The Great OCD Whistle Stop Tour of 2024 (Episode 54)

SPEAKER_02 0:03

Welcome to Disordered. This is episode 54 entitled The Great OCD Whistle Stop Tour of 2024. I'm Joshua Fletcher, also known as Anxiety Josh, and I'm a psychotherapist and author who specializes in anxiety disorders. I'm a previous sufferer, co-host of this podcast, and author of the book, and how does that make you feel?

SPEAKER_03 0:25

And I am Drew Linsolata. I am a therapist in training in New York in the US of A, specializing in anxiety and anxiety disorders. Also an author, a podcaster, and a former sufferer for many, many years of my life. Welcome to the great OCD Whistle Stop Tour of 2024. What are we going to do today, Josh?

SPEAKER_02 0:42

Go around in circles. That's what we do on the OCD Whistle Stop Tour, and that's what everyone does on the OCD tour. I have struggled a lot with OCD in the past. It's a question that we get asked a lot. And it's whistle stop because OCD is different for each person. We're going to look at the three kind of types of OCD today, which is type one, which is pure O, type two, which is somatic, and type three, which is uh traditional, conventional. All this can be as crippling as one another, but I find comfort in kind of kind of labeling, distinguishing between them all. Um, Drew and I also want to talk through how it overlaps with other anxiety disorders as well because of the obsessive-compulsive nature of our relationship with anxiety.

SPEAKER_03 1:34

I think the three different categories, if you will, they're broad. Apologies in advance if we do not specifically talk about your particular OCD theme, but we're trying to do the broad categories, and most of them will fit into one of those three. So we just can't hit every possible theme. What is OCD? OCD, technically, if you want to talk about like the technical clinical definition, it's an obsession with a particular problem of some kind, a threat, a fear, an issue, uh, and something that you cannot solve, whatever it may be, a perceived threat, and then corresponding obsession or compulsions that you engage in, mental or physical, that are meant to bring down your anxiety level when you are in that obsessed mode. That's in a nutshell, that's a definition.

SPEAKER_02 2:20

Yeah. The need for certainty and satiation for a lot of people, the need to shortcut discomfort from maybe an intrusive thought. Yep. Uh, which we'll talk about today. We have spoken about intrusive thoughts, but they come um hand in hand with uh OCD, particularly uh with Pure O. And satiation, where you just want to feel that comfort to make think things feel just right to make to stop and lower this threat response. Uh OCD is very common. I know a lot of listeners do struggle with OCD, and you'll hear a lot of similarities between how to approach OCD with how we approach other things too, whether it's fear of fear, panic, um, etc. And yeah, we're gonna do a whistle stop tour today. We'll like Drew said, we'll try and go name some of the most common themes, some uncommon themes, but what you will find is a common theme that links all of them together.

SPEAKER_03 3:17

The common theme for the common themes, for sure. Sounds like a really poor album name, doesn't it? It kind of the common theme. Well, that's that's what that's the inward compulsion. It's our second album after the inward compulsion.

SPEAKER_02 3:29

Both oh, yeah. That wouldn't be synth wave, though. This would be something or whatever it was, yeah.

SPEAKER_03 3:35

It would be like uh medieval folk jazz fusion, because we're that pretentious. So yeah, just saying.

SPEAKER_02 3:42

I'll talk today from personal experience as well. I with OCD, it's it's interesting because the fixator is something that we spoke about in the past. You are a fixator, I'm a fixator. When that fixation part of our brain is misused, because we use it in really interesting ways and creative ways, but when it's misused, you're open to themes of OCD and you end up on the hamster wheel of OCD. I've struggled a lot in the past with obsessive compulsive themes, um, usually around deterioration and health. Um, but I have had other ones as well, um, sexual intrusive thoughts, things like that. Uh, my brain is an OCD brain. I am probably gonna get another trigger at some point, but that's cool because I've been practicing willful tolerance. And if I do get a trigger, I'm gonna bet on me that it's not gonna affect me for as long as my anxiety suggests it might.

SPEAKER_03 4:37

Oh, I like that. I'm gonna bet on me, as opposed to betting on the the thought or the fear or the perceived threat. I better follow that. Nope, I'm gonna follow me instead.

SPEAKER_02 4:46

Yeah. Um, what is it? I mean uh the first thing I think we should address is what does it feel like to have OCD?

SPEAKER_03 4:55

For me, I would say when I was in the thick of that, my OCD, if I had diagnosable OCD, it would have been of an existential subtype. Like I was a hundred percent fixated on death and existence and obliteration at the time of death. Like that was my my theme. And it persisted for the better part of a year and a half, probably, which I know is nothing compared to people who suffered for years. To me, it felt like like a thing that I just couldn't get away from, no matter how hard I tried. I would try not to think about it. That didn't work. I would try to think about it and find a solution. I tried to reason with myself, like, well, you're not dead now. It's you know, you're fine, just live your day. I could not get away from it. It was like it was, I don't know, it was like glued to me all the time. That's what it felt like to me. It was inescapable.

