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A
I was diagnosed with OCD when I was 16. I hid my OCD for a while and that's why I didn't get diagnosed till 16. As things went on, you know, I went through a situation in college where I was abused by coaches for my ocd and that became a national story. And I think that situation didn't just help me grow in those moments, but years after too. OCD is heavy, right? It's just heavy to carry. You know, something I always say is just because I carry it well doesn't mean it's not heavy. When I brought the Project Anxiety and Athletes to the icdf. And so essentially what I wanted to build with the ICDF was this blueprint of resources, storytelling about sharing experiences with ocd, anxiety related disorders, pushing that for the athletic realm.
B
Whether you realize it or not, you probably know someone with obsessive compulsive disorder or maybe you love someone with ocd. And if those two don't fit, you might be the person with obsessive compulsive disorder. Because of this, OCD awareness is so personal for all of us. We hope that raising awareness will bring hope to everyone and their friends and their families who are affected by obsessive Compulsive Disorder. When we recognize what OCD really is, it offers us a couple of options. We can see the signs in ourselves and others much quicker that can help to end a great deal of suffering. NOCD is the world's leading OCD treatment provider and I'm honored to lead a team of licensed clinicians who are specially trained to accurately diagnose OCD and provide the treatment of choice, exposure, exposure and response prevention so that we know that we can give people the lives that they want to live and help them not live the lives that OCD wants them to live. In addition to that, for ocd, it means applying the work that we do to other conditions that often come along with obsessive compulsive disorder, such as body focused repetitive behaviors, tics, hoarding, anxiety disorders, mood conditions, trauma and and even body dysmorphic disorder. If any of these are things that are affecting you or your loved ones or family, know that help is available. If you're looking for help, you can check us out@nocd.com that's n o c d com. Our goal is simple to make sure that nothing, not ocd, not stigma, not misconceptions, gets in the way of you living the life you want. You deserve to focus on things that bring you joy and meaning. Helping you is just personal to Us. It's what we do. Hi, everyone, and welcome to another episode of the get to Know OCD podcast. I'm Dr. Patrick McGrath, the Chief Clinical Officer for NOCD. Today, Tom Smalley is here with me. Tom, how are you?
A
Good to see you. Good to see you too. I'm very, very excited to be here. Awesome.
B
Well, we're glad you're here, too. You do a lot of work in the area of athletics and working with athletes and also with the International OCD Foundation. So why don't you share a little bit about yourself so that you can introduce yourself to everyone and then we'll get into some Q A. Yeah, definitely.
A
Yeah. So I was a. I was diagnosed with OCD when I was 16. So, I mean, I guess I could start there. You know, I. I was shortly after started speaking probably about years, I would say age 17, about my OCD. I think it's been a. Such a major part of my recovery, you know, the past decade now, speaking about OCD and, And addressing the stigma around it, which is pretty crazy to say it's been a decade. I mean, and when I think about how my story has evolved over those years of sharing it, it's different than what it was when I first started sharing it. But I do a lot of work in athletics. Like you said, I'm a certified mental performance consultant. I own my own business. Struggle and destroying performance. You help high performers, athletes, coaches, parents with, With. Of. Of athletes with managing performance anxiety and confidence, self esteem, mindfulness, things that get in the way of. Of everyday performance. So my psychology work is. Is very much based in performance. I decided when I, When I went to school that OCD was so close to home. And as much as I love advocacy work, I didn't want to. I didn't want to be treating OCD because I felt like it would be tough for me to separate the two. And I give, you know, every clinician. I know so many amazing clinicians that have OCD and treat ocd, and I give them just so much kudos. And, and so I have so much. Such a high level of respect for them because it is. OCD is heavy. Right? It's just heavy to. To carry. You know, something I always say is just because it's. Just because I carry it well doesn't mean it's not heavy. Right? And I know a lot of people feel that way too, but, yeah, so I, I work mainly with athletes, high performers, and people that want to just address their mindset and, and improve their mental fitness. But, yeah, I I love everything sports, I love that, that world and I love everything OCD advocacy. So being able to, to combine the work of athletics and, and my, my psychology, my love for psychology and, and advocate for oc, advocate for OCD in athletics and mental health and athletics in general has been definitely just really, really fulfilling. Awesome.
B
Well, thank you for the work that you're doing because obviously the more people out there trying to help those with OCD, the better. Right. And especially for people who are well trained in what OCD is. And I'm assuming you've probably who have gotten some pretty bad advice about OCD and how to help it. So how, how do you address that? How do you help people correct that and really learn about good evidence based care for ocd?
