WEBVTT
00:00:00.080 --> 00:00:02.640
POCD is one of the most taboo themes in OCD.
00:00:02.799 --> 00:00:07.919
Many people aren't even comfortable saying the word pedophile, let alone admitting the intrusive thoughts that torment them.
00:00:08.160 --> 00:00:10.080
Today we're leaning into that discomfort.
00:00:10.240 --> 00:00:16.800
We're gonna say the words, have a conversation, and expose ourselves to the very thing OCD tells us we can't talk about.
00:00:16.960 --> 00:00:21.760
Because bringing these fears into the light is often the first step towards taking their power away.
00:00:22.399 --> 00:00:23.120
I'm Alicia.
00:00:23.440 --> 00:00:24.399
And I'm Liam.
00:00:24.480 --> 00:00:25.920
We both have OCD.
00:00:26.000 --> 00:00:30.800
And instead of spiraling alone, we decided to turn our symptoms into a podcast.
00:00:31.039 --> 00:00:31.679
You're welcome.
00:00:31.920 --> 00:00:41.679
Here we overshare real stories, laugh through the anxiety, and talk to actual experts who can explain why your brain keeps asking, What if I accidentally marry my cousin?
00:00:41.920 --> 00:00:48.640
Whether your thing is hand washing, mental rituals, or just silently panicking during normal conversations, congrats.
00:00:48.799 --> 00:00:50.000
You have found your people.
00:00:50.240 --> 00:00:53.039
This is a safe place, unless you're an interest of thought.
00:00:53.200 --> 00:00:55.280
In which case, get in line, buddy.
00:00:55.359 --> 00:00:56.079
We're booked.
00:00:56.240 --> 00:01:01.439
So grab a weighted blanket, cancel your plans for the fifth time, and let's dive in.
00:01:01.679 --> 00:01:03.840
This is the OCD Confessional.
00:01:04.079 --> 00:01:07.680
And yes, we did check this recording four times before uploading it.
00:01:10.239 --> 00:01:12.640
Today on the podcast, we are joined by Lucas S.
00:01:12.799 --> 00:01:18.000
Sneer, a licensed professional counselor specializing in OCD and related disorders.
00:01:18.239 --> 00:01:29.599
Lucas primarily uses exposure and response prevention, or ERP, the gold standard treatment for OCD, and works with individuals navigating anxiety, OCD, and co-occurring disorders.
00:01:29.840 --> 00:01:39.280
In today's episode, we are specifically diving into POCD, what it is, how it presents, and some of the biggest misconceptions surrounding it.
00:01:39.519 --> 00:01:46.480
We're excited to have Lucas here to share his insight and help bring more understanding and hope to a topic that is so often misunderstood.
00:01:46.560 --> 00:01:48.239
So, Lucas, thank you so much for joining us.
00:01:48.319 --> 00:01:49.599
We really appreciate it.
00:01:50.000 --> 00:01:50.879
Thank you for having me.
00:01:51.200 --> 00:01:52.480
All right, we're just going to jump in.
00:01:52.640 --> 00:01:56.560
For listeners who may not know, can you explain what POCD actually is?
00:01:56.719 --> 00:02:04.640
I know it's a very taboo and uncomfortable conversation, but we are going to expose ourselves and say the uncomfortable.
00:02:04.719 --> 00:02:05.840
So let's dive in.
00:02:06.319 --> 00:02:09.520
Well, POCD is pedophilia-themed OCD.
00:02:09.919 --> 00:02:14.639
And right out of the gate, the word pedophilia is kind of a bombshell to just drop on people.
00:02:14.879 --> 00:02:16.400
But I use it all the time.
00:02:16.560 --> 00:02:22.960
When we're talking about POCD, there is no sense in shying away from the idea that that is pedophilia-themed OCD.
00:02:23.120 --> 00:02:27.360
It's OCD just like any other theme that has that obsessive-compulsive cycle.
00:02:27.599 --> 00:02:39.759
This individual theme is the worry about if I may secretly be a pedophile, if I may become a pedophile, if I was a pedophile, any kind of worry about that, that's what OCD latches on to.
00:02:40.000 --> 00:02:42.560
How do you differentiate, right?
00:02:42.719 --> 00:02:55.360
So someone comes to a therapist or confesses to a person in their family and says, I'm having these thoughts, these fears that I might be a pedophile.
00:02:55.759 --> 00:02:58.240
What helps you as a counselor differentiate?
00:02:58.400 --> 00:03:09.280
Okay, this person might actually have some sort of pedophilia tendencies, or no, this is purely OCD and we need to work on them with that.
00:03:10.000 --> 00:03:17.439
Especially if OCD hasn't been brought up in their life before, and that is the first that that's tough.
00:03:17.520 --> 00:03:17.840
Yeah.
00:03:18.240 --> 00:03:18.639
Good question.
00:03:19.520 --> 00:03:19.680
Yeah.
00:03:20.400 --> 00:03:24.560
What a big fear right out of the gate is is this something that we need to be worried about?
00:03:24.719 --> 00:03:25.919
Is this OCD?
00:03:26.080 --> 00:03:42.639
And what I typically tell people, especially therapists that I'm talking to about this, is if somebody is bringing this up to you, good nine out of 10 times, this is gonna be OCD because true pedophilia as a paraphilic disorder is an egosyntonic thing.
00:03:42.800 --> 00:03:47.759
That that is typically a desire that a person has that is very disordered.
00:03:47.919 --> 00:03:54.000
And they're not really interested in going to a therapist or even their loved ones to talk about being worried about that.
00:03:54.319 --> 00:03:58.560
POCD, like all other forms of OCD, is ego dystonic.
00:03:58.800 --> 00:04:01.680
This person is very devastated by this worry.
00:04:01.840 --> 00:04:04.639
It's their worst case scenario that this may be true.
00:04:04.800 --> 00:04:08.960
And that right there is the biggest flag of this is OCD.
00:04:09.360 --> 00:04:14.240
Which is interesting because a lot of people who have those thoughts are not going to be so eager to share them.
00:04:14.479 --> 00:04:18.240
And I think that's where the trouble comes in, right?
00:04:18.639 --> 00:04:29.759
Even I, as a dedicated OCD specialist, with some marketed material that I even specialize in POCD, people experiencing this come to me knowing that I'm already going to know what they're talking about.
00:04:30.240 --> 00:04:33.600
It's even then still so hard for them to bring up.
00:04:33.920 --> 00:04:38.240
And it all the time I can sense it that, okay, we're talking around this thing.
00:04:38.399 --> 00:04:44.560
And usually the most comfortable way for me to bring that up is to ask somebody permission to, hey, let me guess real quick.
00:04:44.800 --> 00:04:48.879
I I think that I know and I can only imagine how hard that is to bring up.
00:04:49.120 --> 00:04:52.399
So, hey, are you worried that you may be a pedophile?
00:04:52.639 --> 00:05:16.959
And the relief that comes off of a person when they're like, okay, you already know is amazing because can you imagine being worried that somebody might judge you for that worry, that somebody might directly step on that thing that you've been so scared about, especially sitting in front of a professional that might that might go, oh God, we need to be really worried about that.
00:05:17.279 --> 00:05:23.120
My wife is a clinical psychologist and she tells this story when she was in her graduate training.
00:05:23.199 --> 00:05:28.639
So these were all people who were on the path to getting a PhD in clinical psychology.
00:05:28.879 --> 00:05:37.360
And one of her classmates brought this case before them of one of her clients had come in with this fear of being a pedophile.
00:05:37.920 --> 00:05:51.120
And the clinician quickly assessed this is OCD and POCD specifically, but brought the case to the rest of the group as part of supervision and part of their education.
00:05:51.519 --> 00:05:57.439
And my wife, Leah, said most of the people in the group were actually really concerned.
00:05:57.600 --> 00:06:05.759
No, I what if the person really is a pedophile and you're not taking the proper steps to make sure they don't have access to kids, et cetera?
00:06:05.920 --> 00:06:10.319
And Leah said it was so clear in the documentation that it was actually OCD.
00:06:10.480 --> 00:06:19.040
And even people in the field were judging this person and had real concerns that they might actually be a pedophile.
00:06:19.279 --> 00:06:20.959
How do we confront that?
00:06:21.199 --> 00:06:32.959
Because as you said, that it must be terrifying for someone with POCD to say the words out loud, knowing, boy, if this goes sideways, I could be prosecuted.
00:06:33.120 --> 00:06:36.560
I'm certainly could be shunned, I could be disowned by my family.
00:06:36.639 --> 00:06:40.959
I mean, the stakes are very, very high for someone who is experiencing this.
00:06:41.600 --> 00:06:44.480
As far as the answer to that, I think we're doing it right now.
00:06:45.120 --> 00:06:46.079
That's what I was just gonna say.
00:06:46.480 --> 00:06:47.920
We have to talk about it more.
00:06:48.160 --> 00:06:50.000
And I tell the story all the time.
00:06:50.079 --> 00:06:51.680
And I at this point I don't remember.
00:06:51.759 --> 00:06:54.639
I think I was at the end of my associateship.
00:06:54.800 --> 00:07:02.639
I think it was just almost fully licensed when I learned about POCD, and I learned about it on Reddit.
00:07:03.920 --> 00:07:19.439
I have been through grad school in like a year and a half of supervision at this point, and I'm still reading somebody's experience that they're posting about this great big worry that they have, and I'm kind of reading it in the same voice that in the same vein that probably a lot of your wife's classmates were of, oh my God, that's really worrying.
00:07:19.519 --> 00:07:20.480
This is a lot.
00:07:20.720 --> 00:07:25.199
And then I saw the top comment that said, Hey, everybody, pump your brakes.
00:07:25.519 --> 00:07:30.480
There's this random OCD specialist on Reddit that was saying, this is an OCD thing.
00:07:30.639 --> 00:07:36.720
And you need to go to the IOCDF, and here's all these resources and articles about what it is.
00:07:37.439 --> 00:07:57.519
And my the dichotomy of my own reaction to being so worried about it and then recognizing what that was was the first thing that really led me into having a bit of a passion for POCD because it is a thing that even I, with all of the knowledge that I thought that I had, had no idea what was going on with this person.
00:07:58.000 --> 00:08:00.720
And I I love that I love that you feel passionate about it.
00:08:00.879 --> 00:08:02.319
We need more people to speak up about that.
00:08:02.480 --> 00:08:09.519
And I and I imagine that like Liam and myself, people go years and years and years not knowing they even have OCD.
00:08:09.600 --> 00:08:18.560
And for that to be a recurring intrusive thought to be so debilitating is it's absolutely heartbreaking.
00:08:18.720 --> 00:08:21.920
So I think exactly what you said is just continuing to speak up about it.
00:08:22.160 --> 00:08:25.680
Why do these thoughts feel so real and convincing to the person experiencing them?
00:08:25.759 --> 00:08:28.399
I mean, most people aren't defused from their thoughts.
00:08:28.480 --> 00:08:32.639
And of course, OCD immediately makes you go, oh, what does that mean?
00:08:33.039 --> 00:08:34.799
What does it mean that I even had this thought?
00:08:34.960 --> 00:08:36.799
What does it mean that that crossed my mind?
00:08:37.200 --> 00:08:40.879
Why do some people have those thoughts and some don't that have OCD, do you think?
00:08:41.120 --> 00:08:43.440
It's just like anything it attacks what we value most.
00:08:43.519 --> 00:08:44.639
It's something that we fear.
00:08:45.120 --> 00:08:46.799
It attacks what we value most.
00:08:47.120 --> 00:08:47.679
Yeah.
00:08:48.159 --> 00:09:05.039
I it's interesting in the modern era, hearing more about people's recent triggers, like uh worry that I'm in the Epstein Files is a new the first emergence was that they heard heard about this thing going on and worry that I was a part of that.
00:09:05.759 --> 00:09:10.080
And of course, you hear that and go, What are you talking about?
00:09:10.240 --> 00:09:15.919
But the OCD logic of the thing, yeah, that feels like it really needs to be investigated.
00:09:16.159 --> 00:09:19.679
The intrusive doubt, which is what gets us into that vicious cycle, right?
00:09:19.840 --> 00:09:22.639
It's like you're questioning your own questions of the thing.
00:09:22.799 --> 00:09:23.759
Did I enjoy that?
00:09:23.919 --> 00:09:27.039
Was that a real thought that I actually enjoyed?
00:09:27.279 --> 00:09:28.799
Or am I lying to myself?
00:09:28.960 --> 00:09:36.639
And I think that's where the psychological torment comes in, is when then what lends to depression and then yeah.
00:09:37.039 --> 00:09:47.919
Well, it's the data gathering that keeps that cycle going so badly that yeah, the obsessional worry is there, the intrusive thought is there.
00:09:48.240 --> 00:09:50.720
And you can't actually control that.
00:09:50.960 --> 00:09:52.080
It's gonna be there.
00:09:52.240 --> 00:10:01.519
And then, like we know about the cycle of compulsion, all of the gathering data, checking myself and ways that you can never actually find 100% certainty.
00:10:01.759 --> 00:10:02.799
Just blow that up.
00:10:02.879 --> 00:10:08.480
Aaron Ross Powell What are the compulsions that someone with POCD is doing?
00:10:08.720 --> 00:10:18.399
I've heard stories of people with pedophilia OCD who will go on to porn websites to kind of test whether or not they're aroused.
00:10:18.559 --> 00:10:21.600
So what are some of the compulsions that they're engaging in?
00:10:22.480 --> 00:10:27.759
Pornography is one that is hard for people to bring up because nobody wants to talk about porn with their therapist.
00:10:28.000 --> 00:10:30.080
Uh but yeah, that's absolutely a compulsion.
00:10:30.159 --> 00:10:31.519
People will go and test themselves.
00:10:31.679 --> 00:10:38.720
And to be clear, they're watching adult regular normal porn, but testing to make sure that I'm still attracted to that.
00:10:38.960 --> 00:10:42.879
Oh also a huge amount of avoidance.
00:10:43.120 --> 00:10:44.879
They'll avoid kids, period.
00:10:45.039 --> 00:10:51.600
They'll avoid even walking by an elementary school, uh, a very common early.
00:10:52.480 --> 00:10:58.000
And a pedophile, I don't sorry to interrupt, but a pedophile, an actual pedophile is not going to avoid those things.
00:10:58.320 --> 00:10:58.960
No, not at all.
00:10:59.519 --> 00:10:59.600
Right?
00:10:59.840 --> 00:11:01.919
They're going they're gonna actively seek it out.
00:11:02.159 --> 00:11:07.039
So that alone is proof that you are not a pedophile.
00:11:07.600 --> 00:11:08.240
Yes.
00:11:08.720 --> 00:11:16.240
And to anyone listening to this, worried that you're a pedophile, notice how that reassurance doesn't last all that long.
00:11:16.720 --> 00:11:17.919
It feels great to hear that.
00:11:18.639 --> 00:11:21.759
And oh my God, thank God there's proof that I'm not a pedophile.
00:11:22.000 --> 00:11:23.759
But that's not gonna last, actually.
00:11:23.919 --> 00:11:25.039
That's not the treatment.
00:11:25.360 --> 00:11:28.399
You can't find certainty that you're definitely not.
00:11:28.639 --> 00:11:31.519
It is what is the treatment, Lucas?
00:11:31.679 --> 00:11:33.279
What is the treatment?
00:11:33.679 --> 00:11:34.000
Yeah.
00:11:34.480 --> 00:11:38.960
Just like I was uh unfortunately, the hardest thing is the treatment.
00:11:39.120 --> 00:11:47.759
That's to resist the compulsion and uh resisting a lot of purely mental compulsions, thought replacement of things.
00:11:47.919 --> 00:11:50.320
Um, body checking is a very hard one.
00:11:50.480 --> 00:12:00.320
We talk a lot about what we call gronal responses, which unfortunately having sensations in your genitals is a thing that is just an anxious response.
00:12:00.559 --> 00:12:10.080
So if you're already anxious about a thing and then go checking, oh, did I experience arousal during that, there's a good chance that you're gonna have a feeling of, oh no, I did, didn't I?
00:12:10.399 --> 00:12:14.559
And then everything just keeps going and it grows and grows and grows.
00:12:15.039 --> 00:12:22.240
The biggest takeaway is the is the the knowledge of this and knowing that what's coming up is an interesting thought in OCD.
00:12:22.320 --> 00:12:23.360
That's the the biggest.
00:12:24.080 --> 00:12:28.159
Yes, and even that certainty you can't be certain of.
00:12:28.399 --> 00:12:28.559
Yeah.
00:12:28.960 --> 00:12:38.080
We would go into an exposure like walk around your local mall and don't do that compulsion that you do where you only stare at the horizon and don't look at anybody.
00:12:38.240 --> 00:12:41.360
Like I need you to walk around and look at people and notice people.
00:12:41.519 --> 00:12:46.960
And if you have a thought that, wow, that girl looked really beautiful, I need you to keep walking forward.
00:12:47.120 --> 00:12:48.399
Don't overanalyze that.
00:12:48.559 --> 00:12:49.840
Don't double check it.
00:12:50.000 --> 00:12:51.759
Just keep moving forward.
00:12:52.159 --> 00:12:55.679
And that's a hard thing to do when the stakes are.
00:12:56.000 --> 00:12:57.360
Am I a pedophile?
00:12:57.679 --> 00:13:06.240
So the mental compulsions you mentioned, those seem particularly difficult to tackle from an exposure standpoint, right?