SPEAKER_02 5:43

Uh, one of the main parts of OCD that links a lot of them is the need for a hundred percent certainty or the illusion that you think you can get close to or achieve a hundred percent certainty with existential OCD. And I've also had this as well. You ain't gonna get anywhere near, you ain't gonna get one percent certainty, you know, with a big question like I tried, I tried really hard. Yeah, on the on the hamster wheel, yeah. Existential OCD, yeah, that's a very common one when you start thinking about you know your anxious response that's thousands of years old is trying to find the singularity or the certainty because we believe certainty is the way to feel comfortable.

SPEAKER_03 6:27

Yeah, I would say that you know, when you ask what does it feel like, this is a I'm never gonna forget these feelings. I've had thousands of panic attacks in my life, those were super scary. That moment where you think you're dying. What was even more intense for me was the moment where I had to confront the idea of possible annihilation, obliteration, whatever the lights out theory of death, like that's it, it's over, you're just done. Oh my god, just I would never have been able to say that. That trigger was so intense and so deep. It felt like such a deep trigger. I would, it would practically, I know I argue against this term all the time, but at the moment I would say this incapacitated me. And it and it kind of would for days on end.

SPEAKER_02 7:09

Yeah. I imagine one of the most toughest exposures during that theme was to watch ice hockey because that would describe the sport to a T.

SPEAKER_03 7:17

Obliteration. You're kind of right, to be honest with you. Yes, we can joke about that, but you actually are correct. I was so careful in those days to try to not see any reference at all to anything that was death or even extreme injury that might lead to death. It was it was not a good way to live. And it was inescapable.

SPEAKER_02 7:37

What makes OCD as opposed to worrying about existential anxiety? Because you can get existential anxiety and then it can step into the realms of OCD.

SPEAKER_03 7:48

What's the difference in your case? In my case, the difference was definitely the corresponding compulsion. I felt so triggered by those thoughts and so afraid of those thoughts that I would desperately try to answer them and find solutions and soothe myself. And well, there must be I spent a huge amount of time looking for proof of an afterlife. You know, I'm man, that's really tough. That's tough. You're not going to find that anywhere. Uh people will say that they have faith, and that's great. You can rely on your faith, that's awesome. But I spent so much time. I think it was the compulsion because I would try to fix that feeling that I was getting, and I couldn't. And the more I tried, the more it got its grips in me. So the difference between, like, yeah, I'm still worried about death now, I don't want to die, but I don't, there's nothing I launch into to make myself less worried about it anymore. So your compulsion was rumination. My compulsion was a rumination to the max, excessive trying to research and problem solving.

SPEAKER_02 8:47

Which brings us to the first kind of categorization, which is pure O. O.C. can often in most cases I see, I'm not quite sure of the stats, most cases of OCD I see entirely cognitive, where we worry about something and then we try to solve it with the compulsion that is rumination. Rumination is a behavior, it's when we step on the hamster wheel to try and think our way and solve our problems or to seek certainty through an analysis of ruminating about the catastrophe. Um, Drew did it with existential OCD. I've done it with health anxiety, which is a branch of OCD, by the way, if the health anxiety is severe. Um it can be many things. Um, other types of pure OCD are things like uh relationship OCD, which is one that I hear a lot more now, where you're obsessed and looking for certainty in your relationship. Uh you have uh taboo ones like POCD, which is when you have intrusive thoughts about minors. Um you have violence OCD, which is when you have, which is basically what if I lose control and be violent towards a loved one or not even a loved one, a stranger. Yeah. And the stakes are so high here that I must keep ruminating about it and keep scanning and controlling and compulsively not doing that. Um, there's so many, it's infinite. There's the self-harm version of that, self-harm, yeah. So people, yeah, people like um and things like suicide OCD, where people who aren't suicidal then start to develop a fear that they may become suicidal, and that's a very pure old one.

SPEAKER_03 10:31

If you want to see a group of like, because I'm in it now, if you want to see a group of adults who are trained being trained at the master's degree level and above get really uncomfortable, sit in a training session for new therapists when the when that self-harm OCD theme comes up. It makes it makes therapists very uncomfortable because you know you're trained in that suicidal threat assessment, of course. And the the idea that, like, no, no, no, you have to understand the difference between the person who's just afraid they might, but doesn't want to. Boy, does that make even therapists very uncomfortable?

