It's going to be a bad thing. Maybe I'm insulting my ancestors,” or just whatever that might be. Let's say the obsession is—I already mentioned praying—maybe if I don't read the Bible correctly, I'm going to go to hell. I don't know. Something along the lines of that. If that's their obsession, chances are, there's probably somebody that maybe they have a time where they're reading the Bible or maybe that we have to add in an in vivo where they're going to be reading or something like that. A setup could potentially be, what is your obsession? “I'm afraid that any time I read my Bible, I'm not reading it correctly and I'm going to go to hell.” What is your compulsion? “Well, my compulsion is I read it over and over and over again and I reassure myself that I understand it, I'm reading it correctly.” Who's going to be in your story? This one you might hear just, “Oh, it's just me.” Really, OCD doesn't necessarily care too much if anybody else is in this story. Where are you? “I'm in my living room. It's nighttime. That's when I read my Bible.” When is this taking place? “Oh, we can do it tonight.” Let's say it's tonight.  Interestingly enough, when you have stuff that's going to go to hell, that means, well, how are you getting to hell to begin with? Because that's not just something that can happen. Sometimes in these imaginals, the person has to die in order to get there, or they have to create some type of fantastical way of them getting to hell.  I actually had a situation, this was several years ago, where the person was like, “Well, death doesn't scare me, but going to hell scares me,” because, in some cultures and some religions, it's believed that there are demons living amongst us and so forth. “It's really scary to think about, what if a demon approaches me and takes me immediately to hell and I don't get to say goodbye to my family, my family doesn't know.” Just even like that thought. We were able to incorporate something very similar to that.  Just to make up an imaginal on the spot, it could be, I'm reading my Bible. I'm in my living room, I'm reading my Bible, and the thought pops up in my brain of, did you read that last verse correctly? I decide to just move on and not worry about reading my Bible correctly. Well then, all of a sudden, I get a knock at the door and there's these strange men that I've never seen in my life, and they tell me that they're all demons, and that because I didn't review the Bible correctly, I'm going to go to hell. I would go on and on and probably describe a little bit more about my family not missing me, I don't get to see my kids grow up, I don't get to experience life, the travel, and the stuff that's really important to me, incorporate some of those values. I don't get to live my value-based life. And then at the very end, I was summoned and taken to hell by demons, all because I had the thought of reading my bible correctly and I decided not to.” Kimberley: I love it, and I love what I will point out. I think you use the same model as me. We use a lot of “I” statements like “I did this and I did that, and then this happened and then I died,” and so forth. The other thing that we do is always have it in present tense. Instead of going, “And then this happens, and then that happens,” you're saying as if it's happening. Krista: Yeah. Because you want it to feel real to the person. In all honesty, and I wonder what your experience has been, I find some of the most difficult people to do imaginals with our children. Even though you would think, “Oh, they're so imaginative anyways,” one of the biggest things I really have to remind kids is, I want you to be literally imagining yourself in that moment. Again, I see this with kids more than adults, but I think it just depends on context and perspective. We'll say, “Well, I know that I'm in my living room,” or “I know that I'm in your office, so this isn't actually happening to me in this moment.” You almost have to really work them up and figure out, what's the barrier here? What are you resisting? Kimberley: That's a good question. I would say 10 to 20% of clients of mine will report, “I don't feel anything.” I'll do a Q and A at the end of this series with common questions, but I'm curious to know what your response is to a client who reads like, “I kill my baby,” or “I hurt my mom,” or “I go to hell,” or “I cheat on my husband,” or whatever it is, but it doesn't land. What are your thoughts on what to do then? Krista: A couple of things pop up. One, it makes me wonder what mental compulsions they're doing. And then it also makes me wonder, are we going in the right direction with the story? Because again, like I mentioned before, if a client comes back and they've habituated to one thing, but they're still having the obsession, well, guess what? We're just telling stories. Because the OCD narrative is typically not just laser-focused—I mean, it can be laser-focused, but usually, it has branches—you can pick and choose. I'm going to go ahead and guarantee, that person who is terrified of killing their husband ensure they're not going to see their grandchildren and children. I'm going to go ahead and waiver that there's probably other things that they're afraid of missing.  Kimberley: Yes. That's what I find too, is maybe we haven't gotten to the actual consequence that bothers them. I know when I've written these for myself, we tend to fall into normal traps of subtypes, like the fear that you'll harm somebody or so forth. But often clients will reveal like, “I'm actually not so afraid that I'll harm somebody. I'm really afraid of what my colleagues and family would think of me if I did.” So, we have to include that. Or “I'm afraid of having to make the call to my mom if I did the one thing.” I think that that's a really important piece to it, is to really double down on the consequence. Do you agree? Krista: Oh, I agree a hundred percent. You got to figure out what is that core fear. What are you really, really trying to avoid? With harming somebody, is it the consequences that might happen afterwards? Is it the feeling of potentially snapping or losing control? Or is it just knowing that you just flat out, took the life of somebody and that that was something that you were capable of? I mean, there's so many different themes, looking at what does that feared self like, what does that look like, and maybe we didn't hit it last time. Kimberley: Right. Krista: I know this is going to sound silly and I tell my clients this every once in a while, is I'm not a mind reader. What I'm asking you, is that the most challenging you can go and you're telling me yes, I'm going to trust you. I tell them, if you are not pushing yourself in therapy to where you can grow, I'm still going to go to bed home and sleep tonight just fine. But I want you to also go home and go to bed and sleep just fine. But if you are not pushing yourself, because we know sleep gets affected super bad, not just sleep, but other areas, you're probably going to struggle and you might even come back next week with a little bit more guilt or even some shame. I don't want anybody to have that. I want people to win. I want people to do well in this. I know this stuff is scary, but I'm going to quote somebody. You might know her. Her name is Kimberley Quinlan. She says, “It's a beautiful day to do hard things.” I like to quote her in my practice every once in a while.  