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- [00:00]
A
I had my first baby in 2021. 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. 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. And when you have a baby, you're all of a sudden responsible for this thing. You've your whole life you've only been responsible for yourself and then, boom, overnight you're now responsible for this thing that can't do anything for itself. And you are the person that's in charge of keeping them alive. And so I think OCD can latch on to every single possibility. And with a baby who can't speak for itself and communicate and they're so fragile, it's. It's ripe territory for OCD to latch on.
- [01:02]
B
You've probably heard of ocd, but I bet you don't really know that it's a condition that impacts 1 in 40 adults in the United States. Obsessive Compulsive Disorder is more than about just cleaning and organization. It causes intrusive, persistent, sticky feelings and thoughts and images that can seize on any topic from romantic relationships to illness to spirituality and really anything that matters to you. Now, this can cause significant anxiety and guilt and shame and disgust and whatever uncomfortable emotion it may grab onto and it may make it hard to function in day to day life. If this sounds familiar, know that you're not alone and help is available. I'm a licensed clinical psychologist with 25 years of OCD treatment experience. So I know how scary these symptoms can be. But I also know that they can be managed with the right type of treatment. This is why I lead a team of top tier clinical experts at nocd. NOCD is an online platform offering specialized, accessible and convenient OCD treatment. My team and I have helped people take back their lives from OCD through specialized therapy that's covered by insurance. To learn more about OCD and effective treatment, head to nocd.com that's n o c d dot com. You deserve to live the life that you want to live and not the life that OCD wants you to live. And also, don't forget to subscribe to our YouTube channel so that you can stay up to date on our latest podcasts and webinars. Now, onto today's episode. Hi everyone and welcome to another episode of the get to know OCD podcast. I'm Dr. Patrick McGrath, the Chief Clinical Officer here at NOCD. If you like this, please, please subscribe to our NOCD YouTube channel. Today. I'm honored to have Julia Hale with us. Hi, Julia, how are you?
- [02:49]
A
I'm good, how are you? Thank you for having me.
- [02:52]
B
Absolutely. Thank you for being here. And you know, there's some interesting things that I wanted to discuss with you today that really go around two areas. One is around parenting and one is around working with really high achieving people as well. So just to set the stage for people so they know what's coming, we've got some interesting topics to go over today that we haven't talked talked all that much about yet on the podcast. So to start off with, tell everybody a little bit about yourself and the work that you do.
- [03:22]
A
So my name is Julia. I'm a licensed independent clinical social worker and I run a group practice that's here in Cambridge, Massachusetts, in the heart of Harvard Square. So for people that don't know, that's right over the river, the Charles river from Boston, and we specialize in ocd, anxiety and related issues. I myself have a special interest in the intersection of OCD and perinatal issues, as well as the intersection of OCD and eating disorders. And of course, just by nature of being in Harvard Square, I've developed a sub niche in working with high performers. And that was sort of by just chance location where we are the kind of people that we see.
- [04:10]
B
Does Harvard have a few high performing people? I wasn't sure if that's a few.
- [04:14]
A
A few as well as mit, bu. I mean, they're all a lot.
- [04:23]
B
No doubt. Well, happy to chat about those things. Your, your practice is called Soul Tality. I like that name.
- [04:30]
A
That's coolity. So it's a portmanteau, which is sort of the fusion of two different words. Okay, so soul and vitality. I think our goal as a practice is at the deepest level to help people get back to a place of growth and flourishing. Right. Where they're really living their values. And so that's kind of how I came up with the word saltality. And it just has stuck since, even though it's not technically a real word. I think it's a real word. And you know, I mentioned we, we specialize in ocd, anxiety, related disorders. We also have clinicians that have subspecialties and BFRBs, ADHD, trauma, and all of the intersections that come along with that.
- [05:21]
B
I think after you do this long Enough. You get to invent words. That's just a perk of the job.
- [05:26]
A
Yeah, well, somebody once pointed out that it wasn't a real word, so that always stuck with me, but I think it now is because enough people have heard of it.
- [05:38]
B
So I say that OCD is unfigureoutable. I don't know if that's a word either, but I like to use it all the time.
- [05:44]
A
It is now. It is now.
