1 00:00:10,840 --> 00:00:14,520 Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly 2 00:00:14,560 --> 00:00:19,320 Speaker 1: conversation about mental health, personal development, and all the small 3 00:00:19,360 --> 00:00:22,520 Speaker 1: decisions we can make to become the best possible versions 4 00:00:22,520 --> 00:00:26,640 Speaker 1: of ourselves. I'm your host, doctor joy hard and Bradford, 5 00:00:27,000 --> 00:00:32,080 Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or 6 00:00:32,200 --> 00:00:35,600 Speaker 1: to find a therapist in your area, visit our website 7 00:00:35,720 --> 00:00:39,440 Speaker 1: at Therapy for Blackgirls dot com. While I hope you 8 00:00:39,479 --> 00:00:43,479 Speaker 1: love listening to and learning from the podcast, it is 9 00:00:43,520 --> 00:00:46,440 Speaker 1: not meant to be a substitute for a relationship with 10 00:00:46,479 --> 00:00:57,560 Speaker 1: a licensed mental health professional. Hey, y'all, thanks so much 11 00:00:57,560 --> 00:00:59,720 Speaker 1: for joining me for session four twenty five of the 12 00:00:59,680 --> 00:01:02,840 Speaker 1: Therapy for Black Girls Podcast. We'll get right into our 13 00:01:02,880 --> 00:01:15,000 Speaker 1: conversation after word from our sponsors. Have you ever heard 14 00:01:15,080 --> 00:01:19,160 Speaker 1: someone casually say I'm so OCD just because they like 15 00:01:19,240 --> 00:01:23,520 Speaker 1: things neat and organized. That kind of language often oversimplifies 16 00:01:23,560 --> 00:01:26,399 Speaker 1: a serious mental health condition and can make it harder 17 00:01:26,440 --> 00:01:30,280 Speaker 1: for those living with OCD to be seen and understood. Today, 18 00:01:30,319 --> 00:01:33,960 Speaker 1: we're digging into what obsessive compulsive disorder actually is and 19 00:01:34,040 --> 00:01:37,679 Speaker 1: how it uniquely impacts black women. I'm so excited to 20 00:01:37,720 --> 00:01:41,479 Speaker 1: welcome back doctor Jamika Moore for this conversation. You may 21 00:01:41,520 --> 00:01:44,120 Speaker 1: remember doctor Moore from session four oh seven, where she 22 00:01:44,200 --> 00:01:47,760 Speaker 1: joined us to talk about driving anxiety. She's a licensed 23 00:01:47,800 --> 00:01:52,560 Speaker 1: clinical psychologist who specializes in OCD, anxiety and trauma, and 24 00:01:52,600 --> 00:01:55,680 Speaker 1: she's deeply committed to making mental health care more accessible 25 00:01:55,680 --> 00:01:59,400 Speaker 1: and affirming for Black women and girls. During our conversation, 26 00:02:00,040 --> 00:02:03,840 Speaker 1: we explore what OCD looks like beyond the stereotypes, the 27 00:02:03,880 --> 00:02:07,680 Speaker 1: ways it often goes unrecognized, are misdiagnosed in Black women, 28 00:02:08,200 --> 00:02:12,200 Speaker 1: and how effective treatment can help. Doctor Moore also offers 29 00:02:12,200 --> 00:02:15,640 Speaker 1: insights on supporting loved ones with OCD and tips for 30 00:02:15,680 --> 00:02:20,040 Speaker 1: finding culturally responsive care. If something resonates with you while 31 00:02:20,120 --> 00:02:23,400 Speaker 1: enjoying our conversation, please share with us on social media 32 00:02:23,520 --> 00:02:27,160 Speaker 1: using the hashtag tbg in session, or join us over 33 00:02:27,200 --> 00:02:29,800 Speaker 1: in our patreon. To talk more about the episode, you 34 00:02:29,840 --> 00:02:33,000 Speaker 1: can join us at Community dot therapyfrom Blackgirls dot Com. 35 00:02:33,600 --> 00:02:39,640 Speaker 1: Here's our conversation. Well, thank you for joining us again, 36 00:02:39,720 --> 00:02:41,560 Speaker 1: doctor Wore. It's a pleasure to see you again. 37 00:02:42,080 --> 00:02:42,480 Speaker 2: Thank you. 38 00:02:42,600 --> 00:02:44,400 Speaker 3: I'm so excited to be back. It's a pleasure to 39 00:02:44,440 --> 00:02:45,400 Speaker 3: see you again as well. 40 00:02:45,919 --> 00:02:48,760 Speaker 1: Yeah, so when we talked last, you were talking about 41 00:02:48,840 --> 00:02:52,080 Speaker 1: your actual specialty is working with clients with OCD, and 42 00:02:52,120 --> 00:02:54,480 Speaker 1: I was like, we haven't had a full episode on OCD, 43 00:02:54,560 --> 00:02:56,119 Speaker 1: so we definitely got to bring you back to talk 44 00:02:56,160 --> 00:02:58,880 Speaker 1: about that. OCD. It feels like it's one of those 45 00:02:59,120 --> 00:03:03,680 Speaker 1: terms even for clinicians that is misused. People don't quite know. 46 00:03:04,120 --> 00:03:06,760 Speaker 1: You know, I think what all of the symptoms are 47 00:03:06,760 --> 00:03:09,200 Speaker 1: required to meet the diagnosis. So tell me a little 48 00:03:09,200 --> 00:03:11,840 Speaker 1: bit about what OCD is and how you actually got 49 00:03:11,880 --> 00:03:13,440 Speaker 1: started with this as your specialty. 50 00:03:14,000 --> 00:03:15,960 Speaker 3: Okay, Yeah, that's one of the reasons why I was 51 00:03:16,000 --> 00:03:18,960 Speaker 3: super excited to come back and talk about OCD because 52 00:03:19,320 --> 00:03:22,600 Speaker 3: there is a lack of information and misinformation about what 53 00:03:22,720 --> 00:03:26,240 Speaker 3: it actually is. And usually people will think about OCD 54 00:03:26,320 --> 00:03:29,720 Speaker 3: in the context of contamination or order in symmetry, but 55 00:03:29,800 --> 00:03:33,280 Speaker 3: it's so much more than that. And broadly speaking, OCD 56 00:03:33,400 --> 00:03:38,720 Speaker 3: is this experience of having intrusive images, thoughts, or impulses, 57 00:03:39,120 --> 00:03:41,560 Speaker 3: and as a result of that, it can trigger a 58 00:03:41,600 --> 00:03:44,920 Speaker 3: lot of distress in clients, and in order to neutralize 59 00:03:45,000 --> 00:03:47,600 Speaker 3: or get rid of that distress, people will perform what 60 00:03:47,640 --> 00:03:51,560 Speaker 3: we call rituals or compulsions, which can also be thoughts 61 00:03:51,920 --> 00:03:55,760 Speaker 3: behaviors that people feel compelled to do in order to 62 00:03:55,880 --> 00:04:00,560 Speaker 3: experience some relief, and compulsions do work sometimes, and because 63 00:04:00,600 --> 00:04:03,520 Speaker 3: they work and bring down that distress, it increases a 64 00:04:03,720 --> 00:04:07,640 Speaker 3: likelihood that the client will do that behavior again. And 65 00:04:07,760 --> 00:04:10,640 Speaker 3: before you know it, OCD just takes hold and it 66 00:04:10,680 --> 00:04:13,080 Speaker 3: will make your life smaller and smaller and smaller. 67 00:04:14,280 --> 00:04:16,040 Speaker 1: So when you say it makes your life smaller, what 68 00:04:16,080 --> 00:04:16,520 Speaker 1: do you mean? 69 00:04:17,080 --> 00:04:20,240 Speaker 3: People will start performing what we call safety behaviors, and 70 00:04:20,279 --> 00:04:25,120 Speaker 3: that could be escape, avoidance, distraction, and the compulsions in 71 00:04:25,160 --> 00:04:28,520 Speaker 3: and of themselves. And so that means that things that 72 00:04:28,520 --> 00:04:30,359 Speaker 3: are important to you, the ways that you used to 73 00:04:30,400 --> 00:04:32,520 Speaker 3: show up in your life, you may no longer be 74 00:04:32,560 --> 00:04:35,960 Speaker 3: showing up in that way because you are operating from 75 00:04:36,160 --> 00:04:39,240 Speaker 3: fear and because you could be spending more time doing 76 00:04:39,279 --> 00:04:43,120 Speaker 3: the actual compulsions or having other people join you in 77 00:04:43,200 --> 00:04:46,359 Speaker 3: doing those compulsions. And so it can just take things 78 00:04:46,400 --> 00:04:50,080 Speaker 3: away from you because OCD really operates on a value system, 79 00:04:50,279 --> 00:04:52,880 Speaker 3: and so you'll typically find it in areas of your 80 00:04:52,920 --> 00:04:55,880 Speaker 3: life that are really important. And if you've developed like 81 00:04:55,880 --> 00:04:59,040 Speaker 3: an anxious response to that, you can understand how people 82 00:04:59,080 --> 00:05:02,200 Speaker 3: will initially think that avoidance is the best thing to do, 83 00:05:02,720 --> 00:05:04,800 Speaker 3: or that the compulsions are the best thing to do 84 00:05:04,880 --> 00:05:07,679 Speaker 3: in order to feel better. But OCD is a liar 85 00:05:07,800 --> 00:05:11,200 Speaker 3: for sure, and it'll have you doing things in the 86 00:05:11,240 --> 00:05:13,960 Speaker 3: best interests of the OCD and not in the best 87 00:05:13,960 --> 00:05:15,279 Speaker 3: interests of your own life. 88 00:05:16,080 --> 00:05:18,120 Speaker 1: So doctor boy, I don't feel like that is something 89 00:05:18,160 --> 00:05:20,280 Speaker 1: I've heard talked about, and I don't think we talk 90 00:05:20,320 --> 00:05:22,839 Speaker 1: about most diagnoses like this, like that. It operates on 91 00:05:22,880 --> 00:05:24,599 Speaker 1: a value system. What do you mean by. 92 00:05:24,440 --> 00:05:27,840 Speaker 3: Matt so with OCD, because it has a great imagination 93 00:05:28,120 --> 00:05:31,400 Speaker 3: and it can actually attach to anything. And so when 94 00:05:31,400 --> 00:05:34,839 Speaker 3: I'm talking about the misinformation and lack of information about OCD, 95 00:05:35,000 --> 00:05:37,720 Speaker 3: this is exactly what I'm talking about. When we see 96 00:05:37,760 --> 00:05:41,680 Speaker 3: it in such a limited view as OCD is hand washing, 97 00:05:41,720 --> 00:05:47,239 Speaker 3: OCD is straightening these pictures behind me, it totally disregards 98 00:05:47,240 --> 00:05:50,080 Speaker 3: how wide reaching it can be. And so when I 99 00:05:50,120 --> 00:05:52,400 Speaker 3: say it attaches on a values level, think about it. 100 00:05:52,760 --> 00:05:54,320 Speaker 2: If I have an intrusive. 101 00:05:53,800 --> 00:05:56,920 Speaker 3: Thought about something I don't care about, there's no reason 102 00:05:57,040 --> 00:05:59,760 Speaker 3: for me to develop as much disgust or anxiety or 103 00:05:59,760 --> 00:06:02,360 Speaker 3: shit or guilt around it. But if it's something that 104 00:06:02,400 --> 00:06:05,640 Speaker 3: I genuinely care about, then it's like WHOA wait a minute. 105 00:06:05,720 --> 00:06:07,680 Speaker 3: And so an example would be, let's take a new 106 00:06:07,720 --> 00:06:10,800 Speaker 3: parent they really obviously love this beautiful bundle of joy 107 00:06:11,200 --> 00:06:13,480 Speaker 3: that they have. But then an intrusive thought comes in 108 00:06:13,600 --> 00:06:15,840 Speaker 3: that says, what if I just toss this baby across 109 00:06:15,880 --> 00:06:18,919 Speaker 3: the room? That's going to generate a lot of anxiety 110 00:06:18,960 --> 00:06:22,279 Speaker 3: because it's like, why did I have that thought? Do 111 00:06:22,360 --> 00:06:24,880 Speaker 3: I actually want to do this? Am I losing it? 112 00:06:25,200 --> 00:06:28,680 Speaker 3: What is this about? And so because it's intrusive and 113 00:06:28,760 --> 00:06:31,160 Speaker 3: the person is paying attention to it, it also increases the 114 00:06:31,240 --> 00:06:33,760 Speaker 3: likelihood that you're going to have that thought again and 115 00:06:33,760 --> 00:06:35,719 Speaker 3: that it's not going to be like a passing or 116 00:06:35,760 --> 00:06:38,520 Speaker 3: fleeting thought. And so now the person's going to develop 117 00:06:38,560 --> 00:06:42,440 Speaker 3: some safety behaviors because they're responding to the thought and 118 00:06:42,600 --> 00:06:46,760 Speaker 3: the anxiety discomfort that it generates. And so now it's like, 119 00:06:46,920 --> 00:06:50,719 Speaker 3: maybe I won't do the breastfeeding, maybe I won't change 120 00:06:50,760 --> 00:06:53,440 Speaker 3: the diapers, maybe I won't hold the baby as much. 121 00:06:53,680 --> 00:06:57,120 Speaker 3: And they're doing that as a reaction because they ultimately 122 00:06:57,120 --> 00:06:59,440 Speaker 3: want to keep the baby safe. And when I say 123 00:06:59,440 --> 00:07:02,000 Speaker 3: OCDS liar, what I mean is what you really want 124 00:07:02,040 --> 00:07:03,279 Speaker 3: to do is protect the child. 