The real story behind NOCD: Make-or-break moments & the mission that drives us

Summary

---

Get to Know OCD Podcast

Episode: The Real Story Behind NOCD: Make-or-Break Moments & the Mission That Drives Us
Host: Dr. Patrick McGrath (Chief Clinical Officer, NOCD)
Guest: Stephen Smith (Founder & CEO, NOCD)
Date: February 12, 2026

---

Episode Overview

In this special live episode from New Orleans, Dr. Patrick McGrath sits down with Stephen Smith, founder and CEO of NOCD, to explore the untold, behind-the-scenes story of how NOCD was born from Stephen’s personal struggle with severe OCD and grew into a mission-driven organization. The conversation is candid and unscripted, tracing NOCD’s evolution through make-or-break moments, early failures, critical team relationships, and a relentless focus on supporting those living with OCD.

---

Key Discussion Points & Insights

1. Stephen’s Personal OCD Journey (00:56–05:04)

• Initial Symptoms and Misconceptions:
  • Stephen describes having early OCD symptoms, like a persistent fear of a pen cap being stuck in his throat, and frequent ER visits seeking reassurance.
  • "I kind of had symptoms early on that I now attribute to being related to OCD, but I never really had a severe onset until my sophomore year." (01:33)
• Severe Onset and Treatment Struggles:
  • After sophomore year in college, Stephen’s OCD became severe. He faced distressing, taboo intrusive thoughts, not matching the typical stereotypes of OCD.
  • He visited multiple providers, each offering misguided treatments—including rubber band snapping, thought-challenging techniques, and the blame being placed on family dynamics.
  • "Ended up getting worse, not realizing that that was, in fact, a compulsion." (02:12)
• Isolation and Escalation:
  • Misdiagnosis and ineffective treatments led Stephen to depression and being housebound.
  • He describes compulsions as almost entirely mental: rumination, checking, and reviewing past events, all to disprove his fears.

2. Discovering Community & Accessing ERP (Exposure and Response Prevention) (05:05–07:43)

• Finding Others Like Him:
  • Online, Stephen finds a community of people with similar OCD experiences, a “profound moment” of realization.
  • “There are other people out there who are going through the exact same experience, same fears, same reactions to them, same … life consequences, right?” (05:08)
• Barriers to Treatment:
  • Despite learning about evidence-based care (ERP), Stephen encounters major barriers—long waits, out-of-network costs, and minimal between-session support.
  • With help from family, he eventually begins ERP with a specialist, referencing “Stop Obsessing” by Edna Foa, and slowly starts to make progress.
• OCD as a Hidden Crisis:
  • “One in 40 people could suffer like this, yet there’s available options for care that are actually evidence-based… and that, to me, was an ops issue, not a clinical issue.” (07:29)

3. The Initial Idea for NOCD: Creating Better Support (07:43–12:58)

• The Spark:
  • On a road trip, Stephen sketches the idea for an app offering ERP support between sessions, envisioning integration with a smartwatch for real-time response prevention.
• Early Prototyping & Hustle:
  • Returning to school with no funds, Stephen goes to China to teach English, developing the prototype there and seeking clinician feedback remotely (notably from Taylor Newendorp).
• Securing Initial Funding:
  • Back in the US, he raises ~$80k from “friends and family” to develop the first version, working with engineers in Armenia while juggling school and college football.
• Early Feedback and Pivot:
  • Clinician testers like Laurie Johnson provide crucial feedback, but initial user adoption is underwhelming. Asking users about their biggest needs reveals a strong desire for peer connection, inspiring the creation of the NOCD Community.

4. Building the Team & Surviving “Make-or-Break” Moments (12:58–28:00)

• Team Turbulence & Breakthroughs:
  • After failed engineering partnerships, Stephen turns to Anil Vitla (early Hulu team) and Ilas (data scientist), who stabilize and mature the platform.
• Scraping By:
  • With less than $10,000 in the bank and high server costs, a crucial partnership with San Jose Behavioral Health brings in the first $1,000/month contract, soon growing to $2,500/month.
• Unexpected Breaks:
  • At a bio-conference in San Diego, Stephen networks his way into clinical trial partnerships (e.g., with Biohaven), leading to a $100k/year contract and huge validation.
• Growing Pains:
  • Technical problems like servers crashing due to unexpected publicity (e.g., UK television coverage) underscore the fragile state of the startup.
• Investment and Growth:
  • Larry, a seasoned executive, joins as a key leader; Seven Wire Ventures invests $1 million, marking the transition from scrappy startup to scalable company.

5. The NOCD Model: Bridging Community and Clinical Care (28:00–33:00)

• Clinical Research & Scaling:
  • Collaboration with Columbia University shows NOCD plus a therapist is more effective than standard care; this informs the creation of NOCD Therapy (formerly “NOCD Pro”).
• Learning Critical Lessons:
  • Dr. Fiesner’s intervention pushes NOCD away from a messaging-based service toward a clinically effective virtual specialty therapy model.
  • “Again, there’s all these points along the journey where you could have taken the wrong step. But again, with the right team, you take the right step.” (31:13)
• Insurance Obstacles:
  • Insurers initially don’t recognize OCD as a problem due to misdiagnosis and mis-coding; NOCD overcomes this by mobilizing their own user data to prove demand and get covered.
  • Partnerships with major insurers begin in 2019.