A
Yeah, I think it just starts with really relying on the gold standard of treatment. Right. ERP and, and cbt. And then I, I think ACT has been a really, really helpful tool tool for myself in my adult life. Right. Like, so when I first started, you know, getting treatment, it was all ERP focus. But then as I've transitioned to being an adult, a young adult at 20, you know, 23 to 27 now, like we really started focusing on a lot of ACT and acceptance therapy. I think that's been a really, really amazing tool for me. But just telling people what real evidence based treatment is, I always say we tend to get really emotional when we talk about OCD because especially when you're an advocate that has ocd. Right. Because you've probably seen some really dark times. You've probably seen, have felt very isolated and when someone pokes fun, even if it's unintentionally at ocd, it gets really frustrating because it just feels like we're going backwards. But the reality is these are really great opportunities. And I think leaning with that empathy of they just don't know better.
B
Yeah.
A
You know, so that's where how I address the stigma and in terms of someone getting bad advice, you know, I usually ask them like, oh, what kind of what do you do in therapy? What do you do in treatment? And if their first response isn't making a hierarchy and exposure response, then I know that they haven't had effective OCD treatment. Right. And I think we're getting to a point now where, you know, with NOCD and with the IOCDF and just so many different outlets of advocacy, we are getting to a point where we're getting the word out about what effective treatment is. But it is still so surprising at how many people go through two or Three therapists that say they treat OCD and don't receive VR.
B
Yeah.
A
Yes.
B
We could do a whole pod. We could do a whole show on that one. But we're going to focus on you with your work today. But we definitely. It might be an interesting thing to discuss at some point in the future. You know, your interest, starting at age 17, to talk about OCD is. Is really unique because most. Most people try to hide any mental health stuff, right? And think that if I admit to it, it shows a weakness in me, a detriment. And here's the other thing that I look forward to the day that this is done. It's okay to have a physical health issue, but it's not okay to have a mental health issue, right? And, boy, when we destroy that stigma, that'll be a day I'll dance around and celebrate. You started early, though, in saying, no, no, we need to talk about this.
A
What.
B
What was the impetus of that, especially at 17, to. To decide to take a different path than most people would normally do?
A
No, it's a really, really fair question and a good question. I think I hid for a while, right? And I think it. It goes without saying, I hid my OCD for a while, and that's why I didn't get diagnosed till 16. You know, I was struggling for years before, and I hid because I had these thoughts of, you know, what if I grab that knife and stab somebody? And when you say that out loud to somebody that doesn't know what OCD is, and for myself at the times having that thought didn't know what OCD was, I felt dangerous. I was. I labeled myself as dangerous because I was like, oh, if I'm having that thought, I'm bad, right? Or if, you know. So I think I hid that aspect, and I hid that what my thoughts were because I didn't want to be, you know, locked away forever, right? Because that's. That's the ultimate fear of, like, you know, you start saying these intrusive thoughts to people that don't have OCD or don't know what OCD is. And, you know, if somebody came up to me and said that, I mean, yeah, you'd probably be a little bit alarmed, right? It's a little scary. So I think for me, I did hide it. And then when I got diagnosed, there was a. Actually, Chris Pittenger was running a. An OCD Awareness week event at Yale. From Connecticut originally. I live in Austin, Texas now, but I'm from Connecticut. Lived in New York and. And Massachusetts for a While, so I'm from the Northeast through and through. And my, my therapist was connected to OCD Connecticut, the affiliate of the rcdf. And so she, she presented the opportunity of like, hey, they need a young adult. And for me, I really didn't know what that was, was going to entail. And I started speaking about it and it was really just like 35 people total probably. And for me, speaking about it at that point was really just about connecting with other people for myself that have gone through it and maybe along the way it helps my recovery. And then I saw the impact my story could have on other people and other families when I spoke. And it just, you know, reminded me that I wish I had that when I was isolated and alone and wasn't talking about my OCD and just reminded me that, wow, we have so much work to do. So fast forward. I went to the, the, my first IOCDF conference. I think I've been to every conference since this. That point. I went to my first conference and Chris Johnson was running a talk.
B
Can't that guy come on? I love Johnson. He's one of my dearest friends, you.
A
Know, and I got. I don't know what it was, you know, I was, they were just with my dad, we. And that was the first time I had flown in a long time. Flew across the country to la. I mean, the weekend was just so fulfilling. You know, I'm set 16, 17 years old and I'm like, wow. Like, you know, you raise your hand and say a thought and everybody has the same thought or something similar. You never feel. I've never felt more part of a community in my life.
B
Right.
A
And for some reason I was just compelled to go up and share my testimonial, like, you know, or testimony about my ocd. You know, he was asking for audience participation and it went better than I expected, was well received. And I leave the room and he chases me out kinda, and he's like, hey, I'm Chris. You know, I run young, I run the young adult track. We're looking for more speakers. And that's when it just took off. And, you know, I give all the credit to Chris for, for kind of plugging me in to some of those, those young adult tracks. And. And then, you know, as things went on, you know, I went through a situation in college where I was abused by coaches for my, for my ocd. And that became a national story. And so my, my platform obviously expanded.
