Lauren Rosen: Mental Compulsions in OCD (#522)

Summary

---

The OCD Stories

Episode 522: Lauren Rosen - Mental Compulsions in OCD

Host: Stuart Ralph
Guest: Lauren Rosen, Therapist, Author of "The Mental Compulsions Workbook for OCD"
Release Date: January 25, 2026

---

Main Theme & Purpose

This episode delves deeply into the topic of mental compulsions in OCD, a frequently misunderstood and under-recognized aspect of the condition. Stuart Ralph welcomes back therapist Lauren Rosen, founder of the Center for the Obsessive Mind and author of The Mental Compulsions Workbook for OCD. Together, they unpack what mental compulsions are, why they’re so tricky, how mindfulness and cognitive techniques can help, and strategies for building a healthier relationship with one's thoughts.

---

Key Discussion Points & Insights

1. Lauren's Recent Work and Courses (02:24–05:20)

• Lauren is developing a practical mindfulness course for anxiety disorders, with colleagues Drew Linsalata and Joanna Hardas, to make acceptance-based skills more accessible outside formal therapy.
• The course uses principles from Acceptance and Commitment Therapy (ACT) and is not solely for OCD, but broadly for anxiety, focusing on “how do I accept?” and “how do I let go?”.
• Quote — Lauren:
  “Everyone engages in mental behaviors… before I found the realm of OCD, I had no sense that there was some activity going on in my mind that I had any sort of agency around, you know?” [05:20]

2. The Challenge of Mental Compulsions (05:20–09:00)

• Mental compulsions are universal human experiences, but in OCD they become entrenched and automatic.
• Before discovering OCD resources, neither Lauren nor many clients realized these internal processes could be changed.
• There’s an overlap in applications — guilt, anxiety, and other emotions.
• Quote — Stuart:
  “It feels like you can't… no agency, can't control it.” [06:04]

3. About the "Mental Compulsions Workbook" (09:00–16:28)

• Lauren's book grew out of clinical experience and a desire to bring clarity and self-help tools for those grappling primarily with internal compulsions.
• Writing the book was an exercise in deepening her understanding and making complex concepts actionable without the need for direct therapy.
• Journaling mental compulsions (with appropriate guidance) can help identify patterns and support mindful awareness.
• Quote — Lauren:
  “By writing it down, it slows you down in the process, and it does help to breed that sort of mindful awareness of what's going on...” [12:40]
• Quote — Stuart (on seeing thoughts in writing):
  “It might increase the chances of being like, oh, that’s ridiculous, for sure.” [13:30]

4. Defining and Recognizing Mental Compulsions (16:27–20:26)

• Mental behaviors include thinking, problem solving, analyzing, evaluating—most human minds do these, but in OCD, they become excessive and serve to reduce discomfort.
• Specifically, in OCD, these are mental compulsions—actions done in the mind to try to resolve doubt, alleviate anxiety or guilt, or gain certainty.
• Mental compulsions may look like worry, rumination, debate, review, or rehearsal.
• Quote — Lauren:
  “...mental compulsions… are intended to resolve doubt and uncertainty… but they come at a great cost, as all compulsions do.” [18:30]

5. The Hidden Nature and Impact of Mental Compulsions (20:26–23:25)

• Mental compulsions are harder to spot—therapists may miss them, and so might individuals with OCD.
• A large portion of what people call “obsessing” is actually compulsing.
• Mental compulsions cause significant life impairment; for many, they can appear functional externally but leave people internally absent.
• Quote — Stuart:
  “I was engaging in life and just about holding a job, but I wasn’t present. I wasn’t doing a good job.” [21:11]

6. Mental Compulsions and Co-Occurrence with Other Compulsions (23:25–24:13)

• Most people who perform physical compulsions also engage in mental compulsions, usually without realizing it.

7. Book Structure & Theoretical Framework (24:25–32:09)

• The book’s first section maps the “topography of the mind”—giving language for mental processes, distinguishing thoughts vs. thinking vs. compulsions.
• Explains how mental compulsions play out across different OCD subtypes.
• Explores why disengagement is difficult; compassionately addresses the fear and ambivalence that come with stopping mental behaviors.
• Offers cognitive strategies (values-based decision-making, not just restructuring for reduction in emotion).
• Mindfulness is framed as attentional training—a core component for response prevention in OCD.
• “Mindfulness practices really are uniquely suited to supporting someone in noticing when they’re thinking, and dropping it, and then coming back and re-engaging with life.” — Lauren [30:24]
• ERP is discussed, with mindfulness as a practical tool for “response prevention”.
• Quote — Lauren:
  “Having a really clear sense of, like, how do I practice response prevention with this? A lot of the book is dedicated to that as well.” [29:40]

8. Mindfulness & Attentional Training (32:09–41:45)

• Mindfulness meditation is the central skill Lauren recommends—it develops non-judgmental awareness and the capacity to notice & disengage from mental compulsions.
• The process is: anchor attention, notice when you wander (often quickly), practice non-judgment, and gently refocus—over and over.
• This builds a “congenial relationship” with your mind and can be applied across daily life.
• Quote — Lauren:
  “It gives a lot of opportunity for practicing non-judgment... which is crucial because it, that breeds acceptance.” [44:08]
• Quote — Stuart, on mindfulness helping therapists too:
  “There’ll be times I’m with clients and, of course, my mind will wander, and I have to notice that, accept it, bring myself back to the client in the moment.” [31:19]

9. Adapting Mindfulness for Those Triggered by Meditation (42:14–44:54)

• For some, meditation can be overwhelming. Lauren suggests alternative mindful activities (e.g., mindful dishwashing, listening to music attentively) for those unable or unwilling to start with formal seated practice.
• It's about adapting, not forcing: “Meeting people where they’re at is important.”