SPEAKER_02 11:01

That's why it's so important to have an anxiety disorder-informed therapist, yeah, uh ERP therapist hear this stuff all the time. Like, yeah, all right, yeah. Yeah, that sounds like yeah, yeah, it doesn't phase me at all. Yeah, but that's but yeah, if you take it to perhaps a someone who is unaware of anxiety disorders, they might be like, Whoa, red flag. And actually, no, you know, I see it all the time. It's like, okay, let's I can see this in the mold of OCD. You're obsessing about this what if that guess what is scary because that's how all OCD starts, starts with a thought. It's always scary. The amygdala kicks in and goes, Hey, maybe that thought is a threat because of whatever X, Y, and Z. Now, the stakes are so high with that thought, and so bizarre and so life-ruining. So, if you think about relationship OCD, you could lose your partner, you might hurt your child, you might lose control and hurt yourself, you have to have certainty with this. Tell you what, the stakes are so high, it's dangerous to leave this alone. So, why don't we compulsively obsess until we find the answer or at least strive towards that 100% certainty? So, I'm gonna Google, I'm gonna ask for reassurance from my partner, I'm gonna ask for reassurance through forums, I'm gonna keep doing things. For me, when I had deterioration OCD, I'd weigh myself 80 times a day because OCD gives you the illusion that I'm getting closer to certainty. I am not, I am just weighing my ass 80 times a day and not living life. I know what it feels like to be in the cycle of OCD. It's scary, but that's a lot of pure row stuff.

SPEAKER_03 12:40

Yeah, and I think that one of the common themes in this common theme will be the, and it goes across all the themes, no matter what type, traditional, you know, cognitive or somatic. The argument that the fear will put in your head is, well, this is surely you cannot mean that like self-harm OCD is is okay. It can't, it these rules can't extend to this obsession, right? It'll always try and draw a line in the stand around itself. Like, no, no, no, no, no. We're talking about kids here. I can't take that kind of chance, or talking about my health, or I'm talking about my my life partner here. I have sexual orientation OCD. What if I'm actually not heterosexual? What if I'm secretly gay and I don't know that? Like it seems like no, this is special. You don't understand this is a special fear. Yeah.

SPEAKER_02 13:22

Sexual orientation uh OCD is really interesting because it proves that OCD just wants 100% certainty. I've worked with people who are literally pansexual, find everyone attractive, but the OCD will look on to but how much? What's your what's your preference? Are you more this because it wants a definitive answer?

SPEAKER_03 13:45

Yeah.

SPEAKER_02 13:45

Uh, and yeah, I work with um heterosexual people who just have it as thought, it doesn't matter, it's not special. And I think what Drew's saying there about when you're looking at the spicy themes like self-harm or uh you know uh OCD and stuff like that, it's difficult in this profession because when you hear those words, you do have to be alert as a therapist, but when you're an experienced kind of therapist in the world of anxiety disorders, we tend not to treat that as any more special. Obviously, we do a risk assessment, safeguarding, etc. But you'll often hear Drew and I say that there's no special symptom and there's no special um presentation. What it is is the doubt. You just doubt.

SPEAKER_03 14:39

And you know, so you've heard Josh talk about, you know, deteriorating or wasting themes. Me, I had a death theme. And at the time I would have said, but this is death, it's the most important, it is the biggest issue for every human being. How could you say that that I'm supposed to get okay with that? And I'll touch on that in a while, but that was my thing. But if you have a contamination type OCD or somatic type OCD, we will acknowledge here that you feel as strongly about your fear as I felt about my fear of death. It does not discriminate. It's not like death OCD is somehow worse than you know a contamination OCD. It's not, they feel the same to the sufferer.

SPEAKER_02 15:16

And yeah, everyone with OCD will say, I wish I could switch my theme. Do you know why? Because their theme doesn't trigger your amygdala. Yeah, their theme triggers their amygdala with the same intensity as yours. So while you're thinking, like, you know, I've got I've got a somatic OCD, so I worry that I'm fixating on my breath. I can't quite catch a full breath. If you do have this, by the way, have some assurance. You're actually not really in charge of most of your breathing, it does it for you. Anyway, and the fear that someone with somatic anxiety will have with that would be like, oh, I I I would give anything to change this theme about my breath to someone who's obsessing about contaminating their children with bleach. Yeah, that's true. Amygdala.

SPEAKER_03 16:01

Shut up, amygdala. Tired of a powerful part of our like the way our brain is built that when it gets activated, it doesn't matter what the theme is, you'll feel just as bad. I've heard people say, I would pay, I would pay to have somatic OCD. No, you wouldn't.