B
Yeah.
A
And so I started bringing in the athletics component and started, you know, the IOCDF Did a really amazing job of kind of giving me the keys to help build some of those things, you know, that I know we're going to talk about at some point, but. So I think, you know, my advocacy evolved, but really the central point of it was like, man, I'm connecting with so many amazing individuals, whether they're healed in recovery or they're still going through their recovery or they're at rock bottom right now. Like, your story doesn't need to be perfect to be powerful. And that's what I realized in those moments was like, man, you don't have to be perfect to be. To have an impact. You just need to be authentic and be you and share those experiences. And these people need. Need this as much as I do.
B
Yeah.
A
So that's what just kind of carried that advocacy work.
B
Have you met anyone who's perfect yet? I have not. I'm just curious if you. If you have.
A
Nah.
B
You got the Hero award from the iocdf and, you know, I. I think part of that is related to your college experience and stuff with your coaches and stuff, and. And obviously, people can very much see in depth there, but you really just kind of. More in a nutshell, you. You. You really highlighted the fact that here's. Here's a weekend where you go and you have all this fellowship, and then here's another point in your life where somebody totally doesn't understand, and it's just the butt of jokes and ridicule and things like that. And it's gotta be. I can't even imagine how deflating it must feel to go from such a high where I'm like, wow, people really get me and understand me, to someone's undercutting me and just trying to, you know, abuse this. This experience of my life, you know, which is not a weakness or anything that you're lacking. It's just. It's just something that you have. Right. And I wonder. I wonder if those coaches would have made fun of someone if they had, you know, some kind of physical issue that they had to, you know, take a daily medication for. Oh, no, that's fine. But not the mental health that. So, you know, you really take this experience and run with it and build upon it, and, you know, that's a lot of resilience for someone. And. And as much as you're comfortable, you know, what is it you want people to know about that whole part of your life and how. How you bounce back from.
A
Yeah, I mean, that was. That whole situation. I mean, it's something that you Know, now it's. It's crazy. There was six years, seven years ago, and. And, you know, it feels like yesterday still, and. But I think that situation didn't just help me grow in those moments, but. But years after, too, it gave. It gave me so much perspective on. On how I want to respond to situations like that. But, I mean, you know, getting the Hero Award, you know, it was proud. I mean, definitely the greatest honor of my life. Um, you know, and IOCDF really backed me through that whole situation, and that's why, you know, they're family to me, and I just can't say enough good things about the work they do and. And how they've supported, you know, my advocacy and. And, you know, my. My business and my. My. My work. Right? And I think in. In that situation, you know, if you asked me four, three, four years ago, there's still a lot of anger and resentment, right? And for a while, one, I didn't feel like a hero, right? Because I was still struggling, and still, you know, how can I take this Hero Award? You know, the people at this conference are my heroes, you know, and how can I take this Hero Award and be this poster for recovery, right, When I'm still struggling behind the scenes? But the Hero Award isn't about that. And I learned that, you know, it's. It's about being vulnerable through resilient and being resilient through those times and. And being dedicated to a greater cause. Right? And so I think as I grew up, I. I started to reflect more and more as I saw other people be being given the hero word after me. The years after I. I did a lot of reflection on, like, hey, the reason you got that was because you were. You were vulnerable and showed up through those tough times. And I think that's what I want people to know about that situation is that, like, just because somebody is bullying you or bring you down is like, you have that choice of still showing up as yourself and not letting somebody put you in a box. Yeah. And I think it's crazy because three years ago, two years ago, even if you asked me, you know, I was doing a keynote at my alma mater this past March, and I said, I forgive that coach. Right. I don't forget it. Right. I'll never forget the words and every day, you know, what went on. But I forgive because I like to think of it as like, wow, how sad is it that that individual didn't grow up with people that taught them how to treat other individuals right and be kind and show empathy? They clearly didn't have that in their environment growing up. And we're products of our environment. Right. And so to an extent, so I really, I try to look at that whole situation now with empathy of, hey, they just didn't understand how to support people and be kind and listen. I mean, would I have said that five years ago, six years ago? No. Right. And, and you know, if I ran in. Into them to that. I don't know. Right. It might, it would bring up a lot of feelings. Right, sure. Because, you know, you, like you said, you get to that, you know, I got past high school and you go into college and you're like, oh, fresh start. I'm not the kid with OCD that's stepping on certain tiles and missing chunks of school at a time and making weird tics with faces, you know, face facial tics and, and weird sounds like, like I don't have all these things. There are labels on me. All of a sudden I can be this, this new person.
