← The OCD Stories
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- [00:00]
A
You're listening to the OCD Stories podcast hosted by me, Stuart Ralph. The OCD Stories is a podcast dedicated to raising awareness and understanding around obsessive compulsive symptoms. I do this through interviewing inspired therapists, psychologists and people who have experienced OCD. Welcome to the OCD stories and welcome to episode 533 of the podcast. And in this one I chat with Dr. Steven Philipson and one of his patients, Sean. Steve is a licensed clinical psychologist who specialises in cognitive behavioural therapy for ocd. He is a clinical director at the center for Cognitive Behavioural Psychotherapy in New York and he is joined by one of his patients, Sean, who has kindly agreed to share his story with us. So in particular we talk about Shaun's story. We discussed the idea of Sarnos, so Sarnos are psychosomatic symptoms and how Sean's OCD latched onto this idea of Sarno's, Sean's difficulty bragging, exposure response prevention therapy, the idea of the brain voice and the gatekeeper voice and much more. And thanks to our podcast partners, nocd. If OCD is interfering with your life, NOCD can help their licensed therapists specialize in exposure and response prevention therapy. The most proven therapy for OCD we with NOCD, effective treatment that is 100% virtual is available for children and adults with OCD and most members can get started within seven days on average. No hassle, just real science backed help and support between sessions. Begin your journey@nocd.com or I'll put the link in the episode description. So thank you so much to you guys for listening as always. It does mean a lot and of course thank you to Steve as always and thank you to Sean for giving his time and his story and his work with Steve. I deeply appreciate it. Without further ado, here is Steve and Sean. Welcome to the show, Steve. And welcome to the show, Sean.
- [01:59]
B
It's always good to be here. Once again, I think this is about number 20. I haven't been counting though.
- [02:06]
A
Something like that.
- [02:07]
C
Yeah, thanks for having me, sue and Steve.
- [02:10]
A
Yeah, welcome, welcome Sean. So yeah, Steve, where do you want to start?
- [02:16]
B
So I want to start just with a very brief educational mention of the different types of people who are working with OCD and the differential credentials and terms that go along with those different credentials. It's still very kind of disconcerting that even nowadays so few people know the difference between, let's say a therapist or a psychotherapist or a social worker or psychologist or psychiatrist. And I just want to briefly go over some of the educational credentialing that goes into each of those terms and why it's very important for persons who are either working with someone that they might have some concerns about their qualifications or someone maybe even considering starting therapy, either with a new person or for the first time and, and what to kind of look for. So it's funny because I will tell patients often, you know, they can kind of call me anything, but the only thing I really do not want to be referred to as is a therapist. The reason that I don't want to be referred to as a therapist is because the term therapist is a completely non, non sort of restricted term. So right behind me are two of my dog therapists and they are certified, you know, dog support people. And now anyone basically can refer to themselves as a therapist without any restriction in terms of their training. The next term is even psychotherapist, which almost sounds a little bit more official. But in actuality, at least in this country, the term psychotherapist also is not in any way regulated or restricted in a person being able to refer to themselves as that. So very important that if you're seeing someone to really make inquiries about what their educational background is and what their hours of supervised training also involves. The next term is psychologist. And so a psychologist requires that you have either a PhD or a PsyD in psychology, which is often a five to eight year post college degree where I would say 90% of psychologists also have a degree undergraduate in psychology. So to be called a clinical psychologist, you have to be licensed after not only your five to eight year training, but, but then you do a one year postdoctorate in which you receive more training under supervised psychologist before you then get your licensed. And then a psychiatrist is someone with a medical degree, so they go to a four year medical school post undergraduate and then after a four year medical degree they specialize usually in a three to four year residency in which they learn predominantly about prescribing different medications for different types of conditions. So just want to make sure that people make inquiries with anyone that they want to work with, especially in terms of like, you know, what percentage of your caseload are people with OCD and how much of your training involved a specialist who taught you to really work with OCD patients. And the last thing I'll say on this is that I don't require, but strongly recommend all patients of mine record their meetings and then listen to that meeting in between the session and many of my patients report. And Sean, maybe you could speak to this, that they Glean more clinical information from relistening to the meeting than actually being in it live in person. So, Sean, do you have anything you can say on that note?
