OCD and Productivity: The Struggle Behind the Scenes

Summary

Podcast Summary: Breaking the Rules – OCD and Productivity: The Struggle Behind the Scenes

Episode Details

Hosts: Dr. Celin Gelgec and Dr. Tori Miller
Release Date: April 6, 2026
Podcast: Breaking the Rules: A Clinician's Guide to Treating OCD
Episode Theme: Exploring the impact of OCD on productivity in academics and the workplace, the hidden nature of these struggles, misdiagnosis challenges, and practical strategies for clinicians and clients.

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Episode Overview

This episode focuses on a critical but often unspoken dimension of OCD: how it disrupts productivity in education and the workplace. Dr. Celin Gelgec and Dr. Tori Miller discuss how OCD can manifest behind the scenes, sabotaging efficiency, fostering despair, and often masquerading as diligence or even being mistaken for conditions like ADHD. The hosts aim to raise clinician awareness of these hidden struggles and offer concrete, compassionate strategies for supporting clients whose OCD seriously hinders their daily functioning.

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Key Discussion Points & Insights

1. OCD’s Hidden Impact on Productivity

• OCD as a Catalyst for Seeking Therapy:
  • OCD’s interference in work or study is often the “final straw” that prompts people to seek help (05:14).
  • “That feeling of ineffectiveness or stuckness at work can really be a point at which people say, enough is enough.” – Dr. Tori Miller [05:14]
• Difficulty Representing Abilities:
  • Sufferers struggle to showcase their intelligence or skills due to distressing symptoms, leading to frustration and hopelessness, especially among students.

2. How OCD Masks Itself As Diligence

• OCD Traits Rewarded by Society:
  • OCD-driven behavior often appears as positive traits (hard-working, rule-following, studious) and garners praise from parents and teachers (07:03-07:29).
  • “It kind of is easily hidden as all those traits parents and society reward… as being the hard worker.” – Dr. Celin Gelgec [07:24]
• The Agony Beneath Productivity:
  • Hours spent “studying” or “working” may mask anxiety-fueled repetitive behaviors – rereading, checking, rewriting – which greatly reduce true productivity (07:34-08:08).

3. When OCD Looks Like Avoidance or Inattention

• Paralysis and Avoidance:
  • Overwhelming compulsions can drive avoidance: not starting tasks, avoiding the workspace, taking excessive sick days (09:09-09:51).
  • “It can be mislabeled as laziness or lack of motivation, whereas, in fact, they really wish they could be doing their work.” – Dr. Tori Miller [09:25]
• Misdiagnosis with ADHD and Learning Difficulties:
  • The overlap of symptoms (preoccupation, poor focus, rabbit-holing on details) often leads to confusion with ADHD or learning disorders (15:44-16:15).

4. Understanding Clinical Presentation

• Distinct from Perfectionism:
  • While some perfectionism is normal, OCD leads to paralysis – e.g., hours spent on a short email, repeatedly checking and seeking reassurance (10:00-11:29).
  • “There is a difference… between someone who is fastidious or conscientious…and what we’re talking about, which is people paralyzed.” – Dr. Tori Miller [10:13]
• Emotional Toll:
  • Clients are left exhausted, doubting themselves, and sometimes mislabelled by family or educators (15:13-15:44).

5. Differentiating OCD from Other Neurodevelopmental Conditions

• Importance of Functional Assessment:
  • Clinicians are urged to listen for impacts on daily life and to consider OCD in initial assessments, even if the referral is for ADHD (16:16-19:36).
  • “It’s not just about what you’re ruling in, it’s what you’re ruling out as well. …have OCD be on your radar.” – Dr. Tori Miller [19:18-19:36]

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Practical Strategies for Clinicians and Clients

1. Target OCD First (ERP/ACT) but Support Executive Functioning

• Focus on Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and mindfulness as first-line treatments [21:41].
• Simultaneously help clients set practical boundaries and limits around compulsive behaviors.

2. Coping Strategies for Productivity

• Intention Setting & Mindful Attention Shifting:

  • Notice intrusive thoughts and gently redirect focus back to the intended task, even if it requires constant readjustment (22:55-24:23).
  • “You cannot control your intrusive thoughts…but what you can do is redirect your attention back.” – Dr. Tori Miller [23:05]

• The “Good Enough” Approach:

  • Encourage clients to embrace “good enough” rather than perfection, using templates (especially for emails or notes) as scaffolding [24:25-25:22].
  • “Accepting what a good enough email looks like. Letting go of perfection…using templates.” – Dr. Tori Miller [24:41]

• Set Physical Limits and Time Boundaries:

  • Restrict the number of “checks” before submitting work; set time-boxed tasks with alarms for both research and writing (26:09-26:58).
  • “Give themselves a limit of checks… setting alarms, clients would find really helpful.” – Dr. Celin Gelgec [26:09]

• Strategies for Reading/Note Taking:

  • Using a finger as a physical guide when reading to anchor attention (25:33-25:54).
  • Limiting the scope of research (e.g., number of articles) and summarizing within set periods.