Kimberley: I love her. Yes, I agree with this. The way you explained it is so beautiful and it's logical the way you're explaining it too. It makes sense. I have one more question for you. Recently, I was doing some imaginals with a client and they were very embarrassed about the content of their thoughts. Ashamed and guilty, and horrified by their thoughts. I could see that they were having a hard time, so I gave them a little inch and I went first. I was like, “Alright, I'm going to make an assumption about what yours is just to break the ice.” They were like, “Oh yeah, that's exactly what it is.” There was a relief on their face in that I had covered the bases. We did all of the imaginal and we recorded it and it was all set. And then at the end I said, “Is there anything that we didn't include?” They reported, “Yeah, my OCD actually uses much more graphic words than what you use.” I think what was so interesting to me in that moment was, okay, I did them the favor by starting the conversation, but I think they felt that that's as far as we could go. How far do you go? Krista: As far as we need.  Kimberley: Tell me what that means. Krista: Like I mentioned before, the limit does not exist and I mean, the limit does not exist. This is going to sound so silly. I want you to be like a young Stephen King before he wrote his first novel and push it. Push it and then go there. Guess what? If that novel just doesn't quite hit it, write another one, and then another one, and let's see how far you can go. Because OCD is essentially a disorder of the imagination, and you get to take back your imagination by creating the stories that OCD is telling us and twisting it. I mean, what an amazing and powerful thing to be able to do. I'm sure you're the same in that you know that there's a lot of specialists that don't believe in imaginals, don't like imaginals, especially when it comes to issues with pedophilia OCD. I think we also need to not remind our clients because that would be reassurance, but to tell these specialists, we're not putting anything into our client's heads that aren't there to begin with. Just like you said, if your client is thinking like real sick, nasty core, whatever, guess what? We're going to be going there. Are you cutting off the heads of babies in your head? Well, we're going to be talking about stories where you're cutting off the heads of babies. If that's what's going on, we're going to go there. Kimberley: What's really interesting, and this was the example, is we were talking about genitals and sexual organs and so forth. We're using the politically correct term for them in the imaginal. Great. Such a great exposure. Vagina and penis, great. Until again, they were like, “But my OCD uses much more graphic words for them.” I'm like, “Well, we need to include those words.” Would you agree your imaginals don't need to be PC? Krista: I hope my clients watch this, and matter of fact, I'm going to send this to them, just to be like, no, no. Krista's imaginals with her clients. Well, not my imaginals. Imaginals that are with my clients. Woah, sometimes I'm saying bye to my client. I'm like, “I think I need a shower.” Kimberley: Again, when people say they don't like imaginals or they think that it's not a good practice, I feel like, like you said, if OCD is going to come up with it, it gives an opportunity to empower them, to get ahead of the game, to go there before it gets there so that you can go, “Okay, I can handle it.” I would often say to my clients, “Let's go as far as we can go, as far as you can go, so that you know that there's nothing it can come up with that you can't handle.” Krista: I think that where it gets even more complex is when we're hitting some of the taboo stuff. Not only pedophilia, but something like right now that I'm seeing a lot more of in my office is stuff relating to cancel culture. This fear that what if I don't use somebody's pronouns correctly? What if I accidentally say an inappropriate racial slur? I will ask in session and I'll be super real. It's hard for me to hear this stuff because this goes outside of my values. Of course, it goes outside of their values. OCD knows that. That's why it's messing with them. I'll say, “Okay, so what is the racial slur?” My clients are always like, “You really want me to say it?” I said, “We're going to say it in the imaginal.” I realized how hard that is to stomach for therapists. But in my brain, the narrative that OCD is pushing, whether it is what society views as OCD or taboo OCD, it doesn't matter. We still have to get it out. It is still hard for that client. If that's hard for that client to think of an imaginal or a racial slur, it is almost the exact same amount of distress for somebody maybe with an imaginal that I'm afraid I'm getting food poisoning.  We, as clinicians, just because we're very caring and loving people, sometimes we can unintentionally put a hierarchy of distress upon our clients like, okay, I can do this imaginal because this falls with my values, but I don't know if I can do this imaginal because pedophilia is something that's hard for me to do and I don't want to put my client through that. Well, guess what? Your client is already being put through that, whether you like it or not. It's called OCD. Kimberley: Right. Suppressing it makes it come on stronger anyway. Love that. I think that the beauty of that is there is a respectful value-based way of doing this work, but still getting ahead of OCD. Is that what you're saying? Krista: Absolutely. OCD tries to mess with us and think, what if you could be this person? Well, like I mentioned before, if a story is like a weapon, well, I'm going to tell a story to attack OCD because it's already doing it to me. Kimberley: Yeah. Tell us where people can hear more from you, get your resources because this is such great stuff. Krista: Thank you. I'd say probably the best way to find me and my silly videos would be on my Instagram @anxiouslybalance. Kimberley: Amazing. And your private practice? Krista: My private practice, it's A Peaceful Balance in Wichita, Kansas. The website is apbwichita.com. Kimberley: Thank you so much. I'm very grateful for you for inspiring this whole series and for also being here as a big piece of the puzzle. Krista: Thank you. I'm grateful for you that you don't mind me just like this. I'm grateful for you for letting me talk even though clearly, I'm not very good at it right now. You're amazing. Kimberley: No, you're amazing. Thank you. Really, these are hard topics. Just the fact that you can talk about it with such respect and grace and compassion and education and experience is gold.  Krista: Thank you. At the end of the day, I really truly want people to get better. I know you truly want people to get better. Isn't that just the goal? Kimberley: Yeah. It's beautiful. Krista: Thank you. 