---

Notable Quotes & Memorable Moments

• On the universality and agency in mental behaviors:
  “Everyone engages in mental behaviors… before I found the realm of OCD, I had no sense that there was some activity going on in my mind that I had any sort of agency around, you know?”
  — Lauren Rosen [05:20]

• On writing and self-awareness:
  “By writing it down, it slows you down in the process, and it does help to breed that sort of mindful awareness of what's going on...”
  — Lauren Rosen [12:40]

• On noticing the process instead of content:
  “If you see the process that's going on… If you're seeing that, you're not really seeing the content… You can leave it alone easier.”
  — Stuart Ralph [46:41]

• On the costs of mental compulsions:
  “One of the greatest costs associated with mental compulsions is the amount of time that gets lost in your own mind.”
  — Lauren Rosen [31:01]

• Metaphor for rumination:
  “The more you stick your foot in the puddle, the cloudier it gets… You keep your foot in, trying to clear it, and it gets cloudier. It’s the same in our mind.”
  — Stuart Ralph, referencing Alan Watts [33:02]

• On being gentle with oneself:
  “Be gentle with yourself. Put one foot in front of the other. One step at a time, you can walk through it and you’ll deal with it as it comes.”
  — Lauren Rosen [51:22]

---

Timestamps for Important Segments

• 02:24 — Lauren discusses her new mindfulness course
• 05:20 — Agency and universality of mental behaviors
• 09:00 — Writing “The Mental Compulsions Workbook” and the unique challenges
• 13:46 — Using journaling as an act of diffusion
• 15:32 — Breaking down mental processes into a “flow”
• 16:28 — What are mental compulsions? Definitions & examples
• 18:43 — Compulsions as attempts to resolve doubt
• 21:11 — How mental compulsions can create functional but disengaged lives
• 24:25 — Structure and overall flow of the workbook
• 29:58 — Book strategies: cognitive, values, and mindfulness approaches
• 32:09 — Mindfulness as attentional and response prevention practice
• 41:06 — Stuart’s experience with mindfulness and daily life skills
• 42:35 — Adapting mindfulness for those unable to meditate
• 44:54 — Using music as a mindfulness anchor

---

Practical Tools & Skills Highlighted

• Mindfulness Meditation:
  Seen as the “most comprehensive intervention” for mental compulsions. Fosters non-judgmental awareness, acceptance, and repeated practice of noticing and disengaging from rumination or worry. [34:45–41:45]
• Adapted Mindful Activities:
  Mindful dishwashing, listening to music, or other sensory-focused tasks can serve as accessible alternatives. [43:39–44:54]
• Journaling (with clear purpose):
  As a structured way to externalize and examine mental patterns—not as compulsion, but as conscious awareness practice. [11:46–13:46]
• Values-driven Decisions:
  Choosing response (or non-response) to thoughts based on values and long-term goals rather than emotional discomfort. [27:58–29:58]

---

Closing Reflections

Lauren’s Key Message:
Even when the mind seems overwhelmingly messy, the underlying mechanics of OCD—and particularly mental compulsions—are simple and understandable with practice and the right tools. Approaching the inner world with non-judgment and curiosity can become freeing.

Stuart’s Take:
Skills like mindfulness and response prevention are not just for OCD, but are relevant life skills for everyone who wants a better, more present relationship with their own minds.

---

Further Resources

• Find more about Lauren Rosen and updates for her mindfulness course via her Instagram (as referenced by Stuart, [09:00]).
• The Mental Compulsions Workbook for OCD — available now.
• The OCD Stories Podcast

---

Transcript

[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 for interviewing inspired therapists, psychologists and people who have experienced OCD. Welcome to the OCD stories and welcome to episode 522 of the podcast. And in this one I got back on Lauren Rosen. Lauren is a therapist and and founded the center for the Obsessive Mind, an outpatient clinic serving individuals in California, Florida, Utah, Nevada, Oregon, Pennsylvania and a select other states and countries. So it's great to get Lauren back on. Lauren recently has offered the Mental Compulsions Workbook for ocd. She also co hosts the Purely OCD podcast. So in particular we go into the details of her new book, what are Mental Compulsions? Rumination, noticing mental compulsions, some skills for dealing with mental compulsions, Mindfulness attention, mindfulness meditation, and much, much more. And thanks to our podcast partners, nocd. If OCD is interfering with your life, NOCD can help. They're licensed therapists, specialize in exposure and response prevention therapy and provide most proven therapy for OCD with no CD. 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 [e-mail] or I'll put the link in the episode description. So if you struggle with rumination and mental compulsions, I think this episode could be quite useful for you. Thank you to you guys for listening, as always, it means a lot and of course thank you to Lauren as always, it's a pleasure chatting with her. Without further ado, here is Lauren. Welcome to the podcast, Lauren.

[B]

Thank you for having me.

[A]

It's good to have you back on. It's been, obviously we've spoken a lot since then, but it's been a long time since I've had you on the show.

[B]

Yeah, well, it, it was a pleasure then and it's a pleasure now and yeah, I'm glad that we've gotten to connect in the meantime too.

[A]

Yeah, yeah, absolutely. So what have you been up to?