00:13:06.480 --> 00:13:16.879
Because avoidance of children, you can tackle that by saying, no, you're going to walk by the elementary school, you're going to go to the mall, you're going to do the thing that you're not doing in order to avoid children.
00:13:17.279 --> 00:13:24.799
But the mental checking that they're doing of thinking back through the day and, oh, I remember seeing that kid.
00:13:25.039 --> 00:13:27.120
Was I aroused by that, whatever.
00:13:27.360 --> 00:13:32.159
How do you tackle that, the exposure to that, and tell them, like, just don't do that?
00:13:32.399 --> 00:13:35.600
Because of course, that it's not that simple, right?
00:13:36.000 --> 00:13:36.639
Yeah.
00:13:37.279 --> 00:13:45.600
And a lot of the classic, uh, maybe, maybe not, gets really hard when we're dealing with maybe I'm a pedophile and maybe I'm not.
00:13:45.840 --> 00:13:48.320
That's a lot of anxiety to sit inside of.
00:13:48.720 --> 00:13:49.120
Yes.
00:13:49.440 --> 00:13:59.200
Uh so typically it does fall back on leaning into the uncertainty of the thing, recognizing this pattern where I'm trying to prove that I'm not, and it never works.
00:13:59.519 --> 00:14:03.200
And so I just have to remain uncertain.
00:14:03.440 --> 00:14:13.120
I can even be 99.999% sure, and I know that OCD wants 100%, and I have to deny OCD that 100%.
00:14:13.759 --> 00:14:15.279
I have to just keep moving forward.
00:14:15.600 --> 00:14:17.840
What's the worst case of it you've seen?
00:14:18.080 --> 00:14:26.799
Just the the most debilitating this person potentially has to be put into inpatient care as a result of it.
00:14:27.200 --> 00:14:31.759
What is the most intense case you've seen and how did that manifest for that person?
00:14:32.399 --> 00:14:34.639
Uh bedridden and suicidal.
00:14:35.360 --> 00:14:35.679
Yeah.
00:14:36.720 --> 00:14:50.000
And that is the thing that a large number of people that experience POCD walk around with, which is that I'm either going to figure this out or I'll kill myself before I harm a child.
00:14:50.960 --> 00:14:57.279
Yeah, gosh, I just got goosebumps all over my body because you know that it's so heavy and so heartbreaking.
00:14:57.519 --> 00:14:57.679
Yeah.
00:14:58.480 --> 00:15:03.360
Do these thoughts ever go away for someone?
00:15:05.120 --> 00:15:06.320
Yes and no.
00:15:07.200 --> 00:15:12.559
And this comes down to the ever-present argument of like, do we cure OCD or do we manage it?
00:15:12.639 --> 00:15:13.759
Is this a chronic thing?
00:15:14.080 --> 00:15:19.519
And while no, the thoughts probably don't fully go away.
00:15:20.000 --> 00:15:28.080
It's incredible meeting a person before and after ERP where they go, oh yeah, yeah, I have the thoughts, but who cares?
00:15:28.240 --> 00:15:29.759
I'm not worried about that.
00:15:30.000 --> 00:15:33.600
What ERP does is take the distress out of the thoughts.
00:15:33.919 --> 00:15:40.240
We literally retrain the amygdala to not have as robust of a response to these triggers.
00:15:40.559 --> 00:15:45.200
We've successfully taught a brain that this discomforts, because it is discomforting.
00:15:45.360 --> 00:15:48.559
It's allowed to be discomforting to worry that you're a pedophile.
00:15:48.720 --> 00:15:51.279
And that discomfort does not equal danger.
00:15:51.440 --> 00:15:52.480
You don't have to respond to it.
00:15:52.559 --> 00:15:53.600
You don't have to prove it wrong.
00:15:54.000 --> 00:16:04.399
You mentioned before that, you know, maybe ERP for somebody that that battles POCD would be going to the mall and having a thought like this girl looked beautiful.
00:16:04.639 --> 00:16:10.320
Is this something that you would recommend them doing on their own or should they have a partner with them?
00:16:10.559 --> 00:16:17.279
I imagine that that is not something that they're publicly going to announce that they're doing right in therapy.
00:16:17.919 --> 00:16:21.440
If they have a spouse, then maybe they've they've confided in their spouse.
00:16:21.519 --> 00:16:22.639
I would hope they would.
00:16:22.879 --> 00:16:30.639
Is that something that you would recommend they do on their own, or do they have support in those moments with somebody that they trust?
00:16:31.200 --> 00:16:37.120
The beauty of the post-COVID world and teletherapy is that they bring me with them on their cell phone.
00:16:37.679 --> 00:16:38.000
Oh.
00:16:38.879 --> 00:16:40.960
We can go through this together.
00:16:41.200 --> 00:16:45.519
And the primary reason for that is to help manage the compulsions that come up.
00:16:45.759 --> 00:16:46.159
Right.
00:16:46.320 --> 00:16:51.360
Uh it's a lot of response prevention work in those moments doing those exposures.
00:16:51.519 --> 00:16:58.000
And so being together, especially the first few times that we do it, uh, yeah, we're almost always together.
00:16:58.399 --> 00:17:04.400
After that, it does turn into a, okay, I was initially a much higher distress level about this.
00:17:04.559 --> 00:17:07.519
Now I can go to the mall and only be a little bit triggered.
00:17:07.680 --> 00:17:12.079
And at that point, we go, great, continue that as homework in between sessions for sure.
00:17:12.319 --> 00:17:15.839
So much of the work of ERP happens in between sessions.
00:17:16.000 --> 00:17:19.680
And yeah, once they're ready for it, they can absolutely do these on their own.
00:17:20.160 --> 00:17:23.759
You treat multiple subtypes of OCD, of course.
00:17:24.079 --> 00:17:26.000
Is POCD stickier?
00:17:26.160 --> 00:17:28.799
Do you find that it's a harder one to treat?
00:17:29.039 --> 00:17:36.880
Or is it like any other subtype where if you stick with the ERP or in some cases medication, the person will reliably get better?
00:17:36.960 --> 00:17:40.480
Aaron Ross Powell A person can reliably get better no matter the theme.
00:17:43.920 --> 00:17:54.160
I would say the one truism, the one kind of pattern is how deep into the obsessive-compulsive cycle a person gets.
00:17:54.400 --> 00:17:55.680
It doesn't really matter the theme.
00:17:55.839 --> 00:18:11.920
If it's a thing that they kind of notice and capture soon and get specialized help soon, they're very able to break out of that easier than somebody who had the unfortunately standard path of seven years of not getting the correct treatment.
00:18:12.880 --> 00:18:19.039
Managing my experience exclusively through compulsions and then trying.
00:18:19.519 --> 00:18:22.559
Yeah, that's really hard no matter the theme.
00:18:22.960 --> 00:18:31.519
And a thing that may be relevant is probably someone with PFCD is more likely to spend a long time not getting the help that they need.
00:18:31.920 --> 00:18:32.319
Yes.
00:18:32.559 --> 00:18:38.559
And so that probably does end up in presenting it as being particularly sticky.
00:18:38.880 --> 00:18:44.880
Uh yet, no, I wouldn't say that it's necessarily uniquely more difficult than any other form of OCD.
00:18:45.200 --> 00:18:45.359
Right.
00:18:45.440 --> 00:18:56.720
Because I imagine if somebody went years and years and years with this secret, um, and they're living with these thoughts, that they've they've created this identity, a false identity around who they are.
00:18:56.880 --> 00:18:59.119
So you have to work through those layers, right?
00:18:59.279 --> 00:19:01.920
You have to like, yeah, there's a lot of layers there.
00:19:02.160 --> 00:19:02.799
This is so good.
00:19:02.880 --> 00:19:04.240
I'm so excited we're doing this.
00:19:04.400 --> 00:19:05.759
I hope we can save life.
00:19:06.559 --> 00:19:10.400
I hope we can save somebody out there who is living with these thoughts.
00:19:10.640 --> 00:19:11.200
Quick break.
00:19:11.359 --> 00:19:12.160
We'll be right back.
00:19:12.240 --> 00:19:13.920
But first, a word from our sponsor.
00:19:14.160 --> 00:19:18.240
The same distressing, unwanted thoughts keep playing over and over in your mind.
00:19:18.400 --> 00:19:22.960
The same rituals keep eating up your time, holding you back from enjoying your life.
00:19:23.200 --> 00:19:32.720
You've tried talk therapy before and spent session after session diving into those thoughts, trying to understand them, trying to fix them, but somehow they just get worse.
00:19:32.880 --> 00:19:35.920
And the shame piles on because you think, why isn't this working?
00:19:36.079 --> 00:19:37.119
What's wrong with me?
00:19:37.359 --> 00:19:39.920
If this sounds familiar, here's what you need to know.
00:19:40.160 --> 00:19:41.680
You are not the problem.
00:19:41.920 --> 00:19:45.920
You're experiencing something that a lot of people with OCD experience.
00:19:46.240 --> 00:19:50.799
Getting your life back is possible because OCD is highly treatable.
00:19:50.880 --> 00:19:55.039
It just requires a completely different approach than other mental health conditions.
00:19:55.279 --> 00:20:03.599
In fact, standard talk therapy often makes OCD worse because it encourages you to analyze those intrusive thoughts or try to replace them with positive ones.
00:20:03.759 --> 00:20:08.240
But with OCD, the more attention you give the thoughts, the stickier they become.
00:20:08.559 --> 00:20:10.799
That's where No C D comes in.
00:20:11.039 --> 00:20:15.359
No CD provides virtual therapy designed specifically for OCD.
00:20:15.519 --> 00:20:25.759
Every single one of their therapists is extensively trained in a type of therapy called ERP, or exposure and response prevention, which is the most effective treatment available for OCD.
00:20:25.920 --> 00:20:35.359
And they get their training from world-renowned OCD experts so they truly understand what you're dealing with, even this stuff that feels impossible to say out loud.
00:20:35.599 --> 00:20:45.599
In live, face-to-face virtual sessions, your No CD therapist will teach you how to take the power away from intrusive thoughts so you can live the life you want to live.
00:20:45.759 --> 00:20:56.000
In between sessions, you'll be able to message your therapist anytime, join dozens of live support groups, and continue your progress with other expert-developed therapy tools.
00:20:56.240 --> 00:21:04.079
NoCD is also covered by insurance for over 138 million Americans, and their team makes it really simple to get started.
00:21:04.319 --> 00:21:08.559
Visit nocd.com and book a free 15-minute call.
00:21:08.720 --> 00:21:17.920
That's nocd.com to learn more and talk to someone who can help because you deserve treatment that actually works for OCD.
00:21:18.480 --> 00:21:20.400
And now, back to our show.
00:21:20.640 --> 00:21:35.200
With a lot of OCD subtypes, Lucas, and this has been true for Alicia and me for most of our experience with it, is that often you do have some level of insight that this fear is illogical.
00:21:35.839 --> 00:21:46.480
I know that for some people that insight is lower than for others, but often there's some voice in there going, all right, I know it's not true, but I'm gonna perform the compulsion to give myself the comfort anyway.
00:21:46.720 --> 00:21:58.160
With POCD, do most of the patients you see know I don't think deep down I actually am a pedophile, but this fear of it is just consuming me.
00:21:58.240 --> 00:22:01.200
And so I'm gonna perform that compulsion to Get the relief?
00:22:01.599 --> 00:22:09.440
Or have you found people who are truly lost in it and have no insight into the fact that they're really not a pedophile?
00:22:09.839 --> 00:22:30.000
I think the worry about being a pedophile, and similarly to all kinds of sexual or sexuality-based compulsions, there is a genuine level of complete unknown that you really can't have a confidence in I'm definitely not.
00:22:30.480 --> 00:22:41.599
Be uh partially because of that checking groanal response kind of thing, where my anxiety kind of produces the symptoms that I'm looking for, anyways.
00:22:41.920 --> 00:22:42.160
Yes.
00:22:42.319 --> 00:22:44.799
Can we dive in a bit on the groinal response?
00:22:45.119 --> 00:23:01.039
Which, you know, for for someone listening, I I would imagine that that's some sort of tingling or right that you experience with one of these sexually taboo OCD subtypes, and it then confirms your fear.
00:23:01.359 --> 00:23:08.960
But you're saying that that response often is just a function of anxiety more than anything else.
00:23:09.119 --> 00:23:18.640
So just I not getting too much into the mechanics of it or whatever, but but can you just explain a groinal response for someone who might be listening going, oh my God, I've had that?
00:23:19.039 --> 00:23:20.160
Yeah, absolutely.
00:23:20.480 --> 00:23:23.759
The sympathetic nervous system is the thing that amps us up.
00:23:24.000 --> 00:23:29.039
And the sympathetic nervous system is uh not all of that complicated.
00:23:29.200 --> 00:23:32.880
It's the thing we tend to talk about as the fight or flight response.
00:23:33.359 --> 00:23:40.480
Um there is another F in that triangle, uh, and we can call that fornicating.
00:23:40.640 --> 00:23:42.319
That's a form of arousal.
00:23:42.480 --> 00:23:47.599
That is still your uh sympathetic nervous system becoming aroused.
00:23:47.839 --> 00:23:54.720
So your body is not very good at knowing when this is a fear response or an anger response or a sexual response.
00:23:55.039 --> 00:24:02.319
So even though it's an anxiety response, the sympathetic nervous system is doing what the sympathetic nervous system does.
00:24:02.559 --> 00:24:09.200
Your pupils dilate, your heart rate increases, there's increased blood flow everywhere in your body.
00:24:09.759 --> 00:24:11.759
If you're a man, including to your penis.
00:24:12.000 --> 00:24:14.000
If you're a woman, including to your vagina.
00:24:14.160 --> 00:24:18.640
And so you have this experience and you don't know what that means.
00:24:18.960 --> 00:24:20.640
Yeah, it's a body response.
00:24:20.720 --> 00:24:23.599
It's not a statement of desire.
00:24:24.000 --> 00:24:25.119
Absolutely.
00:24:25.519 --> 00:24:28.799
That is so awful.
00:24:28.960 --> 00:24:39.759
Like I can't even Isn't that we talked about it Yeah, we talked about that with Chrissy Hodges, and she's had the groinal response and she's had taboo OCD stuff.
00:24:39.839 --> 00:24:41.839
Unfortunately, she talks very openly about it.
00:24:41.920 --> 00:24:54.640
But my God, when you have a subtype, any subtype, relationship OCD, health OCD, P O C D, you are constantly looking for evidence that it's real, right?
00:24:54.720 --> 00:24:58.559
You know, because your OCD is trying to latch on to stuff.
00:24:58.799 --> 00:25:09.759
And so for that detective element of your OCD to be able to latch on to that, like it's an actual physical response, like what a confirmation of my fear.
00:25:10.000 --> 00:25:16.640
That is, and so how do you talk to a patient about that, right?
00:25:16.880 --> 00:25:20.319
Because as you say, reassurance can only take you so far.
00:25:20.480 --> 00:25:30.240
So you can sit with them in the session and say, well, when you have that groinal response, it's actually your sympathetic nervous system, and you can just explain it to them the way you just explained it to us, which was really helpful.
00:25:30.480 --> 00:25:38.240
But that reassurance will only last for so long, where they're gonna go, you know, the OCD is gonna go, no, no, no, it's the other part of the triangle that you're actually experiencing.
00:25:38.559 --> 00:25:43.440
And how do you help them with that when that groinal response shows up?
00:25:43.519 --> 00:25:45.759
How do you expose your way out of that one?
00:25:46.960 --> 00:25:56.559
There's many, many themes of OCD that as an ERP specialist, I will let you know out of the gate, you're getting zero reassurance from me.
00:25:57.920 --> 00:26:02.640
OCD is one that oftentimes I don't do that with.
00:26:02.799 --> 00:26:12.640
And I'll give them my little shtick, kind of like I did a minute ago of, hey, I want you to notice how this doesn't actually help long term, but I do want you to know that this is what that is.
00:26:12.960 --> 00:26:18.319
And now, moving forward, we need to accept that you can't actually know that.
00:26:18.640 --> 00:26:26.480
So now when you're triggered and you notice that you walked by the elementary school and then you had an erection, and does that mean something?
00:26:26.640 --> 00:26:29.200
Well, I don't think there's any way to know for sure.
00:26:29.519 --> 00:26:31.839
It could be this sympathetic nervous system thing.
00:26:32.000 --> 00:26:34.079
It could be because you're a pedophile.
00:26:34.319 --> 00:26:38.640
And ooh, that's yucky to hold on to that, isn't it?
00:26:38.880 --> 00:26:39.920
Yeah, it is.
00:26:40.160 --> 00:26:43.839
And let's hold that, don't make it go away.
00:26:44.240 --> 00:26:49.599
Sit with that feeling for long enough until you notice it slowly come down.
00:26:49.839 --> 00:27:02.880
When you habituate that worry over and over again, you can eventually have the experience, which again is a bizarre experience to talk about, to walk by an elementary school, get an erection, and go, hmm, I don't know what that means.
00:27:03.039 --> 00:27:04.559
And it's not so loud anymore.
00:27:04.880 --> 00:27:06.640
Oh, yeah, I cannot sit with that.
00:27:06.880 --> 00:27:07.839
No chance.
00:27:08.559 --> 00:27:09.200
No chance.