Bonnie Grossman is a licensed therapist who is trained in EFT (tapping), Family Constellations, Energy healing, Transpersonal Psychology, Eposure and Response Prevention, Cognitive Behavioral Terapy, and Radical Forgiveness. She's a strong believer in her patients' road to recovery, a path that she guides them to through sessions that are tailorfit to their backgrounds. In this episode, we talk about:  ◾️ Trusting yourself ◾️ Cultivating bravery ◾️ Bonnie's perspective on what recovery is Find Bonnie here: pathwaystt@gmail.com Find Zach here:  zachwesterbeck.com @zach_westerbeck

Welcome. This is Week 4 of the Sexual Health and Anxiety Series. I have loved your feedback about this so far. I have loved hearing what is right for you, what is not right for you, getting your perspective on what can be so helpful. A lot of people are saying that they really are grateful that we are covering sexual health and anxiety because it's a topic that we really don't talk enough about. I think there's so much shame in it, and I think that that's something we hopefully can break through today by bringing it into the sunlight and bringing it out into the open and just talking about it as it is, which is just all good and all neutral, and we don't need to judge. Let's go through the series so far. In Episode 1 of the series, we did sexual anxiety or sexual performance anxiety with Lauren Fogel Mersy. Number two, we did understanding arousal and anxiety. A lot of you loved that episode, talking a lot about understanding arousal and anxiety. Then last week, we talked about the sexual side effects of anxiety and depression medication or antidepressants with Dr. Sepehr Aziz. That was such a great episode. This week, we're talking about sexual intrusive thoughts.  The way that I structured this is I wanted to first address the common concerns people have about sexual health and intimacy and so forth. Now I want to talk about some of the medical pieces and the human pieces that can really complicate things. In this case, it's your thoughts. The thoughts we have can make a huge impact on how we see ourselves, how we judge ourselves, the meaning we make of it, the identity we give it, and it can be incredibly distressing. My hope today is just to go through and normalize all of these experiences and thoughts and presentations and give you some direction on where you can go from there. Because we do know that your thoughts, as we discussed in the second episode, can impact arousal and your thoughts can impact your sexual anxiety.  SEXUAL OCD OBSESSIONS Let's talk a little bit today about specific sexual intrusive thoughts. Now, sexual intrusive thoughts is also known as sexual obsessions. A sexual obsession is like any other obsession, which is, it is a repetitive, UNWANTED—and let's emphasize the unwanted piece—sexual thought. There are all different kinds of sexual intrusive thoughts that you can have. For many of you listening, you may have sexual intrusive thoughts and OCD that get together and make a really big mess in your mind and confuse you and bring on doubt and uncertainty, and like I said before, make you question your identity and all of those things.  In addition to these intrusive thoughts, they often can feel very real. Often when people have these sexual intrusive thoughts, again, we all have intrusive thoughts, but if they're sexual in nature, when they're accompanied by anxiety, they can sometimes feel incredibly real, so much so that you start to question everything.  SEXUAL SENSATIONS Now, in addition to having sexual intrusive thoughts, some of you have sexual sensations, and we talked a little bit about this in previous episodes. But what I'm really speaking about there is sensations that you would often feel upon arousal. The most common is what we call in the OCD field a groinal response. Some people call it the groinal in and of itself, which is, we know again from previous episodes that when we have sexual thoughts or thoughts that are sexual in nature, we often will feel certain sensations of arousal, whether that be lubrication, swelling, tingling, throbbing. You might simply call it arousal or being turned on. And that is where a lot of people, again, get really confused because they're having these thoughts that they hate, they're unwanted, they're repetitive, they're impacting their life, they're associated with a lot of anxiety and uncertainty, and doubt. And then, now you're having this reaction in your body too, and that groinal response can create a heightened need to engage in compulsions.  As we know—we talk about this in ERP School, our online course for OCD; we go through this extensively—when someone has an obsession, a thought, an intrusive thought, it creates uncertainty and anxiety. And then naturally what we do is we engage in a compulsion to reduce or remove that discomfort to give them a short-term sense of relief. But then what ends up happening is that short-term relief ends up reinforcing the original obsession, which means you have it more, and then you go back through the cycle. You cycle on that cycle over and over again. It gets so big. It ends up impacting your life so, so much. INTRUSIVE SEXUAL URGES Now, let's also address while we're here that a lot of you may have intrusive sexual urges. These are also obsessions that we have when you have OCD or OCD-related disorders where you feel like your body is pulling you towards an action to harm someone, to do a sexual act, to some fantasy. You're having this urge that feels like your body is pulling you like a magnet towards that behavior. Even if you don't want to do that behavior, or even if that behavior disgusts you and it doesn't line up with your values, you may still experience these sexual OCD urges that really make you feel like you're on the cusp of losing control, that you may snap and do that behavior. This is how impactful these sexual intrusive thoughts can be. This is how powerful they can be in that they can create these layers upon layers. You have the thoughts, then you have the feelings, then you have the sensations, you also have the urges. Often there's a lot of sexual intrusive images as well, like you see in front of you, like a projector, the image happening or the movie scene playing out that really scares you, concerns you, and so forth. And then all of those layers together make you feel absolutely horrible, terrified, so afraid, so unsure of what's happening in and of yourself.  TYPES OF SEXUAL OCD OBSESSIONS Let's talk about some specific OCD obsessions and ways in which this plays out. Now, in the OCD field, we call them subtypes. Subtypes are different categories we have of obsessions. They don't collect all of them. There are people who have a lot of obsessions that don't fall under these categories, but these subtypes usually include groups of people who experience these subtypes. The reason we do that is, number one, it can be very validating to know that other people are in that subgroup. Number two, it can also really help inform treatment when we have a specific subtype that we know what's happening, and that can be very helpful and reduce the shame of the person experiencing them.  1. SEXUAL ORIENTATION OBSESSIONS OR SEXUAL ORIENTATION OCD It used to be called homosexual OCD. That was because predominantly people who were heterosexual were reporting having thoughts or sexual intrusive thoughts about their sexual orientation—am I gay, am I straight—and really struggling with having certainty about this. Again, now that we're more inclusive and that I think a lot more people are talking about sexuality, that we have a lot less shame, a lot more education, we scrapped the homosexual OCD or homosexual obsessions or subtype category. Now we have a more inclusive category, which is called sexual orientation OCD. That can include any body of any sexual orientation who has doubt and uncertainty about that.  