3. Rebuilding Self-Trust

• Paradox of OCD and Productivity:
  • The more someone relies on compulsions to “get it right,” the less productive and satisfied they are (28:00-28:32).
  • “One of the biggest things…is people lose trust in themselves…They start trusting the compulsion.” – Dr. Celin Gelgec [28:14]
• Encouraging Experiential Learning:
  • Clients can’t restore self-trust intellectually; they need to take risks and experience that it is safe (28:47-29:15).
  • “You can’t do that intellectually. You have to do that experientially.” – Dr. Tori Miller [28:47]

4. Additional Practical Suggestions

• Bring Movement, Food, and Sleep:
  • Move around when stuck, stay hydrated, eat well, prioritize sleep, and study or work when fresh [29:46-30:21].
• Self-Compassion and Realistic Goal-Setting:
  • Practice kindness toward oneself and avoid working in isolation (30:21-30:48).
• Value-Driven Motivation:
  • Anchor goals in personal or professional values to build motivation, accepting flexibility in how those values are met (30:48-31:46).
  • “Show up at work as a reliable teammate…What goals do I have to set for this week to be able to help me do that?” – Dr. Celin Gelgec [31:18]

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Notable Quotes & Memorable Moments

• On the Visibility of OCD’s Struggle:

  • “It’s exhausting…it’s definitely easy to hide, because it comes across…I think for me…as personality characteristics: diligence… dedicated… But that hours and hours at the desk is agony.” – Dr. Celin Gelgec [06:44-07:34]

• On Misdiagnosis:

  • “The preoccupation and the lack of attention…and the rabbit-holing…is very almost identical [to ADHD]…That overlap can lead to a lot of misdiagnosis and ineffective treatment.” – Dr. Celin Gelgec [15:44-16:08]

• Rebuilding Trust:

  • “I’m asking you to trust that your mind and your body will know when you are actually doing the wrong thing, not when OCD says… So I’m asking you to step off this cliff… I'm telling you there’s a safety net at the bottom.” – Dr. Celin Gelgec [28:47-29:04]

• On Compassion:

  • “Bring compassion for yourself into the struggle that you’re having. And don’t try to do it by yourself.” – Dr. Tori Miller [30:33-30:47]

• On Outcomes:

  • “A C is better than an F.” – Dr. Celin Gelgec [32:29]

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Timestamps for Important Segments

• 05:14 – Work/academic struggles as a trigger for seeking help
• 07:03-07:29 – Societal/parental reward of OCD-related traits
• 09:25 – Avoidance mistaken as laziness
• 10:00-11:29 – Difference between perfectionism and OCD paralysis
• 15:44-16:08 – Overlap with ADHD/learning disorders
• 19:18-19:36 – Importance of ruling out vs. ruling in diagnoses
• 22:55-24:23 – Intention setting and attention-shifting strategies
• 24:25-25:22 – The “good enough” approach and use of templates
• 26:09-26:58 – Setting limits for checking and reassurance
• 28:14-28:47 – Loss of trust in self, reliance on compulsions
• 30:33-30:47 – Compassion and support
• 31:18-31:46 – Value-driven goal setting for motivation
• 32:29 – Accepting “good enough” outcomes

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Episode Tone

The episode maintains a warm, conversational, and compassionate tone. Both clinicians are supportive, realistic about the emotional challenges, and practical in their advice—intertwining validation with encouragement for both fellow clinicians and those impacted by OCD.

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Summary Takeaways

• OCD’s impact in the workplace and academic settings is profound yet often invisible, masked by socially rewarded traits or misunderstood as other neurodevelopmental disorders.
• Clinicians must be vigilant for hidden OCD presentations, differentiate them from ADHD/learning issues, and consider functional impacts—not just observable behaviors.
• Effective treatment hinges on addressing OCD at its core (ERP, ACT, mindfulness), but also on empowering clients with practical strategies to reclaim productivity and self-trust.
• Compassion, gradual goal-setting, and value-driven approaches are essential in helping sufferers move from paralysis and avoidance toward meaningful achievement.

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For clinicians and carers: keep OCD on your radar, look for the hidden struggles, and balance treatment with strategies that foster real-world functioning and self-compassion.