SPEAKER_02 16:17

No, because you would still feel the same discomfort and level of fear or level of doubt. Um, you know, because your threat response, a makedala, is your doubt, and the level of doubt is the same, but when you try to picture yourself in someone else's shoes, no matter what the theme of OCD is, you can't empathize with the cognitive side of it. You can only empathize with the doubt, and you would you can't imagine and doubt doubting something that only your rational brain knows about now. Well, yeah, I know I've not put glass in my children's omelette. That's why I hear that quite a lot, and and I'd be fine with that. Okay, but if you had that thought with the threat response kicking off, and suddenly the brain's latched onto it, uh, if you're someone with OCD, it feels very real. I know. I look back and weigh myself 80 times. I remember how I felt. I was felt it felt convincing, you know, and it's yeah, you can't compare it to other people's because the only thing that's the same is the level of doubt.

SPEAKER_03 17:19

And in a way, the comparison doesn't help us, but it can help us to look at how many different themes there are and say, like, oh, look, that you know, that person over there who's dealing, say, with a contamination theme, they're suffering just as much as I am with my relationship theme. So that is in a way, there's a little bit of crowdsourcing assurance that I know it feels so special, but look at all these different human beings from different backgrounds and different cultures that all get fooled by a fear that you can see that that person's fear is not rational. Well, they can see that yours isn't. Take a lesson in that, like lean on that a little bit. Like, oh, I'm not uniquely broken here, I'm just scared of thoughts, like sometimes human beings do, and we can get scared of almost any thought. I think it's comfortable.

SPEAKER_02 18:03

That's interesting as well because people can empathize with phobias. Yes, they can, can't they? So my friend Sean is scared of snakes. I'm not scared of snakes. Don't get me wrong, if a massive python came through the window, now I'd be like, What? Yeah, I'd probably run. But I'm not generally, I don't have a phobia of snakes, but I don't like big spiders, and I have a phobia of spiders. Now, Sean loves spiders. Now he can empathize. He can like, I can see why you're scared of the spider because I feel like that about snakes. It's the same fear, we do the same thing, and it applies to themes of OCD too. Um looking at more somatic examples as well. You know, the the breathing one, the air hunger ones are a big one, but there's there's several somatic uh themes you can have. You can often lean into things like trichotilomania, um uh skin pulling, hair pulling, yeah. Um blinking is a big one. Blinking OCD, we're obsessed with that. Uh, and there'll be people listening going, Oh my god, what if I do that? It's fine, doesn't matter. We don't avoid triggers, you're okay. Yep. Um, yeah, that somatic one's there, and again, you it's the same. You're on the hamster wheel. I feel uncertain, so this gives I have to give this all of my attention until I feel certain again.

SPEAKER_03 19:19

Yeah, and it's it's kind of rough too. And in the end, another somatic one uh that I know people will be moan all the time, like this is the worst one to have. The two that I hear all the time are the breathing, fixation on breathing, and trying to.

SPEAKER_02 19:30

I I've heard people I had that for like three weeks.

SPEAKER_03 19:33

Yeah, and that's where like we always say, you know, I'm a big fan of meditation as focus training, but we have to always understand that the default for meditation is breath focused. But for people who are dealing with breath-focused somatic OCD, that's a bad idea. We use something else for sure. You have to keep that in mind. But the breath focus OCD or card people call it cardiophobia, you know, they become completely obsessed. I don't know if there is such a thing as cardiophobia, but they become completely obsessed with their heartbeat. That puts me. So the two that I hear the most.

SPEAKER_02 20:08

Yeah, and yeah, and that kind of treads the line with health anxieties, right? I told you this is a whistle stop tour. We are going round them because there's so many, there's literally infinite memes that you can have. Um uh some of the ones that we must mention is that you can become obsessed with recovery itself. OCD recovery can be a theme of OCD. I know there's a few idiots out there who have set up um recovery practices not realizing that they are experiencing OCD, an OCD theme where they are obsessed with OCD recovery. The irony of that and the meta uh irony of it is just you know, it's it's lost on me. It's like um you can become obsessed with it, and you've got to be careful with that things, and that can apply to even anxiety recovery. Yeah, so if you're compulsively buying 400 books on recovery, or ah, another one I found. Whistled to stop tour, sorry. Yeah, what if I've missed something in recovery? Yeah, yeah. What if I've missed that bit of information?

SPEAKER_03 21:18

Or the other thing, I think the other place that that uh sometimes expresses itself is every experience I have, every emotion I have, every thought I have, everything I do, every interaction I have, I judge immediately in the context of was that recovery or not? Was that good for my recovery or not? Should I have done that or not? Was I am I going forward or not? Was that avoidance or not? Like if you are stuck where every experience you have throughout the day gets judged immediately in the context of recovery, that's an indicator that your recovery has become impulsive.