6. The Make-or-Break Pandemic Moment (34:06–38:59)

• Crisis and Decision:
  • In early 2020, a major clinical trial partnership abruptly ends, gutting revenue and putting NOCD at a financial cliff—six months from shutting down.
• All-In Commitment:
  • The team, buoyed by family and collective mission, chooses to go all-in.
  • The pandemic accelerates the adoption of virtual therapy, and NOCD grows rapidly, closing a $12 million Series A that summer.
• Reflecting on Mission:
  • “We’re giving not just life-changing care for many people, we’re giving life-saving care and that’s really impactful.” (37:25)
  • Stephen credits persistent, iterative team effort as the key to NOCD’s growth, not “having things handed to us.”

---

Notable Quotes & Memorable Moments

• On Realizing OCD Is Not Just a Quirk:

  • “I had no idea of such a disabling chronic condition that affected one in 40 people globally that was treated in a really specialized type of way.” (05:16, Stephen)

• On Barriers to Care:

  • “I saw that there was one provider in my area, she was cash pay, charged $400 an hour, and she has seven month wait list. And that was the only chance to actually get better.” (06:07, Stephen)

• On Early User Feedback:

  • “We launched it, thinking everyone’s just gonna come and use it, and no one actually used it. And we were perplexed, right?” (13:55, Stephen)

• On the Power of Team and Mission:

  • “With the right team, you take the right step. ... A good lesson for all of us here going forward too.” (31:13, Stephen)

• On the Pandemic Pivot:

  • “We had two options. Option A was we’d shut down the business. Option B was we’d go all in.” (34:47, Stephen)

• On the Deeper Purpose:

  • “We’re giving not just life-changing care for many people, we’re giving life-saving care, and that’s really impactful.” (37:25, Stephen)

• Dr. McGrath on Being Welcomed to NOCD:

  • “The fact that you took a risk on me knowing what was going on in my personal life and allowed me to be able to work with you and take care of [my wife] at the same time, we’ll always meet a lot.” (39:00, Patrick McGrath)

• On Stephen as a Founder:

  • “You amaze us every day with the work you do. We are honored with what you do, what you represent, what you have taken from a personal side and brought to the world because one person suffering meant no one else should suffer anymore.” (39:47, Patrick McGrath)

---

Important Timestamps

• 00:56–05:04 — Stephen’s personal journey with OCD and failed early treatments
• 05:05–07:43 — Discovery of the online OCD community and the reality of treatment access
• 07:43–12:58 — Origin of the NOCD app, early prototyping, and funding stories
• 12:58–28:00 — Early product iterations, team building, and the value of community
• 28:00–33:00 — Clinical partnerships, product pivots, and insurance breakthroughs
• 34:06–38:59 — Pandemic crisis, critical choices, and NOCD’s scale-up phase
• 38:59–40:43 — Reflections on mission, leadership, and gratitude for the team

---

Recurring Themes

• Personal Experience as a Foundation: Stephen’s struggle drives a relentless focus on clinical quality and user-centered design.
• Community as Catalyst: Early user needs and peer connection shaped the platform’s evolution.
• Mission Over Money: NOCD survived on grit and purpose, not on large upfront investment.
• Navigating Uncertainty: Multiple “life-or-death” moments—from financial crises to server meltdowns—were overcome through ingenuity and teamwork.
• Pioneering Virtual Therapy: The journey from community app to evidence-based virtual therapy reflects ongoing adaptation and learning.
• The Unseen Epidemic: A central concern throughout is the misdiagnosis and under-recognition of OCD, both among providers and insurers.

---

Final Message

NOCD’s mission is rooted in personal experience, strengthened by community, and realized through evidence-based care, innovation, and persistence. The episode is a candid chronicle of how one person’s suffering was transformed into a resource that now changes—and saves—lives worldwide.

---

Transcript

[A]

Foreign.

[B]

And once again, welcome to another episode of the get to Know OCD podcast. My name is Dr. Patrick McGrath. I'm the Chief Clinical Officer for NOCD. I'm thrilled today to be here with a cast of thousands live in New Orleans. And honored to have as my very special guest, Stephen Smith, the founder and CEO of NOCD. Hi, Steven.

[A]

Hey, Dr. McGrath. Hello, everyone. Thanks again.

[B]

This is fun to really hear from you firsthand about the development of nocd. People have heard some of your story of ocd, but probably don't know the full development of NOCD and where that came from. So I'm wondering if you could kind of give us a little background today on where that came from and how we're here today.

[A]