125 00:07:03,520 --> 00:07:05,159 Speaker 2: But when you avoid the child. 126 00:07:04,920 --> 00:07:07,280 Speaker 3: There is no protection of the child in that because 127 00:07:07,320 --> 00:07:10,120 Speaker 3: you're impacting the way you will bond with the child, 128 00:07:10,200 --> 00:07:13,800 Speaker 3: and so the OCD is constantly looking for what's important 129 00:07:13,840 --> 00:07:16,880 Speaker 3: to you because if it hooks onto that, it increases 130 00:07:16,920 --> 00:07:19,520 Speaker 3: the likelihood that it can get the compulsion, and it 131 00:07:19,560 --> 00:07:22,640 Speaker 3: absolutely needs the compulsion in order to exist. 132 00:07:23,000 --> 00:07:26,720 Speaker 1: So what do we know about how OCD actually develops? 133 00:07:26,760 --> 00:07:29,720 Speaker 1: Because it feels like there's like general kind of garden variety, 134 00:07:29,760 --> 00:07:33,200 Speaker 1: so to speak, anxiety, but this definitely feels much more severe, 135 00:07:33,400 --> 00:07:36,320 Speaker 1: much more kind of personalizings in the way that you're 136 00:07:36,360 --> 00:07:39,040 Speaker 1: talking about it. So how does OCD develop? 137 00:07:39,560 --> 00:07:42,560 Speaker 3: It's that same thing we say about how anything develops. 138 00:07:42,560 --> 00:07:46,800 Speaker 3: There's a component that's definitely structural in the brain, surrounding 139 00:07:46,840 --> 00:07:50,240 Speaker 3: things like you're serotonin and actual brain structures. But then 140 00:07:50,280 --> 00:07:52,760 Speaker 3: there are alongside of that, there can be some modeling 141 00:07:53,120 --> 00:07:54,160 Speaker 3: that can take shape. 142 00:07:54,320 --> 00:07:55,200 Speaker 2: And I believe that. 143 00:07:55,320 --> 00:07:58,720 Speaker 3: You can be predisposed for OCD. But just because you 144 00:07:58,760 --> 00:08:01,840 Speaker 3: have that predisposition, it doesn't always mean that it will 145 00:08:01,840 --> 00:08:04,600 Speaker 3: present inside of itself. There can still be some sort 146 00:08:04,600 --> 00:08:06,880 Speaker 3: of mitigating factor in the same way that you could 147 00:08:06,880 --> 00:08:08,800 Speaker 3: carry a trade for like my brains, but it doesn't 148 00:08:08,880 --> 00:08:12,440 Speaker 3: mean that that gene will actually be realized inside of you. 149 00:08:13,120 --> 00:08:15,800 Speaker 3: So there's still a lot more. Seems like as much 150 00:08:15,840 --> 00:08:18,440 Speaker 3: research as we do on ideology, we still are like 151 00:08:19,120 --> 00:08:22,480 Speaker 3: and actually specifically how does it start? But we have 152 00:08:22,600 --> 00:08:25,880 Speaker 3: some understanding that we can speak about along those lines. 153 00:08:26,200 --> 00:08:28,800 Speaker 1: M And I know so much of your work is 154 00:08:28,840 --> 00:08:32,280 Speaker 1: working with black patients specifically who struggle with OCD. What 155 00:08:32,440 --> 00:08:35,720 Speaker 1: have you seen about how OCD shows up differently in 156 00:08:35,800 --> 00:08:37,640 Speaker 1: black women specifically. 157 00:08:37,520 --> 00:08:41,559 Speaker 3: In black women specifically? That's a very interesting question, and 158 00:08:41,760 --> 00:08:44,920 Speaker 3: I do I want to say that from research, what 159 00:08:44,960 --> 00:08:48,520 Speaker 3: we can see is OCD will show up and people 160 00:08:48,600 --> 00:08:51,520 Speaker 3: like equally across the board. But when we try to 161 00:08:51,760 --> 00:08:55,320 Speaker 3: think about how it impacts black communities specifically, and I'm 162 00:08:55,320 --> 00:08:58,800 Speaker 3: going to deviate from the specific woman conversation, one thing 163 00:08:58,880 --> 00:09:01,160 Speaker 3: that we do notice is there there can be an 164 00:09:01,160 --> 00:09:05,200 Speaker 3: increase in more contamination based fears. But when they actually 165 00:09:05,240 --> 00:09:07,760 Speaker 3: looked at some of the limited research that's been completed 166 00:09:07,800 --> 00:09:10,360 Speaker 3: on this, they found that to be also found in 167 00:09:10,440 --> 00:09:14,520 Speaker 3: non clinical populations as well. And so what they're essentially 168 00:09:14,520 --> 00:09:16,559 Speaker 3: saying is that, how do I say this? 169 00:09:17,120 --> 00:09:17,640 Speaker 2: Culturally? 170 00:09:17,720 --> 00:09:21,640 Speaker 3: We may have some differences in our approach to cleanliness 171 00:09:21,679 --> 00:09:24,800 Speaker 3: and what's important to us surrounding cleanliness, and I think 172 00:09:24,840 --> 00:09:27,079 Speaker 3: that if we look through a historical lens, we can 173 00:09:27,200 --> 00:09:29,920 Speaker 3: understand why that may be the case, right, And so 174 00:09:29,960 --> 00:09:31,920 Speaker 3: if you're a group of population who's been told that 175 00:09:32,200 --> 00:09:36,040 Speaker 3: interacting with you causes harm to someone else and you 176 00:09:36,120 --> 00:09:38,200 Speaker 3: have to try to find a way to survive in 177 00:09:38,240 --> 00:09:41,320 Speaker 3: a society that has a lot of oppression against you, 178 00:09:41,520 --> 00:09:44,520 Speaker 3: we can understand how safety behaviors towards cleanliness could have 179 00:09:44,520 --> 00:09:47,640 Speaker 3: been conditioned over time. And so I think that's why 180 00:09:47,720 --> 00:09:51,040 Speaker 3: contamination is one area of focus, and again it can 181 00:09:51,080 --> 00:09:53,720 Speaker 3: be plenty of other areas of focus. And that's one 182 00:09:53,760 --> 00:09:55,920 Speaker 3: of the main points that I do want to make 183 00:09:56,240 --> 00:09:58,920 Speaker 3: is that when we have such a limited view of OCD, 184 00:09:59,480 --> 00:10:01,840 Speaker 3: we can deal treatment for people, and so we have 185 00:10:01,920 --> 00:10:05,280 Speaker 3: to take it outside of that lens of contamination in 186 00:10:05,440 --> 00:10:08,040 Speaker 3: order and symmetry. But that is something that's on the 187 00:10:08,080 --> 00:10:10,760 Speaker 3: table and I think interesting to dissect when you look 188 00:10:10,760 --> 00:10:12,120 Speaker 3: through that historical lens. 189 00:10:12,920 --> 00:10:16,000 Speaker 1: Yeah, I mean immediately I'm thinking about how many years 190 00:10:16,000 --> 00:10:18,720 Speaker 1: we've been told goy skin is not clean, or even 191 00:10:18,880 --> 00:10:22,040 Speaker 1: recent conversations I feel like developing on social media where 192 00:10:22,120 --> 00:10:24,880 Speaker 1: people are saying, like, oh, dermatologists suggests like you only 193 00:10:25,000 --> 00:10:27,319 Speaker 1: need a shower like every other day or every three days, 194 00:10:27,320 --> 00:10:29,880 Speaker 1: and like black people are like absolutely not like that, 195 00:10:29,960 --> 00:10:33,000 Speaker 1: it's what we do kind of thing, right, And so 196 00:10:33,040 --> 00:10:35,480 Speaker 1: it definitely feels like there is clearly some ties to 197 00:10:35,559 --> 00:10:39,040 Speaker 1: our history and our association with clearness. 198 00:10:39,360 --> 00:10:42,040 Speaker 3: And I think the social media impact of it all, 199 00:10:42,120 --> 00:10:44,400 Speaker 3: like we get exposure to the things of the I 200 00:10:44,400 --> 00:10:46,240 Speaker 3: don't wash my legs or I don't do this, and 201 00:10:46,280 --> 00:10:48,320 Speaker 3: like black people are like, wait a minute, what or 202 00:10:48,440 --> 00:10:51,200 Speaker 3: other behaviors that we may find to be a bit 203 00:10:51,240 --> 00:10:54,040 Speaker 3: more disgusting based off of what we are not willing 204 00:10:54,040 --> 00:10:56,080 Speaker 3: to do and putting that in a context of OCD. 205 00:10:56,280 --> 00:11:00,000 Speaker 3: So if generally speaking we have that condition conditioning connect 206 00:11:00,200 --> 00:11:03,199 Speaker 3: to cleanliness, you can imagine that if you have OCD, 207 00:11:03,320 --> 00:11:05,800 Speaker 3: that's going to be the temperature around that is going 208 00:11:05,840 --> 00:11:09,160 Speaker 3: to be turned up higher than it would be. But again, 209 00:11:10,240 --> 00:11:13,080 Speaker 3: I don't think that's to say that black people won't 210 00:11:13,120 --> 00:11:16,200 Speaker 3: necessarily have a worse presentation of that. It is just 211 00:11:16,280 --> 00:11:18,600 Speaker 3: something that you can be on the lookout for based 212 00:11:18,640 --> 00:11:20,840 Speaker 3: off of some research that's been conducted. 213 00:11:22,160 --> 00:11:24,440 Speaker 1: So you've already talked about the fact that like cleaning 214 00:11:24,480 --> 00:11:26,640 Speaker 1: and checking are the most common ways I think that 215 00:11:26,720 --> 00:11:30,720 Speaker 1: we see OCD presented. What are some other presentations of 216 00:11:30,720 --> 00:11:32,640 Speaker 1: OCD that may be a little less typical. 217 00:11:33,120 --> 00:11:36,200 Speaker 3: Okay, I love that question. And so because I said 218 00:11:36,200 --> 00:11:39,840 Speaker 3: OCD can attach to anything, I really mean anything. We 219 00:11:39,880 --> 00:11:43,760 Speaker 3: have like relationship OCD, how it will attach to your 220 00:11:43,840 --> 00:11:47,760 Speaker 3: romantic relationship. We have sexual orientation OCD, and I want 221 00:11:47,760 --> 00:11:50,440 Speaker 3: to say these are subcategories. If we treat OCD, we 222 00:11:50,440 --> 00:11:52,920 Speaker 3: don't think any of these hold more power over any 223 00:11:52,920 --> 00:11:55,960 Speaker 3: other presentation because they all get the same treatment. 224 00:11:56,080 --> 00:11:57,400 Speaker 2: But sometimes clients like. 225 00:11:57,320 --> 00:12:00,240 Speaker 3: To be like, oh, you know, I have ROCD, which 226 00:12:00,280 --> 00:12:04,240 Speaker 3: is a relationship OCD, or this pedophilia OCD POCD. That's 227 00:12:04,280 --> 00:12:06,800 Speaker 3: another way that it can show up. We have like 228 00:12:06,880 --> 00:12:10,520 Speaker 3: religious OCD with the scrupulocity, which can also have the 229 00:12:10,800 --> 00:12:13,560 Speaker 3: moral or ethical component to it. Am I being a 230 00:12:13,600 --> 00:12:16,440 Speaker 3: good person? Am I going to cheat someone out of money? 231 00:12:16,520 --> 00:12:19,320 Speaker 3: How do I know that I'm actually good? And there's 232 00:12:19,360 --> 00:12:23,560 Speaker 3: this existential category as well, where people will ask bigger 233 00:12:23,600 --> 00:12:26,480 Speaker 3: life questions. Am I here? Or am I in the matrix? 234 00:12:26,880 --> 00:12:28,000 Speaker 3: What's the meaning of life? 235 00:12:28,160 --> 00:12:30,040 Speaker 2: How do I know? This is not a simulation? 236 00:12:30,760 --> 00:12:34,600 Speaker 3: So it really can hit like OCD is creative. I 237 00:12:34,600 --> 00:12:37,720 Speaker 3: mean it is very creative. And so when I'm saying 238 00:12:37,800 --> 00:12:40,439 Speaker 3: like it can attach to anything. I really mean that 239 00:12:40,520 --> 00:12:43,559 Speaker 3: the possibilities are endless, and. 240 00:12:43,559 --> 00:12:46,360 Speaker 1: So relationship OCD, I don't think I've heard very much 241 00:12:46,360 --> 00:12:47,960 Speaker 1: about what does that mean? Is that like a fear 242 00:12:47,960 --> 00:12:49,800 Speaker 1: of cheating? Like what is the concern around? 243 00:12:49,840 --> 00:12:51,640 Speaker 2: Relationship with can be right? 