Transcript

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[Dr. Tori Miller]

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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]

Every fortnight, wherever you get your podcasts. Hello. Hello.

[Dr. Celine Gelgich]

How are you? I'm all right.

[Dr. Tori Miller]

I'm all right, yeah. Just, you know, I don't know.

[Dr. Celine Gelgich]

These intros we always find awkward, don't we?

[Dr. Tori Miller]

They're so awkward because we've been hanging out.

[Dr. Celine Gelgich]

Well, I had been talking for 20 minutes. No, now we're sitting here, I have

[Dr. Tori Miller]

to pretend like I'm just. I just happened upon this studio and this microphone and now I'm just hanging with you.

[Dr. Celine Gelgich]

This is how we hang all the time. That's right.

[Dr. Tori Miller]

I know.

[Dr. Celine Gelgich]

That's right. Yeah.

[Dr. Tori Miller]

But this is the first episode we're recording.

[Dr. Celine Gelgich]

Post baby.

[Dr. Tori Miller]

Post baby. Welcome back.

[Dr. Celine Gelgich]

Welcome back. Got evicted. That's enough mooching off my body. Out you get. It's going well.

[Dr. Tori Miller]

Yeah, yeah.

[Dr. Celine Gelgich]

Can't complain.

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Yeah.

[Dr. Celine Gelgich]

Big sisters having massive. All the feelings. All the feelings. But, you know, can't say how much of a psychologist I am in those moments, you know, you're not supposed to be. You're a mum. But like.

[Dr. Tori Miller]

No, that's right.

[Dr. Celine Gelgich]

No, we're dealing with it.

[Dr. Tori Miller]

Yeah, yeah. It's so true, though, isn't it? As a psychologist and a parent or a psychologist and a friend, like the dual roles and navigating that.

[Dr. Celine Gelgich]

Yeah. Oh, yeah, yeah, yeah. It's always tricky.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And then the expectation we put on ourselves, like we have to be the perfect parents.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

This is going to turn into another whole episode juggling that. Yeah, yeah.

[Dr. Tori Miller]

But no, no, I agree. When I had my girls, I felt like my knowledge was like a gift. It certainly helped.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

But then there were times where I felt like I knew too much or it was hard because, you know, just because, you know, it doesn't mean it's easy to implement it.

[Dr. Celine Gelgich]

100. Yeah. We have our own baggage, we have our own triggers, we have our own life experiences, upbringings.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

All of that comes up. Yeah, yeah, yeah.

[Dr. Tori Miller]

Absolutely.

[Dr. Celine Gelgich]

Lots to sit with. I've been doing lots of sitting in discomfort these past three months now. Oh, my God, it's gone so fast.

[Dr. Tori Miller]

I know. Yeah, I know.

[Dr. Celine Gelgich]

Crazy times.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Little bubba's three months old.

[Dr. Tori Miller]

I know, it's amazing. Yeah, yeah.

[Dr. Celine Gelgich]

But here we are.

[Dr. Tori Miller]

Yes. All right, today's topic.

[Dr. Celine Gelgich]

Let's launch right into it. What are we talking about today?

[Dr. Tori Miller]

Well, this is one. An area that I find very interesting, and I reckon it comes up a lot, which is the impact of OCD on studying.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

And on just working in general.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

And I think that there's. I just find that a lot of clients bring it up or in fact. Okay. I think that the impact that it has for adults in the workplace is often a catalyst for people coming to therapy, because that feeling of ineffectiveness or stuckness at work can really be a point at which people say that, you know, enough is enough. But also, I think for the teens that we work with and the young adults who are trying to study at uni, it's a space that brings a lot of hopelessness and despair and frustration because they feel like they can't represent their abilities or their intelligence or their academic skills enough because they. They're grappling with their OCD symptoms.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And so it's a really important aspect, I think, of. Of the. Of what we can offer a psychologist, how to understand and how to. How to sort of support yourself. But I also think that a lot of people, when. I mean, this is like, you know, going back, we've talked about this over and over about the idea of,

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you

[Dr. Tori Miller]

know, the hidden nature of OCD and how impactful it is, but how people often, they don't see the struggle.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And I. So I think for just people listening, I think it's really good to know that if, you know, someone with ocd, this, you know, this is the kind of daily struggle that they have to contend with.

[Dr. Celine Gelgich]

Yeah. And it's exhausting.

[Dr. Tori Miller]

Yeah, yeah, yeah.

[Dr. Celine Gelgich]

It's definitely easy to hide because it comes across, I think for me, you. You see it a lot in year 10, 11, 12, students finishing high school, or like you said, uni and workplace. Most definitely. But it comes across in terms of personality characteristics. Diligence.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And, you know, if you want to, for lack of a better word, the teacher's pet kind of thing. The rule follower.

