← The OCD Whisperer Podcast with Kristina Orlova
The OCD Whisperer Podcast with Kristina Orlova
136. Rebuilding Trust in Yourself: OCD, Identity, and the ICBT Path to Healing
00:31:42
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- [00:00]
Christina Orlova
You.
- [00:03]
Podcast Host (Christina Orlova)
Hi, I'm Christina Orlova, host of the OCD Whisperer podcast. As someone who lives with ocd, I understand the struggles firsthand. If you're here, you're not alone. Before we start, grab your free OCD survival kit at www.corresults.com to help you take control. That's K O R results.com now let's dive into today's episode.
- [00:32]
Christina Orlova
Welcome to OCD Whisperer Podcast. Today's guest is Dr. Frederik Ardema, a clinical psychologist and co creator of Inference Based Cognitive behavioral therapy, or ICBT. It's an innovative approach to treating OCD, and with nearly three decades of experience, Dr. Adima has helped hundreds of patients and continues to redefine effective treatment for OCD through his groundbreaking research, clinical work, and global contributions to the field. Welcome to the show.
- [00:57]
Dr. Frederik Ardema
Thank you. Glad to be here.
- [00:59]
Christina Orlova
Absolutely. I am so glad that I got you because there are so many questions still for people out there about ICBT and what really is it? How does it really work? So with that, I'd love to jump into asking you my first question, which is I know that ICBT emphasizes the role of imagination in the formation of obsessions, and so I'd love to hear how does the imaginative process contribute to OCD symptoms? And how does ICBT address this aspect differently than the other traditional therapies like ERP or ACT or even metacognitive?
- [01:37]
Dr. Frederik Ardema
Yeah, okay. Yeah. ICBT does emphasize the role of the imagination. I think it's important to clarify what is meant by that. Exactly. Because it addresses imagination in a very specific way or exactly in a more global way. When we think about the imagination, we often think about images. Right. Or imagery. ICBT conceptualizes imagination more as a faculty of the imagination that operates in parallel to the faculty of perception. So it's not meant in a derisive way that the imagination is involved in ocd, like it's all in our imagination or you're making things up. The problem according to icbt, starts with imagination starting to override perception. So it no longer works in tandem. Faculty of the imagination doesn't work in tandem anymore with the faculty of perception. And when the imagination comes in, it usually does in the form of not just imagery, but possibilities where reasoning together with im, imagination starts to override what a person already knows. So usually it starts out with a distrust of the senses or a distrust of the self. The person typical example would be, I see the door is unlocked. I just locked it, but it may still be unlocked. That's where the Imagination right away starts to come in. The person dismisses what is seen, what is sensed, and then the imagination starts to override with all kinds of possibilities as to why this could be the case. There might be dust in the lock. Maybe the lock broke just while I was turning it. Maybe I have to open it up to see that it's still functioning correctly. Maybe I'm not remembering correctly where I locked it. That's the imagination in action in ocd. And that's what we try to correct in IGBT as well, where the imagination no longer operates on its own, unstattered from perception and the senses, but actually start working in tandem with perception again.
- [03:30]
Christina Orlova
So I know ICBD talks about a reasoning process and understanding that in OCD there's a faulty reasoning process. It's this obsessional doubt process. And I would love to hear from you kind of, how can you explain what is meant when we're talking about a reasoning process? Because I know that out there in the world, people get a little confused about what that really, what are we addressing, what are we studying? How, what, what is reason? So if you can talk a little bit about, that'll be great.
- [03:58]
Dr. Frederik Ardema
So ICBT starts with a central premise, first of all, that an obsession is more like a conclusion or a premise or an idea that a person has arrived at through reasoning. It doesn't come out of nowhere. It's not like just an intrusive thought that pops into your mind, can feel like that often. But it's really an obsessional doubt, more a conclusion that a person has arrived at. If it's a conclusion, then usually there are reasons behind it, meaning the person has reasoned their way there. People have justifications why this could be or might be true. It's not a certainty. That's why it's a doubt. Right? Obsessional doubt. The person thinks it might be true or it could be true, and that in an abstract way that's often correct. We have possibilities. A lot of things are possible. Not everything's possible, but a lot of things are possible. So in the abstract, OCD is not incorrect. What is incorrect in OCD is that the person with OCD treats these abstract possibilities as probabilities that are somehow relevant to the error. Now, that shift from an abstract possibility to just to a probability. Something that the person thinks could be or might be relevant, that's done by reasoning and by imagination. And that's the process that IGBT specifically tries to address, tries to bring the person back to realizing you're dealing with an asterisk possibility has no relevance to you. Whatever the thought may be, I might be this person, I might be bad person, I might be terrible person, I might be contaminated, I may not have done something correctly or good enough in your stride ocd, the person arrives through that. But the mistake they're making in those moments is that these possibilities are not really relevant to the era. Now they're actually treating them as probabilities, not in terms of the likelihood. Obviously. It's not about exaggeration of threat or anything like that. It's about actually considering them relevant to the era. Now it's obsessional reasoning and imagination that makes them appear to be relevant to the here and now.