Sure. So we, you may, some of you may have listened to the OCD Stories podcast at one point or another. We did an episode about a year ago where we talked about some of the details of the no City story. We're going to do that here today. We're going to talk specifically about, you know, how the company started and how it scaled into again, the organization that we all work at and, and that we're, that we're building here for the future. So just to kind of give you the backdrop, so I had a severe onset of OCD after my sophomore year of college. So I was 20 years old. You know, prior to my severe onset, I had kind of inklings that I had ocd. I had a fear that, for instance, that I had a pen cap stuck in my throat at one point. And like, I would, you know, I was. I was just wondering, would I chew on a pen cap and part of it get stuck in my throat? And I was, I'd go to the ER sometimes just to actually ensure that there wasn't something stuck in my throat, even though I kind of knew there wasn't. So I kind of had symptoms early on that I now attribute to being related to ocd, but I never really had a severe onset until my sophomore year. And then, you know, when I was a sophomore, after my. Finished up my, my finals, I came back to, to Chicago for summer break and I started having the unwanted intrusive thoughts that are characterized as ocd, as we all know. And they were very different from that pop culture definition. Right. It wasn't the contamination or perfectionistic types of fears. They were more taboo in nature. Right. And so I didn't know what to do. I was, I was, I was very distressed by them. And so I went to try to find help, and there was a Provider in my area. She was cash pay. She. I'm sorry, wasn't cash pay. She was in network. She was a psychologist from Northwestern. And. And the person said, hey, for every time you have a fear, I want you to take a rubber band. I want you to snap it across your wrist. And I was like, this is a really credible person, you know, and they were in, you know, just. And I didn't know much about mental health care, but I knew that you wanted to see a professional if you were. If you were struggling. And so I started doing that and ended up getting worse, not realizing that that was, in fact, a compulsion. And then I saw another provider, and that next provider said, you know, you, again, just have anxiety. I want you to. I want you to figure out a way to. To pause when you have these fears, to challenge them, and to imagine a train running through your head. And every time a train car goes on by, I want you to take one of your thoughts and place in the train car and let it just like, imagine it running on by. And then you just kind of take your thought with you. Was like, wow, it's kind of strange, but I'm gonna. I'm gonna do it. So I ended up doing it got worse. Saw a third provider. They said, you know, your family's the issue, right? I'm. I'm one of five kids, you know, they said, you're. You know, you have a lot of chaos going on at home. I think that might be the problem. That's why you feel a lot of anxiousness. It's why, you know, it happened when you came home for summer break, you should probably move away from your family. So packed my bags, I went back down to. To Texas, and it was where I was going to school, and I had a, you know, a really strong community, and I thought that would help, and ended up getting worse and developed depression. And then I had a. From. From that point on, I had to leave school because I was depressed, and I had severe OCD fears from the time I woke up until the time I went to sleep at that point. And my compulsions were mainly mental, where I would, you know, ruminate, and I would review past events. I would do a lot of the mental checking to try to disprove the fact that my fears were actually, you know, I was trying to disprove the legitimacy behind the fear. And then when I became housebound, things really started to spiral. I actually had symptoms spike even further. I was crippled by them. Saw another provider, and they said, we should address this depression. Because that's the problem right now. Again, no one was actually talking about OCD yet. And here I was at a point where I was the previous year. If you were to go back in time. I was starting quarterback at a very small school in South Texas. Everything was going perfectly at a great social life. And at the point where I was in that moment, I was completely housebound. I was crippled by this horrific condition and then desperation. And also based on now my knowledge of ocd, I was Google searching for reassurance. So I was searching online for help, just typing in the specific fears that I was having to try to figure out if I could find an answer that would satisfy the questions in my head.

[B]

And.

[A]

And I stumbled upon a feed of other people who were, who were going through the exact same thing as me. And that was a profound moment. Cause I was like, man, there are other people out there who are going through the exact same experience, same fears, same reactions to them, same, you know, life consequences, right? So this must be similar to what I'm going through. And as I was learning more, they were defining their symptoms as ocd. And I was like, ocd? You know, I thought that just a personality quirk or an adjective used to describe somebody who's type A. I had no idea of such a disabling chronic condition that affected one in 40 people globally that was treated in a really specialized type of way. Like all these nuances about the condition and the treatment, I had no idea about. So my next logical step was, well, where do I go get treatment? Right? I'm at this low point and I started searching more and I saw that there was one provider in my area, she was cash pay, charged $400 an hour, and she has seven month wait list. And that was the only chance to actually get better. Right. And fortunately I had very strong support from Kara, my wife, who's here somewhere, as well as her family, as well as my family. And I was able to get into that provider and off the wait list after some time. And she diagnosed me with ocd. I had a family member helped me with the cost of treatment because I was out of school. I had no money and started doing ERP therapy with this provider. And then between sessions I was on my own. So it was kind of a tough process because I'd see this provider once a week outpatient. The only other option was I could go to Houston and drive three hours because I was in San Antonio and drive three hours there, three hours back. That wasn't feasible though. So that was just My option to get better. So I was, I was seeing this provider, I was reading Stop Obsessing by Edna Foa and trying to understand, like, how to really integrate erp. Because I was so, you know, interested in getting better. I mean, I really wanted to regain my life, right? It was, it was a tough position at the end. And then kind of like slowly but surely started making progress because ERP is really effective, right? And at that point I was like, man, you know, this is a pretty crippling condition, right? It's really, it's like the worst thing you could possibly imagine going through. I can also define it besides that, but you can get access to life changing treatment, which so many of you today here, you know, offer on a daily basis. And you see it firsthand. So it's amazing. Like now we look back and like, all right, well, this is life changing with the time. Like, it was not very well known. So. So to me, it was like a, it was, it was kind of wild to think that one in 40 people could suffer like this, yet there's available options for them for care that are actually evidence based. And so to me, that, that was an OPS issue and it wasn't necessarily a clinical issue. And so, so at that point I was like, you know, there's gotta be a better way of solving this problem. And so the next part was I was like, okay, I was on a road trip going from San Antonio to Dallas, right? In this kind of point in time where I was starting to get better, it wasn't fully better yet. It takes time. I mean, you never really get fully better with oc. It's chronic. But I was starting to see significant progress. And I was kind of whiteboarding or I was on a notepad. I was sketching out an idea for if you had access to support between your therapy sessions. Because that's where I was. I was between therapy sessions. Literally in that moment, I was like, you know, I would love to more easily do ERP in this time that I have right now. And so I was sketching out this idea for support between sessions and I was like, this is really potentially awesome if this can be built. Like, we should build this. Why is no one building anything like this? So the idea was to build a mobile app to help people with OCD between their sessions that connect it to a smartwatch app. And this was before, you know, the Apple Watch. This was like, right, right as the Apple Watch was starting to emerge. Okay. And the idea was, what if you could identify through biometrics that you were having an OCD episode. And you can do response prevention in that moment. And then even you can, you can do ERP homework more easily as well, right? So this is the idea of no City at the time. And so I was like, okay, we're going to pursue this. And I was out of school, remember, I didn't have any money, I was out of school. And there's a guy who I went to. To school with who was interested in supporting the process. So I was like, all right, great, we could work together on this. And so we started to whiteboard, start to map out kind of like a blueprint for what this product would look like. And we didn't have Figma, we didn't have Miro boards, we didn't have even Sketch, which Larry and I joke about is what I use, like the old school design software. But we had this software called Fluid ui, okay. And you could actually build a prototype on Fluid ui and it would, it would show you screen by screen, like what this would look like. So we created a document, we tried to build. It had an engineer that didn't work out at the time. So we parted ways and then we, you know, we realized we probably want to go in and build this platform with a partner developer. Okay. So we. And that's when I was like, I don't have any money for this. I'm going to have to.