[Dr. Tori Miller]

Yep.

[Dr. Celine Gelgich]

The person who wants to do the right thing, the polite student, the one who doesn't, you know, the dedicated. The dedicated one. All that sort of stuff.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

You often see.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Being. And then the studious one.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

Right. So it kind of is easily hidden as all those traits. Parents rewards.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And society rewards as well.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

As being the hard work hours now

[Dr. Tori Miller]

is at your desk. Yeah, yeah.

[Dr. Celine Gelgich]

But that hours and hours of the desk could. Is just things like. Is agony in a sense that there's lots of rereading happening and uncertainty and rewriting things.

[Dr. Tori Miller]

Yeah. And that's why I think what a lot of people talk about isn't it is that they're spending. That they, they don't feel efficient or effective, that they might be spending a lot of time at work or going over a document or, you know, whatever. But in fact, for the two or three hours that they spent, they were only effective for 30 minutes of that time.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And that's a. That's a really difficult thing to experience.

[Dr. Celine Gelgich]

A massive waste of time. Yeah.

[Dr. Tori Miller]

Oh, yeah.

[Dr. Celine Gelgich]

And it's frustrating too.

[Dr. Tori Miller]

Oh, yeah, completely.

[Dr. Celine Gelgich]

So these are some of the ways that it shows up. Right. Like in the workplace, it can show up looking like. So if you're assessing a client, these are some of the things to look out for. Multiple checks of emails before hitting send. Lots of asking for clarification, lots of meetings requested, checking ins and all the rest. Check ins and all the rest of

[Dr. Tori Miller]

it might be missed deadlines.

[Dr. Celine Gelgich]

Yes, Missed deadlines. Or falling way behind at work. Another way, especially in at uni, would be constantly asking for extensions. Lots of reassurance, Lots of reassurance seeking. Lots of highlighting of articles, the textbook, all of it. In younger years in high school, it can look like what we described before of the diligence, the hard worker, the studious one. Hours and hours being locked away in study and just feeling irritated and agitated going, you got to come out for dinner. No, I've got to study for this test. You don't understand what, that you know, I'm going to fail. Lots of tears, lots of meltdowns.

[Dr. Tori Miller]

Well, the opposite can also be true, actually.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

You know, because I mean, yes, there's a fastidiousness, but there's also kids who will avoid 100 doing their work at all because it's so painful or they're so scared of their desk space that they, that they don't want to get started.

[Dr. Celine Gelgich]

Yeah. I'm glad you mentioned.

[Dr. Tori Miller]

And so there can be that tension around, why aren't you doing your homework? It can look like it can be mislabeled as laziness or lack of motivation. Absolutely. Whereas in fact, they really wish that they could be doing their work. Yeah, yeah. They're trying to.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

They want to avoid that space.

[Dr. Celine Gelgich]

And I think the same would go for uni or.

[Dr. Tori Miller]

I think so. Yeah.

[Dr. Celine Gelgich]

You know, failed Subjects at the workplace.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Not turning up to work or taking lots of days off.

[Dr. Tori Miller]

Yep.

[Dr. Celine Gelgich]

Just massive avoidances for fear of not being able to deal with the intense compulsions and checking and whatnot and reassurance seeking that happens.

[Dr. Tori Miller]

And the, the. I mean, we can't stress enough. I mean, I think again, like, this is. This is where, you know, the difference between someone who is fastidious or conscientious or. Yeah. Perfectionist, singer might just have some anxiety. I might have a strong sense of responsibility or, you know, want to be really good at their job, who might, you know, reread an email or draft something, you know, a few times. I mean, I certainly do that. But there is a difference between that and what we're talking about, which is people paralyzed.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Paralyzed in this moment. Unable to press send on an email. Sometimes spending hours on a single email. And the email doesn't even have to be something that's particularly important. It's not like people are getting stuck because they've. They're firing someone and they. They're trying to figure out the nicest way to do it. We're talking about someone. Look, it could. It could be completely. A completely neutral topic and people going over and over and over and then perhaps once the email is sent, going back over and over and again, rereading, rereading. Looking for mistakes, afraid that there was something, that there was an error in there. Seeking out reassurance from the recipient. So just, you know, like a whole day or hours of a day spent preoccupied with a single email because they're afraid of causing harm.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

You know.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Events offending somebody. Yeah, It's.

[Dr. Celine Gelgich]

Which is painful.

[Dr. Tori Miller]

Extremely painful. So we're talking about really. I mean, you know, we're not talking about being anal.