00:27:09.440 --> 00:27:13.599
I I have a big issue with that of going, yeah, maybe I am, maybe I'm not.
00:27:13.680 --> 00:27:19.920
And every subtype, every part of OCD is crazy to me.
00:27:21.359 --> 00:27:35.039
I I feel like if you're in therapy and we've already established that it's egogystonic, and then they're doing exposure and response prevention, and you're having them walk by and still still tell themselves that maybe they are, maybe they're not.
00:27:35.519 --> 00:27:36.799
There's no way to know.
00:27:38.960 --> 00:27:41.599
You can't be a hundred percent certain.
00:27:43.119 --> 00:27:46.000
In this particular topic, we should be.
00:27:48.079 --> 00:27:48.480
You can.
00:27:48.799 --> 00:27:49.359
Yeah, yeah.
00:27:49.440 --> 00:27:56.319
That Alicia does not like she does not like the maybe maybe not uh thing.
00:27:56.559 --> 00:28:11.680
Um and well, I think okay, for example, I've had I've had intrusive thoughts of the FBI is gonna knock on my door and tell me I committed some act.
00:28:11.759 --> 00:28:13.279
I I can't even kill an ant.
00:28:13.599 --> 00:28:17.279
I I know rationally that that's unlikely.
00:28:17.440 --> 00:28:20.880
So you want me to say that maybe I did actually commit a murder in my sleep?
00:28:21.599 --> 00:28:23.119
No, I know I didn't.
00:28:23.759 --> 00:28:30.559
I know I didn't, but that thought still comes up, and I've done enough work on myself to know that that is an irrational thought.
00:28:30.799 --> 00:28:40.000
So I guess it's hard for me to wrap my head around somebody in therapy knowing that they are not a pet, they yeah, that that is weird to me.
00:28:40.160 --> 00:28:41.440
Sorry, I don't understand that one.
00:28:41.680 --> 00:28:43.680
No, that's weird to a lot of people.
00:28:43.920 --> 00:28:48.799
And in the majority of cases, like worry that the FBI is gonna come and get you.
00:28:49.119 --> 00:28:54.000
You can find functioning in that worry and then just move on with your life.
00:28:54.160 --> 00:28:56.400
You you can achieve a level of functioning there.
00:28:56.880 --> 00:29:03.680
But if you would like freedom from that worry, you do have to begin to practice sitting with.
00:29:03.839 --> 00:29:06.559
Let me imagine the FBI is on their way right now.
00:29:06.799 --> 00:29:10.880
And maybe I have some rare amnesiac disorder where I don't remember.
00:29:11.200 --> 00:29:12.400
Oh, I've done that.
00:29:12.960 --> 00:29:16.960
So if that gets you, oh, that's yucky.
00:29:17.039 --> 00:29:17.920
I don't like that.
00:29:18.079 --> 00:29:19.839
I feel very accused by that.
00:29:20.000 --> 00:29:21.759
I really make that go away.
00:29:22.000 --> 00:29:31.119
And then if you refuse and you hang on to that thought, now the anxiety associated with that is gonna feel like it's gonna go up forever until you die.
00:29:31.359 --> 00:29:31.519
Yeah.
00:29:32.720 --> 00:29:36.160
It will peak and it will slowly come down.
00:29:36.480 --> 00:29:41.279
Okay, so eventually you will look back and go, hey, watch, I can trigger myself.
00:29:41.440 --> 00:29:43.359
Go, the FBI is coming to get me.
00:29:43.599 --> 00:29:43.920
Huh.
00:29:44.240 --> 00:29:45.839
Remember when that used to really worry me?
00:29:47.279 --> 00:29:47.440
Okay.
00:29:47.920 --> 00:29:48.880
Okay, fine.
00:29:49.680 --> 00:29:50.240
Like that.
00:29:50.640 --> 00:29:52.720
You really don't need to do.
00:29:53.039 --> 00:29:56.400
You don't need to, unless you want to.
00:29:57.440 --> 00:30:04.880
If you want to not have to experience that distress anymore, you can go for this freedom over functioning kind of ideal.
00:30:05.200 --> 00:30:10.480
With something like POCD, people don't want to have this thought anymore.
00:30:10.799 --> 00:30:12.240
They do not want to worry about it.
00:30:12.400 --> 00:30:17.359
It's very hard to achieve a level of functioning in saying that maybe, maybe not.
00:30:17.599 --> 00:30:22.880
And so we have to really power through that and accept that you cannot have the certainty.
00:30:23.759 --> 00:30:29.279
A lot of times that looks like the uncertainty of what if I one day become a pedophile?
00:30:30.319 --> 00:30:33.039
And well, how would you ever disprove that?
00:30:34.720 --> 00:30:35.200
Right.
00:30:35.440 --> 00:30:38.880
You have to accept the uncertainty in that scenario.
00:30:39.279 --> 00:30:40.000
You can't know.
00:30:40.240 --> 00:30:45.599
I have gotten a lot from that kind of school of thought of like maybe, maybe not.
00:30:45.759 --> 00:30:51.359
I apply it daily, regularly to some of the intrusive thoughts that come up for me a lot.
00:30:51.599 --> 00:30:57.279
Um, how have you seen POCD affect people's romantic relationships?
00:30:57.440 --> 00:31:01.839
I have to imagine that is an especially complex one.
00:31:02.000 --> 00:31:07.359
I mean, maybe in some ways, even more complex than relationship OCD, which it's right in the name there.
00:31:07.599 --> 00:31:11.119
But you can work on that with your partner and try to get your partner to understand.
00:31:11.200 --> 00:31:25.519
But POCD is just so taboo, so unspoken, so shameful, which it it shouldn't be, but it is, uh, that I have to imagine it makes it very hard to form intimate relationships with another adult.
00:31:26.880 --> 00:31:35.279
A lot of people are surprisingly successful at suppressing this worry so that they can still have a relationship with another adult.
00:31:36.000 --> 00:31:44.400
Uh and ideally, yes, this is a thing that you should be able to tell your spouse or significant other and uh help them walk alongside you.
00:31:44.559 --> 00:31:54.160
But I can't tell you the number of sessions that I've done with, hey, I need my partner to come in here and we need to tell them together because Lord knows I cannot do it on my own.
00:31:54.319 --> 00:31:56.720
And I say, all right, bring them in, let's do it together.
00:31:57.119 --> 00:32:05.359
And then I'm gonna spend a lot of time probably reassuring your partner and educating them about exactly what this is and how you don't need to be worried.
00:32:05.519 --> 00:32:11.279
And also you plug your ears, don't listen to any of this reassurance that I'm giving your partner because this will help them.
00:32:11.440 --> 00:32:13.119
It's not gonna help you.
00:32:14.559 --> 00:32:24.720
Uh and one of the biggest ways that I do see it affect relationships is when the POCD is centered around my own kids.
00:32:25.119 --> 00:32:26.400
That is Oh.
00:32:27.119 --> 00:32:27.839
Oh yeah.
00:32:28.000 --> 00:32:28.480
Oh, wow.
00:32:28.799 --> 00:32:32.000
Because how do you parent when you're dealing with that?
00:32:32.720 --> 00:32:37.200
And especially if you're dealing with that and your partner doesn't know that you're dealing with that.
00:32:38.720 --> 00:32:39.599
That's heavy.
00:32:40.400 --> 00:32:41.039
Oh my gosh.
00:32:41.359 --> 00:32:43.200
What does a compulsion with that look like?
00:32:43.359 --> 00:32:47.279
Is it them just avoiding parenting, avoiding bath time, I imagine?
00:32:47.440 --> 00:32:48.720
How is it showing up?
00:32:49.279 --> 00:32:58.079
Bath time, diapers, any possible trigger you can think of, uh, even holding my child, if they're going to be straddling me, nope, can't do that.
00:32:58.160 --> 00:32:59.440
I need to hold them this away.
00:32:59.599 --> 00:33:02.319
When I put them in the car seat, I have to do it so so.
00:33:03.200 --> 00:33:11.440
A thousand ways to manage my own triggers that all are just a version of compulsive avoidance that keeps this problem around.
00:33:11.839 --> 00:33:17.359
And can you imagine if you're the spouse and your partner's like, I can't do the diapers?
00:33:17.599 --> 00:33:21.119
You know, and you're like, Well, why why I have to do every diaper?
00:33:21.200 --> 00:33:23.359
Like, if you've never done a bath tonight.
00:33:25.039 --> 00:33:28.960
It's at minimum, I need you right here over my shoulder while I'm doing bath time.
00:33:29.359 --> 00:33:32.559
Yeah, I need proof that I didn't do anything.
00:33:32.960 --> 00:33:33.599
Absolutely.
00:33:33.920 --> 00:33:36.480
Oh man, that is tough.
00:33:36.720 --> 00:33:37.039
Yeah.
00:33:37.359 --> 00:33:45.519
Can POCD show up for somebody and there not be any other It can be the emergent theme for sure.
00:33:45.759 --> 00:33:48.880
Sometimes that's the first time OCD ever shows up.
00:33:49.440 --> 00:33:56.880
So POCD can be the emergent theme, which is the very first one that shows up for somebody and the only one ever.
00:33:58.240 --> 00:34:02.799
Um, it's rare that somebody has OCD that never jumps stain.
00:34:03.359 --> 00:34:03.680
Okay.
00:34:04.480 --> 00:34:12.639
But that can be the first one for somebody, which is why it becomes so debilitating and debilitating no matter when it shows up.
00:34:12.960 --> 00:34:20.320
There are kids and teenagers that I have worked with that are themselves minors worried that they are a pedophile.
00:34:21.840 --> 00:34:23.519
And how do you work through that?
00:34:23.679 --> 00:34:27.840
That, hey, you're 15, your attraction to 15-year-olds is normal.
00:34:29.360 --> 00:34:31.199
But no, what if that means that I'm a pedophile?
00:34:31.280 --> 00:34:34.239
What if I'm always attracted to 15-year-olds, even when I'm 40?
00:34:35.199 --> 00:34:35.519
Wow.
00:34:35.840 --> 00:34:38.239
Yeah, that's a thing you can't have certainty about.
00:34:39.039 --> 00:34:39.519
Wow.
00:34:39.679 --> 00:34:40.880
Yeah, because it for one.
00:34:41.440 --> 00:34:43.199
That statement alone is OCD.
00:34:43.440 --> 00:34:47.599
If you're sitting with a therapist, they're like, okay, this is what that is.
00:34:47.840 --> 00:34:54.480
But how does that person know to express that to somebody before they know it's OCD?
00:34:54.639 --> 00:34:59.360
Nobody is going to express that to a 15-year-old is not going to know to share that.
00:34:59.519 --> 00:35:07.360
They're going to have to almost have other OCD themes in order for that to come up for them to feel comfortable enough.
00:35:07.440 --> 00:35:09.440
And I think that's the biggest issue, right?
00:35:09.599 --> 00:35:11.199
Well, with people that have POCD.
00:35:11.519 --> 00:35:21.039
I think that they would probably have to stumble upon a very beautifully produced podcast to learn a lot about experience.
00:35:22.639 --> 00:35:23.039
Truly.
00:35:23.920 --> 00:35:28.400
That's the answer is getting it out there, letting people know that this is a thing.
00:35:28.639 --> 00:35:36.480
And that's a hard thing to do with this particular theme because it is so societally abhorrent.
00:35:36.800 --> 00:35:37.360
Yeah.
00:35:37.599 --> 00:35:44.880
And do you think that is because people think, okay, you can have someone who's like, okay, I understand what OCD is.
00:35:45.039 --> 00:35:45.519
I get it.
00:35:45.599 --> 00:35:47.039
I understand the intrusive thoughts.
00:35:47.119 --> 00:35:50.159
I understand that someone with POCD is not a pedophile.
00:35:50.320 --> 00:35:55.039
But that doesn't take away the fact that I know that person still had those thoughts.
00:35:55.360 --> 00:36:00.559
That's probably where the shame comes in for a lot of people is like, I can talk about it openly.
00:36:00.639 --> 00:36:03.280
I mean, I personally do not struggle with that one.
00:36:03.360 --> 00:36:09.440
And I thank God because I know that OCD alone is horrific, let alone that thing.
00:36:09.840 --> 00:36:23.519
However, I imagine that people that do struggle with that, the shame is so intense, whether people understand it or not, that they will they will die with that secret.
00:36:23.679 --> 00:36:24.960
They will die with that secret.
00:36:25.280 --> 00:36:27.280
Here's a huge barrier to that.
00:36:27.599 --> 00:36:42.880
And a uh trigger that comes up surprisingly often is that at a lot of malls, and I don't know, it's probably at a Spencer's in a mall somewhere, there are t-shirts on display that say kill all pedophiles.
00:36:44.559 --> 00:36:50.480
Can you think of one single other class of humans that you could put under kill all?
00:36:50.719 --> 00:36:54.480
And we as a society would go, yeah, that's great, put on a t-shirt, we'll buy it.
00:36:54.719 --> 00:36:55.280
Right.
00:36:55.760 --> 00:37:00.719
No, it's so abhorrent, not just to the individual, but to society.
00:37:00.960 --> 00:37:02.559
And so, yeah, absolutely.
00:37:02.800 --> 00:37:15.119
People and other practitioners that I have talked to about this will hear that somebody had those thoughts and go, full stop, mandated reporting, keep this person away from kids, all of this stuff.
00:37:15.360 --> 00:37:19.599
And I really emphatically stop them and say, absolutely not.
00:37:20.000 --> 00:37:20.320
No.
00:37:21.280 --> 00:37:30.960
Any one of my people that I have worked with that struggle with POCD, I would trust with my own children because they're worried about it.
00:37:31.360 --> 00:37:35.360
Do you think that therapists struggle with giving that diagnosis?
00:37:35.519 --> 00:37:38.960
Because there is a lot of responsibility on that, on them for that, right?
00:37:39.280 --> 00:37:45.599
And a very salient point is that there are only three reasons to break confidentiality in therapy.
00:37:45.840 --> 00:37:49.599
Harm to myself, harm to others, and harm to kids.
00:37:50.800 --> 00:38:00.800
And even though somebody coming and reporting POCD is not even remotely a reportable thing, people know about this, and that keeps people from bringing it up with their therapists.
00:38:00.880 --> 00:38:01.840
Absolutely.
00:38:02.159 --> 00:38:11.599
And then hearing that how does somebody, especially a young therapist, somebody who doesn't know that POCD even exists, like I did, sub-learning about it on Reddit?
00:38:11.920 --> 00:38:12.159
Right.
00:38:13.039 --> 00:38:14.719
How would that person respond?
00:38:15.119 --> 00:38:25.599
If someone's in their car right now and they're listening to this episode and they're going check, check, check, and it really resonates with them, what should they do?
00:38:25.920 --> 00:38:37.119
Because again, this one is slightly different from other OCD subtypes, where there is some risk that you're going to be misunderstood when you show up to the therapist's office.
00:38:37.280 --> 00:38:42.079
I mean, we've we've given a few examples here of times when it's gone sideways for people.
00:38:42.320 --> 00:38:44.400
So what should they do?
00:38:44.559 --> 00:38:57.280
What steps should they take to ensure that when they do finally take this weight off their chest and open up to a therapist, that they are not going to be reprimanded in some way.
00:38:57.599 --> 00:38:59.920
Find a specialist immediately.
00:39:01.119 --> 00:39:02.719
There are very good resources.
00:39:02.880 --> 00:39:12.159
The International OCD Foundation, of course, IOCDF.com, has a directory that only includes people that have been through their behavior therapy training institute.
00:39:12.320 --> 00:39:17.199
Uh anybody at nocd.com has all been through No CD Academy.
00:39:17.519 --> 00:39:19.280
They are all educated on this.
00:39:19.599 --> 00:39:28.480
We know all about it and probably could pick up on it without you even having to take us there a whole lot.
00:39:29.039 --> 00:39:32.480
And that is a specialty that is quite rare.
00:39:32.639 --> 00:39:46.400
And you have to be kind of careful with that one because there are a huge majority of people, a huge majority of therapists that put together a psych today profile and just tick OCD, because they go, Yeah, that's OC, that's anxiety with extra steps.
00:39:46.480 --> 00:39:51.119
I can help out with that without actually having any real specialization in it.
00:39:51.440 --> 00:40:04.719
I'm curious, as someone who specializes in POCD, if you have taken criticism yourself from people in the public or people who might somehow be aware of your specialty and what it is you do.
00:40:04.880 --> 00:40:08.480
I follow Allegra Castins, I'm sure you're familiar with her.
00:40:08.960 --> 00:40:12.880
And she's very outspoken about her own battle with POCD.
00:40:12.960 --> 00:40:17.599
And she now thankfully is in a place where she has kids and she's doing much better.
00:40:17.840 --> 00:40:29.920
But I look at the comments under her posts, and a lot of them are filled with hate and questioning of, you know, whether, you know, basically calling her a pedophile.
00:40:30.320 --> 00:40:35.599
I mean, that ships proof that she's that far along and confident with who she is and what's going on.
00:40:36.000 --> 00:40:36.639
Good for her.
00:40:36.719 --> 00:40:39.920
Like to be able to do that, that just shows that there's proof.
00:40:40.079 --> 00:40:47.039
That is proof for people with POCD that you can get to the other side and with and and you know, take the the criticism at some point.
00:40:47.199 --> 00:40:51.440
I'm sure it it doesn't feel good, but she knows in her heart the truth.