- [05:45]
B
It is now. So you were at the OCD foundation conference, which was fun, and we got to say hi in the hall. That was cool. One of the things that you did there was called Good Parents have Bad Thoughts, a group for birthing parents with intrusive thoughts. And I think that that's a really interesting title and really brings to the forefront this notion that giving birth isn't always the wonderful, awesome, you know, unicorns, farting rainbows experience. Right. That everybody would like it to be. Is it?
- [06:19]
A
No, it's not. And I think, you know, I was inspired to run this group for a lot of reasons, and I think I'm. I work with enough parents and mothers that I know this is a common issue that comes up. And for myself as an OCD therapist that at the time, I had my first baby in 2021, in the middle of the pandemic. And 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. And there was enough times I can remember my husband saying, you're doing all the things you're telling your patients not to do. And I would be like, leave me alone. Leave me alone. Get away from me.
- [07:09]
B
Shut up.
- [07:10]
A
Exactly. I was really blindsided by that. I remember right after she was born having a very intense, intrusive thought that made me question, do I deserve to be her mom? Am I? Do I love her enough? Am I grateful enough for this experience? And I couldn't get rid of that thought for a really long time. It really stuck with me, and it morphed into a lot of different things. So I think I share that because for a lot of people, we're on the lookout for postpartum depression. Everybody says postpartum depression. Postpartum depression, right, Correct. And. 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. And I think it's important to share that even as myself, as someone who works with this, I didn't realize what was happening and the depths to which this got. And I think the second piece from that, that I think is really important, I think for birthing parents, mothers specifically, to be able to have a place to share what that experience has been like for them to destigmatize. It is important. And then the second piece of it is, especially in this group that we had at IOCDF conference, so many moms brought up secondary grief like, and I know this comes up a lot within the OCD community where there is often a phase of treatment where we're having to process, well, what did you lose in your life because of this? And so I think the second piece of why it was important for me to run the group was also to have a place for people to process that grief of what they missed out on due to anxiety, intrusive thoughts, OCD in the pregnancy, postpartum period.
- [09:14]
B
Yeah, I, I think it's, it's an untapped discussion. Right, because you're right, everybody thinks of postpartum depression and just assumes that if you're going to have an issue after having a child, you're just going to be depressed, but you can be anxious, you can have ocd, you can have psychosis, you can have all sorts of things that happen after having a child. And it is very important to discuss that. In fact, when I see couples or individuals who've had a baby, I don't go up to them and say, oh, isn't it wonderful? I say, how are you feeling?
- [09:51]
A
Yeah, exactly. And there's not enough, especially in this country and not enough focus on how mom is doing after the baby. I remember going to my six week visit and I think I, you know, other than the box that said, do you want to, to kill yourself? You know, are you crying? I mean, I check 555-555-VAKE, you know, like feeling hopeless, crying. And my doctor didn't even address it in the actual appointment. You know, here I am filling out the survey, a bit of a cry for help. The only one that I didn't click was that I wanted to hurt myself. And yeah, I don't think anyone even looked at that.
- [10:31]
B
And this is something that can happen to the non birthing parent too. I've, I've treated dads who have this and see this in adoptive families. You can see this in foster families as well, right?
- [10:43]
A
Yeah, absolutely. And even surprisingly, men go through a hormonal shift when a baby is born too. Not obviously to the extent that women do, but there is a change in, in the Body of a male as well. And I think that's important to point out because they are also susceptible to things like this.
- [11:06]
B
So what were some of the things that came up in group? Obviously not giving away names or anything, but just what are the themes that you typically see that people bring up around the birth of a child?
- [11:17]
A
You know, I heard a lot of people talk about the struggle of indecision about going back to work, leaving their baby with another caregiver, even a partner, a parent, another, you know, a grandparent. And that a lot of. And then, of course, that impacted sleep issues, not being able to let anybody else care for the baby. There was a lot of people that struggled with connection, you know, that I think everybody's, oh, were you just bonding with your baby? It must be so amazing. You have. The oxytocin is just flowing. And what I heard was 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. So that certainly comes up as well.