244 00:12:51,679 --> 00:12:54,559 Speaker 3: So the intrusions can center around is this the perfect 245 00:12:54,600 --> 00:12:57,640 Speaker 3: partner for me? How do I know that I've made 246 00:12:57,640 --> 00:12:59,880 Speaker 3: the right choice? How do I know that I'm actually 247 00:13:00,160 --> 00:13:02,720 Speaker 3: really attracted to this person? Are they good enough for me? 248 00:13:03,000 --> 00:13:05,480 Speaker 3: Are they smart enough for me? Are they whatever enough 249 00:13:05,520 --> 00:13:08,360 Speaker 3: for me? And now it's natural to have some questions 250 00:13:08,400 --> 00:13:10,959 Speaker 3: about your relationship, as you should, you know, as you're 251 00:13:10,960 --> 00:13:15,160 Speaker 3: trying to progress anything we inside questioning reflection is important, 252 00:13:15,360 --> 00:13:19,040 Speaker 3: but this is pervasive, it is persistent, it's constant, and 253 00:13:19,080 --> 00:13:23,760 Speaker 3: it's extremely extremely distressing, and especially because oftentimes people are 254 00:13:23,800 --> 00:13:26,599 Speaker 3: feeling the opposite of what the intrusive thoughts. 255 00:13:26,320 --> 00:13:27,000 Speaker 2: Are telling them. 256 00:13:27,000 --> 00:13:29,880 Speaker 3: So they really want the relationship, but these intrusions are 257 00:13:29,880 --> 00:13:32,560 Speaker 3: coming in that's creating a lot of doubt. OCD had 258 00:13:32,600 --> 00:13:36,080 Speaker 3: a nickname called the doubting disease, which makes them believe 259 00:13:36,240 --> 00:13:38,440 Speaker 3: that because they start to feel anxious around it. And 260 00:13:38,480 --> 00:13:41,280 Speaker 3: now we have emotional reasoning right, I have these thoughts, 261 00:13:41,480 --> 00:13:44,360 Speaker 3: I'm anxious. I start a reason from my anxiety. I 262 00:13:44,440 --> 00:13:47,320 Speaker 3: need to know. I have to have absolute certainty that 263 00:13:47,440 --> 00:13:52,160 Speaker 3: this partner is right for me, and uncertainty is the 264 00:13:52,200 --> 00:13:56,679 Speaker 3: core distortion of OCD. Essentially, people are struggling with intolerance 265 00:13:56,720 --> 00:13:57,520 Speaker 3: of uncertainty. 266 00:13:57,800 --> 00:13:59,360 Speaker 2: Will it will it. 267 00:13:59,320 --> 00:14:02,120 Speaker 3: Won't, and they're just trying to answer those questions. But yeah, 268 00:14:02,200 --> 00:14:06,079 Speaker 3: relationship OCD can present like that, or it can be 269 00:14:06,480 --> 00:14:09,840 Speaker 3: I looked at someone and I found them attractive, and 270 00:14:09,960 --> 00:14:12,520 Speaker 3: as I looked at someone, I experienced like a grano, 271 00:14:12,679 --> 00:14:15,400 Speaker 3: which is maybe there was a sensation somewhere in the body. 272 00:14:15,520 --> 00:14:16,480 Speaker 2: Now what does this mean? 273 00:14:16,760 --> 00:14:18,960 Speaker 3: Does this mean that I really don't love my partner, 274 00:14:19,000 --> 00:14:20,560 Speaker 3: that I don't like my partner, that I want to 275 00:14:20,560 --> 00:14:23,320 Speaker 3: be with someone else, And so again, the questions can 276 00:14:23,360 --> 00:14:25,960 Speaker 3: be endless. But it's just this idea that the OCD 277 00:14:26,040 --> 00:14:29,240 Speaker 3: has attached to, and it's coming for your perception of 278 00:14:29,280 --> 00:14:32,040 Speaker 3: your relationship, and you're going to start to doing some 279 00:14:32,120 --> 00:14:36,920 Speaker 3: compulsions around that. And so compulsions could be checking I'm 280 00:14:36,920 --> 00:14:38,520 Speaker 3: going to check my body to make sure I still 281 00:14:38,520 --> 00:14:42,120 Speaker 3: feel attracted to this person, or I'm going to ask 282 00:14:42,280 --> 00:14:45,240 Speaker 3: reassurance or I'm going to confess I looked at someone 283 00:14:45,280 --> 00:14:46,760 Speaker 3: else the other day and I thought they were like, 284 00:14:46,840 --> 00:14:48,760 Speaker 3: really attractive. I just need to let you know that 285 00:14:49,400 --> 00:14:53,080 Speaker 3: I found someone else attractive. Now, imagine someone's constantly doing this. 286 00:14:53,400 --> 00:14:56,800 Speaker 3: At first, you might be like, okay, cool. But if 287 00:14:56,800 --> 00:15:00,800 Speaker 3: someone's doing this and you're experiencing these confessions and wawful 288 00:15:00,800 --> 00:15:02,680 Speaker 3: times a day or a week, that's the thing that's 289 00:15:02,720 --> 00:15:05,360 Speaker 3: going to actually at tax your relationship. So when I 290 00:15:05,360 --> 00:15:08,040 Speaker 3: says that OCD will have a tendency to do the opposite, 291 00:15:08,200 --> 00:15:11,360 Speaker 3: this relationship is really important to you. You are engaging 292 00:15:11,400 --> 00:15:15,200 Speaker 3: your behaviors that can definitely impact your relationship in a 293 00:15:15,200 --> 00:15:18,120 Speaker 3: negative way. But the OCD is lying to you and 294 00:15:18,160 --> 00:15:21,240 Speaker 3: telling you that you absolutely need to do these compulsions. 295 00:15:22,600 --> 00:15:25,360 Speaker 1: So I want to talk about the religious OCD also 296 00:15:25,480 --> 00:15:27,400 Speaker 1: because I think that that feels like one that could 297 00:15:27,480 --> 00:15:30,080 Speaker 1: be something that maybe will maybe not in terms of 298 00:15:30,120 --> 00:15:32,920 Speaker 1: like the actual stats and numbers, but because of the 299 00:15:33,040 --> 00:15:36,200 Speaker 1: history of the Black community with religion and spirituality, it 300 00:15:36,200 --> 00:15:38,600 Speaker 1: feels like this could be something that it does attach 301 00:15:38,640 --> 00:15:40,600 Speaker 1: to you, right, Can you say more about that? 302 00:15:41,320 --> 00:15:45,520 Speaker 3: I think that the religious aspect of OCD becomes very 303 00:15:45,520 --> 00:15:49,120 Speaker 3: difficult to treat especially when some of the things that 304 00:15:49,120 --> 00:15:54,280 Speaker 3: we learn in our association with whatever our religion is, 305 00:15:54,800 --> 00:15:58,360 Speaker 3: it perpetuates, It can perpetuate some of the thoughts connected 306 00:15:58,400 --> 00:16:01,760 Speaker 3: to the compulsions, like there is this idea that you 307 00:16:01,800 --> 00:16:06,040 Speaker 3: are praying or whatever those expectations are, and sometimes people 308 00:16:06,080 --> 00:16:08,840 Speaker 3: will blur the line between how do you show up 309 00:16:08,920 --> 00:16:14,440 Speaker 3: as a faithful participant of your religion versus showing up 310 00:16:14,520 --> 00:16:18,200 Speaker 3: for the OCD, and those are two totally different things. 311 00:16:18,520 --> 00:16:20,480 Speaker 3: And that's why I think it's important when you're working 312 00:16:20,520 --> 00:16:23,800 Speaker 3: with someone who's presenting with scrupulosity that you get that 313 00:16:23,880 --> 00:16:26,600 Speaker 3: release of information signed if it's okay with the client 314 00:16:26,880 --> 00:16:29,960 Speaker 3: to maybe talk with their spiritual leader, their pastor their preacher, 315 00:16:30,040 --> 00:16:33,880 Speaker 3: whatever the case may be, because we can understand if 316 00:16:33,880 --> 00:16:36,600 Speaker 3: there's a difference between saying a prayer, and there's a 317 00:16:36,640 --> 00:16:39,400 Speaker 3: difference between praying for two hours because you're getting a 318 00:16:39,440 --> 00:16:43,600 Speaker 3: word wrong or because an intrusive thought or image came 319 00:16:43,640 --> 00:16:46,160 Speaker 3: into your mind that forced you to have to start 320 00:16:46,240 --> 00:16:49,240 Speaker 3: over again. That doesn't serve your relationship with God. That 321 00:16:49,320 --> 00:16:51,080 Speaker 3: serves your relationship with OCD. 322 00:16:52,400 --> 00:16:56,040 Speaker 1: Right, Yeah, this does feel like the well, I probably 323 00:16:56,080 --> 00:16:59,120 Speaker 1: all of the OCD sometimes have some particular nuance that 324 00:16:59,160 --> 00:17:01,440 Speaker 1: makes it difficult. But this I think in particular, does 325 00:17:01,440 --> 00:17:04,159 Speaker 1: I feel like it's difficult to tease out because you know, 326 00:17:04,600 --> 00:17:06,879 Speaker 1: how do you know what is the line between like 327 00:17:06,920 --> 00:17:09,600 Speaker 1: I'm being very faithful, I'm being obrient so to speak, 328 00:17:09,720 --> 00:17:12,840 Speaker 1: versus OCD. But the question you just asked feels like 329 00:17:12,880 --> 00:17:15,120 Speaker 1: it's an important one, right, like does this actually serve 330 00:17:15,160 --> 00:17:18,080 Speaker 1: my relationship to my higher power? Or does this serve 331 00:17:18,119 --> 00:17:19,240 Speaker 1: the relationship to OCD? 332 00:17:19,359 --> 00:17:22,080 Speaker 3: I found some percent right, who is actually being served 333 00:17:22,560 --> 00:17:26,400 Speaker 3: by engaging in this compulsion? And it's always the OCD 334 00:17:26,760 --> 00:17:29,680 Speaker 3: that's being served in the person might temporarily think they're 335 00:17:29,720 --> 00:17:33,520 Speaker 3: being served if that compulsion still works for them, because 336 00:17:33,560 --> 00:17:36,600 Speaker 3: if you're still in that pattern of negative reinforcement where 337 00:17:36,640 --> 00:17:41,280 Speaker 3: you are receiving some relief, it works, but oftentimes it 338 00:17:41,440 --> 00:17:45,320 Speaker 3: starts to, you know, take up more time, create more agitation, 339 00:17:45,400 --> 00:17:49,040 Speaker 3: and so people aren't experiencing as much relief, but it's 340 00:17:49,080 --> 00:17:51,240 Speaker 3: worth it to do it because in their mind, the 341 00:17:51,320 --> 00:17:56,119 Speaker 3: alternative I've offended God, I'm not being a perfect Christian. 342 00:17:56,720 --> 00:17:59,560 Speaker 3: That can get in the way of the treatment. And 343 00:17:59,600 --> 00:18:02,359 Speaker 3: so now we're back on wanting to do the compulsion. 344 00:18:01,880 --> 00:18:06,240 Speaker 1: Again and so what do you feel like? Clinicians often 345 00:18:06,359 --> 00:18:09,200 Speaker 1: miss maybe when diagnosing OCD. 346 00:18:10,520 --> 00:18:15,280 Speaker 3: I think that because there's so much limitation around people's 347 00:18:15,359 --> 00:18:19,920 Speaker 3: understanding of what OCD is, they miss it, like if 348 00:18:19,960 --> 00:18:23,840 Speaker 3: it's not presenting in a way that media portrays it 349 00:18:24,200 --> 00:18:26,919 Speaker 3: and it's more nuanced, like in your relationship or in 350 00:18:26,960 --> 00:18:29,560 Speaker 3: your religion, or you have that new mom coming in 351 00:18:29,640 --> 00:18:32,159 Speaker 3: and saying, oh my goodness, like I'm afraid I might 352 00:18:32,200 --> 00:18:35,679 Speaker 3: harmless baby. What clinicians will typically do if they don't 353 00:18:35,720 --> 00:18:40,960 Speaker 3: have exposure to ERP training is let's. 354 00:18:40,800 --> 00:18:41,280 Speaker 2: Look at this. 355 00:18:41,400 --> 00:18:44,240 Speaker 3: Why would this happen even if they're doing solid general 356 00:18:44,280 --> 00:18:47,800 Speaker 3: CPT work. Let's examine the evidence for this behavior. You've 357 00:18:47,840 --> 00:18:51,480 Speaker 3: never heard anyone before. You don't want to hurt the baby. Now, 358 00:18:51,520 --> 00:18:55,040 Speaker 3: the issue with that is the client. Okay, that's reassurance. 