SPEAKER_02 21:47

It's a part of obsession and compulsion. Yeah. And it it listen, anxiety disorders overlap. And you're so right there, Drew's. Like if they overlap, um don't start saying, well, now I've got OCD right. No, no, no. It's all the same. Or very similar things. Yeah. Um and it's just one loop. It starts with a scary thought or sensation that you don't like and gives you anxiety. And because you want to stop it quickly, you do a compulsion. The compulsion leads to short-term relief or the illusion of short-term relief or the illusion of control where you think you can get short-term relief, and then you end up back at the start again. But actually I still don't like it. And that gives me anxiety. So then I'm going to go and use my compulsion to chase the illusion of relief. And I may sometimes even get it short-term. Then you end up at the start again. And anyone who ruminates, particularly with Pure, will get this. But look, let's move on swiftly to the more kind of conventional um OCD. So people like hand washing.

SPEAKER_03 22:51

Yeah, these are the ones that people know, I think. The general public knows these.

SPEAKER_02 22:55

Yeah, hand washing. Uh, and that people can hand wash for different reasons. What if I've contaminated someone? What if I contaminate myself? What if I didn't wash my hands just right? Yeah. People get that as well. They're like, you just don't get it. It just needs to feel just right until the point where there's blisters, but then obviously, because they're in the the circle, yeah, you know, I need to keep chasing it. But if you struggle with OCD, well done for getting through each day. So it's tricky. You get all compact, you've you've you're doing really well. I'm no stranger to it. You can get to a good place. Turning your back on what feels like high stakes is literally courage. So, you know, you'll get the you know.

SPEAKER_03 23:42

Yeah, yeah, no, I'm I'm with you on that. One of the more interesting, interesting uh situations with hand washing that I ever encountered was hand washing was it it sort of fell into that almost magical thinking thing or ritualist like superstitious thing. Hand washing whenever I felt like I might fail an exam. I would have to wash my hands when I would get upset about I'm not doing well in school and I might be failing in a, you know.

SPEAKER_02 24:05

Oh, superstition. That's so right.

SPEAKER_03 24:09

Expressed itself as I wash my hands because I think that that means I'll I'll do okay on this exam and my parents won't be upset with me.

SPEAKER_02 24:17

Superstition, so you know. I have this thing as a kid where if I didn't picture all my loved ones' faces before I fell asleep, followed by prayer. This is how I knew I was always out of the OCD brain. I was like six. Picture all my family's faces followed by a prayer where I name each family member, then something bad wouldn't happen to them. Yeah, yeah. Uh uh, and so my exposure for this was to go out and murder my family. No, it wasn't really. Uh, but just do all the but it was but it was like I remember that as a kid and looking back, like now I've always had an OCD brain.

SPEAKER_03 25:00

Yeah, uh it's interesting because when you compare that, and and that I the one thing I hate is that whole, like, oh, we're all a little OCD. I don't like that because it's that minimizes the OCD experience. We're not all a little OCD. We're not all a little OCD, but all human beings create thoughts. And so, for instance, I have someone, you know, I think she would be okay with this, I believe, but would never say the word tired because tired was associated with a really bad experience when this person was younger. Her parents were out and they were coming home very late, and she got very nervous, she was a kid, that something was wrong and they were never going to come home. And she was very tired, but she couldn't go to sleep. And she just developed this little superstition. It didn't impact her life in any way. In fact, it became a joke for her, but and she would never say the word tired after that. So you can see where any this person didn't have OCD, didn't struggle with it, it wasn't impacting their lifestyle in any way, just a little quirk. But you could see how every human being will create, every human brain creates that sort of stuff. Sometimes it just gets really stuck and it kicks into high gear. But it doesn't mean we're all a little OCD, that's so dismissive.

SPEAKER_02 26:03

OCD is very specific in the sense of the pattern's always the same. Yep. It just uh, you know, um, the theme generally isn't important, but how can you say that I'm having thoughts of that are so taboo and life ruining? Nope. Yep, it's not important. It's the anxious response being triggered in your interaction with it that's important. I'm not saying it's easy, but that's what's important. Uh oh, I forgot about sorry, whistle stop tour. We forgot the exhibit that's on um words and songs obsessions. I just have a word in my head and it just goes away. I just heard it once, my friend said it, heard it on the news. You know, that that that's that's a big one as well. And also one of the most common ones that doesn't get talking about in the mainstream. What if I hit someone with my car on the way here? I went over a speed bump. Actually, what if? Because I'm stressed, that wasn't a speed bump, but uh the corpse of a mangled farmer that I've hit with my Vauxhall Vectra. Highly unlikely, but my amygdala isn't interested in highly unlikely. It's interested in, but what if it did? I know people that have gone out at night at 3 a.m. with a torch because it's that convincing. That's what you're up against. Clever, intelligent, rational people with the amygdala hijacks so much. Like, no, no, no, no. This is why we always practice the willful tolerance of uncertainty.