- [12:13]
B
Yeah. And how difficult that is due to the fact that you've just assumed usually during pregnancy that everything's going to be just so wonderful and everyone only tells you the stories about how great things are going to be. And so when this happens, it's such a. Such a shift in what you were expecting and what you thought was coming. It's got to be overwhelming, I would think.
- [12:37]
A
And I think there's this societal pressure of, you should enjoy this time. One of my best friends just had a baby in February. She lives in London, where she's lucky to have way more maternity leave than we have. And she confided in me that she wants to go back to work. She's having such a hard time with this period and. And she's terrified to tell anybody that. She's terrified to admit that to her mom group, because who would ever want to go back to work? And I think it can be a really hard space. And obviously she's. There's a. You can be torn with that, I think feeling like the experience is hard, and so that feels like the alternative. So I think it's important to normalize that. This can be very hard.
- [13:26]
B
We know that OCD picks on things that are important, and obviously having a child is important. What are some of the ways the intrusive thoughts or images or urges manifest themselves for people who have a baby coming into their lives?
- [13:41]
A
Yeah, I mean, I think some of the ways. For example, I think about hyper. Responsibility. A lot of the times, which is one of the features we know with ocd. And when you have a baby, right, you're all of a sudden responsible for this thing. Your whole life you've only been responsible for yourself, and then, boom, overnight you're now responsible for this thing that can't do anything for itself. And you are the person that's in charge of keeping them alive. And if you are a person that already has a tendency towards OCD or has a history of ocd, especially with hyper responsibility, it can really latch onto that. I thought it was wild when I had my first baby and they were just going to let us take her home in the car seat. I remember calling the nurse like 10 times. Are you sure? Is it too tight? Is it too loose? Are you sure? And they can't even give you a 100% certain answer because of liability reasons. They're like, you know, they can't even touch it. And I'm like, can you just touch it? You sure? And I mean, you know, and then here you go and see you later. Keep it alive, feed it, you know, good luck, right? And so if you have a tendency towards that hyper responsibility, I think there's a huge area that that OCD can latch onto that. So that's a big, big one. I also think just loss of control, too. I think if you have OCD is so much about control. And when you have a baby, there's so much of that experience that you can't control. There's so much of like, birth that you can't control. And that can feel really hard for people. And I know that specifically it's not uncommon for people to have intrusive thoughts around sleep, safety, harm, fire, safety, feeding, love, right? Do I love my baby enough? How do I know? So those are all the ways that I definitely can see it come up for. Some of the ways, yeah.
- [15:58]
B
And it's never enough, is it?
- [16:01]
A
No, of course. Because somewhere on the Internet it will tell you that there's one more thing that you could do to ensure safety. When.
- [16:14]
B
I. I like what you said. This child comes into the world, they are 100 reliant on you, which means you are 100% responsible. And when you have a condition that tells you how irresponsible you are all the time, unless you do compulsions. It's so easy to see how a child can get sucked into OCD then in this situation. I. I worked with someone once and. And I can speak about her. We did an article about her, but she didn't touch her Child for the first six months of her child's life. The first time she picked her baby up was in my office at month seven.
- [16:52]
A
Yeah. I mean, heartbreaking.
- [16:54]
B
Totally. Absolutely. But what a joy when that therapy finally worked and she was willing to take the risk. Right. And. And actually pick up her baby and hold her child out of fear of what if she would molest her child or do something inappropriate or something like that.
- [17:10]
A
I mean, yeah, I mean, I, you know, and even just, I know people refusing to change baby's diaper, not being able to give the baby a bath, specifically alone. I had a lot of trouble with bathing my baby alone in those early days, specifically. If my husband wasn't home, I couldn't do it. At the same time, you know, traveling, you know, there's no shortage of disasters that can happen in. In life. Right. And so I think OCD can latch on to every single possibility. And with a baby who can't speak for itself and communicate and they're so fragile, it's. It's ripe territory for OCD to latch on.
- [17:57]
B
Yeah. Kind of a jerk, honestly. Yeah.
- [18:02]
A
So. Very much so. And it's sneaky. It's so sneaky. You know, so many women that I've worked with, they. And not necessarily in a compulsive way, but in the kind of. I'm going to advocate for myself. I'm going to set myself up for postpartum. I'm going to get the night nanny, I'm going to take appropriate time off work, I'm going to get meals planned and. And then it. It still can blindside you. It can creep up without you knowing and in a way that you never expected either.
