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Foreign.
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Before we begin today's episode, I want to share some important safety information. In this episode, we'll be discussing suicidal ocd, a specific subtype of obsessive compulsive disorder where people experience unwanted intrusive thoughts about suicide. These thoughts can feel vivid and deeply distressing, but they do not reflect a genuine desire to die. Instead, they trigger intense fear and anxiety, leading people to question their own safety and engage in compulsive reassurance seeking behaviors. Suicidal OCD is not the same as being suicidal. Understanding the distinction between suicidal OCD and true suicidal intent is crucial for accessing appropriate help and treatment. Reaching out to a mental health professional is important to ensure your safety and that you get the best treatment possible. If you think what you're experiencing is suicidal OCD, please reach out to us@nocd.com if you or someone you love is experiencing thoughts of wanting to die versus what if I wanted to die? Or they're making plans to harm themselves. This is not OCD, it's suicidal ideation and it requires immediate attention. Call 988 in the United States for the Suicide and Crisis lifeline or go to the nearest emergency department to ensure your safety. Now, onto today's episode. Hi, everyone. Welcome to another episode of the get to Know OCD podcast. I am Dr. Patrick McGrath. I'm the Chief Clinical Officer for NOCD. Today, my guest, as I have nicknamed her, Taboo Tracy. Hello, Tracy. How are you?
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Hello. I am doing fabulous. Yes, I'm Tracy Ibrahim. I'm a therapist with no CD and the chief compliance officer. And Taboo Tracy, obviously, I mean, that's.
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The best name of all.
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A
I'm going to change it soon.
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B
I think I would like to go to that hearing, actually, when you do legally change your name, that would be fun. Awesome. Well, today we are going to be discussing what's the difference between a crisis that's occurring and where OCD can take something to make it seem like a crisis, but it's really ocd. And as we know, ocd, being the master manipulator, will say things like, yeah, sure, all the other ones were ocd, but this one, this one might actually be the thing, be the crisis, or something like that. And with your own experiences of depression and OCD that you've been very open about and live with and everything, no doubt this is something that's probably hit home for you at various times in your life as well.
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Absolutely. From. From everything from getting misdiagnosed and mistreated to getting treated and understanding what I had so or have I still have it?
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Yeah. So because of our positions at nocd, we often get contacted when there is some kind of a crisis experience. So what do you see as a crisis? What gets defined as a crisis? What are things that we need to be really paying attention to and may require intervention right off the bat?
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A
That is an excellent question. And the answer to that lies more so in the areas of certainty. So feeling certain that you are done with this life or with your situation, feeling absolutely hopeless, helpless, and you maybe you're starting to plan to do something to harm yourself, or maybe you've already started collecting things to harm yourself, something along those lines. When you start crossing the line into this feels right. This is what I want to do. I'm going toward this for sure. That's when you have hit a crisis, that's when it's time to get crisis resources in place immediately.
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B
Okay. And that could be about harm to self. That could be about harm to others. Right, those things.
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Yep.
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There's, there's also non suicidal self injury which can occur for people, which we also have to take seriously because not though people may not intend to literally sometimes cut too deep, it, it, it could occur. Right. And there could still be serious consequences of, of even that type of behavior.
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Absolutely. Having worked in multiple settings like psychiatric hospitals in the emergency room, I have seen people with non suicidal self injury. It could be cutting, burning, all kinds of different things you might do to yourself, go too far, if you will, or go further than you planned or didn't go as planned and have either led to very serious consequences and medical interventions being needed to actually accidentally ending your life.
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B
Yeah. And then there's ocd, which whenever we're working with people with ocd, we'll always say this phrase. But it feels so real.
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Yes.
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B
How do you help somebody who has OCD when they're feeling like this thing feels so real? Understand what's the difference between a crisis and obsessive compulsive disorder?
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Yes. That's. That is on the other side of the. Where I think we have a lot of uncertainty. When you're trying to figure out if you're suicidal, are you trying to figure out if your depression somehow is going to turn into a suicide attempt? Is it, oh, I'm, I'm getting intrusive thoughts or images or urges about suicidal things. So I have suicidal ocd. It could be anything from, oh, you're standing really close to that window, you're probably going to throw yourself out the window or aren't you going to. Or definitely you're going to. So, yes, with ocd, we have a lot of uncertainty. Lots of trying to figure it out, lots of worrying about. Looks very different than a true crisis.