SPEAKER_03 27:37

What if I am a bad person? The scrupulosity theme. Like, I what if this means I'm actually a bad person, or I don't have good morals, or my ethics are shot, or I'm hurting people. Scrupulosity is a really tough one because like you're constantly on the look for a hundred percent certainty that you are in fact a good person. That's a very broad brush, but that's a theme too for a lot of people.

SPEAKER_02 27:56

Yeah, and for religious people who follow faith, regardless of what your faith is, you know, they'll stand there at the place of worship and have intrusive thoughts about um the prophets or that goes against scripture. And even though this person is really, really like kind of committed to their faith, the intrusive thoughts and the omegdola will be like, ooh, this is high stakes. When actually, no. One of my main rules here, I'm gonna put it on my rules, but you know, one of my main mantras is just intrusive thoughts thrive because they're the opposite of who you are, but I always put a little joke in the bottom of it in brackets. But what if I, you know, what if what if I'm the exception? Right. That was OCD in a nutshell. Intrusive thoughts thrive because they're the opposite of who you are. What if I'm the exception?

SPEAKER_03 28:43

It's uh I always picture Kim has Kim Quinlan, who's just a good friend of ours. She has that little silly image that she has of the guy sitting on the beach chair with his beer, like with his sunglasses, a cigarette hanging out of his mouth. His only job is to sit on the sideline, wait until you're nice and comfy, and then like, yeah, but you know, it could really be. It's just a smarmy dude she came up with. I love the image because that's literally what it does. Just when you think you're okay and like, uh, all right, I know this is irrational. He'll be like, Yeah, but you know, what if it isn't? Damn it.

SPEAKER_02 29:11

And then you're right back in the thick of it again. What if it isn't?

SPEAKER_03 29:14

Yeah, man.

SPEAKER_02 29:15

Yeah, um, plug checking, socket checking. What if I leave a plug in and it and it burns down the house? Yeah, but the stakes are high. Notice here, the stakes are always high, yeah.

SPEAKER_03 29:27

Or it feels like they're very high.

SPEAKER_02 29:30

Yeah, yeah, exactly. It's never like what if Charlie Sherong comes around and wants to play PlayStation with me, is it? Actually, no, if I had relationship OCD, that might become a theme, but in general, no, it's like it it's never anything like it's always something high stakes that taps into your values and morals, yeah. Loved ones, partners, scrupulosity, all into your values and morals because it the amygdala wants to protect the self-concept that is you, and so that's why you always get nasty ones, you know. You know, why am I picturing this family member naked? Why am I picturing um harming my baby? Why am I picturing driving my car into a crowd of people? Why am I doing all these things? Because it's tapping against into your morals, and because it's the doubt response. This is why OCD is such a pain in the ass, is that because it's your doubt response, you will doubt yourself. So 99% of you will be like, that's pretty dumb. The guy on the beach goes, but what if it's not? And you're like, Oh, I gotta get that 100%. Yeah, that damn it, why did you whisper that at me again? You know, I need to confirm because I feel so close, but you can't get 100%. The only thing certain in life, death, taxes, and red tailed, by the way. Cold eagle, named Eagle.

SPEAKER_03 30:57

Let's talk for a second about that whole thing, because it leads people to often like, if I could just just as one more thing, just as one, if I just read this one more book, that's going to be the thing. This is why, you know, and I know if you're out there and you're an you know ICBT person, you know, maybe we'll talk about that one day. But that's why this still the gold standard is exposure and response prevention, because no matter what you do, if you are going to indulge in the compulsion that makes you feel a little better, it will never, ever, ever be enough. That's the RP part that's so important.

SPEAKER_02 31:30

Love IRP. Um enjoying ICBT as well. It's amazing that in a world where there's different modalities, you know, multiple things can work. Take note, therapists.

SPEAKER_03 31:41

Yeah. Now, you know what I'll do another episode on that. Sooner or later it comes down to not doing the compulsion anyway.

SPEAKER_02 31:47

Yeah, it always leads to the thing, oh, yeah, by the way, don't do the compulsion.

SPEAKER_03 31:50

Right. Sooner or later, that's what you're confronted with, which is the hardest freaking part of this. So the E is we're gonna trigger you intentionally, if you're not already triggered, you know, organically. And then the RP is, and I know you want to read another book or ask or say it out loud or take a picture of the mole on your arm again for the tenth time today, but you're not gonna do that.