00:40:51.679 --> 00:40:53.119
So what do you can do?
00:40:53.440 --> 00:40:57.920
But I'm curious if if you've taken criticism like that and how you deal with it.
00:40:58.159 --> 00:40:59.039
Absolutely.
00:40:59.280 --> 00:41:04.239
Uh and I don't uh have an experience of POCD.
00:41:04.320 --> 00:41:08.880
I don't have a particularly wide internet following or anything like that.
00:41:09.119 --> 00:41:16.400
But I do uh die on that hill every single time I'm able to when I'm having a conversation with another professional.
00:41:16.719 --> 00:41:20.000
And they do have those kind of probing questions.
00:41:20.320 --> 00:41:27.280
And I will stop my whole day and we will talk about this until you understand that this is POCD.
00:41:27.440 --> 00:41:44.239
This uh this population are not pedophiles, and I need you, as a professional, at minimum, to refer that person to a specialist when you meet them and do not judge them because otherwise, how many years will it be before they walk back into another therapist's office?
00:41:44.400 --> 00:41:56.079
Aaron Powell For a family member who's listening, they have someone in the family who's struggling with POCD, and thankfully that person has felt free enough to confide in them.
00:41:56.400 --> 00:42:04.320
What would you tell them about offering support without feeding the OCD and the POCD specifically?
00:42:05.199 --> 00:42:07.519
The same as any other theme of OCD.
00:42:07.760 --> 00:42:09.760
Reassurance is not support.
00:42:10.239 --> 00:42:11.519
It feels like it is.
00:42:11.760 --> 00:42:18.559
It even feels particularly cool not to reassure my loved one about this thing that I can see so clearly.
00:42:18.800 --> 00:42:20.559
Hey, the germs aren't gonna kill you.
00:42:20.719 --> 00:42:23.199
Hey, I'm not gonna die because you left the stove on.
00:42:23.360 --> 00:42:26.400
Hey, you're not a pedophile for all of these reasons.
00:42:26.719 --> 00:42:30.000
Feels like a very logical thing to do, but it doesn't help them.
00:42:30.159 --> 00:42:32.320
It does actively make OCD worse.
00:42:32.480 --> 00:42:42.480
And you can support them and help them manage the way that they're feeling without reassurance and absolutely encourage them to seek out treatment with a specialist.
00:42:42.880 --> 00:42:50.159
Would you recommend that they sit in on some of the sessions with them so that you can help educate and how to respond and how not to respond?
00:42:51.039 --> 00:42:54.000
In my work, that's completely up to my members.
00:42:54.400 --> 00:42:54.719
Okay.
00:42:55.119 --> 00:42:57.840
If they want that, absolutely.
00:43:03.679 --> 00:43:08.159
What do you wish more people understood about intrusive thoughts generally?
00:43:08.320 --> 00:43:19.039
You know, we've talked, obviously, we're diving deep this episode on POCD, but intrusive thoughts generally, what do you wish people understood more about them as they relate to OCD?
00:43:19.440 --> 00:43:20.880
Everybody has them.
00:43:21.599 --> 00:43:23.840
And you will never be free of them.
00:43:24.639 --> 00:43:27.440
And that second one sounds kind of intense.
00:43:28.400 --> 00:43:32.880
Uh and that is to say, you're never not gonna have intrusive thoughts.
00:43:33.280 --> 00:43:39.280
Even if you are fully maintaining freedom from your OCD, the thought's gonna come up.
00:43:40.400 --> 00:43:44.960
What's going to change is the amount of distress that you experience around that thought.
00:43:45.519 --> 00:43:48.320
The thought will be there in the future, for sure.
00:43:48.559 --> 00:43:51.760
But you'll know exactly how to respond to it.
00:43:52.079 --> 00:43:52.480
Yeah.
00:43:52.800 --> 00:43:56.000
Then you won't give it the power that the obsessive compulsive cycle gives it.
00:43:56.320 --> 00:43:59.599
And the intrusive thought does not reveal anything about your character.
00:44:00.880 --> 00:44:02.079
You can't be sure though.
00:44:09.360 --> 00:44:11.679
I just got a sick feeling in my stomach.
00:44:17.840 --> 00:44:18.880
Alicia's face.
00:44:20.079 --> 00:44:22.079
No, I'm back to being a horrible person.
00:44:22.159 --> 00:44:23.440
I'm a terrible person.
00:44:27.760 --> 00:44:34.000
That our ERP therapists are uniquely broken individuals.
00:44:35.679 --> 00:44:37.920
That's an insane thing for me to say.
00:44:38.159 --> 00:44:44.079
Like we all get a little weird and engage in life where there is no certainty about anything.
00:44:45.199 --> 00:44:46.559
There's no way to know.
00:44:46.880 --> 00:44:53.760
And for the vast majority of human beings, our experience of that is minimal.
00:44:53.920 --> 00:45:00.480
It's very unconscious that we engage with the uncertainty of the world where you could die in a car wreck today.
00:45:00.639 --> 00:45:03.840
But you didn't think about that when you started up your car today.
00:45:04.159 --> 00:45:05.280
Oh, I do every time.
00:45:05.760 --> 00:45:07.440
A million maybe you do.
00:45:08.079 --> 00:45:10.400
People with harm OCD definitely think about it.
00:45:10.880 --> 00:45:11.360
Every day.
00:45:12.079 --> 00:45:18.159
And yet there's a million other uncertainties that are just below the level of our consciousness, really.
00:45:18.480 --> 00:45:18.960
Yeah.
00:45:19.280 --> 00:45:28.480
And then something slips through that filter, hits you right in the amygdala, and all of a sudden, that is a great big threat that I need to protect against.
00:45:28.639 --> 00:45:32.159
Especially because if I don't protect against that, that would mean something about me.
00:45:32.239 --> 00:45:34.400
That would be my fault for not taking care of that.
00:45:34.559 --> 00:45:35.920
And then we compulse.
00:45:36.159 --> 00:45:39.760
And then the thought gets louder and compulsions get less effective.
00:45:39.920 --> 00:45:42.880
And so the thought gets louder and then the compulsions grow.
00:45:43.119 --> 00:45:47.440
And before I know it, I can't manage this anymore.
00:45:47.920 --> 00:45:53.519
I think I'm very much still in the function, not freedom stage of my uh OCD for sure.
00:45:54.400 --> 00:45:55.440
That's okay.
00:45:56.239 --> 00:45:59.760
If that's crazy, if your life is okay.
00:45:59.920 --> 00:46:00.960
Yeah, absolutely.
00:46:01.280 --> 00:46:04.559
I I mean I my life is my life is great.
00:46:04.639 --> 00:46:08.079
And I make conscious decisions every day to tell myself it is.
00:46:08.239 --> 00:46:12.800
However, I do still battle intrusive thoughts regularly, hourly.
00:46:13.039 --> 00:46:17.440
I I think I need to just get back into ERP like yesterday.
00:46:19.039 --> 00:46:19.599
You can.
00:46:20.079 --> 00:46:21.039
It's available.
00:46:21.440 --> 00:46:22.960
You don't have to.
00:46:24.639 --> 00:46:26.320
You certainly do not have to.
00:46:26.480 --> 00:46:33.199
I am in a camp of uh people that will encourage freedom over functioning.
00:46:34.320 --> 00:46:34.639
Yeah.
00:46:35.119 --> 00:46:36.880
Because it's available.
00:46:37.199 --> 00:46:41.679
Just like I'm I'm a person that would encourage anybody with OCD to try some meds.
00:46:41.760 --> 00:46:44.000
Get on an SSRI because it works.
00:46:44.079 --> 00:46:44.719
You're gonna be able to do that.
00:46:45.840 --> 00:46:47.920
You have to believe it's available, right?
00:46:48.079 --> 00:46:51.519
You have to first choose to believe that freedom does exist.
00:46:51.599 --> 00:46:56.159
And I think our OCD keeps us from believing that it even exists.
00:46:56.320 --> 00:47:02.880
I know I have spent my entire life um with this brain.
00:47:03.280 --> 00:47:09.119
And I think there is fear around who am I without the way that I think.
00:47:09.519 --> 00:47:16.960
Because in my mind, I'm protecting myself, you know, with the way that I am and who I am.
00:47:17.360 --> 00:47:27.199
And there are so many habitual thoughts that happen that I think are protecting me.
00:47:27.519 --> 00:47:33.280
The the layers and and depth of my OCD are so deep.
00:47:34.079 --> 00:47:41.119
There's a second answer to your question, Liam, about what more people can know about intrusive thoughts.
00:47:41.440 --> 00:47:52.960
And that is that the really the way that the mental health industry is set up is not ready for OCD.
00:47:53.840 --> 00:47:59.039
Because the primary modality of therapy generally is CBT or talk therapy.
00:47:59.280 --> 00:47:59.679
Right.
00:48:00.000 --> 00:48:18.239
And what CBT or talk therapy would teach us to do with our intrusive thoughts is to gather evidence, challenge those thoughts, uh, look to your values, really try to understand something about the situation, and all of those responses is helping a person get better at compulsing.
00:48:18.480 --> 00:48:18.880
Right.
00:48:19.199 --> 00:48:23.920
And so a lot of people that have OCD have an experience of going to talk therapy.
00:48:24.079 --> 00:48:26.960
I feel better for the 53 minute hour.
00:48:27.119 --> 00:48:32.639
And then I walk out of there, and even as I'm driving home, I go, oh, but what if she didn't know about this thing?
00:48:32.719 --> 00:48:34.320
What if I didn't articulate that just right?
00:48:34.400 --> 00:48:37.840
What if, what if, what if and then we're not even back to square one.
00:48:37.920 --> 00:48:39.199
We're set back even farther.
00:48:39.599 --> 00:48:42.320
My experience with talk therapy.
00:48:42.559 --> 00:48:45.119
When I first got into therapy, I didn't know I had OCD.
00:48:45.199 --> 00:48:47.840
It's a very common experience for people with OCD.
00:48:48.000 --> 00:48:49.840
And so I was in talk therapy at first.
00:48:49.920 --> 00:48:53.280
And there were ways in which that therapy helped me.
00:48:53.440 --> 00:49:05.679
The primary, primary one being that she is the one who persuaded me to get on an SSRI, but she did not clock it as OCD and treated it the way you would any other issue.
00:49:05.920 --> 00:49:08.400
And it made things worse.
00:49:08.559 --> 00:49:24.480
It it, you know, I was doing a lot of exactly as you say, kind of looking at my thoughts and the thought process and you know, balancing against my values and then trying to do meditation and put myself into a safe place during meditation and all this stuff.
00:49:24.559 --> 00:49:30.400
And and I just after a few months, I remember saying to my wife, like, I think I'm actually worse.
00:49:30.800 --> 00:49:35.039
You know, and that I don't I don't think that's what should be happening.
00:49:35.199 --> 00:49:58.639
And so finally, you know, we came around and and determined that it was OCD, but um you're exactly right, that that so many people can get into that, you know, cycle of the current system where they finally, and that's what's so cruel about it, is they finally open up.
00:49:59.039 --> 00:50:01.360
Like, I'm gonna finally go get help, I'm gonna do it.
00:50:01.440 --> 00:50:07.199
And then they navigate the labyrinth that is our mental health system and insurance system in this country.
00:50:07.280 --> 00:50:12.800
And and they finally find a therapist, they take all the steps, and then it's they're worse.
00:50:12.880 --> 00:50:17.280
And they're like, well, all right, I'm I'm that's not an option for me anymore.
00:50:17.360 --> 00:50:22.639
I mean, and what a disservice that is to people who are already struggling so much.
00:50:22.960 --> 00:50:28.800
And then I always talk about the second minotaur in that dungeon is okay, you finally figure all that out.
00:50:28.960 --> 00:50:35.039
You go to find a specialist, and then there's three people in your entire Metroplex.
00:50:35.599 --> 00:50:40.480
They're giving only 250 bucks an hour and booked out for three months.
00:50:40.719 --> 00:50:42.480
None of them take insurance.
00:50:42.800 --> 00:50:43.599
Now what?
00:50:44.639 --> 00:50:46.079
They call no cd.
00:50:46.320 --> 00:50:47.679
No seeding.com.
00:50:52.159 --> 00:50:52.800
That's right.
00:50:53.119 --> 00:51:00.639
Lucas, thank you so much for joining us and helping shine a light on one of the most misunderstood and stigmatized forms of OCD.
00:51:01.280 --> 00:51:04.480
It has been a pleasure, and I'll pay for your future therapy.
00:51:04.559 --> 00:51:06.320
Sorry for traumatizing you.
00:51:10.079 --> 00:51:11.039
Thank you, Lucas.
00:51:11.440 --> 00:51:13.280
Absolutely thank you all for having me.
00:51:15.679 --> 00:51:17.599
Okay, so I so I have a confession.
00:51:17.679 --> 00:51:34.079
I realize one of my OCD um compulsions this morning that I've been doing is that when I go to take my meds, I have to say it out loud three times because I've told myself that if I do, I'll remember that I took them.
00:51:34.960 --> 00:51:36.239
Um, and it has to be three.
00:51:36.400 --> 00:51:37.760
Four feels uncomfortable.
00:51:38.079 --> 00:51:42.320
So I was like, okay, I take my meds, I take my meds, I took my meds.
00:51:42.559 --> 00:51:47.360
And then I went into the bathroom to do my hair and I was like, Spencer, do you realize I do that?
00:51:47.519 --> 00:51:49.039
He's like, uh, I guess I I do.
00:51:49.119 --> 00:51:50.639
I'm like, do you think that's OCD?
00:51:50.719 --> 00:51:52.159
He's like, yeah, 100%.
00:51:52.480 --> 00:51:53.440
I go, you don't do that?
00:51:53.519 --> 00:51:55.760
You don't have to tell yourself you took your meds.
00:51:56.400 --> 00:51:59.760
He goes, No, I go, how do you know for sure you don't double up on them?
00:52:00.239 --> 00:52:02.719
I'm afraid I'm gonna take like 10 pills.
00:52:05.519 --> 00:52:08.239
Wait, so why the number three?
00:52:08.800 --> 00:52:09.280
Why three?
00:52:09.599 --> 00:52:10.400
I don't know, it feels good.
00:52:10.800 --> 00:52:11.519
It feels good.
00:52:11.840 --> 00:52:12.639
It just feels right.
00:52:12.719 --> 00:52:13.760
So you say it out loud.
00:52:13.840 --> 00:52:16.079
You go, I took my meds, I took my meds, I took my meds.
00:52:16.239 --> 00:52:18.159
I took my meds, I took my meds, I took my meds, yeah.
00:52:18.480 --> 00:52:19.679
And your fear if you don't do this.
00:52:21.360 --> 00:52:24.880
Four makes me go, and two is not enough.
00:52:25.119 --> 00:52:30.960
Yeah, so it's interesting though, because I don't know that I've ever counted out loud like that.
00:52:31.519 --> 00:52:39.440
I don't know if or maybe I have, and it just wasn't as apparent or evident to me since I didn't know I had OCD.
00:52:39.599 --> 00:52:40.400
I don't know.
00:52:40.639 --> 00:52:42.719
But I thought, oh, I gotta share that today.
00:52:43.119 --> 00:52:45.599
Yeah, you might start finding other patterns too.
00:52:45.679 --> 00:52:52.800
I what my thing with the pills is yes, I do sometimes worry about whether or not I've taken them, but I think that's kind of normal.
00:52:52.880 --> 00:53:01.840
But but um but what I do is when I when I take the pills and you know, drinking the water, I have to take 10 sips of water.
00:53:02.239 --> 00:53:04.800
So I like am counting as I gulp.
00:53:05.119 --> 00:53:09.440
So um now I now I don't.
00:53:09.519 --> 00:53:14.880
And so sometimes I'll I'll like count it out and be like 11 to do one more than 10.
00:53:14.960 --> 00:53:23.519
And other times I'll try to like confuse my brain about how many I've Yeah, but Liam, I think that if you do 11, that's just a new compulsion in disguise.
00:53:24.079 --> 00:53:26.559
Well, it's to challenge not doing the 10, right?
00:53:26.639 --> 00:53:33.360
The 10 was the I know it is, but you've just created a new compulsion, challenging the 10.
00:53:33.679 --> 00:53:35.760
You're not supposed to count at all.
00:53:36.159 --> 00:53:41.119
Yeah, so now, but that the the counting is just so habit-forming.
00:53:41.280 --> 00:53:45.360
Like I'll just be drinking the water and be like, oh wow, I'm counting right now.
00:53:45.519 --> 00:53:51.920
So then what I'll do is try to confuse my own brain about how many I've done, and I'll be like, eight, one, hundred, eleven.
00:53:52.079 --> 00:54:00.559
Like it's so that I don't know how many I've got you, brain.
00:54:01.199 --> 00:54:02.320
Fuck you, brain.
00:54:02.400 --> 00:54:04.000
You don't know where you are.
00:54:06.480 --> 00:54:07.599
Oh yeah?
00:54:07.920 --> 00:54:09.840
Let's see if we can count.
00:54:14.239 --> 00:54:17.360
Thanks for listening to another episode of the OCD Confessional.
00:54:17.440 --> 00:54:20.159
Be sure to follow the show so you get new episodes.
00:54:20.400 --> 00:54:26.079
You can subscribe to us on YouTube or find us on Instagram and TikTok at the OCD Confessional.