- [06:29]
C
Yeah, I definitely agree with that sentiment. I think that sometimes in session, for example, off the top of my head, I can feel a little overwhelmed maybe. What I got a certain angle of my theme and in the session it kind of feels like I'm kind of having a lot of like speaker's block, like writer's block. And then I'm not quite even sure sometimes exactly what I'm getting across. But then after the in person session and listening to things, I kind of can see. Oh, okay. This is what Steve meant when he said xyz just off the top of my head. I've had that experience a few times recently, but definitely in many regards, I think recording is very, very valuable. Yeah.
- [07:19]
B
So before we continue, Sean, would you mind giving a bit of a history in terms of, I guess, going back maybe even when we first met or even before that in terms of your OCD's kind of multifaceted presentation and some of the work that you've been doing in treating your ocd?
- [07:42]
C
Yeah, absolutely. It's kind of funny. To start off, I was hoping I would come on the OCD stories eventually as a recovered patient, but I'm still in treatment and working hard at it, so I'm happy to share where I'm currently at too. Yeah. I say my OCD first kind of had its full blown effect on my life when I was maybe about 12. I think looking back, I sort of saw the inklings of it, you know, maybe for the year or two before that. But yeah, started when I was like 12. I think as many people who have OCD, you know, I had no idea what was happening to me.
- [08:33]
B
Can you mention the theme that emerged at that age?
- [08:37]
C
Yeah, it was really interesting because it's completely different than my themes now. It was, I guess, some sort of magical thinking combined with religious ocd. But at the time I wasn't religious. It was like a fear of the number six and just being around the number six and thinking that somehow that would make me connected to the devil and how I was going to have really horrible things happen to me. Yeah, so that went on about for like a year. And then I think I actually on my own employed the capsule technique that you've written about, which is basically delaying sort of any sort of rumination ritualization as much as you can until an allotted time at the end of the day. And you know, Sort of sandboxing your rituals to that time, and then over a few months, that actually worked out really well for me. And my OCD kind of went away for like maybe a year, but then it came back. And then in high school, I had contamination OCD for a few years, and then that carried on into college. And now I'll say my current day might have even started some type debt in high school. I, you know, wasn't really managing OCD well, wasn't really managing anxiety well, and I smoked a lot of weed, drank a lot of alcohol, and I think my brain kind of blew up. And Steve kind of characterizes it as a sort of starting old, as in like a mind body manifestation and also altered states of consciousness. Steve did a podcast with you Stew of this, like I think a few years ago now. And, you know, I agree with Steve's assessment of this is sort of what's happening and that what ended up manifesting was that I started seeing the world a little tilted and, you know, I went to like a whole, you know, so many doctors within like a year's period. And, you know, I got like so many brain scans, so many, like eye doctors, like endocrinologists, you name it. And then all of them came back normal.
- [11:20]
B
John, when we first met, and what's interesting is talking about historical podcast with Stu, I did give a podcast on the two tail spike, and you were the kind of main character, unbeknownst to you perhaps back then, but when we first met, I recall that you were in a dorm and some of your, your neighbors were kind of smoking pot at your university, and you had this kind of quagmire, this, this intrusive thought of, you know, should I go in and say, hey guys, could you cut down on your weed? Because smoking because it's kind of getting into my room and therefore being assertive, or should you just kind of be a cool neighbor and. And not really say anything and not give in to the temptation to see if you could intervene on their pot smoking. And you were kind of caught between these, these two choices that seemed kind of equally valid and equally kind of indicative that, you know, if you go in and assert yourself, you sort of lose because you're giving in, and if you don't say anything, you sort of lose because you're being passive. And so your brain was very much caught up on, on that kind of answer seeking and trying to figure out, like, what's the best thing for me to do? Is that. Is that correct?
- [12:52]
C
No. You're 100% right, I was going to touch on that.
- [12:55]
B
Well, I'm sorry.