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Right. Then I'm going to do this. I have made the decision, gathered everything together, and I'm going to follow through on something, Right?
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Absolutely. I can give a very concrete example from my own life. I, as somebody who had, luckily, a failed suicide attempt versus my suicidal ocd, the day that I had lost hope for everything, I started making plans, and those plans were certain plans, and I started to gather the things I needed, and then I carried that plan out without asking for assistance or help. Right. That was a true crisis that led to all kinds of things on a daily basis. I have suicidal OCD that might even talk about maybe those same means that I used at that time. But I'm not, you know, might say, oh, you're. You know, you're collecting pills or you're getting sharp objects or whatever. Sure, I could collect pills today, and I don't want to take them, but OCD says. Yeah, but you do. But you do want to take those. You're depressed today. Don't you want to end it? I know you're going to end it. You're going to. You have enough pills, and I don't want to. That's not what my value is today, Right. Today, right now, today, that is not what I want to do. So I. I can sit with those intrusive thoughts and images and urges. Absolutely.
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B
Yeah. And OCD might not even be as direct for some people that might say, but what if you do want to today? You know, that's. That's all that it needs, is that. That nugget of uncertainty to be put into that experience and lead you down the path of. Well, now I have to try to figure it out. As someone who's lived with ocd, Tracy, how much of your OCD have you ever figured out?
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I have never figured any of it out and have spent, I'm sure, decades trying. Yeah, yeah.
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B
And then you come into this world of OCD work, right? You. You go from a person who's been misdiagnosed, who's been hospitalized, who's sadly been misinformed for so many years about things that were going on, not. Not your fault by any means whatsoever. Right. And now you're in this community. You're. You're doing this work, and there's a couple of places that I want to go with that one. I think it probably validates the Idea that actual correct evidence based treatment is the thing that changed your life.
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100%. 100%.
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That doing this work isn't just important for you, but it's important for this community at large, right?
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Absolutely. Absolutely. Everybody has to know about this. It's too serious for people to be misunderstanding to this day.
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And that you're an example of a person who can live with a really scary thought or image or urge. Scary in quotes at this point in your life. Right?
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Yeah.
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And manage that. And know that just because you have that doesn't mean that you're going to do something about it or follow through on it or that it will have any pull on you toward doing that very thing. Is that correct?
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A
That is absolutely correct. Yep. It might feel like it. Sometimes I'll get an intrusive urge. This happened a couple weeks ago. I was just having breakfast and I got this very. I don't normally get them too deeply, but I got this urge that was like, you're gonna go run out into the middle of the busy street and get hit by a car because you wanna die. I was like, okay, let me finish my breakfast and then I'll get my running shoes on and then I'll run toward the street. But you know what I'll do? I'll stop at the sidewalk because this isn't, this isn't where I'm going today. And it will come in with other things. Like I recently all of the people who normally live in my house were all gone for three weeks and a new one. Right. OCD is like, well, we haven't had this one in a while. You're alone. So won't it make it more likely now that you don't feel responsible that people will find you dead? That you will now, now is your time. Now you're going to do it. And I was like, awesome. You're right, that sounds amazing. Maybe, maybe I'll do it outside though, because I don't want to smell up the house. I don't know, I don't want to ruin it for anybody. Right. So yeah, it's always finds its way in. I was like, oh, that's a new one. I'm not normally home alone for so long. So yeah, I'm like, great, sure, sure, yes. Now I'm alone. So now OCD comes true. Great. Right.
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B
And as a person with a comorbid depression and ocd, I think what's really eye openening potentially for people is you can even talk as candidly as you are about that right now. And Know that. Sure. I have both conditions and I know how to live with them. And they don't have to rule my life.
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A
Absolutely. Which is just knowing what to do and having the right treatment and the right tools on board is what makes that possible. It's the things that I help my members at NOCD do who have comorbid depression and suicidal OCD or any other, you know, OCD showing up in any other way is the same way I deal with it in my daily life life. You know, it's the things that help me get to the other side, where you're just somebody living with it just like anybody else.
