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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 for interviewing inspired therapists, psychologists and people who have experienced OCD. Welcome to the OCD stories and welcome to episode 511 of the OCD Stories podcast.
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B
And in this one I got back on Melissa Moses.
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A
Melissa is a licensed marriage and family therapist who treats OCD. Melissa is president of the ISDF affiliate OCD SoCal. And just on that note, OCD SoCal are running a two day online OCD conference on November 15th and 16th of this year obviously.
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B
And if you're interested in that or.
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A
Want to attend, I'll put a link in the show notes or you can just google OCD SoCal to find out more.
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B
So in this episode we discuss her.
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A
New book for therapists on integrating Internal Family systems therapy for ocd. What is ifs, which is obviously Internal Family Systems therapy for short, Integrating IFS and exposure Response Prevention Therapy. Working with parts that get in the way of therapy, Noticing and working with OCD parts, Understanding parts of us understanding OCD parts in detail so that we can notice intuition better and much, much so.
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B
IFS is a much more relational therapy.
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A
So I think it's a really nice addition or maybe a nice addition to ocd. You be the judge. I should say nice addition to ERP or ibcbt.
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B
So yeah, I'm probably going to cover.
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A
More relational based therapies because we've got the kind of behavioral element covered so we can look more at the relational as well as the behavioral and integrating the two. And thanks to our podcast partners, nocd. If OCD is interfering with your life, NOCD can help. They're licensed therapists, specialise in exposure and response prevention therapy, the most proven therapy for OCD 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 Melissa for her time.
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B
Always a pleasure to speak with her.
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A
I found this talk really interesting. I hope you do too. And of course thank you to you guys for listening. As always, it means a lot. And without further ado, here is Melissa.
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B
Welcome back to the podcast, Melissa.
[02:47]
C
Thanks, thanks for having me again.
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A
Yeah, it's good to have you on.
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B
And Obviously, the first time we spoke, we talked about integrating ERP and internal family systems, or ifs for sure. And that's what we're going to talk about today. But since we last spoke, like, how have you been, what you've been up to? Released anything?
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C
Yes, as a matter of fact, I have finally finished the book. So I think when we spoke it was in various stages of almost done. So I finished the book. The book came out on September 8th and it's called internal family systems therapy for OCD. A clinician's guide. It's real pithy and rolls off the tongue, but it's been. That came out and it's been quite a journey. I feel like lots has evolved in the couple of years that I spent writing that book in terms of my work with clients and ways in which I use IFS with ocd. And even since the book's come out. So I've been doing a lot of consulting with people that it's been wonderful to see both communities really welcome this approach. I was concerned that both communities would be mad at me, but actually it's just such a great fusion. It's this infusing the way we work when we're doing really solid, good OCD treatment with. With this approach that tends to be really healing. So I've gotten a great reception and I'm really, really pleased about it and have started writing a workbook for individuals. Yeah. So there's been a lot going on.
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A
Yeah.
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B
That's amazing. And I. I guess it might be. How long is a piece of string? But you have a rough timeline for the workbook.
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C
Yeah, that's a good. How long is a piece of string? It's technically theoretically final draft is due February 1st, so maybe out next fall. Yeah, hoping that that happens. That's the intention. I just wanting to make sure it's really user friendly and really solid. So got a few more edits to do, but it seems easier to talk about theory and. And making it really applicable so that people can jump in and get something out of it is not always as easy.
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A
No, no, exactly.
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B
No. But that'll be a brilliant workbook. No doubt when it comes out. Really add to the variety of workbooks out there.
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A
So. Awesome.
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B
So I guess initially for those that don't know what ifs is or haven't heard our first episode, of course people can pause it. Go listen to that now. But just for ease, how would you describe IFS to anyone listening?
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C
Yeah. So IFS is an approach that was developed clinically out of the practice of Dick Schwartz, where he. Who worked with eating disorders and started to notice that he heard his clients say, well, part of me wants to do this, get better, make good choices. This other part of me just doesn't want to. This other part of me wants to do that. And he started just listening to that language, and we all kind of use that language. I feel that way all the time. You know, part of me wants to keep working until I finish this chapter. And another part of me knows that, you know, people need me over here. So. So ifs is the idea that we are essentially multiplicity. It's not like wrong or bad or problematic to have parts. We are naturally that way. And that we all have a self as well. We have. It's not that we have to develop self over time. It's that when parts relax back, what naturally emerges is a state of clarity as an awareness, an ability to step back and be curious, really. And it's that curious, open, aware state of mind that Dick Schwartz calls self. It's not unlike, problematically, sort of what some Buddhist traditions would call no self, or, you know, DBT might call wise mind, or, you know, we have this concept in other traditions, but it's the you who's aware that you have parts. What's distinct about ifs versus other, like ego state and other. Other kinds of parts work is that as a family systems therapist, Schwartz really began to notice that our parts interact as if they're a family. You know, the same way that we do family therapy. We can work with our parts. And so it's not like they're little people running around in there. But it works better when we treat them that way, when we recognize these two parts kind of work together. And these two parts don't like each other, and this one tends to dominate. So we may need to ask that one to step back and. Or go into the waiting room a little bit while we get these other ones talking. So that's the general concept. And healing is really not about getting rid of parts. It's about accepting parts and helping them sort of let go of their more extreme positions. So it's about finding a balance. It's about being actually the self in the leadership role, the parent in the room, the CEO, the one who guides the parts, rather than parts leading.
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B
Yeah, yeah. So you're taking the reins again, so to speak. And the parts are still at the round table, but you're the one leading the conversation.
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C
Exactly.
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A
Yeah. Okay.
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C
Yeah. It's not unlike what we are looking for when People use mindfulness, right? It's decentering in mindfulness. In act, we might talk about diffusion from parts. We call it unblending in ifs. And so, yes, it's about putting that wise self in the lead.
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A
Yeah.
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B
Yeah, I like that. So I, I think I, I probably would have asked you this in our first episode. I didn't listen back because I don't like to hear my own voice too much. I have to listen to it each week when I listen back anyway.
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A
But.
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B
It'S a. Sorry if I have asked you this, but what led you down the path of ifs?
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C
Well, I. It's been a 30 year stretch of being a clinician, so I've done lots of different things in those 30 years. I started out actually in a more psychodynamic program that was my. Where my master's and my doctoral work was all more depth psychology and Jung and psychoanalysis, which I never practiced, but it was a psychodynamic approach. And then I trained in family systems therapy when I actually got out into the work, because that's, that's the kind of internship I got. So family systems is really how I worked. For the first 15 years I worked with teens and families and then I switched over completely when my daughter had her sudden onset of OCD after strep infection. And our world's changed, so she got very severe very quickly and I watched her get better using erp. So I went, oh, wow, I want to do that. So I trained in ERP and I trained in actin. I trained in getting, you know, really treating OCD in a big, big way. But then sort of along in that process, I was introduced to Martha Sweezy, who has written tons of books on ifs. And she talked, started talking about parts and family systems and it's sort of this both depth approach and family systems approach. And I decided to take a training and it kind of brought everything together for me. I've also got like a 30 year meditation practice that I discovered in college and so forth. Like what I. My approach to things and the way I really do my therapy. What informs my therapy is mindfulness is that state of being open to whatever arises, right? So being present with and IFS really seem to call sort of lean on that as well. But then so does erp. And so here I am seeing my clients with OCD and I've got this, wait a minute, parts going on in my, you know, one part of my brain and I'm doing my exposures in the other part of my brain. And I just sort of naturally, I think when you start studying ifs, you just naturally start thinking in terms of parts. And when you're speaking with a client you're aware, like especially if they're particularly activated, I'm talking to their angry part, for instance, or I'm talking to a scared part, or I'm talking to a part with an agenda that just wants to figure out how to fix this. And so it's really intellectual. And I just began to naturally use my IFS training in the course of doing ERP and really found that where they're very much alike is the idea of exposure. If you zoom out and you take exposure as the healing principle in a lot of this and a lot of our different theories, actually. But if you think of it as turning towards the thing that you've been avoiding with openness and curiosity and a willingness to learn, that's exposure. It's also exactly what ifs is all about. We're turning towards parts, even dangerous, scary parts. Parts that are talking about suicide or parts that are binging, or parts that are criticizing and shaming inside. And we're turning towards those unblending from them and opening to them with curiosity and kind of saying, what are you, what are you doing? What are you trying to do here? What's your job? And the theory is parts are all trying to help in some way or another. It may have gotten very dysfunctional over the years, but at the root of it is a good intention. And so OCD just naturally lends itself to parts work. We're constantly talking about the bully in your brain, or our clients are saying, my brain is telling me this, but I know, I know I don't really have to do that. And so that's what ifs is. We speak four parts, you know, part, you know, even in a relationship, it might be, part of me is really angry with you right now, but I know you didn't mean to hurt me. Right. So that's an unblending. So just that that move became very natural. And so I decided to keep exploring. And I found that people responded really well to unblending and befriending their OCD parts. Yeah. As opposed to fighting them all the time. So that freed up a lot of energy. And so. And it be. And it also teaches a way to have self compassion that's a little more effective than just be self compassionate towards your.
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A
Have.
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C
Have self compassion. It's really hard to do, but ifs really teaches that skill in a very powerful way. So.
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B
Okay. And Self compassion, sort of specifically targeting one part as opposed to giving your whole self kind of self compassion.
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C
Right. So. And I think that's a really great distinction because sometimes when we look at ourselves as a whole, it's hard to be to, you know, people will say, I don't, I don't deserve compassion. Right. Because I do these things. And if you really can help someone, see, well, there's a part of you that does these things because it feels like it has to and you don't like it. So there's the you in there. Right. So even being able to turn towards the part that's doing something destructive, let's say it's a, you know, excessive hand washing or, you know, something in our field and just having some appreciation for. I get why you're doing that. You know, I get that you think it helps. I know you're working really hard and helping a person notice the criticism, notice the frustration with these other parts and unblend from those as well, can help us access what's naturally there. And it really does come up naturally. Like just spontaneously, you really do start to have compassion for parts of yourself who are working so hard to protect you in this really awful, counterproductive way. It just again and again never ceases to amaze me that you can have that compassion towards a part of you that's just doing the best it can with limited information.
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B
Absolutely. And do you find with ifs, it's useful for, like, when people have blocks to doing erp? Because some people. But some people, some of my clients, for example, um, there's just this block. They can't do it for whatever reason. It's always various reasons, and sometimes you can try and motivate them and do other things, but it doesn't work because the block, the part in this case, is so strong. So, yeah, you were nodding a second ago. So. Yeah, what. What do you want to say?
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C
Yeah, that was initially what I thought this was going to be all about. Initially I thought, well, ifs is going to be useful for treatment readiness, really. And it is. That's a huge piece of it. It ends up being useful all the way through treatment through ERP or icbt. It works really well with that as well. But initially I was focused very much on the parts that get in the way. There might be skeptical parts that have heard stories about erp, and I don't want to try that. There might be parts that are just really intimidated, scared. With ifs, what we are able to do is notice how that shows up I noticed you were able to do these exposures, but you don't want to do this one, so let's sit with that. So instead of trying to get rid of the block or the quote unquote resistance, let's get really curious about it. How does it show up? Like, how do you notice it? Do you feel it in your body? Is it more of a thought, kind of do that describing thing. That act does a lot, you know, like, how big is it? What color is it? You know, does it tingle? Does it. How would you identify it? I think with parts. Sometimes they take on these characteristics. Like, you know, it's just like a. It's like a bouncer, you know, in a club, or, you know, it's got, you know, you can kind of personify it a little bit. But mostly we're. We're doing that move where we're turning towards it, which allows us to step back and have a little perspective and. And really work with the part that's in the way. What's it trying to do for you? Okay. Does that make sense to you? Are you on board with the idea of not wanting to die? Well, yeah. Right. Okay, so let the part of, you know that you actually are on the same team. You don't want to die either, but you. You actually have a lot more information than that part of you does. Right? You have all these other parts. You have the big picture. So we're. We're trying to kind of set up an alignment with like a part that's blocking so that it can soften. And I use a lot of, like my. My previous teen therapy skills where, you know, the teenagers were always trying to. Battling their parents, right. And I would teach them the skill. Like, if you want them to listen to you, sometimes you have to hear them first. Sometimes you have to say, you know, Mom, I. I really understand why you're worried about this situation. You know, that guy just. You're right. Doesn't always make the best decisions. And this is all of these things. And I understand your concerns. I. I feel them too, but I think it's going to be fine for these reasons. Right? So I teach that skill, relationship skills. It's all about relational work, right? So we're doing the same thing inside with apart. Like, all right, bouncer guy. Like, I'm on board with the fact that this seems really disgusting and scary, and I. I don't want to put myself in a situation where I'm doing compulsions all night either, but would you let me make the call, rather Than just blocking it. You get to where you can negotiate with these parts of you, and they soften a little bit just by virtue of being heard. I found that that's helped. And I've heard other clinicians say clients who were stuck are getting better because they're willing to do the work, because the parts that are blocking get out of the way. So we're really bringing a relational element into the behavioral work and a whole set of new tools when we do that.
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B
I agree. And I think. And I think whether therapists buy into ifs or not, I think there's something nice here about ifs, that it is helping people create a inner understanding of all their feelings and thoughts and emotions and a better relationship to that. Even if we don't believe in the parts, let's say. Yeah, yeah, yeah.
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C
If you. Even if you want to think of it as just thoughts and feelings. Right. States of mind that recur, patterns of behavior. I mean, that's the same thing. It's how we. How we engage with the world and then what we do about it. You know, how do. Do we sweep it under the carpet, ignore it, do we battle with it? Or can we work more effectively with our moods when we acknowledge them and have some understanding and allow them to soften, so letting them sort of go through and out? Yeah, yeah.
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B
And in ifs, correct me if I'm wrong, whereas some parts work in other therapies. You're talking about the parts and what's coming up in ifs. You're talking to the part as if it's an actual person, so to speak. Is that correct?
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C
That's one way of working in ifs. Yeah, that's the insight work where people will speak to the part. And that can be very effective. But not everybody works that way. And so that's only one mode of working. What's really helpful, though, is when we allow people a moment to listen inside. So it's not necessarily talking to parts like they're little beings. At least the way a lot of clinicians work, a lot of ifs, therapists work. And certainly how I work, it's. If you pose the question, what is the message here? What is this doing for me? And you just listen instead of think. A different kind of answer comes. And then you can actually send a message to your system, like a public service announcement, like let that part know you're here. So we're. We're sort of exuding confidence. I think of it as security, attachment, security that allows parts to feel like they can do Scary things maybe not be safe because they have the security of a self in the room. Right. But we're communicating with our body all the time. When we're sending signals, you know, move, pick up this glass, we're sending messages. So it's really that kind of communication inside that we're doing okay.
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B
Where you said about kind of don't think, it's the word can't just kind of listen was intuition came to my mind.
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A
Yeah.
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B
And I hesitate to say that because sometimes if OCD people get really stuck on this idea of I can't listen to my gut or intuition or. And interestingly, I did a podcast recently with Dr. Sam Greenblatt, and he was talking about relationship OCD, and he was using his own kind of journey as a. As a case study. Um, and he talked about having done IFS therapy for himself as the patient or client recently, and how that had fed into his understanding of his journey with relationship ocd. And, and he talks in that about. I think we talk about trusting your gut intuition.
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A
And.
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B
And he said in one of his first episodes with me years ago, he kind of said, you know, don't. Don't trust your gut. Don't listen to it. And he says, okay, I think I was wrong there now. And in some of the therapies I do like, I use Sam play with. With my kids and teens sometimes, not just with OST clients, with the different clients I see. But Sam play is very much intuition first, think second, and trust what comes up in the tray and process that.
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A
And.
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B
And obviously, CBT sometimes neglects that kind of, you know, think, think, act and all that's wonderful. But. So I don't know what I'm trying to say here. Just. Any reflections on that?
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C
