Podcast Summary: The OCD Stories – Dr Sam Greenblatt: Unlocking Relationship OCD (ROCD) Treatment (#506)

Date: October 5, 2025
Host: Stuart Ralph
Guest: Dr. Sam Greenblatt, Licensed Clinical Psychologist

Episode Overview

This episode dives deep into the complexities of Relationship OCD (ROCD): its nuances, effective treatment, and Dr. Sam Greenblatt’s personal and professional journey to “unlocking” more successful ROCD therapy approaches. Sam discusses his lived experience with ROCD, why classic approaches sometimes fail, integrating exposure/response prevention (ERP) with internal family systems (IFS) therapy, and the importance of learning to process genuine emotions—rather than compulsively analyzing them.

Key Discussion Points and Insights

1. Personal Update and Introduction

• Sam shares a life update, underscoring the importance of holistic well-being:
  • He's developed a passion for West Coast Swing dance, which fulfills his need for creativity, connection, and joy.
    • “I’m dancing like 10 to 15 hours a week… It is the epicenter of so many things that I’m really passionate about and need in life.” (02:01)
  • He’s in a happy, healthy relationship and feels grateful for where he is in life.
• Therapeutic insight:
  • Both host and guest note that part of recovery and growth is about discovering who you want to be now—not just symptom management. (04:03)

2. Dr. Greenblatt’s Personal Journey with ROCD

• Unique dual perspective as therapist and sufferer:
  • Dr. Greenblatt describes the frustration and pain of experiencing ROCD intensely, despite being an OCD specialist and receiving high-quality treatment.
  • Standard ERP and ACT approaches provided some relief, but often didn’t address everything, especially in high-stakes, committed relationships.
    • "…the skills were just not enough. There was something that was missing." (11:18)
• Breakthrough moment:
  • He realized that anxiety was masking deeper, authentic feelings (like sadness), and over-reliance on ERP or cognitive approaches could inadvertently suppress true emotions.

3. Transition from Standard Approaches to Deeper Emotional Work

• Classic ERP/ACT:
  • Traditionally, these focus on disengagement from thoughts and on accepting uncertainty.
  • Sam found that sometimes, disengagement was not enough—thoughts persisted, and underlying emotions went unprocessed.
    • “What happens when you disengage and… still the thoughts are coming intensely 24/7?” (12:54)
• Key revelation:
  • In his previous marriage, “the anxiety was really serving to obscure my feelings of sadness.” (16:10)
  • Emotional pain that was being masked by ROCD symptoms actually pointed to clear relational misalignments.
    • “That sadness was authentic and was true. It led to this insight that I have been saddened and dissatisfied in this relationship for a while.” (16:12)

4. Integration of Internal Family Systems (IFS)

• Therapy shift:
  • Working with a non-OCD-specific therapist (using IFS) brought new understanding.
  • IFS allowed him to conceptualize intrusive, compulsive thoughts as protective parts—designed to keep him safe, but also capable of obscuring authentic emotions.
    • “We are made out of multiple selves… OCD as kind of a protector self.” (19:29)
  • Emotional awareness (rather than just analysis) became essential to recovery.

5. The Pitfalls of Emotional Reasoning and Compulsive Analysis

• Automated “analysis” blocks emotional experience:
  • “Whenever I experience even a few seconds of an emotion… that would be such a quick and automatic trigger to my OCD of wanting to immediately understand what that emotion meant.” (25:35)
• Key skill:
  • Learn to “feel emotions without immediately analyzing them,” even though it runs counter to what many with OCD have done for their whole lives. (27:19)
• Host reflection:
  • “When I was going through it… I treated it all like relationship OCD.” (28:42)

6. Actionable Strategies for Clinicians and Sufferers

• Order of Operations in Treatment:
  1. ERP first, to reduce “inflammation”:
     • “Put down the snow globe and let the pieces settle before trying to make big decisions.” (35:56)
     • “Passive insight” works better than “active insight” for most major life decisions. (36:03)
  2. Rational Assessment: Needs vs. Wants (not perfection):
     • “Needs need to be evaluated as a binary, not a spectrum.” (39:06)
     • Note: “Is my partner attractive enough?” is answerable, “Could I be happier with a more attractive partner?” is not productive. (39:17)
  3. Emotional Assessment:
     • Identify authentic emotions versus OCD-driven anxiety or despair.
     • Practice feeling sadness/frustration/etc. without compulsion to interpret or “fix” them.
     • Collect a “sample size” of emotional experiences — not just analyze a single good/bad day.
       • “You need more than a singular point in order to make that pattern.” (46:11)
• Avoid “Compulsive Therapy":
  • “If you’re doing the exposure because you’re hoping to get your answer at the end of it, you’re not doing an exposure, you are compulsing…” (43:59)
  • Search for “clarity in the medium term, but not in the immediate experience.” (43:44)