00:00:00.080 --> 00:00:02.640
POCD is one of the most taboo themes in OCD.
00:00:02.799 --> 00:00:07.919
Many people aren't even comfortable saying the word pedophile, let alone admitting the intrusive thoughts that torment them.
00:00:08.160 --> 00:00:10.080
Today we're leaning into that discomfort.
00:00:10.240 --> 00:00:16.800
We're gonna say the words, have a conversation, and expose ourselves to the very thing OCD tells us we can't talk about.
00:00:16.960 --> 00:00:21.760
Because bringing these fears into the light is often the first step towards taking their power away.
00:00:22.399 --> 00:00:23.120
I'm Alicia.
00:00:23.440 --> 00:00:24.399
And I'm Liam.
00:00:24.480 --> 00:00:25.920
We both have OCD.
00:00:26.000 --> 00:00:30.800
And instead of spiraling alone, we decided to turn our symptoms into a podcast.
00:00:31.039 --> 00:00:31.679
You're welcome.
00:00:31.920 --> 00:00:41.679
Here we overshare real stories, laugh through the anxiety, and talk to actual experts who can explain why your brain keeps asking, What if I accidentally marry my cousin?
00:00:41.920 --> 00:00:48.640
Whether your thing is hand washing, mental rituals, or just silently panicking during normal conversations, congrats.
00:00:48.799 --> 00:00:50.000
You have found your people.
00:00:50.240 --> 00:00:53.039
This is a safe place, unless you're an interest of thought.
00:00:53.200 --> 00:00:55.280
In which case, get in line, buddy.
00:00:55.359 --> 00:00:56.079
We're booked.
00:00:56.240 --> 00:01:01.439
So grab a weighted blanket, cancel your plans for the fifth time, and let's dive in.
00:01:01.679 --> 00:01:03.840
This is the OCD Confessional.
00:01:04.079 --> 00:01:07.680
And yes, we did check this recording four times before uploading it.
00:01:10.239 --> 00:01:12.640
Today on the podcast, we are joined by Lucas S.
00:01:12.799 --> 00:01:18.000
Sneer, a licensed professional counselor specializing in OCD and related disorders.
00:01:18.239 --> 00:01:29.599
Lucas primarily uses exposure and response prevention, or ERP, the gold standard treatment for OCD, and works with individuals navigating anxiety, OCD, and co-occurring disorders.
00:01:29.840 --> 00:01:39.280
In today's episode, we are specifically diving into POCD, what it is, how it presents, and some of the biggest misconceptions surrounding it.
00:01:39.519 --> 00:01:46.480
We're excited to have Lucas here to share his insight and help bring more understanding and hope to a topic that is so often misunderstood.
00:01:46.560 --> 00:01:48.239
So, Lucas, thank you so much for joining us.
00:01:48.319 --> 00:01:49.599
We really appreciate it.
00:01:50.000 --> 00:01:50.879
Thank you for having me.
00:01:51.200 --> 00:01:52.480
All right, we're just going to jump in.
00:01:52.640 --> 00:01:56.560
For listeners who may not know, can you explain what POCD actually is?
00:01:56.719 --> 00:02:04.640
I know it's a very taboo and uncomfortable conversation, but we are going to expose ourselves and say the uncomfortable.
00:02:04.719 --> 00:02:05.840
So let's dive in.
00:02:06.319 --> 00:02:09.520
Well, POCD is pedophilia-themed OCD.
00:02:09.919 --> 00:02:14.639
And right out of the gate, the word pedophilia is kind of a bombshell to just drop on people.
00:02:14.879 --> 00:02:16.400
But I use it all the time.
00:02:16.560 --> 00:02:22.960
When we're talking about POCD, there is no sense in shying away from the idea that that is pedophilia-themed OCD.
00:02:23.120 --> 00:02:27.360
It's OCD just like any other theme that has that obsessive-compulsive cycle.
00:02:27.599 --> 00:02:39.759
This individual theme is the worry about if I may secretly be a pedophile, if I may become a pedophile, if I was a pedophile, any kind of worry about that, that's what OCD latches on to.
00:02:40.000 --> 00:02:42.560
How do you differentiate, right?
00:02:42.719 --> 00:02:55.360
So someone comes to a therapist or confesses to a person in their family and says, I'm having these thoughts, these fears that I might be a pedophile.
00:02:55.759 --> 00:02:58.240
What helps you as a counselor differentiate?
00:02:58.400 --> 00:03:09.280
Okay, this person might actually have some sort of pedophilia tendencies, or no, this is purely OCD and we need to work on them with that.
00:03:10.000 --> 00:03:17.439
Especially if OCD hasn't been brought up in their life before, and that is the first that that's tough.
00:03:17.520 --> 00:03:17.840
Yeah.
00:03:18.240 --> 00:03:18.639
Good question.
00:03:19.520 --> 00:03:19.680
Yeah.
00:03:20.400 --> 00:03:24.560
What a big fear right out of the gate is is this something that we need to be worried about?
00:03:24.719 --> 00:03:25.919
Is this OCD?
00:03:26.080 --> 00:03:42.639
And what I typically tell people, especially therapists that I'm talking to about this, is if somebody is bringing this up to you, good nine out of 10 times, this is gonna be OCD because true pedophilia as a paraphilic disorder is an egosyntonic thing.
00:03:42.800 --> 00:03:47.759
That that is typically a desire that a person has that is very disordered.
00:03:47.919 --> 00:03:54.000
And they're not really interested in going to a therapist or even their loved ones to talk about being worried about that.
00:03:54.319 --> 00:03:58.560
POCD, like all other forms of OCD, is ego dystonic.
00:03:58.800 --> 00:04:01.680
This person is very devastated by this worry.
00:04:01.840 --> 00:04:04.639
It's their worst case scenario that this may be true.
00:04:04.800 --> 00:04:08.960
And that right there is the biggest flag of this is OCD.
00:04:09.360 --> 00:04:14.240
Which is interesting because a lot of people who have those thoughts are not going to be so eager to share them.
00:04:14.479 --> 00:04:18.240
And I think that's where the trouble comes in, right?
00:04:18.639 --> 00:04:29.759
Even I, as a dedicated OCD specialist, with some marketed material that I even specialize in POCD, people experiencing this come to me knowing that I'm already going to know what they're talking about.
00:04:30.240 --> 00:04:33.600
It's even then still so hard for them to bring up.
00:04:33.920 --> 00:04:38.240
And it all the time I can sense it that, okay, we're talking around this thing.
00:04:38.399 --> 00:04:44.560
And usually the most comfortable way for me to bring that up is to ask somebody permission to, hey, let me guess real quick.
00:04:44.800 --> 00:04:48.879
I I think that I know and I can only imagine how hard that is to bring up.
00:04:49.120 --> 00:04:52.399
So, hey, are you worried that you may be a pedophile?
00:04:52.639 --> 00:05:16.959
And the relief that comes off of a person when they're like, okay, you already know is amazing because can you imagine being worried that somebody might judge you for that worry, that somebody might directly step on that thing that you've been so scared about, especially sitting in front of a professional that might that might go, oh God, we need to be really worried about that.
00:05:17.279 --> 00:05:23.120
My wife is a clinical psychologist and she tells this story when she was in her graduate training.
00:05:23.199 --> 00:05:28.639
So these were all people who were on the path to getting a PhD in clinical psychology.
00:05:28.879 --> 00:05:37.360
And one of her classmates brought this case before them of one of her clients had come in with this fear of being a pedophile.
00:05:37.920 --> 00:05:51.120
And the clinician quickly assessed this is OCD and POCD specifically, but brought the case to the rest of the group as part of supervision and part of their education.
00:05:51.519 --> 00:05:57.439
And my wife, Leah, said most of the people in the group were actually really concerned.
00:05:57.600 --> 00:06:05.759
No, I what if the person really is a pedophile and you're not taking the proper steps to make sure they don't have access to kids, et cetera?
00:06:05.920 --> 00:06:10.319
And Leah said it was so clear in the documentation that it was actually OCD.
00:06:10.480 --> 00:06:19.040
And even people in the field were judging this person and had real concerns that they might actually be a pedophile.
00:06:19.279 --> 00:06:20.959
How do we confront that?
00:06:21.199 --> 00:06:32.959
Because as you said, that it must be terrifying for someone with POCD to say the words out loud, knowing, boy, if this goes sideways, I could be prosecuted.
00:06:33.120 --> 00:06:36.560
I'm certainly could be shunned, I could be disowned by my family.
00:06:36.639 --> 00:06:40.959
I mean, the stakes are very, very high for someone who is experiencing this.
00:06:41.600 --> 00:06:44.480
As far as the answer to that, I think we're doing it right now.
00:06:45.120 --> 00:06:46.079
That's what I was just gonna say.
00:06:46.480 --> 00:06:47.920
We have to talk about it more.
00:06:48.160 --> 00:06:50.000
And I tell the story all the time.
00:06:50.079 --> 00:06:51.680
And I at this point I don't remember.
00:06:51.759 --> 00:06:54.639
I think I was at the end of my associateship.
00:06:54.800 --> 00:07:02.639
I think it was just almost fully licensed when I learned about POCD, and I learned about it on Reddit.
00:07:03.920 --> 00:07:19.439
I have been through grad school in like a year and a half of supervision at this point, and I'm still reading somebody's experience that they're posting about this great big worry that they have, and I'm kind of reading it in the same voice that in the same vein that probably a lot of your wife's classmates were of, oh my God, that's really worrying.
00:07:19.519 --> 00:07:20.480
This is a lot.
00:07:20.720 --> 00:07:25.199
And then I saw the top comment that said, Hey, everybody, pump your brakes.
00:07:25.519 --> 00:07:30.480
There's this random OCD specialist on Reddit that was saying, this is an OCD thing.
00:07:30.639 --> 00:07:36.720
And you need to go to the IOCDF, and here's all these resources and articles about what it is.
00:07:37.439 --> 00:07:57.519
And my the dichotomy of my own reaction to being so worried about it and then recognizing what that was was the first thing that really led me into having a bit of a passion for POCD because it is a thing that even I, with all of the knowledge that I thought that I had, had no idea what was going on with this person.
00:07:58.000 --> 00:08:00.720
And I I love that I love that you feel passionate about it.
00:08:00.879 --> 00:08:02.319
We need more people to speak up about that.
00:08:02.480 --> 00:08:09.519
And I and I imagine that like Liam and myself, people go years and years and years not knowing they even have OCD.
00:08:09.600 --> 00:08:18.560
And for that to be a recurring intrusive thought to be so debilitating is it's absolutely heartbreaking.
00:08:18.720 --> 00:08:21.920
So I think exactly what you said is just continuing to speak up about it.
00:08:22.160 --> 00:08:25.680
Why do these thoughts feel so real and convincing to the person experiencing them?
00:08:25.759 --> 00:08:28.399
I mean, most people aren't defused from their thoughts.
00:08:28.480 --> 00:08:32.639
And of course, OCD immediately makes you go, oh, what does that mean?
00:08:33.039 --> 00:08:34.799
What does it mean that I even had this thought?
00:08:34.960 --> 00:08:36.799
What does it mean that that crossed my mind?
00:08:37.200 --> 00:08:40.879
Why do some people have those thoughts and some don't that have OCD, do you think?
00:08:41.120 --> 00:08:43.440
It's just like anything it attacks what we value most.
00:08:43.519 --> 00:08:44.639
It's something that we fear.
00:08:45.120 --> 00:08:46.799
It attacks what we value most.
00:08:47.120 --> 00:08:47.679
Yeah.
00:08:48.159 --> 00:09:05.039
I it's interesting in the modern era, hearing more about people's recent triggers, like uh worry that I'm in the Epstein Files is a new the first emergence was that they heard heard about this thing going on and worry that I was a part of that.
00:09:05.759 --> 00:09:10.080
And of course, you hear that and go, What are you talking about?
00:09:10.240 --> 00:09:15.919
But the OCD logic of the thing, yeah, that feels like it really needs to be investigated.
00:09:16.159 --> 00:09:19.679
The intrusive doubt, which is what gets us into that vicious cycle, right?
00:09:19.840 --> 00:09:22.639
It's like you're questioning your own questions of the thing.
00:09:22.799 --> 00:09:23.759
Did I enjoy that?
00:09:23.919 --> 00:09:27.039
Was that a real thought that I actually enjoyed?
00:09:27.279 --> 00:09:28.799
Or am I lying to myself?
00:09:28.960 --> 00:09:36.639
And I think that's where the psychological torment comes in, is when then what lends to depression and then yeah.
00:09:37.039 --> 00:09:47.919
Well, it's the data gathering that keeps that cycle going so badly that yeah, the obsessional worry is there, the intrusive thought is there.
00:09:48.240 --> 00:09:50.720
And you can't actually control that.
00:09:50.960 --> 00:09:52.080
It's gonna be there.
00:09:52.240 --> 00:10:01.519
And then, like we know about the cycle of compulsion, all of the gathering data, checking myself and ways that you can never actually find 100% certainty.
00:10:01.759 --> 00:10:02.799
Just blow that up.
00:10:02.879 --> 00:10:08.480
Aaron Ross Powell What are the compulsions that someone with POCD is doing?
00:10:08.720 --> 00:10:18.399
I've heard stories of people with pedophilia OCD who will go on to porn websites to kind of test whether or not they're aroused.
00:10:18.559 --> 00:10:21.600
So what are some of the compulsions that they're engaging in?
00:10:22.480 --> 00:10:27.759
Pornography is one that is hard for people to bring up because nobody wants to talk about porn with their therapist.
00:10:28.000 --> 00:10:30.080
Uh but yeah, that's absolutely a compulsion.
00:10:30.159 --> 00:10:31.519
People will go and test themselves.
00:10:31.679 --> 00:10:38.720
And to be clear, they're watching adult regular normal porn, but testing to make sure that I'm still attracted to that.
00:10:38.960 --> 00:10:42.879
Oh also a huge amount of avoidance.
00:10:43.120 --> 00:10:44.879
They'll avoid kids, period.
00:10:45.039 --> 00:10:51.600
They'll avoid even walking by an elementary school, uh, a very common early.
00:10:52.480 --> 00:10:58.000
And a pedophile, I don't sorry to interrupt, but a pedophile, an actual pedophile is not going to avoid those things.
00:10:58.320 --> 00:10:58.960
No, not at all.
00:10:59.519 --> 00:10:59.600
Right?
00:10:59.840 --> 00:11:01.919
They're going they're gonna actively seek it out.
00:11:02.159 --> 00:11:07.039
So that alone is proof that you are not a pedophile.
00:11:07.600 --> 00:11:08.240
Yes.
00:11:08.720 --> 00:11:16.240
And to anyone listening to this, worried that you're a pedophile, notice how that reassurance doesn't last all that long.
00:11:16.720 --> 00:11:17.919
It feels great to hear that.
00:11:18.639 --> 00:11:21.759
And oh my God, thank God there's proof that I'm not a pedophile.
00:11:22.000 --> 00:11:23.759
But that's not gonna last, actually.
00:11:23.919 --> 00:11:25.039
That's not the treatment.
00:11:25.360 --> 00:11:28.399
You can't find certainty that you're definitely not.
00:11:28.639 --> 00:11:31.519
It is what is the treatment, Lucas?
00:11:31.679 --> 00:11:33.279
What is the treatment?
00:11:33.679 --> 00:11:34.000
Yeah.
00:11:34.480 --> 00:11:38.960
Just like I was uh unfortunately, the hardest thing is the treatment.
00:11:39.120 --> 00:11:47.759
That's to resist the compulsion and uh resisting a lot of purely mental compulsions, thought replacement of things.
00:11:47.919 --> 00:11:50.320
Um, body checking is a very hard one.
00:11:50.480 --> 00:12:00.320
We talk a lot about what we call gronal responses, which unfortunately having sensations in your genitals is a thing that is just an anxious response.
00:12:00.559 --> 00:12:10.080
So if you're already anxious about a thing and then go checking, oh, did I experience arousal during that, there's a good chance that you're gonna have a feeling of, oh no, I did, didn't I?
00:12:10.399 --> 00:12:14.559
And then everything just keeps going and it grows and grows and grows.
00:12:15.039 --> 00:12:22.240
The biggest takeaway is the is the the knowledge of this and knowing that what's coming up is an interesting thought in OCD.
00:12:22.320 --> 00:12:23.360
That's the the biggest.
00:12:24.080 --> 00:12:28.159
Yes, and even that certainty you can't be certain of.
00:12:28.399 --> 00:12:28.559
Yeah.
00:12:28.960 --> 00:12:38.080
We would go into an exposure like walk around your local mall and don't do that compulsion that you do where you only stare at the horizon and don't look at anybody.
00:12:38.240 --> 00:12:41.360
Like I need you to walk around and look at people and notice people.
00:12:41.519 --> 00:12:46.960
And if you have a thought that, wow, that girl looked really beautiful, I need you to keep walking forward.
00:12:47.120 --> 00:12:48.399
Don't overanalyze that.
00:12:48.559 --> 00:12:49.840
Don't double check it.
00:12:50.000 --> 00:12:51.759
Just keep moving forward.
00:12:52.159 --> 00:12:55.679
And that's a hard thing to do when the stakes are.
00:12:56.000 --> 00:12:57.360
Am I a pedophile?
00:12:57.679 --> 00:13:06.240
So the mental compulsions you mentioned, those seem particularly difficult to tackle from an exposure standpoint, right?