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B
Yeah. You'll hear those folks who will say, though, but I don't want to live with it. Right. I want it to be gone. And they will be very disappointed in us for not having developed a treatment yet that will make all intrusive thoughts, images and urges go away.
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That is true. And of course, if there was such a thing, if there was a cure, we would all be using it. There is not a cure. There are a lot of things out there that people say, if you do this, you won't have this anymore. It's simply untrue. And I think that because of that, when we really accept that, when we radically accept that you are somebody who has OCD and will always have OCD or you have depression and you may or may not always have depression. Depression can come and go, go. But that, that's part of your life and it's, It's. You can go through a mourning period of like the life that you thought you were going to have. The, you know, life without intrusive thoughts and images and urges. It's absolutely valid to say, you know, this, this maybe isn't like my. Anyone's first choice. Right. I don't want to always be thinking about, constantly be seeing myself, you know, hanging from trees or whatever, whatever it is that I see on a daily. I can't just look at a forest. I have to look at a forest. And like, I see myself hanging from the majority of trees. And then I narrow it down. Like, that one can't hold you up. That one's not shady enough. You know, it's. I like to insert humor into helping as somebody who has to live with it every day. But what I like to tell people is I think it's. What sounds hard is living with OCD that's on full blast. That would be miserable. That is not what we are talking about. When you have full blast untreated ocd. That's not as good as it gets. That's, I think, the most important message. They're like, wow, I just have to suffer like this every day. It's like, no, I live with it every day. And I'm not suffering the vast majority of days because it's not triggering like it used to be. Because I got evidence based ERP treatment.
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B
Yeah. And you accepted the notion that you can have a thought, even if it goes to that level, of, what if I harm myself? What if I harm other people? And you still don't have to believe that to be true.
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A
Absolutely. And you know that a lot of times we get asked, yeah, but what if it's. What if it's not about that? What if it's a command? You are definitely going to do this. I get those too. I get those. They're not different. It doesn't matter what the message is. It doesn't matter if it's an urge or an image or a thought or a feeling. They're all equal. It's all equal playing grounds. And it all quiets itself to a lower, more manageable level when you get appropriate treatment.
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B
I watched a movie when I was a kid, the Toxic Avenger, Classic B horror film, kind of in the attack of the killer tomatoes genre, which was another amazing film. And there's a scene in there where the Toxic Avenger is driving the Toxic Avenger mobile, and he sees a kid that teased him before he became the Toxic Avenger riding a bike and he's like, oh, 50 points. And since then, at about age 13, I. I cannot see someone on the street on a bike or a stroller, wheelchair, unicycle, walking, jogging, motorcycle, other car, whatever it would. It doesn't even matter. And assign point values to. If I were to hit that, what. What points would I get for it? All because of that one time in that one scene in that one movie that. That's there and I don't have OCD. And yet now, 40 years later, I'm still doing that thing and having that and just recognizing that. Wow. Yeah, there it is. Okay.
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Absolutely. Any day could be a high point day. We don't know any.
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Any day. Right? Yeah.
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Anything could happen. Right. And it's also possible that maybe someday you will accidentally run into somebody.
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I may. It is a possibility. Yeah.
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Will you get points? That is uncertain?
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That's another version of not great therapy when there's people telling you that, oh, this could never happen. Right. Or something like that. Well, I can't give a guarantee about the next 20 minutes, much less. I might not be alive in 20 minutes. There's a chance I will have a heart attack or something like that or a stroke or something right here on this podcast. It is a possibility that I live with, and I have no guarantee that it won't happen.
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A
Exactly. Just like I can sit in the uncertainty that someday I might change my mind about how I feel about whatever haunts me on any given day in the form of an intrusive thought. It's like, maybe you're going to jump out the window. Maybe. Maybe I will someday. Today, though. Not right now, in this moment, not at the moment.
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B
Yeah. Fix them to get ready to, as they say. Right.
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Fix them to get ready to. That's right.
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Yeah. There's a lot of clinicians out there who aren't familiar with ocd, so they will hear stories about maybe in an intake. I'm so afraid of, what if I were to harm my child? And they'll hear that and think, well, this person is a danger to their child without doing any kind of investigation. What's your message to clinicians now that you're on this side of the work, about how do you approach people who have some of these intrusive thoughts, images or urges, and not just the moment you hear something, be like, hospital, you know, or something of that nature.