- [18:35]
B
What was the turning point for you? When did you start? Or when have you seen other parents start to feel a difference? Some people, of course, will hope it just changes by itself, but I think intervention is probably a much more better line of defense against some of this than just hoping for something different to happen.
- [18:56]
A
Yeah, I mean, I think intervention for sure, for myself, it. It took a long time. It wasn't until I was sleeping again and sort of had the wherewithal to step outside of myself and take an observation. I mean, it's been point for me was when I got out of bed one night and I went out into the garden to the window where my daughter's room is, and I cut a hole in the screen because I figured if there was ever a fire and I couldn't get to her room, I could. So I was defacing my own property. Right. That was like my tipping point and enough wherewithal to take a step outside myself and say, okay, this. This is not normal. And to, you know, connect back to therapy. I think a lot of people, and understandably so I did the same thing, say, I'm gonna take a break when the baby comes from therapy, because everything is a lot, you know, I mean.
- [19:52]
B
Right.
- [19:52]
A
And. And I have a lot of clients that will say, you know, you know, I'm due next week, and so this will be our last session. And, you know, I'll reach out when I'm a few weeks in or a couple months in and things feel more settled. And sometimes. And sometimes that is fine, and things are fine, but a lot of the times things are not fine in that period of time. And I'll tell you, in that period of time when things are not fine, the distance between where I'm sitting right now and the door right there is 10 miles.
- [20:23]
B
Yeah.
- [20:24]
A
You know, and so I think I really do recommend make that first appointment a week or two after you have the baby, and if things are good and you want to take a break after that, but make sure you have that touch point of somebody that is outside looking in.
- [20:40]
B
Yeah, There's. There's nothing wrong with getting another opinion in a situation. Right. And. And having support through a difficult situation as well.
- [20:48]
A
Yeah, exactly.
- [20:53]
B
When you have a group like that, Right. At the conference, I'm assuming everybody's got to, at first feel a little like, oh, do I even want to go in the room? And what if people see me? But what's it like by the end when people start opening up and sharing? I mean, I'm sure you've got to just see relief just hit the face of people when someone starts talking and they all look at the person go, oh, I had that thought, too. Wow. What do you know? I mean, it's got to be incredible, right?
- [21:19]
A
I mean. Yeah. I mean, I have to say, everybody asks, how was the conference? How were your talks? That was my. That was the favorite. My. That was the highlight of the whole weekend for me. It was interesting. Myself and Maria Rossiter was my co facilitator who works with me at Soul Tality. We were in the room and, like, nobody was coming, and we thought, you know, the room was tucked away in the furthest. Furthest area of those conference rooms.
- [21:44]
B
Oh, over on, like, the third floor in the back there. Yeah. Or the fourth floor. Yeah, I know where that was.
- [21:49]
A
Yeah.
- [21:49]
B
Yeah.
- [21:50]
A
Very long walk. And. But, you know, then people started kind of trickling in and we had, I think, maybe 17 people total in the group. Two people came with their partners, which I thought was wonderful. A couple people in the group were also providers, in addition to having lived experience. And, you know, everyone. We went. We went around and everybody got a little bit of an opportunity to share. And then people kind of ping ponged off each other. And I think everyone felt really heard. And there was a lot of tears and validation. And I think specifically the part I mentioned earlier about grief, I think there was pain, but also 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? Do I have. 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.
- [23:09]
B
It's okay to grieve that, isn't it? It's okay to grieve. What OCD took away from you at the birth of your child.
- [23:16]
A
Exactly. But most people will say, oh, but your baby's healthy. You should feel grateful. You had a beautiful, long maternity leave. You got to take long walks by the river, you know, or whatever that people often will focus on. But your baby's healthy, so you should be grateful. Or you seemed fine.
- [23:40]
B
Yeah.
- [23:40]
A
You had a little anxiety, but everybody does, right?
- [23:44]
B
You just said a vacation in a tropical paradise for a week. Yes, but I had diarrhea the entire time. Right. I mean, it's like, yeah.