B
Yeah.
A
And then you get that again and it's like, oh, back to square one.
B
Yeah.
A
Right. But what I've realized is like, those, those are the situations that shape us. And without that situation, I had someone at that keynote ask me, like, would you. If you could get rid of your ocd, would you, or have you, you know, if you could have not gone through that situation, would you? And, and yeah, I mean, like, OCD sucks and it's, you know, just to put it simply. Right. And, and there's a lot of, of bad that comes with it. But like, I also say that, like, I wouldn't be the resilient person that I am today. I wouldn't be the person that has empathy for people of all demographics, all walks of life, welcoming them and being able to find common ground with anybody. It just brought a level of sensitivity and empathy and resilience that I can't explain. And you'll see that amongst the whole OCD community, I'm not the only one like that. When I step into these conferences and into these virtual events and whatever it may be, or even just having a conversation with the family that reaches out like they are going through the similar thing and they have that same personality and the same characteristics and traits that I, that I, I feel like that I, that I've gained because of my experiences. So I think just overall, you know, recognizing that people sometimes don't have the, you know, they lack the skills because of maybe how they grew up and, and trying to look at things from a different perspective of empathy I think in today's world especially, we can use empathy more than anything.
B
What are your teachable moments for people when they misuse ocd? Right. I'm sure you still, if you say you have ocd, someone's going to say to you, oh, I have a little OCD too. Right? Or, God, I wish I had a little ocd. I could really clean my house or something. How do you reply to those kinds of experiences?
A
Yeah, again, I mean, I think it's so funny because 10 years ago when I, you know, when I just was just diagnosed, I was definitely more, I won't say aggressive, but emotional. Right. And when we, when we speak with them with too much emotion and come off and start speaking loudly at somebody, people are then going to label you as like, oh, he's crazy. Like, look at that. Like, there he is. Right. And they're get, they get defensive. Right. So if I come off, if someone says, I'm so ocd and I'm like, oh, really? You have ocd? Yeah. Right. And, like, start spewing all this knowledge, they're not going to listen.
B
Right.
A
So, like, what my approach now is like, hey, they have innocent ignorance. They have. They don't. Again, they don't know. Okay, here's. Oh, I heard you say you have ocd. That's really interesting. I have ocd. What are your subtypes? And if they have no subtypes or they can't name certain thoughts, like, maybe they're not comfortable. But also they probably don't actually have real ocd. Right. And so my thought process on educating people and kind of responding to those comments now is, is rooted in education.
B
Good.
A
And taking, trying to take the emotion out of it, because the minute you take the emotion out of it, they're like, wow, this person is really educated and, and really intelligent and really calm. I would have never known. They have. They deal with all these thoughts. Right. And that's what real OCD is. Right. We're, you know, the people in the OCD community are. I know, so many intelligent people in this community. Right. And, you know, and it's like, hey, let's show that, and let's push the education and the support instead of the abrasiveness or, like, emotional reaction. And I get. That's tough when you're dealing with so much trouble underneath the surface with OCD and someone minimizes it. Right. Like if somebody had diabetes and they made fun of their diabetes, they probably get pretty upset too. Right?
B
Sure.
A
But, but I think if you can really root that that response and education with a calm demeanor, people are going to be more apt to listen. And what's our common goal here? It's to educate and break down that stigma. So whatever way we can get them to listen is the best way.
B
Yeah, I think that's great. I was walking through the airport a couple of weeks ago and someone had a shirt on that said ocd. And I was like, all excited and I started walking toward them like, oh, cool. And then I read the subtype and it said obsessive camping disorder. And I was just like, oh. And if I didn't have a ride waiting for me, I might have. I might have stopped. But it was just, oh, it hurts so much.
A
I think what hurts really bad about that is that, you know, like, we've made so much progress. Right. And, you know, I look at the past decade, I've been a part of this community, really. Right. I mean, the information we've been put. We've been putting out and the education, the research is just so advanced and improving rapidly. But you get instances like that, and it's very micro, you know, focused. But it's like, oh, gosh, like we're still. We still have T shirts being made that say that. Yeah, right? Yeah, come on.
B
Yeah.
A
So it can feel deflating at times. Right. And I think, I think it's not to push, suppress those emotions of feeling frustrated when you see something like that. I mean, I remember the Target sweaters. Obsessive Christmas Disorder. We, you know, I wrote an article about it for the icdf, you know, five years ago, six years ago, and it was about how, you know, holidays are tough. And then you see that. I mean, it's a slap in the face for people with ocd. But starting a riot and being upset about it, like, isn't the answer. Right. Like, it's, hey, let's. Let's formulate a really educational public response to that. Right. And I think that's where we're headed. And what I love seeing is those educated responses.
