Exposure Therapy in a Public Bathroom

Summary

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Breaking the Rules: A Clinician's Guide to Treating OCD

Episode: Exposure Therapy in a Public Bathroom
Hosts: Dr. Celin Gelgec & Dr. Victoria (Tori) Miller
Date: May 18, 2026

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Episode Overview

In this engaging episode, Dr. Celin Gelgec and Dr. Tori Miller take their clinical expertise out of the consulting room—literally—to record from the floor of a public bathroom. They discuss the importance of experiential exposure for treating contamination-based OCD and explore the broader cultural impact of "Clean Girl Culture," reflecting on how visible wellness trends can intersect with obsessive-compulsive patterns. With a blend of playful irreverence and thoughtful clinical insight, they examine when the pursuit of cleanliness crosses into impairment, and how clinicians can spot the signs in their clients.

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Key Discussion Points & Insights

1. On-Location Exposure: Practicing What They Preach

• Setting the Scene:

  • The hosts record from a public bathroom, underlining their commitment to experiential exposure, a key treatment tool for contamination-focused OCD.
  • "We are on location in a bathroom. We are in a public toilet. This is not AI. We are seriously sitting on the bathroom floor… Practice what we preach." —Dr. Celin Gelgec (02:02–02:52)

• Triggering Contamination Themes:

  • Discussion of how the episode's setting could be both challenging and therapeutic for listeners with contamination fears.
  • "If along the way, a few people's contamination themes are triggered and they have to engage in a bit of urge surfing, then I think that's great." —Dr. Tori Miller (02:55–03:03)

2. Therapist Realness: Breaking Down "Clean" Personas

• Therapist Fallibility:
  • Tori shares her experience with a child client who fears her therapist might be “contaminated,” and how therapists are, in fact, just as “gross” and human as everyone else.
  • "I imagine that you imagine that I'm actually this sort of beacon of cleanliness, but mate, I'm not." —Dr. Tori Miller (04:06–04:15)

3. Deep Dive: What is "Clean Girl Culture"?

• Defining the Trend:

  • Celin introduces “Clean Girl Culture,” a social media trend centered around simplicity, cleanliness, and an aesthetically “fresh” look, mainly targeting girls.
  • "I've been hearing about this phenomenon called Clean Girl Culture. It's all over TikTok… the idea of keeping a simple, clean wardrobe … fresh face, fresh brows, simple hairstyles, eating clean, all that kind of stuff." —Dr. Celin Gelgec (04:49–06:50)

• Comparisons to Orthorexia:

  • The hosts discuss parallels to orthorexia—when healthy habits become so extreme they become unhealthy—and how similar patterns may emerge with cleanliness and appearance.
  • "Orthorexia is when someone is dieting and exercising … to be healthy, but then it goes too far … they become unhealthy." —Dr. Celin Gelgec (05:03–06:04)
  • "They can't socialize with friends … there's not enough flexibility or they're incredibly preoccupied … they become extremely anxious or depressed." —Dr. Tori Miller (06:12–06:28)

• Cultural Paradoxes:

  • The contradiction of a “natural” look demanding complex rituals and a lot of time is highlighted.
  • "That in an attempt to look extremely natural and simple, it's actually quite a complex phenomenon that often takes, I would imagine, quite a long time." —Dr. Tori Miller (08:05–08:18)

• Social Belonging and Status:

  • Discussion on whether the pursuit of Clean Girl Culture serves as a form of social belonging or, at times, a feeling of superiority.
  • "I'm wondering if there is an 'I found my people' thing happening… or if there's a level of, dare I say, superiority." —Dr. Celin Gelgec (08:54–09:26)

4. When Does “Clean” Become Clinically Concerning?

• Defining “Too Far”:

  • The line between healthy and unhealthy is discussed as highly individual, grounded in values, flexibility, and impact on daily functioning.
  • "Whether something has gone too far, I think, needs to be incredibly individual… have you strayed off course relative to your own personal wishes, desires, values?" —Dr. Tori Miller (12:29–12:39)

• Warning Signs to Watch:

  • Shrinking flexibility, social withdrawal, preoccupation and distress, and the role of trends and need for control are highlighted as possible warning signs.
  • "All of that shrinks, right? So that's when you know it's going too far." —Dr. Celin Gelgec (12:01–12:05)

5. Clinical Overlaps: When Culture Masks OCD

• Compulsions Hidden in Plain Sight:

  • Clean Girl Culture can serve as a mask for compulsive behaviors—vigilant checking, reassurance-seeking, or strict adherence to routines—which could reinforce underlying OCD.
  • "Someone could be engaging in some of these things really compulsively, but it's masquerading as clean girl culture… it could be sort of hiding in plain sight." —Dr. Tori Miller (16:21–16:36)

• Social Reinforcement:

  • The hosts highlight the danger that compulsive behaviors can be positively reinforced by social media, echoing similar dynamics found in eating disorders.
  • "Someone could be really suffering and yet be, like, on socials, getting a lot of compliments … when really there's just a minefield of distress underneath it all." —Dr. Tori Miller (17:31–17:44)

6. Advice for Clinicians: Curiosity and Compassion

• Probing Gently:
  • Clinicians are encouraged to ask open questions and gently explore the underlying values, flexibility, and impact of these behaviors in their clients’ lives.
  • "If this is resonating with a lot of people or you might be thinking this might be some of my clients… be curious about it. Ask the questions and start from there." —Dr. Celin Gelgec (17:44–18:03)

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Notable Quotes & Memorable Moments

• Immersive Exposure:
  "We are on location in a bathroom… down and dirty. Practice what we preach."
  —Dr. Celin Gelgec (02:02–02:52)

• Therapist Humanity:
  "I imagine that you imagine that I'm actually this sort of beacon of cleanliness, but mate, I'm not… I am human."
  —Dr. Tori Miller (04:06–04:16)

• Cultural Paradox:
  "In an attempt to look extremely natural and simple, it's actually quite a complex phenomenon."
  —Dr. Tori Miller (08:05–08:18)

• Clinical Red Flags:
  "That's when you know it's going too far … All of that shrinks."
  —Dr. Celin Gelgec (12:01–12:05)

• Culture Masking Compulsions:
  "Someone could be engaging in some of these things really compulsively, but it's masquerading as clean girl culture."
  —Dr. Tori Miller (16:21–16:36)

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Important Timestamps

• 02:02–02:52: Setting the scene — recording in a public bathroom; exposure in action.
• 04:06–04:16: Therapist realness—dispelling the myth of therapist as cleanliness icon.
• 04:49–06:50: Defining Clean Girl Culture and discussing its rise on TikTok.
• 08:05–08:18: Paradox of the “natural” aesthetic requiring complex routines.
• 12:01–12:05: Signs that perfectionism and rigidity are becoming problematic.
• 16:21–16:36: When compulsions are masked as wellness.
• 17:44–18:03: Advice for clinicians—curiosity and asking open-ended questions.

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Takeaways for Clinicians

• Model Experience: Don’t just recommend exposure—demonstrate it where appropriate.
• Monitor Wellness Trends: Engagement with trends like “Clean Girl Culture” can signal the emergence or masking of OCD symptoms.
• Measure Impact, Not Just Behavior: The threshold for concern is not abstract standards of “health” or “cleanliness,” but functional impairment and loss of flexibility.
• Stay Curious and Compassionate: Explore each client’s motivations, values, and functioning individually; avoid assumptions.

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Next Episode Teaser:
"Who knows where our location is going to be next. Think of OCD themes and you can be creative with the locations." —Dr. Celin Gelgec (18:18)

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Transcript

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[Dr. Celine Gelgich]

Hi, I'm Dr. Celine Gelgich.

[Dr. Tori Miller]

And I'm Dr. Tori Miller. Welcome to Breaking the Rules. On Breaking the rules, we talk about all things OCD.

[Dr. Celine Gelgich]

Obsessive compulsive disorder. OCD impacts up to 1 to 2% of the population. We are here to provide not just education, but to inspire clinicians, families and people who are impacted by OCD to be able to access the treatment they need in order to get better.

[Dr. Tori Miller]

Catch us every fortnight wherever you get

[Dr. Celine Gelgich]

your of the house.

[Dr. Tori Miller]

This is new.

[Dr. Celine Gelgich]

Very new. Change of location. We are on location in a bathroom. We are in a public toilet. This is not AI. We are seriously sitting on the bathroom floor. This is not AI generated crap.

[Dr. Tori Miller]

Not a pre cleaned bathroom either.

[Dr. Celine Gelgich]

No, just your regular Joe Public toilet.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

I mean look at these. Beautiful.

[Dr. Tori Miller]

I mean it's adorable.

[Dr. Celine Gelgich]

It even speaks to its era.

[Dr. Tori Miller]

Yeah, it's cute. The pink is cute.

[Dr. Celine Gelgich]

It's gorgeous.

[Dr. Tori Miller]

I love it. Yes.

