Get to Know OCD: The “What If” OCD Thought That Took Over My Life

Podcast Host: Dr. Patrick McGrath (NOCD)
Guest: William Schultz, therapist and President of OCD Twin Cities
Release Date: February 26, 2026

Episode Overview

In this compelling episode, Dr. Patrick McGrath welcomes William Schultz, a therapist whose personal journey with OCD not only shaped his professional life but also provides deep insights into the lived experience of obsessive-compulsive disorder. William discusses how a single “what if” thought in 2007 spiraled into an all-consuming battle with OCD, the challenges of receiving a proper diagnosis, his path to effective treatment, and how these experiences influence his clinical practice today. The conversation highlights the profound nature of OCD, the pitfalls in treatment, and the immense courage required to confront one’s deepest fears.

Key Discussion Points & Insights

William’s OCD Origin Story

• The First Intrusive Thought ([02:41])

  • William describes the exact moment his OCD “stormed into” his life: a thought while eating lunch, “What if I have an STD and don’t know about it?”
  • The intrusive thought triggers a relentless loop of analysis, checking, and escalating fears about health risks and contamination.
  • Quote:

    “Out of nowhere, I noticed this thought, ‘oh, what if I have an STD and I just don’t know about it?’…Now I’m in this very detailed analytic process...I’m not even eating my lunch anymore.” – William ([03:17])

• Seeking Reassurance & Testing ([07:02]–[10:44])

  • William seeks medical reassurance, insisting on unnecessary tests for “peace of mind.”
  • Gets a fleeting moment of relief, only to be hijacked by new obsessive doubts (e.g., “what if the elastic band was contaminated?”).

• The Compulsion Escalation ([12:18]–[15:35])

  • Compulsions generalize: avoiding touching things, excessive checking, elaborate “safety” routines, memory doubt (“false memory OCD”).
  • Encounters friends and professionals who try, but largely fail, to understand the irrationality and intensity of his fears.

When OCD Expands: Rabies Fear & Beyond

• The Rabies Obsession ([17:46])

  • A chance conversation about bats and rabies triggers new obsessions, transforming everyday encounters into imagined threats:

    “So I say to my friend, why do they have to remove bats?...the thought that came up was, well, what if that bat bit me and I somehow didn’t notice it?” – William ([18:31])

• Medical & Therapeutic Runaround ([21:18]–[25:52])

  • Multiple medical consultations result in anxiety diagnoses, prescription medications (benzodiazepines), and temporary relief but not resolution.
  • Attempts with three therapists fail; they can’t recognize OCD or refer him appropriately.

Reaching a Turning Point: Diagnosis and True Treatment

• Discovery and Stagnation ([25:52]–[27:39])

  • Only in graduate school does William finally learn he has OCD and is introduced to Exposure and Response Prevention (ERP).
  • Realizes intellectual understanding isn’t enough—he is unwilling to commit to exposures out of fear, especially of the “one time” risk.

• Identifying the Core Fear ([27:39]–[31:26])

  • With a therapist’s help, William confronts his true core fear—not death, but the regret of never having the courage to face his OCD.

    “The thing that hit the hardest was I never took my chance to challenge my OCD. The words that actually went through my mind: I missed my chance to be brave.” – William ([30:08])

  • This realization becomes the catalyst for true behavioral change.

The Shift: Values-Based Motivation and Recovery

• Embracing Uncertainty, Choosing to Live ([31:26]–[34:35])

  • William reframes recovery: overcoming OCD—not “staying alive”—becomes his top priority, allowing him to finally engage deeply with ERP.

    “If in some kind of bizarre, tragic accident…this is the one time I needed to check, and I end up making a mistake by not checking…then I’m going to go down fighting my OCD. And I don’t like that, but I can live with it.” – William ([31:27])

  • Achieves robust remission in about two and a half months.

Therapy, Treatment Agreements, and Barriers

• The Role of True Treatment Commitment ([34:50]–[36:13])

  • Psychoeducation is crucial, but true agreement to treatment requires a willingness to “live life with uncertainty, with thoughts you don’t like, with feelings you don’t like.”

    “If you’re not willing to do that, you’re going to keep doing your safety behaviors.” – William ([35:43])

• Treatment-Interfering Behaviors ([36:13]–[38:23])

  • Many years are lost not to a lack of knowledge or diagnosis, but to avoidance—a lesson William brings to his clinical practice.

The “What If” Disorder: Living with Uncertainty

• The Heart of OCD: Uncertainty ([40:58]–[45:08])

  • OCD creates endlessly plausible, emotionally charged “what if” scenarios—no amount of logic resolves them.

    “The rule of OCD is: if you can imagine a picture of the event in your head, then it’s possible…It doesn’t mean it’s likely, but it could happen. And technically, that’s true.” – William ([41:00])

  • The emotional brain doesn’t distinguish between possible and probable—feelings of danger feel real, even when logic says otherwise.

    “The movie is being projected into the psyche, and psyche's responding as if it's real. In OCD, those scary stories get projected…even if a part of you knows it's unrealistic, you'll bump into: ‘yeah, but it feels real.’” ([44:42])

Notable Quotes & Memorable Moments

• On seeking reassurance:

  “One test would tell me everything I need to know, right? Of course. 100%.” – Dr. McGrath ([08:44])

• On shame and alienation:

  “I recognized at some level that this was really off the rails. But to explain that to another person felt impossible and very embarrassing.” – William ([47:56])

• On fear driving behavior:

  “I was literally afraid of my own shadow.” – William ([47:55])

• On values shift:

  “Staying alive is no longer my top priority. Overcoming my OCD is my top priority.” – William ([31:26])

• On the reasoning trap:

  “You could rename OCD the Yeah, But What If Disorder.” – Dr. McGrath ([41:43])

• On treatment barriers:

  “Clients come in because they’re hurting…and they kind of want to feel better…but maybe I don’t actually want to feel that much better if that’s what it means.” – William ([37:12])

Key Timestamps

• 02:41–06:59 – First intrusive thought; the “What If” spiral begins
• 08:38–11:47 – Medical reassurance, fleeting relief, new doubts
• 12:18–15:42 – Spread of compulsive behaviors, loss of trust in memory
• 17:46–21:18 – Rabies obsession emerges
• 25:18–27:39 – Accumulation of “safety” behaviors, failed therapy attempts
• 27:39–31:26 – Core fear identified: missing courage/opportunity
• 31:26–34:35 – Values shift, ERP engagement, remission
• 35:43–38:23 – Clinical reflections on treatment-agreement and barriers
• 40:58–45:08 – The impossibility of “certainty” in OCD (“Yeah, but what if…”)
• 47:36–47:56 – Afraid of own shadow; shame experienced

Tone and Language

• Both William and Dr. McGrath blend humor (“Cheetos bat, yes.” ([23:31])), candor, and warmth, destigmatizing OCD while emphasizing the pain, courage, and work required to recover.
• The conversation offers compassion for sufferers (“It feels impossible and very embarrassing.” ([47:56])) and clarity for listeners unfamiliar with OCD's intensity.

Conclusion

This episode of Get to Know OCD is a raw, insightful exploration of how one “what if” thought can consume a life—and how, with the right understanding and willingness, it is possible to reclaim it. William’s story demystifies OCD, highlighting the vital importance of true therapeutic commitment, the limits of reassurance, and the need to live aligned with values—rather than fear-driven compulsions. A must-listen (or summary to read) for sufferers, clinicians, and anyone seeking to understand OCD’s lived reality.

Next time: Part two will dive deeper into clinical insights, practical treatment tips, and current research on OCD and ERP.