B
Yes. So we get to 2021. You co found the Anxiety and Athletes Initiative with the iocdf. Tell us about that and, and what it does.
A
Yeah. So, you know, it's evolved and, and changed and shifted, but I'm really excited where it's headed now. You know, us signing the. The partnership with Ali Raisman, I spent some time with me and Kelly Werner spent some time with Ali. And Zane Gonzalez, our Illumination Award winner, he's an NFL player. Ali was obviously multiple gold champion. Gold medal.
B
We had her on this Podcast, actually.
A
Yeah. So, I mean, she's, I mean, phenomen, two phenomenal people. And you know, if you told me that, you know, 10 years ago, or, sorry, five years ago, four years ago, when I started, when I brought the Project Anxiety and Athletes to the icdf, that me and Callie would be standing in a room with Zane and Ally really like chopping it up about our OCD experiences, I would have called you absolutely crazy.
B
Right, sure.
A
You know, but that was the goal is, is highlighting those stories. And so when I was, I was in grad school at the time and, and you know, the advocate program had really taken shape and everybody kind of had this passion project. And for me, obviously, with, with what I had went through and what I had seen, as, you know, I had worked at colleges in college athletic departments, you know, four different schools at that point. And what I saw was a common theme of hush hush about mental health. Right. They'll poke, they'll post a graphic and Mental Health Awareness Month on their Instagram page for everybody to see. But what are the actual initiatives that are taking place behind closed door to really support their student athletes? And the answer was very little. And so for me it was, hey, we have anxiety in the classroom. And I took that model and said, hey, what about anxiety in athletes? And so essentially what I wanted to build with the ICDF was this blueprint of resources, storytelling about sharing experiences with ocd, anxiety related disorders, perfectionism, things of that nature that athletes were struggling with, and then provide educational resources for coaches, for administration, for parents. So really taking the model of anxiety in the classroom that they had completed and rolled out so well, and just pushing that for the athletic realm. And so it started with just getting a bunch of content from former athletes, current athletes, myself included, and Cali, and then building a separate website and, and now we have that, that website living on the iocdf, you know, homepage. And I know it's going to be more integrated in the years to come. We have some, some strategic plans for that. So I'm really looking forward to it. But really at the core it's really, hey, here's a hub for people to come to where you're not feeling seen, you're not feeling heard, or you want to know if someone has had a similar experience. Well, here's an article on this, here's an article on that. Here's some stories to inspire you. Oh, you're a coach not knowing how to create an environment that encourages people to talk about mental health. Here's some strategies to help with that giving coaches free resources and educational tools was really the priority.
B
Fill us in on what are some of the unique challenges of OCD and athletes. You know what, what separates that out from some other groups?
A
Yeah, I think the main thing that we see and we really with anxiety and athletes, another part was that was that stigma that we wanted to change and that, that was another core focus of anxiety and athletes of that project is changing the stigma of OCD and of anxiety and mental health in sports in general. Right. And with ocd, there was a lot of people that would think that OCD helps performance. And while I see what their argument is like, oh, well, you're, you know, you're putting in the work, you're getting in the reps, extra reps. What they don't realize is that like those extra reps, when you're, you're, you feel so isolated and bound to the court to get shots up because you're afraid your family is going to die in a car accident if you don't make the next five jumpers or if you don't take an extra thousand makes on the court. Right. Like, those aren't good reps that your, that your, your body is actually training. And so like your cortisol levels as we know with OCD are so high. Right. So it's not those you're in fight or flight while you're just doing all this extra work and over training is such a problem in sports already in the culture of like hustle, work hard, right. You could actually hurt yourself by really detrimental, physically, elementally. And so we really wanted to split that script of like, hey, OCD does not help performance. Right. Imagine if, you know, Cali shares some really amazing examples of, you know, when she was in Olympic trials, how ends of when she was at Rice as, you know, an all American cross country runner. And she's, she talks about how like, imagine if I had actually like recovered properly because I wasn't, you know, trying to get extra miles in or trying to do extra work. Right. Or I wasn't focused on the wrong things during a race. Right. Like, OCD doesn't help performance. No, she doesn't help anything. Right. Like, so I think that was the, the first stigma we wanted to, to really flip, you know, that's a great.
B
One to flip, right.
A
I, yeah.
B
I even remember hearing during COVID a newscaster say, wouldn't it be great if we all just had a little ocd because then we wouldn't get Covid.
A
Right? Right.
B
Yeah.
A
And it's like, yeah, that's what's stopping it. Right?
B
Yeah, There you go. We, we've solved it. Just a little OCD to everyone.