[Dr. Celine Gelgich]

I do love it.

[Dr. Tori Miller]

Nice blush. Pink.

[Dr. Celine Gelgich]

Yes. Yeah. Adds to the lighting.

[Dr. Tori Miller]

Yeah. We just thought this would be really fun.

[Dr. Celine Gelgich]

Yes. Because we Wanted to. Well, I mean, my thinking was we could. I know you'd be similar. Get in there and down and dirty. Yeah. And.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Practice what we preach.

[Dr. Tori Miller]

That's right.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

All right.

[Dr. Tori Miller]

I mean, look, if along the way, a few people's contamination themes are triggered and they have to engage in a bit of urge surfing.

[Dr. Celine Gelgich]

Yep.

[Dr. Tori Miller]

Then I think that's great.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Happy to help.

[Dr. Celine Gelgich]

Yes. So if you're listening, go to YouTube and watch us for this episode. Yeah. It's also a smart way of getting you to Watch us on YouTube to check us out in the butt. And if you want to treat it as an exposure exercise, go for your life.

[Dr. Tori Miller]

Yeah, yeah, yeah. So this is something that you can do if you have contamination them, OCD or if you're a practitioner. You can sit.

[Dr. Celine Gelgich]

Yep.

[Dr. Tori Miller]

Yep. We're actually just talking just before we started recording about how one of my little clients.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Bless her. Had said that she didn't like the idea that I might do something disgusting because then I would be contaminated and she couldn't come and see me again in. In person. We'd have to. We'd have to do telehealth.

[Dr. Celine Gelgich]

How dare you be a disgusting person.

[Dr. Tori Miller]

And I empathize with her. And then said, yeah, but here's the thing. Like, I do disgusting things, like, every day.

[Dr. Celine Gelgich]

Yeah, we do. We're pretty gross.

[Dr. Tori Miller]

And I imagine that you imagine that I'm actually this sort of beacon of cleanliness, but made. I'm not.

[Dr. Celine Gelgich]

I am human.

[Dr. Tori Miller]

And I trust and I believe that

[Dr. Celine Gelgich]

you can handle 100.

[Dr. Tori Miller]

My capacity for disgustingness. Yes. Case in point.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

I can't wait to tell her I see you next week. I can't wait.

[Dr. Celine Gelgich]

Yeah, I know. Right. And every other client.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And even some of our team members, perhaps.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

We won't name names. No. We love you all. All right.

[Dr. Tori Miller]

But you wanted to tell me about Clean Girl Culture, which we thought was a good topic for sitting on the bathroom floor.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

So tell me about Clean Girl Culture.

[Dr. Celine Gelgich]

I wanted to just have, like, a little bit of a discussion episode slash. Let's talk about this.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

I've been hearing about this phenomenon called Clean Girl Culture. It's all over TikTok.

[Dr. Tori Miller]

I'm sure it's going to enrage me.

[Dr. Celine Gelgich]

Yes. And look, no judgment, no shame. It's a safe space, all of that. I wanted to talk about it because I wanted to raise the idea or the concern of how far is too far. Right. So just like with anything, like, when would you say, you know, There was a movement around moving our bodies and exercise and diet and all the rest. I mean, there always has been, but I think in the 2000s, it kind of got louder and louder, I think, through social media and stuff, becoming bigger and bigger. And we, you know, we were brought the idea of author, not the idea, but orthorexia was brought to our attention. And what orthorexia is, is when someone is dieting and exercising and all the rest of it to be healthy or with the desire to be healthy, but then it goes too far. And then coins, not coincidentally, but then they become unhealthy.

[Dr. Tori Miller]

Yeah. Because partly because maybe they're malnourished, but also partly because the impact on their life is so significant.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

That they actually become functionally impaired.

[Dr. Celine Gelgich]

That's right.

[Dr. Tori Miller]

They can't socialize with friends.

[Dr. Celine Gelgich]

Exactly.

[Dr. Tori Miller]

There's not enough flexibility or they're incredibly preoccupied with the thoughts of health.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

That in fact, they're. They become extremely anxious or depressed.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

So, yeah.

[Dr. Celine Gelgich]

It's very similar with clean girl culture.

[Dr. Tori Miller]

Right.

[Dr. Celine Gelgich]

Okay. But the idea of it is. Is this idea of, like, you know, keeping a. A simple, clean wardrobe. So, like, the way that you look and you dress, fresh face, fresh brows, simple hairstyles, eating clean, like all that kind of stuff.