[B]

If I'm.

[A]

We're going to pursue this, we're going to have to get that. We're gonna have to get some data behind the decisions we're making, that this is actually a strong product. So I actually went to teach English in China, so I can get my room and board covered. I can work on OCD and be in a position where I was minoring in Chinese. I can learn Chinese a little bit better. And if one day I wanted to go back to school, I could certainly use that to help. So I was in. I packed my bags, went to a small city in China called Luoyang. And when I was in China, I was developing the software, right? And we would send the prototypes to different clinicians here in the US who are kind enough to spend their time giving us feedback. One in particular is actually here today. Taylor Newendorp. Everybody raise your hand. Here's Taylor. So Taylor may remember these early days, but we would send a YouTube clip of this Nocity app before we had therapy to Taylor, and Taylor would, you know, give feedback. I was actually looking, as we were preparing for this, I was looking through my emails and I was stumbled upon 1 from 2015 where going back and forth with Taylor, who had his practice in Chicago at the time, and he.

[B]

Worked for me too. Now I know why he was absent all the time, because he's doing those things. Hey, we're gonna have a chat later, Taylor, just so you know.

[A]

Yeah, yeah, yeah.

[B]

So we. So.

[A]

So we were building this though, and it was. And again, like, it was a. It was. I was. The city I was in was a little bit remote, and so the WI fi was kind of spotty. It was difficult. Again, didn't have any money. So I was just trying to get interest in what we were doing, trying to figure out if we could raise some funds. And it was very difficult. We couldn't actually raise funds while we were in China. So I was like, okay, I need to find a different path here to get this off the ground. And so I went back to the US and re enrolled in school at Pomona College in Southern California. And at Pomona was able to, because I was in the US was able to raise a friends and family round of funding. So I was able to fund the initial development of NOCD. And we raised $80,000. And that was hard to do. We had, we, you know, we had to figure out how to get people to write, you know, two to $5,000 checks, right, that were just, you know, and that meant a great deal to us because these are people that we knew in the community who just entrusted us in this idea and wanted to pursue it. And the passion that we had for it was, Was. Was hopefully, you know, seen by them. And I think they, they, they. That was why they ended up doing it. They didn't know much about the condition or what we can do. We had no track record. We just had a lot of passion for this, this, this challenge that, that we were solving. And so then from there, right again, we had to figure out how to develop this. So we raised the funds. So we. We found. After calling hundreds of different engineers and product groups here in the US we found a firm that said, hey, you know, we don't have the bandwidth to do this, but we have an office in Armenia and that we can, we can help you work with. So we ended up working with that group and, you know, that they took on the project. I.

[B]

The.

[A]