[B]

Well, quite a bit actually. I mean, I've been working on a mindfulness course for anxiety disorders which I'm really enjoying with a couple of colleagues, Drew Linsalata, Joanna Hardas, which has been really interesting. I mean, it's a topic that, as you know, I really love and that I think is really important and, and obviously like disseminating that those skills more widely than maybe, you know, therapy isn't necessarily always accessible to people or something that people are willing to try. So kind of cool to be exploring another way of helping people to help themselves. So. Yeah, working on that. And. Yeah, other than that, a lot of the same, you know, But I. Yeah. And then, of course, the book.

[A]

Yeah, nice.

[B]

Yeah.

[A]

So that course sounds really good. Is that. Is that for people with ocd or is it more of a general population thing?

[B]

So it's actually practice. The course is called Practical Mindfulness for Anxiety. And so it's. It's specifically geared toward people with anxiety disorders. And when. When Drew approached me about it, one of the sort of impetuses behind it was people kept asking, like, how do I. But how do I let go? Right. How do I. How do I accept? And I think it's a question that we get a lot in our field as therapists and so really trying to offer, like, a practical guide to this is how you accept something like making it. Honestly, a lot of it drawn from acceptance and commitment therapy principles, because I think they do a really great job of saying, like, let's make this granular, and this is how you accept. So. Yeah. So it is very targeted, though, toward people not necessarily with ocd, but with anxiety disorders as a whole. Including, obviously, OCD is not a. Technically an anxiety disorder, but, you know, a.

[A]

Lot of people with. With ocd. But obviously, even if guilt is the primary emotion, the same skills surely still still apply. Right. Of letting go of the guilt, of making space for it and.

[B]

Absolutely. Absolutely. So I think it's. It. There's a lot of application probably more broadly than that, too. I mean, this is why I love this skill set. It is so it has such wide application.

[A]

Yeah.

[B]

And honestly, why the. The subject. Not to. To jump ahead, but the subject of mental compulsions has always been so interesting to me, is that mental behaviors as a whole are so. So tricky. And. And they're. They're. Everyone engages in mental behaviors. But I know before I. Before I found the realm of ocd, I had no sense that there was some activity going on in my mind that I had any sort of agency around, you know?

[A]

Yeah. Yeah, that's a really good point. Absolutely. It feels like you can't. I say no. Agency can't control it.

[B]

Right. It's just a mess up there. Right. Like.

[A]

Doesn'T it? When you're deep in rumination and mental compulsion, it's. It's like a cloud.

[B]

Totally. But it's like everybody gets Lost in their minds. And it's a very human thing. And I think most people can relate to sort of like being angry with somebody and then, you know, having an argument in their mind with that person. And like that is a mental behavior. And so recognizing where, you know, like whether we're talking about just as you were saying with anxiety disorders and anxiety and OCD or other emotions in ocd, like guilt, like you know, any really emotion that understand the thing that I'm probably one of the things that most interests me is like the transdiagnostic approach to all sorts of different challenges that humans face.

[A]

Yeah.

[B]

And that's again what. Yeah. Draws me to mindfulness and drew me to, to sort of the topic of mental compulsions.

[A]

Yeah, yeah, good point. And because I know people probably might be interested when will the course be finished and where will they find it?

[B]

Oh well that's. So it's actually a live course. It's so different than what we're used to these days is not recorded as of yet. And there might be, we've, we've certainly talked about it. But what as of right now, what we're offering is it's like a six week course sort of structured similarly to like a mindfulness based stress reduction course, but with that, that focus on anxiety. So certainly following me on social media, I offer updates there. I think the next course is probably going to start in February and I think our hope too is to offer a sort of ongoing group practice where people can kind of drop in, we can do some mindfulness practices and then sort of focus on a topic. And just because I, I think that ongoing wellness does necessitate a practice. This is not like we're not trying to get somewhere. We're not, you know, like, oh well now I'm done with that now. Next it's, it's like, okay, how do I approach my life in a, a more accepting, open, value driven manner and Right. Like it. It's. So anyway, that's roundabout, long winded way of answering your question, I think.

[A]

No, I like it. Or yeah, I'll put your Instagram in the show notes. People can then follow you and find out about that group. Cool. And so the Mental Compulsion Workbook for ocd, CBT and mindfulness skills to navigate intrusive thoughts and mental traps. So yeah, it's out now. Congrats first of all.

[B]

Thank you.

[A]

Yeah.

[B]

And thanks for reading it and for endorsing it.

[A]

Yeah, my pleasure, My pleasure. Obviously it's an important area. Mental compulsions to cover. It's been missed over the years a lot by everyone. So. Yeah, I mean, firstly, what was it like writing the book?

[B]

It was, you know, I learned a lot in the process and not just like, obviously like I was able to do some deeper dives in areas within the topic, but just the process of writing a book is. Yeah, it was, it was a couple years all told and a lot of work. I guess unsurprisingly, I'm like, wow, this is, this is a lot. But was really, I don't know, like I just putting all of it into one place and. And also I think when as clinicians we can, we can use all of the skill set in session related like putting these things into practice and like helping people to do exercises and such, but really trying to formulate it in a way that's like, okay, you can take this and you can do this without any, any sort of help. I mean obviously not everyone can and it's not, it's not therapy. But I just was, it was interesting to even get creative in ways of like how, how can I help somebody to understand this concept or apply this concept or practice with this. Yeah. And just was surprised like this is I guess not anything to do with ocd, but just fascinated by the fact that I never thought about the fact that when you write a book you kind of forget what you've written because it's such a long process. And so the amount of times I've had to reread this book is quite astonishing.

[A]

Yeah, that's true. Yeah. I suppose you spend so long on like later chapters than you know, what you wrote earlier is just a long time ago.