- [05:57]
Christina Orlova
So it's interesting, as you're talking, a question comes up because I do hear this and through just again, my own clients and in general people posing these questions, which is because what you said stands out. How is it can ICBT be used with erp? Because people, I think that if you're doing exposure response prevention, you're also understanding kind of the cognitive distortions, typically, as it's called, that you might have some thinking that's really negatively biased where you're either catastrophizing something or you're minimizing something. So how would you say ICBT really separates itself or is really different than erp, or where you wouldn't even have to do an exposure?
- [06:41]
Dr. Frederik Ardema
There are two different things you're bringing up there. On the one hand is that cognitive distortions that we see in anxiety, catastrophe or all or nothing thinking, maybe in depression, all those processes are important in a lot of different conditions. With ocd, we are focused on a different process. We focused on specific reasoning and imaginative distortions that make the obsessional doubts seem real. And we can go deeper into that. But that's the principal thing of how IGBT differs from other cognitive approaches. ICBT in itself is a cognitive first approach. So we have cognition always at the front end of treatment. You start with cognition until the person actually sees. Yeah, there's no reality to this doubt to start with. I don't even need to worry about that. But erp, they do any cognitive work at the back end of the therapy. You first put them into a situation or you put people in a situation. It's an approach based on fear confrontation. Right. That's what ERP is, is an anxiety centric approach that says, okay, you're going to confront your fears, you're going to face your fears and then something will happen, that your symptoms will diminish as A result of that, either through habituation or experiential learning, inhibitory learning, people talk about more these days. With icbt, there's no fear confrontation, because we first of all try make the point that if the obsessional doubt is not true, incorrect, then there is nothing to fear. So we have some exercises, some behavioral exercises at the end of icbt. But again, it's not in order to expose yourself to experience anxiety or anything like that. It's to actually go into that obsessional situation without any anxiety and without any doubt. So you're not creating a situation in order to expose yourself to anxiety. Actually, you're actually going to go situation. And that's all the way at the end of treatment. And with not experiencing doubt to begin with, through staying with reality. That's not reassurance, that's staying with reality, as we all do when you don't have obsessional doubt.
- [08:43]
Christina Orlova
Well, because we're not obsessionally doubting or walking around like this all the time every day in all situations. So this kind of brings me to my second question, which is, can we talk a little bit about this kind of sense of self? Because I know that there's definitely a lot more focus on that in this model, which is, I've certainly not seen before about this whole self concept and how the self concept makes you susceptible to obsessional doubts, this whole identity construction, because there's who we think we are. And quite often we will hear from people with OCD that I feel like I miss who I used to be. I'm no longer that and almost overly focused on this other sense of self that's now developed from this OCD place, it seems, of distrusting yourself or thinking you're really incapable or, or that you're really close to being this kind of potentially horrible person who'll do whatever horrible thing you think it might be. And so how does this kind of identity construct? How is it involved in this therapeutic process? What are you trying to have people understand and resolve or learn through icbt?
- [09:46]
Dr. Frederik Ardema
Yeah. So OCD always will take you away from reality and that includes your authentic self. So it will always, in effect, OCD creates a false self and that's a theme or that's a characteristic of OCD that runs through every different form of ocd. It's very obvious, for example, when we looking at the unwanted thoughts. Right. So I might be this terrible person that could do awful things. But it's also in checking where there's often an underlying theme and differs from person to person. But it could be an underlying theme is like, what if I'm a person who's negligent? So that those sort of feared selves, as we call them, the self that we think we could be or might be, form the fruitful ground for obsessional doubts to. To occur. But in essence, the creator, that's the sphere itself, is in essence created exactly the same way as obsessional doubts, where the person comes up with reasons that take them away from reality. They go into the imagination about what they could be or might be, even though it's very far removed from reality. So in igbt, we're trying to bring people back to their real self, to who they actually are, to take some of that urgency that obsessional doubt has for people to take that away. Obsessional doubts are always about what is personal and significant. Right. It's almost like it's standard. You don't have obsessions about things you don't care about, otherwise you wouldn't have obsessions about. And OCD uses that in order to distort areas of life where you already have a vulnerability. You already maybe feel a little bit less confident. But it doesn't mean that the fear itself is real. It's still created by the same distortions.
