Get to Know OCD Podcast

Episode: The Postpartum Struggle No One Talks About: OCD
Date: September 11, 2025
Host: Dr. Patrick McGrath (NOCD Chief Clinical Officer)
Guest: Julia Hale, LICSW (Founder, Soul Tality, Cambridge, MA)

Overview

This episode shines a light on an often-misunderstood postpartum experience: Obsessive Compulsive Disorder (OCD) among new parents, especially birthing mothers. Dr. Patrick McGrath and guest Julia Hale—herself an OCD specialist and survivor—explore the hidden struggles new parents face, why OCD often goes undiagnosed during the perinatal period, and how shame, guilt, and grief impact parents beyond the standard narratives of postpartum depression. The conversation also delves into working with high-achieving individuals and the nuanced overlap between OCD and perfectionism, especially in populations like students at elite universities.

Key Discussion Points & Insights

1. OCD in the Postpartum Experience (00:00–23:52)

• Julia’s Personal Story: Julia shares her own unexpected collision with postpartum OCD, despite almost a decade as an OCD therapist.
  • “Even though I had been an OCD therapist at that point for almost 10 years, I was blindsided by the experience that I had with intrusive thoughts and anxiety.” — Julia (00:00)
• Misconceptions: The focus is typically on postpartum depression, not anxiety or OCD.
  • “For a lot of people, we're on the lookout for postpartum depression. And I wasn't depressed. I really wasn't. I was functioning well. And so on the surface, I think this was something that really went below the radar.” — Julia (00:00)
• Hyper-responsibility & New Parenthood: The sudden, overwhelming responsibility of newborn care can trigger or exacerbate OCD symptoms.
  • “When you have a baby, you're all of a sudden responsible for this thing...it’s ripe territory for OCD to latch on.” — Julia (00:00; repeated insight at 13:41)
• Common Intrusive Themes: Indecision about returning to work, sleep, safety rituals, feeding, and questions about love or adequacy.
  • “A lot of women who were so consumed with their intrusive thoughts in the postpartum period that they actually weren't able to enjoy themselves.” — Julia (11:17)
• Secondary Grief: Many parents later grieve the parts of early parenthood that OCD stole from them.
  • “So many moms brought up secondary grief...having to process, well, what did you lose in your life because of this?” — Julia (07:10)
• Stigma and Medical Blindspots: Healthcare focuses more on infant health than maternal mental wellbeing; screening tools are often overlooked or disregarded.
  • “My doctor didn't even address it in the actual appointment...I don't think anyone even looked at [the screening].” — Julia (09:50)
• It Affects Partners Too: Intrusive thoughts and anxiety are not exclusive to birthing parents—adoptive, foster, and non-birthing partners can experience them as well.

Memorable Quote

“OCD can latch onto every single possibility. And with a baby who can't speak for itself and communicate and they're so fragile, it's ripe territory for OCD to latch on.” — Julia (17:09)

2. Real-Life Group Support & The Power of Destigmatization (20:52–24:16)

• Highlights from the IOCDF Group: Julia describes running a group named “Good Parents Have Bad Thoughts,” which offered a rare, validating space for new parents to discuss intrusive thoughts without shame.
  • “Everyone felt really heard. And there was a lot of tears and validation....immense relief among everyone in the group. That was like, yes, like. Yes, like, that is what I feel. I feel so sad I missed out on that bonding period. Or I was so consumed with X, Y, or Z and do it. Do I have permission to grieve?” — Julia (21:49)
• Normalization: Just being able to say “I had those thoughts too” is powerful.
• Societal Pressure: The myth of blissful parenthood makes it hard for parents to admit struggle.
  • “There's this societal pressure of, you should enjoy this time.” — Julia (12:37)

3. Clinical Strategies & Recommendations (18:34–20:40; 19:52–20:48)

• Seeking Help Early: Julia recommends scheduling a therapy appointment soon after childbirth, even if things seem fine, because getting help “from outside” can make a real difference before problems escalate.
  • “Make that first appointment a week or two after you have the baby...the distance between where I'm sitting right now and the door right there is 10 miles.” — Julia (19:52)
• Turning Points: For many, it’s recognizing a “tipping point” behavior (e.g., Julia cutting a hole in a window screen for imagined emergencies) that underscores the need for intervention.