- [12:56]
C
Yeah, I was going to touch on. No, no, no, don't apologize. Yeah, yeah, that's correct. And so when I first saw Steve, my team had kind of evaporated from the contamination and then went into this two tailed spike. Steve used to call me king of the two tail spike. It was very much this, you know, kind of like a remnant of, you know, the pot smoking in that. Like if I spoke, if I like told the people in my dorm to start smoking, I was being uncool. But even if I didn't, I was kind of being a coward. And it was this, you know, to tell like, damn if I do, damn if I don't. And that also like, you know, shown itself in like other instances like at work, you know, if I didn't make a crude joke. I think cv remember used to be a lot about like how crude I was because I think, you know, I have a, you know, a pretty dark sense of humor. And at work it will show up in that regard. And also in dating it was like if I didn't say certain things during a date, was I being authentic? You know, this manifestation of if I wasn't being authentic, then I couldn't like take care of myself because then I wasn't speaking up when it mattered. So that went on for a few years and then the last couple of years has been this back to the, these like Sarnos, Steve calls them Sarnos, from This back surgeon, Dr. John Sarno, who kind of talked a lot about how our psychological state produces all these symptoms. So you know, he tends to call all of these mind body symptoms. Start off. So my ocd, you know, for the past couple of years has been a lot of obsession around like, do I really have these, Charles? Am I like, you know, have some rare condition that's just not, you know, able to be managed? Yeah. We joke about how, you know, my brain projects that I'm going to end up as a, on a gurney because I'm so dysfunctional. Even though right now, you know, I'm doing jujitsu classes. So I'm a bit far away from that. We would say. Yeah. Anyways, I hope that wasn't too long of.
- [15:24]
B
Yeah, no. And also your theme as I recall, is that your sort of excesses of pot smoking in high school had this kind of delayed damage effect. And now your either tilted vision, your dizziness and your headaches are this present day manifestation of the damage that you did to yourself. And then once again in talking about how people with OCD with often act extremely desperate because of their spike themes. You know, you've been checked out multiple times, multiple types of doctors to make sure that your dizziness, your tilted vision, and your headaches, you know, are not like brain tumors or Ms. Or als, even though your brain continuously finds evidence that your. Your symptoms are worsening. And you were on your way to that gurney.
- [16:24]
C
Yes, that's correct. Yeah. My brain produces a lot of victimization and desperation, as I believe you're going to talk about shortly.
- [16:33]
B
Yes, yeah. But also, you know, one of the aspects of your treatment, which I've only mentioned about 50 times and it seems very difficult for you to kind of follow through with, is this idea about bragging, which you did a little bit, which I was happy to hear about that. You know, in my opinion, Sean has a great sense of humor. He's extremely intelligent. He has an amazing job as a programmer. As far as I know, you're not on probation because of your ineptness as a programmer. Sean skis mountains in Japan and does jiu jitsu and is after a tremendous amount of avoidance of dating because it wouldn't be fair for Shawn to date a woman just to have her push him around in a wheelchair, because probably by next week, Sean's not going to be able to walk across the room, according to his brain. And so, you know, happy that Shawn initiated dating and is living, you know, a very, very balanced life. And yet I've been suggesting that Sean, you know, really kind of indicate to others and his own brain, hey, despite me deteriorating rapidly, you know, I'm still engaged in these very, very, you know, varied tasks that require a significant amount of capabilities. And, Sean, do you want to mention why it's so difficult for you to brag?
- [18:03]
C
Yeah, that's a really, really good question. And, yeah, I suppose it's just. I think my brain's tenacity with kind of producing these symptoms and how it's, you know, most moments of every day, it. You know, it's really convincing at warning me that, hey, something is horribly, horribly wrong. And, yeah, I think I'm still working on it, you know, figuring out myself why it's so hard to brag. But that's definitely one part of it. I think another part is, and you probably hate this term when it comes up in group, but it's like these kernels of truths that our brain kind of like, attaches itself to, you know, like, you know, maybe I'll read something on the Internet, not like, even I'M Googling or something, but I'm on Instagram and like, for example, lately there's been some, like, content about people who have, like, you know, chronic fatigue syndrome and then after, like, a flu or like some. Some sort of virus, and my brain would be like, oh, look, you know, that's probably something similar to you. You know, they're like, permanently changed. And then my brain goes and think, well, maybe that's also a start.
- [19:39]
B
No, you know, for most people who also have difficulty bragging, you're not the only one, Sean, is the idea that, well, if you bragged about how balanced and rewarding your life is, maybe the person you're speaking to would be sort of fooled into not being so informed as to how bad things are, and therefore you wouldn't necessarily get the best proper treatment or the person wouldn't be educated about your. Your sort of desperation for symptom relief. And so, you know, for many people, bragging, you know, is kind of a contradiction of. Of their sense of the need to be fully understood as to, you know, what's really wrong with me.