- [11:23]
Christina Orlova
Is it fair to say that when examining or looking or to understand, like for anybody who's listening right now, and if they're trying to grasp this concept about, okay, where did. Where does the sense of self come from? Is it fair to say that some of these things might be because of insecurities and vulnerabilities from the way you grew up, or the culture you're in, or any other messaging or anything maybe that's happened to you before, where it created a little bit of that place, and then OCD uses that and really exaggerates and expands on it and kind of becomes a bigger trap.
- [11:52]
Dr. Frederik Ardema
Exactly. We all have our vulnerabilities, right. So there's nothing unique about that. But OCD exploits those vulnerabilities and actually, actually warps it in a way that it leads to obsessional doubt, but it can also lead to other problems. A person who has, who might fear being worthless might develop depression instead. Right. So it doesn't define OCD in that sense, and it doesn't cause OCD in that sense. But OCD can use these vulnerabilities that we all have in a way that it leads to obsessional doubts. Now, there are situations where a person's self may be more fragile than at other times. So the is individual variation here. For example, when A person becomes a parent for the first time, obviously they will feel like a little bit fragile about their identity as a parent, because it's new, doesn't mean that they automatically will develop OCD either. But if OCD hooks into that, again, these reasoning and imaginative distortions I mentioned earlier, if OCD hooks into that, yes, then it's going to attack exactly that area of life. You see it in the same way when OCD tends to develop at around. Usually the average age is adolescents. There's variation there. It can develop much earlier. The average age is adolescence. And probably not coincidence that the average age for OCD to develop there, because that's why we're still trying to figure out who we are, what our identity is. So it's a little bit more fragile and maybe have a little bit less confidence at that point of time. If the person is not vulnerable to developing ocd, okay, then that will take its course. If OCD hooks into that, yes, then obsessions can develop according to how LGBT conceptualizes ocd.
- [13:36]
Christina Orlova
So I have two questions that I know are just burning for people in general, because again, I hear these two things most commonly. One is, but what if something did happen in the past? Right? And I'm sure you hear this as well. But what if I did do something or my OCD fear did come true? Then I do have information I do have, like my senses or my experiences that it did happen. So how would ICBT address that?
- [14:04]
Dr. Frederik Ardema
It always comes down to the same distortion of misapplying previous experiences that may have really happened, or even facts and misapplying that to the here and now. That's what OCD does. It takes a particular experience and then puts it into the presence. If it's relevant to the here and now. It does the same thing with facts. We all, we all agree with the fact that accidents happen. It's a fact, right? And accidents may have happened to you in the past, but how is that relevant to the here and now when you're taking normal precautions to deal with life to start with? So again, it's the reasoning that OSD uses to take facts and previous experience out of context and then put them in here and now. You look at that, you start to see how these obsessional doubts are falsely constructed in the present. For example, real event OCD is sometimes talked about, which I think is a big misnomer misnomer, because there is not really anything like real event ocd, because OCD is never justified what happened in the past. It's characteristic of OCD to take these events that happened in the past, to infuse doubt into that, even into the past, and also to bring them in the present and make them relevant to the present in the here and now. So I think it's a term we're actually better off without.
- [15:18]
Christina Orlova
I see what you're saying. Yeah. So this is where, for example, where you'll start to doubt globally. Like doubting my memory or doubting what happened, or doubting, okay, because that happened then, then it's likely about or going to happen now or in the future. So I need to therefore do all of these, whatever things I'm doing, to quote unquote, self protect or try to make sure these things don't happen.