Now remember when we started, we talked about the fact that sexual intrusive thoughts are usually unwanted, they're repetitive and they don't line up with our values. What we are not talking about here is someone who is actually questioning their sexual orientation. I know a lot of people are. They're really exploring and being curious about different orientations that appeal to them. That's way different to the people who have sexual orientation OCD or sexual orientation obsessions. People with OCD are absolutely terrified of this unknown answer, and they feel an incredible sense of urgency to solve it.  If you experience this, you may actually want to listen back. We've got a couple of episodes on this in the past. But it's really important to understand and we have to understand the nuance here that as you're doing treatment, we are very careful not to just sweep people under the rug and say, “This is your OCD,” because we want to be informed in knowing that, okay, you also do get to question your sexual orientation. But if it is a presentation of sexual orientation OCD, we will treat it like that and we will be very specific in reducing the compulsions that you're engaging in so that you can get some relief. That is the first one.  2. SEXUAL INTRUSIVE THOUGHTS ABOUT FAMILY OR SEXUAL INTRUSIVE THOUGHTS ABOUT INCEST Incest sexual OCD or that type of subtype is another very common one. But often, again, one that is not talked about enough in fear of being judged, in fear of having too much shame, in fear of being reported. When people have these types of obsessions, they often will have a thought like, “What if I'm attracted to my dad?” Or maybe they're with their sibling and they experience some arousal for reasons they don't know. Again, we talked about this in the arousal and anxiety episode, so go back and listen to that if you didn't. They may experience that, and that is where they will often say, “My brain broke. I feel like I had to solve that answer. I had to figure it out. I need to get complete certainty that that is not the case, and I need to know for sure.”  The important thing to remember here is a lot of my patients, I will see and they may have some of these sexual intrusive thoughts, but their partners will say, “Yeah, I've had the same thoughts.” It's just that for the person without OCD, they don't experience that same degree of distress. They blow it off. It doesn't really land in their brain. It's just like a fleeting thought. Whereas people with OCD, it's like the record got stuck and it's just repeating, repeating, repeating. The distress gets higher. The doubt and uncertainty get higher. Therefore, because of all of this bubbling kettle happening, there's this really strong urgency to relieve it with compulsions.  3. SEXUAL INTRUSIVE THOUGHTS ABOUT GOD OR ABOUT A RELIGIOUS LEADER This is one that's less common, or should I say less commonly reported. We actually don't have evidence of how common it is. I think a lot of people have so much shame and are so afraid of sinning and what that means that they may even not report it. But again, this is no different to having thoughts of incest, but this one is particularly focused on having sexual thoughts about God and needing to know what that means and trying to cleanse themselves of their perceived sin, of having that intrusive thought. It can make them question their religion. It can make them feel like they have to stop going to church. They may do a ton of compulsive prayer. They may do a ton of reassurance with certain religious leaders to make sure that they're not sinning or to relieve them of that uncertainty and that distaste and distress. These are all very common symptoms of people who have sexual intrusive thoughts about God. 4. BESTIALITY OBSESSIONS These are thoughts about pets and animals, and it's very common. It's funny, as we speak, I am recording this with a three-pound puppy sitting on my lap. We just got a three-pound puppy. It is a Malti-Poo puppy dog, and he's the cutest thing you've ever seen. But it's true that when you have a dog, you're having to take care of its genitals and wipe it up and its feces and its urine and clean and all the things, and it's common to have sexual intrusive thoughts about your pet or about your dog or your cat. Some people, again, with bestiality obsessions or bestiality OCD, have a tremendous repetitive degree of these thoughts. They're very distressing because they love their dog. They would never do anything to hurt their dog, but they can't stop having these thoughts or these feelings or these sensations, or even these urges. Again, all these presentations are the same, it's just that the content is different. We treat them the same when we're discussing it, but we're very careful with addressing the high level of shame and embarrassment, humiliation, guilt that they have for these thoughts. Guilt is a huge one with these sexual obsessions. People often feel incredibly guilty as if they've done something wrong for having these obsessions. These are a few.  5. PEDOPHILIA OBSESSIONS Now, for someone who has intrusive sexual thoughts and feelings and sensations and urges about children (POCD), they tend to be, in my experience, the most distressed. They tend to be, when I see them, the ones who come in absolutely completely taken over with guilt and shame. A lot of the time, they will have completely removed themselves from their child. They feel they're not responsible. They won't go near the parks. They won't go to family's birthday parties. They're so insistent on trying to never have these thoughts. Again, I understand. I don't blame them. But as we know, the more you try not to have a thought, what happens? The more you have it. The more you try and suppress a thought, the more you have it. That can get people in a very stuck cycle.  SEXUAL OCD  COMPULSIONS Let's move on now to really address different sexual OCD compulsions.  Now, for all sexual obsessions, or what I should say is, for all obsessions in general, there are specific categories of compulsions and these are things again that we do to reduce or remove the discomfort and certainty, dread, doubt, and so forth.  1. Trigger Avoidance This is where you avoid the thing that may trigger your obsession or thought. Avoiding your dog, avoiding your child, avoiding your family member, avoiding people of the sexual orientation that you're having uncertainty about.  2. Actual Sex Avoidance We talked about that in the first episode. We talked a lot about how people avoid sex because of the anxiety that being intimate and sexual causes.  3. Mental Rumination This is a really common one for sexual intrusive thoughts because you just want to solve like why am I having it? What does it mean? You might be ruminating, what could that mean? And going over and over and over that a many, many time.  4. Mental Checking What you can also be doing here is checking for arousal. Next time you're around, let's say, a dog and you have bestiality obsessions, you might check to see if you're aroused. But just checking to see if you're aroused means that you get aroused. Now that you're aroused, you're now checking to see what that means and trying to figure that out and you're very distressed.  We can see how often the compulsion that the person does actually triggers more and more and more distress. It may provide you a moment or a fleeting moment of relief, but then you actually have more distress. It usually brings on more uncertainty. We know that the more we try and control life, the more out of control we feel. That's a general rule. That's very much the case for these types of obsessive thoughts.  