359 00:18:55,040 --> 00:18:58,080 Speaker 3: This feels great, and that's a reason why people will 360 00:18:58,080 --> 00:19:02,520 Speaker 3: attend their sessions and feel better in the moment. But 361 00:19:02,560 --> 00:19:04,880 Speaker 3: then they go home and that intrusive thought comes in again, 362 00:19:04,920 --> 00:19:08,560 Speaker 3: and if this doesn't feel great, because I'm not still 363 00:19:08,600 --> 00:19:11,679 Speaker 3: afraid of harming this trial. So I think just doing 364 00:19:11,800 --> 00:19:15,160 Speaker 3: a more like using measures like the Y box can 365 00:19:15,200 --> 00:19:18,440 Speaker 3: be helpful in making sure your assessment is on point, 366 00:19:18,480 --> 00:19:22,560 Speaker 3: because then they have all of these different obsessions and 367 00:19:22,600 --> 00:19:27,680 Speaker 3: compulsions that people will in different categories, aggressive counting, ordering, 368 00:19:27,720 --> 00:19:30,920 Speaker 3: symmetry just right, those sorts of things that will help 369 00:19:31,000 --> 00:19:37,240 Speaker 3: pick up some of the war less known OCD subcategories. 370 00:19:38,200 --> 00:19:40,280 Speaker 3: And then that'll be like, okay this, And I've had 371 00:19:40,320 --> 00:19:43,000 Speaker 3: clients all the time in sessions say I never even 372 00:19:43,040 --> 00:19:47,280 Speaker 3: considered that a part of my OCD category, like that category, 373 00:19:47,359 --> 00:19:50,400 Speaker 3: I would have never considered that. And so that's why 374 00:19:50,760 --> 00:19:54,400 Speaker 3: I think proper training is important, and inside of that, 375 00:19:54,480 --> 00:19:58,720 Speaker 3: proper assessment is important, and just us having these conversations 376 00:19:58,760 --> 00:20:01,760 Speaker 3: to just say hi, it is more than just cleanliness 377 00:20:01,880 --> 00:20:05,960 Speaker 3: checking and perfectionism is helpful as well. 378 00:20:06,680 --> 00:20:08,520 Speaker 1: You mentioned the why box. Can you tell us what 379 00:20:08,560 --> 00:20:11,400 Speaker 1: that stands for and how might like a client use 380 00:20:11,440 --> 00:20:12,440 Speaker 1: it or even. 381 00:20:12,240 --> 00:20:17,520 Speaker 3: As AFROHANMS, But I think it's the yell obsessive compulsive scale. 382 00:20:18,119 --> 00:20:18,960 Speaker 2: That's where it is. 383 00:20:19,040 --> 00:20:20,879 Speaker 3: And that's just one of the measures. And now you 384 00:20:20,880 --> 00:20:24,520 Speaker 3: can also do some general measures of generalized anxiety and 385 00:20:24,560 --> 00:20:28,960 Speaker 3: social anxiety as well as part of your assessment, just 386 00:20:28,960 --> 00:20:31,320 Speaker 3: to kind of see where your client is standing on 387 00:20:31,359 --> 00:20:34,240 Speaker 3: those metrics and how I do it I start with 388 00:20:34,400 --> 00:20:37,639 Speaker 3: a general intake just so that I can get to 389 00:20:37,720 --> 00:20:40,119 Speaker 3: learn more about the client, and then I do a 390 00:20:40,160 --> 00:20:45,280 Speaker 3: more specific OCD based assessment once we have that initial 391 00:20:45,359 --> 00:20:47,960 Speaker 3: check in. Some therapists may just move straight into a 392 00:20:48,119 --> 00:20:51,600 Speaker 3: Y box, but I don't do that because I think client, 393 00:20:51,640 --> 00:20:53,240 Speaker 3: you know, I want the client to warm up a 394 00:20:53,240 --> 00:20:55,320 Speaker 3: little bit and then we can get to know your 395 00:20:55,400 --> 00:20:58,600 Speaker 3: history because I want to also be assessing for traumatic 396 00:20:58,680 --> 00:21:01,840 Speaker 3: experiences and how that's want to intersect with the OCD. 397 00:21:01,960 --> 00:21:04,199 Speaker 3: I want to know who the members are, like what 398 00:21:04,280 --> 00:21:07,080 Speaker 3: the social context, like who does this person have on 399 00:21:07,119 --> 00:21:10,520 Speaker 3: their team? Are they married, are they not married? Or 400 00:21:10,600 --> 00:21:12,720 Speaker 3: do they have siblings? Are they close with their family? 401 00:21:12,800 --> 00:21:15,159 Speaker 3: I want to understand some of those things because it 402 00:21:15,200 --> 00:21:18,320 Speaker 3: can also matter when we get into the OCD treatment 403 00:21:18,640 --> 00:21:22,680 Speaker 3: as well. And I'm saying it matters because if someone 404 00:21:22,760 --> 00:21:25,439 Speaker 3: co compolsing with the client, right, like, how does the 405 00:21:25,520 --> 00:21:29,120 Speaker 3: system support and maintain the OCD and so in order 406 00:21:29,160 --> 00:21:31,040 Speaker 3: for me to get that, I want to know who 407 00:21:31,040 --> 00:21:33,920 Speaker 3: the support system is in the role that they play 408 00:21:34,040 --> 00:21:36,760 Speaker 3: in the client's life. 409 00:21:37,080 --> 00:21:48,720 Speaker 1: More from our conversation after the break, I want to 410 00:21:48,760 --> 00:21:50,560 Speaker 1: go back to something about the why box because I 411 00:21:50,600 --> 00:21:54,000 Speaker 1: think that there are lots of like checklists or like 412 00:21:54,320 --> 00:21:57,760 Speaker 1: DIY kind of things that like clients can take online 413 00:21:57,800 --> 00:22:00,919 Speaker 1: as like a screener almost yes, why box and like 414 00:22:00,920 --> 00:22:03,000 Speaker 1: some of the other things that you have mentioned and 415 00:22:03,000 --> 00:22:06,200 Speaker 1: that even other clinicians use are not actually things meant 416 00:22:06,200 --> 00:22:08,199 Speaker 1: for a client to do themselves. 417 00:22:08,520 --> 00:22:10,439 Speaker 2: Right you, you may be. 418 00:22:10,520 --> 00:22:14,560 Speaker 1: Able to find a copy online online they are online, Okay. 419 00:22:14,920 --> 00:22:16,800 Speaker 3: By time people get to meet, some of my clients 420 00:22:16,800 --> 00:22:20,240 Speaker 3: are so they are experts in anxiety, right and not 421 00:22:20,760 --> 00:22:24,359 Speaker 3: I won't say a great significant number half, but because 422 00:22:24,359 --> 00:22:27,040 Speaker 3: my clients are experts in understand and anxiety, and part 423 00:22:27,119 --> 00:22:30,720 Speaker 3: of the composition can be hitting the Googles and being 424 00:22:30,840 --> 00:22:33,280 Speaker 3: like they come in they tell me about OCD and 425 00:22:33,280 --> 00:22:35,600 Speaker 3: I'm like, you got it, okay, so what are we 426 00:22:35,680 --> 00:22:37,879 Speaker 3: doing now? You you took a y box and like 427 00:22:38,680 --> 00:22:41,600 Speaker 3: that's great. How are we going to further this treatment? 428 00:22:41,640 --> 00:22:44,520 Speaker 3: Because now I just know how powerful the compositions can 429 00:22:44,560 --> 00:22:45,359 Speaker 3: be in your life. 430 00:22:45,440 --> 00:22:47,000 Speaker 2: Once you've already reached me and. 431 00:22:46,960 --> 00:22:51,359 Speaker 3: You've you can teach me about so but that's a 432 00:22:51,480 --> 00:22:54,320 Speaker 3: very big composion that you'll see people do is research 433 00:22:54,400 --> 00:22:58,119 Speaker 3: research research, research, research in more research. But it is 434 00:22:58,160 --> 00:23:00,520 Speaker 3: true that like clients who reach me that a lot 435 00:23:00,840 --> 00:23:03,919 Speaker 3: also haven't. It's taken the why box zombie in a 436 00:23:03,920 --> 00:23:06,560 Speaker 3: little bit silly when I say that, but it is 437 00:23:06,600 --> 00:23:11,200 Speaker 3: important to know that you get experts in anxiety by 438 00:23:11,240 --> 00:23:13,680 Speaker 3: the time they reach you, you have to know how 439 00:23:13,680 --> 00:23:14,360 Speaker 3: to deal with that. 440 00:23:14,920 --> 00:23:16,880 Speaker 1: Yeah, And I think that that is an important distinction 441 00:23:16,960 --> 00:23:19,679 Speaker 1: to make, right because there are instruments like this and 442 00:23:19,760 --> 00:23:22,720 Speaker 1: others that may not be so easily findable online although 443 00:23:22,760 --> 00:23:24,399 Speaker 1: I don't even know. A lot of stuff probably is 444 00:23:24,440 --> 00:23:26,320 Speaker 1: online just because of where we are in the world 445 00:23:26,400 --> 00:23:29,600 Speaker 1: right now. But just like you mentioned, like you wouldn't 446 00:23:29,600 --> 00:23:31,800 Speaker 1: necessarily start with the Y box and you consider that 447 00:23:32,040 --> 00:23:34,920 Speaker 1: as a part of an assessment not. The only thing 448 00:23:35,240 --> 00:23:37,520 Speaker 1: I think that that's important for non clinicians to hear 449 00:23:37,680 --> 00:23:39,840 Speaker 1: is that, Okay, you take this Y box because you 450 00:23:39,880 --> 00:23:41,760 Speaker 1: find it and you feel like, oh, I checked like 451 00:23:41,800 --> 00:23:44,840 Speaker 1: all of these boxes. That doesn't necessarily mean that there 452 00:23:44,880 --> 00:23:47,240 Speaker 1: is an OCD diagnosis, but it could be grounds for 453 00:23:47,480 --> 00:23:50,240 Speaker 1: a larger conversation with your clinician to. 454 00:23:50,240 --> 00:23:53,680 Speaker 3: Consider, especially in this day and age where we use 455 00:23:53,760 --> 00:23:58,080 Speaker 3: words casually right like people say I'm so OCD or 456 00:23:58,160 --> 00:23:59,680 Speaker 3: I'm so on the spectrum. 457 00:23:59,840 --> 00:24:02,840 Speaker 2: And I think that with OCDOCD. It is painful. 458 00:24:02,920 --> 00:24:05,239 Speaker 3: It's not like I wish I had a little bit 459 00:24:05,240 --> 00:24:08,760 Speaker 3: of OCD. People are struggling. It can be a pretty 460 00:24:09,800 --> 00:24:13,119 Speaker 3: disabling condition for people when they're in the thick of it. 461 00:24:13,119 --> 00:24:15,760 Speaker 3: There's a severity level to this, and so that's why 462 00:24:15,760 --> 00:24:17,760 Speaker 3: I like for us to be careful with our words. 463 00:24:18,080 --> 00:24:21,960 Speaker 3: These are things that actually impact the quality of people's lives, 464 00:24:21,960 --> 00:24:24,359 Speaker 3: and it can derail your life. And so it's not 465 00:24:24,720 --> 00:24:28,040 Speaker 3: a casual thing to be tossed around. It's very serious. 466 00:24:28,280 --> 00:24:29,080 Speaker 2: And we wouldn't do. 467 00:24:29,080 --> 00:24:32,679 Speaker 3: That same thing with other medical conditions, right, we wouldn't 468 00:24:32,680 --> 00:24:33,919 Speaker 3: be like, oh my gosh, I wish I had a 469 00:24:33,920 --> 00:24:37,080 Speaker 3: little cancer. It means it's not the same and like that, 470 00:24:37,320 --> 00:24:41,440 Speaker 3: the OCD can be as impactful on people's lives and 471 00:24:41,520 --> 00:24:43,360 Speaker 3: we just need to be more sensitive to that. 472 00:24:43,840 --> 00:24:45,960 Speaker 1: Yeah, So you mentioned that a part of what you're 473 00:24:46,000 --> 00:24:48,119 Speaker 1: doing in the assessment is also thinking about like the 474 00:24:48,240 --> 00:24:51,840 Speaker 1: history of trauma and like considering how that impacts how 475 00:24:52,080 --> 00:24:54,240 Speaker 1: the compulsions of showing up. Can you talk about how 476 00:24:54,280 --> 00:24:57,000 Speaker 1: trauma might inform an OCD diagnosis? 477 00:24:57,640 --> 00:25:00,880 Speaker 3: I think that in how I work with trauma, Well, 478 00:25:00,880 --> 00:25:03,359 Speaker 3: first of all, if it's like big trauma to the 479 00:25:03,400 --> 00:25:06,080 Speaker 3: point where it's hard for us to get to OCD treatment. 480 00:25:06,520 --> 00:25:07,440 Speaker 2: I will work for out. 481 00:25:07,560 --> 00:25:10,000 Speaker 3: I can do CBT in form trauma, but I believe 482 00:25:10,040 --> 00:25:12,440 Speaker 3: in specialists. You know, if there's someone who can treat that, 483 00:25:12,680 --> 00:25:14,919 Speaker 3: they're going to be more helpful than I can be. 484 00:25:15,000 --> 00:25:16,360 Speaker 2: So I want to make that referral. 485 00:25:16,760 --> 00:25:21,600 Speaker 3: But if it's it's that they have some well managed trauma, 486 00:25:21,640 --> 00:25:24,560 Speaker 3: it's in their history, it might like pop out and say, Hi, 487 00:25:24,560 --> 00:25:24,920 Speaker 3: I am. 488 00:25:24,840 --> 00:25:27,280 Speaker 2: Here paying attention to me. I can work with that. 489 00:25:27,440 --> 00:25:30,560 Speaker 3: And what we're doing is really looking at how the 490 00:25:30,920 --> 00:25:35,320 Speaker 3: OCD wants to reinforce the trauma, and so think about behaviors. 