I got an audio question from Burrito John who wanted to know he can deal with a situation. He’s obsessing about whether he actually liked someone, or whether he was just obsessing and didn’t. He is worried he made it awkward with his co-worker and now wonders whether he and trust his intuition about whether he genuinely likes someone or whether OCD is just clouding his judgment. This question comes up in a lot of different ways so I’m glad John asked it.

Jeffrey messaged me and wanted to know how to forgive himself for his obsessions and past choices so he can finally move on with his life past the grip of SO-OCD. His question has a lot going on, and includes elements of shame and guilt from his past behaviors, doubt and confusion about motivations for said actions, confusion about titles and identity, and a struggle with a sticky comment made by someone when young that served as the basis for his obsession. I do my best to address some of these issues and help him see how his obsession was created, how it persists, and how he can try to let himself off the hook and move on with his life.




For more about Sexual Orientation OCD (SO-OCD), check out this article from the California OCD and Anxiety Treatment Center

Dan reached out with an audio question to ask about what he can do when his interests and values happen to also be the focus of his obsession. Hijacking your values, hobbies, and interests is a really common tactic of OCD, but does that mean you have to give it all up to get better? What happens then if you value intimacy in a relationship? Is Dan doomed? I discuss what people can do to grow their awareness about their obsessions and how to short circuit the obsession/ compulsion cycle when it hits. However, I also discuss some other, broader, relationship considerations that may be at play.

Just in case the threats of the Rapture didn’t get you down (or amped up with anxiety) enough, GS comes along to ask the question about what to do, and how to move on with life, now that, apparently, science proves that we have no free will. So, GS struggles to know what to do with this information. Luckily, this isn’t my first rodeo, and I’ve got just the right chaps and spurs for this question. We talk about Existential OCD, what to do with scary information like this, how to challenge the thoughts, and how to live a meaningful life with the looming threat of meaninglessness.




For more about Existential OCD, check out this article from the California OCD and Anxiety Treatment Center.

For today’s episode, I got a relatively simple question; what are the differences between the compulsions and other behaviors found in Generalized Anxiety Disorder (GAD) and how do they differ from those in Obsessive Compulsive Disorder (OCD). While this was a pretty quick answer, it spun out into a comparison between OCD and GAD, how they differ diagnostically, and how they are really similar! You can have both, and sometimes it’s hard to see the differences between the two.








For more on Generalized Anxiety Disorder (GAD), check out this article from the California OCD and Anxiety Treatment Center

Dr Jeremy Shuman, PsyD, joins me today to discuss OCD treatment for those on the Autism Spectrum. Dr. Shuman offers a wealth of knowledge, insights, and encouragement to clinicians, families, and individuals alike. We discuss some of the diagnostic complications with the overlap of OCD and Autism symptoms, obstacles in the way of using CBT and ERP, and ways to adapt common treatment methods for OCD to meet the unique needs of the Autism community.

Alan sent me a message asking me about how he can deal with a spike in Real-Event OCD themes. He’s a reporter who used AI to help with his grammar, but his anxiety latched on about violating AI policies at work. He struggles to let go of the obsession and get back to appreciating his craft again. We go over Real-Event OCD and how it differs from other obsessions, the use of AI in treatment, and some ways he can disconnect from his guilt through acceptance and compassionately making space for his anxiety.








For more on Real Event OCD, check out this article from the California OCD and Anxiety Treatment Center

Annie reached out to me as a follow up to a previous question she had about her toenail fungus and her obsession about it. She noticed that after all her ERP treatment she continues to have an obsession because she continues to get infections! How frustrating!? I talk about the expectations of ERP and anxiety treatment, how we can deal with the possibility (and reality) that bad/ unwanted things happen no matter how much exposure we do, and how to practice acceptance with situations we really don’t want to accept.

I recently got a follow up question from the Emotional Contamination episode (#240) asking about what to do if/ when someone actually believes their OCD fear is absolutely real. In Therapy-Land, we call this a high Fixity of Beliefs, or their thoughts are highly rigid or fixed. I know a word that doesnt sound like a word. I talk about what can be done when someone has high Fixity of Beliefs, what it looks like, and how treatment is the same and different than in typical OCD/ CBT/ ERP treatment.

Today’s episode feature Dr. Caitlin Pinciotti, PhD, and Jon Hershfield, MFT in our discussion of the National OCD Survey. The goal of the National OCD Survey is to gather information about the demographic differences in OCD subtypes across the United States in alignment with identified cultural groupings within the United States. This was a really fun episode to record and is full of fascinating information about OCD and the way people experience it differently.