5. Pornography Use A lot of people who have sexual orientation OCD in particular, but any of these, they may actually use pornography as a way to get reassurance that they are of a certain sexual orientation, that they are not attracted to the orientation that they're having uncertainty about, or they're not attracted to animals or God or a family member because they were aroused watching pornography. That becomes a form of self-reassurance.  There's two types of reassurance. One is reassurance where we go to somebody else and say, “Are you sure I wouldn't do that thing? Are you sure that thing isn't true? Are you sure I don't have that? I'm not that bad a person?” The other one is really giving reassurance to yourself, and that's a very common one with pornography use.  SEXUAL INTRUSIVE THOUGHTS PTSD  There are some sexual intrusive thought examples, including specific obsessions and subtypes, and also compulsions. But one sexual intrusive thought example I also wanted to address is not OCD-related; it's actually related to a different diagnosis, which is called PTSD (post-traumatic stress disorder). Often for people who have been sexually assaulted or molested, they too may experience sexual intrusive thoughts in the form of memories or images of what happened to them or what could have happened to them. Maybe it's often some version of what happened to them, and that is a common presentation for PTSD. If you are experiencing PTSD, usually, there is a traumatic event that is related to the obsession or the thoughts. They usually are in association or accompanied by flashbacks. There are many other symptoms. I'm not a PTSD specialist, but there's a high level of distress, many nightmares. You may have flashbacks, as I've said. Panic is a huge part of PTSD as well. That is common. If you have had a traumatic event, I would go and see a specialist and help them to make sure that they've diagnosed you correctly so that you can get the correct care.  SEXUAL INTRUSIVE THOUGHTS TREATMENT If you have OCD and you're having some of these sexual intrusive thoughts, the best treatment for you to go and get immediately is Exposure and Response Prevention. This is a particular type of cognitive behavioral therapy where you can learn to change your reaction, break yourself out of that cycle of obsessions, anxiety, compulsions, and then feed yourself back into the loop around and around. You can break that cycle and return back to doing the things you want and have a different reaction to the thoughts that you have. PEOPLE ASK HOW TO STOP SEXUAL INTRUSIVE THOUGHTS?  Often people will come to me and say, “How do I stop these sexual intrusive thoughts?” I will quickly say to them, “You don't. The more you try and stop them, the more you're going to have. But what we can do is we can act very skillfully in intervening, not by preventing the thoughts, but by changing how we relate and respond to those thoughts.” For those of you who don't know, I have a whole course on this called ERP School. ERP is for Exposure and Response Prevention. I'll show you how you can do this on your own, or you can reach out to me and we can talk about whether if you're in the states where we're licensed, one of my associates can help you one-on-one. If you're not in a state where I belong, reach out to the IOCDF and see if you can find someone who treats OCD using ERP in your area. Because the truth is, you don't have to suffer having these thoughts. There is a treatment to help you manage these thoughts and help you be much more comfortable in response to those thoughts. Of course, the truth here is you're never going to like them. Nobody likes these thoughts. The goal isn't to like them. The goal isn't to make them go away. The goal isn't to prove them wrong even; it's just to change your reaction to one that doesn't keep that cycle going. That is the key component when it comes to sexual intrusive thoughts treatment or OCD treatment. That's true for any subtype of OCD because there are many other subtypes as well.  That's it, guys. I could go on and on and on and on about this, but I want to be respectful of your time. The main goal again is just to normalize that these thoughts happen. For some people, it happens more than others. The goal, if you can take one thing away from today, it would be, try not to assign meaning to the duration and frequency of which you have these thoughts. Often people will say, “I have them all day. That has to mean something.” I'm here to say, “Let's not assign meaning to these thoughts at all. Thoughts are thoughts. They come and they go. They don't have meaning and we want to practice not assigning meaning to them so we don't strengthen that cycle.”  I hope that was helpful for you guys. I know it was a ton of information. I hope it was super, super helpful. I am so excited to continue with this.  Next week, we are talking about menopause and anxiety, which we have an amazing doctor again. I want to talk about things with people who are really skilled in this area. We have a medical doctor coming on talking about menopause and the impact of anxiety. And then we're going to talk about PMS and anxiety, and that will hopefully conclude our sexual health and anxiety series.  Thank you so much for being here. I love you guys so much. Thank you from me and from Theo, our beautiful little baby puppy. I will see you next week.

Parenting is one of the most significant factors that impact a child's mental health. Unfortunately, there's a tendency that your parenting skills can worsen your child's Obsessive-Compulsive Disorder (OCD) or other mental health disorders.There are cases when parents are unaware they are already contributing to their child's OCD. Thus, it's a must to educate parents about these things. Don't feed your child's OCD.Let's flip the script and help parents understand that there are ways to improve their child's OCD.How OCD works in the brainEverything is about the brain. It's all about how we use the brain to unlearn things, learn what we should do, and learn how to calm the brain. So everything starts with the brain. When we use brain-informed techniques, we use techniques that improve kids and families.When we speak of negative reinforcement, what happens is that we reinforce a behavior that is more likely to happen again. Then it becomes a habit. That's what happens with OCD. Negative beliefs, worries, unwanted thoughts, intrusive thoughts, and fears are reinforced.That's what obsessions, compulsions, and rituals are all about. They don't even have to make sense. Parents must let go of the idea that this has to make sense because that's not the case. It doesn't make sense to them, and it won't make sense to you, either.It even scares the children when you ask them if it makes sense and, if it does, how it makes sense. So what should be done is to avoid reinforcement. We shouldn't reinforce their worries or fears, especially when they're already overwhelmed by them.The more we push back, the more your child's brain says, "The bad thing didn't happen."We push our kids to feel distressed whenever we reinforce these unwanted and intrusive thoughts, worries, or fears. However, we must remember that the more we push back, the more we stop feeding the barking dog.The same can be said for anxiety, depression, and other mental health problems. The more we push back, the more your child's brain says, "Oh, the bad thing didn't happen. The worry didn't happen. I can do this." So it works by pushing down these behaviors, and eventually, we get to extinguish them.Undoubtedly, the journey