- [20:33]
C
Yeah, I agree. I think since I started seeing you again about a year and change ago, definitely, you know, the first, like many months, it was, I think you use a phrase like, I will come in and kind of bleed out to you, like, hemorrhaging emotionally. And I think that was definitely like, hey, I really need Steve. My brain was successful in convincing me that, hey, I really need Steve to understood the magnitude of, you know, the discomforting experience in that I'm in. So it was a lot of describing, like, hey, you know, this is the symptoms that I had today. This is why it was a problem. And so I definitely agree with that. Yeah. And I think that can definitely, definitely deter my kind of treatment prognosis. Yeah.
- [21:27]
B
Or shall we say, speed of recovery or the brain's inclination for self healing.
- [21:35]
C
Yeah.
- [21:36]
B
And I think that, you know, what's really important, because I want to segue into this concept of desperation, is, you know, my faith about the treatment for OCD is for the patient to set up an environment in which it allows their brain to recognize that the gatekeeper is not going to contextualize the symptoms as a problem or as something that needs to be, you know, sought relief from, because as we're hopefully all aware, it's. It's the relief seeking, which is kind of the natural instinct when you have an anxiety disorder that, you know, substantiates the idea that the emergency signal, which is a malfunction, you know, is Legitimate. You know, when. When the brain says, wash your hands because that doorknob might have AIDS on it, and a person gives into that emotional impulse, it completes the cycle of substantiating the idea that there really was a problem with the doorknob and I really needed to, you know, get relief from it. So, Stuart, are we completely on the same page with that?
- [22:52]
A
Yeah, no, we are. We are. And I'm curious around the exposure side of things with the bragging, whether you did, you know, brag to me in session, you know, or wherever. Like, next week when you come in, I want you to brag about something always as a. As an exposure. That's the Eve review.
- [23:13]
C
Yeah, I think I'm definitely. I'm not. I mean, I'm definitely not doing it as much as Steve wants me to do. I think I am able to recognize that, hey, you know, despite X, Y and Z, like, tilted, you know, dizziness, you know, these, like, head tensions that I get, you know, I still want to work. I still, you know, invest in my relationships. I still spend time on my hobbies. So I am in. In the current state of, like, acknowledging that, hey, you know, I still did these things. I think Steve's exposure methodology is. If I said, like, you know, hey, yeah, I saw the room tilted, but I still rolled around on the floor doing jiu jitsu with, you know, five other people. Yeah, you know, dizziness, whatever, tilting this, whatever, you know, bring it on. You know, I'm still gonna roll around until I, you know, throw up from rolling around or something like that, kind of, like, bar of relevance. And I think sometimes in my day to day, I'm, you know, choosing to do that. But it's still very much work in progress when it comes to the sessions with Steve. I think mainly the difficulty if I'm doing some reflecting on the spot, is I think Steve hits on the nail pretty well, is that if I let go of seeing it as a problem, then if it's actually a problem, I'm just being completely negligent about it. If I go into session and say to Steve, hey, yeah, I saw things 5 degrees tilted today instead of 3 degrees tilted yesterday, but whatever. I think my brain doesn't want to do that because it thinks that, hey, you know, we can't be negligent about this. If you brag with such fever or, like, such enthusiasm, that would be like, this, like, ultimate display of negligence. And it's still scared to do that sometimes. And unfortunately, my gatekeeper, it's convinced still sometimes.
- [25:48]
B
Yeah, I Think so much of recovery is, you know, a tug of war between, you know, the gatekeepers, autonomous capacity to make choices, and the brain's extremely powerful ability to manipulate and create, you know, a sense of emotional desperation. And I think that in that tug of war for you to override your brain's instinct emotionally to neglect the symptoms, which is actually a huge part of recovery, to demonstrate the irrelevance of the symptoms. So this tug of war really is defining the difference between a successful outcome and a perpetuation of your brain's sense that you're in a crisis, that needs attention, that needs, you know, relief from. And I'm sure you're still very tempted to, as you said, you know, kind of do Internet research. So I'm not happy to hear about stumbling upon. What is that called? Chronic, what? Fatigue. Right. Chronic fatigue syndrome. Yeah. So in terms of desperation, one of my cute little sayings is, it's okay to feel desperate, but not okay to act desperate. And so, you know, what you just mentioned about going on the Internet and looking up more and more information on your theme for you and for me, many, many people, is probably one of the most common forms of acting in a desperate way. And, you know, on one hand, you're in a treatment that suggests not information seeking, not more information about what you actually might be suffering from neurologically, but rather, you know, kind of throwing caution to the wind and just letting whatever remaining resources you have be sufficient and even kind of bragging about them. So that's.