[B]

Totally. Like you have an outline but then you're like, wait, did I already write about this? I'm being redundant here. And then. Yeah. So it's just. Yeah.

[A]

Awesome. We're glad you did it overall.

[B]

I am, absolutely. And you know, as we, we were talking about before we started the, the recording part of this that like it's just I, if I had endless time I would, I would do much more of it. I really enjoy writing and, and it. What. It's interesting. So one of the, the things that my publisher had me do for the book was create like some, some forms, some compendium forms for clinicians using to use with clients in their practice if they, you know, they got the book. And one of, one of the exercises within that was to have somebody journal their, their mental compulsions essentially. Right. And like what they're spinning about, but to stop and write it down and obviously Obviously, I don't think that that's a great practice on the whole. I don't. I'm not advocating for people to go out and just, like, just write a lot about you, like what you're concerned about and try and figure it out. Like, that's definitely not a good plan. But I think what it does is that by writing it down, it slows you down in the process, and it does help to breed that sort of mindful awareness of what's going on, if you're approaching it from that lens. And likewise, I think, while writing the book, it sort of forces you to really clarify, like, very specific aspects of things and to get very aware.

[A]

Yeah. Yeah. That's interesting. Yeah. And I think writing it down is almost an act of diffusion. Right. If you see it, it's one thing, you have it in your head, but then when you see that worry on paper, it might increase the chances of being like, oh, that's ridiculous, for sure.

[B]

And actually, so, yeah, going back to the exercise part of it, that what I. What I have people do is to write it down and to then identify the different pieces of what's happening. Right. And because it's slowed down enough and because you have this, like, written thing, somebody says, I'm. I'm worried that I'm going to harm my baby. And I just had this thought that I could harm my baby. And I'm feeling really scared, and I. But what if I do it? What if I actually want to do it? What if. What if this isn't ocd? Whatever might come from that journaling to sit down and go, like, okay, so you've had this initial thought. That's an obsession. You're experiencing emotions, right. Like fear. And obviously it's not going to always be quite so like, formulaic like that. But. But then to say, like, okay, now you're asking and trying to answer all of these questions, that's where you have some agency. Because as. As we were saying earlier, it's such a mess in your head when you're experiencing ocd. Generally, OCD that is primarily, you know, like, involves mental compulsions, even more so, because where does obsession and. And mental compulsions begin? Right. So. So helping people to see.

[A]

That's true. Like you said earlier, it will be in a big mess in. In one's mind that. Yeah. Breaking it down, you can start to see, oh, it's not so much a mess. There's a formula to it, or a flow or a narrative.

[B]

Yeah, yep, exactly. Which, of course, allows for interrupting. Right. And knowing that, you know, people with OCD tend to like, then become very focused on, can I, can I perfectly identify the obsession and the like, what's which. Which is which? And I have to clearly delineate and I have to do it perfectly. It's not that. And when, when we're, when the mess is happening, ultimately it does start to bleed together. And it's really more about like identifying. Oh, I'm thinking and disengaging when you realize it, rather than like perfectly parsing these experiences.

[A]

Yeah, yeah, good point. Yeah. And, and I guess just thinking just, just to take us back a bit. So for anyone not really familiar with mental compulsions.

[B]

Yeah.

[A]

How, how would you describe them? What are they?

[B]

So to describe mental compulsions, I think we first have to describe mental behaviors. And so in terms of what they are, what mental behaviors are, we could come up with a list like thinking, problem solving, evaluating, analyzing. And then we could start to sort of narrow in on problematic mental behaviors like worrying, rumination, mental rehearsal, mental review. And that's where we start to get into the realm of what happens a lot in mental disorders. And so within ocd, we call these problematic mental behaviors mental compulsions. And again, that can involve things. I think the term rumination gets thrown around quite a bit as sort of a catch all. There are some technical differences between say rumination and worry. Functionally doesn't really matter, but mostly worries about the future versus, you know, rumination being more past focused or debating. Right. Like mentally debating something that these specific behaviors are in excess of what is useful to a person. Much like excessive hand washing can become a compulsion. Excessively reviewing the same information to reassure yourself can, can really detract from your life, keep you from being present. So when we're talking about mental compulsions, we're, we're talking actually about mental behaviors that are done with the intent to alleviate uncomfortable emotional states like anxiety, guilt, and that are. Yeah. That are intended to resolve doubt and, and uncertainty, oftentimes related to the original obsession that arises. But they come at a great cost, as all compulsions do.

[A]

Yeah, yeah, exactly, exactly that. Yeah. And obviously mental compulsions are not as easily seen.

[B]

Obviously.

[A]

Because they're mental.

[B]

Yeah. Not exactly visible. Yeah, no, exactly.

[A]

Which is why I think historically they didn't get spotted a lot by therapists. But also I think historically people with OCD weren't aware of it, so then they weren't going, oh, I'm in my head thinking about this. Right, yeah, right.

[B]

And then you, you hear people talk about all the Time. Oh, I've been obsessing about this, which of course. Right. Like obsessions will come up repetitively by their very nature. But so much of the time, the bulk of that activity of quote, obsessing is actually compulsing. And the relevance of that, of course, as we were saying earlier, is like that. That gives you some degree of power in changing, like how you're relating to thinking, whether or not you're continuing to engage in thinking. And that's so crucial if we're going to help people get back to their lives in the same. Because otherw. I think one of the major problems with. Not with historically, maybe a focus on more physical compulsions is that mental compulsions detract every bit as much from life. And so if you're not aware that they're happening, you're just sort of on this runaway train with no, wouldn't. It feels very helpless.