to treating your child's OCD will be long and challenging. But it's going to be worth everything. That's why it doesn't make sense why around 30% of people drop out of Exposure and Response Prevention (ERP).OCD is such a tyrant. It takes over not just the child struggling with his mental health but also the whole family, who has to work around and learn about OCD.Exposure and Response Prevention teaches parents how not to reinforce desired behaviorsWe've been emphasizing how badly we must stop reinforcement from stopping feeding your child's OCD. We can better accomplish this through Exposure and Response Prevention, which teaches parents how not to reinforce desired behaviors. Instead, strengthen their autonomy and coping skills. One of the most freeing things parents can get is the feeling after extinguishing these behaviors, worries, and fears. Parents must be supportive of their children because they're the CEOs of their families and also because they are the first role models of their children.And so, when they feel like someone understands them, that's a big deal. Hence, parents should have a positive attitude. They should be ready to do what should be done for the betterment of their children. There is no “magic wand”Parents should know that there is no magic wand because there's this common notion that Selective Serotonin Reuptake Inhibitors (SSRI) or some medication will reduce the discomfort their child is experiencing. It can reduce discomfort, but not entirely.With anxiety and OCD, there will always be physical discomfort. That's why

Although Obsessive-Compulsive Disorder (OCD) is considered to be treatment-resistant, parents shouldn't lose hope. Don't let fear or worries ruin your family's life. Treatments are available for you, effectively stopping OCD in its tracks.There's always room for growth. You can find professional care that will save you thousands of money and long years of pain and worried thoughts. Now, let's talk about these treatments to help us stop OCD symptoms. The more you give in to OCD, the more it gets reinforcedIt's essential to consult with mental health professionals, especially OCD experts, as they are the ones who can significantly help you and your kids. So, do whatever you need to do to get that mental healthcare provider.Remember that the more we give in to OCD, the more it gets reinforced and the harder it is to treat. That's when your kid's OCD becomes treatment-resistant, although it doesn't have to be because there are treatments that work and have been proven to be effective. The BrainBehaviorResetTM Program helps calm the brain and make families happy in various ways. So we need to reset the brain by calming it down and then undergo this program. We'll also be releasing our supplement line called Neurotastic, which will help treat OCD, so watch out for that.Using science-backed tools to calm the brain is essential, and it gives us better resultsIt's vital that patients use science-backed tools in calming the brain, as relying on scientifically proven tools gives us better results in treating OCD.We create wiggle room and then couple it with other types of mindfulness-based or evidence-based practices because sometimes, something as simple as breathwork is hard for somebody with OCD for various reasons.Most of the time, they're physically and cognitively jacked up, and the idea of calming down sickens them. When they do that, they might even have a nauseous parasympathetic response, so we have to be mindful.We want to ensure that the techniques and treatments our kids are getting are safe and gentle, which is essential. So we help them through various brain-based activities that calm and regulate the nervous system. Then, we come in with new learning through Exposure and Response Prevention (ERP)How OCD hijacks the brain and how to deal with itWe've mentioned that Exposure and Response Prevention therapy does much for the brain. But we also have to couple it with a lot of psycho-education about how OCD hijacks the brain. Educating parents is necessary to inform them about their tendencies to accommodate and reinforce OCD.Many services and activities could be done to help a person feel more in control. But more than that, the first and most crucial part of treating and stopping OCD symptoms is understanding what's happening.You can't address OCD if you don't entirely understand it. If you don't know how sneaky OCD is, the next thing you know is you're already answering the questions your kid has about OCD. The fear is, “If we don't do x, this bad thing will happen.”Worried or anxious thoughts invade your kid's mind when they have OCD. They fear that something terrible will happen if they don't do something.There are OCD cases that highlight a kid's good performance in school, at home, or elsewhere. But you only sometimes know whether high-performing kids are mentally healthy because they might be able to direct it well. Of course, their perfectionist tendencies will save them academically, but we can see the signs when we look back.Sometimes, our kids say scary and quite worrisome statements that don't necessarily make sense. However, this shouldn't be treated like such a bad thing because, through their statements, we get a glimpse of their thoughts.No matter where you are in your journey, we have...

Ask David: Featuring Matt May, MD What causes anxiety? Is recovery permanent? What if the cognitive distortions aren't helpful? Do hormones cause anxiety and depression? What's the role of vitamins and nutrition? How do Exposure and Response Prevention work? And many more answers to your questions! In today's podcast, three shrinks discuss many intriguing questions about anxiety from individuals who attended one of Dr. Burns' free workshops on anxiety sponsored by PESI more than a year ago. Several of the questions were answered on the podcast, and a great many more are answered in the show notes below. But first, Rhonda opened the podcast by reading an endorsement from a listener named Rob, with a link. Here it is! Hi Dr. Burns: I'm a long-time listener/reader, first-time caller. I stumbled upon this endorsement for Feeling Good today, and I thought it was worth sharing with you. I can't think of a better endorsement for a book. I hope you enjoy it! "I've replaced my copy close to ten times, as I keep lending it to friends who never give it back." https://girlboss.com/blogs/read/feeling-good-david-burns-review Have a great day! Rob Thanks, Rob! And now, for the many excellent questions submitted by listeners like you! Many were answered in depth on the podcast, but you'll see that all questions have written answers as well. When you talk about someone recovering, is that free of panic attacks and anxiety forever, or a great decrease in symptoms but you will always be an anxious person to a certain extent? Especially for someone who has fundamentally been anxious since they were young so not episodic but continuous. David's Answer. Some people are anxiety-prone, and that is likely due to a genetic cause. I am like that, for example. Once you are 100% free of any form of anxiety, like my public speaking anxiety, you need to continue with exposure, or the old anxiety will try to come creeping back in. So, I do public speaking all the time! What if your client/patient understands the Cognitive Distortions but doesn't believe them to be true? David's Answer. It is hard for me to comprehend what you mean. But I will say this. Anxiety and depression and other negative feelings result 100% from distorted negative thoughts. And the exact moment when you stop believing the thought that's triggering your anxiety or depression, you will almost instantly feel relief. And here's the precise answer to your question. When someone says, “I understand the distortions but it doesn't help,” they still believe their negative thoughts. Resistance, too, is an issue. Nearly 100% of therapeutic failure results from jumping in and trying to help the patient without first comprehending the many reasons why the patient will fight against the therapist's efforts to “help.” Has research been done on the possible relationship in hormone levels in women and anxiety or depression? Especially during pregnancy, post pregnancy, and those going through menopause? Also, can negative thoughts also depend on the person's nutrition? Could it be that vitamins that are lacking? David's Answer.  