The development of no CD while I was in school. So at nighttime, it was like 11 o' clock at night, and I'd finish up with school. I finished up playing football because I was playing football on the team at Pomona. And Then we project manage this team in Armenia. So it was this daytime in their. In their country, and that's how the process works. So the initial Nocity app, after about eight months, was developed through this process where you had this development team in Armenia. I was in the US we project managed them. And then in 20, the app finally shipped and there was a beta group of testers. I think Lori Johnson, who's here, was one of them. Laurie, were you. You know, you're not one, you. Oh, man. Well, hey, you know, but you did, you did influence it. We did talk to you, but no. So we had a team of early testers, clinicians primarily, who would use NOCD and give us feedback, saying, look, I like this feature, I don't like this feature. And then eventually we had enough feedback to like, okay, we. People are in general saying this, this should be shipped to patients. And so we started shipping it to people who have ocd. And then we got a whole host of other feedback. We realized in a short order that we actually wanted to improve it even more. We had a lot of changes we wanted to make. We couldn't make it fast enough, unfortunately, with the group in Armenia. So we had to figure out a different way of building this product. And so we ended up raising another round of friends and family funding because we didn't have the money. So we said, okay, well, we're gonna raise this time $120,000, and we're gonna, through this money, get an engineer here in the US that can help us build this out, an augmented design for this platform. And then what's gonna happen is over time, we're gonna improve the product experience enough for our members to use it. Right? We were at a point where we ended up engineering the V2 version, and no one actually used it. So we had this elaborate new design that passed every single clinical benchmark. And everyone that was about to use it said, hey, look, you know, we're going to use this in a. As much as we can. This is great, blah, blah. So we launched it, thinking everyone's just gonna come and use it, and no one actually used it. And we were perplexed, right? We said, why? Why is no one actually, you know, using this. This platform of everyone's giving us great feedback. And the. The reason for it was from what. From. In reflection was people said they wanted to do something, but what they. They showed a different type of action. So we started asking people, hey, you know, if you could snap your fingers and fix three things about your OCD treatment, what Would you fix and why? And they gave us feedback again. I want to more easily get help in the moment of an episode. I want to more easily do my ERP therapy. I want to. I want to understand what happened between sessions and more effectively communicate to my therapist. We were doing these things, like, we couldn't understand why that was a feedback because we were doing those things. But we saw in the dialogue where people actually wanted to connect with one another. So we asked that question on social media and in the replies, people were liking each other's replies. They were connecting with one another, following each other, they were supporting one another. And we're like, wow. What they're showing us is they want connection. They want to actually connect with one another. And so we said, okay, well, we want to build a way to have people with OCD connect to others like them or understand them. And that was a turning point in our company because what that did was that was like the initial phases of the NOCD community. Okay. So we started, you know, trying to build this or ideating on it. And we quickly realized that team in Santa Monica was also not the right fit. Okay. So we parted ways and we were running out of cash. So that 120,000 we raised because we worked with them, you know, dwindled quite a bit. And we had a point in time where we were. If we didn't find a new engineer quickly, it would have been. It would have been the end of the company. Right? So we went and we called one person who I know very well from growing up, and he was one of the early team members at Hulu, Anil Vitla, who's our co founder and cto. So he. Anil, it was like a. It was a. Again, we were in la, it was a very late night in Santa Monica. I think it was actually at a McDonald's in Santa Monica. We were going through our GitHub and showing him what we built. And I asked him, like, can you help us with this? And, you know, the first few times he was like, I'm not sure if I can. And then he finally said, okay, I'll do it. I'll help you stabilize the. The platform in such a way where you can actually start to build. And so Anil came in and he did that within the first week. Like, we saw performance for this platform that we never saw before. And I was like, wow. I mean, this is the benefit of working with someone who really knows what they're doing. And so then Anil brought in Ilas and Ilas you know, Ilas was a data scientist in Santa Monica at a rapidly growing startup, and he decided to join part time. And so it was. I was in school still. Anila was part time, Ilias was part time. We were, you know, whiteboarding on the weekends and building out the NOC platform and integrating the community. And we saw quickly that when we built out the beta for the community, our engagement grew quite a bit and people started to use the treatment elements of the platform more too. So we had this unique situation then where we said, okay, wow, we're onto something here. But the problem is our bank account had like $10,000 in it. So we had to get money quickly because we had server costs. Our server costs were $2,500 a month. We had to pay Amazon Web Services $2,500 a month to keep going, and we had $10,000 in the bank. So you could kind of see, like that wasn't a situation that was going to sustain unless we figure out a solution. So one day there was, if you all recall, some of you may have been there. There was an ADAA conference in 2017, I believe it was in San Francisco. So I was in LA and drove up to San Francisco. We got into the conference, not going to share how we ended up getting in. And we ended up connecting with different people at the conference. There was one person who was generous enough to give us her time and she was super helpful in helping us think about how we could use this budding community to help other groups out in mental health care. She'll have the peripheral person you should connect with. And it was this one individual who was leading business development at San Jose Behavioral Health. And so we partnered with them after going up again in the Bay Area the next week, and we closed in $1,000 a month contract. And that was amazing for us. Like, it was because that gave us, you know, more time to hopefully, you know, cover these costs. We ended up, as a result, reducing our burn rate significantly. Burn rate means, you know, the amount of money you lose each month that you know, so that you in a startup looks at that figure very closely to ensure they can stay alive. Right? So then the next month, the contract grew to $2,500 a month and we could cover all of our costs. And I was like, wow, you know what? There's value in connecting people from our community into care. Okay. So that summer we were, as we were developing the platform more, we started figuring out other ways to connect people with OCD to different providers. And one opportunity was in the life sciences. So there was a conference in San Diego called the Bio Conference that was happening in 2017. It was one