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- [00:06]
A
Hi, I'm John Green, and I'm here to answer the Internet's biggest questions on ocd. And I am going to answer those questions, but I am joined by an actual expert in the field, Dr. Patrick McGrath of NOCD. So he's going to help me out some.
- [00:20]
B
Sounds great. All right, I'll throw the first one out to you, John. There are people who look at OCD as jokey and quippy. How do you respond to OCD jokes?
- [00:30]
A
I try to be a good sport about it, but it does annoy me privately, I'll tell you. Because when you're like, oh, that's so ocd, or it's just a little bit. It's a little bit of my ocd, I'm always like, I think you might be underestimating how debilitating this disorder can be for people. So I try not to be like a negative Nancy about it, but it does annoy me.
- [00:50]
B
OCD somehow brought itself into the culture to be a part of that. So when I'm doing something of my professional talks and I've got a room full of therapists, I'll say, imagine if I walked into a group of people who were struggling with weight, and I said, have you considered a little anorexia?
- [01:07]
A
Right?
- [01:07]
B
And everyone goes, oh, oh. Ah. But how many times have people said, oh, if I just had a little ocd, I could get this house cleaned up.
- [01:14]
A
Yeah, yeah.
- [01:15]
B
And then they get it. They're like, oh, it is the same kind of thing.
- [01:20]
A
It's really. It's quite inappropriate. I understand that it's part of the culture, but, yeah, it does feel a little bit dismissive.
- [01:28]
B
No doubt, because you're outspoken about ocd. People have probably tried to give you a lot of advice. What is some of the most useless advice you've ever heard about ocd?
- [01:37]
A
I mean, by far the most useless advice is just snap out of it or stop doing that.
- [01:40]
B
Oh, well, of course.
- [01:42]
A
Because obviously if I could, I would. I'd like to, but I can't. But, yeah, I don't know. What's the most useless advice you've heard similar?
- [01:51]
B
And I say, well, then I wouldn't have a job if it was that easy. I would just cure everyone in one session. People would come in, sit down, and tell me, and I would say, okay, now stop it. Like the Bob Newhart skid, if you've ever seen that one, which is a great one. And it would be that. That would be what therapy is. It'd be five minutes for $5. And. And people Would go, oh, you know, I never thought about not doing it. Thank you. Thank you. I'm cured. And it's all good.
- [02:16]
A
Yeah. I wish that I could stop it. I wish that I could snap out of it, but I can't, obviously, or I wouldn't be sitting in this chair.
- [02:24]
B
I talk about almost the paradoxical nature of the brain. The more we try not to think of something, the more guaranteed we are to think of it. And then if we only try to think of something, it becomes hard to think of it when I say to you now think about what you want for dinner or something. And suddenly it's hard to focus on that one thing anymore when something else is introduced. Right. I know in our discussions we've talked about you've had anxiety since you were a kid. It was diagnosed first as anxiety, before ocd. Did you at all think about it as being OCD or was it not till a diagnosis? And what was that experience like? Just having a name for.
- [03:01]
A
Because in my imagination, OCD was very much a disorder of hand washing and cleanliness and contamination fears. I never thought that I had OCD until a doctor was listening to me talk about my obsessive thoughts and the compulsive behaviors. I used to manage them. And my doctor said, I think you have ocd. Gotcha. And then I read a book called the man who Couldn't Stop. And I was like, oh, I definitely have this. There's no question in my mind now. And it was at once scary to have words for it, but also really empowering. A lot of times, the way down deep stuff that we go through, we don't have language for, and that can make it even scarier and harder to go through. Once I had language for it, I felt more comfortable with it.
- [03:54]
B
And you're a man who uses language?
- [03:56]
A
I try to.
- [03:58]
B
Who the hef is Hank and what does he think of your ocd?
- [04:02]
A
Well, Hank is my brother. He is an Internet phenomenon, vertical video sensation. And, you know, he's always been very supportive. I think he knew that I was different from him and from most other kids when. Even when we were very young in terms of my anxiety. But he never treated me differently, and he's always. He's always taken me seriously.
- [04:26]
B
That's awesome.
- [04:27]
A
He's a great guy. I've. I've got one for you.
- [04:29]
B
Okay.
- [04:30]
A
So intrusive thoughts feel. Feel as real as anything else. How do I know what's an intrusive thought and what's me?
- [04:39]
B
Oh, great question. Because I think that that's very difficult to know until you understand what obsessive compulsive disorder really is. So I'm going to bet that prior to an OCD diagnosis, anytime that one of those thoughts or images or urges occurred, and it triggered that fight, flight, or freeze response, it was the end all. Be all of things you needed to focus on and you had to figure out. And when we get to a point where people understand what that is and they start to see that, wait a minute, I can't figure this out. That's, I think, where you start to recognize when it's ocd. Because if you keep going down that rabbit hole and trying to figure it out and figure it out and figure it out, and then even if you get a tinge of it, OCD's like, ooh, he might be getting close to figuring it out. Ocd, whack. A mole occurs, and now the new mole. But now you got to go over there and everything. And so I take a look at it as, once someone accepts the fact that it's okay not to have to figure something out, then they can really recognize the role that OCD is playing. But you get way too stuck in it if all you're trying to do is figure it out all the time.
- [05:43]
A
Yeah, no, that really resonates for me.
- [05:46]
B
You didn't have to tell anybody about ocd. You could have just kind of hidden that from the rest of the world and done your books and your things, but you made a conscious decision to open up about it. And what brought that on? And what have you gotten out of doing that?
- [06:01]
A
Well, I think what brought it on initially was feeling like my life could have been quite different if more people had been talking about OCD as it really is, instead of OCD as a, you know, plot device in movies and detective shows. So I think I wanted to. I almost felt an obligation to talk about it because I felt like a lot of our viewers are younger people. The kind of age that I was when I started to get really sick and hearing from someone like me might. Might be able to help them.
- [06:36]
B
And that is the age we see OCD for the vast majority of people, from that puberty to that transition, young adulthood time. Those are the two peak times for ocd.
- [06:48]
A
Well, it was certainly the case for me.
- [06:50]
B
OCD will at times take a look at health, disease, hand washing. I mean, it is something that's obviously in tv, but it does actually also really impact people's lives. And you've done a lot of work also in disease awareness. And I'M wondering if there's any correlation between your OCD and some of the disease awareness work that you've done.
- [07:10]
A
Yeah, it's hard to know for sure. Like, I'm always very cautious to ever talk about OCD as having upsides. And so I don't want to talk about there being like an upside in that. Like, I got interested in tuberculosis. I don't think I got interested in tuberculosis because of ocd, but I do think that it has maybe helped me be alive to suffering. And if there is a gift to be taken from it, maybe that's the gift. And so I do think that I'm more conscious of and connected to people who are suffering with illness than maybe the average person would be be. So, in your experience, how has OCD in people affected their creative processes? I'm curious about that, as a creative person myself.
- [07:59]
B
Well, it was interesting. Just on the ride over here today, we had a driver that we were talking to who said he thought he had adhd and it was hard to focus. And I started talking about ocd and he looked at me like the biggest light bulb in the world had ever gone on and said, hold on, are you saying that maybe I can't put my music out and produce something and I keep just scrapping projects all the time because maybe I'm trying to be perfect at it and I get so frustrated by it that I give up and then I start over, but I never actually finish anything I said, well, it's a possibility, and I see that a lot, where sometimes for a writer, they can't get past the first line, because did I convey everything I wanted to in that very first sentence? Or for a reader who can't stop reading the same paragraph over and over? Because what if John Green wrote something amazing and I didn't quite get the meaning he wanted me to get? I better read that again just to be sure. So it can go from the creating, but it can also go to the consuming of creativity, of did I do it well enough or did I receive it well enough?
- [09:01]
A
Yeah, and my own experience has been that my creativity is really inhibited by OCD in profound ways. And. And when I'm well, I can write, and when I'm sick, I can't write. And that's actually one of the ways I know that I'm sick.
- [09:15]
B
Wow, that's interesting insight right there. Social media still has quips about ocd, jokes about ocd, things of that nature, or maybe just new ways to trigger you about information. Do you find a relationship with social media to be tenuous at times due to OCD triggers?
- [09:36]
A
Oh, yeah, no, it's bad. I mean, I think social media is bad anyway, so I think it would be bad even if it didn't trigger my ocd. But it does in really intense ways. And that's one of the ways in the last few years that OCD has kind of like, found a way to wiggle into my life is through my social media posts. So I delete a lot of my social media posts a couple minutes after posting them because I get freaked out or overwhelmed or just scared that somebody's gonna misread it or that I maybe accidentally might have hurt someone's feelings or whatever. And so, yeah, it definitely. There is definitely a relationship between social media and ocd. For me, it can be triggering. And also it can be a place where my OCD kind of tries to flourish.
- [10:27]
B
It can also be a place where I've seen a lot of people try to seek reassurance.
- [10:30]
A
Absolutely. Absolutely. People seek reassurance. And you know, that's. That predates social media.
- [10:37]
B
Right.
- [10:37]
A
That happened on forums back in the old days. Like, I remember spending hours and hours and hours on these cancer diagnosis forums and looking at how people got their diagnosis and then also seeing people who were like me, who were looking for reassurance that they did not, in fact, have the cancer in question.
- [10:56]
B
Sure. Did you ever forward those emails that if you don't within 24 hours, somebody in your family will die? So you have to send it to
- [11:01]
A
50 people back in the day, they had mail for that. They did it over the mail.
- [11:07]
B
Actual physical mail.
- [11:09]
A
Physical mail with stamps. And I once did it when I was, like, 13.
- [11:13]
B
I knew it. I knew it. There's a waxing and waning to mental health conditions. You've described being in a great spot now. I'm really thrilled for you. But let's be honest, there's going to be triggers in the future, and there's going to be times that it won't feel maybe as good today. How do you deal with that, knowing that that's a possibility for the future? Because so many people say to me, I just never want to feel this again. And we can't set that up as an expectation for treatment because you can't know that you will or won't be triggered at some point.
- [11:47]
A
Yeah, yeah, I know that I will have hard days ahead, and the hardest days are really hard to get through. And, you know, somebody told me once, your first obligation is to survive. And I've found That very helpful. That if all you can do that day is survive, that's a great day. That's a very successful day.
- [12:07]
B
I like that. Because if it was to thrive, it means you have to be a little bit better today than you were yesterday and then a little bit better tomorrow than you were today. But sometimes we do just survive, don't we?
- [12:18]
A
Yeah, sometimes we just get through it. And, you know, it's important to remember that there is another side to it.
- [12:23]
B
Yeah.
- [12:24]
A
When I'm really sick, a lot of times I can't remember that. I can't see that this ends, that it always ended before. And even like, my wife will tell me, like, remember every other time how it ended, and I'll be like, yeah, but this time is different. This time is always different.
- [12:39]
B
Yeah.
- [12:39]
A
And so, you know, it's not. Not an easy thing to live with, but it's worth it. It's worth it to live with it. Because, you know, at the same time that it's hard to live with, I also have a really good, lovely life. So I know that I often felt like my obsessions were impossible for me to talk about. Too shameful, too embarrassing, too guilt inducing to ever say out loud. How do I get help when I'm feeling like that
- [13:14]
B
the best thing that I can do in a situation like that is to create an environment of no judgment. And as easy as it is to say that, it's hard to create, especially for somebody who is stuck in some kind of shame spiral where they think they are the worst person in the world. And so sometimes we'll first talk about what is it like to be the worst person in the world before they even tell me what led them to feel that way. And if I can just get somebody talking even about that, and they see that I have a poker face, I'm not going just making no judgment on them whatsoever. There's an olive branch in that experience, I think, for them to maybe offer a slight nugget of something and it just cracks the door open and they don't feel like I'm the SWAT team barging in and trying to figure everything out or shame them for it. And they realize that I'm going to sit with them for as long as it takes for them to be comfortable. Then they know that I'm not someone who's out there to do some harm to them. Because I think for a lot of people the fear is that once this is out, the door doesn't close.
- [14:33]
A
Right.
- [14:33]
B
Right. And now the police could get involved or it could be in social media or I could be canceled or all of these things. And we see examples of that all the time. And what if that were to happen to me? And so I do everything that I can to create that sacred confidential space for someone to know that we can talk about anything.
- [14:55]
A
So one thing I hear a lot from people living with OCD is that maybe it's not possible to get better. That, like, this is just something that they have to live with for the rest of their lives. And how do you respond to that?
- [15:10]
B
Well, first of all, I say I would feel like a fraud in my job if I didn't help people. You know that I don't just do this for the money and leave the session going. They're never going to get better. But there's another payment toward the car. You know that, right? That's number one, isn't what it is. If they want to hear from me examples of what treatment is or people that I've worked with, that's wonderful. But I can even steer them to the podcast and say, just watch people who have OCD and watch what they talk about how their lives were to what their lives are now. Right. And you don't have to take my word for it. I don't have ocd. Although the best compliment I ever received from someone with OCD was, I can't believe you don't have ocd, because you sure think like you have ocd, which I thought was very complimentary. I love that. But if they can see that other people have gone through the treatment that I'm describing to them and received something out of it, then hopefully that cracks that door open. Now that specialness still comes in. That's great for everyone else in the world, but I'm the one who isn't going to be able to get better. And so I always say to people, I take on the challenge of specialness with people every day. And if you are the first person who can't get help for ocd, we'll. We'll just write a book together and we'll. We'll call you patient zero. You're the first one who hasn't been able to make a change.
- [16:39]
A
I very much felt like I was not going to get. I felt like medicine wasn't going to work, and I felt like therapy wasn't going to work. But I got to a place where I was desperate enough that the fact that they weren't going to work wasn't as important as the fact that I needed to try everything. And then of course they did work. Yeah, they worked great.
- [17:06]
B
Darn them. Yeah.
- [17:07]
A
Yeah, they worked really well. All right, I think the last question we should both answer. What's the most important thing someone struggling with OCD should know?
- [17:16]
B
That as much as their OCD tells them that they're unique and that there's no help for them, that that's a lie that OCD tells people to keep them stuck into doing compulsions, because OCD eats compulsions for breakfast, lunch, and dinner, and that's all that it wants you to do. And I'm going to help you starve ocd.
- [17:35]
A
Yeah. And my answer would be on a similar front, that especially when you feel like there is no hope, there, in fact, is hope. And this is a very treatable condition. It's nefarious, it's insidious, it's difficult, and it's treatable. All that is true at the same time.
- [18:00]
B
Sometimes I'll pull the scene of Red opening the box and reading Andy's letter from Shawshank Redemption, where he says, hope is a good thing. And I'll pull that up on YouTube and just. I want you to recognize this, that no matter how desperate some things might be, which is why it's one of my favorite movies to show people in amazingly desperate situations still hanging on to some kind of hope.
- [18:25]
A
Yeah. I mean, I think that it's important to recognize that what people with OCD are going through is incredibly difficult and really scary and really overwhelming. And the shame and anxiety and guilt are so profound. And yet also, it is also true that it doesn't always have to be that way.
- [18:47]
B
John, we could probably talk about OCD all day. In fact, it might even like us to talk about it all day long. But as you've lived, the truth is, is that OCD is treatable. And as you've experienced, when you find somebody who really understands what OCD is, they can help you get better. Right.
- [19:09]
A
Yeah.
- [19:10]
B
So thank you for being here. I really appreciate your time today.
- [19:13]
A
I know facing OCD can feel overwhelming, but you don't have to do it alone. That's why NOCD is here. They're here to help. You can visit nocd.com to schedule a free call with their team and get matched with a NOCD trained therapist. They have licensed therapists who are trained at treating OCD with exposure and response prevention therapy. They'll create a plan tailored to your specific needs and guide you every step of the way. Making the call to start treatment was a difficult moment in my life, born of true desperation. But gosh, is current me grateful to past me for making that call.