[Dr. Celine Gelgich]

We're talking about talking about type A personality. We're talking about people who are generally. I'm not saying they don't suffer either, but like, you know, it's. It's like paralysis, I think, is a word you mentioned.

[Dr. Tori Miller]

And it's.

[Dr. Celine Gelgich]

I think it's a really wonderful way of describe. A nice way of describing it in a sense that it really is a form of paralysis.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And. And a stuckness.

[Dr. Tori Miller]

Yes. And teens that, that we talk to are often unable to get their work done. Yeah. And I mean, I've talked with. With plenty of kids, as you will have, Celine, who have a literature book that they have to read and they can't do their assignments or their tests, but they can't get past the first page because the compulsion to read and reread and reread and reread. Because what if I miss something? What if I didn't properly understand or comprehend that? What if I misunderstood or, you know, for some people, if there's a contamination theme or a harm theme, they're reading, but they're having to avoid all words that start with T. So they're scanning for danger. So while they're, they're reading a text, they're not actually comprehending any of the information because they're scanning for dangerous words or triggering words. I mean, how are you supposed to then go and do a test or write, write an essay on.

[Dr. Celine Gelgich]

Yeah, exactly.

[Dr. Tori Miller]

On that, on that text if you haven't even been able to read the fucking thing?

[Dr. Celine Gelgich]

Yeah, exactly.

[Dr. Tori Miller]

It's, it's. We're talking about something that is really. Because in terms of the day to day demands, kids go to school, people study for a vocation, for their career, people go to work. This is like fundamental day to day stuff that OCD messes with.

[Dr. Celine Gelgich]

Absolutely. And it makes it impossible to function and it's exhausting. Like, I know a lot. It's one of the first things I often say to my clients is I'm always, I'm amazed at how they're still functioning.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

With all of that mental work that's going on, all of those mental compulsions that are happening, the checking, the reread or everything we've been talking. Everything you've been talking about,

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[Dr. Celine Gelgich]

it's just so tiring. So you can imagine why there's massive meltdowns and tears and whatnot from younger people at the end of the day or during the day because they're just so exhausted because there's so much going on. But the other thing I often notice is they start to think, what's wrong with me? Yeah. Am I dumb? Am I stupid? Am I all the rest of it?

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And so it can then trigger things unnecessarily.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Like looking into, does this person have a learning difficulty? Do they have adhd?

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Because the preoccupation that someone experiences and the lack of attention and focus or the rabbit holing that can occur on specific things that are triggering for OCD is very. Almost identical.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And so I think that overlap can lead to a lot of misdiagnosis as well and ineffective treatment.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And it's not to say that people don't have a co occurring condition. Yep, very much so. But oftentimes. No.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

And so it can get really tricky. Can get really. When we're assessing for someone, have a listen for all the things that you've been talking about and that we've mentioned, but also have a think about what is the functional impact on this person.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And how much is it impacting day to day? How intense is it, what's going on for them and how, you know, what, how can we use that to then go, okay, I think this is OCD that's happening here. Yeah, yeah. So I think that's an important distinction between that and an executive function difficulty.

[Dr. Tori Miller]

Yeah, yeah, that's exactly right. Yeah. Yeah. And I think that, I think that you raise a really good point because there are plenty of people who have co occurring difficulties. And so sometimes, sometimes, you know, the pathway to find that out is intervention.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

And experimenting with different, different strategies and different tools. See what works, what doesn't, what you're left with.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Once OCD is cleared up or sort of reduced in intensity, what difficulties are left. Yeah, absolutely. But I think there's also, I think especially I think in kids Although that may not necessarily be true, but sometimes I think people think ADHD before they think anything else.

[Dr. Celine Gelgich]

Really.

[Dr. Tori Miller]

People are. Have a greater awareness of what ADHD looks like or have that sort of sense of everyone else can focus. Why can't I maybe have adhd? So sometimes that'll even be the, you know, actually be. The referral question will actually be about ocd.

[Dr. Celine Gelgich]

That's exactly right.

[Dr. Tori Miller]

Yeah. It'll be about adhd.