Ellie reached out to ask about how to help her 14 year old who is struggling with a fear of becoming like other people. Emotional Contamination the name we often apply to the OCD subtype where someone is afraid they will take on the unwanted characteristics of other, or specific, people. To help, I discuss what Emotional Contamination is, how obsessions and compulsions sometimes present, and what Exposure and Response Prevention looks like in these cases.

Ward emailed me to share a struggle he’s going through related to his SO-OCD. He notes that he’s in therapy and making progress, but the anxiety is impacting his performance in the bedroom and his libido is much lower than he wants. Anxiety can have serious negative impacts on someone’s sexual life. I discuss how the expectations of sexual performance impacts performance, how health and lifestyle changes can help with overall anxiety and subsequently sexual performance, and some exposure ideas to help him along the way.








For more about Sexual Orientation OCD (SO-OCD), check out this article from the California OCD and Anxiety Treatment Center

Payton reached out with a voice question on Instagram with a question that a lot of people who listen to this podcast can understand. She struggles with what she believes is Hyperawareness OCD/ Sensorimotor OCD and is fixated on the fact that she can see the tip of her nose. While it may seem harmless, like all other obsessions in the category, she agonizes over her awareness of it, when it will go away, and whether it will ruin her future. So, it’s hardly just about her nose being there, it’s about her future not being there.








For more on Sensorimotor OCD and Hyperawareness OCD, check out this article from the California OCD and Anxiety Treatment Center

Alana messaged me recently and asked about how she can tackle her perfectionism. It’s stopping her from sending in assignments, writing papers, and even makes her write down all the words she hears to make sure she knows them. Perfectionism can be awful, time consuming, and shame inducing. To try to help, I discuss perfectionism, some things to think about when challenging the thoughts that support perfectionism, and offer some exposure ideas.

Ever wonder what it’s like to be the partner of someone with Relationship OCD (ROCD)? Well, one listener did too, and they reached out to me and asked if I could have someone on to talk about their experience. So, Danielle Cohen, LMFT, joined me to talk about her experience with someone who struggles with ROCD. Danielle was kind enough to share her experience, her struggles, and her wins, which she shares with her husband, over ROCD’s efforts to derail them.

Rick reached out to me recently to ask a very simple question with a not-so-simple answer. He wanted to know if it’s normal to have intrusive thoughts on purpose? It got me thinking about a lot of my clients who ask similar questions about their thoughts and why they have them and what their responsibility is to them. Did they want them, so they came? Now that they are there, are they really THEIR thoughts, or just a thought that have? Why do those thoughts go away when they are doing other things? So many questions, so I got into intrusive vs intentional thoughts, what they mean for us, and what we can do about them.

Abby reached out to me via Instagram to ask a question that starts off a little Harm OCD, but ends up a little Sensorimotor/ Hyperawareness OCD. She wants to know how to deal with her intrusive, looping thoughts that focuses on harm related thoughts toward a family member. She knows it’s her OCD, so she’s not doing compulsions, but she hates that they are even there. Does she need to do ERP, and if so how? I offer some ideas on how she can approach the situation with some Cognitive Behavioral Therapy skills, some ACT skills, and of course offer some ideas on exposures she can try.




To Learn More About Harm OCD, Check Out This Article From The California OCD And Anxiety Treatment Center

M messaged me recently to ask about a situation that is all too common. They struggle with POCD, but are terrified to go see a therapist for treatment because what if the therapist 1) doesn’t diagnose them with POCD but actually thinks they are their worst fear, and 2) they actually are their worst fear and they don’t fully and clearly communicate their symptoms and they mistakenly get diagnosed with POCD and not… you know… that other thing. Either way, it’s a fear of getting misdiagnosed, not getting the right treatment, and suffering needlessly. This happens with POCD as well as any number of other taboo subtypes, so it is very relatable across the board.




For more about POCD, check out this article from The California OCD and Anxiety Treatment Center

Struggling Artist emailed me with an admittedly long question. They want to become a full time artist but are struggling to take the leap because their Religious and Moral Scrupulosity OCD is trying to overtake their life. Obsessions about moral perfection are leading to checking compulsions, donating art sales profits, excessive confession, and mental rumination. Can they learn to work around it, or are they doomed to give up on their dream?








For more about Moral Scrupulosity and Religious Scrupulosity, check out this article from The California OCD and Anxiety Treatment Center

Today I get to share a comment from Eden and a question from Nicholas. Eden wanted to share her experience with Casadastraphobia. I love being able to share others’ experiences because everyone’s experience is a little bit different; even when people share the same anxiety subtype. After this, I get to answer Nicholas’ question about taking power away from the sensations that seem to be plaguing him.








To learn more about Sensorimotor OCD and Hyperawareness OCD, check out this post from the California OCD and Anxiety Treatment Center