491 00:25:35,640 --> 00:25:38,320 Speaker 3: If you're talking about a fight or flight reaction, it 492 00:25:38,400 --> 00:25:41,200 Speaker 3: can say I need to keep myself safe above anything else. 493 00:25:41,200 --> 00:25:43,560 Speaker 3: So if this compulsion is keeping me safe, then it 494 00:25:43,600 --> 00:25:44,440 Speaker 3: makes sense for me. 495 00:25:44,440 --> 00:25:45,480 Speaker 2: To do this compulsion. 496 00:25:45,840 --> 00:25:48,920 Speaker 3: If avoiding this is keeping me safe, it makes sense 497 00:25:48,920 --> 00:25:49,919 Speaker 3: to have that avoidance. 498 00:25:49,960 --> 00:25:50,880 Speaker 2: And I do think. 499 00:25:50,720 --> 00:25:53,280 Speaker 3: That that's a functional way of being when you have 500 00:25:53,440 --> 00:25:56,560 Speaker 3: had some trauma. But even if you're doing trauma informed 501 00:25:56,560 --> 00:25:59,000 Speaker 3: exposure work, at some point it is going to be 502 00:25:59,040 --> 00:26:03,480 Speaker 3: about confronts those uncomfortable feelings in finding safe ways to 503 00:26:03,520 --> 00:26:07,280 Speaker 3: confront those situations that you have been avoiding, because again, 504 00:26:07,359 --> 00:26:09,960 Speaker 3: it's just another way to shrink your life and keep 505 00:26:10,000 --> 00:26:14,560 Speaker 3: it smaller. If there are safe spaces and safe and 506 00:26:14,600 --> 00:26:16,360 Speaker 3: I'm not using this in a healthy way. 507 00:26:16,400 --> 00:26:18,280 Speaker 2: It's like, this is a safety behavior, this is a 508 00:26:18,320 --> 00:26:19,280 Speaker 2: safe space. 509 00:26:19,160 --> 00:26:21,320 Speaker 3: And so I only go here. These are safe people, 510 00:26:21,359 --> 00:26:24,639 Speaker 3: so I only talk to them. That puts limitations on 511 00:26:24,720 --> 00:26:27,480 Speaker 3: your life. And so we really want to understand the 512 00:26:27,520 --> 00:26:31,720 Speaker 3: trauma and have the utmost respect for it and acknowledge 513 00:26:31,800 --> 00:26:35,600 Speaker 3: like you have values that you're dissonant in because we're 514 00:26:35,640 --> 00:26:39,199 Speaker 3: allowing your trauma and your OCD to come together to 515 00:26:39,240 --> 00:26:42,480 Speaker 3: be like you can't, you can't do this, And I'm like, 516 00:26:43,480 --> 00:26:45,520 Speaker 3: what feels like it can't is more of a willingness 517 00:26:45,560 --> 00:26:48,560 Speaker 3: issue is will you do this? Because you can right 518 00:26:48,680 --> 00:26:50,919 Speaker 3: if you want to, if you make that decision, But 519 00:26:50,960 --> 00:26:54,200 Speaker 3: it's are you willing to take the risk and sit 520 00:26:54,240 --> 00:26:57,879 Speaker 3: with the uncertainty connect it to whatever the OCD and 521 00:26:57,920 --> 00:27:00,560 Speaker 3: trauma are telling you. 522 00:27:00,560 --> 00:27:03,320 Speaker 1: You also mentioned who's in the support system and how 523 00:27:03,400 --> 00:27:06,160 Speaker 1: might they be co compulsing, which is also a newer term. 524 00:27:06,200 --> 00:27:08,960 Speaker 1: I've not heard that one, but it makes complete sense, right, Like, 525 00:27:09,000 --> 00:27:10,800 Speaker 1: if I have a loved one and I'm trying to 526 00:27:10,800 --> 00:27:15,119 Speaker 1: support them, I may unconsciously maybe sometimes support them in 527 00:27:15,200 --> 00:27:18,119 Speaker 1: ways that aren't actually helping them to be better. So 528 00:27:18,320 --> 00:27:20,639 Speaker 1: talk to me more about co compulsing and how to 529 00:27:20,680 --> 00:27:21,719 Speaker 1: be attentive to that. 530 00:27:22,240 --> 00:27:24,280 Speaker 3: Okay, So yeah, co compulsing is what it sounds like. 531 00:27:24,320 --> 00:27:27,959 Speaker 3: It's when you pull someone into your pattern of compulsing 532 00:27:28,200 --> 00:27:29,840 Speaker 3: and a lot of people are willing to do it 533 00:27:29,880 --> 00:27:32,840 Speaker 3: because they want you to feel better, right, and so 534 00:27:33,440 --> 00:27:36,919 Speaker 3: unfortunately that serves as a safety to the OCD is 535 00:27:36,960 --> 00:27:39,440 Speaker 3: if every time I ask you for reassurance, you give 536 00:27:39,480 --> 00:27:42,600 Speaker 3: it instead of learning what happens when I don't get 537 00:27:42,600 --> 00:27:45,560 Speaker 3: that reassurance, I'm just learning that this behavior makes my 538 00:27:45,560 --> 00:27:48,840 Speaker 3: anxiety go down, and therefore I'm going to continue to 539 00:27:48,880 --> 00:27:49,840 Speaker 3: do this behavior. 540 00:27:50,440 --> 00:27:52,480 Speaker 2: I really like to take the same way. I like 541 00:27:52,520 --> 00:27:52,920 Speaker 2: to take a. 542 00:27:52,840 --> 00:27:55,679 Speaker 3: Team approach and working with OCD, and so I'm like, 543 00:27:55,880 --> 00:27:58,399 Speaker 3: I'm going to be the Phil Jackson, You're MJ. We 544 00:27:58,480 --> 00:28:01,639 Speaker 3: have our Pippins and on the team, we're all going 545 00:28:01,720 --> 00:28:04,680 Speaker 3: to work together in that same system that could help 546 00:28:04,920 --> 00:28:05,920 Speaker 3: progress your treatment. 547 00:28:06,160 --> 00:28:07,639 Speaker 2: It's the same system that can. 548 00:28:07,520 --> 00:28:11,359 Speaker 3: Derail the treatment. And that's why the conversations the assessments 549 00:28:11,400 --> 00:28:14,600 Speaker 3: are really important to make sure we aren't having the 550 00:28:14,680 --> 00:28:19,520 Speaker 3: team not support the treatment around that. And when you're 551 00:28:19,680 --> 00:28:22,199 Speaker 3: talking to people who are on the team, it can 552 00:28:22,240 --> 00:28:25,320 Speaker 3: be a relief to know I don't have to do this, 553 00:28:25,600 --> 00:28:29,040 Speaker 3: like I don't have to carry this along with you. 554 00:28:29,119 --> 00:28:30,919 Speaker 3: Because ultimately, at the end of the day, the person 555 00:28:30,920 --> 00:28:32,960 Speaker 3: in the treatment is the person in the treatment and 556 00:28:33,000 --> 00:28:35,480 Speaker 3: they have to be accountable for their treatment. We cannot 557 00:28:35,520 --> 00:28:39,360 Speaker 3: overly rely on the system. And so people can feel relieved, 558 00:28:39,400 --> 00:28:41,880 Speaker 3: but they can also feel distressed because now they. 559 00:28:41,760 --> 00:28:44,200 Speaker 2: Have to watch someone go through. 560 00:28:44,720 --> 00:28:49,520 Speaker 3: The anxiety discussed or shame connected to whatever is involved 561 00:28:49,560 --> 00:28:52,160 Speaker 3: in that OCD cycle, and that can be hard to watch, 562 00:28:52,200 --> 00:28:54,640 Speaker 3: and so they also have to learn how to resist 563 00:28:54,640 --> 00:28:58,400 Speaker 3: that urge to rescue and provide that compulsion. 564 00:29:00,080 --> 00:29:03,479 Speaker 1: So you mentioned that CBT is not necessarily like the 565 00:29:03,520 --> 00:29:07,040 Speaker 1: gold standard when we're talking about an OCD treatment plan. 566 00:29:07,160 --> 00:29:10,960 Speaker 1: You mentioned ERP. So what does ERP stand for and 567 00:29:11,000 --> 00:29:13,920 Speaker 1: can you say more about what treatment for OCD actually 568 00:29:14,000 --> 00:29:14,400 Speaker 1: looks like. 569 00:29:15,000 --> 00:29:17,600 Speaker 3: Yes, so we have our umbrella CBT and ornder that 570 00:29:17,680 --> 00:29:20,480 Speaker 3: we have exposure and response prevention. In exposure and response 571 00:29:20,520 --> 00:29:23,960 Speaker 3: prevention is, like you said, the golden standard for treating OCD, 572 00:29:24,080 --> 00:29:26,560 Speaker 3: because you're not going to be able to talk your 573 00:29:26,600 --> 00:29:30,000 Speaker 3: way out of OCD p will and traditional talk therapy. 574 00:29:30,320 --> 00:29:32,160 Speaker 3: And that's because the part of the brain where the 575 00:29:32,160 --> 00:29:35,840 Speaker 3: OCD is, like the mid brain, that's where you're getting 576 00:29:35,840 --> 00:29:38,959 Speaker 3: that firefly reaction language is in the cortex, and so 577 00:29:40,120 --> 00:29:42,760 Speaker 3: OCD does not care about all of that. It's going 578 00:29:42,800 --> 00:29:46,040 Speaker 3: to always provide you another what if or what if? 579 00:29:46,080 --> 00:29:48,960 Speaker 2: What if? What if? Right, It's an endless what if maker. 580 00:29:49,440 --> 00:29:51,880 Speaker 3: And so because of that, we have to have a 581 00:29:51,920 --> 00:29:55,600 Speaker 3: treatment that allows people to get exposed to the things 582 00:29:55,600 --> 00:29:57,880 Speaker 3: that are anxiety provoking for them, and that can be 583 00:29:57,920 --> 00:30:01,800 Speaker 3: an actual situation or feeling or thought. And then we 584 00:30:01,840 --> 00:30:04,600 Speaker 3: want to teach them a strategy called response prevention, which 585 00:30:04,680 --> 00:30:08,560 Speaker 3: essentially means you are not engaging in that compulsion anymore. 586 00:30:08,800 --> 00:30:10,880 Speaker 3: And so a big picture, we're trying to teach people 587 00:30:10,880 --> 00:30:14,000 Speaker 3: that they can sit with whatever that emotion is in 588 00:30:14,040 --> 00:30:17,880 Speaker 3: the absence of that compulsion, because the OCD says you 589 00:30:17,960 --> 00:30:20,640 Speaker 3: cannot sit with this. You need to do the compulsion 590 00:30:20,680 --> 00:30:24,200 Speaker 3: in order to feel better or prevent a negative outcome 591 00:30:24,520 --> 00:30:27,840 Speaker 3: from occurring. Right, And if the compulsion is always completed, 592 00:30:28,160 --> 00:30:31,200 Speaker 3: the person doesn't really get to learn what actually happens. 593 00:30:31,400 --> 00:30:33,080 Speaker 3: And at the end of the day, ERP is a 594 00:30:33,120 --> 00:30:33,880 Speaker 3: learning model. 595 00:30:33,960 --> 00:30:34,840 Speaker 2: We want to. 596 00:30:34,840 --> 00:30:38,680 Speaker 3: Teach people new behaviors and allow them opportunity to practice that, 597 00:30:39,000 --> 00:30:41,720 Speaker 3: so that as they're practicing this new behavior, they get 598 00:30:41,720 --> 00:30:44,640 Speaker 3: those older behaviors can shift to the background, and they 599 00:30:44,680 --> 00:30:46,640 Speaker 3: learn that they're competent and they can do it. 600 00:30:48,000 --> 00:30:50,280 Speaker 1: So in the example that you gave around like, Okay, 601 00:30:50,320 --> 00:30:52,360 Speaker 1: I'm a new mom and you know, I feel like 602 00:30:52,400 --> 00:30:55,400 Speaker 1: I might just throw this baby. Would an ERP kind 603 00:30:55,400 --> 00:30:56,840 Speaker 1: of treatment look like there? 