[Dr. Tori Miller]

Like, not too loud, like you're talking, like.

[Dr. Celine Gelgich]

Neutrals. Neutrals. Yeah. All that sort of thing.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Natural going for the natural look. Yes. Natural makeup. Even though it's makeup.

[Aura Announcer]

Yeah.

[Dr. Tori Miller]

And there's often the fresh brows.

[Dr. Celine Gelgich]

Yeah, exactly. The polished look, I guess, is basically what it is mostly for girls or

[Dr. Tori Miller]

for girls and guys as well.

[Dr. Celine Gelgich]

That is a good question. I'm not too sure, but I've been hearing around, like, the idea of it for girls at the moment, but it triggered a thought for me in terms of that's all well and good. You do you. But at the same time, when does that go too far? In a very similar way would have for orthorexia, in a sense that. When do we become so preoccupied with the clean girl aesthetic or lifestyle that dinner with friends isn't dinner with friends anymore? It's I can only eat certain things or do certain things, or I can only look a certain way, or I can't leave the house because the way I want to look isn't just so. And I'm getting frustrated or my fresh makeup isn't actually looking like fresh makeup anymore, and I got to start again.

[Dr. Tori Miller]

Well, it's the paradox of these things, isn't it? Yes. That in an attempt to look extremely natural.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

And simple.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

It's actually quite a complex phenomenon that often takes, I would imagine, quite a long time.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Because what I'm imagining is actually a lot of time curating a wardrobe and potentially looking in the mirror. Yeah, I know that, that.

[Dr. Celine Gelgich]

Lots of checking.

[Dr. Tori Miller]

Yep, lots of checking. And I could. I mean, I guess I'm curious about what the motivation behind the clean culture is. I mean, people who identify with this esthetic or this lifestyle, what's it. Do you know what it's about? What the. Is it about an appearance in the way that they look? Is it about promoting? I don't know. What is it?

[Dr. Celine Gelgich]

I would say there's probably a bit of both going on in terms of not just how someone looks or wants to live in terms of what they consume. But I'm wondering, and I've often been curious about, would there be. And please don't shut me down for this. It's just. It's a thinking out loud. I'm wondering if there is a I found my people thing happening for some people who can identify with that, or if there's a level of, dare I say, superior superiority.

[Dr. Tori Miller]

Yeah, right.

[Dr. Celine Gelgich]

In terms of. I live my life like this, therefore it's better than what other people might. The way other people might live their. So their lives and all the rest of it and how they are so. But I don't. I mean, I haven't spent too much time on Tick Tock to get down to the. Yeah. To the thinking behind why.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

But that would be some of my thinking out loud. So what I'm looking for ramblings, I guess.

[Aura Announcer]

Yeah.

[Dr. Celine Gelgich]

Yeah. Does anything come to mind for you?

[Dr. Tori Miller]

Well, it brings me back, I think about that question you asked before, about what takes it too far.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Like what does too much look like?

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And the reason I asked that question is, you know, about what is it for? I think is partly how we help people think about.

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[Dr. Celine Gelgich]

Oh, no.

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[Dr. Tori Miller]

Whether they have gone too far.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

What was their initial aim? What were they hoping to feel or achieve? What is their value system?

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

What are their wishes?

[Dr. Celine Gelgich]

And.

[Dr. Tori Miller]

And therefore, if they are engaging in this sort of lifestyle, are you, you know, living according to your values? How's your mental health? How's your anxiety? How's your ability to be flexible, to be spontaneous?

[Dr. Celine Gelgich]

Which shrinks. All of that shrinks. Right. So that's when you know it's going too far.

[Dr. Tori Miller]

Yeah. And. Yeah. How's your ability to maintain connections with other people? And. And also I think about within all of that sort of measures of health, beyond just, you know, what you're eating, how you're moving your body. Yeah. You know, the size of your. The size of your clothes and things.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And so I think the question of how. Whether something has gone too far, I think, needs to be incredibly individual.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Because I think, for me, makes me think of that idea about have you strayed off course relative to your own personal wishes, desires, values. Yeah.

[Dr. Celine Gelgich]

I think that's a fair yardstick. Yeah. And an important question to ask, especially if clients are presenting in that way or if there's a change in the way they're presenting. I think those points of. The points that you've raised are a good measurement.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

In terms of being able to determine when it's gone too far.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Another thing that came to mind as soon as you were talking in terms of the. Why would be just picking up on a trend?

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Sometimes I think people just get caught up in trends, especially when it's all over TikTok or something like that and everyone else is doing it because we do. We like to follow trends. We like to be part of the pack.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

We like to not get left behind, or we might just give it a go.