of those things where we were wondering, should we go or should we not go? And one of my colleagues who invested in that second round of funding was a very, very close friend. His name's Goggin Bambra. He was like, no, we should go to this. You should certainly go to this. And he really encouraged it, which I think, in retrospect, it was a profound moment. So go to the conference. And, you know, I don't know anyone there, and I was in college, and these are all, you know, typically pharma executives and researchers. And so I was in a hotel lobby and there was this. This group of. Of Canadian researchers who, who saw me, and they're like, what are you doing by yourself here in the lobby doing work on your laptop? It's Friday night, and we have this conference this weekend. Like, you should come out with us. I was like, you know what? You're right. And so we ended up. We ended up going with those guys and, and they, they, they were so thoughtful in teaching how to connect with different contract research organizations. They saw the platform, they saw the community, they saw the opportunity. Like, you really need to think about how you can augment clinical trial recruitment, because this is a problem that many people face, especially in psychiatry, where there's a lot of stigma that prevents recruitment. And I was like, that's interesting. So went and talked to most booths at the conference that weekend. Came, came back, and I was like, are there any good clinical Trials happening in OCD? And so I went to ClinicalTrials.gov and saw many different groups. One group was a group called Biohaven, and their CEO is a famous OCD researcher and an incredible human being. And I contacted the whole team on LinkedIn. They're probably like, this guy's kind of nuts. Why is he contacting all of us? But the CEO was the only one that responded, and he responded very thoughtfully, says, hey, you have to meet me. Are you going to be at the IOCDF conference in San Francisco? And I had no plans on being there, but I told him, yeah, I'll be there. And so ended up figuring out a way to get there. I think it was like a Frontier Airlines flight. And, you know, that, that, that. Which, you know, it was. It was a. I think we connected in Denver, but it was, it was, it was. We got there early in the morning on that Saturday, ended up meeting him, and when we met him, he was just the nicest person, he saw what we were doing. So we want, we want you to be a part of this trial and help augment research for oc, knowing how this is going to change the way people get. Get treated long term, and said, sure, would love to. And so we closed a contract at that point. That gave us, I think it was like $100,000 a year and just a wild amount of money we couldn't even fathom. And so that was huge, though, because that gave us a good track record to say we're onto something and we can navigate adversity. In a company like this, you start off with nothing. You build a company on a shoestring, right? You really don't have money, resources, and didn't have personally the funds to, to support the growth of the ocd. And so, so we, as a kind of a small collective group, we went in, we were starting to work on the contract, and then I think this was like September of 2017, while we had our internship where we were. We would have interns at school Pomona, who would come in on Friday nights and they would have pizza and drinks and they would, they would contact different providers in the area. And we, and the provider said, oh, I see that there's an OCD app and I'm going to use this with my, my clients or members or patients, however you define them, between sessions. And we, we were like, great, that, that works out well. And so there was a. I think it was a late at night type of situation where all of a sudden our servers crashed and we were really disheartened by it because we had all these great providers who were referring to us and, you know, they crashed and the service crashed. And there was a point where we're like, okay, this is a problem. This is like the second or third time it's happened. We thought someone was hacking us initially. And then we saw that on the other side of the world, in the uk, in the British equivalent of Good Morning America, one of the top OCD specialists went on TV and started talking about nocd, how the app helps between sessions. We still have the clip and I can share it to y' all afterwards. But that, that was a really interesting moment because we realized we're here as a small team in Southern California. We are on the other side of the world, though, at three o' clock in the morning here. Like, you know, people are talking about this like, we're onto something, we gotta, we gotta pursue this. And so that's when Larry joined, because people who are initially invested in Us, we had some great angel investors, Glenn Tullman and Lee Shapiro in particular. Like you need to, you need to work with someone who's gonna help you scale up this enterprise to a real company. And they said, we have the perfect person for you, but you're gonna have to really sell them because he's, he's pretty senior. And that ended up being hilarious. We met at a Starbucks. These are commonality. A lot of us meet in food places, right? But we met at Starbucks and it was an incredible conversation. And we had to kind of beg Larry to join us and he said, okay, I'll join you part time initially. And then one thing led to another and by the time December rolled around that year, we closed around a funding with Seven Wire Ventures as our first investor. They invested a million dollars into our business, which is unfathomable. So we went from, you know, having 0 to 80,000 to 120 trying to like make it. And then we raised a million dollar seed amount of funding and it closed in January 2018. At that point allowed us to bring on a team that was full time so that, that in that same kind of time frame. The researchers from Columbia University Medical center saw the Nosti app. I think it was part of our intern outreach effort. And they like look, we want to study this and we want to study impact it has. And in between therapy sessions when we have ERP specialized therapists that can use no CD with their, with their patients and then we believe it's going to help them scale care. So we start up that research. Meanwhile, we are trying to help our clinical trial recruitment business. What that would do is it built the muscle in our company to identify hard to reach people with ocd, build trust with them and then connect them into evidence based treatment. Like that process is very challenging to do and some of you may know that firsthand, right. It's very difficult to convince someone to take their first steps into care. And so you know, that process was built though by our team here and we kind of built it brick by brick. Well, 2019 rolls around and we like the study was starting to show some promise and we were trying to figure out how do we really scale this company to be an actual company that, you know, solves the OCD crisis. And as I was starting to show results like we realized, wow. From our experience, if you were to pause, there's three problems in, in the ocd, you know, ecosystem, unfortunately. First is it's hard to identify people. Sure, right. Second is once you identify someone, it's really hard to build trust with them enough to get them into the evidence based care. So there's a specially, you know, care gap, I guess. Right. And then finally, if you get someone to a specialist, like many of us personally have experience, it's really hard to manage between sessions. Like there's three problems. So the app was solving that third problem. And we saw from our, from our work with the