- [28:10]
C
I didn't actively look it up. It was just popped up on my Instagram. The algorithm, I will admit I probably maybe is a little bit naughty with the algorithm sometimes in terms of maybe looking at the video for longer than I would if I was completely dismissive. And, yeah, okay, this is what you want to see, but, yeah, yeah, yeah. So it's not as bad as you
- [28:38]
B
thought, but okay, right. So you didn't voluntarily do a Google search, but your naughty Instagram algorithm fed it to you and you. You investigated. Rather than being like, you know what? I don't need to learn about chronic fatigue syndrome, but other expressions of desperation is probably also very common. Is seeking symptom relief in the first place. The gold standard of treatment for OCD being ERP exposure and response prevention is really about the demonstration of the symptoms being irrelevant. And in engaging in aggressive erp, it sets the stage to show the brain that the signals are not relevant, and it allows the brain to then kind of heal itself. And so this is an area that Most people are very confused about is that the benefit of this treatment is an indirect effect in terms of symptom relief. That when you. The goal of therapy being the demonstration of the irrelevance of the signals, both the emotional ones as, you know, anxiety or guilt or shame, you know, depression, anger or disgust. And so by demonstrating that these signals are irrelevant and the thoughts associated with the brain's activity as being irrelevant, that the brain, over some time, you know, will then kind of autocorrect. And that's sort of a beautiful thing about our brain and our whole sort of body and physiology is it has an amazing autocorrect capability when left to its own devices. But when the anxiety signal repeatedly becomes substantiated and given relevance through ritualizing or desperate symptom relief, the brain, unfortunately, is kind of prevented from engaging in its own natural, you know, kind of symptom relief. So, you know, people engaging in rituals to bring about symptom relief or even in therapy to, you know, kind of, let's say, do an exposure exercise and then be like, hey, I didn't have erp. Why am I still being challenged? As opposed to, you know, kind of, hey, I'm doing rp. And it doesn't matter that I'm challenged because I'm not giving into those challenges is really much more of a therapeutic mindset. So, you know, desperate symptom, relief seeking, or even another form of desperation is a significant amount of avoidance. And, you know, we mentioned, Sean, that you had really not aggressively sought out dating for a period of time because you, your brain, had so tragically convinced you that you're, you know, going to be a basket case in the near future. So, you know, compassionate to the poor woman that might have to push you around in a wheelchair or a gurney, you decided to avoid dating altogether. And I'm hoping now that you've started to date this very lucky young lady that you're shutting down that. That warning to some significant degree.
- [32:05]
C
Yeah, yeah, I definitely am. I think I'm pretty good about at least doing the committing to my life path portions. So currently my relationship, yes, very much committed. Yeah, I. I wouldn't say I completely, completely avoided dating. Like, I would go on dates and I would put myself out there, but it definitely wasn't with as much commitment as I had before this, you know, shall we call it, like, broken brain spike came about. But yes, yes, there was definitely some level of avoidance, for sure. Yeah.