A
Yeah. And I think that's where, you know, that's where that stigma definitely we wanted to focus on. And then I think in terms of mental health and athletics, man, it's such a, it's such a battle. I mean, I think, listen, we're seeing more, more organizations like Morgan's Message and the Hidden Opponent that are doing great things with, with building ambassador programs that's at call on college campuses. But I don't think we, I still don't think we do a lot at the grassroots level of like elementary school and middle school, because that's whether the generations are going to grow up and understand, like, it's okay to talk about it. And I would like to see more, More influence of encouraging vulnerability at the grassroots level. But, you know, I'll say it till I'm blue in the face. I know, I know. I've said this on probably three different podcasts at this point, but, you know, these colleges and universities will pay their football coach to go 4 and 8 and they'll pay him $750,000 a year to, to be mediocre, but they won't pay someone eighty to a hundred thousand to be a sports psychologist just for the student athletes. Right. Like, Right. And that's where, like, hey, it's not about not having the funds, it's where you're allocating a fund. So how much does this matter to you? Right. Are you more focused on your travel and gear budget?
B
Yeah.
A
Or are you more, more focused on supporting the holistic health and wellness of the student athletes? And, and I'm going to.
B
Maybe you'd be 5 and 7 or, or 6 and 6 if you did that, instead of 4 and 8.
A
Yeah. Right. And that's the thing. Right. It's like, hey, if you took even 75k of that, that coach's salary and put it towards some mental health and mental performance resources, maybe you'd seek a better outcome for all the athletes and all the teams. Right. And so it's just, it's just priorities and allocating, you know, what we. What is most important. I think obviously, you know, money drives a lot of different things and revenue drives a lot of different things, especially in those major sport markets. But I think raising these concerns more and more has been at the focus of what I want to do.
B
I hadn't thought about this until, as you were describing it, but imagine if we said people who Pray more because of scrupulosity, are at. Or are actually better at their religion.
A
Right, right.
B
Makes no sense whatsoever.
A
Right.
B
Yeah, it's.
A
It's the. It's trans. Yeah. So those situations, Right. They translate into other, other subtypes. Right. Like, OC improves things. Right. It doesn't improve our relationship with our faith. It doesn't improve our relationships, period. Right. So I think just that was kind of baffling to me when I, when I stepped into that realm of like, you know, and, and what's. What was tough was that there were some prominent athletes that didn't have proper education on ocd. Seeing they had ocd, and then, like, would say how much it helped them. And then once you get one, you know, post from a major athlete, it just spreads like wildfire. So it's just, you know, the IOCDF has done a really, really good job now of having really strategic and, and immediate responses to stuff like that.
B
Yeah, it's so important.
A
Right.
B
Because I think you and athletes and I and, you know, working with. Even on the podcast, we've had a lot of people who are in TV and, you know, rather famous and always, always working to make sure that that message is, is they're not famous because of ocd, they're famous despite ocd. And like you said, if you learn something from ocd, it's that there's a lot you need to do to make yourself not be driven by ocd. There's a lot you need to do to live the life that you want to live. And if you can take the tenacity that you use to overcome OCD and you can also apply that to other things in your life, that's awesome. But it's not because you have OCD that you're good at these other things in your life.
A
Right? Right. Yeah, absolutely. No, I mean, you hit the nail on the head. I think it's. It's so important to make that distinction, especially early on when people are getting diagnosed.
B
Yeah, yeah. It's a great message for sure. And I appreciate really all the effort that you've put into that. And there's also struggle into strength. Tell us a little bit about that and what that does.
A
Yeah, yeah. So struggling to strength was the, the. The. The name actually comes from when I was, you know, in. In treatment and things were really, really tough. My family and I created this mantra, struggle and a strength. Like, we're going to turn this struggle and we're going to make it strength. Right? Like, it's going to be our strength. Eventually, like this vulnerability and this, this, this hard time is going to be something that, that we turn into purpose. Right. And so when I realized kind of what I wanted to, to do with my career, I knew the name was going to be Struggling with Strength Performance. And so my, my business is a mental performance consulting business. And so essentially just, it's just, it's not just, it's, it's helping high performers really address their mindset and they're that. And a lot of times that's the limiting factor to them being at their best when their best is required. But the whole message behind it, you know, behind struggle and strength is that like, hey, struggle doesn't make you weak, it makes you human. And that, you know, every part of struggle and strength is rooted in lived experience. Right. Like I know what it's like to feel broken, misunderstood, stuck. And I know it's like to find healing and use that story to uplift others. Right. And so that's the core of the mission. And so I think we want people to just to know that their pain doesn't disqualify them from living a full purpose driven life. And things can get so much better. Right. And then it carries over into the, the ass. Yeah. The aspect of athletics and as a performer, right. Hey, the pain you're feeling now, like, we're going to take that and we're going to make it your greatest strength, right? We're going to take that struggle and make it your greatest strength and eliminate that weakness. That weakness. I hate that word because it's not weakness. It's something that you might be dealing with, a challenge that you're going to overcome. So it's really just about looking at these challenges as opportunities for growth.