[A]

Yeah, yeah.

[B]

And hopeless.

[A]

Yeah, I agree. Yeah, you're right. I mean, I think people have met. Yeah. It's not as clear cut as this, but I think people with mental compulsions might. They can engage in life maybe because then in terms of they're not stuck at home doing physical compulsions and can't get out of the house. Maybe they're able to get out of the house, but the whole time they're in a completely different world. Can't engage. And I remember in my past life, in my past career, being sat at my computer, just zoned out for hours on end, like maybe I'd come into consciousness here or there.

[B]

Yeah.

[A]

Do a couple spreadsheets and then I would zone out again. Yeah, fantasy land. So I was engaging in life and just about holding a job, but I wasn't present. I wasn't doing a good job.

[B]

Yeah, yeah. No, it's so true. And I. Yeah. I think I'm actually quite amazed looking back at my own experience and seeing all of the people that I work with, like the. The ability to carry on conversations or to be, you know, reading a book or. Or doing some task and also, you know, elbows deep in trying to figure something out is quite extraordinary actually, when you think about it. The fact that people are able to. It's just that it is. It's so. It's so depleting. It's so there's no escaping it either. And I think that that's one of the things that is. Yeah. It makes it all very, very challenging. Besides that, one of the things. And this is true, I think, of all compulsions, that compulsions can Be re. Triggering. I just think that it happens that mental compulsions are uniquely primed for that because there is no answer in your mind. Right. Like, you're not going to find it in there. Whereas, you know, like, I guess perhaps there's a little bit more concreteness to something like reassurance seeking or hand washing that you can, you can do the task. Now, whether or not that's sufficient, obviously, like, oftentimes not, and like, there'll be the desire to keep going, but I think you're in this literal echo chamber in your own mind. And as you're sort of thinking through these things and maybe, maybe somebody's trying to reassure themselves, which is one of the more common mental compulsions. And then they're like, but what about that one time where you did this? And now it's like you've started a whole other train of obsessionality and now you're trying to fix that as well as the initial obsession.

[A]

Yeah, yeah. You're. You're 100, right? Yeah. Yeah. And I guess obviously a people with a lot of physical compulsions that there's a very high chance they're going to be compulsing mentally as well.

[B]

Yeah, yeah. And the research, you know, that. That exists out there, you know, it gives different rates of. Of how. Yeah. Like how frequently people or how. How many people, rather the prevalence of. Of people performing mental. But I, I tend to think that I. I have a hard time imagining a person who's engaging in other compulsions, who's not also trying to write things in their own mind.

[A]

Yeah. Almost every client I ask, are you doing anything in your head? And I might have to give a few examples, but almost all of them will say, yeah, varying degrees. Some people, it's not so much. And then other clients, they're in it all the time, you know.

[B]

Yeah, totally.

[A]

Yeah. Yeah. Okay. So what's. Like, how would you describe the flow of the book? Like, what would people find in it?

[B]

So I think the initial part of the book is sort of outlining the topography of your mind because again, like, there's just really not a. There's not a language for it in our society as a whole. So saying like, okay, well, what's a thought and what's thinking and how do we engage in thinking? What does that look like? And also what does it look like in the context of different obsessions as well? So I do. I have a whole chapter that breaks down how mental compulsions often show up in different subtypes too. So that with the hopes that people can kind of see their own experience in it and therefore, you know, use it more effectively. Effectively. And then I also spend a fair amount of time looking at why we want to disengage, because obviously, like when people. Well, I guess not obviously, but when people come to treatment, they don't want to disengage. They do. They feel ambivalent, of course, because they can, especially as you start to recognize some of the pitfalls associated with engaging in these mental behaviors. But at first, that's the life raft. And so saying, okay, well, I think it's a good idea for you to stop this behavior is all well and good, but people need to understand why in the world they would stop the behavior if they're going to do this very challenging thing. Because it's scary, right? Like the idea that, you know, I remember in, you know, the throes of an OCD episode. And I've, I've talked a lot. I think I, we talked about it last time I was on the podcast actually, like, related to relapsing that I was so scared that I would drop out of like the deliberating and trying to figure out whether or not I had relapsed and that I would be a bad person for having done so. And, and it was, yeah, it was terrifying to say, like, okay, well, I'm just gonna not answer this question. So like I said, having a real clear understanding as to why is so crucial if you're gonna do that. So there's a lot of space in the book dedicated to exploring what the liabilities of mental compulsions are, the fact that they don't work. And from there it really turns to concrete strategies as to how to better navigate mental compulsions. I have a chapter dedicated sort of cognitive approaches to navigating thoughts in a more effective and more structured manner than just, oh, I'm going to try and figure this out. It's like, okay, well, wait a second, does it make sense to keep trying to figure this out? And that's not always going to be appropriate for somebody with ocd, right? Like, the book is a catch all and some people are really clear that it doesn't make sense to keep doing the behaviors, in which case they can kind of, I suppose, skip ahead. Um, but I do find that a lot of people struggle with, you know, is it, is it actually okay to let these things go? And so having some reality testing around that is really important. I talk about values and, and really letting values be the decision maker when we're looking at things through this cognitive lens. Like, I guess, without going into too much detail for listeners, you know, when we. When we look at cognitive therapy, a lot of it is about identifying different thought errors and restructuring thoughts, like considering them from different lenses. And sometimes I think people do that with a view toward changing their emotional experience, which in OCD can easily become a mental compulsion itself. Right. If you're doing it all the time in your head, or you could see where somebody, like writing out an automatic thought record could become easily compulsive. Like, I'm going to just. I'm going to explain why I don't need to worry about this. But. But sometimes it's really useful, I think, to consider, all right, like, well, am I going to engage or not? And why? And again, connecting with values and like, does a response serve the person that I want to be? Rather than, can I talk myself out of this emotion is really the. The focus that I take there. And then I talk a lot about mindfulness and how mindfulness supports with accepting internal experience with pivoting attention to something else, which is so crucial when we're looking at an issue of attention with mental compulsions. And then of course, I talk a lot, talk some about ERP But I actually will say, I think a lot of the chapters, like all the mindfulness chapters are really response prevention chapters. Right. Like, it's the. The focus with mental compulsions because they're so tricky to spot because people don't really know how to disengage from mental behaviors. Like, having a really clear sense of, like, how do I practice response prevention with this? And that's. A lot of. The book is dedicated to that as well.