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Oh, this is like one of my absolute favorite things to answer because.
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B
Might have been why I asked the question, actually.
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Yeah, because it's so personal to me. And why I became a therapist. Okay. I became. It was a lawyer or a therapist. I went with therapists because, yeah, we have enough lawyers in this world. Fine. We don't have enough OCD specific therapists, though. So, yeah, what I say to therapists is you are taught to always err on the side of the patient, err on the side of caution, error, on the side of doing no harm. But what we don't always hear is there's another kind of doing harm that you hadn't thought about. So when I sat at 10 years old in an. In an assessment and somebody said, have you had thoughts about hurting yourself? I said, yes, I had. I had thoughts. And they were like, well, you know, like what? You know, what. What would you do? And I was like, well, I don't know. I don't know. These are the various thoughts that have come up and that turned into a. You're on suicide precautions and you're in a hospital. And that was clinical harm because they didn't ask enough clarifying questions to find out if Maybe it was something else. Or what if it's something else? What if you asked, do you want to kill yourself right now in this moment? I would have said no. That sounds very scary to me. If they would have said, have you tried to do anything to start to do something? I would have said absolutely not. If they would have said, do you want to be dead right now? I would have said no. They didn't ask clarifying questions to find out that I was just having intrusive thoughts because they asked me a weird question for a 10 year old that to have to answer.
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B
So especially a 10 year old who's probably been told if an adult asks you a question, you tell them the truth. Right. Or something.
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Always say the truth. And the truth is you asked me a question which gave me thoughts. Then I said, yes, I have thoughts. Now that you've asked me the question, I've had thoughts I didn't have thoughts before that day. Yeah, yeah. Like ask that. How long have you had these thoughts? I would have said just now, just this moment. This is the first time I thought of it. So many follow up questions that a responsible clinician could have asked, but instead they did clinical harm. You put somebody who is 10 years old in a hospital and said your intrusive thoughts are real and you're a harm to yourself. So we are going to treat you exactly like that. And that is doing clinical harm.
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B
Right. Even that parent who is afraid to touch their child but has done all of these other things to assure that their child is safe by having relatives move in or something. That's, that's not a case where I have to call Department of Children and Family Services because there's neglect. They've done everything they possibly can to make sure that that child is cared for. They're just not the ones who's caring for the child out of fear. And that's where we come in to say, let's get rid of that fear of harming your child so that you can care for your child and learn that you can still have the thoughts about what if I were to do something harmful? But it doesn't make you do something. That idea of Thought Action Fusion, right, that, that a thought is equal to an action and it is as bad as an action. And boy, if that was the case, I don't think anyone would be alive at this point if, if Thought Action Fusion actually worked.
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A
No, because when I lived in Los Angeles and was commuting every day in the hell of traffic that is known of Los Angeles and Orange County, California. I often would imagine, like in a. In a sweet way in my mind, imagine if everybody just exploded who's in front of me, but only the people between me and my destination so that I could just get there.
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Yeah.
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Can you imagine, like most of California, most of Los Angeles would be gone.
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Would be gone.
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Would be gone.
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Yeah.
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A
Everyone would be gone.
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Yeah. I ended a webinar with this will be the last webinar I'll do because after this webinar, I'm going to wish for no one to be alive tomorrow morning but me so that I can then clear all the cars off the highway, find some supercars and just race them up and down highways for a few days until I run out of gasoline. But I think that that sounds really, really fun. And then I came back to the webinar next week and said, well, guess it didn't work.
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A
What a shame. Yeah. If you could just also keep me alive, I would like to also race car.
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B
That's fine. Yeah. Yeah. You don't. You live far away? So we're not competing.
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A
No. Fine. Different stretches of road.
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B
Yeah, absolutely. Different stretches of road. So that'll be good. You know, with the comorbid and we say comorbid meaning co occurring. That's one of our terms. It's a morbid term to say comorbid in a way.
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A
But happening at the same time.
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B
Yes. With the happening at the same time. Depression and OCD that we see in people, are there treatments for both that we can provide folks?