- [23:53]
A
My parents live on Cape Cod. And so for about two months of my maternity leave, I just went down there because I thought, it'll be cooler down there. I can get outside more with the baby. But in hindsight, it was a pretty awful decision for me because I was pretty alone and isolated and. But I'm in a beautiful setting, so none of that should matter.
- [24:16]
B
Yeah. Come on. You're in Cape Cod. Fried scallops, let's go. Yeah. You know, I mean, chowder. Yeah. Well, it's great to normalize this and to show folks that. That this is a experience that people have and it is not one that is needing to be secret. And we shouldn't punish it or make fun of it or anything. That it really is an overwhelming experience for people who deal with having a child. And I just think, you know, thank you for sharing, because there aren't enough people who do speak about it, and that keeps other people who may live in places that are even maybe more rural, where they don't have specialists, there's not someone doing a conference or someone who can't afford to go to the conference or something who, who would never know that, oh, there's other people out there in the world like this as well.
- [25:18]
A
Exactly, exactly. And even just hormonally, all the research we know is that just pregnancy itself can make intrusive thoughts louder, stickier, more frequent.
- [25:32]
B
All right. On the flip side, those, those kids grow up eventually and some of them become really high performing individuals. And, and just because you're doing really well and you're performing really well, doesn't mean you're immune to OCD or the effects of it, correct?
- [25:50]
A
Yes, absolutely.
- [25:53]
B
Speak about that to us. I think that that would be an interesting education for our audience.
- [25:58]
A
You know, I, I think that there, there's some overlap. I mean, we know that there's a lot of overlap between OCD and things like perfectionism. And so I think that you have a lot of people that end up at places like Harvard, mit, bu, BC who have these overlapping tendencies. And there's ways in which they're there, what they've been doing their whole life. Like, you know, a lot of, a lot of my clients will say, well, my double checking and rechecking and reassurance seeking and seeking validation, all these things are why I'm here at Harvard. Like, that's how I got here. Right. I got here by double checking my paper 15 times at night. I got here by checking with my teachers about every single assignment 15 times. Right. And so there's this way in which some of those behaviors end up getting reinforced and do fuel success. Right. And I think it can be really hard for people to pick apart, okay, what is me, what is perfectionism and my desire to excel, succeed at the highest levels, and then what is potentially ocd, Right. So sometimes we're seeing people that are getting this diagnosis for the first time.
- [27:29]
B
Yeah.
- [27:29]
A
Other times we're seeing people who got this diagnosis when they were very young. They somehow found a way to fuel a lot of these things into ways that worked for them. And then they get to college and it's not working anymore, and that's how they end up in our office.
- [27:45]
B
I'm glad you brought that up too, because sometimes I meet people and they want to try to convince me that the reason they're successful is because they have ocd, which would mean that my job would be to give OCD to people so that they could become successful.
- [28:00]
A
Right, exactly.
- [28:04]
B
I Think you're successful despite ocd, not because of ocd. And I don't know that people who check their papers 15 times really enjoy that experience whatsoever. And obviously we, you and I know from research that the more you check, the less confidence you actually have. So if, if rechecking things made papers better, why do I have less confidence in the work that I did as I check it more often? Right.
- [28:36]
A
Yeah, exactly. And I, and I hear that all of the time, whether we're talking about OCD compulsions or self compassion, it's. Well, I've gotten here if, you know, I've gotten here by being hard on myself and critical of myself and I've gotten here because I've been hyper vigilant. Right. So there can be. It's really hard for people to think about doing things any differently despite the fact that they're on academic probation because they can't hand in their assignments because they're spending way too much time on every single assignment.
- [29:13]
B
100%. Yeah. Right.
- [29:15]
A
Or because they can't, they're not getting to class on time because they're tied up with washing or rechecking things or whatever it is at home.
- [29:24]
B
Yeah, yeah. I've never walked up to someone and said, hey, it looks like you're having a tough day. How about a compulsion? You know, that, that's just that just not the way to help somebody through the experience.