[A]

Yeah. Nice. Because if you're obviously being mindful, you're less likely to engage in it, and therefore you're not doing the compulsion.

[B]

Exactly, exactly. And again, if you're practicing mindfulness, you are able. You're essentially attentional training. Right? You're engaging in attentional training. And you're able to, in certain mindfulness practices, notice when you're thinking, drop it. Reorient your attention, which is response prevention with mental compulsions. And it's a practice that is, you know, like, it's ongoing, that you. Every time they come up, which oftentimes when you first are. Are working on it, is constant. It's like, nope, not. Not figuring that out. Not gonna do that. So, yeah, that. That mindfulness practices really do. Are uniquely suited to supporting somebody and noticing when they're thinking and dropping it and. And then coming back and re. Engaging with the life that's in front of you. Because, like you were saying at your job, it's like the amount of time that gets lost in your own mind is one of the greatest costs associated with mental compulsion. So how do we, like, anchor people back in what's actually happening in front of them?

[A]

Yeah, good point. And I think this is a useful. Like I sometimes say it's not. I didn't come up with this, but like, erp, being a kind of a lifestyle and a way of being. I think sometimes this sort of mindful awareness and be able to bring yourself back to the present moment is a. Is a life skill well beyond ocd. Because there'll be times I'm with clients and of course my mind will wander or something will come up as something I have to do later, and I have to notice that, accept it, the uncertainty, bring myself back to the client in the moment. So we're using these skills all day, every day, completely. Yeah. Okay, interesting. So, yeah, it's a really good book. And obviously I will put a link in the show notes and. Yeah, I think it's an important one and hopefully it will help people who have lots of mental compulsions and are stuck with what.

[B]

I hope so. I hope so. Yeah. Because there's. Yeah, it's a. It's a very difficult experience to have. And I so often hear people say it, like, it feels like I'm losing my mind. And like. And really, like, that lack of clarity about what's happening or, like, how. How you can help yourself when it seems like getting an answer or resolving something is so, so critical. I mean, now I'm speaking to all of ocd, but I think again that that sense of, like, I'm losing my mind, I don't know what's happening, I just can't stop. Yeah, that's so tough.

[A]

Yeah. And the more you ruminate or mentally compulse, the murkier it gets. Like the Alan Watts and the muddy puddle.

[B]

Yes.

[A]

Metaphor. Yeah. The more you stick your foot in the puddle, the cloudier it gets. And you keep your foot in, trying to clear it, and it gets cloudier. And it's the same thing in our mind completely.

[B]

Yeah. You lose the. The forest for the trees. Absolutely. Which I guess makes sense. I mean, we. Yeah, I think that that's ocd. Like, what we. I'm so curious about this. Actually, I should look a little bit further into this, but it's sort of like within the realm of BDD and bdd research the differences in terms of serial Processing versus more global processing or like more detail oriented, I should say. I imagine that that would, you know, we. They may exist and I just may be unaware of them. But that sort of focus on like the small pieces of things is so, so central I think in OCD.

[A]

Yeah, yeah. 100 we're in BDD. There's like perceptual retraining. You familiar with that?

[B]

Yeah, yep, absolutely.

[A]

Helping people zone out and take everything in as opposed to mono focusing or whatever the word is on. Yeah, details. Yeah.

[B]

Even like mirror retraining. Right. Is it so much about like, like zooming back out and, and having a more mindful or non judgmental approach to your body?

[A]

Yeah, yeah, yeah, absolutely. So you met, you mentioned a bit about the tools and things like that. Is there any one thing you maybe want to share in terms of like tools so to speak around dealing with mental compulsions or, or how to come back or how to let go or come back to the moment or.

[B]