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A
There are. And. And we can provide them at the same time. As a matter of fact, adno CD for people who have anxiety disorders or maybe you have depression, maybe of ocd. I can't even possibly. We don't. I don't think we have time to go over the list of things that we could treat at the same time at no c. D.
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B
It's a lot. Yeah. And both of them have a behavioral component to them. Right. I mean, in ERP we're having people do opposite behaviors of compulsions, be they mental or physical. And in, you know, doing work with behavioral activation for depression, were having people go back and live their lives and do the things that they used to do before the depression set in. Because if you look at the definition of depression, one is I feel depressed and two is I've lost interest or pleasure in things I once enjoyed. Well, if you once enjoyed them, you could probably still enjoy them, but you're not enjoying them anymore because you're depressed. So maybe if we get you back to doing them, you'll start to enjoy them again and that'll decrease your depression. And that's what we really tried to move people toward Israel is getting folks to learn. Okay, I can handle this. I may not like, may not be comfortable, but I can handle.
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A
Absolutely. And as somebody who has at the same time comorbid depression with ocd, I, I build my ERP and my behavioral activation into my day to day life. So if one of them is louder on a given day, I'll do more of that particular, you know, intervention and if one's quieter, then maybe I'll, I'll do something else. So, yeah, and, and it works, you know, I mean, with behavioral activation, it's not that you go out and do the thing and like you feel joy that moment, but it's about building it up over time. Because all the things you let go of when you're depressed, you don't realize, but they are adding to it. So like for me, if I were in a deeper depression, I might shower less. But when you shower less, you also don't feel clean. And then when you don't feel clean, then you also don't feel great about yourself or you don't feel presentable. Maybe you don't even smell good. I always smell good. But you know, you know, I can go so long. But, but yeah, it's so, so it's just all the little things like get up and you brush your teeth and you eat because if you don't eat, then you don't have enough energy to get up and do the things you used to do. So it's really building all those things back into your life so that over time you can build up the good juju in your, in your brain and become less depressed. Juju is a, is a official word. It means, it means good stuff in your brain.
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B
On that, actually. Then there's the people who are afraid. Well, what if my brain doesn't have good stuff in it? In it, right? What if, what if it's only negative stuff? And you'll notice that as I'm bringing these up, I, I always start off with that two word phrase, what if? Because I would contend OCD is a what if condition. It is a what if disorder. It is those two words, what if followed by whatever worst case scenario that person can drum up or OCD can drum up in that particular area, type whatever it may be. Which is why there may be myriads of things going on in your life that don't bother you. But this one thing suddenly Takes hours and hours and hours of your day. And it could be something that almost nobody else in the world would even notice. But for you, it's the most important thing. So consider that OCD is that what if condition.
- [28:29]
A
Definitely. And I feel like sometimes too when people overthink or ruminate, which is a mental compulsion that people do, they might come to a conclusion and say, okay, what if? It's not what if? Maybe I'm really hearing these words saying this and I'm seeing it happen for sure. So it's not a what if anymore. Now what do I do? Now I'm worried. And the answer is it's just one more step of ocd, right? It's now it's just saying something else on top of something else on top of something else on top of something else. And that's, that's OCD for you. Even if you could get actual certainty, hundred percent, it would come take it from you by adding something even with a morsel of truth to make you nervous about it. Like, sure, I might jump out a window. And in fact there is a window here, for instance, that opens. Like, okay, yeah, it's true, there's a window that opens. But does it mean that I'm going to jump out? Well, what if my. I feel an urge that says this urge feels like I'm going to jump out. It really feels. It's not even a what if urge, it's a real urge. And it's saying, oh, like you feel like you're going to jump out of the window. Well, again, but do I want to? You know, if I have to figure out if I want to, if I'm not over there opening the window and flinging my, you know, intending to fling myself out, I'm still in an OCD cycle.
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B
Want to go back to that certainty thing because that's so interesting, you know, for people who have OCD who might develop later in their teenage years. You know, we know that that 12 year old range, that 18 year old range there, it may be hard for them to remember, but often when we're kind of chatting, even at the end of treatment we're in maintenance, they talk about how they remember doing things without ocd, right? But then once OCD hits, you almost forget that you ever did it without ocd. Like, like, no, I always wanted certainty about this thing. And then later through treatment, they're like, yeah, I never, I never cared about certainty in this thing, right? So one of these bastardizations of the brain in some way that occurs is ocd has convinced you that certainty is an option, certainty is a goal, certainty is a reality, and certainty is attainable. And those are all some of the lies that I hear OCD tell people that you can achieve this thing that is unachievable.