First, I am not aware of any convincing evidence linking hormone levels with depression, anxiety, irritability, or any other negative feelings. However, we can say with certainty that whatever the cause, which is unknown, distorted thoughts will always be present and will be the trigger for the negative feelings. In or near the first chapter of my most recent book, Feeling Great, I describe case of post pregnancy depression, and you can take a look and see the mother's negative thoughts clearly. And you will also see that the moment she crushed those thoughts, her depression disappeared! People want to “biologize” emotional problems, and I started out as a “biological psychiatrist” and researcher, but found the biological explanations to be erroneous and unhelpful. Could you please give a brief overview about Exposure with Response Prevention for OCD treatment.  Thank you! David's Answer. Sure, these are tools that can be helpful, along with many other kinds of tools, in the treatment of anxiety, including OCD. They are not, for the most part, treatments. I use four models in the treatment of every anxious patient: the Motivational, Cognitive, Exposure, and Hidden Emotion Models. Exposure is facing your fears and enduring the anxiety until the anxiety subsides and disappears. Response Prevention is refusing to give in to the superstitious rituals OCD users when anxious, like counting, arranging things in a certain way, and so forth. END OF QUESTIONS DISCUSSED LIVE ON THE PODCAST The answers to the questions below were written by Dr. Burns but not discussed on the Podcast. Questions can I ask to overcome the Cognitive Distortion “jumping to conclusions”? That is the toughest for me. David's Answer. I would need a specific example. Jumping to Conclusions includes a vast array of topics and negative thoughts. Fortune Telling and Mind Reading are the most common forms of Jumping to Conclusions. Feelings of hopelessness always result from Fortune Telling. All forms of anxiety always result from Fortune Telling as well. Social Anxiety typically includes Mind-Reading, and Mind-Reading is almost universal in relationship conflicts. In addition, I never treat a distortion, an emotion, a diagnosis, or a problem. I treat human beings systematically, using the T E A M algorithm. Matt's Answer. There are many methods in TEAM that can be applied in the form of a question. These methods and how they are carried out, depends on the circumstances and the specific thoughts a person is having. Below are some examples of negative thoughts (NT's) and the types of questions that might help overcome them. (NT): ‘Something really bad is going to happen'  (Be Specific Technique): ‘Like what? What's going to happen?'  NT: ‘I'll fail my biology test'  What-If Technique: ‘What if I failed my biology test, why would I be worried about that? (write down any new thoughts) What if those things happened, too, what then? (write down any new thoughts) What's the absolute worst thing that could happen? (write this down).  Measurement: How certain am I, that these things will happen? On a scale from 0 – 100%, how likely are each of these predictions, in the form of negative thoughts, to occur?  Socratic Outcome Resistance: What do each of these negative thoughts say about my values that I can feel proud of? (write these down) What is appropriate about how I'm feeling and thinking? (write these down) What are the advantages of having these thoughts? (write these down). What would I be afraid of, if I didn't have this thought? (write these down)  Pivot Question: Given the many positive values related to worrying, the advantages of doing so, the disadvantages of a carefree existence and the many reasons why my worry is appropriate, why would I change this?  Forgetful Clone (Double-Standard Amnestic Technique for Outcome Resistance): What would you say, to a dear friend, in an identical situation, when they asked these questions: ‘I'm really worried about failing my biology test, would you be willing to help me? (if ‘yes', then continue) … Don't I need to keep worrying? Won't that protect me from failing? Don't I need to worry, so that I'm highly motivated to succeed? Don't I need to worry, so I avoid making mistakes? Don't I need to worry, to maximize my rate of learning new material? Won't I get lured into a false sense of security, if I stop worrying? Won't I jinx it, if I get too confident? What would you recommend to me? How much do you think I should worry? I am prepared to do so … would it be helpful for me to go into a sustained panic, at this time?'  Cost-Benefit Analysis: Is worrying about failure worth the price? How would you weigh the advantages of worrying about failure against the disadvantages? What are the pro's and con's? How would you divide 100 points, to reflect the power of these two arguments?  Examine the Evidence, Motivational: What evidence is there that worrying improves academic performance, concentration and learning? What evidence is there that worrying worsens academic performance, concentration and learning? Magic Dial Question: ‘‘Should I remain maximally worried, at all times, forever? (If not, keep going) 'What amount of worry is best, for me, in this moment?', ‘How about future moments? How frequently do I need to worry and for how long?'  Process Resistance for Activity Scheduling, Worry Breaks/Cognitive Flooding, Self-Monitoring/Response Prevention: ‘Would it be alright to ignore my worry most of the time and only focus on it during scheduled times? Let's say I could learn how to be extremely calm and focused most of the day, without worry … would I be willing to worry as intensely as possible, for ten minutes, three times per day, to achieve this? When my worry comes up at other times, would I be willing to observe and record that event, then return to the task on my schedule?  Socratic Questioning: Am I absolutely certain that this thought is true, that I will fail? How do I know that I will fail? What specific questions will be on the Biology test that I will get wrong? What number grade will I get? A 60? 58? 39?', ‘Would I bet money on my getting precisely that grade? Why not?'.  Examine the Evidence (cognitive): ‘What evidence is there that I will fail? What evidence is there that I will pass?  Reattribution: Let's say that I fail. Would that be entirely my fault? Are there any other factors, outside my control, that might have contributed to this outcome? My genetics, for example? Or the nature of the world, into which I was born? Did I choose my genetics? Did I choose the world into which I was born, when I was born, my parents, teachers, etc.? Could any of these factors have played any role in the outcomes in my life?  Other examples of Inquiry-based methods, using different NT's:  Negative Thought: ‘People will be angry and judge me, if I fail'  Interpersonal Downward Arrow: ‘What kind of people are they, if they judge me and look down on me, when I fail? How would I feel towards those types of people? Is it possible I feel angry? How do I express that feeling? What ‘rule' am I following, in my relationships?'  