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It's not uncommon that people ask me if a specialized therapy is required for obsessive compulsive disorder. And my answer is always yes. It is definitely the most efficacious way to make sure that somebody will get the help that they're looking for. Why can I make that statement? Well, let me tell you a little bit about me. I'm Dr. Patrick McGrath, I'm the Chief Clinical Officer for NOCD. And if you're looking for help for OCD, by the way, you can check us out@nocd.com that's N O c d com. My work in the field of OCD has now spanned 26 years, starting with a postdoctoral fellowship and moving all the way up to being the chief clinical officer here at this great company. And our goal is always the first and foremost to be member first to make sure that we provide our therapy members the best possible service that they can get and to provide them that best possible service. It means to give them the most efficacious treatment for obsessive compulsive disorder and that is exposure and response prevention therapy. So when you're talking about the right treatment for OCD and finding the right therapist for ocd, you're really looking at a few things. Number one, does your therapist actually have specialized training in obsessive compulsive disorder? Not a, you know, went to a few hour webinar and learned about ocd. And not just because on a popular website they clicked off a box that says that they know how to treat ocd. You should feel comfortable saying to anyone you're working with, tell me about your credentials and your ability to treat this condition and what is that work that you do? How do you know to diagnose ocd? How do you know to treat ocd? If someone doesn't give you an answer that satisfies you, find somebody else who does. Right. And those answers ought to be having a very significant specialized training course in obsessive compulsive disorder. We spend weeks here at NOCD making sure that our therapists who come into NOCD are educated in OCD and exposure and response prevention therapy. And then somebody who will apply exposure and response prevention therapy, or ERP as we call it. And that therapy really is two parts. We're purposely exposing people to things that are uncomfortable, which are their obsessions, those thoughts, those images and those urges. And unfortunately, there's a lot of therapists who stop there, who think, well, I've exposed you to it, now you're going to be better but if that was the case, people with OCD wouldn't even need therapy because they're constantly being exposed to their obsessions. So exposure therapy is not the answer. And that's why I don't ever say that I do exposure therapy. I say that I do ERP, exposure and response prevention. Because the most curative aspect of any of the work that we do is the response prevention aspect. And what is response prevention? It's the elimination of the compulsion and other safety behaviors that people with OCD may do, because it is those very safety behaviors that maintain obsessive compulsive disorder. If you want OCD to stick around, do more compulsions. If you want OCD to go away, do less compulsions. That's really the key experience, more than anything else, is making sure that people with OCD do not do safety behaviors, that they do not do compulsions. Now, that may sound difficult, and I will be somewhat apologetic, but not totally that, yes, the therapy is not easy, right? It can be stressful. The goal, though, is not to stress you out of therapy. I don't want you running away from treatment. In fact, I want you to be excited about it. I look at treatment not as throwing you deep into the deep end of the pool so that you will figure out how to swim. I look at therapy more along the lines of I'm going to stick a toe in the water and see how it feels, and then I'm going to stick another toe in and then my foot and then my ankle and then my, my calf and then my leg. And just I'm going to build up to doing all of the things that I need to do to eventually move into the deep end of the pool and figure out how to float and then how to swim. That's what great therapy will look like. And that's what we do here at nocd. If you're not confident in the person that you're working with that they know what OCD is or that they're going to do good exposure and response prevention therapy, it is okay to check around to find somebody that does specialize in it. I would bet you would do this in medical, right? If you had a pretty significant break in an arm or a leg, you're probably going to go first to see your general practitioner, but they're going to refer you to a specialist. Why? Because that's not their area of specialty. Their area of specialty is finding things, diagnosing things, and then getting you to the people who can really help with certain major things. And they can Handle more of the small to middle level things. OCD is a serious mental illness. It is a serious mental health condition. And therefore we feel and know from research that that it requires a specialty care and not a general therapy. A general therapist might approach OCD thinking, how can I help this person to calm down as quickly as possible? Maybe I will teach them some diaphragmatic breathing or muscle relaxation exercises. Maybe I will give them some safety behaviors to do. Maybe there will be coping strategies and coping techniques that I teach them. This would be the sign of somebody who isn't specialized in treating obsessive Compulsive Disorder. Because the goal of ERP is to help people learn that they can live with discomfort, they can live with uncertainty. I bet not one person watching this lives a life of absolute certainty. Does anyone have a guarantee that lightning won't strike near their home or a plane won't buzz their house later and maybe hit the chimney or something like that? Absolutely not a 100% guarantee. Now, should we put a net up around our house to stop small planes from flying by or a Faraday cage around our house so that no electricity will ever hit or hurt our home? Or do we just live with the knowledge that it could happen? It's a possibility. But possibility does not equal probability. And therefore, just because something is possible does not make it 100% probable. However, in the world of OCD, possibility does equal probability. And OCD says if it's possible, it's highly probable. And we better do a compulsion just to make sure, just in case. What if we didn't neutralize that thing? What if something terrible, awful, horrible did happen? We wouldn't that be the worst thing ever in the entire world? Let's just neutralize it. When the people we're working with learned that they can live with whatever their thoughts or their images or urges are, I'll give you an example right now. I hope the ceiling crashes on me while filming this. We'll see. I will do no compulsion or safety behavior to try to stop that from happening. And we'll recognize that just because we think something doesn't make it true. Just because we have an urge about something doesn't cause us to do it. And just because we have an image of something doesn't mean that it will be burned in our mind for the rest of our lives. Want OCD to stick around? Try to get rid of the thought I always keep with me at my desk, my pink elephant. And I always use the example of the moment I tell you not to think of a pink elephant, you're pretty much guaranteed to think of it. But the opposite could also be true. If I tell you to only think of the pink elephant, probably within about 20 to 30 seconds, something else will pop in your mind, like, what do I want for dinner tonight? Or I wonder how everyone's doing at school or work or something like that. Our brains kind of work in this paradox. The more we don't want to think of something or have an image or urge about it, the more we will. And the more we accept that it's there, the less it will actually bother us. Now, people with OCD may always say, yeah, but what about this? And what about this and this subtype? Or this doesn't really matter, right? ERP is the treatment for ocd regardless of what the subtype is. So you don't need to find a specialist in a subtype. You need to find a specialist in obsessive compulsive disorder. And when you do that, and when you commit to actually allowing yourself to live in the uncertainty that the world gives us on a daily basis and you stop listening to the lies that obsessive compulsive disorder tells you that all will be fine and everything will be okay. If you just do a compulsion, you will then start to learn and realize you can handle a world like anybody else without ocd. You can handle the world in its glorious uncertainty and its absolute unpredictability, and know that you can live your life the way that you want to and not the life that OCD wants you to. And that's always my hope for everyone. So in closing, my goal for you is find a therapist who really knows what they're doing, who understands ocd, who understands exposure and response response prevention therapy, who can implement ERP with you, who can do it in a way that won't frighten you away from the treatment, and who has that one goal of you living your life and not the life of ocd. I hope this has been helpful. Thanks for listening in for a little bit. And remember, if you're looking for that help, you can check us out here@nocd.com that's n o c d.com where we work with OCD, but other things as well, like body focus, repetitive behaviors. That would be things along the lines of skin picking, hair pulling. We work with ticks, we work with hoarding, we work with mood conditions and even trauma. Check us out. Nocd.com thanks for listening.