- [31:07]
A
Absolutely. Because most things in life are uncertain. It's one of my favorite things to say to people I work with is you don't have to accept facts. But the fact is that most things are uncertain, not even just to people with ocd, just in life. We take leaps of faith all the time. You know, if I save enough, I'll have enough for retirement. Well, you might not make it to retirement. So there's lots of things that we can plan and we can try, but there's still going to be uncertainty. I don't know how much rent will be in five years. I don't know if I'll be alive in two minutes. I don't know if I don't know, all of my hair will turn gray by next November. You know, there's so many things we just. That are just facts that we don't know. Will this relationship last forever? You know, will I definitely feel. Feel. Do I definitely feel this way or not feel this way? Will I jump out a window? What would I tell you that just so much uncertainty. You don't have to accept it, but it's a fact. And if you are fighting against it, it's really just a waste of time and energy because life mostly is uncertain. Like, if you said, tell me something you're certain about, I would say, I know my legal name because I have a Social Security card with it. I have, you know, I have a passport that says it, and I have a driver's license. And I go, yeah, that's it, though. That's it. That's probably where it stops. My certainty.
- [32:38]
B
Yeah. Yeah. And. And even with that level of certainty, OCD could still lead to doubt about it, because, yes, I see my passport, but what if I read the name wrong and it's not actually Patrick on there? What if. What if it's. What if it's something else and it's misspelled? And then I leave the country and they don't catch it, but when I try to come back in, they do catch it, and then they. They don't let me in. Right. I mean, it's just. That's just where it will go. You know, you can. You can be laying on the ground looking under your car for a dead body for five hours and not see one, but still not Feel like you've looked enough to get yourself convinced that you haven't killed somebody, even though you have zero proof of it. OCD gets you to doubt your own senses and sensory experiences, and you. You can't even rely enough on them to satisfy ocd. So when people start to recognize the insatiability of ocd, that you just can never give it enough for it to go, oh, thanks, I'm out of here. Hopefully that's when people stop trying.
- [33:50]
A
Yeah, I agree.
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B
What was the turning point for you? I mean, we've known each other a long time. I know your story. But this. I've not asked you this question, actually. What. What was that moment where you started to finally get Evan's base treatment and recognize, well, wait a minute. Maybe. Or all of that just isn't necessarily true. That one we've not talked about.
- [34:15]
A
Actually, we have not. So I never did count the number of people that got it wrong, but I know it's for sure over 100 people, whether they were psychiatrists, doctors, therapists, counselors, intake coordinators, residential humans, all the people that are supposed to know. And when the turning. There were a couple of turning points. The first turning point was I was a therapist treating OCD the way I had been taught, which was incorrectly, like, most of us are incorrectly taught. And my people were not getting better, so I really needed to figure out how I could help them. And in finding out about exposure response prevention therapy, which I then was like, you need to go out and learn that so that you can help people. I learned about suicidal and homicidal ocd, these taboo themes. I already knew I had ocd. I knew I had contamination ocd. And I just thought it was like a life sentence, that I would always be super grossed out and I would always avoid things, and I would always act sort of strange anywhere I went in public and not touch certain things.
- [35:24]
B
You still do, by the way. Just so. Yeah, yeah, but that's a whole different podcast.
- [35:28]
A
Yeah, yeah, probably. It probably. It was very. I was very extreme on the contamination. So the. The first turning point was finding exposure response prevention. Then it was, you should probably try this yourself before you try it with other people. So my very first thing was a contamination exposure regarding money. I used to not accept change from anyone at any time. A lot of people got to keep change. And one day I was like, I'm going to hold two handfuls of change and see if all of my worst things come true. And I held them for an hour, and my hands sweat and I had sweaty Pennies and a lot of gross stuff in there. And I didn't die. And that was like, oh my gosh. I thought that I was going to have all the diseases, I was going to die, I was going to have a lot of problems. So I got. That was my very first exposure and it worked. And over time I was able to start touching money and accept my change. That was a big deal. And then I realized I could actually do some work in the other areas, including my taboo themes. So that was really the turning point for me. It was finding ERP and then trying it. And then it worked. Yeah, absolutely.