604 00:30:57,360 --> 00:30:57,719 Speaker 2: Okay? 605 00:30:58,080 --> 00:31:02,040 Speaker 3: And so if we're doing exposure your work around harm 606 00:31:02,120 --> 00:31:06,440 Speaker 3: based OCD, I would ask of that client what I 607 00:31:06,520 --> 00:31:09,040 Speaker 3: want to know what they're avoiding? First of all, because 608 00:31:09,160 --> 00:31:11,280 Speaker 3: if I can figure out what you're avoiding, I could 609 00:31:11,280 --> 00:31:14,920 Speaker 3: turn that into an exposure and it's likely going to 610 00:31:14,960 --> 00:31:18,000 Speaker 3: be things that are naturally occurring and repeating. So that's 611 00:31:18,040 --> 00:31:20,520 Speaker 3: a helpful one. So what that means is have you 612 00:31:20,560 --> 00:31:22,720 Speaker 3: stopped holding the baby as much? We're going to hold 613 00:31:22,760 --> 00:31:25,520 Speaker 3: the baby, we're going to change the diapers, we're going 614 00:31:25,560 --> 00:31:29,120 Speaker 3: to do the breastfeeding. We're also might write what we 615 00:31:29,160 --> 00:31:33,320 Speaker 3: call in a magical script, which is obviously we're not 616 00:31:33,320 --> 00:31:35,320 Speaker 3: going to tell someone to throw a baby, like that's 617 00:31:35,680 --> 00:31:38,120 Speaker 3: you know whatever. But we can use our imagination to 618 00:31:38,240 --> 00:31:41,120 Speaker 3: create a script that says, there's a possibility that I'm 619 00:31:41,120 --> 00:31:44,040 Speaker 3: not a safe mom. There's a possibility that I may 620 00:31:44,120 --> 00:31:47,560 Speaker 3: throw this baby when I am feeding the baby, and 621 00:31:47,600 --> 00:31:50,400 Speaker 3: despite this unwilling to take the risk, I may never 622 00:31:50,440 --> 00:31:53,360 Speaker 3: have one hundred percent certainty that I will not throw 623 00:31:53,400 --> 00:31:55,600 Speaker 3: this baby. But it's important for me to buy with 624 00:31:55,680 --> 00:31:58,600 Speaker 3: my child, and so I'm going to work through these 625 00:31:58,920 --> 00:32:01,680 Speaker 3: interests of thoughts and sit with these uncomfortable feelings and 626 00:32:01,720 --> 00:32:02,560 Speaker 3: hold my baby. 627 00:32:02,880 --> 00:32:03,040 Speaker 2: Right. 628 00:32:03,080 --> 00:32:05,800 Speaker 3: That could be an example of script work. And so 629 00:32:05,960 --> 00:32:08,280 Speaker 3: when we're talking about exposure, I do want to say 630 00:32:08,280 --> 00:32:10,880 Speaker 3: like there are different types of exposures we do. That 631 00:32:11,080 --> 00:32:14,840 Speaker 3: example was an imaginal exposure, and we do imaginal exposures 632 00:32:14,840 --> 00:32:19,840 Speaker 3: when it might be illegal unethical to do an exposure, 633 00:32:19,920 --> 00:32:23,920 Speaker 3: and so we use our imagination and vivo exposures are 634 00:32:23,960 --> 00:32:26,200 Speaker 3: things that we can actually do right. Like I can 635 00:32:26,720 --> 00:32:28,880 Speaker 3: lick my finger and touch a door knob and lick 636 00:32:28,920 --> 00:32:31,400 Speaker 3: it again. I can totally we can do that. We 637 00:32:31,480 --> 00:32:34,320 Speaker 3: can get in a car and practice driving over bunks 638 00:32:34,360 --> 00:32:37,880 Speaker 3: without practicing turning around to make sure we didn't hit someone. 639 00:32:38,280 --> 00:32:39,280 Speaker 2: So when we can do. 640 00:32:39,280 --> 00:32:42,040 Speaker 3: In vivo, we do in vivo and in narrow interro 641 00:32:42,120 --> 00:32:44,680 Speaker 3: stuftive exposures when people may have trouble sitting with the 642 00:32:44,720 --> 00:32:48,600 Speaker 3: physiological sensations of the anxiety, and so I might have 643 00:32:48,720 --> 00:32:52,160 Speaker 3: someone hold their breath, spin in a chair, do some 644 00:32:52,280 --> 00:32:55,480 Speaker 3: jumping jets in order to get their body really disregulated, 645 00:32:56,240 --> 00:32:58,520 Speaker 3: and teach them how to sit with that. And then 646 00:32:58,560 --> 00:33:00,640 Speaker 3: we combine all of them. So I might do an 647 00:33:00,680 --> 00:33:04,280 Speaker 3: intero sceptive with an imaginal script for a more deepened 648 00:33:04,320 --> 00:33:06,440 Speaker 3: extinction to facilitate that learning. 649 00:33:07,400 --> 00:33:09,160 Speaker 1: And how would you work? Even if we stay with 650 00:33:09,200 --> 00:33:12,080 Speaker 1: this example, right, like we know babies fall like they've 651 00:33:12,080 --> 00:33:14,600 Speaker 1: bum been to stuff, And if you are somebody who 652 00:33:14,640 --> 00:33:18,560 Speaker 1: is struggling with like OCD type symptoms related to like 653 00:33:18,600 --> 00:33:21,520 Speaker 1: can I actually keep this baby safe? And then something happens? 654 00:33:21,840 --> 00:33:23,680 Speaker 1: Like what does that then look like now when I 655 00:33:23,720 --> 00:33:25,000 Speaker 1: bring that back into treatment? 656 00:33:25,520 --> 00:33:28,120 Speaker 3: Yes, I love when those things happen, because what we 657 00:33:28,240 --> 00:33:31,240 Speaker 3: do know is babies will fall and toddlers will scrape 658 00:33:31,240 --> 00:33:31,760 Speaker 3: the knee. 659 00:33:32,000 --> 00:33:35,560 Speaker 2: And so it's not OCD is not about always. 660 00:33:35,200 --> 00:33:38,440 Speaker 3: Did the outcome happen or not happen? Because sometimes when 661 00:33:38,440 --> 00:33:43,280 Speaker 3: you get into that pool, it can unintentionally trigger a 662 00:33:43,360 --> 00:33:47,240 Speaker 3: series of compulsions. It's also about what could you tolerate 663 00:33:47,280 --> 00:33:50,200 Speaker 3: it the baby fail and then what happened? Did you 664 00:33:50,320 --> 00:33:53,600 Speaker 3: explode or were you able to sit with that dysregulation? 665 00:33:54,040 --> 00:33:57,080 Speaker 3: And how did that anxiety respond over time? How did 666 00:33:57,120 --> 00:33:59,440 Speaker 3: that guilt I can't believe I let my baby fall? 667 00:33:59,520 --> 00:34:02,360 Speaker 3: How did that respond over time? And so when the 668 00:34:02,360 --> 00:34:05,880 Speaker 3: worst case scenarios happen, it gives us an opportunity to 669 00:34:05,920 --> 00:34:08,239 Speaker 3: see and how did you handle it? Because we want 670 00:34:08,280 --> 00:34:10,840 Speaker 3: clients to learn that your OCD is lyned to you 671 00:34:11,040 --> 00:34:15,080 Speaker 3: can handle more than it's telling you you can handle, right, 672 00:34:15,160 --> 00:34:16,920 Speaker 3: And so that would be a great example when we 673 00:34:16,960 --> 00:34:18,920 Speaker 3: know the baby's going to fall again, the toddler's going 674 00:34:18,960 --> 00:34:21,399 Speaker 3: to scrap the knee again, and so the parent gets 675 00:34:21,440 --> 00:34:24,200 Speaker 3: an opportunity to learn that they can actually sit with 676 00:34:24,239 --> 00:34:27,160 Speaker 3: whatever emotions, like if that guilt is there, that the 677 00:34:27,200 --> 00:34:31,120 Speaker 3: guilt doesn't stay at one hundred percent for the rest 678 00:34:31,120 --> 00:34:32,880 Speaker 3: of their life, that it is a thing that's going 679 00:34:32,920 --> 00:34:33,720 Speaker 3: to ebb and flow. 680 00:34:35,280 --> 00:34:37,239 Speaker 1: And what does the treatment look like when you bring 681 00:34:37,239 --> 00:34:39,120 Speaker 1: in like the support system, like what kinds of things 682 00:34:39,160 --> 00:34:41,680 Speaker 1: are you talking with family members and friends about around 683 00:34:41,719 --> 00:34:44,160 Speaker 1: how to support them while they're going through ERP. 684 00:34:45,239 --> 00:34:48,000 Speaker 3: Yeah, so I want to understand where the co compolsients 685 00:34:48,000 --> 00:34:50,160 Speaker 3: are happening so that we can have a plan to 686 00:34:50,719 --> 00:34:53,640 Speaker 3: decrease and then stop those I also want to talk 687 00:34:53,640 --> 00:34:56,400 Speaker 3: about how you can support in a way that doesn't 688 00:34:56,440 --> 00:34:59,920 Speaker 3: allow the OCD to score points or to feel better. 689 00:35:00,440 --> 00:35:03,440 Speaker 3: And sometimes that might mean saying things like if the 690 00:35:03,480 --> 00:35:06,160 Speaker 3: person says, well, what if I harm the baby? Are 691 00:35:06,200 --> 00:35:08,120 Speaker 3: you sure you want me to do the feeding tonight? 692 00:35:08,200 --> 00:35:12,040 Speaker 3: And you say maybe you will, maybe you won't. We're 693 00:35:12,080 --> 00:35:15,120 Speaker 3: just willing to take that risk. And what it does 694 00:35:15,280 --> 00:35:19,520 Speaker 3: is now the person was seeking certainty and reassurance and 695 00:35:19,520 --> 00:35:22,200 Speaker 3: now we're back in the gray. And so if that 696 00:35:22,280 --> 00:35:24,799 Speaker 3: other person doesn't come and do that compulsion by taking 697 00:35:24,840 --> 00:35:27,880 Speaker 3: the baby and doing the feeding, now this gives the 698 00:35:27,960 --> 00:35:31,400 Speaker 3: client and opportunity to learn what actually happens in the 699 00:35:31,440 --> 00:35:34,440 Speaker 3: absence of that compulsion and what they can actually tolerate. 700 00:35:35,520 --> 00:35:37,840 Speaker 1: I would imagine that this could be something and you 701 00:35:37,880 --> 00:35:41,040 Speaker 1: talked about like it being a very disabling kind of condition, 702 00:35:41,120 --> 00:35:43,680 Speaker 1: because I could also see like relationship concerns being a 703 00:35:43,680 --> 00:35:45,600 Speaker 1: spin off of this, right, Like, now I don't feel 704 00:35:45,640 --> 00:35:48,120 Speaker 1: supportive because you know you're not enabling me to kind 705 00:35:48,120 --> 00:35:49,839 Speaker 1: of keep up with the compulsions, right, So I would 706 00:35:49,840 --> 00:35:52,440 Speaker 1: imagine there could be a whole host of other concerns 707 00:35:52,440 --> 00:35:54,800 Speaker 1: that pop up as a result of trying to manage OCB. 708 00:35:55,840 --> 00:35:58,239 Speaker 3: Yeah, And as you can imagine when you're trying to 709 00:35:58,239 --> 00:36:01,040 Speaker 3: do this work and you're used to receiving reassurance and 710 00:36:01,080 --> 00:36:04,480 Speaker 3: you're not getting it. We all have our natural reactions 711 00:36:04,520 --> 00:36:07,560 Speaker 3: to things, and so OCD aing or is a thing, 712 00:36:07,640 --> 00:36:10,560 Speaker 3: like people get upset and we have to work through 713 00:36:10,560 --> 00:36:13,359 Speaker 3: that and learn how to navigate that. But as we're 714 00:36:13,400 --> 00:36:16,160 Speaker 3: having our team conversation and I try to remind people 715 00:36:16,480 --> 00:36:19,960 Speaker 3: that it's us against the OCD, right, Like, ultimately, at 716 00:36:19,960 --> 00:36:21,440 Speaker 3: the end of the day, even if we have to 717 00:36:21,480 --> 00:36:25,680 Speaker 3: do some things that feel uncomfortable, let's remember what we're 718 00:36:25,719 --> 00:36:28,680 Speaker 3: in it for, like who our actual opponent is, and 719 00:36:28,760 --> 00:36:32,960 Speaker 3: it's not us against each other, it's us against the OCD. 720 00:36:34,520 --> 00:36:37,600 Speaker 1: Something else you've talked about, doctor More is how hoarding 721 00:36:37,719 --> 00:36:41,319 Speaker 1: can be like a part of the OCD spectrum and 722 00:36:41,440 --> 00:36:43,920 Speaker 1: how this might look especially in black families. Can you 723 00:36:43,960 --> 00:36:45,960 Speaker 1: talk about like hoarding and what that look like. 724 00:36:46,640 --> 00:36:49,360 Speaker 3: Yeah, I think hoarding is one of those interesting things. 725 00:36:49,360 --> 00:36:51,719 Speaker 3: I'm not a hoarding specialist, but again, like if it's 726 00:36:52,239 --> 00:36:55,640 Speaker 3: hoarding connected to OCD, I work with that, and I 727 00:36:55,719 --> 00:36:59,360 Speaker 3: just think about like generations of families where collecting things 728 00:36:59,640 --> 00:37:02,640 Speaker 3: was like not having access to things, and then having 729 00:37:02,680 --> 00:37:05,920 Speaker 3: access you get these knickknacks, you get these plastic containers 730 00:37:05,920 --> 00:37:09,160 Speaker 3: that just seem to be endless, and sometimes people have 731 00:37:09,239 --> 00:37:11,920 Speaker 3: had to oppern Maybe if we looked at it, we 732 00:37:11,960 --> 00:37:14,279 Speaker 3: can say, I don't know if that comes from like survival, 733 00:37:14,480 --> 00:37:17,280 Speaker 3: but it definitely can be a thing where every space 734 00:37:17,680 --> 00:37:21,640 Speaker 3: seems to be filled with something. Right in OCD, what 735 00:37:21,640 --> 00:37:25,279 Speaker 3: we're looking at is what's the function of that behavior, 736 00:37:25,840 --> 00:37:28,560 Speaker 3: And the function of that behavior can be different from 737 00:37:28,800 --> 00:37:32,759 Speaker 3: how traditional orbing presents. And so if someone's holding on 738 00:37:32,920 --> 00:37:36,160 Speaker 3: to an item because they're afraid that they'll never be 739 00:37:36,160 --> 00:37:38,799 Speaker 3: able to find that perfect item again, and it has 740 00:37:38,840 --> 00:37:41,759 Speaker 3: to be that way even if they don't like it 741 00:37:41,880 --> 00:37:44,799 Speaker 3: or use it, they want to hold on to it. 742 00:37:44,920 --> 00:37:47,080 Speaker 3: Or people who will just keep buying things like new 743 00:37:47,080 --> 00:37:49,120 Speaker 3: shirts and that they don't want to break the new 744 00:37:49,160 --> 00:37:52,200 Speaker 3: shirt in, so they'll just leave it in the closet 745 00:37:52,239 --> 00:37:53,920 Speaker 3: and then they'll get another shirt and they don't want 746 00:37:53,960 --> 00:37:56,560 Speaker 3: to break it in and so they just keep accumulating 747 00:37:56,719 --> 00:38:00,560 Speaker 3: shirts because they don't want to rooining. 