Yeah, I have a lot of thoughts about that. I think that if you want to think of intuition as what we're calling self, and the brilliance of being able to tell the difference between what I want and what OCD wants. So I have any number of clients now because of what I do. And one in particular who started with me, I don't know, 12, 15 years ago, and immediately went to residential, so did a lot of erp, has done IOP several times, has done like, top notch, excellent treatment, tms, all these kinds of things. And at a certain point, she'd moved away. She came back to me, she said, I. I've had OCD my whole life. I've had erp, like, my whole life. And so I've been taught to not listen to my thoughts and feelings. Oh, how do I know what I want or who I am or what? Like, I'm lost in my 30s. Don't know if I don't know what to do. So the brilliance of ifs is you begin to develop a sense for the sound of OCD thoughts in your head and the sound of, like, compulsive parts of you or the feel of them, so they become familiar. And you can then get in that space where intuition, there's more room for intuition because, you know, the quality of that thought, it sounds different in your head, doesn't it? Right. It has a more shrill kind of a tone, or it's more pressured, or it's more urgent, or your body posture changes when you're sort of in that OC part of you. And if you notice that and you listen to it, you can hear what it's saying. But you also then have more space for that intuition. Right. And you use that wonderful construction, I think, which is. Part of me says this, but I know that. And sometimes that's a really hard place to get to. But if you are, you know, with some work of identifying these parts, people have a lot more access to that intuition into the ability to say, well, there's all this noise going on, but I'm. I'm here, I'm doing that, or I feel this, or I'm aware. And so what this one particular client eventually said to me is, you know, she was really resistant to ifs at first. She's like, I don't buy it. The self stuff, these eight Cs. I. And she eventually said, you know, when you have access to yourself during exposures, it makes all the difference. And it really is true that we've got all these prompts during an exposure now. Like, I can notice, like, hey, did a. Did a part just come in? Yeah, I'm starting to get really intimidated about this. I'm starting to worry that. That, you know, I'm going to just compulso all night. Okay, so turn to that part, ask it to step back, and then we go back into the exposure. So we're unblending during an exposure, making the actual contact with what we're doing much, much deeper. So I think I veered off your topic of intuition a little bit, but it's that the more we identify parts, the more we are able to unblend and get them to step back, the more spaciousness people feel inside. And that's where their intuition of who I am and what's the why, where are the values in act when we talk about values, that's self. Like, I don't want to be stuck here because I can see this future. And learning to trust, that is an internal attachment relationship. Right. It's. It's security. It's like, so that's, you know, security, not safety. Right. We don't want safety seeking all the time, but we do want, you know, to be like. Like with space. We have parents be with their kids in a supportive way. It's kind of like teaching clients to be with their obsessive compulsive thoughts and feelings in that same way. Accepting, compassionate. I hear you. I see you jumping up and down over there, and I know we'll get through it, so we're gonna hang out and whatever. So I think. I think what you're saying is really right on. Being able to listen, being not afraid to listen, knowing there is a self in there is the huge shift.
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A
Yeah.
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B
I think two things come to my mind. I'm blanking on the first, so maybe I'll go to the second. Elena Fasan, who you may know in. She's in California.
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A
Right.
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B
She does space. I do space. Sounds like you do space. And when I was speaking with her, she was the one that pointed me on that she gets her clients that. The supportive language that we teach parents, she encourages the clients to use that on themselves when they're, you know, facing. And it made obvious sense, like when she said it. And now I do that with my clients. And the self talk of when that's. Those scared parts are coming up. We can get through this. We've got this. Let's just keep going. I know it's scary, but we're going to be okay. We can move forward, blah, blah, blah. That's sort of in a dialogue versus the dialogue of. We invest in these parts, we buy into them, and at that point it's game over. We're doing compulsions.
[33:05]
C
Right, Right.
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B
Right. And then the.
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C
The.
[33:08]
B
The. And almost came back to me there, my first point. Yeah. Well, I think something about. In terms of intuition, because again, I always hesitate to say it because I know when people are in the thick of it, they're so full of doubt. Right. And that's the doubting disorder.
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A
And.
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B
But I think if you can, as it sounds like what you're saying, like, really get to know that OCD part, you can start to know what it looks like, smells like, tastes like, feels like. So when it comes up, you can see it from a mile away. Yeah. And then enact, diffuse from it or unblend in.
[33:47]
C
Yeah, sometimes I'll do something around because, you know, as therapists, we're seeing the posture of our clients. You know, we're. We're noticing a lot of things that are visual that they may or may not be. But. But say that doubting part, that's fretting, that's worrying. That's what if. Ing. And when people are really blended with that, you. You can feel it, and they almost look different. Right. And so I'll have them, like, really notice that. Like, notice your posture right now. Notice your tone of voice. Like, kind of imagine this, like, character that you're in, this role that this part of you is in. Right. And if you were to put that character on a stage, like, who might play that one in a. In a play. Right. What would it look like in. On a. Outside of you? And really get curious about how we embody states of mind. You know, our feelings really are palpable, and they. They change us how we are. And so that way, it's. There's all these cues to when you're beginning to be taken over by that spiral or by that swirl of inner turmoil is you start to wring your hands. It's like, okay, there's that part. I see that part. Okay. I can. I might still get taken over by it. I might still, you know, really feel it strongly. But at least I'm aware that I'm here, too. And that's the first step, and that's the powerful step, and that. That creates the willingness to do treatment.
[35:36]
A
Yeah, yeah.
[35:38]
B
Now that you say it.
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A
Yeah.
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B
Because I see it in session as well, that when you see suddenly someone just start closing down, almost like a flower that's not been watered, you know, and it just collapses in. And then. And then you do various things, and suddenly the shift is completely different. They're sitting differently. They look more rel. Unburdened, which I know is an IFS term, but I'm not using it in that way. And it's just miraculous. And sometimes I can point out, say, you can shift back from this state, and you see them as if they're really triggered. They'll do this 10 times in a session where they'll keep dropping back in, and you try and pull them back out. Ifs will have a better explanation for that. But it's interesting. Yeah. You point that out.
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C
Well, you know, we blend and unblend all day long. That's how we function. Right. So I have a part that organizes my thoughts well enough to speak to you right now. You know, that's a, that's a part of me. You know, it's, it's a functional part of me. And it, it's a different part than the one that talks to my cat. It's just a different aspect. It's a different state of mind. It's a. So, you know, we're constantly changing and it isn't, it's just a useful shorthand. Parts are just a useful shorthand for a state of mind that I can recognize that recurs, that has patterns. And when I can recognize that, I can more easily do something about it. You have to. You know, my, my little brother's baseball coach used to always say, you have to catch the ball before you can throw it. Right. So we have to be able to recognize these things before we can actually relate to them differently, which is what I think is key, which is the mindfulness piece and then be able to choose how we behave rather than be, you know, subject to the compulsions rather than the have to's and the can'ts. So that, that, that just ability to notice and you know, one could argue it is very much like mindfulness based cbt. It does it, but it's a little different in that we begin to notice some of these parts. Like this part will trigger that part so we can get into the inner dynamics of it a little bit more. And it's not just I be aware of my thoughts and feelings. I also listen to them because they have a lot of information. You know, it's not just a random obsession. It's something that's usually cued in around a theme. Right. And has some information. For me, it doesn't mean that it's narrative about that is true. Right. So yeah, it's just, it's, it's more, it's just bringing the relational into the behavioral is how I like to describe it.
[38:52]
B
Yeah, no, I fully agree. That's why, you know, off air, I was saying I'm interested in functional analytics, psychotherapy, because that brings the same thing relational into the behavioral. And, And I'm not. I'm interested in ifs. And at some point in the future I will get to it. Like I said, I have read your book and I need to reread it. But where am I going with that? Yeah, I think that's why you're seeing, you mentioned it off air that it's being well received, this idea of merging IFS with ERP and BAP and ERP was fairly well received whenever we've talked about it. I'm trying other relational therapies that we talk about in relation, but I think ERP therapists are open and looking for that more relational adjunct or adjuncts. The right word addition to erp. So how do you. For anyone wondering, both sort of sufferer or passive OCD and therapist, what. What do the sessions look like? Are you going through the normal sort of ERP protocol and then pausing for ifs when you see things coming up? Or are you setting up ifs, parts terms and all of that straight away? Like, how does. Yeah. How are you blending it?
[40:11]
C
Yeah, So I. It kind of depends why people come to me at this point. Sometimes they're coming to me wanting ifs for ocd. Usually I discover it's because they're avoiding exposure therapy.
[40:33]
A
Right.
[40:34]
C
And so because, you know, I'm a huge fan of ERP and I do ERP and I'm, you know, an OCD therapist, what I. What I do in these cases is I say, fine, we'll do ifs, but I'm always infusing my parts, work with exposure principles of what happens if we welcome that feeling into the room. What is it I'm looking at? What are their parts avoiding? Like, what if we could get curious and go there? You know, so an IFS session might be. We start with, what do you notice? What's up right now, today? So we would identify the parts in the room, what part needs. We sort of get a contract for the session. What part needs your attention most? And it might be, I'm just aware of tracking everything in the room. Right. I've watched everything you've touched. I know exactly where I've been. And so there's this part of me that's tracking and keeping and scanning. So then we would turn our attention towards that part and get kind of curious. What do you notice about it? How do you feel it? How do you know it's active? Do you hear a voice in your head? Do you have a feeling in your body? And we go through a little version of what IFS calls the six Fs, where we find it, focus on it, kind of flesh it out. And then there's this befriending thing, which you have to be a little careful about, honestly, because we're not. We don't want to interview the part and get into its content or entangled in what it's saying at all. But we want to generally get a gist for what is. What do you suppose it's doing for you? It's trying to protect me. Okay, why do you suppose it's doing that? It doesn't want me to die. Whatever, you know, like. Like you get a sense for. Okay, there's a good motive here. So that's a befriending move like I was talking about earlier. And then what if. Then what we do is we try and sort of imagine if that part could soften back for a minute and let you decide where you put your eyes. Would you be willing to try that? And so what I'm doing is an exposure in parts language. So I'm. Let's do a little experiment here. The scanning part could maybe walk out and go into the waiting room for a second. And it's weird, but they do that. It's like if it could trust you for a second and settle down and. And it's a little disarming. So oftentimes parts will just do that. And then we do an experiment. What if, you know, I'm going to get up and walk around and you don't watch where I go or, you know, like, we'll do whatever the exposure is and notice the feelings that come up when the protective part isn't there. So in my mind, that's what oc what ifs would call an exile. An exile is just whatever we're trying to exile. I don't want that, so I don't want to feel it. So I'm pushing it out. And so it might be uncertainty, it might be contamination, disgust, it might be shame, it might be, I'm not enough, I'm not perfect. It might be whatever the feeling is, we begin to sit with that. So that's sort of a more ifs. That's what I call ifs infused with exposure principles. Other people come to me with OCD and they need exposure work, but because I do ifs, I can't just do. I can't not think. In parts. We might be doing in vivo exposures. We might be touching the classic doorknob. And I'm asking, well, what are you noticing inside as you touch that? What else are you noticing? I'm identifying parts. There's this critical part that's telling you you're doing it wrong because you don't have your whole hand on there. We're addressing that part and getting that to soften. Sometimes I'm doing ERP infused with parts work and helping person unblend and unblend as they do an exposure. Sometimes I'm doing more what looks like an IFS therapy session with always with turning towards and, you know, trying something new would that part of you be willing to try something new right now. So it really does vary depending on the person. And it's a beautiful thing to have at your disposal if you have somebody who also has trauma, because you're able to work with both at the same time because you're working with the parts that are organized around feelings that came on board during trauma. So that's another whole episode maybe. But you can work with other. It's trans diagnostic. So we can really work with people who also have substance. Substance use issues. We can, you know, we. Gaming addictions. It works really well because we're identifying the characters that are involved in different behaviors kind of as an extended family.
[46:19]
B
Yeah, absolutely. That was a really good, good rundown. And you really illustrated how you integrate it into ERP.
[46:30]
A
Blanking again. Now, what was it?
[46:35]
B
Yeah. Do you find that using this sort of parts language allows some people to feel that, oh, I'm not broken, it's just a part of me that is hyperactive, you know, overprotective, versus some people buy into this narrative of I'm sick, I'm broken, I'm weak, I'm.
[46:56]
C
Yeah, it's really helpful for that. And that is something that. The shame of OCD is something that we need to talk about more. I'm actually going to speak about that a little bit at the OCD SoCal conference in November because, yes, it's not me. I'm not pathetic because I can't do these things that everybody else can.
[47:28]
A
Right.
[47:28]
C
There are parts of me that are basically overprotective. And you know, you can really identify the critical parts. Right. Parts that are, you know, have internalized this shame and blame kind of narrative and then parts that just feel shameful. And in ocd, of course, that's huge because so many people are experiencing intrusive thoughts that are just disturbing and awful. And they, you know, how many times have we all heard, I'm, I'm a monster. I just, I don't know if I even deserve to be in therapy with you. Right. So really doing a lot of psychoed around first parts is hugely destigmatizing. Um, even, you know, suicidal parts. Right. It's so powerful to say, well, there's a part of you that's really trying to help. And they, they're like, what? Yeah, it's trying to get you out of here. Like, this is a really awful situation you're in. There's a part that has a solution, but it's a really extreme solution. So maybe we could try some Other things, you know, to, to be able to accept even. There's the saying in ifs no bad parts. So even self destructive parts, even compulsive parts that won't stop can be viewed as functional. They're there trying to do something. Maybe if you do it instead, we could find another way. Right. Maybe if you get present, we can help them, you know, relax. So yeah, it's very, very helpful for destigmatizing and to recognize you do know who you are. You don't have to walk around saying, maybe I'm a pedophile, maybe I'm not. It's like, you know, you're not a pedophile. Right. But there's a part of you that gets really loud about what if? And can you feel the difference? If you can learn to feel the difference, huge relief. I mean that is unburdening in and of itself self. And so, you know, it's in those cases, I think sometimes life changing. Yeah. In fact, life saving. Actually. The client I was alluding to earlier that was resistant to ifs and had nothing but erp, but she's like, there's a, there's a person here that's worth saving, you know, and, and that's, you know, it, it's really, really powerful and really healing. And on the totally other end of the spectrum, I'm also now seeing clients who have done ERP and OCD is better. Right. So. And they still have relationship issues that they want to talk about and they're afraid to go to a non ERP therapist or non OCD specialist because they know those therapists can actually really trigger OCD again. Right. So those people are coming to me for ifs, which is really helpful because we can now look at parts and we can work with what do you want in your relationship without triggering relationship ocd. So there's that aspect as well.
[50:59]
B
Yeah, I like that. And I guess thinking from like an act lens of diffusion and self as observer and getting distance and all of that, then, then talking really strongly in these, in this part language is like, yes. There's a part of me that worries about being a serial killer in seeing as a part. Is that noticing and naming an act, it's that distance diffusion, it's.
[51:25]
C
Yeah, yeah, yeah, very exactly. It's like in my mind I've got all my inventories that I do and I've rewarded them in parts language instead of. I worry about such and so part of me worries about such and so. I mean, it's just, it's a Very powerful shift. Yeah, yeah. And lots of overlap with ACT and lots of differences, you know, and it's also, you know, it just in all the different ways, including ICBT that people work with ocd, you, you can do all of it in parts language. So it's not, you know, it's, you know, you can look at the, the part that's engaged in obsessional doubts, you know, and those, the storytelling parts. That's a big part of what we do. It's like, because you also want to talk about the brain based part of OCD and that you've got this sticky brain circuit and that's real. We don't change neurobiology, but we can change how parts respond to it and then diffuse it over time. If you have a part that's really highly valuing this anxious signal and you can teach that part to not give it so much attention and not to trigger these other parts. Because I do think like obsessional parts kind of recruit these. You know, you sort of get your family to communicate differently inside. It unhooks from the reinforcement cycle.
[53:09]
B
Yeah. Because I imagine if there's this obsessional compulsive part that is terrified and it's going to be like all alarms are going off. It will naturally recruit other parts because they're going to buy into the urgency of this alarm signal. Yeah, yeah, yeah. Okay.
[53:28]
C
That's where it differs a little from ACT in that there's more mapping parts, more externalizing them as a way of relating to them and noticing this one recruits that one. So when that's happening, we can also want to disarm that. But it's all very experientially done rather than just talking about it. But identifying it is sometimes I think it's a big thing that people relate to with IFS and are appreciative of is is it helps them identify things, what's going on easier so that they can get centered and come from choice. Yeah, yeah.
[54:16]
B
I like that we're near the end of time. Someone else. Is there anything else you want to get in today on IFS and OCD and erp? No.
[54:28]
C
Other than just to say how much I appreciate people like you, you know, inviting the conversation and, you know, allowing space to bring other, you know, bringing creativity into the. Into what we do. Because that's why I think AI is not going to take over therapists because, you know, we can, we're curious and we evolve and we have these other things that we bring and it's not going to be for everybody. But for the people that, that are needing something more, it's a really valid and really healing way to go. And so I just appreciate you being willing to talk and spread the word a little bit and, and to hear about other people who are doing some similar things. Like, like I can't remember who you mentioned earlier who had done IFS therapy.
[55:27]
B
Dr. Sam Greenblatt.
[55:29]
C
Greenblatt. That's what I thought. You know, it's just like, it's, it's out there. People are, people are hearing it and I'm just really grateful. So. And then I do think the OCD SoCal conference is going to be recording it. If people hear this and it's already kind of happened to reach out there, there's probably going to be some way to access some of those recordings and if not, sign up because we're constantly doing new things.
[55:58]
B
Absolutely. I'll put a link in the show notes and they'll be able to find hopefully some conference content there. But yeah, no, thank you. Thank you for being open minded and exploring. And I just like therapy as a special interest of mine. So it's always nice to hear different perspectives, um, and how I can help my clients better. Uh, so, yeah, thank you. Thank you again.
[56:26]
C
Thank you so much. Take care.
[56:28]
A
Thank you for listening to this week's podcast and thank you to our Patreons who helped make this episode possible.
[56:33]
B
And if you would like to find.
[56:35]
A
Out more about Patreon and the rewards.
[56:37]
B
And benefits, then there will be a.
[56:39]
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 until we speak. Take care.
[57:13]
C
Sam.