- [36:47]
B
How did it switch over from doing something in your hands like that to more of the mental based kinds of things?
- [36:56]
A
I. That's a great question. I started by doing more of the physical things. Like you are safe around knives. Probably go hold a knife, put a knife near you, go do this. I did a lot of the physical ones first. And then it was like, you know, you're gonna harm somebody thoughts. And then I was like, well, you know what, what if I just say, maybe I will, I don't know, maybe, but not today. You know, I can just have the thought but not actually do something. That's really when it sort of turned because I had a lot of harm. OCD was like harm to my children, harm to my family, harm to myself. So yeah, it really crossed over when I was like, well, I'm still tortured by thoughts constantly, so what should I do? It was like, don't get lost in your thoughts, for starters. Don't get lost in your thoughts.
- [37:49]
B
Words to live by, right?
- [37:51]
A
Absolutely.
- [37:52]
B
And much easier said than done, unfortunately.
- [37:56]
A
Right. I always say you can't know you're going to go into a rumination, but you can catch yourself once you get there.
- [38:03]
B
Right.
- [38:04]
A
And refocus. I don't get, like. I've always said it would be nice if your thumb lit up before you fell into a mental compulsion. So you could have a pre warning.
- [38:11]
B
But that'd be great, right?
- [38:13]
A
It doesn't work that way. I'm like, oh, the other day I was, I thought that originally I was solving an issue in my head. I was thinking about something reasonable and then it turned into a rumination, which then I realized. So then I had to refocus.
- [38:28]
B
ET's finger heals and his thumb warns of rumination.
- [38:35]
A
Wouldn't that be so cool? Yes. Wow.
- [38:39]
B
And the third one is a left turn signal.
- [38:46]
A
Yes. I've always said, please, just like, come on, give us some warning signs or something. But yeah, it feels like it's going to suck you in. Like, you have to solve it. I felt like if I thought about it a little bit longer, I would have gotten to the answer, and I'm like, get up. Move. Get out. Do something else. Don't sit here and try and solve this unsolvable issue.
- [39:08]
B
Yeah. And people will always say, well, why does it have to be this? Why do I have to think about killing myself? Why does OCD have to go there? And, you know, we know the answer as well, because living is obviously very important to you. Right. Because OCD only goes toward things that are important. Tracy and I have never once treated someone who didn't care about the OCD they had prior to treatment. No one ever showed up and said, I don't really care about this. But, you know, that just. That's just not how it works.
- [39:37]
A
That's true. I've actually, like, some people think, like, what if I listen. What if I read about someone else's theme of OCD and I catch their theme or something and say, you know what? It's not possible to catch a theme. So I. There's a couple themes that I, on purpose, tried to catch to see if I could get them, and I can't get them because I don't care enough about. About them. So that's an interesting situation.
- [40:02]
B
Yeah, for sure.
- [40:04]
A
Yeah. If you're. If it's not important to you or you're not afraid of it, it's probably not going to come haunt you because it won't feel scary.
- [40:10]
B
Probably not. Yeah.
- [40:11]
A
Yeah.
- [40:13]
B
So hopefully we've gotten across today to people this idea that, first of all, nothing's off the table for ocd. Right? There is. There is no topic too small, too big, too precious, too guarded, too careful, too religious, too bad, too great that OCD won't attack. So let's just keep that in mind. If living your life is important to you, then OCD will be like, yeah, but what if you wanted to kill yourself and not live your life? Right. And it will go there, and it will then get you to have doubts and uncertainties about whether any behavior you're doing is pro or anti living. Right. And we'll always lean toward. Well, that might have had an anti living angle to it right there. So maybe it's best if you go to a hospital. Maybe it's best if you always make sure someone is around you to protect you from doing something to yourself that you might be fixing to get ready to do at some point in time, maybe, who knows? Right. With all of the caveats that are in that experience.