748 00:38:00,239 --> 00:38:02,120 Speaker 2: It by actually using it. 749 00:38:02,320 --> 00:38:05,320 Speaker 3: That's a presentation that I could see in OCD, and 750 00:38:05,400 --> 00:38:07,960 Speaker 3: so that's why again the assessment in understanding the function 751 00:38:08,360 --> 00:38:11,840 Speaker 3: of the behavior is really important because both will present 752 00:38:11,880 --> 00:38:14,680 Speaker 3: with distress though, but I want to understand the function. 753 00:38:15,120 --> 00:38:29,399 Speaker 1: Right more from our conversation after the break. Something I've 754 00:38:29,480 --> 00:38:32,560 Speaker 1: learned more about recently is PANDACE. So this is like 755 00:38:32,600 --> 00:38:36,040 Speaker 1: an OCD type disorder that happens in kids as a 756 00:38:36,080 --> 00:38:38,800 Speaker 1: result of them getting stripped through correct Yes, yeah, and 757 00:38:38,880 --> 00:38:40,799 Speaker 1: so that is a newer kind of thing. I feel 758 00:38:40,800 --> 00:38:44,120 Speaker 1: like that's recently something that medical professionals have discovered. Is 759 00:38:44,200 --> 00:38:47,439 Speaker 1: there an equivalent or something like that where people will 760 00:38:47,440 --> 00:38:52,320 Speaker 1: develop an OCD like symptoms related to a medical condition 761 00:38:52,560 --> 00:38:53,240 Speaker 1: in adults? 762 00:38:54,280 --> 00:38:57,000 Speaker 3: So yeah, that's very specific. There is PANS and pandas. 763 00:38:57,080 --> 00:39:00,280 Speaker 3: I may treat an adult and what they may find 764 00:39:00,400 --> 00:39:03,160 Speaker 3: is that they've had like they started having struck when 765 00:39:03,160 --> 00:39:05,719 Speaker 3: they were younger in life that was unmanaged, and so 766 00:39:05,760 --> 00:39:08,399 Speaker 3: I'll work for them to a medical provider and maybe 767 00:39:08,400 --> 00:39:11,759 Speaker 3: they keep having like getting struck over and over again. 768 00:39:11,800 --> 00:39:14,520 Speaker 3: There's that resurgence and so I may have them go 769 00:39:14,640 --> 00:39:17,279 Speaker 3: see a medical provider so that they can get on 770 00:39:17,400 --> 00:39:20,760 Speaker 3: some long term management for that, because that could actually 771 00:39:20,800 --> 00:39:26,200 Speaker 3: be activating and maintaining OCD symptoms. But typically I see that. 772 00:39:26,760 --> 00:39:28,799 Speaker 3: I don't really work with kids anymore I used to, 773 00:39:29,120 --> 00:39:31,279 Speaker 3: but even with younger teens when I work with them, 774 00:39:31,280 --> 00:39:34,160 Speaker 3: I would see that presentation and it would be interesting. 775 00:39:34,200 --> 00:39:37,759 Speaker 3: And again that's why proper assessment is important, because if 776 00:39:37,760 --> 00:39:40,120 Speaker 3: you're asking those questions now that we know that, that 777 00:39:40,280 --> 00:39:45,160 Speaker 3: is a thing that can inform your treatment in your referrals, 778 00:39:45,560 --> 00:39:49,080 Speaker 3: right because we can see those symptoms, severity drop down 779 00:39:49,360 --> 00:39:52,560 Speaker 3: a lot if it is a PANDACE presentation once they 780 00:39:52,640 --> 00:39:55,160 Speaker 3: get that management for the STREPP or whatever else is 781 00:39:55,480 --> 00:40:00,640 Speaker 3: underlying condition that's activating the OCD. And I think that's 782 00:40:00,760 --> 00:40:01,960 Speaker 3: super that's interesting. 783 00:40:02,239 --> 00:40:04,440 Speaker 1: Yeah, it is very interesting. And I feel like, again 784 00:40:04,480 --> 00:40:06,640 Speaker 1: that's probably something in the last ten years or so 785 00:40:06,719 --> 00:40:09,560 Speaker 1: that they are learning more about. So we're always learning. 786 00:40:09,560 --> 00:40:12,880 Speaker 1: I think as weel what this looks like. So what 787 00:40:12,960 --> 00:40:16,080 Speaker 1: if somebody is enjoying our conversation and they are thinking, like, 788 00:40:16,160 --> 00:40:18,480 Speaker 1: you know what, this sounds like a condition that I 789 00:40:18,560 --> 00:40:21,239 Speaker 1: might meet qualifications for, or I think a loved one 790 00:40:21,600 --> 00:40:24,280 Speaker 1: may actually have some OCD symptoms. Where should they start? 791 00:40:24,480 --> 00:40:28,319 Speaker 3: The International OCD Foundation is a really great resource. They 792 00:40:28,360 --> 00:40:32,719 Speaker 3: have so many different things, articles, books that you can 793 00:40:32,840 --> 00:40:36,840 Speaker 3: look into on OCD. They do a lot of trainings 794 00:40:36,840 --> 00:40:39,279 Speaker 3: for professionals as well. So if you're a professional out 795 00:40:39,280 --> 00:40:41,359 Speaker 3: there and you think you might want to do some 796 00:40:41,400 --> 00:40:44,760 Speaker 3: OCD work, I think IOCDUF is a great place to start. 797 00:40:44,920 --> 00:40:50,279 Speaker 3: There's also a newer resource it's called erp Kaleioscope, and 798 00:40:50,320 --> 00:40:54,000 Speaker 3: it's actually founded by a group of black women, and 799 00:40:54,080 --> 00:40:56,640 Speaker 3: I think they're just recently getting it off the ground. 800 00:40:56,680 --> 00:41:00,080 Speaker 3: And again it's meant to be a space for providers 801 00:41:00,120 --> 00:41:01,200 Speaker 3: and people who. 802 00:41:01,160 --> 00:41:02,400 Speaker 2: May be struggling with OCD. 803 00:41:02,880 --> 00:41:06,960 Speaker 3: And so I think that those like IOCDF, erp Coaleidoscope 804 00:41:07,440 --> 00:41:12,480 Speaker 3: are great places if you're looking for some specific OCD resources. 805 00:41:12,520 --> 00:41:14,960 Speaker 1: Something else I wanted to ask you, doctor Moore, what 806 00:41:15,160 --> 00:41:17,279 Speaker 1: is the connection? And I feel like you talked about 807 00:41:17,280 --> 00:41:19,920 Speaker 1: this a little bit around the religiosity, but you know, 808 00:41:20,200 --> 00:41:24,240 Speaker 1: what is the connection between like OCD and things like superstitions? 809 00:41:24,719 --> 00:41:26,920 Speaker 1: Right like how can you tell the difference? 810 00:41:27,560 --> 00:41:30,040 Speaker 3: Okay, that's also a great one. Like I can say 811 00:41:30,040 --> 00:41:32,000 Speaker 3: in my family, we have a lot of superstitions that 812 00:41:32,040 --> 00:41:34,359 Speaker 3: we operate on. You know, like some cultural things don't 813 00:41:34,400 --> 00:41:36,440 Speaker 3: put the person on the floor. Even this thing with 814 00:41:36,480 --> 00:41:40,719 Speaker 3: the broom or a filiures like a whole bunch of things. Now, 815 00:41:40,760 --> 00:41:43,560 Speaker 3: the difference with that someone splits the pole, I'm like, 816 00:41:43,600 --> 00:41:47,440 Speaker 3: wait a minute, turn around. If someone did not turn around, 817 00:41:47,560 --> 00:41:52,360 Speaker 3: I'm probably not going to experience a lot of distress. 818 00:41:52,440 --> 00:41:55,520 Speaker 3: I might be annoyed momentarily like why couldn't you just 819 00:41:55,600 --> 00:41:57,759 Speaker 3: do that? You know how I feel about this, But 820 00:41:57,880 --> 00:42:00,040 Speaker 3: it's not something that's going to stick with me and 821 00:42:00,160 --> 00:42:03,439 Speaker 3: create the amount of distress that they have to turn 822 00:42:03,480 --> 00:42:06,239 Speaker 3: around or else is going to derail my next hour 823 00:42:06,440 --> 00:42:08,520 Speaker 3: or the rest of my day. That's how we can 824 00:42:08,560 --> 00:42:13,120 Speaker 3: differentiate with superstition from OCD. OCD has a high level 825 00:42:13,120 --> 00:42:16,120 Speaker 3: of distress around it, and if that person is in 826 00:42:16,160 --> 00:42:19,000 Speaker 3: that base, the compulsion has to be completed or they're 827 00:42:19,000 --> 00:42:22,120 Speaker 3: going to be very dysregulated. With us, it's probably just 828 00:42:22,160 --> 00:42:24,960 Speaker 3: going to be more of a fleeting thing if it's 829 00:42:25,040 --> 00:42:26,200 Speaker 3: just regular superstition. 830 00:42:27,080 --> 00:42:27,400 Speaker 2: M hm. 831 00:42:28,080 --> 00:42:31,280 Speaker 1: Thank you for that. So are there any affirmations, books, 832 00:42:31,400 --> 00:42:33,440 Speaker 1: or other resources that you would like to offer to 833 00:42:33,480 --> 00:42:35,640 Speaker 1: people who would like to learn more about this or 834 00:42:35,680 --> 00:42:37,279 Speaker 1: feel like this is something they're struggling with. 835 00:42:38,840 --> 00:42:42,560 Speaker 3: My affirmation is you must be willing to risk, right. 836 00:42:42,600 --> 00:42:45,400 Speaker 3: It's not the type of affirmations that people think about 837 00:42:45,440 --> 00:42:48,759 Speaker 3: that are reassuring. My affirmation is if you want your 838 00:42:48,840 --> 00:42:51,120 Speaker 3: life back, you have to go get your life back. 839 00:42:51,200 --> 00:42:53,719 Speaker 3: That means you have to take actions and steps. I 840 00:42:53,760 --> 00:42:55,920 Speaker 3: say things like, let's be in our value here, and 841 00:42:55,960 --> 00:42:58,439 Speaker 3: what is the value? Is it to kind of stay 842 00:42:58,440 --> 00:43:01,640 Speaker 3: here and copepost with your OCD or is it to 843 00:43:01,880 --> 00:43:03,960 Speaker 3: be able to go out and connect with your friends 844 00:43:04,000 --> 00:43:06,759 Speaker 3: in this space that might not be ideal for you, right, 845 00:43:06,840 --> 00:43:09,279 Speaker 3: So my affirmations are more things that are here toward 846 00:43:10,560 --> 00:43:14,719 Speaker 3: pushing people into more discomfort willingly than just are sort 847 00:43:14,719 --> 00:43:18,640 Speaker 3: of like feel good affirmations. Like I said, IOCD have 848 00:43:18,760 --> 00:43:21,279 Speaker 3: like there are great resources listed there. I just think 849 00:43:21,280 --> 00:43:22,480 Speaker 3: it's a great place to start. 850 00:43:23,960 --> 00:43:26,399 Speaker 1: You know, as you're talking, I definitely think the way 851 00:43:26,440 --> 00:43:29,840 Speaker 1: you show up as an ERP therapist or a therapist 852 00:43:29,880 --> 00:43:33,080 Speaker 1: who does ERP feels maybe a little different than would 853 00:43:33,080 --> 00:43:35,640 Speaker 1: you and might see in terms of like a typical presentation, 854 00:43:35,760 --> 00:43:38,840 Speaker 1: but it feels like it fits the condition, right, Like 855 00:43:38,880 --> 00:43:40,640 Speaker 1: that is why every therapist is not going to be 856 00:43:40,640 --> 00:43:43,120 Speaker 1: the right therapist for everybody because we all have different 857 00:43:43,120 --> 00:43:45,600 Speaker 1: trainings and our presentations I think can look very different. 