Summary6 min read

The OCD Stories, Episode #511

Melissa Mose: Integrating IFS and ERP for OCD
Released: November 9, 2025

Episode Overview

In this episode of The OCD Stories, host Stuart Ralph welcomes back licensed marriage and family therapist Melissa Mose to discuss her new book and pioneering clinical work in integrating Internal Family Systems (IFS) therapy with Exposure and Response Prevention (ERP) for treating OCD. The conversation explores what IFS is, how it complements ERP, the concept of "parts" in therapy, and practical strategies for both clinicians and individuals with OCD. The episode maintains a conversational and optimistic tone, highlighting the importance of therapeutic creativity, compassion, and the evolution of OCD treatment.

Key Discussion Points and Insights

1. Melissa’s Evolving Work and New Book

Melissa recently published Internal Family Systems Therapy for OCD: A Clinician’s Guide (Sept 8), which blends IFS and ERP approaches (03:08).
- "It's been wonderful to see both communities really welcome this approach... It's just such a great fusion." — Melissa, [04:08]
She is also working on a user-friendly workbook for individuals, aiming for release in Fall 2026 (04:47).

2. What is Internal Family Systems (IFS)?

IFS, developed by Dick Schwartz, is based on the idea that everyone has multiple "parts" — aspects of the psyche with different roles and intentions (05:54).
The "Self" is a centered, curious leader among parts, which naturally emerges when parts relax.
Unlike some therapies aiming to eliminate symptoms, IFS focuses on acceptance and balance among parts.
- “It's about finding a balance. It's about being actually the self in the leadership role, the parent in the room, the CEO, the one who guides the parts, rather than parts leading.” — Melissa, [08:31]

3. How IFS and ERP Fit Together

Melissa's clinical history combines psychodynamic, family systems, and mindfulness approaches.
Personal experience (her daughter’s severe OCD and ERP recovery) motivated her to train in ERP and later integrate IFS.
Both IFS and ERP value "turning towards" discomfort with curiosity, making them compatible (13:34).
- “If you think of [exposure] as turning towards the thing you've been avoiding with openness and curiosity and a willingness to learn, that's exposure. It's also exactly what ifs is all about.” — Melissa, [13:36]
Viewing distressing compulsions and intrusive thoughts as "parts" can help clients unblend from them, reducing struggle.

4. Self-Compassion and Working with "Blocks"

IFS facilitates self-compassion not as an abstract idea, but as a practical skill directed toward individual parts (15:19).
- “If you really can help someone, see, well, there's a part of you that does these things because it feels like it has to and you don't like it. So there's the you in there, right?” — Melissa, [15:38]
When clients are "blocked" from engaging in exposure, IFS focuses on understanding and negotiating with resistant parts, instead of brute-forcing through the block.
- “Instead of trying to get rid of the block or the 'resistance', let's get really curious about it... Then you get to where you can negotiate with these parts of you, and they soften a little bit just by virtue of being heard.” — Melissa, [18:14]

5. The Practicalities of IFS in Therapy

Not all IFS is about "talking to parts as if they're people" — often, it involves simply listening and sensing what comes up internally (23:34).
The practice is relational: clients might use metaphor, imagery, or simply curiosity to approach parts.
- "If you pose the question, what is the message here?... and you just listen instead of think. A different kind of answer comes." — Melissa, [23:46]

6. Intuition, Doubt, and Differentiating OCD

The more clients distinguish the voice/feeling of OCD from their core Self or intuition, the more they can trust their genuine instincts (26:54).
- “The brilliance of ifs is you begin to develop a sense for the sound of OCD thoughts in your head…and you can then get in that space where intuition, there’s more room for intuition because you know the quality of that thought.” — Melissa, [27:17]
Over time, unblending from intrusive parts allows more access to values and direction—core aspects of ACT, relational therapies, and IFS overlap (28:10).

7. Destigmatizing OCD: No Bad Parts

The “parts” model helps de-stigmatize OCD by externalizing symptoms: clients see themselves as whole, not "broken" (46:56).
- “I'm not pathetic because I can't do these things… It's not me. There are parts of me that are basically overprotective." — Melissa, [47:28]
Even highly destructive, shameful, or suicidal parts are framed as (misguidedly) protective, reducing internalized shame.

8. Integrating IFS Into ERP Sessions

Melissa adapts her approach based on client needs. Sometimes classic ERP is "infused" with parts-awareness; other times, IFS is foregrounded with ERP principles layered in (40:11).
Identifying, listening to, befriending, and negotiating with parts becomes central to both readiness and implementation of exposures.

9. Transdiagnostic and Relational Applications

IFS plus ERP is effective for clients with complex comorbidities (e.g., trauma, addiction), as the "parts" language allows tailored, nuanced work across problems.
The approach also benefits clients post-ERP, who still need to navigate relationships or life decisions without triggering OCD relapse.