- [32:56]
B
I mean, very significant forms of avoidance that some people engage in, which is, you know, also very Very tragic is, you know, people will take off from work because they feel that their mind is so distracted. And I tell people, I would rather you go to work, you know, with 10% of your mental faculties rather than take off from work. I said in my Choice article that I believe unemployment is a form of mental illness because humans are just not designed to have a lot of free time and low structure. So taking off work, avoiding friends, are also avoidance. People often avoid things that might even trigger, you know, a spike. So a lot of people don't watch the news because if someone spikes about being a murderer or violent, you know, the news talks about so and so having committed some violent crime, they think, oh, boy, you know, what? What's the difference between that person and myself? So avoidance is a very, very important part of, you know, demonstrating once again, that the theme is legitimate and that's, I think, such a huge part of the treatment that OCD doesn't have the ability to be impacted by a voice in terms of we can't talk someone out of their spike theme because the part of the brain that's malfunctioning has no language capabilities. And, you know, a lot of people spend a lot of time wasting a lot of money discussing their themes as if there's some relevance to that rather than, you know, just kind of understanding that the therapeutic pathway, the recovery pathway, is achieved through demonstrating the irrelevance of a spike rather than just, you know, discussing the irrelevance of a spike. So I was thinking earlier today, Stu, you know, if I had met you a while ago and said, you know, stu, there are no sharks in the swimming pool. One of my favorite pieces of information about you, you know, gee, do you think you'd be able to go into the pool and be like, hey, I'm cured?
- [35:29]
A
No, of course not. I would say, I know there's no shark, but I just can't do it because the moment I get in, my amygdala freaks out and I'm in panic mode.
- [35:37]
B
Yeah, exactly, exactly. And I think that that's a message that I don't think can be repeated often enough, is stop talking about spike themes and engage in situations that demonstrate irrelevant. That's why ERP is such a powerful mechanism. And another sort of often mistake is that people think that engaging in ERP demonstrates to the brain, that teaches the brain that these things aren't legitimate, but it's really that it just demonstrates to the brain that these things are irrelevant, that the brain signal is not going to produce any significant effect.
- [36:19]
A
Yeah, yeah, exactly. And what I'm hearing from your story, Sean, is. Yeah, I'm sure in those some tougher moments where you're really sort of hooked on ocd, it's. You get pulled in. But the way you're describing, you know, relevance, the gatekeeper, the brain voice, all of that, in this more moment, a calm, maybe it shows that you've really picked up what Steve's done with you and the thinking and the theory, which is, I think, a really good thing, because some people can't describe what their therapy has been about, you know, and I think you're very articulate with it. And then in combination with. You are living your life now. You know, you're dating, working jiu jitsu, whatever else.
- [37:01]
B
Skiing in Japan.
- [37:02]
A
Being in Japan. Yeah. Okay. Awesome. Yeah. So. So I think that's. It's all really good.
- [37:10]
C
Yeah. Yeah.
- [37:12]
B
So another, I think, important topic that can contribute to a prolonged kind of recovery is a sense of victimization. And here Sean and I have had, unfortunately, a number of discussions in terms of, like, a lot of people with OCD think that their overall life is extremely polluted by, and hampered by the existence of ocd, rather than it being a part of. And, you know, obviously, hopefully a kind of a small part in terms of what substantive, you know, that Sean's brain pings him about the neurophysiology defects that are occurring, like tilted vision, you know, dizziness or pressure or headaches that, you know, according to Sean, you know, he. He and I have had a little bit of a contest. Who. Who's had a bit more of a challenged life. And I think we're about tie at this point, wouldn't you say, Sean?
- [38:29]
C
Well, yeah, we'll land on that.
- [38:32]
A
Okay.
- [38:34]
B
But Sean would definitely say at this point, he's living a much more miserable life than I am because of the presence of his ocd. And. And you would agree to that, right, Sean?
- [38:51]
C
Unfortunately, yes.
- [38:53]
B
Yeah. And I think that when people, you know, having OCD consider their lives to being especially damaged, especially polluted, especially handicapped, that. That. That takes away from the. The healing process. The. The brain, in order to heal, we need to kind of create a nest for it to say, hey, you know what? You can make me feel like things are. Have there's a crisis. You can make me feel like these thoughts mean I'm a horrible person or that my life is coming to an end, and you can make me feel that way. But I'm going to demonstrate to you that I'm living a full life that These associations emotionally and cognitively are meaningless. And, and that, you know, I'm in the mud hole with every other human. And, you know, we all have these challenges. And, you know, not only for Sean, but the vast majority of people that I work with, they really kind of reel against a perspective that I have. I know you and I still have had a little disagreement on it, but, you know, I believe all of us humans are in that mud hole, equally dirty, equally impaired, and, you know, engaged in equal challenges across the board over a lifetime. I think that you had said that you had some disagreement with that, but I think that for people with OCD to really believe that with this condition, their lives are especially burdened and polluted, that it really, it goes against, you know, that nest of, of comfort and security that we really need to build to show the brain that it doesn't need to protect us.