858 00:43:45,640 --> 00:43:47,680 Speaker 1: And so what you're talking about, like you said, it 859 00:43:47,760 --> 00:43:50,520 Speaker 1: is very different than like the touching feeling when not touching, 860 00:43:50,600 --> 00:43:54,080 Speaker 1: but you know, the more feeling, Yeah, the more feeling 861 00:43:54,200 --> 00:43:57,480 Speaker 1: kind of like, let's support you as opposed to this. Really, 862 00:43:57,600 --> 00:43:59,920 Speaker 1: it sounds like there's a high level of challenge that 863 00:44:00,000 --> 00:44:01,800 Speaker 1: that is necessary for this disorder. 864 00:44:02,120 --> 00:44:04,000 Speaker 3: There is a high level of challenge, and I think 865 00:44:04,000 --> 00:44:06,160 Speaker 3: that if you're going to do ERP work, you have 866 00:44:06,239 --> 00:44:08,839 Speaker 3: to be willing to do the exposures that your clients do, 867 00:44:09,120 --> 00:44:11,120 Speaker 3: and you have to be really willing to sit with 868 00:44:11,239 --> 00:44:14,920 Speaker 3: other people's discomfort. A lot of providers like the techniques 869 00:44:14,960 --> 00:44:18,440 Speaker 3: like breathing exercises and things like that because if helps 870 00:44:18,440 --> 00:44:24,520 Speaker 3: clients feel better and people struggle with watching people reacting 871 00:44:25,040 --> 00:44:27,960 Speaker 3: to things. And here where like we don't really do 872 00:44:28,040 --> 00:44:31,520 Speaker 3: breathing exercises when we're doing ERP. We don't really try 873 00:44:31,560 --> 00:44:34,280 Speaker 3: those interventions because we're willing to sit with our clients 874 00:44:34,320 --> 00:44:38,520 Speaker 3: having that distress because it's an important part of the treatment, right, 875 00:44:38,640 --> 00:44:43,320 Speaker 3: Like those sorts of interventions become distractions when it's directed 876 00:44:43,360 --> 00:44:46,759 Speaker 3: towards OCD. And that's why I think proper training for 877 00:44:46,880 --> 00:44:49,520 Speaker 3: clinicians is really important because a lot of times we 878 00:44:49,560 --> 00:44:53,239 Speaker 3: would love it inadvertently co compose with our clients because 879 00:44:53,239 --> 00:44:57,919 Speaker 3: we don't fully understand OCD and the mechanisms that kind 880 00:44:57,920 --> 00:45:00,960 Speaker 3: of maintain it. And you could be now, I will say, 881 00:45:01,000 --> 00:45:03,640 Speaker 3: outside of ERP, if someone wants just as a life, 882 00:45:03,640 --> 00:45:06,160 Speaker 3: they're like, I breathe like this, this is me and 883 00:45:06,239 --> 00:45:08,239 Speaker 3: my self care go for it. But it's just not 884 00:45:08,719 --> 00:45:11,560 Speaker 3: in the context of doing ERP work. So I think 885 00:45:11,600 --> 00:45:14,239 Speaker 3: you bring up a very important point in that the 886 00:45:14,280 --> 00:45:18,439 Speaker 3: treatments can look different and pertaining to OCD. You want 887 00:45:18,440 --> 00:45:22,360 Speaker 3: to be trained to implement ERP, and you have to 888 00:45:22,400 --> 00:45:24,560 Speaker 3: have some willingness to sit with discomfort. 889 00:45:24,840 --> 00:45:27,480 Speaker 2: I mean all be infested with a lot of discomfort. 890 00:45:26,920 --> 00:45:29,799 Speaker 3: But a lot of anxiety, and you have to be 891 00:45:29,840 --> 00:45:32,239 Speaker 3: willing to show up and do the things that your 892 00:45:32,239 --> 00:45:33,080 Speaker 3: clients are doing. 893 00:45:34,400 --> 00:45:37,640 Speaker 1: And is the IOCDF the place there you get trained 894 00:45:37,800 --> 00:45:40,520 Speaker 1: in ERP or where would clinicians go to get training 895 00:45:40,520 --> 00:45:40,759 Speaker 1: for this? 896 00:45:40,840 --> 00:45:43,239 Speaker 3: Yeh, that's one of the places they do some advanced 897 00:45:43,360 --> 00:45:47,120 Speaker 3: training in OCD, And so I did some training with 898 00:45:47,160 --> 00:45:49,759 Speaker 3: them as well. A knowledge tree is a place that's 899 00:45:49,800 --> 00:45:52,640 Speaker 3: popped up that's doing some more specific training and you'll 900 00:45:52,640 --> 00:45:56,280 Speaker 3: get some overlap of experts in the field to work 901 00:45:56,520 --> 00:46:00,120 Speaker 3: in those different spaces. So yeah, those are two places 902 00:46:00,120 --> 00:46:03,520 Speaker 3: to look for training. But I just think ERP it's 903 00:46:03,520 --> 00:46:06,880 Speaker 3: great to watch people level up in there. They feel 904 00:46:06,920 --> 00:46:10,960 Speaker 3: more confident, they learn how they can actually tolerate things 905 00:46:10,960 --> 00:46:14,080 Speaker 3: that the OCD told them that they can't tolerate. It's 906 00:46:14,120 --> 00:46:18,120 Speaker 3: great watching people like grab bits of their life bag 907 00:46:18,200 --> 00:46:20,320 Speaker 3: that they haven't been able to do things in years. 908 00:46:20,800 --> 00:46:22,440 Speaker 3: And I just think that when we talk about a 909 00:46:22,440 --> 00:46:24,880 Speaker 3: barrier to treatment, one thing I see is people feel 910 00:46:24,920 --> 00:46:27,960 Speaker 3: away by the time they reach an ERP specialists because 911 00:46:28,000 --> 00:46:31,200 Speaker 3: sometimes people have had treatment and they're like, why didn't 912 00:46:31,239 --> 00:46:34,480 Speaker 3: I know this treatment was available to me seven years ago, 913 00:46:34,920 --> 00:46:39,200 Speaker 3: because I would have like, I've had some great therapeutic experiences, 914 00:46:39,200 --> 00:46:41,640 Speaker 3: but it just didn't move the needle on my OCD. 915 00:46:42,040 --> 00:46:44,719 Speaker 3: Help with my trauma, help with some general coping strategies, 916 00:46:44,760 --> 00:46:48,640 Speaker 3: but MYOCD seemed to never quite benefit from that. And 917 00:46:48,719 --> 00:46:51,319 Speaker 3: I think the reason why I wanted to do this 918 00:46:51,440 --> 00:46:54,320 Speaker 3: podcast is the information out there that there is specific 919 00:46:54,400 --> 00:46:57,919 Speaker 3: OCD treatment that it is very effective. We just want 920 00:46:57,920 --> 00:47:01,480 Speaker 3: to make sure we are pushing people in that direction 921 00:47:01,640 --> 00:47:04,600 Speaker 3: so that we don't delay treatment and have people and 922 00:47:04,680 --> 00:47:07,720 Speaker 3: curing extra things that cost time a waste of resource 923 00:47:07,719 --> 00:47:08,399 Speaker 3: when it comes to. 924 00:47:08,400 --> 00:47:11,880 Speaker 1: Time, and I'm sure there's no kind of standard on 925 00:47:12,040 --> 00:47:15,520 Speaker 1: like how long you would be in ERP, but is 926 00:47:15,560 --> 00:47:17,840 Speaker 1: there kind of generally like how long you would be 927 00:47:17,960 --> 00:47:18,640 Speaker 1: in sessions? 928 00:47:19,120 --> 00:47:22,080 Speaker 3: Yeah, I want to check in around twelve and twenty sessions, 929 00:47:22,520 --> 00:47:24,799 Speaker 3: and so I just want to look like if we're 930 00:47:24,800 --> 00:47:26,640 Speaker 3: doing treatment for three months, I want to kind of 931 00:47:26,640 --> 00:47:28,920 Speaker 3: look and see where they are. And part of that 932 00:47:29,000 --> 00:47:32,040 Speaker 3: Wybox scale, there's a severity scale that goes along with it, 933 00:47:32,440 --> 00:47:34,600 Speaker 3: and so it's two parts. We look at the severity 934 00:47:34,600 --> 00:47:37,200 Speaker 3: scale and I'll reassess that just to see how that 935 00:47:37,360 --> 00:47:40,279 Speaker 3: number is decreasing over time. And when I say that 936 00:47:40,400 --> 00:47:43,640 Speaker 3: number is decreasing over time, that doesn't always mean like 937 00:47:43,680 --> 00:47:47,120 Speaker 3: the client gets to be anxiety free. ERP is about 938 00:47:47,320 --> 00:47:50,840 Speaker 3: learning how to live with anxiety versus pure symptom reduction, 939 00:47:51,360 --> 00:47:53,640 Speaker 3: and so a lot of people will come in thinking 940 00:47:53,719 --> 00:47:57,040 Speaker 3: like OCD work means I don't have intrusive thoughts anymore, 941 00:47:57,320 --> 00:47:59,680 Speaker 3: or I don't have anxiety anymore. And I'm not signing 942 00:47:59,680 --> 00:48:03,160 Speaker 3: that tree plan. This is really learning how to live 943 00:48:03,320 --> 00:48:06,120 Speaker 3: with in all caps. So I say things like when 944 00:48:06,120 --> 00:48:08,360 Speaker 3: we talk about affirmations, be anxious and do it anyway. 945 00:48:08,920 --> 00:48:12,040 Speaker 3: Be disgusted and do it anyway. And so yeah, like 946 00:48:12,120 --> 00:48:15,480 Speaker 3: we can look at a session limit and I use 947 00:48:15,560 --> 00:48:18,359 Speaker 3: that resource, the y box of Verity scale, in order 948 00:48:18,400 --> 00:48:19,920 Speaker 3: to help us know if we're on track. And I 949 00:48:19,960 --> 00:48:23,880 Speaker 3: think it's a great accountability for me and for the client, 950 00:48:24,000 --> 00:48:26,320 Speaker 3: so that we're holding ourselves accountable for the treatment. 951 00:48:27,280 --> 00:48:30,840 Speaker 1: Perfect. So, doctor Moore, where can we stay connected with you? 952 00:48:30,920 --> 00:48:33,040 Speaker 1: What is your website as well as any social media 953 00:48:33,120 --> 00:48:34,200 Speaker 1: channels you'd like to share. 954 00:48:34,520 --> 00:48:37,920 Speaker 3: Yes, my website is doctor Jamikamore dot com and I 955 00:48:37,960 --> 00:48:43,160 Speaker 3: am on Instagram at jam Sessions that's Jam Underscore s 956 00:48:43,280 --> 00:48:46,200 Speaker 3: E S s IO n Z and so you can 957 00:48:46,200 --> 00:48:47,040 Speaker 3: connect with me there. 958 00:48:47,920 --> 00:48:50,399 Speaker 1: Perfect. Thank you so much for joining us again, doctor Moore. 959 00:48:50,480 --> 00:48:52,040 Speaker 2: Yeah, thank you. It's good to see you. 960 00:48:52,080 --> 00:48:58,840 Speaker 1: Of course, I'm so glad doctor Moore was able to 961 00:48:58,880 --> 00:49:01,960 Speaker 1: join me for this conversation and helping us better understand 962 00:49:02,000 --> 00:49:05,120 Speaker 1: OCD and its impact on black women. If you want 963 00:49:05,160 --> 00:49:07,359 Speaker 1: to learn more about her and her work, be sure 964 00:49:07,360 --> 00:49:09,680 Speaker 1: to visit the show notes at Therapy for Blackgirls dot 965 00:49:09,680 --> 00:49:13,759 Speaker 1: com slash Session four twenty five for more information, and 966 00:49:13,840 --> 00:49:15,839 Speaker 1: don't forget to text this episode to two of your 967 00:49:15,880 --> 00:49:18,279 Speaker 1: girls right now and tell them to check it out. 968 00:49:18,840 --> 00:49:20,600 Speaker 1: Did you know that you could leave us a voicemail 969 00:49:20,640 --> 00:49:23,800 Speaker 1: with your questions or suggestions for the podcast. Whether you 970 00:49:23,880 --> 00:49:27,520 Speaker 1: have ideas for future topics, book or movie suggestions, or 971 00:49:27,600 --> 00:49:29,640 Speaker 1: just something on your mind, we'd love to hear it. 972 00:49:30,120 --> 00:49:32,520 Speaker 1: Head on over to Memo dot fm slash Therapy for 973 00:49:32,560 --> 00:49:35,759 Speaker 1: Black Girls and leave us a voicemail. If you're looking 974 00:49:35,800 --> 00:49:38,920 Speaker 1: for a therapist in your area, visit our therapist directory 975 00:49:39,000 --> 00:49:42,719 Speaker 1: at Therapy for Blackgirls dot com slash directory, and don't 976 00:49:42,760 --> 00:49:45,319 Speaker 1: forget to follow us over on Instagram at Therapy for 977 00:49:45,360 --> 00:49:50,120 Speaker 1: Black Girls. This episode was produced by Elise Ellis, Indechubu 978 00:49:50,320 --> 00:49:54,279 Speaker 1: and Tyree Rush. Editing was done by Dennison Bradford. Thank 979 00:49:54,400 --> 00:49:56,680 Speaker 1: y'all so much for joining me again this week. I 980 00:49:56,760 --> 00:49:59,919 Speaker 1: look forward to continuing this conversation with you all real soon. 981 00:50:00,719 --> 00:50:01,359 Speaker 1: Take it care 982 00:50:04,480 --> 00:50:04,520 Speaker 3: What