10. Resonances with Other Therapies

There’s considerable overlap with ACT’s diffusion and self-as-context, as well as with mindfulness and relational therapies (NALGBT, FAP).
Using parts language promotes distance, perspective, and flexibility (51:25).

Notable Quotes and Memorable Moments

On the spirit of clinical exploration:
"That's why I think AI is not going to take over therapists because... we're curious and we evolve and we have these other things that we bring and it's not going to be for everybody. But for the people that are needing something more, it's a really valid and really healing way to go." — Melissa, [54:27]
On self-leadership:
"It's about being actually the self in the leadership role... the parent in the room, the CEO, the one who guides the parts, rather than parts leading." — Melissa, [08:31]
On parts and self-compassion:
"It really does come up naturally... you really do start to have compassion for parts of yourself who are working so hard to protect you in this really awful, counterproductive way." — Melissa, [16:24]
On internal dialogue during exposures:
"I can notice, like, hey, did a part just come in? Yeah, I’m starting to get really intimidated about this... Okay, so turn to that part, ask it to step back, and then we go back into the exposure." — Melissa, [29:24]

Key Timestamps for Important Segments

New Book Announcement & Backstory........................ [03:08–05:26]
IFS Explained.................................................................. [05:54–09:28]
Melissa’s Path to IFS + ERP Integration........................ [09:52–15:10]
IFS for Blocks, Resistance, and Self-Compassion............ [17:15–22:06]
How IFS Engages with 'Parts' (Practice Models)................ [23:16–25:19]
Intuition, Doubt, and OCD's Voice................................... [25:19–32:09]
Observing Parts in Session / Embodiment........................ [33:47–36:26]
Relational vs. Behavioral Models / Therapy Structure......... [38:51–46:19]
IFS Destigmatization & No Bad Parts.................................. [46:35–50:59]
ACT, Diffusion and Parts Language................................... [51:25–53:27]
Therapist Creativity and Healing.......................................... [54:27–55:58]

Final Reflections

Melissa Mose’s integration of IFS and ERP offers a compassionate, intuitive pathway for both clients and therapists navigating OCD. By reframing symptoms as "parts" with positive intent—even if misguided—she opens doors to self-understanding, readiness for exposure, and profound shame reduction. Her work is a testament to the value of clinical creativity, relational depth, and inviting curiosity not only towards symptoms, but toward the full complexity of our inner lives.

For resources, recordings, and upcoming conferences, visit OCD SoCal or check the episode’s show notes.

