Get to Know OCD Podcast

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

Episode Overview

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.

Key Discussion Points & Insights

1. Tom’s OCD Journey: Diagnosis, Disclosure, and Advocacy

• Delayed Diagnosis & Struggles to Disclose

  • Tom wasn’t diagnosed until 16 after years of hiding symptoms driven by fear and misunderstanding.
  • Quote: "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." (09:32)

• First Steps Into Advocacy

  • First public speaking experience at a Yale OCD Awareness event at 17.
  • Realized storytelling could both help others and support his own recovery.
  • Quote: "Your story doesn't need to be perfect to be powerful. ... You just need to be authentic and be you and share those experiences." (13:29)

• Finding Community

  • Attending International OCD Foundation (IOCDF) conferences was a turning point—found validation and understanding.
  • Quote: "You raise your hand and say a thought and everybody has the same thought or something similar. ... I've never felt more part of a community in my life." (12:14)

2. Stigma, Misunderstanding, and Response

• Facing Stigma in Athletics

  • Experienced ridicule and abuse from college coaches for his OCD, which became national news.
  • Emphasizes the lack of understanding of mental health versus physical health in sports culture.
  • Quote: "...people totally don't understand, and it's just the butt of jokes and ridicule and things like that... which is not a weakness or anything that you're lacking. It's just something that you have." (15:13)

• Navigating Reactions to OCD Misuse

  • Frustration when hearing phrases like "I'm so OCD," but advocates staying calm and educating others rather than reacting emotionally.
  • Quote: "If we speak with too much emotion...people are then going to label you as like, oh, he's crazy. ... My approach now is...is rooted in education and taking...the emotion out of it." (21:58)

• Advocacy and Empathy as Core Tools

  • Personal growth transformed anger about past treatment into empathy for those who don’t understand mental health.
  • Quote: "I forgive that coach. ... 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." (16:00)

3. OCD Treatment: What Works

• Emphasis on Evidence-Based Interventions

  • ERP (Exposure and Response Prevention), CBT, and ACT highlighted as gold-standard treatments.
  • Many people still receive misguided treatment or see multiple therapists before finding effective care.
  • Quote: "If their first response isn't making a hierarchy and exposure response, then I know that they haven't had effective OCD treatment." (07:43)

• Hopeful Message: Recovery is Possible

  • Tom reinforces that thriving—not just surviving—with OCD is achievable, though it requires persistent effort.
  • Quote: "You can thrive. You don't just have to survive. ... I was doing 15 hours of compulsions a day...So...I want to make sure that hope is there too." (45:50)

4. Unique Challenges for Athletes with OCD

• Stigma in Athletics Culture

  • Mental health issues often viewed as weakness; athletes expected to hide struggles and "push through."
  • Universities often invest more in athletics than in athlete mental health services.
  • Quote: "They'll post a graphic in Mental Health Awareness Month...But what are the actual initiatives behind closed doors to really support their student athletes? The answer was very little." (27:24)

• Myth: OCD as a 'Performance Enhancer'

  • Common misconception: obsessive tendencies make athletes better due to focus or discipline, but in reality, compulsions and anxiety often sabotage well-being and performance.
  • Quote: "With ocd, there was a lot of people that would think that OCD helps performance. ... Those aren't good reps that your body is actually training. ... OCD doesn't help performance. No, OCD doesn't help anything." (30:08)

• Overtraining, Perfectionism, and Mental Cost

  • Explains how compulsive extra training spurred by OCD damages mental and physical health rather than improving results.
  • Quote: "When you're...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...those aren't good reps." (30:08)

5. Building Support & Change in Athletics

• Anxiety and Athletes Initiative

  • Co-founded with the IOCDF, the initiative creates resources, storytelling platforms, and support networks for athletes, coaches, and parents.
  • Partnerships with high-profile athletes, e.g., Olympic gymnast Aly Raisman and NFL player Zane Gonzalez, to increase outreach and credibility.
  • Quote: "We have that website living on the IOCDF homepage...it's really, hey, here's a hub for people to come to where you're not feeling seen, you're not feeling heard..." (27:24)

• Struggle into Strength

  • Tom’s business, rooted in his own mantra, helps high performers reframe adversity as a source of growth, not shame.
  • Quote: "Struggle doesn't make you weak, it makes you human. ... Every part of struggle and strength is rooted in lived experience." (37:24)

6. Lived Experience: Beyond the Label

• Identity Beyond OCD

  • Recovery means reclaiming time, energy, and identity previously swallowed by compulsions.
  • Quote: "There's a whole another part of recovery...finding who you are and finding what your views are on things...You don't even think of until you have time back." (43:35)

• Core Message: Resilience, Empathy, and Education

  • Every setback is a chance to model resilience and empathy for others facing stigma or misunderstanding, especially as an athlete.
  • Quote: "...you can do hard things. 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." (46:18)

Notable Quotes & Memorable Moments

• "Just because I carry it well doesn't mean it's not heavy." — Tom (00:00, repeated at 03:23)
• "Your story doesn't need to be perfect to be powerful." — Tom (13:29)
• "If somebody had diabetes and they made fun of their diabetes, they'd probably get pretty upset too." — Tom (23:14)
• "They’ll pay their football coach $750,000 a year to be mediocre, but won’t pay someone $80,000–$100,000 to be a psychologist for student athletes." — Tom (33:40)
• "Imagine if we said people who pray more because of scrupulosity are actually better at their religion... Makes no sense whatsoever." — Dr. McGrath (35:08)
• "You can only be brave if first you’re afraid." — Dr. McGrath (39:51)

Timestamps for Key Segments

• Tom’s Diagnosis & Early Advocacy – 00:00–13:28
• IOCDF Community Impact & Speaking – 12:06–13:29
• College Coach Abuse & Resilience – 13:28–21:38
• Stigma, Misuse of 'OCD', and Educating Others – 21:38–26:23
• Anxiety and Athletes Initiative – 26:23–29:58
• OCD’s Unique Challenges for Athletes – 29:58–36:56
• Struggle into Strength Performance Business – 37:24–40:25
• Identity, Living with OCD, and Hope for Recovery – 43:35–48:04
• Coaching, Message to Listeners, & Resources – 47:44–49:11

Final Thoughts & Resources

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:

• Instagram: @s2smalls
• Website: struggleandstrength.com

Learn more or get help:

• NOCD.com
• IOCDF Athlete Resources (check for latest links)

Host’s Closing Message:
"Be better to yourself than your OCD is."