team at Columbia, we saw from just hearing feedback from our community that, that second problem, getting into a specialist, you know, and defending the trust needed to actually take your first steps into care. Like that's, that was a problem that we needed to solve. So we saw the research and we saw this problem. We said, let's do something about this. And so we ended up, you know, on the whiteboard creating. The idea for no City Therapy at the time was called Nocity Pro. And then we were going to have a service that was more messaging based. And Dr. Fieser, who joined us from UCLA came in and said, you really shouldn't do that. This is not the way to clinically treat people with ocd. And that was guidance. I think it took a lot of courage to give because we're off doing one thing. He said, no, no, you want to pump the brakes. You want to do this instead. Dr. Fiesner, that was a critical moment that you really helped us with. Yeah, but that was a point where, you know, we could have gone one direction. Right. Again, there's all these points along the journey where you could have taken the wrong step. But again, with the right team, you take the right step. Right. It's a, it's a good lesson for all of us here going forward too. So we took the right step and we said, we're going to build no. 3 therapy. It's going to be a virtual specialty therapy service for OCD and it's going to resemble some of the learnings we've had from the Columbia set from the Columbia trial that ended up showing positive results at that time. So we saw that actually, in fact, no City plus a therapist was able to deliver treatment more efficiently than the standard of care. And so at that point we were starting to build no City Therapy. I believe you and I were working together, Patrick, on some of the referrals. And I'll give you a quick story about Patrick. So when we were in 2016, as we were building up the NOC community, we went to IOCDF conference that year and we had a small booth at the Iowa City of Conference and it was in the very back Cause they didn't want to give us the one in the front. Right. And so though it was Goggin and myself, Goggin, one of our angel investors, a good friend of mine and myself, and no one would talk to us. We just had the app. Not one person wanted to spend time with us. That was a key opinion here, I should say, except for Patrick. So Patrick took the time to not only stop us, ask questions, engage with us, but then he said, you know, in fact, I have this really cool VR lab at Amita Health I want you to check out. And so we, we ended up just kind of through friendship, building a connection. And then we started to work together with Chris Novak and Patrick when they were at Amita Health. And we would refer patients or try to refer patients from NOCD to them. And we learned, like, how severe people really are with this, this challenge. And so that's. That was also one of the reasons why we wanted to build, you know, a great therapy service. Because we saw that there was a need for really strong, connected, virtual specialty therapy for ocd. So we started to try to figure out how to get payer involvement. Our plan with insurers. Many of you know how to, you know, the different insurers that we work with today, but back in the day, not one insurer actually wanted to work with us. We had to talk to them dozens and dozens of times. And, you know, they would say, oc is not a problem. And they would, here's how they would define it. They would look into their data and they would see that they have maybe one one out of 500,000 people with OCD. So it's like the prevalence wasn't showing to them. Why? Well, people with OCD were getting misdiagnosed. And when they got misdiagnosed, what happened? Providers would miscode them, meaning they would say, hey, this person. So, like, for me, I would go to my provider, they said I had anxiety. So what happened is the provider would label, someone like myself has anxiety, someone, you too have had a similar experience. And then the insurer would look back and they would see. They would see the fact that this person had, you know, anxiety. They didn't have ocd. It. OCD wasn't talked about. Right. So this, this population was hidden in their data. They couldn't actually see it. And when we made that epiphany, we're like, oh, you know, we could actually get these insurers to cover our, our treatment if we were to showcase the true size of this problem to them. So we started to do with the help of our community and our team. We started asking our members, can you please self identify who your insurer is? And we had one by one different people identifying. I'm a member of Cigna, I'm a member of Aetna, I'm a member of UnitedHealthcare. You know, I have Anthem, I have etc. Identify. And we started coming to these big insurers with a different list of their members saying, hey, there's 5,000 people in all 50 states from your, from your plant who are engaged in nocity right now. We should do something about this. Like can we work together? We have this new service. It's evidence based, it can help them. Can we help them together? And when we made it that simple, some of the payers started saying yes. And they started saying yes too. Because John joined us in 2019 from Magellan. He's, he joined us and was like, I'm joining this startup with five people. What, what am I doing here? And he had all this background in, in behavioral health. And you know, we started getting relationships though with some of these payers and we, a lot of these groups we were talking to for years, but they started to close because John helped us at that last mile. Right. It was really helping us push forward some of these groups. So 2019 happens, we end up starting, we start to close some of these payers like yes, you know what, you have the patients, you have this service. It's an emerging service. We don't know if you're, we've never heard of virtual therapy before if it's 2019, but we trust this can actually work based off the research. Let's give it a shot. And so we closed about 12 different payers at the end of year 2019. So I think it was Cigna. It was, what was it? Larry Blue Cross or Primera? Michigan. Michigan, yeah. So we had a bunch of payers were starting to close. We were in three different states. Michigan, California, North Carolina. I'm sorry, Michigan. Yeah. Michigan, California, North Carolina. And so then we, we, we had a point though where we were starting to see some growth in those three therapy enrollment. It was like our goal for 2019 was to get 50 people to sign up for therapy. 50 people. And that was a majorly difficult task. There was a point in time where someone said, I'm not sure if we'll ever be able to get 50 people. Right. And then, you know, we were kind of, you'll see a theme here. We were a point where we were starting to so to lose resources quickly. And by end of year 2019, you know, we had this merging service and we raised some funding. Our investors were like, look, you have to see growth in the service. Like, you need to get to 400 patients enrolled per month. So here we are enrolling 50 a year. We had to enroll 400amonth to ensure that we could have the resources needed to stay alive as a company. And so that was our goals going into 2020. So then the 20th of January rolls around. We hit the first month of our goals. We were all really ecstatic. February rolls around. The very first week of February, the trial that we were working on on the life sciences side ended up abruptly coming to a halt. There was a problem with one of the medications and they had to actually stop the trial. So we went from having an appropriate burn rate as a seed stage startup to losing all of our money overnight.