- [29:36]
A
Yeah. You know, and I think too, for a lot of these folks, identity ends up getting tied to self worth and achievement in terms of external validation. Right. These are people who, their whole lives, they worked really hard and they got the award, the accolade, the praise, the acceptance to this prestigious program. This prestigious program. Right. So externally they're getting a lot of feedback. Good job, you're doing great. Yes, yes, yes. And that's how they have internalized I'm doing a good job. They get to a place like Harvard now and all of a sudden they're in a sea of other people who, same thing, accolade award this or that. And they have no ability to internally gauge how they're doing. Right. Most, I mean, I think a lot of people can say, hey, you know, I'm working hard on this. I know I'm working hard. I know I'm giving my it my all. And if I make a mistake or it's not perfect, like, I know that I, I did my due diligence. Right. For, for a lot of these people that also have ocd, there's this fear of, I don't Know if I'm doing a good job, there's no one that's sitting over my little shoulder telling me in this very moment that I'm getting the A plus or the accolade or the award. So the only way for me to continue to be sure of that is to keep rechecking, keep redoing, keep rechecking.
- [31:09]
B
Yeah. And when you go from being the one in your school who was the top notch person to being in a school full of them, you're not special anymore, are you? And that's, that's an identity shift also for a lot of people right now. Who am I? And it is.
- [31:26]
A
And also too, I mean there's like immense wealth at Harvard too. There's people from all sorts of prestigious backgrounds. And I think, you know, imposter syndrome is real. You know, I see it more with those students than probably any other population I work with. So, you know, I think in a good way a lot of them are find out, hey, I think I have OCD or I think this is something I want to address. And fortunately, because they work hard and do their homework and find what evidence based treatment is the best to treatment treat them. You know, they come in and they're ready to do act, they're ready to do ERP or ICBT or whatever it is that they heard. And so that's a joy to work with for sure. But yeah, I would say that the environment can definitely breed those sorts of things.
- [32:23]
B
What's your goal at the end of a work then with someone who's such a high achiever? What do you hope they're going to get out of the therapy experience and how they're going to move forward after treatment?
- [32:35]
A
I think so A, A lot of it is that self compassion work and working on internal validation. Right. Not in a self reassuring way, but the willingness to give up seeking certainty and needing a hundred percent sure as a goal. I think another big goal for people like that is, is developing that psychological flexibility and the flexibility to kind of, you know, I have this project that I want to do and I have friends that I want to make too. Right. The willingness to open up their lives. Most of the people that we see are spending so much time on compulsions that they're actually not like they're not doing any of the fun stuff.
- [33:23]
B
Right.
- [33:24]
A
That is involved in college. Right. They're terrified too. Right. So so much of it is, you know, what do you want to be doing? What's important to you? And a lot of people have struggle to identify Values, because their value is a plus. Circumstance, success, external validation. And now they're. But they made it. They're at Harvard. They're there, their grades. So a lot of the times, it's about building a more flexible life, helping people identify their values, opening things back up, creating new relationships. The willingness to give up perfection at times. And I never say the goal here is for you to fail a test or, you know, do poorly on something that is important for your future, but it 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.
- [34:22]
B
Yeah. Are you willing to take a risk? Right.
- [34:25]
A
Yeah. And, you know, from an inhibitory learning standpoint, these are people who are really good learners. And so a lot of that stuff really does stick. They really do have a lot of those amazing aha. Moments that we love to see with erp.
- [34:41]
B
Yeah. And for those of you not familiar with inhibitory learning, it's really learning a new way to behave and practicing that, and doing that makes the recall of that behavior and that way of doing it easier. And the old way kind of fades into the background, hopefully, so that it's less accessible for you to use as an option of how to respond to something.
- [35:02]
A
Yeah. And also, just when we are surprised by something, anything in life, like, oh, my God, did you. Did you know that he started walking when he was one? Like that. You know, we remember things that we're surprised by. So if the client says, no, I will get. I will fail this if I do not triple, quadruple check. Let's try. Let's take a behavioral experiment. And then they go, whoa. And I got an A. You know, I mean, almost always. Still coming back with a very good grade.
- [35:34]
B
I think a fundamental question for a lot of people, especially for high achievers in these situations, is, is it worth the risk? And I think that you have to look at that risk in both ways. Is it worth the risk to maintain OCD for the rest of your life and have it ruling things, or is it worth the risk to do something opposite of it and just see what happens?