[Dr. Tori Miller]

And some of this stuff looks super cute, Right.

[Dr. Celine Gelgich]

It does. And it looks so cool and easy.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

As well. And sometimes you might be like, oh, you know, if you feel like your life's a bit chaotic, like, oh, this is a nice, simple thing to subscribe to, but then you realize it's actually more effort than it's worth. And even so, like. And sometimes it's a matter of control or a need for control because everything else might feel chaotic. So this is a nice way of just toning it back and re obtaining some control in my life. Yeah. So I think there's some other couple of reasons that came to mind. Yeah. But yeah. So I thought it would be an interesting thing to talk about. Don't. Just to bring to people's attention. Because I am a self confessed millennial, obviously. And not confirm it. Not even. That sounded weird. But it's just so random. I am a millennial and don't spend too much time on Tick Tock typically. As most of us do.

[Dr. Tori Miller]

I went on TikTok once.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And I was so overwhelmed. Had to get off straight away.

[Dr. Celine Gelgich]

I know it's really full on. It's really full on.

[Dr. Tori Miller]

And also I paused for like two seconds on a video and then it fed you about Adele. You know, my feed is just full of bloody Adele videos. Concerts.

[Dr. Celine Gelgich]

There you go. But you love Adele, don't you know? Yeah. So it's one of those things I thought it would be good to talk about because we don't spend a lot of time on socials as we probably should. But one that I thought, you know what? This could very well blend into OCD territory in terms of the over needing the potentially when it goes too far. Things like seeking lots of reassurance, lots of clarification around look and aesthetic. Lots of checking behaviors, lots of agitation and frustration because things don't look or feel a certain way. Another thing that could happen is potentially an over concern for contamination as well. Whether it be through not just what people are consuming in their body, but also then being preoccupied with wanting certain types of makeup that are organic or whatever like this. It could be that as well. Or changing all your cooking from Teflon to stainless steel or whatever else it might be. So think real. Like.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

I could really imagine taking it to the next level.

[Dr. Tori Miller]

It flaring up contamination fears.

[Dr. Celine Gelgich]

100. Yes. Yeah.

[Dr. Tori Miller]

Order and symmetry things.

[Dr. Celine Gelgich]

Yes. As well. Yeah. For sure. Yeah. So.

[Dr. Tori Miller]

And I could also. You know what I was thinking just now is that I could also imagine that someone could be engaging in some of these things really compulsively.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

But it's masquerading as clean girl culture.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Which could then be excused. Be excused. And that someone could have a lot of meaning attached to the compulsions that they're doing. And it could be sort of hiding in plain sight, so to speak. Which might mean that someone either doesn't recognize that things have gone too far and under the guise of. Of kind of doing it right or. Or whatever that underlying drive and motivation is, that it might really reinforce and maintain the. The ocd.

[Dr. Celine Gelgich]

Yep.

[Dr. Tori Miller]

Or that other people might not recognize it and might sort of applaud you for it. Which kind of has that sort of overlap with eating disorder culture. You know, where sometimes people are when

[Dr. Celine Gelgich]

you start losing weight and stuff.

[Dr. Tori Miller]

Yeah. That they're not doing well at all. And in fact, their mental health is quite poor. Yet they often get a lot of compliments.

[Dr. Celine Gelgich]

Yeah. For how they look changes and.

[Dr. Tori Miller]

And I could really see that here. That someone could be really suffering.

[Dr. Celine Gelgich]

Yep.

[Dr. Tori Miller]

And yet be like on. On socials, getting a lot of compliments for how well they look and the choices that they're making and how effortless

[Dr. Celine Gelgich]

things seem like when really there's just a minefield of distress underneath it all. Yeah. Yeah. So if this is resonating with a lot of people or you might be thinking this might be some of my clients. Be curious about it. Ask the questions and start from there.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Interesting. I'm going to go and have a look.

[Dr. Celine Gelgich]

I know. And I really need to dig. I'm going to go down a rabbit hole. I can feel

[Dr. Tori Miller]

is your way.

[Dr. Celine Gelgich]

It is my way.

[Dr. Tori Miller]

All right. This has been fun.

[Dr. Celine Gelgich]

Yeah. Thank you guys so much for watching. Who knows where our location is going to be next. Think of OCD themes and you can be creative with the locations. Yeah, that's right. Yeah. Yeah. All right, bye.

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[Dr. Celine Gelgich]

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[Aura Announcer]

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