Loading summary

Transcript95 lines

[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 for interviewing inspired therapists, psychologists and people who have experienced OCD. Welcome to the OCD stories and welcome to episode 511 of the OCD Stories podcast.
[00:27]
B
And in this one I got back on Melissa Moses.
[00:30]
A
Melissa is a licensed marriage and family therapist who treats OCD. Melissa is president of the ISDF affiliate OCD SoCal. And just on that note, OCD SoCal are running a two day online OCD conference on November 15th and 16th of this year obviously.
[00:49]
B
And if you're interested in that or.
[00:52]
A
Want to attend, I'll put a link in the show notes or you can just google OCD SoCal to find out more.
[01:01]
B
So in this episode we discuss her.
[01:03]
A
New book for therapists on integrating Internal Family systems therapy for ocd. What is ifs, which is obviously Internal Family Systems therapy for short, Integrating IFS and exposure Response Prevention Therapy. Working with parts that get in the way of therapy, Noticing and working with OCD parts, Understanding parts of us understanding OCD parts in detail so that we can notice intuition better and much, much so.
[01:31]
B
IFS is a much more relational therapy.
[01:34]
A
So I think it's a really nice addition or maybe a nice addition to ocd. You be the judge. I should say nice addition to ERP or ibcbt.
[01:45]
B
So yeah, I'm probably going to cover.
[01:47]
A
More relational based therapies because we've got the kind of behavioral element covered so we can look more at the relational as well as the behavioral and integrating the two. And thanks to our podcast partners, nocd. If OCD is interfering with your life, NOCD can help. They're licensed therapists, specialise in exposure and response prevention therapy, the most proven therapy for OCD 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 Melissa for her time.
[02:33]
B
Always a pleasure to speak with her.
[02:35]
A
I found this talk really interesting. I hope you do too. And of course thank you to you guys for listening. As always, it means a lot. And without further ado, here is Melissa.
[02:44]
B
Welcome back to the podcast, Melissa.
[02:47]
C
Thanks, thanks for having me again.
[02:49]
A
Yeah, it's good to have you on.
[02:50]
B
And Obviously, the first time we spoke, we talked about integrating ERP and internal family systems, or ifs for sure. And that's what we're going to talk about today. But since we last spoke, like, how have you been, what you've been up to? Released anything?
[03:08]
C
Yes, as a matter of fact, I have finally finished the book. So I think when we spoke it was in various stages of almost done. So I finished the book. The book came out on September 8th and it's called internal family systems therapy for OCD. A clinician's guide. It's real pithy and rolls off the tongue, but it's been. That came out and it's been quite a journey. I feel like lots has evolved in the couple of years that I spent writing that book in terms of my work with clients and ways in which I use IFS with ocd. And even since the book's come out. So I've been doing a lot of consulting with people that it's been wonderful to see both communities really welcome this approach. I was concerned that both communities would be mad at me, but actually it's just such a great fusion. It's this infusing the way we work when we're doing really solid, good OCD treatment with. With this approach that tends to be really healing. So I've gotten a great reception and I'm really, really pleased about it and have started writing a workbook for individuals. Yeah. So there's been a lot going on.
[04:38]
A
Yeah.
[04:38]
B
That's amazing. And I. I guess it might be. How long is a piece of string? But you have a rough timeline for the workbook.
[04:47]
C
Yeah, that's a good. How long is a piece of string? It's technically theoretically final draft is due February 1st, so maybe out next fall. Yeah, hoping that that happens. That's the intention. I just wanting to make sure it's really user friendly and really solid. So got a few more edits to do, but it seems easier to talk about theory and. And making it really applicable so that people can jump in and get something out of it is not always as easy.
[05:26]
A
No, no, exactly.
[05:28]
B
No. But that'll be a brilliant workbook. No doubt when it comes out. Really add to the variety of workbooks out there.
[05:37]
A
So. Awesome.
[05:38]
B
So I guess initially for those that don't know what ifs is or haven't heard our first episode, of course people can pause it. Go listen to that now. But just for ease, how would you describe IFS to anyone listening?
[05:54]
C
Yeah. So IFS is an approach that was developed clinically out of the practice of Dick Schwartz, where he. Who worked with eating disorders and started to notice that he heard his clients say, well, part of me wants to do this, get better, make good choices. This other part of me just doesn't want to. This other part of me wants to do that. And he started just listening to that language, and we all kind of use that language. I feel that way all the time. You know, part of me wants to keep working until I finish this chapter. And another part of me knows that, you know, people need me over here. So. So ifs is the idea that we are essentially multiplicity. It's not like wrong or bad or problematic to have parts. We are naturally that way. And that we all have a self as well. We have. It's not that we have to develop self over time. It's that when parts relax back, what naturally emerges is a state of clarity as an awareness, an ability to step back and be curious, really. And it's that curious, open, aware state of mind that Dick Schwartz calls self. It's not unlike, problematically, sort of what some Buddhist traditions would call no self, or, you know, DBT might call wise mind, or, you know, we have this concept in other traditions, but it's the you who's aware that you have parts. What's distinct about ifs versus other, like ego state and other. Other kinds of parts work is that as a family systems therapist, Schwartz really began to notice that our parts interact as if they're a family. You know, the same way that we do family therapy. We can work with our parts. And so it's not like they're little people running around in there. But it works better when we treat them that way, when we recognize these two parts kind of work together. And these two parts don't like each other, and this one tends to dominate. So we may need to ask that one to step back and. Or go into the waiting room a little bit while we get these other ones talking. So that's the general concept. And healing is really not about getting rid of parts. It's about accepting parts and helping them sort of let go of their more extreme positions. So it's about finding a balance. It's about being actually the self in the leadership role, the parent in the room, the CEO, the one who guides the parts, rather than parts leading.
[08:53]
B
Yeah, yeah. So you're taking the reins again, so to speak. And the parts are still at the round table, but you're the one leading the conversation.
[09:01]
C
Exactly.
[09:02]
A
Yeah. Okay.
[09:02]
C
Yeah. It's not unlike what we are looking for when People use mindfulness, right? It's decentering in mindfulness. In act, we might talk about diffusion from parts. We call it unblending in ifs. And so, yes, it's about putting that wise self in the lead.
[09:28]
A
Yeah.
[09:29]
B
Yeah, I like that. So I, I think I, I probably would have asked you this in our first episode. I didn't listen back because I don't like to hear my own voice too much. I have to listen to it each week when I listen back anyway.
[09:43]
A
But.
[09:46]
B
It'S a. Sorry if I have asked you this, but what led you down the path of ifs?
[09:52]
C
Well, I. It's been a 30 year stretch of being a clinician, so I've done lots of different things in those 30 years. I started out actually in a more psychodynamic program that was my. Where my master's and my doctoral work was all more depth psychology and Jung and psychoanalysis, which I never practiced, but it was a psychodynamic approach. And then I trained in family systems therapy when I actually got out into the work, because that's, that's the kind of internship I got. So family systems is really how I worked. For the first 15 years I worked with teens and families and then I switched over completely when my daughter had her sudden onset of OCD after strep infection. And our world's changed, so she got very severe very quickly and I watched her get better using erp. So I went, oh, wow, I want to do that. So I trained in ERP and I trained in actin. I trained in getting, you know, really treating OCD in a big, big way. But then sort of along in that process, I was introduced to Martha Sweezy, who has written tons of books on ifs. And she talked, started talking about parts and family systems and it's sort of this both depth approach and family systems approach. And I decided to take a training and it kind of brought everything together for me. I've also got like a 30 year meditation practice that I discovered in college and so forth. Like what I. My approach to things and the way I really do my therapy. What informs my therapy is mindfulness is that state of being open to whatever arises, right? So being present with and IFS really seem to call sort of lean on that as well. But then so does erp. And so here I am seeing my clients with OCD and I've got this, wait a minute, parts going on in my, you know, one part of my brain and I'm doing my exposures in the other part of my brain. And I just sort of naturally, I think when you start studying ifs, you just naturally start thinking in terms of parts. And when you're speaking with a client you're aware, like especially if they're particularly activated, I'm talking to their angry part, for instance, or I'm talking to a scared part, or I'm talking to a part with an agenda that just wants to figure out how to fix this. And so it's really intellectual. And I just began to naturally use my IFS training in the course of doing ERP and really found that where they're very much alike is the idea of exposure. If you zoom out and you take exposure as the healing principle in a lot of this and a lot of our different theories, actually. But if you think of it as turning towards the thing that you've been avoiding with openness and curiosity and a willingness to learn, that's exposure. It's also exactly what ifs is all about. We're turning towards parts, even dangerous, scary parts. Parts that are talking about suicide or parts that are binging, or parts that are criticizing and shaming inside. And we're turning towards those unblending from them and opening to them with curiosity and kind of saying, what are you, what are you doing? What are you trying to do here? What's your job? And the theory is parts are all trying to help in some way or another. It may have gotten very dysfunctional over the years, but at the root of it is a good intention. And so OCD just naturally lends itself to parts work. We're constantly talking about the bully in your brain, or our clients are saying, my brain is telling me this, but I know, I know I don't really have to do that. And so that's what ifs is. We speak four parts, you know, part, you know, even in a relationship, it might be, part of me is really angry with you right now, but I know you didn't mean to hurt me. Right. So that's an unblending. So just that that move became very natural. And so I decided to keep exploring. And I found that people responded really well to unblending and befriending their OCD parts. Yeah. As opposed to fighting them all the time. So that freed up a lot of energy. And so. And it be. And it also teaches a way to have self compassion that's a little more effective than just be self compassionate towards your.
[15:11]
A
Have.
[15:11]
C
Have self compassion. It's really hard to do, but ifs really teaches that skill in a very powerful way. So.
[15:20]
B
Okay. And Self compassion, sort of specifically targeting one part as opposed to giving your whole self kind of self compassion.
[15:29]
C
Right. So. And I think that's a really great distinction because sometimes when we look at ourselves as a whole, it's hard to be to, you know, people will say, I don't, I don't deserve compassion. Right. Because I do these things. And if you really can help someone, see, well, there's a part of you that does these things because it feels like it has to and you don't like it. So there's the you in there. Right. So even being able to turn towards the part that's doing something destructive, let's say it's a, you know, excessive hand washing or, you know, something in our field and just having some appreciation for. I get why you're doing that. You know, I get that you think it helps. I know you're working really hard and helping a person notice the criticism, notice the frustration with these other parts and unblend from those as well, can help us access what's naturally there. And it really does come up naturally. Like just spontaneously, you really do start to have compassion for parts of yourself who are working so hard to protect you in this really awful, counterproductive way. It just again and again never ceases to amaze me that you can have that compassion towards a part of you that's just doing the best it can with limited information.
[17:15]
B
Absolutely. And do you find with ifs, it's useful for, like, when people have blocks to doing erp? Because some people. But some people, some of my clients, for example, um, there's just this block. They can't do it for whatever reason. It's always various reasons, and sometimes you can try and motivate them and do other things, but it doesn't work because the block, the part in this case, is so strong. So, yeah, you were nodding a second ago. So. Yeah, what. What do you want to say?
[17:50]
C