Yeah, I honestly the most comprehensive, like the, the best intervention or skill that I, I use from my vantage point with people is basic mindfulness meditation because it hits so many of, of the points of practice that are important when you're dealing with mental compulsion. So it helps with that, you know, mindfulness being the non judgmental awareness of the present moment and that practicing that like there are a lot of different elements that help in navigating compulsions, generally mental compulsions within that. So I have a whole chapter or. Yeah, chapter dedicated to how mindfulness can help awareness and then how it can help with supporting like sort of building the muscle of being able to disengage and come back or reorient your attention. So when we're looking at mindfulness meditation, what I love about it is that you are sort of the way I practice. I close my eyes. You don't have to, but you're in this vacuum, right. And you're trying to like let your attention sit on something that is not particularly stimulating, whether it's your breath or the sounds in your environment. Like, like certainly a lot less stimulating than the world at large these days. Right. And our phones and the, all of the noise and, and so you are putting yourself in a position where your mind is going to wander. It's just a matter of, of time. If you're me, it happens very quickly. And, and the beauty of this is it gives, it gives a lot of opportunity for practicing non judgment. Right. So oh look, I'm thinking or I'm planning or I'm worrying or whatever. You may be doing there's this opportunity specifically for that non judgmental awareness which is crucial because it, that breeds acceptance. Right? So if, if you are, if you have OCD and, and you have a thought and you're, you're feeling anxious, the chances are when you like that you're going to judge all of that negatively and then you're going to immediately push it away, which is the problem, right? Like that's where, why we engage in things like any sort of compulsion is to try to push that experience away. And so if we pull it back to this basic mindfulness exercise for people or mindfulness meditation, that it gives that moment where you can say oh look, that's happen happening, which allows for acceptance. You're not going to immediately like brace against the experience, which is key if you want to make a different choice, if you want to stop doing the habitual thing, which is to engage in whatever compulsion, mental or otherwise. And then once you know, within the framework of mindfulness meditation, you have this opportunity to practice reorienting within that as well. So you usually in a basic focused attention meditation are going to anchor in, like I said, the breath or, or in sounds in our environment or the physical sensations that we're experiencing between like, I don't know, like our body and, and where we're sitting in space. And so we have this, this opportunity to go like okay, I'm, I've been thinking about this thing like I've been thinking about what I'm going to have for lunch, but I'm not doing that right now. Right now I'm listening to the sounds in my environment. And so again this is what it's like. It works on two different skill sets that are so crucial with, especially with mental compulsions. That second one is that, that we're approaching this in a curious non judgmental manner which allows for acceptance, which allows for us to make a different choice. And then making that different choice gets practiced within that exercise. So it's like, oh, okay. And then back I come and you're doing that over and over again. And I think also one of the reasons why mindfulness meditation I think is the, you know, the, the tool that I most wanted to share is like, it mimics in so many ways every like everyday life, right, that you're going to go out into your everyday life and you're going to be doing your own thing and you're going to be engaged maybe in writing an email or reading a book or talking to someone and then all of a sudden you're going to be off and whether that's mentally compulsing and trying to figure out whether or not you said something offensive in the conversation or it's going through your plan for the rest of the day or whatever that then like you have this moment of awareness like oh look, I'm thinking. And if you can do that non judgmentally then you can bring your, you can say, okay, well I'm not doing that right now. Right now I'm having this conversation with Stu. Right. That it's, it directly maps onto daily experience and, and the practice of meditation itself is like there's no aim. You're just trying to get better at noticing and disengaging and coming back ultimately at least with the focused attention meditation. So I think that that would be. And, and I think people are so intimidated by meditation and they have so many associations with it that like really it is so basic. It's just sitting and, and watching what happens in your mind non judgmentally and then trying to orient again. And it's like you don't have to stick with the thing that you're trying to orient to. It's. It's actually like you're, you're gonna wander. That's okay, that's.

[A]

So anyway, no, I, I agree. I think, look, I mean I use like dropping anchor from act as like one of my key sort of of skills day to day. But I can't deny that for me individually, the times I have been very diligent in a mindfulness meditation practice of like 10 minutes a day consistently is my mind has just been way better. Like I catch stuff throughout the day more. I've been more aware when my mind start. Started chattering and, and all of this. I'm just very undisciplined at sticking to a practice.

[B]

Yeah, it's hard. It's, you know, like I, I certainly like weave in and out of that as well.

[A]

So I could watch Netflix or I could sit down and meditate or I.

[B]

Could look at the inside of my eyelids. Yeah, well, again like it's. Yeah, it's purposefully not quite. Not very stimulating.

[A]

Yeah, it's awesome. Once you're in the habit of it, then it's almost like I, I want to do it. I can't wait to do it.

[B]

Yeah.

[A]

But for those that like. Because obviously some people have real objections to it in the sense of I tried it once and it was way over overwhelming. I was just bombarded with thoughts. Is it that some people maybe need to get to a certain level of treatment before they can do that sort of thing, or do you think there's just ways of making it more suitable for them?

[B]

That's a great question. And I honestly, like, there's plenty of people for whom meditation is really triggering because of how quiet that space is and aren't willing to start there. And I think that for folks who find themselves in that camp, we can practice essentially the same skill set in different contexts. So whether that's doing a mindfulness activity in your daily life. So just saying, okay, like, whenever I wash the dishes, I'm going to do it mindfully and I'm going to really anchor in my sensory experience of dishwashing, and I'm going to, like, feel the soap on my hands and against the dish and all of that. Right. Like, it's the same idea as anchoring in something, like the breath or sound in the environment, but there's more going on. So I think it's a little less maybe scary for somebody who's like, oh, that's a lot, and it's overwhelming.

[A]

Maybe the eyes. Sorry to cut you off there. It's not like the eyes shutting might be the deal breaker.

[B]

Yeah.

[A]

Then you are suddenly shutting off senses.

[B]

Yeah.

[A]

Sense. A key sense.

[B]

Yeah. Yeah, absolutely. So I think it's a little bit more engaging naturally to. To be practicing in that way, which comes with its pros and its cons. Right. I think it's a good place to start. I think that the beauty of doing more formal meditation practices, it is so quiet that you get to see things a lot more clearly. So ultimately, I think it's great if you can get to that practice, but whatever you're willing to do. And I've even had people, know, listen to music and. And pick out different parts of the music and if that's what they're willing to do and just to notice and then notice when they wander and come back. Because it's true. Yeah, yeah, yeah, yeah.