- [35:54]
A
Exactly. And I. I think there's that goal of getting to college or the grad school or whatever it is, can feel like, well, that's always what I've been working towards and nothing else has mattered. But then they have to have a kind of aha moment when they get to college of, well, is this it? Is this how I want to be forever? They see people around them making friends, having Relationships. You know, I've had clients that, you know, are in grad school and they're afraid to date because of their ocd. Right. Getting canceled in some way. And the core, you know, so many people I think have these, especially of this perfectionistic, high achieving demographic. There's a lot of, if I get canceled, everything I work for will be for nothing. Right. Because so much of that core fear comes back to everything I've worked for could be taken away. And so, yeah, there does feel like there's a lot of risk.
- [37:01]
B
Your job is to help motivate people to take the risk. One of my favorite phrases is from Ireland. It's only an Irish person can tell you to go to hell and make you look forward to the journey. And sometimes I think about ERP that way, where we're going to ask you to do something really difficult and we're gonna get you really excited to be doing that really difficult thing. Right.
- [37:25]
A
Yeah. I mean, how do I guess, you know, to answer, how do I do that? I think sometimes I do try to share success stories, obviously not giving other people information, but to say, hey, these are the ways in which ERP have positively impacted the lives of other people who struggle with perfectionism in xyz. I try to take examples of what it means to live an ERP lifestyle in our everyday lives as well, but I think a huge part of it is talking with a person and really helping them identify their values. And what is life going to look like if you continue on this way? I always think of, I think it was, I think it's an act exercise. And of course, I wouldn't use this with somebody that was very depressed. But it's the funeral exercise where you have someone envision what would be said at their eulogy if they continue to live their life in service to ocd.
- [38:28]
B
Yeah.
- [38:29]
A
So, you know, sometimes like, what is it going to, you know, I, who, who shared that meme a long time ago is a gravestone which just said almost figured it out or something like that.
- [38:38]
B
Yeah, probably Hirschfield. Yeah.
- [38:40]
A
Yeah, I think it was him. Right. But, but, but truly, what's, what is going to happen? What is life going to look like?
- [38:48]
B
Right.
- [38:49]
A
A year from now, five years from now, 20 years from now, if you, because this is snowballed, to live in service of this. And I think it can be powerful to share some of those other stories because it's so easy with people that have ocd say, well, I'm, I'm the exception, you know, I'm special. Yeah, I Can't, I can't risk it. I get it if you are, you know, whatever, but this is special for me.
- [39:16]
B
Yeah. Yeah. I like to ask people, will you spend the rest of your life sitting next to your tombstone when you'll be six feet and wondering when you'll be six feet under it? Or will you have a great time and on the day of your death arrive at your tombstone and say, well, that was fun.
- [39:31]
A
Yeah, that was fun. Exactly.
- [39:34]
B
Sadly, there's a lot of people just sitting next to their grave wondering, when is it going to happen? When is it going to happen? And they miss out on living their life, unfortunately.
- [39:45]
A
Yeah, I mean, I hear that all the time with people that have health related ocd. You know, they say, well, I'd rather just know that I'm going to get cancer this year and probably die, then live the, the rest of the year not knowing if I'm going to get cancer or not.
- [40:01]
B
Yeah, People say that to me and then I bring up that my wife died of cancer and I say, you know, you don't want that. From, from personal experience, I could tell you that I don't. I don't think that that's really what you want. As, as much as on the idea it may seem like it would make it easier once you get it, then the can of worms that it opens up. Well, and, and how many times do you and I see this, even in our work, where someone will have ocd, will be working with them, and then something else will trigger them. And, and now that thing is the worst thing in the world, even though last week this other thing was the worst thing in the world. And they just say to us, God, I wish I could go back to that thing, because that was so easy actually, in comparison to this thing. You know, it's, it's always the shiny new object for OCD of this is now the most important thing in the world.
- [40:53]
A
Yeah. I run an OCD women's group. We meet monthly and the women in the group always joke about that. You know, they'll say, oh, God, I miss having pocd. That was, that was a lot easier than what I'm dealing with right now. I wish I could go back to that, you know, and of course, when you're in it, that's legally not how you feel.
- [41:13]
B
Right. Or when the other group members who are especially the new one says, oh, I wish I had that kind of ocd. Right? Everybody just goes, yeah, no, no you.