[Dr. Celine Gelgich]

Yeah. Oftentimes it will. I think that does come first.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Yeah. Especially in kids.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Because kids by nature can't sit still.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

You know, and all the rest of it. And find it hard to do all the things while they're little, they're learning. And so you'll hear parents talk about, oh, they were a nightmare when they were little. They would do this and they would do that and they would do it. And you're thinking, okay, but they were 2 years old or 3 years old or 4 years old or whatever it is. But there's different levels of that too. And everyone's experience, I think is relative. But. And, and real. And I think it, it really is. I think the first question that comes up. Well, for me, anyway, thinking back to all the clients I've worked with in the past a little is anyway, yeah. It's oftentimes been behavior based or attention concentration school based results like they're not performing or they're not whatever or they're too anxious or they're whatever else it is. And then when you dig deeper, you're like, this is ocd.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

So it's important to get that.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Right. And I don't mean to say this to scare our listeners and go, oh my God, I gotta figure out, oh my God, have I stuffed up all my ADHD diagnosis. Do they actually have OCD in? But it's really just to highlight and go, don't ignore it. No, I think like. Well, I think it's an important differential.

[Dr. Tori Miller]

Yeah. When we're doing clinical assessments, I think, well, certainly this was way that, you know, that I was trained.

[Dr. Celine Gelgich]

Yeah.

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[Dr. Tori Miller]

Is, you know where I think I've said this before, it's not just about what you're rolling in, it's what you're ruling out as well. And I think all we're saying is when you're doing an assessment, even if the referral question isn't specifically for ocd, is to have OCD be on your radar.

[Dr. Celine Gelgich]

Yeah, exactly.

[Dr. Tori Miller]

Just, you know.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Throw in a few questions.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Be curious Exactly.

[Dr. Celine Gelgich]

Or when you're hearing people describe their day. Day to day life.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

And it's sounding similar to the things we've been describing.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Then your antenna should go up.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

Okay.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

I think this might be ocd.

[Dr. Tori Miller]

Yeah. Yeah.

[Dr. Celine Gelgich]

Either as well or instead.

[Dr. Tori Miller]

Yeah. Yeah. Agreed.

[Dr. Celine Gelgich]

Yeah. So I don't. Yeah. Like I said before, I don't want to freak people out. It could still be both. Like. But don't discount it or don't not think about it. Have it on your radar, I think is a good way to put it.

[Noom/Advertisement Voice]

Yeah.

[Dr. Tori Miller]

So thinking about executive dysfunction.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

And ocd.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

The mental fatigue, the competing demands for attention.

[Dr. Celine Gelgich]

Yeah. And it can physically look as well. Like just on that I would. Working like when I was working at the hospital, even sometimes with clients.

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[Dr. Celine Gelgich]

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[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Not like a dissociation, but preoccupied. They're preoccupied.

[Boost Mobile Advertisement Voice]

Yeah.

[Dr. Tori Miller]

Yeah, yeah, yeah. So obviously the first line treatment, you know, we're talking about erp, we're talking about act, we're talking about mindfulness, you know, like that. That if OCD is part of the picture and is impacting someone's functioning, that's the direction you go, Right? Yeah, but in. But there's also. There are also things that you can do to really. That we can do. To really help our clients with the, the, the executive dysfunction component of it. And I think that those sorts of strategies are really important. I mean, you've, you know, we've got to sort of focus on the ocd, obviously.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Work on reducing how much someone is triggered when they're sitting at their desk or when they're at work. But there are also things that we can do to help improve someone's functioning or their ability to just set some limits around their ocd, which actually fits very much within the sort of the.

[Dr. Celine Gelgich]

Absolutely.

[Dr. Tori Miller]

Space.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

So when I think about this and the kinds of strategies that I recommend to my clients, the kinds of things that I'm thinking about are, I think I have a strong basis in sort of acceptance and commitment therapy and mindfulness. So a lot of intention setting.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

And what, what I mean by that is just observing what is happening in one's mind when you're sitting at the desk, let's say. And let's say there's a contamination obsession and there are intrusive thoughts around what if my keyboard's contaminated? Or what if my phone's contaminated? And now my phone is on the desk and now my fingers have been on my phone and I'm transferring that contamination to the keyboards. And all the time you're trying to write an essay, but all you can think about is, is my keyboard dirty? Is that the intention setting would be. I am going to set the intention that I'm going to focus on the words on the screen and what I'm writing. Now, you can't. We know you cannot control your intrusive thoughts. You cannot stop them popping into your mind. But what you can do is you can redirect your attention back to. You can notice your mind wandering. You can notice, ah, I'm back focusing on my keyboard, but I'm going to ground myself. I'm going to notice other things in the room and I'm going to notice my computer screen, I'm going to notice the sentence that I've written and I'm going to bring my attention back to that. Now, that might be a bit of a dance where you're doing that every 30 seconds. That sounds really simple, but of course it's absolutely not. But that is a strategy. And the more you do it, the more your brain responds and learns to pivot and builds that flexibility.

[Dr. Celine Gelgich]

Shifting attention.