- [40:44]
A
Yeah. Fair. Yeah, absolutely. Yeah. I can't remember what I said. I would agree that all humans suffer. I would.
- [40:51]
B
Equally still. Equally.
- [40:54]
A
I think we don't need to compare suffering. I think that's a losing game, right? And. And if you suffer, you suffer. That's all that matters. Doesn't matter.
- [41:03]
B
I think it's an impossible game. I don't. I don't think we can ever know another person's challenges and the magnitude of those challenges. You know, I had a patient once who had just come from very expensive manicure, and she chipped her. The paint on her fingernail and she reacted as if, you know, both of her parents died in a car crash. So, you know, you know, suffering and what we consider challenges are very, very subjective. And therefore, since we can't compare, I just sort of on faith conclude equality. Although Sean would definitely agree. Disagree with me on that one.
- [41:45]
C
I wouldn't say I for disagree. I think if anyone else but you said this to me, I would. But I think you have a lot of clinical experience and, you know, you're quite skilled psychologist. So you make me hesitate and think, okay, maybe Steve is onto something.
- [42:09]
B
I think that for me, it would be very easy, as you're aware, for me to, you know, hold the victimization trophy. But, you know, rather than seeing my life as being especially challenged or with one of my patients who's Italian with, we have a joke whose life is more cursed. And we're always sort of offering data that each of our lives are kind of cursed. But in reality, I just think of myself as being human, and I choose on faith the equality of the human condition rather than actually thinking that I'M more cursed than he is. But I think that there's a lot of emotional peace that comes from that faith. And, you know, that kind of reminds me of another topic, which is, you know, the thing that we choose to have faith in versus our brains. Contradiction to that choice. And so when I first started letting go of believing that I was, you know, an extremely impaired human and that most vast majority of those around me were living much better lives than I was, my brain didn't agree with that. My brain and my experiences were still very much entrenched in the idea that, you know, my life is. Is especially challenged. And I think that most people, when they, you know, say to their brain, hey, I'm going to treat this, this topic with irrelevance, whether it be Sean's neurological damage from his excessive pot use or your sharks in the swimming pool, you know, or another person with pedophile OCD saying, hey, brain, I'm going to treat this association of being attracted to kids with irrelevance. Many people say that they just don't believe what they're saying. And, you know, that usually is because the person is still acquiring or accessing their brain voice and their brain experience as a representation of their most basic belief system. And this is one of the most difficult aspects of treatment and recovery that I encounter at least 10 times a day where people, they, they still go to the. The brain, you know, foundational experience and the brain voice as the. The end all voice of what they actually, you know, believe. And I know through my, you know, my own sort of relationship with brain voice that when I first started, you know, introducing myself to the principles of cognitive therapy, and I'd be like, hey, I'm human. My brain would scream back, that's just psychological nonsense. You absolutely know that you're a loser and an evil person. There's tons of evidence for it. And this psychological mumbo jumbo is just an excuse to avoid the reality of what you actually are. And so most patients, they just really continue to suffer because the brain voice is so convincing. It has such a long historical influence, and the feelings associated with it are so authentic. Stu, you want to, you want to chime in on that?
- [45:38]
A
No, no. Yeah, I agree with what you're saying. And just for. For those that aren't familiar or haven't heard the brain voice gatekeeper episode we did or haven't heard your other stuff, brain voice basically being like the OCD voice.
- [45:52]
B
Yeah, well, all humans have a brain voice in this context. Yeah. My entire sense of humor Comes from my brain voice. My brain voice loves sarcasm and it loves irony. It finds it everywhere, and then it shares with me these ironic and satirical kind of experiences or ideas as I'm living, and I will then often express them. But my brain doesn't give a darn who I'm talking to or when, because sometimes someone will be talking about something very serious and my brain will throw in a joke, and I actually have to hold back laughter because it's so funny. But I get to choose who, who and when I share it with.
- [46:33]
C
But can I jump really quick? So I think the brain voice, actually using the word voice specifically, actually added to my confusion for a little bit, because I thought it was okay. My brain voice is just whatever, you know, sort of word thoughts will come into my head. But I think it's actually even a lot more than that. Maybe I think you do mean this, Steve. But, you know, I feel like maybe I picked it apart too much. I thought, okay, the voice is just words in my head. But I think brain voice is actually also, like, your entire, like, experience. Sometimes it's like, yeah, feelings even. Sometimes, like the, you know, temporarily involuntary perspective that your brain holds about.