Yeah, that was initially what I thought this was going to be all about. Initially I thought, well, ifs is going to be useful for treatment readiness, really. And it is. That's a huge piece of it. It ends up being useful all the way through treatment through ERP or icbt. It works really well with that as well. But initially I was focused very much on the parts that get in the way. There might be skeptical parts that have heard stories about erp, and I don't want to try that. There might be parts that are just really intimidated, scared. With ifs, what we are able to do is notice how that shows up I noticed you were able to do these exposures, but you don't want to do this one, so let's sit with that. So instead of trying to get rid of the block or the quote unquote resistance, let's get really curious about it. How does it show up? Like, how do you notice it? Do you feel it in your body? Is it more of a thought, kind of do that describing thing. That act does a lot, you know, like, how big is it? What color is it? You know, does it tingle? Does it. How would you identify it? I think with parts. Sometimes they take on these characteristics. Like, you know, it's just like a. It's like a bouncer, you know, in a club, or, you know, it's got, you know, you can kind of personify it a little bit. But mostly we're. We're doing that move where we're turning towards it, which allows us to step back and have a little perspective and. And really work with the part that's in the way. What's it trying to do for you? Okay. Does that make sense to you? Are you on board with the idea of not wanting to die? Well, yeah. Right. Okay, so let the part of, you know that you actually are on the same team. You don't want to die either, but you. You actually have a lot more information than that part of you does. Right? You have all these other parts. You have the big picture. So we're. We're trying to kind of set up an alignment with like a part that's blocking so that it can soften. And I use a lot of, like my. My previous teen therapy skills where, you know, the teenagers were always trying to. Battling their parents, right. And I would teach them the skill. Like, if you want them to listen to you, sometimes you have to hear them first. Sometimes you have to say, you know, Mom, I. I really understand why you're worried about this situation. You know, that guy just. You're right. Doesn't always make the best decisions. And this is all of these things. And I understand your concerns. I. I feel them too, but I think it's going to be fine for these reasons. Right? So I teach that skill, relationship skills. It's all about relational work, right? So we're doing the same thing inside with apart. Like, all right, bouncer guy. Like, I'm on board with the fact that this seems really disgusting and scary, and I. I don't want to put myself in a situation where I'm doing compulsions all night either, but would you let me make the call, rather Than just blocking it. You get to where you can negotiate with these parts of you, and they soften a little bit just by virtue of being heard. I found that that's helped. And I've heard other clinicians say clients who were stuck are getting better because they're willing to do the work, because the parts that are blocking get out of the way. So we're really bringing a relational element into the behavioral work and a whole set of new tools when we do that.
[22:06]
B
I agree. And I think. And I think whether therapists buy into ifs or not, I think there's something nice here about ifs, that it is helping people create a inner understanding of all their feelings and thoughts and emotions and a better relationship to that. Even if we don't believe in the parts, let's say. Yeah, yeah, yeah.
[22:32]
C
If you. Even if you want to think of it as just thoughts and feelings. Right. States of mind that recur, patterns of behavior. I mean, that's the same thing. It's how we. How we engage with the world and then what we do about it. You know, how do. Do we sweep it under the carpet, ignore it, do we battle with it? Or can we work more effectively with our moods when we acknowledge them and have some understanding and allow them to soften, so letting them sort of go through and out? Yeah, yeah.
[23:17]
B
And in ifs, correct me if I'm wrong, whereas some parts work in other therapies. You're talking about the parts and what's coming up in ifs. You're talking to the part as if it's an actual person, so to speak. Is that correct?
[23:34]
C
That's one way of working in ifs. Yeah, that's the insight work where people will speak to the part. And that can be very effective. But not everybody works that way. And so that's only one mode of working. What's really helpful, though, is when we allow people a moment to listen inside. So it's not necessarily talking to parts like they're little beings. At least the way a lot of clinicians work, a lot of ifs, therapists work. And certainly how I work, it's. If you pose the question, what is the message here? What is this doing for me? And you just listen instead of think. A different kind of answer comes. And then you can actually send a message to your system, like a public service announcement, like let that part know you're here. So we're. We're sort of exuding confidence. I think of it as security, attachment, security that allows parts to feel like they can do Scary things maybe not be safe because they have the security of a self in the room. Right. But we're communicating with our body all the time. When we're sending signals, you know, move, pick up this glass, we're sending messages. So it's really that kind of communication inside that we're doing okay.
[25:20]
B
Where you said about kind of don't think, it's the word can't just kind of listen was intuition came to my mind.
[25:30]
A
Yeah.
[25:30]
B
And I hesitate to say that because sometimes if OCD people get really stuck on this idea of I can't listen to my gut or intuition or. And interestingly, I did a podcast recently with Dr. Sam Greenblatt, and he was talking about relationship OCD, and he was using his own kind of journey as a. As a case study. Um, and he talked about having done IFS therapy for himself as the patient or client recently, and how that had fed into his understanding of his journey with relationship ocd. And, and he talks in that about. I think we talk about trusting your gut intuition.
[26:10]
A
And.
[26:10]
B
And he said in one of his first episodes with me years ago, he kind of said, you know, don't. Don't trust your gut. Don't listen to it. And he says, okay, I think I was wrong there now. And in some of the therapies I do like, I use Sam play with. With my kids and teens sometimes, not just with OST clients, with the different clients I see. But Sam play is very much intuition first, think second, and trust what comes up in the tray and process that.
[26:40]
A
And.
[26:41]
B
And obviously, CBT sometimes neglects that kind of, you know, think, think, act and all that's wonderful. But. So I don't know what I'm trying to say here. Just. Any reflections on that?
[26:54]
C
Yeah, I have a lot of thoughts about that. I think that if you want to think of intuition as what we're calling self, and the brilliance of being able to tell the difference between what I want and what OCD wants. So I have any number of clients now because of what I do. And one in particular who started with me, I don't know, 12, 15 years ago, and immediately went to residential, so did a lot of erp, has done IOP several times, has done like, top notch, excellent treatment, tms, all these kinds of things. And at a certain point, she'd moved away. She came back to me, she said, I. I've had OCD my whole life. I've had erp, like, my whole life. And so I've been taught to not listen to my thoughts and feelings. Oh, how do I know what I want or who I am or what? Like, I'm lost in my 30s. Don't know if I don't know what to do. So the brilliance of ifs is you begin to develop a sense for the sound of OCD thoughts in your head and the sound of, like, compulsive parts of you or the feel of them, so they become familiar. And you can then get in that space where intuition, there's more room for intuition because, you know, the quality of that thought, it sounds different in your head, doesn't it? Right. It has a more shrill kind of a tone, or it's more pressured, or it's more urgent, or your body posture changes when you're sort of in that OC part of you. And if you notice that and you listen to it, you can hear what it's saying. But you also then have more space for that intuition. Right. And you use that wonderful construction, I think, which is. Part of me says this, but I know that. And sometimes that's a really hard place to get to. But if you are, you know, with some work of identifying these parts, people have a lot more access to that intuition into the ability to say, well, there's all this noise going on, but I'm. I'm here, I'm doing that, or I feel this, or I'm aware. And so what this one particular client eventually said to me is, you know, she was really resistant to ifs at first. She's like, I don't buy it. The self stuff, these eight Cs. I. And she eventually said, you know, when you have access to yourself during exposures, it makes all the difference. And it really is true that we've got all these prompts during an exposure now. Like, I can notice, like, hey, did a. Did a part just come in? Yeah, I'm starting to get really intimidated about this. I'm starting to worry that. That, you know, I'm going to just compulso all night. Okay, so turn to that part, ask it to step back, and then we go back into the exposure. So we're unblending during an exposure, making the actual contact with what we're doing much, much deeper. So I think I veered off your topic of intuition a little bit, but it's that the more we identify parts, the more we are able to unblend and get them to step back, the more spaciousness people feel inside. And that's where their intuition of who I am and what's the why, where are the values in act when we talk about values, that's self. Like, I don't want to be stuck here because I can see this future. And learning to trust, that is an internal attachment relationship. Right. It's. It's security. It's like, so that's, you know, security, not safety. Right. We don't want safety seeking all the time, but we do want, you know, to be like. Like with space. We have parents be with their kids in a supportive way. It's kind of like teaching clients to be with their obsessive compulsive thoughts and feelings in that same way. Accepting, compassionate. I hear you. I see you jumping up and down over there, and I know we'll get through it, so we're gonna hang out and whatever. So I think. I think what you're saying is really right on. Being able to listen, being not afraid to listen, knowing there is a self in there is the huge shift.
[32:10]
A
Yeah.
[32:10]
B
I think two things come to my mind. I'm blanking on the first, so maybe I'll go to the second. Elena Fasan, who you may know in. She's in California.
[32:24]
A
Right.
[32:26]
B
She does space. I do space. Sounds like you do space. And when I was speaking with her, she was the one that pointed me on that she gets her clients that. The supportive language that we teach parents, she encourages the clients to use that on themselves when they're, you know, facing. And it made obvious sense, like when she said it. And now I do that with my clients. And the self talk of when that's. Those scared parts are coming up. We can get through this. We've got this. Let's just keep going. I know it's scary, but we're going to be okay. We can move forward, blah, blah, blah. That's sort of in a dialogue versus the dialogue of. We invest in these parts, we buy into them, and at that point it's game over. We're doing compulsions.
[33:05]
C
Right, Right.
[33:06]
B
Right. And then the.
[33:07]
C
The.
[33:08]
B
The. And almost came back to me there, my first point. Yeah. Well, I think something about. In terms of intuition, because again, I always hesitate to say it because I know when people are in the thick of it, they're so full of doubt. Right. And that's the doubting disorder.
[33:26]
A
And.
[33:28]
B
But I think if you can, as it sounds like what you're saying, like, really get to know that OCD part, you can start to know what it looks like, smells like, tastes like, feels like. So when it comes up, you can see it from a mile away. Yeah. And then enact, diffuse from it or unblend in.
[33:47]
C
Yeah, sometimes I'll do something around because, you know, as therapists, we're seeing the posture of our clients. You know, we're. We're noticing a lot of things that are visual that they may or may not be. But. But say that doubting part, that's fretting, that's worrying. That's what if. Ing. And when people are really blended with that, you. You can feel it, and they almost look different. Right. And so I'll have them, like, really notice that. Like, notice your posture right now. Notice your tone of voice. Like, kind of imagine this, like, character that you're in, this role that this part of you is in. Right. And if you were to put that character on a stage, like, who might play that one in a. In a play. Right. What would it look like in. On a. Outside of you? And really get curious about how we embody states of mind. You know, our feelings really are palpable, and they. They change us how we are. And so that way, it's. There's all these cues to when you're beginning to be taken over by that spiral or by that swirl of inner turmoil is you start to wring your hands. It's like, okay, there's that part. I see that part. Okay. I can. I might still get taken over by it. I might still, you know, really feel it strongly. But at least I'm aware that I'm here, too. And that's the first step, and that's the powerful step, and that. That creates the willingness to do treatment.
[35:36]
A
Yeah, yeah.
[35:38]
B
Now that you say it.
[35:40]
A
Yeah.
[35:41]
B
Because I see it in session as well, that when you see suddenly someone just start closing down, almost like a flower that's not been watered, you know, and it just collapses in. And then. And then you do various things, and suddenly the shift is completely different. They're sitting differently. They look more rel. Unburdened, which I know is an IFS term, but I'm not using it in that way. And it's just miraculous. And sometimes I can point out, say, you can shift back from this state, and you see them as if they're really triggered. They'll do this 10 times in a session where they'll keep dropping back in, and you try and pull them back out. Ifs will have a better explanation for that. But it's interesting. Yeah. You point that out.
[36:27]
C