- [41:29]
A
Yeah, it does. It gets really, really nuts lately. Mine started coming up with a new thing, which I thought was interesting. I didn't recognize it at first, and then I was like, oh, I thought it was real. Then I was like, this is Hormo cd. And it was. I'm making the wrong meal choices. Moving toward trying to kill myself with cholesterol.
- [41:50]
B
Oh, new one.
- [41:52]
A
You're trying to kill yourself with cholesterol. Which is interesting because about a year ago, I. For several months, it hit me that I was trying to kill my husband with cholesterol. And it took me a minute to recognize this one. And now then it took me a minute to recognize I was doing that to myself. Like, you sure you want to order that red meat? Maybe it's because you're trying to die. If you cared about it, you would have ordered a salad. And I was like, you know what? That's weird. Oh, yeah, Sounds like ocd. Okay, I'm going to order what I.
- [42:22]
B
Want, and I'll take the steak.
- [42:25]
A
Yeah, yeah, I'll take the steak over the salad. If I die. I had a great last meal. Put it on my tombstone if I have one.
- [42:32]
B
Yeah. Enjoyed the steak for one lifestyle.
- [42:35]
A
That's right. She. She ended her life with steak.
- [42:42]
B
Well, and as much as we talk about it, this is obviously a really scary thing for people, right? This idea of how can I truly know if I'm going to live if I want to go through with harming myself? And they hate our answer, which is, we're not here to give you a guaranteed 100% we do or do not know answer. We're here to help you live with the doubt and the uncertainty about the question.
- [43:09]
A
Right. And stop going in circles. I. I always flash back to this time. Probably one of the worst moments. Maybe not the worst. Maybe like the second worst, which was, it's very clear. I'm in a psych hospital. I'm in seclusion. All I can think about is ways to kill myself. It was suicidal ocd, but nobody noticed that, and I was going nuts. Why would somebody be thinking about 52 different ways to kill themselves? Who doesn't want to kill thems? And it was like they took everything away from me, so I had no option. So OCD just. And I didn't know it was ocd. It was like, you're going to bang your head till you die. You're going to try to pull the doorknob off and swallow it. You're Going to, you know, it was just weird. You're going to chew through your arm. OCD will go to the nth degree whether it's reasonable or not reasonable. But yeah, it's like that's just part of it now. I can get those same thoughts and go, sure, okay. But those were torturing me before. I was truly afraid of myself, as apparently were these providers who didn't know what they were doing. So they thought I was dangerous. So did I.
- [44:22]
B
And that's the importance again of evidence based treatment where people will know what they're doing, they'll know how to diagnosis, they'll know how to recognize it, and they'll know what the right treatment is for.
- [44:32]
A
That's right. That's what I live by. Um, that is my only passion now. It's one of my deepest passions in life, is making sure everybody knows this. What is evidence based treatment? Evidence based treatment isn't just treatment that you found online that says it's evidence based. Right. That's not how it works. There's a lot of things that use evidence based that are not. We're talking about real meta analyzed, actual research that said this is it. And exposure response prevention has been the gold standard for decades for treating ocd.
- [45:11]
B
Correct. So well, Tracy, thank you for being here. Where can people find you if they want to see some of your. Your cool stuff?
- [45:19]
A
They can find me on Instagram at Taboo Tracy. Tracy spelled T R A C I E. Yeah, Taboo Tracy, which you named me, which I really appreciate. It was an upgrade because as a teenager I was known as Tracy Negative. Oh, note the depression and they sad outlook. So Taboo Tracy. Yes, on Instagram. And you can also obviously find lots of different things that I've recorded for NOCD on our YouTube channel and on, on, on our socials.
- [45:50]
B
Awesome. Well, thank you, Tracy, for being here today. I think it was very helpful.
- [45:53]
A
Thank you. Thank you for having me. May we live to close this out?
- [45:59]
B
Yes, absolutely. And thank all of you for being here on the get to Know OCD podcast. If you like the get to Know OCD podcast, you could check us out where you get your favorite podcasts or subscribe to the NOCD YouTube channel. And if you're looking for help for OCD or related conditions, check us out@nocd.com that's n o c d dot com. Be good to yourselves or at least much better than your OCD ever will be to you. Thanks for watching. We'll see you again soon.
- [46:29]
A
Bye.