- [41:21]
A
Don'T, no, you don't.
- [41:24]
B
So we've got the Conferences. There'll be more. You know, there are books to write, there are groups to run. What do you look forward to in the mental health field coming up next? What are. What are things that keep you excited and motivated?
- [41:41]
A
Yeah, you know, I'm part of the moms with OCD sig. I'm very excited that the ioc, IOCDF started these special interest groups. And even though my OCD experience was, you know, specifically in the postpartum period, they have let me join their club, which I'm very grateful for.
- [42:02]
B
That was very nice of them. Yes.
- [42:03]
A
Amazing group of women. And I'm excited about some of the things that they're doing there. Specifically Postpartum Support International, which is the leading international agency organization that educates on the perinatal stuff. I think there's some areas that we could do better job in educating what OCD is, what OCD is not the difference between OCD and postpartum psychosis. So I know that there is some effort to bridge that gap. I think maybe the IOCDF has been in contact with them. So specifically I'm, you know, excited to think about expanding, working with the perinatal population.
- [42:50]
B
Yeah, I spoke at one of their conferences once, actually. That was really fun.
- [42:55]
A
Well, they should keep inviting you back because, you know, there. There were some tropes about OCD that. That I think none of us would find too funny, but everybody, they're, you know.
- [43:08]
B
Yeah, it was pre. Covered, so it's time, I think.
- [43:12]
A
Yeah. So I'm excited to think about ways that we can bridge that gap between the perinatal space and the OCD space. I'm excited about the research that's coming out about psychedelics as well in the treatment of ocd. That's something that I really enjoy learning about, specifically having alternatives to things like SSRIs, so that's awesome.
- [43:46]
B
Well, I appreciate the work that you've done and really speaking openly about your own personal experience and the work with this population that sadly goes under recognized and under treatment because. And. And maybe just one more thing to talk about. We. We talk about OCD very often, and the dsm, I think, gets it wrong because it says OCD is about if. If you can't do your compulsion, you'll be anxious or uncomfortable, but there's also shame and guilt and disgust. And I'm just wondering, do you. I'm sure you see a ton of that beyond just anxiety, but maybe the shame or the guilt or the disgust that people have over the thoughts about their children or being a parent once A child comes into their life. Right.
- [44:31]
A
I mean, that's how it started with me. 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. Right. Like, so discussed as well. I have a lot of moms, I have a lot of clients who want to become moms and they think, well, how if I can't even deal with my own poop, pee, vomit, any of that, how could I possibly deal with a baby? You know, I have a lot of moms that have emetophobia. I'm almost thinking I might start a support group next winter when it all starts peaking again. Right. And so much of that is discussed too. But I think you got to take that mastery approach. Right. Like, what do you need to do to be able to change your baby's diaper, even if it means wearing gloves?
- [45:25]
B
Yeah.
- [45:25]
A
You know, do you need to keep a puke bucket under your bed just so you feel like if you do have to puke that you have somewhere.
- [45:31]
B
To puke, you know, hence the emetophobia. Yeah.
- [45:36]
A
Right. So, yeah. You know, and it's not necessarily anxiety, but it's, it's discussed. It's gross. I'm not gonna be able to get rid of this feeling.
- [45:45]
B
Right. Well, Julia, thank you for your time today. I really do appreciate it. And best of luck. How can people reach out to you if they want to get in touch with your practice?
- [45:56]
A
Www.soultality.com S O U L T A L I T Y We have an in person office, like I said, in Harvard Square, and we have plenty of virtual appointments and we're also going to be rolling out intensives this fall. So that might be for anybody that wants a more accelerated path with their ERP treatment. So not really an Iop, but sort of Iot. Yeah, is what we're going to call it.
- [46:28]
B
Cool. And thank all of you for watching again, the get to Know OCD podcast. We really appreciate you and if you like it, subscribe to our NOCD YouTube channel. And if you're looking for help for OCD or related conditions, check us out@nocd.com that's nocd.com we'll be back again with other episodes soon on the get to Know OCD podcast. Until then, be good to yourselves because OCD isn't going to be. So go ahead and take some practice. Try to be nice to you. We'll see you soon.