7. Application in Dr. Greenblatt’s Current Life

• OCD still persists, but is now manageable and less intrusive:
  • “My brain still comes up with intrusive problems, but it is much better managed.” (48:29)
  • More willingness to communicate needs and feelings directly; nuanced understanding of relevance versus irrelevance.
    • “The ability to do so is… such a better lived experience where things are not this binary, but it feels healthier, lighter, and way more effective.” (50:00)

8. Message of Hope and Openness

• OCD is highly treatable.
• Dr. Greenblatt extends an open offer to listeners “to hop on the phone for 15 minutes”—whether they intend to work with him or not.
  • “If you have any questions or want to hop on the phone for 15 minutes… this is an open offer to any listener.” (52:56)
• Encourages listeners: If you’re still stuck after years of therapy, the right approach can make a huge difference, sometimes surprisingly quickly.

Notable Quotes & Memorable Moments

• On recognizing authentic emotion behind OCD symptoms:

  “That sadness rang as very true and authentic. And the more that I sat with that sadness, the more I noticed—that was my default experience in the relationship.” (16:10)

• On the limitations of classic ERP/ACT when overapplied:

  “I didn’t realize that I was using ERP to suppress my emotions… the way that I was using ERP was preventing insight rather than helping kind of achieve it.” (54:16)

• On new, healthier emotional experience:

  “I could have a whole spectrum… the ability to do so is… such a better lived experience where things are not this binary, but it feels healthier, lighter, and way more effective.” (50:00)

• On the open offer to the audience:

  “Honestly, if you have any questions or want to hop on the phone for 15 minutes… I just want people to have this information… it hurts my heart every time I hear of people not being able to access this…” (52:56)

• Advice to his younger self:

  “To let himself feel. He was trying so hard, but too hard or misdirected. I was brute forcing and white knuckling ERP. Coulda, shoulda would have been more attuned with my emotions and not suppress them by using therapy.” (53:44)

Timestamps of Important Segments

• 02:01 – Dr. Greenblatt’s life update; importance of community and hobbies
• 06:57–16:10 – Personal story: How Sam’s ROCD developed, classic therapy trials, and crisis point in his marriage
• 16:10–20:18 – Realizing anxiety masked sadness; marital insight; leaving the relationship
• 19:23–22:13 – Introduction to Internal Family Systems (IFS) therapy and seeing ROCD as a “protector”
• 25:34–28:07 – Emotional suppression via compulsive analysis; challenge of feeling emotions rather than analyzing them
• 35:26–41:50 – Dr. Greenblatt’s “order of operations” for treating ROCD
• 43:33–46:29 – Avoiding compulsive therapy and the importance of collecting accurate emotional “data”
• 48:29–51:02 – Experience in new relationship and practical application of lessons learned
• 52:56 – Open offer to listeners & the importance of accessible care
• 53:44 – Advice to his younger self: don’t mistake suppression for skill

Tone and Language

The episode is personal, candid, warm, and hopeful. Both voices blend clinical expertise with lived experience, using real-world analogies, storytelling, and practical advice while maintaining empathy for anyone currently struggling.

Key Takeaways

• Authentic emotional attunement is foundational to overcoming ROCD.
• Response prevention (ERP) is the necessary first step, but not sufficient on its own for everyone.
• Therapists and individuals must carefully distinguish between enabling compulsive avoidance and supporting genuine emotional experience.
• Self-compassion, patience, and a willingness to feel—without immediate interpretation—are critical.
• Dr. Greenblatt is open to answering listener questions, reinforcing his drive to make good OCD care more accessible.

Resources and Contact

Dr. Sam Greenblatt’s website: ocdspecialists.net
Offers a free 15-minute call to anyone with questions about OCD or ROCD treatment.