[B]

This was about the second day I joined ocd.

[A]

Second day, Second day you joined. So it was. And it was, man, we're all laughing now. But it's like it was a really devastating experience. And I remember calling, I was on the train, I was calling our executive chairman. I was like, look, you know, we had this big problem, like this study that we were supposed to roll over into. And it just wasn't their fault. It just was a regulatory matter. Like, it's not going to be going on anymore. We actually are no longer able to work on this trial. We couldn't find another trial with them either. Just, just logistics didn't work out. And. But we were very successful in helping them with their previous trial. So he's like, that is a big problem. And so our burn rate went from, you know, reasonable amount to, you know, significant amount. And we had six months left, or we were, we had six months left to figure out a solution. So we had two options. Option A was we'd shut down the business. Option B was we'd go all in. This was in again, February 2020. So, very, very difficult decision. And I was mentioning before, like, how the importance of family for those situations. Like, so I know Kara was incredible in that, in that moment, and our kids were too, but it would just, it just, it was a big moment to make it in our team. We had to talk as a team and figure out what we wanted to really do. And the collective decision was no backs against the wall, but we're going to go all in. This is an important problem to solve. We have a best chance of solving it. It's important to the community and our members to solve it, right? So we went all in and we said, we're going to accept this burn rate and we're going to have to figure out a way to grow our network and to grow enrollment, to actually sustain over time and to show this is a real opportunity and we'll get, we're going to get more funding then by having those that great outcome at scale for our members. So we started to go heads down, we started looking at enrollment every day. Meanwhile, the pandemic unfortunately hit in March and so there was a lot of uncertainty in the market, a lot of uncertainty amongst the OCD population and we were starting to show outcomes right as a pandemic was emerging. So our payers were like, wow, this works. Virtual specialty therapy for OC. We're going to need this in all 50 states too. And they're starting to scale even before the pandemic. We need to find a way to work together here. So our team was asked to step up to the plate and they did that. Right. Incredible efforts from so many people, so many people here in this room. And you know, we, we grew brick by brick. And by middle of that year we closed our series A round of funding of $12 million and we were able to have the Runway that needed to actually push the business forward to scale the company. And so here we are about six years later from that moment. And you know, it's taken a village to do this. It's really, it really has. I mean there's so many nights and weekends and whatnot where we're, we're pushing forward, but we're pushing forward for a purpose. The purpose is we're giving not just life changing care for many people, we're giving life saving care and that's really impactful. And I think the benefit is there are more people we can reach to if we keep growing together. But again, why I'm telling the stories too is nothing's really been given to us. We've never been a group that's been given. A lot of companies unfortunately had this problem. They were given a lot of funding upfront and they never really made it because of it. But we had to earn every single step of the way. And, and you know, when you have a great team, you can only do that. So I'm, I'm grateful again for each of you. And that's, that's our story. That's a, that's where we are today. And it's, it's. Yeah, it's good. So enter. You know, there are many People who are going to make a big impact going forward. But as you can see in this room, you know, our company is only as strong as our therapist at the start. Right. We are, we're a team that's delivering an evidence based therapy service delivered by A plus individuals who are both personally and professionally interested in what we're doing here. Right. And it's, that's our main message here, which is we want to stick together as a team that will show that we built this system, mental health care system needed to. Going back to the three problems we're trying to solve. One, identify hard to reach people, to build trust with them enough to actually take their first steps into specialty therapy. And you need really great therapists to do that. Right. To deliver great specialty therapy. Then three, when, when people are on their own, right. Because it's a chronic condition, you need them to have really strong support. Right. So we're, we're. I think when you think about those three problems today, we're really thinking about how do we, one, keep driving awareness and keep driving education in the community. Two, how do we keep building that specialty network? Right. How do we keep, how do we keep making this the best place to be or how do we get better and solving problems for our therapists every single day? Right. We're never going to be perfect, but we want to get continuously better. We want to make this experience better and better every day for our therapist. And third, again, how do we give our members that needed support so that they can spend less time thinking about their ocd, worrying about their OCD and more time living their life and being happy? Right.

[B]

Well, thank you, Stephen, for that story. That was amazing and I'm honored to have been a part of it along the way and from a personal side joining nocd. I came here because my wife was dying at that point and I was driving three hours a day to go to work and come back and wasn't with her to take care of her. The fact that you took a risk on me knowing what was going on in my personal life and allowed me to be able to work with you and take care of her at the same time, we'll, we'll always meet a lot.

[A]

Thanks, Patrick. Awesome.

[B]

And I think from all of us, I, I will speak for all of us, I think, but just Stephen, you, you amaze us every day with the work you do. We are honored with what you do, what you represent, what you have taken from a personal side and brought to the world because one person suffering meant no one else. Should suffer anymore. So thank you for that. So I've got us back in Video Stand Innovation.

[A]

It's streaming at Earth Fair.

[B]

Thank you all for joining. Once again, another episode of the get to Know OCD podcast. If you've enjoyed this episode, you can subscribe to the NOCD YouTube channel. And if you're looking for help for OCD or other related conditions, check us [e-mail] that's n o c d dot com. And remember, be better to yourself than your OCD ever is. We'll see you again for another episode.

[A]

But.