Well, you know, we blend and unblend all day long. That's how we function. Right. So I have a part that organizes my thoughts well enough to speak to you right now. You know, that's a, that's a part of me. You know, it's, it's a functional part of me. And it, it's a different part than the one that talks to my cat. It's just a different aspect. It's a different state of mind. It's a. So, you know, we're constantly changing and it isn't, it's just a useful shorthand. Parts are just a useful shorthand for a state of mind that I can recognize that recurs, that has patterns. And when I can recognize that, I can more easily do something about it. You have to. You know, my, my little brother's baseball coach used to always say, you have to catch the ball before you can throw it. Right. So we have to be able to recognize these things before we can actually relate to them differently, which is what I think is key, which is the mindfulness piece and then be able to choose how we behave rather than be, you know, subject to the compulsions rather than the have to's and the can'ts. So that, that, that just ability to notice and you know, one could argue it is very much like mindfulness based cbt. It does it, but it's a little different in that we begin to notice some of these parts. Like this part will trigger that part so we can get into the inner dynamics of it a little bit more. And it's not just I be aware of my thoughts and feelings. I also listen to them because they have a lot of information. You know, it's not just a random obsession. It's something that's usually cued in around a theme. Right. And has some information. For me, it doesn't mean that it's narrative about that is true. Right. So yeah, it's just, it's, it's more, it's just bringing the relational into the behavioral is how I like to describe it.
[38:52]
B
Yeah, no, I fully agree. That's why, you know, off air, I was saying I'm interested in functional analytics, psychotherapy, because that brings the same thing relational into the behavioral. And, And I'm not. I'm interested in ifs. And at some point in the future I will get to it. Like I said, I have read your book and I need to reread it. But where am I going with that? Yeah, I think that's why you're seeing, you mentioned it off air that it's being well received, this idea of merging IFS with ERP and BAP and ERP was fairly well received whenever we've talked about it. I'm trying other relational therapies that we talk about in relation, but I think ERP therapists are open and looking for that more relational adjunct or adjuncts. The right word addition to erp. So how do you. For anyone wondering, both sort of sufferer or passive OCD and therapist, what. What do the sessions look like? Are you going through the normal sort of ERP protocol and then pausing for ifs when you see things coming up? Or are you setting up ifs, parts terms and all of that straight away? Like, how does. Yeah. How are you blending it?
[40:11]
C
Yeah, So I. It kind of depends why people come to me at this point. Sometimes they're coming to me wanting ifs for ocd. Usually I discover it's because they're avoiding exposure therapy.
[40:33]
A
Right.
[40:34]
C
And so because, you know, I'm a huge fan of ERP and I do ERP and I'm, you know, an OCD therapist, what I. What I do in these cases is I say, fine, we'll do ifs, but I'm always infusing my parts, work with exposure principles of what happens if we welcome that feeling into the room. What is it I'm looking at? What are their parts avoiding? Like, what if we could get curious and go there? You know, so an IFS session might be. We start with, what do you notice? What's up right now, today? So we would identify the parts in the room, what part needs. We sort of get a contract for the session. What part needs your attention most? And it might be, I'm just aware of tracking everything in the room. Right. I've watched everything you've touched. I know exactly where I've been. And so there's this part of me that's tracking and keeping and scanning. So then we would turn our attention towards that part and get kind of curious. What do you notice about it? How do you feel it? How do you know it's active? Do you hear a voice in your head? Do you have a feeling in your body? And we go through a little version of what IFS calls the six Fs, where we find it, focus on it, kind of flesh it out. And then there's this befriending thing, which you have to be a little careful about, honestly, because we're not. We don't want to interview the part and get into its content or entangled in what it's saying at all. But we want to generally get a gist for what is. What do you suppose it's doing for you? It's trying to protect me. Okay, why do you suppose it's doing that? It doesn't want me to die. Whatever, you know, like. Like you get a sense for. Okay, there's a good motive here. So that's a befriending move like I was talking about earlier. And then what if. Then what we do is we try and sort of imagine if that part could soften back for a minute and let you decide where you put your eyes. Would you be willing to try that? And so what I'm doing is an exposure in parts language. So I'm. Let's do a little experiment here. The scanning part could maybe walk out and go into the waiting room for a second. And it's weird, but they do that. It's like if it could trust you for a second and settle down and. And it's a little disarming. So oftentimes parts will just do that. And then we do an experiment. What if, you know, I'm going to get up and walk around and you don't watch where I go or, you know, like, we'll do whatever the exposure is and notice the feelings that come up when the protective part isn't there. So in my mind, that's what oc what ifs would call an exile. An exile is just whatever we're trying to exile. I don't want that, so I don't want to feel it. So I'm pushing it out. And so it might be uncertainty, it might be contamination, disgust, it might be shame, it might be, I'm not enough, I'm not perfect. It might be whatever the feeling is, we begin to sit with that. So that's sort of a more ifs. That's what I call ifs infused with exposure principles. Other people come to me with OCD and they need exposure work, but because I do ifs, I can't just do. I can't not think. In parts. We might be doing in vivo exposures. We might be touching the classic doorknob. And I'm asking, well, what are you noticing inside as you touch that? What else are you noticing? I'm identifying parts. There's this critical part that's telling you you're doing it wrong because you don't have your whole hand on there. We're addressing that part and getting that to soften. Sometimes I'm doing ERP infused with parts work and helping person unblend and unblend as they do an exposure. Sometimes I'm doing more what looks like an IFS therapy session with always with turning towards and, you know, trying something new would that part of you be willing to try something new right now. So it really does vary depending on the person. And it's a beautiful thing to have at your disposal if you have somebody who also has trauma, because you're able to work with both at the same time because you're working with the parts that are organized around feelings that came on board during trauma. So that's another whole episode maybe. But you can work with other. It's trans diagnostic. So we can really work with people who also have substance. Substance use issues. We can, you know, we. Gaming addictions. It works really well because we're identifying the characters that are involved in different behaviors kind of as an extended family.
[46:19]
B
Yeah, absolutely. That was a really good, good rundown. And you really illustrated how you integrate it into ERP.
[46:30]
A
Blanking again. Now, what was it?
[46:35]
B
Yeah. Do you find that using this sort of parts language allows some people to feel that, oh, I'm not broken, it's just a part of me that is hyperactive, you know, overprotective, versus some people buy into this narrative of I'm sick, I'm broken, I'm weak, I'm.
[46:56]
C
Yeah, it's really helpful for that. And that is something that. The shame of OCD is something that we need to talk about more. I'm actually going to speak about that a little bit at the OCD SoCal conference in November because, yes, it's not me. I'm not pathetic because I can't do these things that everybody else can.
[47:28]
A
Right.
[47:28]
C
There are parts of me that are basically overprotective. And you know, you can really identify the critical parts. Right. Parts that are, you know, have internalized this shame and blame kind of narrative and then parts that just feel shameful. And in ocd, of course, that's huge because so many people are experiencing intrusive thoughts that are just disturbing and awful. And they, you know, how many times have we all heard, I'm, I'm a monster. I just, I don't know if I even deserve to be in therapy with you. Right. So really doing a lot of psychoed around first parts is hugely destigmatizing. Um, even, you know, suicidal parts. Right. It's so powerful to say, well, there's a part of you that's really trying to help. And they, they're like, what? Yeah, it's trying to get you out of here. Like, this is a really awful situation you're in. There's a part that has a solution, but it's a really extreme solution. So maybe we could try some Other things, you know, to, to be able to accept even. There's the saying in ifs no bad parts. So even self destructive parts, even compulsive parts that won't stop can be viewed as functional. They're there trying to do something. Maybe if you do it instead, we could find another way. Right. Maybe if you get present, we can help them, you know, relax. So yeah, it's very, very helpful for destigmatizing and to recognize you do know who you are. You don't have to walk around saying, maybe I'm a pedophile, maybe I'm not. It's like, you know, you're not a pedophile. Right. But there's a part of you that gets really loud about what if? And can you feel the difference? If you can learn to feel the difference, huge relief. I mean that is unburdening in and of itself self. And so, you know, it's in those cases, I think sometimes life changing. Yeah. In fact, life saving. Actually. The client I was alluding to earlier that was resistant to ifs and had nothing but erp, but she's like, there's a, there's a person here that's worth saving, you know, and, and that's, you know, it, it's really, really powerful and really healing. And on the totally other end of the spectrum, I'm also now seeing clients who have done ERP and OCD is better. Right. So. And they still have relationship issues that they want to talk about and they're afraid to go to a non ERP therapist or non OCD specialist because they know those therapists can actually really trigger OCD again. Right. So those people are coming to me for ifs, which is really helpful because we can now look at parts and we can work with what do you want in your relationship without triggering relationship ocd. So there's that aspect as well.
[50:59]
B
Yeah, I like that. And I guess thinking from like an act lens of diffusion and self as observer and getting distance and all of that, then, then talking really strongly in these, in this part language is like, yes. There's a part of me that worries about being a serial killer in seeing as a part. Is that noticing and naming an act, it's that distance diffusion, it's.
[51:25]
C
Yeah, yeah, yeah, very exactly. It's like in my mind I've got all my inventories that I do and I've rewarded them in parts language instead of. I worry about such and so part of me worries about such and so. I mean, it's just, it's a Very powerful shift. Yeah, yeah. And lots of overlap with ACT and lots of differences, you know, and it's also, you know, it just in all the different ways, including ICBT that people work with ocd, you, you can do all of it in parts language. So it's not, you know, it's, you know, you can look at the, the part that's engaged in obsessional doubts, you know, and those, the storytelling parts. That's a big part of what we do. It's like, because you also want to talk about the brain based part of OCD and that you've got this sticky brain circuit and that's real. We don't change neurobiology, but we can change how parts respond to it and then diffuse it over time. If you have a part that's really highly valuing this anxious signal and you can teach that part to not give it so much attention and not to trigger these other parts. Because I do think like obsessional parts kind of recruit these. You know, you sort of get your family to communicate differently inside. It unhooks from the reinforcement cycle.
[53:09]
B
Yeah. Because I imagine if there's this obsessional compulsive part that is terrified and it's going to be like all alarms are going off. It will naturally recruit other parts because they're going to buy into the urgency of this alarm signal. Yeah, yeah, yeah. Okay.
[53:28]
C
That's where it differs a little from ACT in that there's more mapping parts, more externalizing them as a way of relating to them and noticing this one recruits that one. So when that's happening, we can also want to disarm that. But it's all very experientially done rather than just talking about it. But identifying it is sometimes I think it's a big thing that people relate to with IFS and are appreciative of is is it helps them identify things, what's going on easier so that they can get centered and come from choice. Yeah, yeah.
[54:16]
B
I like that we're near the end of time. Someone else. Is there anything else you want to get in today on IFS and OCD and erp? No.
[54:28]
C
Other than just to say how much I appreciate people like you, you know, inviting the conversation and, you know, allowing space to bring other, you know, bringing creativity into the. Into what we do. Because that's why I think AI is not going to take over therapists because, you know, we can, we're curious and we evolve and we have these other things that we bring and it's not going to be for everybody. But for the people that, that are needing something more, it's a really valid and really healing way to go. And so I just appreciate you being willing to talk and spread the word a little bit and, and to hear about other people who are doing some similar things. Like, like I can't remember who you mentioned earlier who had done IFS therapy.
[55:27]
B
Dr. Sam Greenblatt.
[55:29]
C
Greenblatt. That's what I thought. You know, it's just like, it's, it's out there. People are, people are hearing it and I'm just really grateful. So. And then I do think the OCD SoCal conference is going to be recording it. If people hear this and it's already kind of happened to reach out there, there's probably going to be some way to access some of those recordings and if not, sign up because we're constantly doing new things.
[55:58]
B
Absolutely. I'll put a link in the show notes and they'll be able to find hopefully some conference content there. But yeah, no, thank you. Thank you for being open minded and exploring. And I just like therapy as a special interest of mine. So it's always nice to hear different perspectives, um, and how I can help my clients better. Uh, so, yeah, thank you. Thank you again.
[56:26]
C
Thank you so much. Take care.
[56:28]
A
Thank you for listening to this week's podcast and thank you to our Patreons who helped make this episode possible.
[56:33]
B
And if you would like to find.
[56:35]
A
Out more about Patreon and the rewards.
[56:37]
B
And benefits, then there will be a.
[56:39]
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 until we speak. Take care.
[57:13]
C
Sam.