00:13:06.480 --> 00:13:16.879
Because avoidance of children, you can tackle that by saying, no, you're going to walk by the elementary school, you're going to go to the mall, you're going to do the thing that you're not doing in order to avoid children.
00:13:17.279 --> 00:13:24.799
But the mental checking that they're doing of thinking back through the day and, oh, I remember seeing that kid.
00:13:25.039 --> 00:13:27.120
Was I aroused by that, whatever.
00:13:27.360 --> 00:13:32.159
How do you tackle that, the exposure to that, and tell them, like, just don't do that?
00:13:32.399 --> 00:13:35.600
Because of course, that it's not that simple, right?
00:13:36.000 --> 00:13:36.639
Yeah.
00:13:37.279 --> 00:13:45.600
And a lot of the classic, uh, maybe, maybe not, gets really hard when we're dealing with maybe I'm a pedophile and maybe I'm not.
00:13:45.840 --> 00:13:48.320
That's a lot of anxiety to sit inside of.
00:13:48.720 --> 00:13:49.120
Yes.
00:13:49.440 --> 00:13:59.200
Uh so typically it does fall back on leaning into the uncertainty of the thing, recognizing this pattern where I'm trying to prove that I'm not, and it never works.
00:13:59.519 --> 00:14:03.200
And so I just have to remain uncertain.
00:14:03.440 --> 00:14:13.120
I can even be 99.999% sure, and I know that OCD wants 100%, and I have to deny OCD that 100%.
00:14:13.759 --> 00:14:15.279
I have to just keep moving forward.
00:14:15.600 --> 00:14:17.840
What's the worst case of it you've seen?
00:14:18.080 --> 00:14:26.799
Just the the most debilitating this person potentially has to be put into inpatient care as a result of it.
00:14:27.200 --> 00:14:31.759
What is the most intense case you've seen and how did that manifest for that person?
00:14:32.399 --> 00:14:34.639
Uh bedridden and suicidal.
00:14:35.360 --> 00:14:35.679
Yeah.
00:14:36.720 --> 00:14:50.000
And that is the thing that a large number of people that experience POCD walk around with, which is that I'm either going to figure this out or I'll kill myself before I harm a child.
00:14:50.960 --> 00:14:57.279
Yeah, gosh, I just got goosebumps all over my body because you know that it's so heavy and so heartbreaking.
00:14:57.519 --> 00:14:57.679
Yeah.
00:14:58.480 --> 00:15:03.360
Do these thoughts ever go away for someone?
00:15:05.120 --> 00:15:06.320
Yes and no.
00:15:07.200 --> 00:15:12.559
And this comes down to the ever-present argument of like, do we cure OCD or do we manage it?
00:15:12.639 --> 00:15:13.759
Is this a chronic thing?
00:15:14.080 --> 00:15:19.519
And while no, the thoughts probably don't fully go away.
00:15:20.000 --> 00:15:28.080
It's incredible meeting a person before and after ERP where they go, oh yeah, yeah, I have the thoughts, but who cares?
00:15:28.240 --> 00:15:29.759
I'm not worried about that.
00:15:30.000 --> 00:15:33.600
What ERP does is take the distress out of the thoughts.
00:15:33.919 --> 00:15:40.240
We literally retrain the amygdala to not have as robust of a response to these triggers.
00:15:40.559 --> 00:15:45.200
We've successfully taught a brain that this discomforts, because it is discomforting.
00:15:45.360 --> 00:15:48.559
It's allowed to be discomforting to worry that you're a pedophile.
00:15:48.720 --> 00:15:51.279
And that discomfort does not equal danger.
00:15:51.440 --> 00:15:52.480
You don't have to respond to it.
00:15:52.559 --> 00:15:53.600
You don't have to prove it wrong.
00:15:54.000 --> 00:16:04.399
You mentioned before that, you know, maybe ERP for somebody that that battles POCD would be going to the mall and having a thought like this girl looked beautiful.
00:16:04.639 --> 00:16:10.320
Is this something that you would recommend them doing on their own or should they have a partner with them?
00:16:10.559 --> 00:16:17.279
I imagine that that is not something that they're publicly going to announce that they're doing right in therapy.
00:16:17.919 --> 00:16:21.440
If they have a spouse, then maybe they've they've confided in their spouse.
00:16:21.519 --> 00:16:22.639
I would hope they would.
00:16:22.879 --> 00:16:30.639
Is that something that you would recommend they do on their own, or do they have support in those moments with somebody that they trust?
00:16:31.200 --> 00:16:37.120
The beauty of the post-COVID world and teletherapy is that they bring me with them on their cell phone.
00:16:37.679 --> 00:16:38.000
Oh.
00:16:38.879 --> 00:16:40.960
We can go through this together.
00:16:41.200 --> 00:16:45.519
And the primary reason for that is to help manage the compulsions that come up.
00:16:45.759 --> 00:16:46.159
Right.
00:16:46.320 --> 00:16:51.360
Uh it's a lot of response prevention work in those moments doing those exposures.
00:16:51.519 --> 00:16:58.000
And so being together, especially the first few times that we do it, uh, yeah, we're almost always together.
00:16:58.399 --> 00:17:04.400
After that, it does turn into a, okay, I was initially a much higher distress level about this.
00:17:04.559 --> 00:17:07.519
Now I can go to the mall and only be a little bit triggered.
00:17:07.680 --> 00:17:12.079
And at that point, we go, great, continue that as homework in between sessions for sure.
00:17:12.319 --> 00:17:15.839
So much of the work of ERP happens in between sessions.
00:17:16.000 --> 00:17:19.680
And yeah, once they're ready for it, they can absolutely do these on their own.
00:17:20.160 --> 00:17:23.759
You treat multiple subtypes of OCD, of course.
00:17:24.079 --> 00:17:26.000
Is POCD stickier?
00:17:26.160 --> 00:17:28.799
Do you find that it's a harder one to treat?
00:17:29.039 --> 00:17:36.880
Or is it like any other subtype where if you stick with the ERP or in some cases medication, the person will reliably get better?
00:17:36.960 --> 00:17:40.480
Aaron Ross Powell A person can reliably get better no matter the theme.
00:17:43.920 --> 00:17:54.160
I would say the one truism, the one kind of pattern is how deep into the obsessive-compulsive cycle a person gets.
00:17:54.400 --> 00:17:55.680
It doesn't really matter the theme.
00:17:55.839 --> 00:18:11.920
If it's a thing that they kind of notice and capture soon and get specialized help soon, they're very able to break out of that easier than somebody who had the unfortunately standard path of seven years of not getting the correct treatment.
00:18:12.880 --> 00:18:19.039
Managing my experience exclusively through compulsions and then trying.
00:18:19.519 --> 00:18:22.559
Yeah, that's really hard no matter the theme.
00:18:22.960 --> 00:18:31.519
And a thing that may be relevant is probably someone with PFCD is more likely to spend a long time not getting the help that they need.
00:18:31.920 --> 00:18:32.319
Yes.
00:18:32.559 --> 00:18:38.559
And so that probably does end up in presenting it as being particularly sticky.
00:18:38.880 --> 00:18:44.880
Uh yet, no, I wouldn't say that it's necessarily uniquely more difficult than any other form of OCD.
00:18:45.200 --> 00:18:45.359
Right.
00:18:45.440 --> 00:18:56.720
Because I imagine if somebody went years and years and years with this secret, um, and they're living with these thoughts, that they've they've created this identity, a false identity around who they are.
00:18:56.880 --> 00:18:59.119
So you have to work through those layers, right?
00:18:59.279 --> 00:19:01.920
You have to like, yeah, there's a lot of layers there.
00:19:02.160 --> 00:19:02.799
This is so good.
00:19:02.880 --> 00:19:04.240
I'm so excited we're doing this.
00:19:04.400 --> 00:19:05.759
I hope we can save life.
00:19:06.559 --> 00:19:10.400
I hope we can save somebody out there who is living with these thoughts.
00:19:10.640 --> 00:19:11.200
Quick break.
00:19:11.359 --> 00:19:12.160
We'll be right back.
00:19:12.240 --> 00:19:13.920
But first, a word from our sponsor.
00:19:14.160 --> 00:19:18.240
The same distressing, unwanted thoughts keep playing over and over in your mind.
00:19:18.400 --> 00:19:22.960
The same rituals keep eating up your time, holding you back from enjoying your life.
00:19:23.200 --> 00:19:32.720
You've tried talk therapy before and spent session after session diving into those thoughts, trying to understand them, trying to fix them, but somehow they just get worse.
00:19:32.880 --> 00:19:35.920
And the shame piles on because you think, why isn't this working?
00:19:36.079 --> 00:19:37.119
What's wrong with me?
00:19:37.359 --> 00:19:39.920
If this sounds familiar, here's what you need to know.
00:19:40.160 --> 00:19:41.680
You are not the problem.
00:19:41.920 --> 00:19:45.920
You're experiencing something that a lot of people with OCD experience.
00:19:46.240 --> 00:19:50.799
Getting your life back is possible because OCD is highly treatable.
00:19:50.880 --> 00:19:55.039
It just requires a completely different approach than other mental health conditions.
00:19:55.279 --> 00:20:03.599
In fact, standard talk therapy often makes OCD worse because it encourages you to analyze those intrusive thoughts or try to replace them with positive ones.
00:20:03.759 --> 00:20:08.240
But with OCD, the more attention you give the thoughts, the stickier they become.
00:20:08.559 --> 00:20:10.799
That's where No C D comes in.
00:20:11.039 --> 00:20:15.359
No CD provides virtual therapy designed specifically for OCD.
00:20:15.519 --> 00:20:25.759
Every single one of their therapists is extensively trained in a type of therapy called ERP, or exposure and response prevention, which is the most effective treatment available for OCD.
00:20:25.920 --> 00:20:35.359
And they get their training from world-renowned OCD experts so they truly understand what you're dealing with, even this stuff that feels impossible to say out loud.
00:20:35.599 --> 00:20:45.599
In live, face-to-face virtual sessions, your No CD therapist will teach you how to take the power away from intrusive thoughts so you can live the life you want to live.
00:20:45.759 --> 00:20:56.000
In between sessions, you'll be able to message your therapist anytime, join dozens of live support groups, and continue your progress with other expert-developed therapy tools.
00:20:56.240 --> 00:21:04.079
NoCD is also covered by insurance for over 138 million Americans, and their team makes it really simple to get started.
00:21:04.319 --> 00:21:08.559
Visit nocd.com and book a free 15-minute call.
00:21:08.720 --> 00:21:17.920
That's nocd.com to learn more and talk to someone who can help because you deserve treatment that actually works for OCD.
00:21:18.480 --> 00:21:20.400
And now, back to our show.
00:21:20.640 --> 00:21:35.200
With a lot of OCD subtypes, Lucas, and this has been true for Alicia and me for most of our experience with it, is that often you do have some level of insight that this fear is illogical.
00:21:35.839 --> 00:21:46.480
I know that for some people that insight is lower than for others, but often there's some voice in there going, all right, I know it's not true, but I'm gonna perform the compulsion to give myself the comfort anyway.
00:21:46.720 --> 00:21:58.160
With POCD, do most of the patients you see know I don't think deep down I actually am a pedophile, but this fear of it is just consuming me.
00:21:58.240 --> 00:22:01.200
And so I'm gonna perform that compulsion to Get the relief?
00:22:01.599 --> 00:22:09.440
Or have you found people who are truly lost in it and have no insight into the fact that they're really not a pedophile?
00:22:09.839 --> 00:22:30.000
I think the worry about being a pedophile, and similarly to all kinds of sexual or sexuality-based compulsions, there is a genuine level of complete unknown that you really can't have a confidence in I'm definitely not.
00:22:30.480 --> 00:22:41.599
Be uh partially because of that checking groanal response kind of thing, where my anxiety kind of produces the symptoms that I'm looking for, anyways.
00:22:41.920 --> 00:22:42.160
Yes.
00:22:42.319 --> 00:22:44.799
Can we dive in a bit on the groinal response?
00:22:45.119 --> 00:23:01.039
Which, you know, for for someone listening, I I would imagine that that's some sort of tingling or right that you experience with one of these sexually taboo OCD subtypes, and it then confirms your fear.
00:23:01.359 --> 00:23:08.960
But you're saying that that response often is just a function of anxiety more than anything else.
00:23:09.119 --> 00:23:18.640
So just I not getting too much into the mechanics of it or whatever, but but can you just explain a groinal response for someone who might be listening going, oh my God, I've had that?
00:23:19.039 --> 00:23:20.160
Yeah, absolutely.
00:23:20.480 --> 00:23:23.759
The sympathetic nervous system is the thing that amps us up.
00:23:24.000 --> 00:23:29.039
And the sympathetic nervous system is uh not all of that complicated.
00:23:29.200 --> 00:23:32.880
It's the thing we tend to talk about as the fight or flight response.
00:23:33.359 --> 00:23:40.480
Um there is another F in that triangle, uh, and we can call that fornicating.
00:23:40.640 --> 00:23:42.319
That's a form of arousal.
00:23:42.480 --> 00:23:47.599
That is still your uh sympathetic nervous system becoming aroused.
00:23:47.839 --> 00:23:54.720
So your body is not very good at knowing when this is a fear response or an anger response or a sexual response.
00:23:55.039 --> 00:24:02.319
So even though it's an anxiety response, the sympathetic nervous system is doing what the sympathetic nervous system does.
00:24:02.559 --> 00:24:09.200
Your pupils dilate, your heart rate increases, there's increased blood flow everywhere in your body.
00:24:09.759 --> 00:24:11.759
If you're a man, including to your penis.
00:24:12.000 --> 00:24:14.000
If you're a woman, including to your vagina.
00:24:14.160 --> 00:24:18.640
And so you have this experience and you don't know what that means.
00:24:18.960 --> 00:24:20.640
Yeah, it's a body response.
00:24:20.720 --> 00:24:23.599
It's not a statement of desire.
00:24:24.000 --> 00:24:25.119
Absolutely.
00:24:25.519 --> 00:24:28.799
That is so awful.
00:24:28.960 --> 00:24:39.759
Like I can't even Isn't that we talked about it Yeah, we talked about that with Chrissy Hodges, and she's had the groinal response and she's had taboo OCD stuff.
00:24:39.839 --> 00:24:41.839
Unfortunately, she talks very openly about it.
00:24:41.920 --> 00:24:54.640
But my God, when you have a subtype, any subtype, relationship OCD, health OCD, P O C D, you are constantly looking for evidence that it's real, right?
00:24:54.720 --> 00:24:58.559
You know, because your OCD is trying to latch on to stuff.
00:24:58.799 --> 00:25:09.759
And so for that detective element of your OCD to be able to latch on to that, like it's an actual physical response, like what a confirmation of my fear.
00:25:10.000 --> 00:25:16.640
That is, and so how do you talk to a patient about that, right?
00:25:16.880 --> 00:25:20.319
Because as you say, reassurance can only take you so far.
00:25:20.480 --> 00:25:30.240
So you can sit with them in the session and say, well, when you have that groinal response, it's actually your sympathetic nervous system, and you can just explain it to them the way you just explained it to us, which was really helpful.
00:25:30.480 --> 00:25:38.240
But that reassurance will only last for so long, where they're gonna go, you know, the OCD is gonna go, no, no, no, it's the other part of the triangle that you're actually experiencing.
00:25:38.559 --> 00:25:43.440
And how do you help them with that when that groinal response shows up?
00:25:43.519 --> 00:25:45.759
How do you expose your way out of that one?
00:25:46.960 --> 00:25:56.559
There's many, many themes of OCD that as an ERP specialist, I will let you know out of the gate, you're getting zero reassurance from me.
00:25:57.920 --> 00:26:02.640
OCD is one that oftentimes I don't do that with.
00:26:02.799 --> 00:26:12.640
And I'll give them my little shtick, kind of like I did a minute ago of, hey, I want you to notice how this doesn't actually help long term, but I do want you to know that this is what that is.
00:26:12.960 --> 00:26:18.319
And now, moving forward, we need to accept that you can't actually know that.
00:26:18.640 --> 00:26:26.480
So now when you're triggered and you notice that you walked by the elementary school and then you had an erection, and does that mean something?
00:26:26.640 --> 00:26:29.200
Well, I don't think there's any way to know for sure.
00:26:29.519 --> 00:26:31.839
It could be this sympathetic nervous system thing.
00:26:32.000 --> 00:26:34.079
It could be because you're a pedophile.
00:26:34.319 --> 00:26:38.640
And ooh, that's yucky to hold on to that, isn't it?
00:26:38.880 --> 00:26:39.920
Yeah, it is.
00:26:40.160 --> 00:26:43.839
And let's hold that, don't make it go away.
00:26:44.240 --> 00:26:49.599
Sit with that feeling for long enough until you notice it slowly come down.
00:26:49.839 --> 00:27:02.880
When you habituate that worry over and over again, you can eventually have the experience, which again is a bizarre experience to talk about, to walk by an elementary school, get an erection, and go, hmm, I don't know what that means.
00:27:03.039 --> 00:27:04.559
And it's not so loud anymore.
00:27:04.880 --> 00:27:06.640
Oh, yeah, I cannot sit with that.
00:27:06.880 --> 00:27:07.839
No chance.
00:27:08.559 --> 00:27:09.200
No chance.