[A]

I like that idea of. Yeah, I've done that before. Like, pick a song and. And really savor it. Listen to it. As you say, when you get distracted, notice that. Come back. Yeah, it's the same. Same skill.

[B]

Yeah, yeah, exactly. Yes.

[A]

Maybe it just needs to be adapted.

[B]

Yeah. Yeah. And I. I do think that I. Yeah. I think meeting people where they're at. Because it's hard.

[A]

Yeah.

[B]

It's hard and it's. Yeah. And if. If you've been at odds with your own mind for a really long time, then you might not be willing to go there alone. Right. When it's dark. I can totally appreciate that. There's something in what you said earlier, too, in terms of the. I think it was more about, like, the broad applicability of this practice. Is that. And maybe in what. As you were talking about your own experience with, like, more consistent practice is that what you're doing, too, is you're building, like, a. A more congenial relationship with your own mind. Right. Like, by approaching all of these experiences without judgment, it. It, like, it just fosters a lot. Much less, I don't know, like, contentious space, too, which I think is what. Yeah. Like, one of the benefits of that is, like, oh, like, I can just be curious about all of this instead of it, I don't know, being so intimidating and. And terrifying.

[A]

Yeah, absolutely. I think with, like, mindfulness meditation and act and all of that, it's helping you see the process. Process that's going on in the. In your mind. And. And. And if you see in that you're not really seeing the content or you're. You're not reading into it as much, you're kind of seeing the mechanics, the nuts and bolts.

[B]

Thoughts. Yeah.

[A]

When you see that this is just thinking or a thought or, you know.

[B]

Yeah.

[A]

You can leave it. Leave it alone. Easier than totally.

[B]

Yeah.

[A]

This bad person or is this gonna happen? Or that. That's all content.

[B]

Yeah. And when you watch the process of, like, oh, and now that feeling is, like, really intense because I've just been thinking about this for a while, and you can kind of bear witness to how all of these processes play out within us that you. Yeah. You can take them all a little less personally and also more skeptical when you find yourself engaged.

[A]

Yeah, yeah, yeah.

[B]

Good.

[A]

Good point. So you got a billboard.

[B]

Oh, my billboard.

[A]

Yeah. What do you want written on that billboard?

[B]

I don't. I. I definitely could have prepared for this because I know you always ask this and I didn't, so there's that. That's a thought. Interesting. I. I think. How do I make a pithy phrase out of. No, I'm lo. I'm lost, actually, Stu, what should I write on my billboard?

[A]

Nothing pop into your mind?

[B]

No, I mean, a lot of thing.

[A]

Don't censor yourself. We'll go.

[B]

Don't censor yourself. No, I know. It's more like, I don't know how to make it into a short, pithy, like, it's not going to be a legible billboard. Right.

[A]

Well, we can have some print. Maybe someone's walking past and they can read it.

[B]

They can, like, Pause. It's like a, A monument. Yeah. I just. The. It's not. I think what I'd like to get across to people and maybe hard to do so on a billboard is like that you're it. It does seem like a mess inside your own mind and very overwhelming and unmanageable, I think when you have. No. Yeah. No. Never stop to, to look at it. But it's actually quite simple. The mechanics of it, as you're talking about are quite simple. And you too can see that. And when you can see that, that's freedom. Right. It's that you're not bound by these processes anymore. Like that you can just bear witness to it all and then go, okay, well what do I want to do? So again, I don't know how to condense that into like a short.

[A]

We can have our code on there that someone can.

[B]

Yeah, it's my. That's so. It feels very me that I wouldn't be able. Yeah. Like, apologies, I don't have a short message for you. Can you listen to my TED Talk on this thing?

[A]

Yeah, no, it's good. It's important, Important message. And then I'm going to say, what would you. If you pick up the phone and call the three. So three years ago you. Not three year old you. Three years ago you. Because I know what age you were and you don't have to tell us. If you could call her, what is that, 20, 23, 20, 22. What would you tell her?

[B]

I would tell her. To, I think, be gentle. Yeah. Like I just thinking back at that time in my life and, and all the anxieties. I was about to become a mom, like a, like a mom of a little person. I had two step kids, but they were a lot older. And it's, you know, it's not quite as scary. They're a little bit more, you know, like. Sure. On their feet at that age. Like at 10 and 11 when I met them. And so like, you know, there's so much concern, I think, and room for anxiety around doing things wrong.

[A]

Yeah.

[B]

And, and, and somehow or like something horrific happening and saying like, you know, be gentle with yourself. Put one foot in front of the other. We don't know what the future holds. And one step at a time, you can walk through it and, and, and you'll deal with it as it comes. Right. That would be, that'd be what I say to her.

[A]

Yeah, yeah, yeah, I like that. Nice.

[B]

Thanks. Yeah.

[A]

And lastly, is there anything else you wish you could have said or shared today?

[B]

Other than, you know what? I'm a throw it back to you. I really appreciate this resource. I said it on the, you know, the. The recording I sent you for the hundredth. Or the. Yeah. What was it? It wasn't.

[A]

Yeah, 500th five.

[B]

Good Lord, you're busy, man, Stu. But, yeah, I think I just. It's. It's really cool what you've done here, so thanks for having me on again. And. And thanks for keeping doing what you're doing.

[A]

Yeah, no, I appreciate that. Thank you. It means a lot.

[B]

Cool.

[A]

Thank you for coming on. And, you know, if everyone's interested, go buy Lauren's book and, yeah, leave a nice review.

[B]

No, no negative ones.

[A]

No, no, you can write negative things. Just hit five stars.

[B]

Yeah.

[A]

That'S awesome. 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.