The OCD Stories – Episode #520

Guest: Brad Hufford
Title: “Functioning well despite OCD distress is still a victory”
Host: Stuart Ralph
Release Date: January 11, 2026

Episode Overview

In this episode, Stuart Ralph welcomes Brad Hufford, a licensed clinical social worker specializing in OCD and a practitioner with over 30 years’ experience. Brad shares his personal journey with OCD, his professional evolution, and key shifts in treatment perspectives over the decades. The core theme centers on the idea that living life fully—despite ongoing OCD symptoms or distress—constitutes a real victory. The discussion provides hope, practical advice, and validation for those with OCD, drawing from Brad’s lived experience as both a sufferer and a seasoned therapist.

Key Discussion Points and Insights

Brad’s OCD and Therapy Journey

[02:04]

• Brad’s OCD onset at age 14: primarily intrusive counting and compulsions around bone-cracking and later, driving themes.
• Early treatment involved medication (Prozac, clinical trials with clomipramine/anafranil) and supportive (not ERP) therapy in the 1980s.
• Lived experience inspired career choice: “With the suffering I went through in high school, in college, I think it just became apparent to me that I did not want anybody else to live with this.” (Brad, 03:04)
• Initial uncertainties about being a therapist with OCD, but found it beneficial: “Even if people do have similar symptoms, I see it as a benefit now… That I can really understand and really help people come to grips with.” (Brad, 06:15)
• Developed into a specialist, working at Dr. Charles Mansueto’s OCD center since 1995.

Exposure and Response Prevention (ERP) – Practice, Evolution, and Insights

[08:03], [10:46], [14:01]

• Brad’s ERP experience: Self-driven exposures, especially around “hit and run” OCD and compulsive driving rituals.
  • “Sometimes I would drive up to an hour away from my house… go back and forth and back and forth, driving the same route over and over again for exposure therapy and not do the rituals.” (Brad, 08:10)
• Evolution in ERP:
  • Shift from strict, linear hierarchies to more flexible, “jumping around” approaches reflecting real-life unpredictability.
  • Reduced emphasis on habituation—the key is exposure and learning to tolerate distress, not necessarily achieving calm in-session.
  • “ERP is still ERP... It’s very beneficial for people. It definitely works.” (Brad, 14:04)
• Broader philosophy: ERP skills helpful beyond OCD—public speaking, relationships, etc.
• ERP success: persistent change in the brain, especially when exposures are maintained.

Therapy Relationship & Support

[17:25]

• Importance of the therapeutic relationship:
  • “You have to have a good relationship with the client… If you are encouraging them to do ERP and you don’t have a good, trusting relationship, they’re not going to probably do ERP.” (Brad, 18:48)
• Reflects on the empathetic support from his own teenage therapist which influences his approach today.

Main Theme: Functioning Well Despite Distress

[19:34]

• Core message: Functioning and living a full life while experiencing OCD symptoms or distress is a victory in itself.
  • “Despite what OCD throws at you… and even if you are still experiencing symptoms… and you’re functioning, you’re living life, you’re doing what needs to be done…, that’s still a victory.” (Brad, 19:56)
  • Counters the myth that overcoming OCD means being symptom-free or perpetually calm.
• Acceptance:
  • Many will continue to experience symptoms, but can still lead happy, meaningful lives.
  • “As long as you don’t allow the OCD to tell you what to do for a job, or who to be with for a relationship, who to get married to, what to do with your time… as long as you don’t allow it, you’re winning. It’s a victory.” (Brad, 26:51)
• ACT (Acceptance & Commitment Therapy) perspective:
  • Values-driven living matters more than symptom status.

Notable Quotes & Memorable Moments

• “It’s always interesting and fascinating and rich, but I know how much suffering people can go through. So I’m highly attuned to that and appreciate… the suffering that people can, can experience with this disorder.” (Brad, 07:27)
• “ERP really does work. And I hope that people… even though it’s difficult treatment and it can be daunting, people will take advantage of it because… You’re going to suffer a lot less in the long run if you do the ERP.” (Brad, 15:03)
• “If you continue on, that’s a victory unto itself. You’re not allowing [OCD] to stop you, you’re not allowing it to control what you’re doing.” (Brad, 22:37)
• “Some people may go for years without symptoms… but there is a sizable proportion of people who are going to experience symptoms throughout their lives. For those people, they need to live their life despite the symptoms.” (Brad, 25:28)
• “You just go on… you just do it. You don’t allow OCD to get in the way.” (Brad, 28:23)
• On hope: “Dark times are temporary. OCD is very treatable. There’s a lot of hope. There are a lot of therapists out there who know what they’re doing with OCD.” (Brad, 32:46)
• If he had a billboard: “Got OCD? [phone number]… Anything that’s going to make it easier for people to get treatment.” (Brad, 34:09)

Tips on Motivating Clients in ERP

[29:42]

• Remind clients of decades of positive research and outcomes with ERP.
• Emphasize that even unique or difficult cases benefit from therapy.
• “ERP helps everyone with OCD. No matter what symptoms you have, no matter your feelings about the symptoms, you can get help with ERP. There is always hope.” (Brad, 30:25)
• Normalize slow, non-linear progress—“Sometimes it’s quick, sometimes it’s slow, sometimes it’s super slow. And that’s okay. It’s their journey…” (Stuart, 31:44)

Words of Hope to Listeners

[32:18]

• “When things are at their worst, people can lose hope… If you keep yourself going… the next day is going to be better… Dark times are temporary… There’s a lot of hope. The most important thing is to keep yourself going.” (Brad, 32:18)

Addendum – Clarifications by Brad

[35:55]

• Running is not a treatment, but supported his well-being during the pandemic.
• Changes in ERP he described are from his own experience—not universal to all practitioners.
• Key advice from his first therapist: “You are in charge.” This helps him when OCD feels overwhelming.
• Symptom persistence: Many who still have symptoms have not accessed effective treatment—70–80% experience significant reduction when treated.
• Obsessions: Not just thoughts—can also be urges, impulses, feelings of disgust, or somatic discomfort.

Timestamps for Key Segments

• 02:04 – Brad’s OCD story and motivation to become a therapist
• 08:03 – Brad’s own ERP experiences
• 10:46 – Key shifts in OCD treatment over 30 years
• 14:01 – Current understanding and approach to ERP
• 17:25 – Importance of the therapeutic relationship
• 19:34 – Embracing “victory” in functioning despite distress
• 22:45 – Life satisfaction despite ongoing symptoms
• 25:28 – Addressing the myth of “complete recovery”
• 27:31 – Using ACT/values-focused approaches
• 29:42 – Motivating clients facing slow/nonlinear progress in ERP
• 32:18 – Words of hope for listeners
• 33:22 – Brad’s billboard message and advocacy
• 35:55 – Addendum with Brad’s clarifications

Episode Takeaways

• Symptom recurrence doesn’t preclude a meaningful, victorious life.
• ERP remains the gold standard but has evolved to mirror life’s unpredictability.
• The quality and trust in the therapeutic relationship is foundational.
• Progress is possible and likely—including “significant symptom reduction” for the majority who seek evidence-based care.
• “Functioning well despite distress is still a victory.” (Theme, Brad, ~20:00)

This episode offers hope, practical wisdom, and validation for anyone living with OCD, delivered with warmth and honesty from both lived and clinical perspectives.