B
I, I have a phrase that I heard once that I love and I use it a lot in therapy and that is you can only be brave if first you're afraid. Right.
A
I love that.
B
If you're not afraid and you go do something that wasn't bravery.
A
Right.
B
You know, you're just a gallant knight on the horse that I had no fear.
A
I'm a brave.
B
No, but if you're afraid to do something and you put in the effort and you go do the challenge even if it didn't succeed, that's bravery. Right. That's putting yourself out there.
A
Absolutely. Yeah. And so the business is, you know, it's expanded and it's, it's, you know, when I first started it, I thought maybe, you know, it provides some value and then it just kind of like I dove more and more into it and realized the impact it could have. And I think, you know, I have some exciting things in the, in the works. We're, we're rolling out this online community soon for athletes and high performers coaches with, you know, with three different, the membership tiers and just it's, it's, it's about getting resources, having community forums, just like bringing people together and, and getting more access to support even if they're not working with me individually. And that's always been my goal is like, how can I reach people even if they're not able to afford a one on one session. Right. Or, or, or don't maybe are too nervous to start working one on one yet. Right. Like, yeah, maybe they want to take a smaller step. And, and that's really what I want to provide value. I mean like my, my core mission to, you know, on this earth is to, to positively impact as many lives as possible before my time is up. And I think with this, I think that's what I'm going to be able to do and I'm really excited for that and it's been nice moving to Austin. I've been working with some teams and at some colleges, so it's exciting to see people starting to jump on board and realizing how important it is when you're doing that.
B
There's two potential light bulb moments. Right. There's the, one of the students who are there who are like, oh, geez, I didn't even realize what this guy's talking about is something that might be going on in my life. And then there's also the coaches light bulb moment of oh, I had no idea. Right. That this would even be a thing because I think we sadly have this notion that people who have a mental health issue can't do well physically in sports or they just don't have the tenacity to put into this. And you're going out there to really prove that wrong. That that is absolutely untrue. And no one should for a second hold on to a belief like that.
A
Right? Yeah, not at all. Not at all. I mean, I would, I would argue that some of the people that, that do have some of our mental health issues or, or challenges or mental illnesses like have been phenomenal athletes because they have faced really challenging times and you know, when their back is against the wall, they know how to be resilient.
B
Yeah, yeah. Talking to Ally, talking to Zayn on the podcast, you know, you really got to see that of, you know, again, people can be successful despite something not, you know, and. And you can learn to live with it. Part of your message, I think, is you've learned to live with ocd. And was it hard to approach that at first versus hoping to get rid of OCD that a lot of people, when they start treatment, like, oh, I just want this to be gone. And. And I always give the message out. I'd love that too. I just don't know how to do that. But. But I could definitely help you learn to live with it. And how. How have you adopted that into your life and then into how you coach other people?
A
Yeah, I mean, I think for a while, OCD was my identity. Right. And I think there's. There's part of it that. Because it consumes you. Right. I was doing compulsions for 15 hours a day. When you start getting better and you get all that time back, you're like, who am I? Right. And so it's. There's a whole another part of recovery that I think is arguably just as challenging of finding who you are and finding what you. What your views are on things, what you're. It might not be the same as everybody in your family or. Or in your friend circle. Right. But these are things like, you don't even think of until you have time back. Right. And. Or what you're interested in. You might not have the same hobbies as your family or friends. Right? Like what your. What your religion is. Right. Like, all these things. Who am I to my core. Right. And so I think the identity portion is really challenging, but I think I also realized, you know, early on that, like, hey, it's. It's. It's chronic. Right. It's not something that, you know, we can cure. But I also don't. When I advocate and I talk, I never want to give off the impression that it's like, I just live with this and just have to muscle through and push through every day. And every day is a battle and. Right. Like, listen, are some days pretty tough? Absolutely. Right. But I have support, and I have support for the community. I have support for my. From therapy. I have some support from my, you know, my family and friends and from my girlfriend. Right. So, like, you find these people in your life, right from my faith, you know, So I think understanding that, like, hey, you can thrive. You don't just have to survive. And I think that's been a core pillar of how my story has kind of shifted and how I tell my story and advocate is trying to provide more hope of, like, hey, look at. I was doing 15 hours of compulsions a day. That leaves nine hours for sleep. You know, schoolwork, being a human being, everything else. Right. So, like.
B
And sleep's gonna take at least seven of those hours. So you really had two hours, right?
A
Yeah, exactly.
B
Yeah.