[Dr. Tori Miller]

Exactly.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Right. So that is, that's, that's a place to start. Obviously, we can also use strategies like the good enough. Yes, the good enough.

[Dr. Celine Gelgich]

Which is so painful to sit with.

[Dr. Tori Miller]

But I sort of accepting.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

What a good enough email looks like. Accepting. Letting go of perfection. Yeah. Practicing sitting in discomfort. And while you're learning to do that, use templates.

[Dr. Celine Gelgich]

Yeah. Yes. So helpful.

[Dr. Tori Miller]

Have templates for an email. Have templates for note taking.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

You know, that sort of thing. You know, so that. That way at least, you know, I mean that. That would be sort of a middle ground while you're grappling with this. While you're learning to sort of. To sit with that uncertainty. To practice the art of good enough. Yeah. But like build, you know, build some templates just to make, you know, so that your email at least is started and finished and you've just got to add a little bit of content or.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

You know, if you're taking notes for. At uni, you know, you've got kind of.

[Dr. Celine Gelgich]

Not pages and pages and pages.

[Dr. Tori Miller]

Yes.

[Dr. Celine Gelgich]

Just give yourself a limit.

[Dr. Tori Miller]

Absolutely.

[Dr. Celine Gelgich]

Yeah. I find a couple extra. Couple of strategies could. That also could be helpful, especially with reading is I said tell my clients to put your finger under the word.

[Dr. Tori Miller]

Yep.

[Dr. Celine Gelgich]

And because then your mind focus on following the finger and it actually will follow the pace.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Because it's forced to do that. So you've got movement happening. Because mind will focus on movement. Yeah.

[Dr. Tori Miller]

And it's. And it's bringing in extra stimuli to help you maintain. Yeah, that's right.

[Dr. Celine Gelgich]

Yeah. So if this was the page, you'd just be like the cat jumped over the fox.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Or whatever. Right. And so you just do that and that help. That would help a lot.

[Dr. Tori Miller]

Yeah, agreed.

[Dr. Celine Gelgich]

The other thing I'd get clients to do is give themselves a limit of checks. So if they would check three or four times, bring it down to two checks or one check before sending an email, for example. Same with asking for clarification and reassurance and all that sort of stuff that can also be helpful. So just even physical limits and boundaries or setting alarms I would find. Or clients would find really helpful. So like they'd give themselves. If they had to study for something. They'd give themselves maybe an hour or something.

[Dr. Tori Miller]

Like if there's compulsive researching happening. Set a limit. Like I'm going to read three.

[Dr. Celine Gelgich]

Three articles.

[Dr. Tori Miller]

Articles about this. Or I'm going to. I'm only going to research for an hour and then what I have at the end of the hour is what I work with. Yeah. Yeah.

[Dr. Celine Gelgich]

But I'm going to give myself 15 minutes to summarize this chapter.

[Dr. Tori Miller]

Yep.

[Dr. Celine Gelgich]

And whatever you come up with in that 15 minutes is all you have to work with. Which makes it really hard. Yeah. Because what then clients are sitting with is, what if I've missed an important point? What if I get my essay wrong?

[Dr. Tori Miller]

What if.

[Dr. Celine Gelgich]

What if I don't have the right quotes? I'm just thinking about an English essay or something like that. And. Or what if I've missed an invoice at work? Or if you're an accountant and you're doing. Going over a fund. What if I've missed whatever else it is? Like an important allocation or something. Or even if you're working in construction, for example, like.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Or engineering, like, you don't want to miss that. Like, the consequence of that would be dire. I shouldn't laugh. It's not funny.

[Dr. Tori Miller]

But, like, I know the stakes feel.

[Dr. Celine Gelgich]

The stakes feel higher. And that's the thing that. And. Or if you're a surgeon, like, you know, the higher the stakes, the scarier all of this is going to feel. But I think at the same time, what you're doing is you're learning to trust yourself again.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

Because one of the biggest things that happens when OCD shows up in this way is people learn to dist. Like, they don't. They lose trust in themselves. And that is a very destabilizing thing as a person.

[Dr. Tori Miller]

What they start trusting is the. Is the compulsion.

[Dr. Celine Gelgich]

Yes, exactly. Exactly. They start trusting the compulsion, they lose trust in their own. Not OCD's judgment, their own judgment. And that is a very destabilizing place to be, especially from an existential point of view. And so that can be really hard. And so a lot of time I say to my clients, you're learning to trust yourself again. You've got to, instinctively. I'm asking you to trust that your mind and your body will know when you are actually doing the wrong thing. Not when OCD says you're doing the wrong thing, but when you are actually doing something. So I'm asking you to step off this cliff.

