Ologies with Alie Ward
Bonus Episode: The OCD Experience with Neurobiologist Uma Chatterjee
Release Date: July 29, 2025

Introduction to Uma Chatterjee

In this bonus episode of Ologies with Alie Ward, host Alie Ward welcomes neuroscientist and OCD advocate Uma Chatterjee. Uma introduces herself as a PhD candidate in neuroscience at the University of Wisconsin, Madison, specializing in the neurobiology of Obsessive-Compulsive Disorder (OCD) and exploring novel therapeutics, including psychedelics. She also serves as the president of OCD Wisconsin and is actively involved in various mental health advocacy roles.

Uma Chatterjee [04:26]: "I'm earning my PhD in neuroscience at the University of Wisconsin, Madison, studying the neurobiology of OCD and novel therapeutics like psychedelics."

Uma's Personal Journey with OCD

Uma bravely shares her personal battle with OCD, detailing a tumultuous journey marked by severe mental health struggles. She candidly discusses her childhood trauma, including sexual abuse and involvement with a religious cult at the age of 14, which exacerbated her OCD symptoms. Despite facing numerous challenges, including a near-death experience and dropping out of college with a GPA of 1.83, Uma's resilience led her to recovery and a passion for understanding the human brain.

Uma Chatterjee [05:05]: "I never thought I would graduate high school or college. I never internalized a single thing about science in school because I was so sick. And I truly just thought I was going to die soon, and I almost did many times."

Understanding OCD: Obsessions and Compulsions

Uma delves into the clinical definitions of OCD, clarifying common misconceptions. She distinguishes between general obsessions—such as being deeply interested in a hobby—and clinical obsessions, which are intrusive, unwanted, and often distressing thoughts that individuals with OCD find hard to dismiss.

Uma Chatterjee [10:41]: "In the context of OCD, an obsession is an intrusive, unwanted, or unrelenting thought that people without OCD have but can let go of, whereas people with OCD feel intense distress about these thoughts and engage in compulsions to mitigate that distress."

She further explains the difference between mental and physical compulsions, emphasizing that while physical compulsions (like hand-washing) are visible, mental compulsions (such as rumination or repetitive checking) are often internal and less noticeable to others.

Uma Chatterjee [10:41]: "Compulsions can be mental, like trying to figure out if you did something wrong, or physical, like excessive hand-washing."

The Neurobiology of OCD

Uma provides an insightful overview of the brain structures implicated in OCD. She highlights the role of the orbitofrontal cortex (OFC) in determining the salience of thoughts and how it can overactivate in individuals with OCD, leading to heightened perception of threats. Additionally, she discusses the anterior cingulate cortex’s (ACC) involvement in monitoring conflict and error, which becomes hyperactive in OCD patients, perpetuating a cycle of obsessions and compulsions.

Uma Chatterjee [16:10]: "The orbitofrontal cortex often fails to filter out different stimuli and can over-detect potential threats, making intrusive thoughts stickier and more distressing."

Genetic and Environmental Factors

Exploring the etiology of OCD, Uma notes that approximately 40% of OCD cases are genetically heritable. However, she underscores the significant interplay between genetics and environmental factors such as stress, trauma, and even infections like Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

Uma Chatterjee [19:14]: "Even if someone is genetically predisposed to OCD, environmental factors like stress or trauma can trigger its onset, acting like pulling the trigger on a loaded gun."

Impact on Relationships and Loved Ones

Uma addresses how OCD affects not only those diagnosed but also their loved ones. She discusses the concept of accommodations—where family and friends inadvertently reinforce compulsions by providing reassurance or modifying behaviors to alleviate the sufferer's distress. Uma emphasizes that while these actions are well-intentioned, they can perpetuate the OCD cycle.

Uma Chatterjee [26:43]: "Accommodations might feel supportive, but they actually reinforce compulsions and prevent the person from breaking the cycle of OCD."

Treatment Modalities: ERP and Beyond

Uma passionately advocates for Exposure and Response Prevention (ERP), a specialized form of Cognitive Behavioral Therapy (CBT) tailored for OCD. ERP involves exposing individuals to their intrusive thoughts or feared stimuli without allowing them to engage in compulsive behaviors, thereby reducing the intensity of their anxiety over time.

Uma Chatterjee [33:18]: "ERP is the frontline treatment for OCD. It involves facing your fears and preventing the compulsive response, which helps break the cycle of obsessions and compulsions."

She also highlights the limitations of traditional CBT and psychodynamic therapies in effectively treating OCD, stressing the necessity for specialized approaches like ERP.

Emerging Therapies: Psychedelics and Brain Stimulation

Uma explores innovative treatment avenues beyond ERP and medication. She discusses the promising role of psychedelics—such as psilocybin, ketamine, and MDMA—in facilitating neuroplasticity and enhancing the effectiveness of ERP by altering brain chemistry and enabling deeper therapeutic engagement.

Uma Chatterjee [40:39]: "Psilocybin has incredible promise for OCD treatment by creating a more malleable brain state, allowing individuals to engage more effectively with ERP therapies."

Additionally, she touches upon deep brain stimulation and non-invasive techniques like Transcranial Magnetic Stimulation (TMS) as potential interventions to interrupt the neural circuits sustaining OCD symptoms.

Advice for Those with OCD and Their Support Networks

Towards the end of the episode, Uma offers heartfelt advice for individuals suffering from OCD and their loved ones. She encourages those with OCD to seek specialized treatment and warns against generalist therapies that may not address their specific needs. For friends and family, she advises maintaining compassion without enabling compulsive behaviors, understanding that support involves not reinforcing OCD's destructive patterns.

Uma Chatterjee [47:14]: "Your suffering is so valid and real. Seeking proper treatment is one of the bravest things you can do for yourself, and to loved ones, keep an open mind and offer compassion without enabling compulsions."

Notable Quotes

• Uma Chatterjee [05:05]: "I almost thought I was going to die soon. Recovery led me to understand my brain and help others."

• Uma Chatterjee [10:41]: "OCD is not just being obsessed with something you like; it's having intrusive thoughts that you desperately try to neutralize."

• Uma Chatterjee [33:18]: "ERP is the frontline treatment for OCD. It involves facing your fears and preventing the compulsive response."

• Uma Chatterjee [47:14]: "Seeking proper treatment is one of the bravest things you can do for yourself."

Resources and Closing Remarks

Uma directs listeners to the International OCD Foundation (iocdf.org) for resources and specialized therapists trained in ERP. Alie Ward wraps up the episode by highlighting Uma’s podcast, A Chat with Uma, and providing links to Uma’s social media platforms and website for further engagement and support.

Uma Chatterjee [50:46]: "Understanding OCD through the right lens is life-changing. Resources are available, and you are not alone."

Final Thoughts

This bonus episode serves as a profound exploration of OCD from both a scientific and personal perspective. Uma Chatterjee's insights bridge the gap between neurobiology and lived experience, offering invaluable knowledge and hope to those affected by OCD and their support systems. Through comprehensive discussions on the nature of OCD, its impact, and innovative treatment options, listeners gain a deeper understanding of this complex disorder and pathways toward healing.

For more information and support, visit the International OCD Foundation and tune into Uma Chatterjee’s podcast, A Chat with Uma.