00:27:09.440 --> 00:27:13.599
I I have a big issue with that of going, yeah, maybe I am, maybe I'm not.
00:27:13.680 --> 00:27:19.920
And every subtype, every part of OCD is crazy to me.
00:27:21.359 --> 00:27:35.039
I I feel like if you're in therapy and we've already established that it's egogystonic, and then they're doing exposure and response prevention, and you're having them walk by and still still tell themselves that maybe they are, maybe they're not.
00:27:35.519 --> 00:27:36.799
There's no way to know.
00:27:38.960 --> 00:27:41.599
You can't be a hundred percent certain.
00:27:43.119 --> 00:27:46.000
In this particular topic, we should be.
00:27:48.079 --> 00:27:48.480
You can.
00:27:48.799 --> 00:27:49.359
Yeah, yeah.
00:27:49.440 --> 00:27:56.319
That Alicia does not like she does not like the maybe maybe not uh thing.
00:27:56.559 --> 00:28:11.680
Um and well, I think okay, for example, I've had I've had intrusive thoughts of the FBI is gonna knock on my door and tell me I committed some act.
00:28:11.759 --> 00:28:13.279
I I can't even kill an ant.
00:28:13.599 --> 00:28:17.279
I I know rationally that that's unlikely.
00:28:17.440 --> 00:28:20.880
So you want me to say that maybe I did actually commit a murder in my sleep?
00:28:21.599 --> 00:28:23.119
No, I know I didn't.
00:28:23.759 --> 00:28:30.559
I know I didn't, but that thought still comes up, and I've done enough work on myself to know that that is an irrational thought.
00:28:30.799 --> 00:28:40.000
So I guess it's hard for me to wrap my head around somebody in therapy knowing that they are not a pet, they yeah, that that is weird to me.
00:28:40.160 --> 00:28:41.440
Sorry, I don't understand that one.
00:28:41.680 --> 00:28:43.680
No, that's weird to a lot of people.
00:28:43.920 --> 00:28:48.799
And in the majority of cases, like worry that the FBI is gonna come and get you.
00:28:49.119 --> 00:28:54.000
You can find functioning in that worry and then just move on with your life.
00:28:54.160 --> 00:28:56.400
You you can achieve a level of functioning there.
00:28:56.880 --> 00:29:03.680
But if you would like freedom from that worry, you do have to begin to practice sitting with.
00:29:03.839 --> 00:29:06.559
Let me imagine the FBI is on their way right now.
00:29:06.799 --> 00:29:10.880
And maybe I have some rare amnesiac disorder where I don't remember.
00:29:11.200 --> 00:29:12.400
Oh, I've done that.
00:29:12.960 --> 00:29:16.960
So if that gets you, oh, that's yucky.
00:29:17.039 --> 00:29:17.920
I don't like that.
00:29:18.079 --> 00:29:19.839
I feel very accused by that.
00:29:20.000 --> 00:29:21.759
I really make that go away.
00:29:22.000 --> 00:29:31.119
And then if you refuse and you hang on to that thought, now the anxiety associated with that is gonna feel like it's gonna go up forever until you die.
00:29:31.359 --> 00:29:31.519
Yeah.
00:29:32.720 --> 00:29:36.160
It will peak and it will slowly come down.
00:29:36.480 --> 00:29:41.279
Okay, so eventually you will look back and go, hey, watch, I can trigger myself.
00:29:41.440 --> 00:29:43.359
Go, the FBI is coming to get me.
00:29:43.599 --> 00:29:43.920
Huh.
00:29:44.240 --> 00:29:45.839
Remember when that used to really worry me?
00:29:47.279 --> 00:29:47.440
Okay.
00:29:47.920 --> 00:29:48.880
Okay, fine.
00:29:49.680 --> 00:29:50.240
Like that.
00:29:50.640 --> 00:29:52.720
You really don't need to do.
00:29:53.039 --> 00:29:56.400
You don't need to, unless you want to.
00:29:57.440 --> 00:30:04.880
If you want to not have to experience that distress anymore, you can go for this freedom over functioning kind of ideal.
00:30:05.200 --> 00:30:10.480
With something like POCD, people don't want to have this thought anymore.
00:30:10.799 --> 00:30:12.240
They do not want to worry about it.
00:30:12.400 --> 00:30:17.359
It's very hard to achieve a level of functioning in saying that maybe, maybe not.
00:30:17.599 --> 00:30:22.880
And so we have to really power through that and accept that you cannot have the certainty.
00:30:23.759 --> 00:30:29.279
A lot of times that looks like the uncertainty of what if I one day become a pedophile?
00:30:30.319 --> 00:30:33.039
And well, how would you ever disprove that?
00:30:34.720 --> 00:30:35.200
Right.
00:30:35.440 --> 00:30:38.880
You have to accept the uncertainty in that scenario.
00:30:39.279 --> 00:30:40.000
You can't know.
00:30:40.240 --> 00:30:45.599
I have gotten a lot from that kind of school of thought of like maybe, maybe not.
00:30:45.759 --> 00:30:51.359
I apply it daily, regularly to some of the intrusive thoughts that come up for me a lot.
00:30:51.599 --> 00:30:57.279
Um, how have you seen POCD affect people's romantic relationships?
00:30:57.440 --> 00:31:01.839
I have to imagine that is an especially complex one.
00:31:02.000 --> 00:31:07.359
I mean, maybe in some ways, even more complex than relationship OCD, which it's right in the name there.
00:31:07.599 --> 00:31:11.119
But you can work on that with your partner and try to get your partner to understand.
00:31:11.200 --> 00:31:25.519
But POCD is just so taboo, so unspoken, so shameful, which it it shouldn't be, but it is, uh, that I have to imagine it makes it very hard to form intimate relationships with another adult.
00:31:26.880 --> 00:31:35.279
A lot of people are surprisingly successful at suppressing this worry so that they can still have a relationship with another adult.
00:31:36.000 --> 00:31:44.400
Uh and ideally, yes, this is a thing that you should be able to tell your spouse or significant other and uh help them walk alongside you.
00:31:44.559 --> 00:31:54.160
But I can't tell you the number of sessions that I've done with, hey, I need my partner to come in here and we need to tell them together because Lord knows I cannot do it on my own.
00:31:54.319 --> 00:31:56.720
And I say, all right, bring them in, let's do it together.
00:31:57.119 --> 00:32:05.359
And then I'm gonna spend a lot of time probably reassuring your partner and educating them about exactly what this is and how you don't need to be worried.
00:32:05.519 --> 00:32:11.279
And also you plug your ears, don't listen to any of this reassurance that I'm giving your partner because this will help them.
00:32:11.440 --> 00:32:13.119
It's not gonna help you.
00:32:14.559 --> 00:32:24.720
Uh and one of the biggest ways that I do see it affect relationships is when the POCD is centered around my own kids.
00:32:25.119 --> 00:32:26.400
That is Oh.
00:32:27.119 --> 00:32:27.839
Oh yeah.
00:32:28.000 --> 00:32:28.480
Oh, wow.
00:32:28.799 --> 00:32:32.000
Because how do you parent when you're dealing with that?
00:32:32.720 --> 00:32:37.200
And especially if you're dealing with that and your partner doesn't know that you're dealing with that.
00:32:38.720 --> 00:32:39.599
That's heavy.
00:32:40.400 --> 00:32:41.039
Oh my gosh.
00:32:41.359 --> 00:32:43.200
What does a compulsion with that look like?
00:32:43.359 --> 00:32:47.279
Is it them just avoiding parenting, avoiding bath time, I imagine?
00:32:47.440 --> 00:32:48.720
How is it showing up?
00:32:49.279 --> 00:32:58.079
Bath time, diapers, any possible trigger you can think of, uh, even holding my child, if they're going to be straddling me, nope, can't do that.
00:32:58.160 --> 00:32:59.440
I need to hold them this away.
00:32:59.599 --> 00:33:02.319
When I put them in the car seat, I have to do it so so.
00:33:03.200 --> 00:33:11.440
A thousand ways to manage my own triggers that all are just a version of compulsive avoidance that keeps this problem around.
00:33:11.839 --> 00:33:17.359
And can you imagine if you're the spouse and your partner's like, I can't do the diapers?
00:33:17.599 --> 00:33:21.119
You know, and you're like, Well, why why I have to do every diaper?
00:33:21.200 --> 00:33:23.359
Like, if you've never done a bath tonight.
00:33:25.039 --> 00:33:28.960
It's at minimum, I need you right here over my shoulder while I'm doing bath time.
00:33:29.359 --> 00:33:32.559
Yeah, I need proof that I didn't do anything.
00:33:32.960 --> 00:33:33.599
Absolutely.
00:33:33.920 --> 00:33:36.480
Oh man, that is tough.
00:33:36.720 --> 00:33:37.039
Yeah.
00:33:37.359 --> 00:33:45.519
Can POCD show up for somebody and there not be any other It can be the emergent theme for sure.
00:33:45.759 --> 00:33:48.880
Sometimes that's the first time OCD ever shows up.
00:33:49.440 --> 00:33:56.880
So POCD can be the emergent theme, which is the very first one that shows up for somebody and the only one ever.
00:33:58.240 --> 00:34:02.799
Um, it's rare that somebody has OCD that never jumps stain.
00:34:03.359 --> 00:34:03.680
Okay.
00:34:04.480 --> 00:34:12.639
But that can be the first one for somebody, which is why it becomes so debilitating and debilitating no matter when it shows up.
00:34:12.960 --> 00:34:20.320
There are kids and teenagers that I have worked with that are themselves minors worried that they are a pedophile.
00:34:21.840 --> 00:34:23.519
And how do you work through that?
00:34:23.679 --> 00:34:27.840
That, hey, you're 15, your attraction to 15-year-olds is normal.
00:34:29.360 --> 00:34:31.199
But no, what if that means that I'm a pedophile?
00:34:31.280 --> 00:34:34.239
What if I'm always attracted to 15-year-olds, even when I'm 40?
00:34:35.199 --> 00:34:35.519
Wow.
00:34:35.840 --> 00:34:38.239
Yeah, that's a thing you can't have certainty about.
00:34:39.039 --> 00:34:39.519
Wow.
00:34:39.679 --> 00:34:40.880
Yeah, because it for one.
00:34:41.440 --> 00:34:43.199
That statement alone is OCD.
00:34:43.440 --> 00:34:47.599
If you're sitting with a therapist, they're like, okay, this is what that is.
00:34:47.840 --> 00:34:54.480
But how does that person know to express that to somebody before they know it's OCD?
00:34:54.639 --> 00:34:59.360
Nobody is going to express that to a 15-year-old is not going to know to share that.
00:34:59.519 --> 00:35:07.360
They're going to have to almost have other OCD themes in order for that to come up for them to feel comfortable enough.
00:35:07.440 --> 00:35:09.440
And I think that's the biggest issue, right?
00:35:09.599 --> 00:35:11.199
Well, with people that have POCD.
00:35:11.519 --> 00:35:21.039
I think that they would probably have to stumble upon a very beautifully produced podcast to learn a lot about experience.
00:35:22.639 --> 00:35:23.039
Truly.
00:35:23.920 --> 00:35:28.400
That's the answer is getting it out there, letting people know that this is a thing.
00:35:28.639 --> 00:35:36.480
And that's a hard thing to do with this particular theme because it is so societally abhorrent.
00:35:36.800 --> 00:35:37.360
Yeah.
00:35:37.599 --> 00:35:44.880
And do you think that is because people think, okay, you can have someone who's like, okay, I understand what OCD is.
00:35:45.039 --> 00:35:45.519
I get it.
00:35:45.599 --> 00:35:47.039
I understand the intrusive thoughts.
00:35:47.119 --> 00:35:50.159
I understand that someone with POCD is not a pedophile.
00:35:50.320 --> 00:35:55.039
But that doesn't take away the fact that I know that person still had those thoughts.
00:35:55.360 --> 00:36:00.559
That's probably where the shame comes in for a lot of people is like, I can talk about it openly.
00:36:00.639 --> 00:36:03.280
I mean, I personally do not struggle with that one.
00:36:03.360 --> 00:36:09.440
And I thank God because I know that OCD alone is horrific, let alone that thing.
00:36:09.840 --> 00:36:23.519
However, I imagine that people that do struggle with that, the shame is so intense, whether people understand it or not, that they will they will die with that secret.
00:36:23.679 --> 00:36:24.960
They will die with that secret.
00:36:25.280 --> 00:36:27.280
Here's a huge barrier to that.
00:36:27.599 --> 00:36:42.880
And a uh trigger that comes up surprisingly often is that at a lot of malls, and I don't know, it's probably at a Spencer's in a mall somewhere, there are t-shirts on display that say kill all pedophiles.
00:36:44.559 --> 00:36:50.480
Can you think of one single other class of humans that you could put under kill all?
00:36:50.719 --> 00:36:54.480
And we as a society would go, yeah, that's great, put on a t-shirt, we'll buy it.
00:36:54.719 --> 00:36:55.280
Right.
00:36:55.760 --> 00:37:00.719
No, it's so abhorrent, not just to the individual, but to society.
00:37:00.960 --> 00:37:02.559
And so, yeah, absolutely.
00:37:02.800 --> 00:37:15.119
People and other practitioners that I have talked to about this will hear that somebody had those thoughts and go, full stop, mandated reporting, keep this person away from kids, all of this stuff.
00:37:15.360 --> 00:37:19.599
And I really emphatically stop them and say, absolutely not.
00:37:20.000 --> 00:37:20.320
No.
00:37:21.280 --> 00:37:30.960
Any one of my people that I have worked with that struggle with POCD, I would trust with my own children because they're worried about it.
00:37:31.360 --> 00:37:35.360
Do you think that therapists struggle with giving that diagnosis?
00:37:35.519 --> 00:37:38.960
Because there is a lot of responsibility on that, on them for that, right?
00:37:39.280 --> 00:37:45.599
And a very salient point is that there are only three reasons to break confidentiality in therapy.
00:37:45.840 --> 00:37:49.599
Harm to myself, harm to others, and harm to kids.
00:37:50.800 --> 00:38:00.800
And even though somebody coming and reporting POCD is not even remotely a reportable thing, people know about this, and that keeps people from bringing it up with their therapists.
00:38:00.880 --> 00:38:01.840
Absolutely.
00:38:02.159 --> 00:38:11.599
And then hearing that how does somebody, especially a young therapist, somebody who doesn't know that POCD even exists, like I did, sub-learning about it on Reddit?
00:38:11.920 --> 00:38:12.159
Right.
00:38:13.039 --> 00:38:14.719
How would that person respond?
00:38:15.119 --> 00:38:25.599
If someone's in their car right now and they're listening to this episode and they're going check, check, check, and it really resonates with them, what should they do?
00:38:25.920 --> 00:38:37.119
Because again, this one is slightly different from other OCD subtypes, where there is some risk that you're going to be misunderstood when you show up to the therapist's office.
00:38:37.280 --> 00:38:42.079
I mean, we've we've given a few examples here of times when it's gone sideways for people.
00:38:42.320 --> 00:38:44.400
So what should they do?
00:38:44.559 --> 00:38:57.280
What steps should they take to ensure that when they do finally take this weight off their chest and open up to a therapist, that they are not going to be reprimanded in some way.
00:38:57.599 --> 00:38:59.920
Find a specialist immediately.
00:39:01.119 --> 00:39:02.719
There are very good resources.
00:39:02.880 --> 00:39:12.159
The International OCD Foundation, of course, IOCDF.com, has a directory that only includes people that have been through their behavior therapy training institute.
00:39:12.320 --> 00:39:17.199
Uh anybody at nocd.com has all been through No CD Academy.
00:39:17.519 --> 00:39:19.280
They are all educated on this.
00:39:19.599 --> 00:39:28.480
We know all about it and probably could pick up on it without you even having to take us there a whole lot.
00:39:29.039 --> 00:39:32.480
And that is a specialty that is quite rare.
00:39:32.639 --> 00:39:46.400
And you have to be kind of careful with that one because there are a huge majority of people, a huge majority of therapists that put together a psych today profile and just tick OCD, because they go, Yeah, that's OC, that's anxiety with extra steps.
00:39:46.480 --> 00:39:51.119
I can help out with that without actually having any real specialization in it.
00:39:51.440 --> 00:40:04.719
I'm curious, as someone who specializes in POCD, if you have taken criticism yourself from people in the public or people who might somehow be aware of your specialty and what it is you do.
00:40:04.880 --> 00:40:08.480
I follow Allegra Castins, I'm sure you're familiar with her.
00:40:08.960 --> 00:40:12.880
And she's very outspoken about her own battle with POCD.
00:40:12.960 --> 00:40:17.599
And she now thankfully is in a place where she has kids and she's doing much better.
00:40:17.840 --> 00:40:29.920
But I look at the comments under her posts, and a lot of them are filled with hate and questioning of, you know, whether, you know, basically calling her a pedophile.
00:40:30.320 --> 00:40:35.599
I mean, that ships proof that she's that far along and confident with who she is and what's going on.
00:40:36.000 --> 00:40:36.639
Good for her.
00:40:36.719 --> 00:40:39.920
Like to be able to do that, that just shows that there's proof.
00:40:40.079 --> 00:40:47.039
That is proof for people with POCD that you can get to the other side and with and and you know, take the the criticism at some point.
00:40:47.199 --> 00:40:51.440
I'm sure it it doesn't feel good, but she knows in her heart the truth.