SPEAKER_02 32:10

Yeah, yeah, we're still on the tour. Let's look at some more traditional physical ones. You've got things like hoarding, cleaning, um, organization, just just right ones are horrible ones. Like this needs to feel just right because I feel the brain has gotten to put a place where in order to turn off the omegdol, this has to be right. You know, this often gets mocked by people like, oh, you're so OCD. Now, for people who actually have this, it's it's really, really like no, it's not a clicky personality trait. Yeah, it's checking door checking. Did I lock the door? We can all relate to that, did I lock the door? But then because we don't respond to it, um, we don't have the propensity or the kind of the fixator brain, we can be like it worries us, and we leave it. Someone with OCD, I've had that this one on ones when I was a kid, actually, when I was 15, did I lock the door? And then I'd have a ritual where I got to the door and not only attempt the handle once, I'd attempt it four or five times so it felt right. Yeah, you know, yeah, and you know, god, I've really did have OCD on my whole life.

SPEAKER_03 33:15

Yeah, you look back on it now and it's like, oh, that's what that was.

SPEAKER_02 33:19

Yeah, interesting. I just thought it was my oh yeah. I I I didn't really question it as a kid, didn't have that metacognitive awareness when you're an adult and you expect to have everything sorted out, and then because you develop more values and responsibility growing up, suddenly the threat response uses that against you, right? Exactly. There's more to lose now. Is there any more we're missing from well? There's loads, there's infinite ones, but I feel like we're missing some. Um this is a big one. If you struggle with sexual intrusive thoughts, either they're immoral or grim or whatever, and they overlap with relationship OCD, there is a phenomenon that occurs called the groinal response. Your amygdala is part of, for the want of a better term, your reptilian brain, although neuroscientists will shoot me for that. But for the sake of simplicity, the reptilian brain, the amygdala fires off part of your brain. You also have a mammal brain, so the groinal response from the occurs sometimes if you're having intrusive thoughts about people or things or whatever that you or just objects, and you suddenly feel like you're getting a groinal response, which is when start things start happening downstairs. That is not confirmation that the thought is true. The thought, your brain sees the potential and listens that okay, maybe there's um a slight possibility here of mammal sexual activity, it's not interested in what's going on, it doesn't care, and that can occur alongside intrusive thought. It's called the groinal response, it's very common and it breaks people's hearts sometimes in the community. Yeah, but if it's not true, why is my body reacting? Because that's a separate part of your brain that is not you. Yeah, you don't get to control that. Yeah, so if you're having intrusive thoughts about the weather person and you're feeling something happen downstairs, that is not further confirmation that you are weird. It's just because the brain is having all these images flashed in front of it. And just in case that there's that possibility for that, that's why it does it. I'm glad I didn't miss out the groin or response. Um, there's a guest book here if you want to sign it on the end of the tour. Um, yeah.

SPEAKER_03 35:36

I think when we do our our then how do I overcome episode, the follow-up, you know, treatment and how you deal with it. We'll just talk about the backdoor spike too. I'm not anxious about this anymore, so that must mean I like it. Makes me crazy. Like that thought isn't really tricky the way it used to, so now I'm freaked out because I'm not anxious about it. Because that must mean now I like the thought, or it's gonna, you know, like we'll get a guest on for that about the backdoor spike. We'll get Nathan, or we can also ask the purely OCD ladies, Kelly and Lauren. You know, yeah, yeah.

SPEAKER_02 36:05

Let's do good, let's let's that sounds good. Right, let's use let's get the community involved again. Yep. Should we do a did it anyway?

SPEAKER_03 36:12

Yeah. Got a good one. Let's play it. Here we go.

SPEAKER_00 36:16

Hi, Drew and Josh. My name is Jen, and I live in the States, and I'm calling with a Did It Anyway. Feel free to use my name. Um, I've been putting off getting my hair colored and cut for the last five months, and I finally got to the point where I couldn't stand it anymore, and I made the appointment. And of course, my anxious brain wanted to tell me to cancel the appointment and get out of it, but I went and did it anyway this morning. I was uncomfortable. I was definitely panicking, but I managed to sit there for the whole two and a half hours, and I felt such pride when I left that I wanted to share this with you. Thank you both for your podcast and your books. I it has really helped me so much, and I really appreciate it, both of you. Thanks so much.

SPEAKER_03 37:04

And I'm sure the minutes too.

SPEAKER_02 37:06

Win-win. Yeah, even better. Exposure and your hair looks great.

SPEAKER_03 37:10

Well done. Brilliant. At the same time, haircutting is such a common problem. I had that problem too.

SPEAKER_02 37:15

Yeah, I had the with the when I had panic disorder agrophobia. I remember, do you remember? I gave him a haircut and I was looking at the clock and I was like, well, what if I just ran out with half a haircut and all that stuff? And I was like, oh no, I'm just gonna say I've got this, it's all good.