[Dr. Tori Miller]

And you can't do that intellectually. You have to do that experientially.

[Dr. Celine Gelgich]

Exactly. A hundred percent. It's definitely not an intellectual thing. You'll never get there intellectually. And I like the analogy I use is I'm asking. I'm asking you to step off this cliff. I'm telling you there is a safety net at the bottom.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

But you can't see it because there's too many clouds.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

So I. Are we going to jump?

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

I mean, I'd be like, fuck, no, I'm not jumping. I can't say the net, but I mean, you know, that's basically what we're asking our clients to do.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

It's how scary it feels to build. Rebuild trust in themselves.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

Yeah. So from a clinician's perspective, when we get frustrated, when shift and movements are happening, hold that in mind as well. But also share that with your client because it can be something that they feel a sense of relief with, knowing that. Okay. It's a process.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

Right.

[Dr. Tori Miller]

Yeah. Yeah, that's right.

[Dr. Celine Gelgich]

Any other suggestions on strategies?

[Dr. Tori Miller]

The other is also just things like bring movement in.

[Dr. Celine Gelgich]

Yes.

[Dr. Tori Miller]

Don't spend a long time sitting at your desk if you're feeling stuck. Get up, move around.

[Dr. Celine Gelgich]

Hydration, Food.

[Dr. Tori Miller]

Absolutely.

[Dr. Celine Gelgich]

Sleep. Oh, my God. Sleep.

[Dr. Tori Miller]

Yep. Absolutely. Think about. Also about, you know, just working with your body's natural sort of energy. So for some people, they might. You might. They might have greater capacity to set limits around ocd. If they're doing their study in the morning, for example, when they're still quite fresh, it's going to be harder. We often see people have. Have a lot more difficulty at the end of the day.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

You know, setting limits around OCD or resisting urges. So maybe think about doing it in the morning, getting your work done and have less pressure on you at the end of the day. And have a lot of self. Compassion.

[Dr. Celine Gelgich]

Yeah.

[Dr. Tori Miller]

Bring compassion into it. Bring compassion for yourself into the struggle that you're having. And. And don't try to do it by yourself.

[Dr. Celine Gelgich]

Yeah, you know, that's an important one.

[Dr. Tori Miller]

Yeah. Yeah.

[Dr. Celine Gelgich]

It's really hard doing it on your own. I think another thing that comes to mind is, especially for people who are avoidant, is value following your values in terms of trying to get back into touch with what is important to you, what you're trying to achieve, what you're wanting to, what standard. You want to hold yourself to have flexibility around that standard, obviously, because that can get really tricky. But then using that to help you move towards setting goals.

[Dr. Tori Miller]

Yeah.

[Dr. Celine Gelgich]

So if my value is to show up at work as a reliable teammate, then in order for me to be reliable, I need to be able to do A, B and C to be

[Dr. Tori Miller]

able to get my work done, I

[Dr. Celine Gelgich]

need to be able to get my work done. And if I'm going to be an effective team member and show up in that way, then what goals do I have to set for this week to be able to help me do that.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

So that can be a really nice.

[Dr. Tori Miller]

Yes.

[Dr. Celine Gelgich]

For a lot of people as well, when they're not feeling motivated because it takes the spotlight off you and brings it back to the bigger picture.

[Dr. Tori Miller]

And it's the same, I think, you know, you could apply the same with a student. Helps help students think about, you know, their, their ambitions and their goals and the kind of student that they want to be and what kind of, what they want to achieve and just help them see the paradox of ocd, which is that the more they do their compulsions in a bid to get things perfect or right, then the less likely they are actually to get their work done.

[Dr. Celine Gelgich]

That's right.

[Dr. Tori Miller]

Or to get it done in a, you know, happy with their work.

[Dr. Celine Gelgich]

Fears are already coming true.

[Dr. Tori Miller]

Yeah, that's right. And in fact, oftentimes you're better off setting limits around OCD and just sending off a good enough assignment because at least then you've got something to be marked. Right?

[Dr. Celine Gelgich]

Yeah, exactly. Rather than nothing.

[Dr. Tori Miller]

Yeah, that's right.

[Dr. Celine Gelgich]

A C is better than an F. Yes. Oh, my goodness.

[Dr. Tori Miller]

I know.

[Dr. Celine Gelgich]

Yeah. All right.

[Dr. Tori Miller]

All right.

[Dr. Celine Gelgich]

Lots of little gems today. Yep. Thank you.

[Dr. Tori Miller]

Thank you.

[Dr. Celine Gelgich]

All right, we'll catch you guys next time.

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[Dr. Celine Gelgich]

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