00:40:51.679 --> 00:40:53.119
So what do you can do?
00:40:53.440 --> 00:40:57.920
But I'm curious if if you've taken criticism like that and how you deal with it.
00:40:58.159 --> 00:40:59.039
Absolutely.
00:40:59.280 --> 00:41:04.239
Uh and I don't uh have an experience of POCD.
00:41:04.320 --> 00:41:08.880
I don't have a particularly wide internet following or anything like that.
00:41:09.119 --> 00:41:16.400
But I do uh die on that hill every single time I'm able to when I'm having a conversation with another professional.
00:41:16.719 --> 00:41:20.000
And they do have those kind of probing questions.
00:41:20.320 --> 00:41:27.280
And I will stop my whole day and we will talk about this until you understand that this is POCD.
00:41:27.440 --> 00:41:44.239
This uh this population are not pedophiles, and I need you, as a professional, at minimum, to refer that person to a specialist when you meet them and do not judge them because otherwise, how many years will it be before they walk back into another therapist's office?
00:41:44.400 --> 00:41:56.079
Aaron Powell For a family member who's listening, they have someone in the family who's struggling with POCD, and thankfully that person has felt free enough to confide in them.
00:41:56.400 --> 00:42:04.320
What would you tell them about offering support without feeding the OCD and the POCD specifically?
00:42:05.199 --> 00:42:07.519
The same as any other theme of OCD.
00:42:07.760 --> 00:42:09.760
Reassurance is not support.
00:42:10.239 --> 00:42:11.519
It feels like it is.
00:42:11.760 --> 00:42:18.559
It even feels particularly cool not to reassure my loved one about this thing that I can see so clearly.
00:42:18.800 --> 00:42:20.559
Hey, the germs aren't gonna kill you.
00:42:20.719 --> 00:42:23.199
Hey, I'm not gonna die because you left the stove on.
00:42:23.360 --> 00:42:26.400
Hey, you're not a pedophile for all of these reasons.
00:42:26.719 --> 00:42:30.000
Feels like a very logical thing to do, but it doesn't help them.
00:42:30.159 --> 00:42:32.320
It does actively make OCD worse.
00:42:32.480 --> 00:42:42.480
And you can support them and help them manage the way that they're feeling without reassurance and absolutely encourage them to seek out treatment with a specialist.
00:42:42.880 --> 00:42:50.159
Would you recommend that they sit in on some of the sessions with them so that you can help educate and how to respond and how not to respond?
00:42:51.039 --> 00:42:54.000
In my work, that's completely up to my members.
00:42:54.400 --> 00:42:54.719
Okay.
00:42:55.119 --> 00:42:57.840
If they want that, absolutely.
00:43:03.679 --> 00:43:08.159
What do you wish more people understood about intrusive thoughts generally?
00:43:08.320 --> 00:43:19.039
You know, we've talked, obviously, we're diving deep this episode on POCD, but intrusive thoughts generally, what do you wish people understood more about them as they relate to OCD?
00:43:19.440 --> 00:43:20.880
Everybody has them.
00:43:21.599 --> 00:43:23.840
And you will never be free of them.
00:43:24.639 --> 00:43:27.440
And that second one sounds kind of intense.
00:43:28.400 --> 00:43:32.880
Uh and that is to say, you're never not gonna have intrusive thoughts.
00:43:33.280 --> 00:43:39.280
Even if you are fully maintaining freedom from your OCD, the thought's gonna come up.
00:43:40.400 --> 00:43:44.960
What's going to change is the amount of distress that you experience around that thought.
00:43:45.519 --> 00:43:48.320
The thought will be there in the future, for sure.
00:43:48.559 --> 00:43:51.760
But you'll know exactly how to respond to it.
00:43:52.079 --> 00:43:52.480
Yeah.
00:43:52.800 --> 00:43:56.000
Then you won't give it the power that the obsessive compulsive cycle gives it.
00:43:56.320 --> 00:43:59.599
And the intrusive thought does not reveal anything about your character.
00:44:00.880 --> 00:44:02.079
You can't be sure though.
00:44:09.360 --> 00:44:11.679
I just got a sick feeling in my stomach.
00:44:17.840 --> 00:44:18.880
Alicia's face.
00:44:20.079 --> 00:44:22.079
No, I'm back to being a horrible person.
00:44:22.159 --> 00:44:23.440
I'm a terrible person.
00:44:27.760 --> 00:44:34.000
That our ERP therapists are uniquely broken individuals.
00:44:35.679 --> 00:44:37.920
That's an insane thing for me to say.
00:44:38.159 --> 00:44:44.079
Like we all get a little weird and engage in life where there is no certainty about anything.
00:44:45.199 --> 00:44:46.559
There's no way to know.
00:44:46.880 --> 00:44:53.760
And for the vast majority of human beings, our experience of that is minimal.
00:44:53.920 --> 00:45:00.480
It's very unconscious that we engage with the uncertainty of the world where you could die in a car wreck today.
00:45:00.639 --> 00:45:03.840
But you didn't think about that when you started up your car today.
00:45:04.159 --> 00:45:05.280
Oh, I do every time.
00:45:05.760 --> 00:45:07.440
A million maybe you do.
00:45:08.079 --> 00:45:10.400
People with harm OCD definitely think about it.
00:45:10.880 --> 00:45:11.360
Every day.
00:45:12.079 --> 00:45:18.159
And yet there's a million other uncertainties that are just below the level of our consciousness, really.
00:45:18.480 --> 00:45:18.960
Yeah.
00:45:19.280 --> 00:45:28.480
And then something slips through that filter, hits you right in the amygdala, and all of a sudden, that is a great big threat that I need to protect against.
00:45:28.639 --> 00:45:32.159
Especially because if I don't protect against that, that would mean something about me.
00:45:32.239 --> 00:45:34.400
That would be my fault for not taking care of that.
00:45:34.559 --> 00:45:35.920
And then we compulse.
00:45:36.159 --> 00:45:39.760
And then the thought gets louder and compulsions get less effective.
00:45:39.920 --> 00:45:42.880
And so the thought gets louder and then the compulsions grow.
00:45:43.119 --> 00:45:47.440
And before I know it, I can't manage this anymore.
00:45:47.920 --> 00:45:53.519
I think I'm very much still in the function, not freedom stage of my uh OCD for sure.
00:45:54.400 --> 00:45:55.440
That's okay.
00:45:56.239 --> 00:45:59.760
If that's crazy, if your life is okay.
00:45:59.920 --> 00:46:00.960
Yeah, absolutely.
00:46:01.280 --> 00:46:04.559
I I mean I my life is my life is great.
00:46:04.639 --> 00:46:08.079
And I make conscious decisions every day to tell myself it is.
00:46:08.239 --> 00:46:12.800
However, I do still battle intrusive thoughts regularly, hourly.
00:46:13.039 --> 00:46:17.440
I I think I need to just get back into ERP like yesterday.
00:46:19.039 --> 00:46:19.599
You can.
00:46:20.079 --> 00:46:21.039
It's available.
00:46:21.440 --> 00:46:22.960
You don't have to.
00:46:24.639 --> 00:46:26.320
You certainly do not have to.
00:46:26.480 --> 00:46:33.199
I am in a camp of uh people that will encourage freedom over functioning.
00:46:34.320 --> 00:46:34.639
Yeah.
00:46:35.119 --> 00:46:36.880
Because it's available.
00:46:37.199 --> 00:46:41.679
Just like I'm I'm a person that would encourage anybody with OCD to try some meds.
00:46:41.760 --> 00:46:44.000
Get on an SSRI because it works.
00:46:44.079 --> 00:46:44.719
You're gonna be able to do that.
00:46:45.840 --> 00:46:47.920
You have to believe it's available, right?
00:46:48.079 --> 00:46:51.519
You have to first choose to believe that freedom does exist.
00:46:51.599 --> 00:46:56.159
And I think our OCD keeps us from believing that it even exists.
00:46:56.320 --> 00:47:02.880
I know I have spent my entire life um with this brain.
00:47:03.280 --> 00:47:09.119
And I think there is fear around who am I without the way that I think.
00:47:09.519 --> 00:47:16.960
Because in my mind, I'm protecting myself, you know, with the way that I am and who I am.
00:47:17.360 --> 00:47:27.199
And there are so many habitual thoughts that happen that I think are protecting me.
00:47:27.519 --> 00:47:33.280
The the layers and and depth of my OCD are so deep.
00:47:34.079 --> 00:47:41.119
There's a second answer to your question, Liam, about what more people can know about intrusive thoughts.
00:47:41.440 --> 00:47:52.960
And that is that the really the way that the mental health industry is set up is not ready for OCD.
00:47:53.840 --> 00:47:59.039
Because the primary modality of therapy generally is CBT or talk therapy.
00:47:59.280 --> 00:47:59.679
Right.
00:48:00.000 --> 00:48:18.239
And what CBT or talk therapy would teach us to do with our intrusive thoughts is to gather evidence, challenge those thoughts, uh, look to your values, really try to understand something about the situation, and all of those responses is helping a person get better at compulsing.
00:48:18.480 --> 00:48:18.880
Right.
00:48:19.199 --> 00:48:23.920
And so a lot of people that have OCD have an experience of going to talk therapy.
00:48:24.079 --> 00:48:26.960
I feel better for the 53 minute hour.
00:48:27.119 --> 00:48:32.639
And then I walk out of there, and even as I'm driving home, I go, oh, but what if she didn't know about this thing?
00:48:32.719 --> 00:48:34.320
What if I didn't articulate that just right?
00:48:34.400 --> 00:48:37.840
What if, what if, what if and then we're not even back to square one.
00:48:37.920 --> 00:48:39.199
We're set back even farther.
00:48:39.599 --> 00:48:42.320
My experience with talk therapy.
00:48:42.559 --> 00:48:45.119
When I first got into therapy, I didn't know I had OCD.
00:48:45.199 --> 00:48:47.840
It's a very common experience for people with OCD.
00:48:48.000 --> 00:48:49.840
And so I was in talk therapy at first.
00:48:49.920 --> 00:48:53.280
And there were ways in which that therapy helped me.
00:48:53.440 --> 00:49:05.679
The primary, primary one being that she is the one who persuaded me to get on an SSRI, but she did not clock it as OCD and treated it the way you would any other issue.
00:49:05.920 --> 00:49:08.400
And it made things worse.
00:49:08.559 --> 00:49:24.480
It it, you know, I was doing a lot of exactly as you say, kind of looking at my thoughts and the thought process and you know, balancing against my values and then trying to do meditation and put myself into a safe place during meditation and all this stuff.
00:49:24.559 --> 00:49:30.400
And and I just after a few months, I remember saying to my wife, like, I think I'm actually worse.
00:49:30.800 --> 00:49:35.039
You know, and that I don't I don't think that's what should be happening.
00:49:35.199 --> 00:49:58.639
And so finally, you know, we came around and and determined that it was OCD, but um you're exactly right, that that so many people can get into that, you know, cycle of the current system where they finally, and that's what's so cruel about it, is they finally open up.
00:49:59.039 --> 00:50:01.360
Like, I'm gonna finally go get help, I'm gonna do it.
00:50:01.440 --> 00:50:07.199
And then they navigate the labyrinth that is our mental health system and insurance system in this country.
00:50:07.280 --> 00:50:12.800
And and they finally find a therapist, they take all the steps, and then it's they're worse.
00:50:12.880 --> 00:50:17.280
And they're like, well, all right, I'm I'm that's not an option for me anymore.
00:50:17.360 --> 00:50:22.639
I mean, and what a disservice that is to people who are already struggling so much.
00:50:22.960 --> 00:50:28.800
And then I always talk about the second minotaur in that dungeon is okay, you finally figure all that out.
00:50:28.960 --> 00:50:35.039
You go to find a specialist, and then there's three people in your entire Metroplex.
00:50:35.599 --> 00:50:40.480
They're giving only 250 bucks an hour and booked out for three months.
00:50:40.719 --> 00:50:42.480
None of them take insurance.
00:50:42.800 --> 00:50:43.599
Now what?
00:50:44.639 --> 00:50:46.079
They call no cd.
00:50:46.320 --> 00:50:47.679
No seeding.com.
00:50:52.159 --> 00:50:52.800
That's right.
00:50:53.119 --> 00:51:00.639
Lucas, thank you so much for joining us and helping shine a light on one of the most misunderstood and stigmatized forms of OCD.
00:51:01.280 --> 00:51:04.480
It has been a pleasure, and I'll pay for your future therapy.
00:51:04.559 --> 00:51:06.320
Sorry for traumatizing you.
00:51:10.079 --> 00:51:11.039
Thank you, Lucas.
00:51:11.440 --> 00:51:13.280
Absolutely thank you all for having me.
00:51:15.679 --> 00:51:17.599
Okay, so I so I have a confession.
00:51:17.679 --> 00:51:34.079
I realize one of my OCD um compulsions this morning that I've been doing is that when I go to take my meds, I have to say it out loud three times because I've told myself that if I do, I'll remember that I took them.
00:51:34.960 --> 00:51:36.239
Um, and it has to be three.
00:51:36.400 --> 00:51:37.760
Four feels uncomfortable.
00:51:38.079 --> 00:51:42.320
So I was like, okay, I take my meds, I take my meds, I took my meds.
00:51:42.559 --> 00:51:47.360
And then I went into the bathroom to do my hair and I was like, Spencer, do you realize I do that?
00:51:47.519 --> 00:51:49.039
He's like, uh, I guess I I do.
00:51:49.119 --> 00:51:50.639
I'm like, do you think that's OCD?
00:51:50.719 --> 00:51:52.159
He's like, yeah, 100%.
00:51:52.480 --> 00:51:53.440
I go, you don't do that?
00:51:53.519 --> 00:51:55.760
You don't have to tell yourself you took your meds.
00:51:56.400 --> 00:51:59.760
He goes, No, I go, how do you know for sure you don't double up on them?
00:52:00.239 --> 00:52:02.719
I'm afraid I'm gonna take like 10 pills.
00:52:05.519 --> 00:52:08.239
Wait, so why the number three?
00:52:08.800 --> 00:52:09.280
Why three?
00:52:09.599 --> 00:52:10.400
I don't know, it feels good.
00:52:10.800 --> 00:52:11.519
It feels good.
00:52:11.840 --> 00:52:12.639
It just feels right.
00:52:12.719 --> 00:52:13.760
So you say it out loud.
00:52:13.840 --> 00:52:16.079
You go, I took my meds, I took my meds, I took my meds.
00:52:16.239 --> 00:52:18.159
I took my meds, I took my meds, I took my meds, yeah.
00:52:18.480 --> 00:52:19.679
And your fear if you don't do this.
00:52:21.360 --> 00:52:24.880
Four makes me go, and two is not enough.
00:52:25.119 --> 00:52:30.960
Yeah, so it's interesting though, because I don't know that I've ever counted out loud like that.
00:52:31.519 --> 00:52:39.440
I don't know if or maybe I have, and it just wasn't as apparent or evident to me since I didn't know I had OCD.
00:52:39.599 --> 00:52:40.400
I don't know.
00:52:40.639 --> 00:52:42.719
But I thought, oh, I gotta share that today.
00:52:43.119 --> 00:52:45.599
Yeah, you might start finding other patterns too.
00:52:45.679 --> 00:52:52.800
I what my thing with the pills is yes, I do sometimes worry about whether or not I've taken them, but I think that's kind of normal.
00:52:52.880 --> 00:53:01.840
But but um but what I do is when I when I take the pills and you know, drinking the water, I have to take 10 sips of water.
00:53:02.239 --> 00:53:04.800
So I like am counting as I gulp.
00:53:05.119 --> 00:53:09.440
So um now I now I don't.
00:53:09.519 --> 00:53:14.880
And so sometimes I'll I'll like count it out and be like 11 to do one more than 10.
00:53:14.960 --> 00:53:23.519
And other times I'll try to like confuse my brain about how many I've Yeah, but Liam, I think that if you do 11, that's just a new compulsion in disguise.
00:53:24.079 --> 00:53:26.559
Well, it's to challenge not doing the 10, right?
00:53:26.639 --> 00:53:33.360
The 10 was the I know it is, but you've just created a new compulsion, challenging the 10.
00:53:33.679 --> 00:53:35.760
You're not supposed to count at all.
00:53:36.159 --> 00:53:41.119
Yeah, so now, but that the the counting is just so habit-forming.
00:53:41.280 --> 00:53:45.360
Like I'll just be drinking the water and be like, oh wow, I'm counting right now.
00:53:45.519 --> 00:53:51.920
So then what I'll do is try to confuse my own brain about how many I've done, and I'll be like, eight, one, hundred, eleven.
00:53:52.079 --> 00:54:00.559
Like it's so that I don't know how many I've got you, brain.
00:54:01.199 --> 00:54:02.320
Fuck you, brain.
00:54:02.400 --> 00:54:04.000
You don't know where you are.
00:54:06.480 --> 00:54:07.599
Oh yeah?
00:54:07.920 --> 00:54:09.840
Let's see if we can count.
00:54:14.239 --> 00:54:17.360
Thanks for listening to another episode of the OCD Confessional.
00:54:17.440 --> 00:54:20.159
Be sure to follow the show so you get new episodes.
00:54:20.400 --> 00:54:26.079
You can subscribe to us on YouTube or find us on Instagram and TikTok at the OCD Confessional.