4. OCD and High-Achieving Individuals (25:32–34:22)

• Overlap with Perfectionism: Students and professionals at elite institutions sometimes credit compulsive behaviors (checking, reassurance seeking) for their achievements.
  • “A lot of my clients will say, well, my double checking and rechecking and reassurance seeking...that's how I got here. Right. I got here by double checking my paper 15 times at night...” — Julia (25:57)
• Diagnostic Challenges: Perfectionistic presentations of OCD may be masked or even celebrated as high-achiever behavior, causing delays in diagnosis or treatment.
• Cost of Compulsions: Excessive rituals eventually undermine success—missed classes, late assignments, or social isolation.
• Therapy Focus: Key clinical goals include developing self-compassion, internal validation, and tolerating imperfection.
  • “The willingness to give up seeking certainty and needing a hundred percent sure as a goal.” — Julia (32:35)

Notable Exchange

Dr. McGrath: “I think you're successful despite OCD, not because of OCD.” (28:03)

5. Values, Identity, and OCD Recovery (33:23–39:30)

• Values Work: Many high-achievers tie all self-worth to external achievements. Therapeutic work shifts focus to building a flexible life based on true values (not just grades/accolades).
• Inhibitory Learning: Emphasizing new behavioral patterns to replace compulsive old ones. “Are you willing to take a risk?” becomes a mantra in therapy.
  • “The goal here is...to see what happens. Like, let's just see what happens if we don't check it five times. Maybe let's check it twice.” — Julia (34:22)
• Living Beyond OCD: Encouraging clients to consider what life would look like if OCD continues vs. if they take risks and open up to new, value-aligned experiences.

6. Parenting, Shame, Disgust, and Non-Anxiety Emotions (43:45–45:45)

• Beyond Anxiety: The traditional DSM focus on anxiety as the driver of compulsions misses crucial elements: guilt, shame, disgust are often front-and-center for parents with intrusive thoughts.
  • “It wasn't anxiety with me. It was like, shame. It was just like, oh, my God, maybe I shouldn't have had a baby.” — Julia (44:31)
• Mastery not Perfection: Interventions may include practical coping (wearing gloves for diaper changes, keeping a sick bucket nearby) to build confidence incrementally.

7. The Future: Research, Collaboration, and Hope (41:40–43:45)

• Intersectional Research and Advocacy: Julia is excited about ongoing work bridging perinatal support and OCD education, and about novel treatments like psychedelics for OCD.
• Need for Education: Improving understanding of the differences between OCD and postpartum psychosis, and raising awareness in both medical and community settings.

Notable Quotes & Memorable Moments

• “Good parents have bad thoughts.” — Group Title (06:19)
• “OCD is unfigureoutable.” — Dr. McGrath (05:37)
• On self-compassion and risk:
  “Are you willing to take a risk?” — Dr. McGrath (34:22)
• On missed experiences:
  “Is there space here for me in that experience? And I think everyone felt incredible, an incredible amount of relief to say, yes, there is. And we can all share that.” — Julia (21:49)
• On therapy avoidance:
  “I have a lot of clients that will say, you know, I'm due next week, and so this will be our last session...And sometimes that is fine, and things are fine, but a lot of the times things are not fine in that period of time.” — Julia (19:52)
• On social pressures:
  “You should feel grateful...But I'm in a beautiful setting, so none of that should matter.” — Julia (23:52)

Timestamps for Key Segments

• Intro, Julia’s Story: 00:00–03:22
• Soul Tality & Group Practice: 03:22–05:20
• Why Postpartum OCD is Overlooked: 06:19–09:14
• Symptoms and Intrusive Themes: 13:41–17:09
• Turning Point (Cutting Window Screen): 18:34–19:52
• Recommendations for Seeking Help: 19:52–20:48
• Group Support and Grief: 20:52–24:16
• Perfectionism and High Achievers: 25:32–34:22
• Values and Identity Work: 33:23–39:30
• Plans for the Field, Research: 41:40–43:45
• Shame, Disgust, and Parenting: 43:45–45:45
• Contact & Closing: 45:55–46:27

Resources Mentioned

• Julia’s Practice: www.soultality.com
• NOCD Treatment: www.nocd.com
• Postpartum Support International: Postpartum.net

Tone & Style

The discussion is personal, honest, and validating—with both host and guest sharing clinical expertise, candid lived experience, and empathy for those suffering in silence. Humor and relatability lighten the mood on this serious topic.

For Listeners

• If you’re a new parent struggling with intrusive thoughts:
  You are not alone, and what you’re experiencing is common and treatable. There is no shame in reaching out.
• For clinicians:
  Be vigilant for OCD (not just depression) in the postpartum and high-achieving populations.
• For all:
  Compassion, validation, and practical support are crucial for recovery.