Melissa Mose: Integrating IFS and ERP for OCD (#511)

Melissa Mose: Integrating IFS and ERP for OCD (#511)

The OCD Stories, Episode #511

Episode Overview

Key Discussion Points and Insights

1. Melissa’s Evolving Work and New Book

2. What is Internal Family Systems (IFS)?

3. How IFS and ERP Fit Together

4. Self-Compassion and Working with "Blocks"

5. The Practicalities of IFS in Therapy

6. Intuition, Doubt, and Differentiating OCD

7. Destigmatizing OCD: No Bad Parts

8. Integrating IFS Into ERP Sessions

9. Transdiagnostic and Relational Applications

10. Resonances with Other Therapies

Notable Quotes and Memorable Moments

Key Timestamps for Important Segments

Final Reflections

The OCD Stories, Episode #511

Episode Overview

Key Discussion Points and Insights

1. Melissa’s Evolving Work and New Book

2. What is Internal Family Systems (IFS)?

3. How IFS and ERP Fit Together

4. Self-Compassion and Working with "Blocks"

5. The Practicalities of IFS in Therapy

6. Intuition, Doubt, and Differentiating OCD

7. Destigmatizing OCD: No Bad Parts

8. Integrating IFS Into ERP Sessions

9. Transdiagnostic and Relational Applications

10. Resonances with Other Therapies

Notable Quotes and Memorable Moments

Key Timestamps for Important Segments

Final Reflections