A
So I think, you know, I wanna make sure that, you know, as I've. As. I've evolved as a speaker and, you know, as I've done keynotes and different things, like, I wanna make sure that hope is there too. Right. Like, and. And for people to know, like, hey, you can get better. It's gonna take some work. Right. Like, nobody's gonna do it for you. And that's like, the problem is that some people want it done for. And. And because it's hard. And the reality is, like, you can do hard things.
B
Yes.
A
And when you do, you're gonna see how much of your life you can get back and how many opportunities start opening up to you because you see the world in a totally different light in a totally different way. And I think a lot of people, you know, do struggle with the fact that, like, advocacy is their whole life. And it's amazing. But who are you outside of ocd? And sometimes people get stuck in this. They don't necessarily want to do the work or recover because they're worried they're going to lose part of their identity. And really what happens is your identity shifts to now. I can support more people in their recovery. And when you start looking at recovery as an opportunity to actually be able to speak about it more and help others at rock bottom, you start wanting to improve more. At least I did. Right. So I think there is this almost, you know, worrying about, who am I if my OCD is. Is, you know, limited? And I asked and I start to be able to function very well. Right. And, you know, I think their lives and our lives actually open up more when. When you. When you can. When you put in the work and you start realizing how much time you get back.
B
Very inspiring stuff, Tom. Thank you. Where can people find you and see the work you're doing?
A
I'm on Instagram, s2 number 2s/smalls. And then my website is struggle and strength dot com. Uh, and I will, you know, if they. If anybody wants to email me, I can. I can answer emails as well. I can. I can give that off to you guys as well.
B
Great. We can link those. That's fine.
A
Yeah. Well, thank you so much for having me. I. This was conversation.
B
Absolutely. And thank you. And thank you for the work you do, because I can speak all day as somebody who treats ocd, but that goes so far.
A
Right?
B
And it's so powerful to have people with lived experience talk about, oh no, it's true. You know what? Treatment can be helpful and like you said, you have to put in the work. Right? It isn't. You just go to therapy and you're going to get better. You, it's kind of like a piano. You go to piano lessons and not be a good piano player if you don't practice between lessons. Right? But, but hey, but I went to piano lessons.
A
Right, right. And I think that's, you know, you know, just circling back to like finding effective treatment. You know, people like yourself, like, people like the, the people we know in the, in the community that really treat OCD effectively, they're going to give you homework to do on your own, they're going to give you assignments, and you're going to be able to carry those skills over into real life situations.
B
Awesome. Well, thank you, Tom. We really appreciate your time and thank all of you for watching the get to Know OCD podcast. If you're looking for help for ocd, that evidence based treatment that we were talking about today, join us@nocd.com that's nocd.com, where we work with things like OCD, body focused, repetitive behaviors, tics hoarding, trauma, anxiety disorders, mood concerns. And we do work in Canada, the US and we also work in the UK and Australia. So again, reach out. We're there to help. Nocd.com thanks for watching today. If you liked what you saw, subscribe to our NOCD YouTube channel where you can get other episodes of the get to Know OCD podcast. And you can watch my Wednesday night webinars that I do live from with people all over the world. And remember this, be better to yourself than your OCD is. Thanks everyone.
Episode: What It’s REALLY Like To Be An Athlete With OCD
Host: Dr. Patrick McGrath (NOCD Chief Clinical Officer)
Guest: Tom Smalley (Certified Mental Performance Consultant, OCD Advocate)
Date: October 23, 2025
This episode delves into the lived experience of Tom Smalley, a mental performance consultant and athlete, who was diagnosed with OCD at 16. Tom shares how his journey through stigma, adversity—including abuse by coaches—and eventual advocacy fused his twin passions for sports and mental health. The discussion explores how OCD uniquely impacts athletes, the persistent stigma in athletics and society, and the importance of evidence-based treatment and community support.
Delayed Diagnosis & Struggles to Disclose
First Steps Into Advocacy
Finding Community
Facing Stigma in Athletics
Navigating Reactions to OCD Misuse
Advocacy and Empathy as Core Tools
Emphasis on Evidence-Based Interventions
Hopeful Message: Recovery is Possible
Stigma in Athletics Culture
Myth: OCD as a 'Performance Enhancer'
Overtraining, Perfectionism, and Mental Cost
Anxiety and Athletes Initiative
Struggle into Strength
Identity Beyond OCD
Core Message: Resilience, Empathy, and Education
Tom’s story is a powerful testament to resilience and the importance of hope, community, and authenticity. His advocacy and work with the IOCDF and Struggle into Strength are opening conversations about mental health in athletics, challenging deeply embedded stigma, and offering real resources for change.
Connect with Tom:
Learn more or get help:
Host’s Closing Message:
"Be better to yourself than your OCD is."