Outcome Resistance: What's good about me, for feeling anxious, rather than angry? What are the advantages of keeping my feelings inside? What would I be afraid of, if I expressed my feelings?  Process Resistance, 5-Secrets: Would I be willing to spend the time to learn the skills required to express my feelings, including anger, to people, in a way that made them feel good?  Negative Thought: ‘I'll get sick and die'  Be Specific: ‘When? What time of day will that occur? What illness is going to kill me?'  Negative Thought: ‘I'll lose my mind, crack up and go crazy'  Examine the Evidence: Has that ever happened to me? When was the last time? When you are working with clients, how do you handle it when they can challenge their thoughts very convincingly using a variety of techniques, state that they can see the logic in their restructured thought BUT they are still experiencing heightened anxiety and state that this hasn't helped them? David's Answer. They still have a strong belief in their negative thoughts. It is 100% untrue that they have “challenged them very convincingly.” Here's an example. Let's say you have an intense fear of glass elevators. You will say, “I can see that they are unsafe, but I am still terrified of going in one.” The moment you get on the elevator your belief that you are in danger will suddenly skyrocket to 100%. In other words, you still believe your negative thoughts. Of course, it is nearly always easy to overcome phobias, including an elevator phobia. As stated above, I use four models in treating every anxious patient. Simplistic formulas are just that—Simplistic! Treating humans is not like changing the oil in your car! Matt's Answer: I am hard pressed to add anything of value to David's awesome response, above. I might just reiterate that the Cognitive model, challenging the logic behind negative, anxiety-producing thoughts, is the least powerful of the approaches we have to anxiety. It is necessary, but almost always insufficient. Exposure, motivational methods and Hidden emotion are the real heavy-hitters. Until trying these, it is likely that the negative thoughts can be disproven ‘intellectually' but not at the emotional level. How do you work with clients who state they are anxious all the time, experience strong somatic symptoms (body sensations) and cannot identify specific thoughts. They don't catastrophize these somatic symptoms but really, really dislike them and want them gone! David's Answer. I just ask them to make up some negative thoughts. That works well. For example, they may have the belief that the anxiety must be avoided because it may never disappear, or may believe that they are on the verge of going crazy, and so forth. Matt's Answer, Anxiety can cause people's brains to shut down, experiencing the ‘deer in the headlights' phenomenon. Try to identify just one upsetting thought, then use the ‘what-if' technique to expand on that. You'll be off and running! How do you do techniques with a person who has active suicidal thoughts? David's Answer. I don't “do techniques.” I find out if they're actively suicidal and in danger. If I know for certain that the person is safe, I treat them like human beings, with T E A M. I'm not a formula person. Each person will be different, and will respond to different methods. My books and podcasts are chock full of examples of actively suicidal people who responded. Matt's Answer. I let them know that I don't have the skill to help them unless I know they're safe. If I'm worried for their safety, I'll be afraid to use aggressive methods that may be required for them to recover. I'd need them to convince me of their safety before agreeing to work with them. If they can do so, I offer TEAM. If not, I ask if they're willing to escalate the level of their care, e.g. to meet with me while hospitalized in a safe setting. I don't work with patients who are at risk of harming themselves because I don't believe in my ability to be helpful to them. Is it really okay to keep continuing the experimental technique when the patient does not want to continue? And, what if the therapist is not confident and something goes wrong in this situation? David's Answer. I would need a specific example, but you are right that 75% or so of therapists are afraid of exposure and will not use it, fearing that something will “go wrong!” Matt's Answer. It's important to identify the resistance before initiating the method of exposure and to talk it through. Why would they not want to continue? What are they afraid of, if they get really anxious, during exposure? Write this down. Then, surrender, acknowledging that these are some excellent reasons to avoid exposure, in which case we can't help them with their anxiety. Perhaps there's something else they want help with? If they can convince you, and themselves, that exposure is precisely what they want to do, and they're willing to keep doing it, even if it makes them very anxious, it's appropriate to push a bit, in the moment of their doing exposure, to bolster them and help them through the rough patch. That said, I always give my patients a way out, if they don't want to continue. That's their choice, I just want them to be aware of the consequences, including a worsening of their anxiety. When doing experimental method, or the exposure method for example with who has sweating issue, how do you handle the hyper-vigilance he would have with people around, especially if someone actually laughed at him? David's Answer. I would use the Feared Fantasy Technique, and Self-Disclosure. I would likely go with the patient into the real world to do these things, and have done so on hundreds of occasions. How would you work with someone who suffers from  Selective/Situational Mutism? David's Answer. I have not run into that in my clinical practice. But 100% of the time, I would want to know what the patient's agenda is. I would also want to know if there are powerful motivational factors that need to be addressed, looking at the whole person rather than the symptom. How different are Team CBT treatments for teens as compared to adults? David's Answer. My experience is limited, but I would say no difference, really. I have loved working with teens, even though my main focus was on adults. When working with little kids, I think you need to incorporate play and games, although the basic concepts are the same. For example, you can do Externalization of Voices with puppets, the “Bad, Mean Self” and the “Positive, Loving Self,” or some such. We have featured shrinks who work with kids on many times on our podcasts. Thanks for joining us today! Matt, Rhonda, and David

In episode 364 I chat with Jenny who has kindly agreed to share her story with us.  We discuss her OCD story including themes false memory OCD and relationship OCD. Jenny shares her experience of Exposure and Response Prevention therapy (ERP), depression, how her fiancé responds in a helpful way to her OCD, and so much more. Hope it helps.  Show notes: https://theocdstories.com/episode/jenny-364  The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories

In episode 360 I interviewed Penny who has kindly agreed to share her OCD story with us. In this episode we discuss her story, sexual orientation themed OCD, relationship themed OCD, figuring out it's OCD, getting married, Exposure and Response Prevention therapy (ERP), working on issues in the relationship without OCD blowing them out of proportion, yoga, a reading of something she wrote, and much more. Hope it helps.  Show notes: https://theocdstories.com/episode/penny-360  The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories