Podcast Summary: "Postpartum OCD and Scary Thoughts About Your Baby"

Podcast: Get to Know OCD
Host: Dr. Patrick McGrath (NOCD's Chief Clinical Officer)
Guest: Dr. Mia Nunez (Director of Clinical Integrity, NOCD)
Date: December 21, 2025

Episode Overview

This episode focuses on the often misunderstood topic of postpartum OCD and "scary thoughts" that new parents may experience about their babies. Dr. Patrick McGrath welcomes Dr. Mia Nunez to discuss the difference between postpartum depression, baby blues, and postpartum OCD, the prevalence and nature of intrusive thoughts among new parents, and what differentiates normal new-parent anxiety from clinical OCD. Dr. Nunez shares her own personal story dealing with postpartum OCD, explores treatment concepts like exposure and response prevention (ERP), and offers advice for parents experiencing these challenges, highlighting the importance of self-compassion and specialized support.

Key Discussion Points and Insights

1. Distinguishing Types of Postpartum Emotional Challenges (00:00–06:24; 15:19–18:30)

Baby Blues: Characterized by feelings of exhaustion, being down, and tearful for several days to a few weeks after birth. Considered normal and transient.
Postpartum Depression: More severe, includes an inability to feel pleasure, numbness, disconnection from the child, possible changes in eating/sleep, and sometimes thoughts of self-harm.
Postpartum OCD: Involves intrusive, ego-dystonic thoughts about harm coming to the baby (including fears of oneself causing it), accompanied by compulsions like seeking reassurance, excessive checking, or avoiding caregiving tasks.
Key Quote:
“You can have anxiety or OCD as well, which looks the way OCD normally does, just most often surrounding ideas about harm coming to the child... Very important to note that these are ego dystonic. These people do not want to harm their babies.” — Dr. Mia Nunez [15:47]

2. The Science of Fear and Treatment: Inhibitory Learning vs. Habituation (04:45–09:41)

Inhibitory Learning: We don’t unlearn fears; we build new, competing associations that override the old ones in recall.
ERP (Exposure and Response Prevention): Effective for supporting this process, emphasizing new learning over anxiety reduction alone.
Habituation: Anxiety naturally lessens with exposure, but sometimes intrusive reactions (like disgust) may not decline quickly.
Key Quote:
“Even if anxiety doesn't go down dramatically during an exposure, if someone is able to come to a place to learn that...I can do it and I can do it again in the future, then that's really powerful as well.” — Dr. Mia Nunez [07:50]
Key Quote:
“In the purely habituation model, if somebody's anxiety didn't go down, we would think, oh no, what's going wrong with the therapy...at least with inhibitory learning...they're not responding in their old way, and that's probably the most important thing.” — Dr. Patrick McGrath [08:25]

3. Prevalence and Normalization of Scary, Intrusive Thoughts (11:53–13:33)

A recent study found 87% of women from mid-pregnancy to six months postpartum experience some kind of intrusive, upsetting thought about harm.
This is not exclusive to those diagnosed with OCD and can affect partners as well.
Key Quote:
"That wasn't a group of women with OCD. In fact, the majority of that group had never been diagnosed with OCD before." — Dr. Mia Nunez [12:21]

4. The Lived Experience and Emotional Impact (13:33–23:39)

Dr. Nunez shares how postpartum OCD felt for her: intense shame, guilt, and fear, compounded by others’ well-intentioned but invalidating comments.
The mismatch between “supposed to” feelings and reality amplifies suffering.
Important moment:
“The worst thing somebody could say was anything that reminded me of the fact that I wasn't having the experience that I...was supposed to be having.” — Dr. Mia Nunez [13:56]
She emphasizes the value of checking in compassionately with new parents, not assuming blissful feelings.

5. Diagnosis and Differentiating OCD from Transient Experiences (23:39–26:29)

OCD tends to be chronic, but intense postpartum symptoms may be time-limited for some.
Key Quote:
"Time frame is the main differentiator for me." — Dr. Mia Nunez [25:14]

6. Treatment Strategies and Family Dynamics (26:29–29:37)

ERP principles work even for subclinical cases. Dr. Nunez “walked herself through” ERP, focused on response prevention, and educated her family about not accommodating compulsions.
Family may unintentionally reinforce avoidance or safety behaviors.
Example: Her spouse/parent would take over bathing the baby, inadvertently reinforcing avoidance.
Gradual Exposure: Stepped involvement—watching, participating, then independently bathing the baby while tolerating anxiety.
Key Quote:
“Exposure just through...spending more and more and more time with my baby, which honestly, I was motivated to avoid doing before...” — Dr. Mia Nunez [26:52]

7. Recovery and Moving Forward (29:37–32:28)

Ultimately, the repeated exposures enabled her not just to function, but to enjoy caregiving.
Some residual guilt may linger, but purpose and compassion for others grow.
Key Quote:
“I actually came to find joy and, and value that time.” — Dr. Mia Nunez [29:50]

8. Advice to Sufferers and the Importance of Self-Compassion (31:49–36:26)

New parents should offer themselves compassion; these thoughts are common and do not define one's value or capability as a parent.
Core message: You are not a bad person for having scary thoughts.
If you're struggling, ask for help, and seek out specialists in OCD and ERP.
Key Quote:
“It doesn't say anything about you as a parent and you can get on the other side.” — Dr. Mia Nunez [32:16]
Dr. McGrath: “There’s no such thing as a good or a bad thought. Thoughts are just thoughts. ... OCD wants you to be judged by one thing...” [32:28–34:13]

9. Encouragement to Seek Professional Support (36:27–37:37)

Even trained therapists need or benefit from expert support when struggling.
ERP can and should be done with professional guidance.
Key Quote:
“Generally, we don't recommend doing that on your own. ...Definitely recommend...get the help. If you're experiencing these sorts of thoughts...reach out for help and get professional help for ERP.” — Dr. Mia Nunez [36:57]

Notable Quotes & Memorable Moments

“Scary thoughts are extremely common – the vast majority of new mothers (87%) have them at some point.” [11:53]
“If you react to these thoughts...with ‘I need to not think about it,’ you're just sending a message to your brain that there is danger in those thoughts.” — Dr. Nunez [18:52]
“ERP seems to work for three different reasons: habituation, inhibitory learning, and building self-efficacy.” [06:54]
“Thoughts are just thoughts. ... If we were to be judged by any one of them, probably all of us would be in jail at this point...” — Dr. McGrath [32:28–34:13]
“Self-compassion. ...Give yourself a lot of compassion. Understand that that is normal.” — Dr. Nunez [31:49]

Important Timestamps

04:45 — Inhibitory Learning Explained
11:53 — Prevalence Statistics on Intrusive Thoughts
13:33 — Dr. Nunez’s Personal Experience with Postpartum OCD
15:19 — Differences between Baby Blues, Depression, and OCD
26:29 — Using ERP Principles as a New Parent
28:08 — Family Support and Compulsions
29:37 — Emotional Transition to Joy in Parenting
31:49 — Self-compassion and Advice to Sufferers
36:27 — Professional Help Recommendation

Final Remarks

Dr. Mia Nunez’s message:
“Ask for help. It can be scary, I think especially with this sort of experience...But asking for help was the best thing I did.” [34:23]

Dr. Patrick McGrath’s conclusion:
“You can read lots of manuals and I'm sure there's tons of books around these things. ...there's nothing wrong with bringing somebody else in to coach you through this experience and get you to the other side.” [37:17]

If you or someone you know is struggling with scary, repetitive thoughts after the birth of a child, know that you are not alone. Professional, specialized help is available, and recovery is possible.

For OCD help and resources:
Visit NOCD.com
Check out NOCD Academy and free continuing education for clinicians.

Podcast Summary: "Postpartum OCD and Scary Thoughts About Your Baby"

Podcast: Get to Know OCD
Host: Dr. Patrick McGrath (NOCD's Chief Clinical Officer)
Guest: Dr. Mia Nunez (Director of Clinical Integrity, NOCD)
Date: December 21, 2025

Episode Overview

Key Discussion Points and Insights

1. Distinguishing Types of Postpartum Emotional Challenges (00:00–06:24; 15:19–18:30)

Baby Blues: Characterized by feelings of exhaustion, being down, and tearful for several days to a few weeks after birth. Considered normal and transient.
Postpartum Depression: More severe, includes an inability to feel pleasure, numbness, disconnection from the child, possible changes in eating/sleep, and sometimes thoughts of self-harm.
Postpartum OCD: Involves intrusive, ego-dystonic thoughts about harm coming to the baby (including fears of oneself causing it), accompanied by compulsions like seeking reassurance, excessive checking, or avoiding caregiving tasks.
Key Quote:
“You can have anxiety or OCD as well, which looks the way OCD normally does, just most often surrounding ideas about harm coming to the child... Very important to note that these are ego dystonic. These people do not want to harm their babies.” — Dr. Mia Nunez [15:47]

2. The Science of Fear and Treatment: Inhibitory Learning vs. Habituation (04:45–09:41)

Inhibitory Learning: We don’t unlearn fears; we build new, competing associations that override the old ones in recall.
ERP (Exposure and Response Prevention): Effective for supporting this process, emphasizing new learning over anxiety reduction alone.
Habituation: Anxiety naturally lessens with exposure, but sometimes intrusive reactions (like disgust) may not decline quickly.
Key Quote:
“Even if anxiety doesn't go down dramatically during an exposure, if someone is able to come to a place to learn that...I can do it and I can do it again in the future, then that's really powerful as well.” — Dr. Mia Nunez [07:50]
Key Quote:
“In the purely habituation model, if somebody's anxiety didn't go down, we would think, oh no, what's going wrong with the therapy...at least with inhibitory learning...they're not responding in their old way, and that's probably the most important thing.” — Dr. Patrick McGrath [08:25]

3. Prevalence and Normalization of Scary, Intrusive Thoughts (11:53–13:33)

A recent study found 87% of women from mid-pregnancy to six months postpartum experience some kind of intrusive, upsetting thought about harm.
This is not exclusive to those diagnosed with OCD and can affect partners as well.
Key Quote:
"That wasn't a group of women with OCD. In fact, the majority of that group had never been diagnosed with OCD before." — Dr. Mia Nunez [12:21]

4. The Lived Experience and Emotional Impact (13:33–23:39)

Dr. Nunez shares how postpartum OCD felt for her: intense shame, guilt, and fear, compounded by others’ well-intentioned but invalidating comments.
The mismatch between “supposed to” feelings and reality amplifies suffering.
Important moment:
“The worst thing somebody could say was anything that reminded me of the fact that I wasn't having the experience that I...was supposed to be having.” — Dr. Mia Nunez [13:56]
She emphasizes the value of checking in compassionately with new parents, not assuming blissful feelings.

5. Diagnosis and Differentiating OCD from Transient Experiences (23:39–26:29)

OCD tends to be chronic, but intense postpartum symptoms may be time-limited for some.
Key Quote:
"Time frame is the main differentiator for me." — Dr. Mia Nunez [25:14]

6. Treatment Strategies and Family Dynamics (26:29–29:37)

ERP principles work even for subclinical cases. Dr. Nunez “walked herself through” ERP, focused on response prevention, and educated her family about not accommodating compulsions.
Family may unintentionally reinforce avoidance or safety behaviors.
Example: Her spouse/parent would take over bathing the baby, inadvertently reinforcing avoidance.
Gradual Exposure: Stepped involvement—watching, participating, then independently bathing the baby while tolerating anxiety.
Key Quote:
“Exposure just through...spending more and more and more time with my baby, which honestly, I was motivated to avoid doing before...” — Dr. Mia Nunez [26:52]

7. Recovery and Moving Forward (29:37–32:28)

Ultimately, the repeated exposures enabled her not just to function, but to enjoy caregiving.
Some residual guilt may linger, but purpose and compassion for others grow.
Key Quote:
“I actually came to find joy and, and value that time.” — Dr. Mia Nunez [29:50]

8. Advice to Sufferers and the Importance of Self-Compassion (31:49–36:26)

New parents should offer themselves compassion; these thoughts are common and do not define one's value or capability as a parent.
Core message: You are not a bad person for having scary thoughts.
If you're struggling, ask for help, and seek out specialists in OCD and ERP.
Key Quote:
“It doesn't say anything about you as a parent and you can get on the other side.” — Dr. Mia Nunez [32:16]
Dr. McGrath: “There’s no such thing as a good or a bad thought. Thoughts are just thoughts. ... OCD wants you to be judged by one thing...” [32:28–34:13]

9. Encouragement to Seek Professional Support (36:27–37:37)

Even trained therapists need or benefit from expert support when struggling.
ERP can and should be done with professional guidance.
Key Quote:
“Generally, we don't recommend doing that on your own. ...Definitely recommend...get the help. If you're experiencing these sorts of thoughts...reach out for help and get professional help for ERP.” — Dr. Mia Nunez [36:57]

Notable Quotes & Memorable Moments

“Scary thoughts are extremely common – the vast majority of new mothers (87%) have them at some point.” [11:53]
“If you react to these thoughts...with ‘I need to not think about it,’ you're just sending a message to your brain that there is danger in those thoughts.” — Dr. Nunez [18:52]
“ERP seems to work for three different reasons: habituation, inhibitory learning, and building self-efficacy.” [06:54]
“Thoughts are just thoughts. ... If we were to be judged by any one of them, probably all of us would be in jail at this point...” — Dr. McGrath [32:28–34:13]
“Self-compassion. ...Give yourself a lot of compassion. Understand that that is normal.” — Dr. Nunez [31:49]

Important Timestamps

04:45 — Inhibitory Learning Explained
11:53 — Prevalence Statistics on Intrusive Thoughts
13:33 — Dr. Nunez’s Personal Experience with Postpartum OCD
15:19 — Differences between Baby Blues, Depression, and OCD
26:29 — Using ERP Principles as a New Parent
28:08 — Family Support and Compulsions
29:37 — Emotional Transition to Joy in Parenting
31:49 — Self-compassion and Advice to Sufferers
36:27 — Professional Help Recommendation

Final Remarks

Dr. Mia Nunez’s message:
“Ask for help. It can be scary, I think especially with this sort of experience...But asking for help was the best thing I did.” [34:23]

If you or someone you know is struggling with scary, repetitive thoughts after the birth of a child, know that you are not alone. Professional, specialized help is available, and recovery is possible.

For OCD help and resources:
Visit NOCD.com
Check out NOCD Academy and free continuing education for clinicians.

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Postpartum OCD and Scary Thoughts About Your Baby

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Summary

Podcast Summary: "Postpartum OCD and Scary Thoughts About Your Baby"

Episode Overview

Key Discussion Points and Insights

1. Distinguishing Types of Postpartum Emotional Challenges (00:00–06:24; 15:19–18:30)

2. The Science of Fear and Treatment: Inhibitory Learning vs. Habituation (04:45–09:41)

3. Prevalence and Normalization of Scary, Intrusive Thoughts (11:53–13:33)

4. The Lived Experience and Emotional Impact (13:33–23:39)

5. Diagnosis and Differentiating OCD from Transient Experiences (23:39–26:29)

6. Treatment Strategies and Family Dynamics (26:29–29:37)

7. Recovery and Moving Forward (29:37–32:28)

8. Advice to Sufferers and the Importance of Self-Compassion (31:49–36:26)

9. Encouragement to Seek Professional Support (36:27–37:37)

Notable Quotes & Memorable Moments

Important Timestamps

Final Remarks

If you or someone you know is struggling with scary, repetitive thoughts after the birth of a child, know that you are not alone. Professional, specialized help is available, and recovery is possible.

Summary

Podcast Summary: "Postpartum OCD and Scary Thoughts About Your Baby"

Episode Overview

Key Discussion Points and Insights

1. Distinguishing Types of Postpartum Emotional Challenges (00:00–06:24; 15:19–18:30)

2. The Science of Fear and Treatment: Inhibitory Learning vs. Habituation (04:45–09:41)

3. Prevalence and Normalization of Scary, Intrusive Thoughts (11:53–13:33)

4. The Lived Experience and Emotional Impact (13:33–23:39)

5. Diagnosis and Differentiating OCD from Transient Experiences (23:39–26:29)

6. Treatment Strategies and Family Dynamics (26:29–29:37)

7. Recovery and Moving Forward (29:37–32:28)

8. Advice to Sufferers and the Importance of Self-Compassion (31:49–36:26)

9. Encouragement to Seek Professional Support (36:27–37:37)

Notable Quotes & Memorable Moments

Important Timestamps

Final Remarks

If you or someone you know is struggling with scary, repetitive thoughts after the birth of a child, know that you are not alone. Professional, specialized help is available, and recovery is possible.