Podcast Summary: OCD Recovery with Ali Greymond

Episode: What Causes Treatment Resistant OCD
Date: October 25, 2025
Host: Ali Greymond

Episode Overview

In this episode, Ali Greymond confronts the concept of "treatment resistant OCD," challenging the validity and usefulness of the label. Drawing from nearly two decades of coaching and her own recovery journey, Ali insists that, with correct understanding and consistent action, everyone can recover from OCD. The discussion centers on why some people struggle to make progress, the importance of self-driven work, and the critical role of method and behavioral reduction in overcoming OCD.

Key Discussion Points and Insights

1. The "Treatment Resistant OCD" Label Is Misguided

• Ali's Position: The term “treatment resistant OCD” is fundamentally flawed. In Ali’s words, “There is no treatment resistant OCD. There’s people who resist treatment, yes, but there is no treatment resistant OCD.” (01:01)
  • Ali highlights her experience that, over 20 years in the field, she has never seen a case that couldn't improve with the right process.

2. The Fundamental Model of OCD

• The equation for OCD severity:
  • Rumination + Compulsions + Avoidances = Anxiety/OCD Strength
  • More engagement in these behaviors heightens OCD and anxiety; less engagement diminishes both.

3. Reasons Behind Apparent “Treatment Resistance”

Ali identifies two main reasons people struggle to make progress:

A. Lack of Commitment

• Some people "just don't want to do the work," or aren't ready to commit fully to the recovery process.
• Quote: “It's almost the same idea of like, I'm going to hire a personal trainer… but I'm not actually going to go to the gym.” (03:13)

B. Incorrect Method or Misguided Approach

• People may be dedicated but misled by the wrong approach (e.g., excessive focus on childhood trauma, or insufficient/ineffective exposure techniques).
• Too many professionals involved can sometimes hinder progress if the person keeps chasing new solutions without actual behavioral change.
• Quote: “They're doing everything to recover. But their doctor told them that this is... childhood trauma and they're digging there. And of course they're never going to recover because the method is wrong, the approach is wrong.” (04:32)

4. The Path to Recovery: Behavioral Reduction

• If you track and systematically decrease rumination and compulsions (and eventually avoidances), recovery will follow.
  • Even small steps matter: reducing behaviors by 10% a week is progress, even if it takes months.
• Metaphor: "Even a snail will get to the end of the street at some point. Hopefully, you know, we're more of a gazelle, but if we're a snail, then we're a snail and we're all a snail in some sort of situations in life.” (08:45)

5. Rewriting the Narrative

• Ali stresses the importance of not believing that “treatment resistant” is an immutable label:
  • Quote: “If somebody incorrectly labeled your OCD as treatment resistant, believe me, it is not. Your brain is absolutely capable of full recovery. Absolutely. I have zero doubt in my mind that you can recover.” (06:27)
  • Dismisses the idea of deeper, unsolvable factors (e.g., unspecific chemical imbalance or childhood trauma).

Notable Quotes & Memorable Moments

• On the flawed label:
  “Treatment resistant OCD became treatment what? Congruent OCD. Right. So, yeah, so absolutely you can recover, but the work needs to be done. No excuses.” (10:12)
• On method over labels:
  “It's just that you are feeding the disorder at a certain level and the disorder remains at a certain level.” (06:03)
• On progress, even if slow:
  “Any reduction will get you to the end goal.” (08:31)
• On self-responsibility:
  “It's not about that you need all of these people around you to help you recover. You need to actually want this, be in it, lock in.” (03:02)

Timestamps for Key Segments

• 01:01 — Dismantling the “Treatment Resistant” Label
• 03:13 — The “Personal Trainer” Analogy and True Commitment
• 04:32 — Problems with Incorrect Approaches
• 06:03 — The Real Mechanism Behind OCD Persistence
• 06:27 — Reassurance of the Brain’s Capacity for Recovery
• 08:31 — The Importance of Incremental Progress
• 08:45 — “Even a snail will get there” Metaphor
• 10:12 — Redefining “Treatment Resistant OCD”

Overall Takeaways

• There is no such thing as treatment resistant OCD—only approaches that are misguided, inconsistent, or incomplete.
• Consistent behavioral reduction (ruminations, compulsions, avoidances) is the proven path.
• You don’t need a team of specialists; you need the right information and real commitment.
• Progress—even if extremely slow—is still progress.
• Belief in your ability to recover is crucial; reject discouraging labels.

For direct coaching or more information, listeners are invited to visit youhaveocd.com.