- [47:27]
B
Yeah, you've probably heard me use the term independent system, Right? So that's. That's the much more broad representation of things in our world that we don't have any choice in the matter of. And so that includes brain voice, which is an independent system, but it also includes, you know, emotional experiences that we do not choose. That's why, you know, I'm sort of a bit well known for saying, I don't care how you feel, because with ocd, the feelings are a representation of a malfunctioning system. So feelings like anxiety, depression, guilt, shame, disgust, anger, you know, those are created by an imbalanced brain and. And not chosen by any. Any person. And so that's why I include that in the independent system world, where brain voice is a part of that. But the point that Stu just made is the important distinction between brain voice and gatekeeper voice so that we understand that the gatekeeper's voice is that which we choose because we believe in the. The relevance of it and the importance of it. But the brain voice often does not coincide and pushes back and says, you know, oh, you are a pedophile, or, you know, you did do damage to yourself in high school, and these symptoms are absolutely obvious, you know, evidence that, you know, you are still suffering from some yet unknown condition.
- [49:04]
C
Yeah.
- [49:05]
A
Good feedback, both of you. Yeah. And I've noticed that Sean, in the way you've told your story, you said a lot of times, like, my brain told me this, or my brain did me that did that, which is obviously you getting that distance or that gatekeeper voice jumping in. Cool. So towards the end, is there anything else E review wish you could have said today or want to add?
- [49:34]
B
Well, the one topic we didn't get to which we can maybe schedule for another time, is when themes shift within the OCD content. It's sort of a very interesting phenomena, which just offhand, you know, it really just demonstrates how absolutely meaningless the themes of OCD are and are never a representation of a person's kind of authentic identity. And just to say very quickly when, you know, theme A shifts to theme B, the person will look at theme A and be like, why was that ever a problem? That's the stupidest thing ever. Theme B now is absolutely a problem and I need to get rid of that. But they look at theme A now because the emotional signal is not plugged into the topic. Like, Sean, I imagine you have no contamination concerns at this point, right?
- [50:31]
C
No, if anything, my girlfriend thinks I'm not washing my hands nearly enough now.
- [50:39]
B
Yeah. And so that's just a very interesting, you know, demonstration that when the. The brain chooses the topic not in any way based on a person's actual agenda. You know, Sean was probably a dirty little kid and now he's a dirty adult just like myself. And. But, you know, the. The emotional energy has gone on to. And. And 2 tail spike isn't so much a big issue for you, right?
- [51:05]
C
No, not at all. Yeah. Then your brain, I could just jump in, is always like, oh, man, give me back that one. That one was easier to manage, the current one.
- [51:17]
B
Yeah, no, I hear that all the time. Give me back the old spike. That was a piece of cake. You know, this new one is the real problem.
- [51:24]
C
Yeah, yeah. Which I. It's just another illusion likely. Yeah, yeah, yeah.
- [51:32]
A
Spot on, spot on. Yeah. So, look, Sean, thank you so much for sharing your story. You're obviously welcome on any time if you want to share it in more detail and reach out in the future and all that. And Steve, thanks as always for your time and expertise.
- [51:51]
B
And Sean, if you start bragging, maybe you can live your dream of coming on as a success case and how bragging was a major part of your recovery.
- [52:00]
C
Yeah, that's a great motivator. Yeah, Hope to do that soon.
- [52:05]
A
You got to email me and tell me you got the best story in the world, and then I'll invite you on. You got a brag to get on? No, Just reach out anytime. Thank you for listening to this week's podcast and thank you to our patrons who helped make this episode possible. And if you would like to find out more about Patreon and the rewards and benefits, then there will be a link in the episode description. If you enjoy the OCD Stories podcast and would like to support us, please subscribe and rate the show wherever you listen to the podcast. And thank you to NOCD for supporting our work. If you want to find out more about nocd, you can click the link in the episode description and quick disclaimer Guys, this podcast is not therapy. It is not a replacement for therapy. Please seek treatment from a trained professional and until we speak, take care.