SPEAKER_03 37:28

I hear you. Um, all right. So what else we got? Anyway, written or questions? I have both of those things. Uh what written did it anyway? Do we have it? Here's a good written did it anyway. I don't know if this person wants to use us to use her name, her name, so I won't. Um here's a did it anyway. Currently battling an inner ear infection with dizziness. My nightmare. That is no fun. Uh, and was prescribed steroids. My other nightmare, I have a huge fear of medications and have heard those can be tough. But this morning, I did it anyway. I took the first pills because I need to do it to get better. I always want to be able to do more in my life rather than less. Thank you for being both inspirational and practical. Your podcast has been a huge help during this illness. Thank you so much for sending that in. You get applause also.

SPEAKER_02 38:13

Excellent. I think Copper liked that as well.

SPEAKER_03 38:16

He did like it. He approved that one ahead of time. He listened.

SPEAKER_02 38:18

So excellent. And we got time for a question?

SPEAKER_03 38:21

Yeah, we can do a question real quick. Um, this one is my question, is perhaps one of categorizing a particular type of anxiety that doesn't seem to quite fit into what I've experienced in the past. My son is eight and has a stammer. The anxiety I feel about his future is overwhelming and has been for years. I appreciate that it's normal to worry about these things, but I worry around in circles. I catastrophize, I change plans if he's had a bad day, and I feel that I can't cope with seeing anyone, et cetera. I don't know how to approach this anxiety because my priority is to do whatever it is it is takes to help him, even if it is to my detriment. So, what is the best tool to approach an anxiety that's actually about somebody else? I would imagine this is a common problem amongst parents with anxiety disorders. That's a great question.

SPEAKER_02 39:05

Really good question. Appreciate you sharing it as well. Um, with this episode in mind, I'm saying it is, but look at the obsessions and the compulsions around it. It's gonna make you feel uncomfortable to sometimes never turn your back on your son, but you know, like to leave it for a little bit. Yeah, you know, it sounds like your son's all right. It's not this isn't a son stammer problem, it's uh I'm having catastrophic thoughts and therefore I am changing and dropping everything problem. Um, remember the golden rules I always say, do what non-anxious you would do. Would non-anxious you stop and run if your son has had a mild inconvenience, you know? Don't get me wrong, if he's a struggle, if he's if he's struggling, go go help, you know. But you know the difference between someone with anxiety. This you know, if this is a me problem, not a my son problem here. If it's a your son problem, then yeah, obviously prioritize your son, but you have to stop there and go, hmm, hold on, this is more of a me problem here because I don't like this feeling of uncertainty and it makes me feel horrible. I'm having all these catastrophic thoughts. Yeah. Um, a side note, by the way, my best mate grew up with a stammer and he's absolutely killing it now. Don't worry, you don't, it's not all about that. You know, people grow up with speech impediments and do well all the time.

SPEAKER_03 40:21

Okay, yeah, for sure. I think if you find that you are if it feels super risky to not take the action that you think you need to take, that also clearly part of you know is is overboard because you're asking this question. So good insight there. If it makes you feel like I'm failing, right? There's a high level of insight, which we would applaud for sure. And if it feels like, but if I if I don't do this thing, aren't I being a bad mom? That's also a good clue or a bad parent. That's a good clue that, like, oh, I'm trying to confirm that I'm a I'm I need confirmation that I'm not a bad parent. And that's what's driving me overboard here. And guess what? You're never, ever, ever gonna get perfect confirmation that you're a good parent. But when that becomes such a big part of your identity, and of course, we all want to be good parents, those of us who have kids, it's important to us, but it can become super important to the point where it's seen as a threat. I'm clearly gonna screw up my son if I don't go this extra mile today.

SPEAKER_02 41:17

But yeah, yeah, but that's um spot on to the point where it becomes a threat. That's right. I'm acting like this is threatening now. Yeah, so so so spot on, Juvia.

SPEAKER_03 41:29

Anyway, that was a good episode. We'll we will do a part two, I promise, because I know we didn't do the treatment.

SPEAKER_02 41:34

We're gonna do a little mini season on OCD and go through stuff like that. Sorry if we didn't miss if we missed your theme or whatever. Um, you're never gonna get them all because there's an infinite amount, but we're gonna try to go through the most common ones. Uh, keep your questions and did it anyways coming in. Disorder.fm. Uh we're on social media, anxietyjosh and the.anxious.truth. And yeah, every Friday we're here talking like stuff. Thanks for the recent reviews as well, by the way, on Apple Podcasts and Spotify. It really chairs us up. I've been super stressed recently, and when I see things like that, um, puts a massive smile on my face.

SPEAKER_03 42:09

And when you leave a review, it helps other people find the podcast. So you're actually helping to help other people. So it's really nice thing. Anyway, thanks for hanging out, guys. We'll see you again next week.