- [15:39]
Dr. Frederik Ardema
Exactly. It always, like I say, it always comes down to. You start out with a distrust of what is right in front of you. And you can. OCD is able to make something seem relevant and seem valid in the moment, even though reality in itself doesn't provide direct evidence or justification for the doubt. And OCD does that by bringing all these different reasons, maybe previous experiences, facts, but it can only do so by dismissing what's actually in front of you. And reality sensing, which is some of the exercises that are part of ICBT at the end, after you realize that these doubts are false conclusions to start with, allow you to actually go into reality again with trust and with ease, including self trust. And that's what ICBT ultimately strives for. That's not exposure, that's just living life as you're supposed to. I know the definition of exposure has been like stretched and I would say diluted over the past couple of years where anything is called exposure. But I think that's a mistake because if I go to the supermarket, I don't feel particularly exposed. I'm just going to the supermarket. So the term itself there is misused to call it exposure. It implies that you're confronting something. If you don't have ocd, you're not confronting anything. You just act from the fact there is nothing here to worry about.
- [16:59]
Christina Orlova
And that speaks to you like you were saying, right? If you're not having OCD in every single area of your life. So in these other areas, if you think about it like what are you doing there? You're just doing your life, whatever that is. And that's the distinction you're making is saying, wait a second, how can we get back to doing that? But with essentially the things that are your specific, let's say topic or theme or issue.
- [17:21]
Dr. Frederik Ardema
Correct? Yeah, no, it's A good point. Because OCD is extremely selective. So when we talk about reasoning and imaginative distortions, we're not talking about anything having to do with intelligence is the misapplication for it in very selective area of life. Most people with OCD have no. There's always an area of life and usually most areas of life where people with OCD have no obsessions. So they actually already agree with that. Something's in disarray when it comes to obsessional situations. And we actually try to harness that knowledge in therapy where the person sees, yeah, I do reason differently in other situations. I may have problems in this area of life, but not in another area at all where I reason differently. Can I not transplant that same reasoning that I use in situations where I have no obsessions into non obsessional situations? And that's something we encourage in treatment as well.
- [18:16]
Christina Orlova
Yeah, and so I was going to ask too, because I think this is such a big topic of folks with ocd, especially when it's been such a chronic long standing way that people have been thinking and acting and there really is a strong sense of distrust. And so how then would you say people can come back to that and really reengage? Because it does. And I often hear this too, that people feel a little bit at odds with this because it suddenly feels like you're missing something, right? If you've been doing a certain routine for so long and suddenly you don't have it, it just feels a little weird. And people often distrust that experience. And of course it's like it should be flipped, right? It's no, this is the thing you should be trusting. But here it is. It's like this one way that OCD tricks us. How? What would you say to anybody listening right now? How can they get that trust back?
- [19:07]
Dr. Frederik Ardema
I think first and foremost, IGBT is a therapy of realization, right? It's a therapy of insight. So by bringing insight into the process of how you arrive at obsessional doubts and how that process actually renders them false and insignificant and irrelevant, that's ultimately how we try to resolve ocd. But that doesn't happen automatically. That realization takes time to set in. And it's not just an intellectual realization either. It has to be lived in a way, it has to go deep and it does not happen overnight. And there are different techniques, most of them cognitive techniques that we use to get the person there, but it's not something that happens automatically. Now if at one point you're at the point where you say, okay, I see that this obsession Is not real. Yeah, there's still some work to be done at that point because you talked about that. I've done these compulsions for so long, it's hard to. It feels wrong not to do them. But that's the trick of the OCD as well. It always gives you the feeling like you're not doing enough. In effect, the easy way of doing things is doing things in a non OCD way. That's a little bit of a paradox there. It takes some time to get used to. I think we have to realize as well that compulsions are ultimately natural phenomena. Meaning what? I mean with that. Not in the obsessional sense that are natural, but when you or I have a doubt and we think that doubt is real, it's going to feel very unnatural not to act upon it. The whole key is, is this doubt justified or not? And that's what makes something obsessional or a compulsion or something else. But the idea that we feel an incredible urge to act on the basis of a doubt is entirely natural. Would be like saying to a parent who thinks that the child might be in danger to not act, if that's what the obsession is. Now let's say that's not an obsession. It's still the same urge you're going to feel. So it's important to be aware of that and also to have self compassion in that respect that it's not that easy to stop compulsions and not that easy to just say, okay, I'm going to stop doing it and that's the end of it. No, there's a little bit more involved because there's a real cognitive concern driving it to start with. And that needs to be addressed. And that is what OCD addresses. As opposed to saying this is an intrusive thought. It's a possibility that you need to accept and that you need to tolerate. Sure, a lot of things are possible, but it's not what IGBT teaches because possibility in itself does not cause ocd. A lot of things are possible. I would agree that a lot of things are possible, but that in itself doesn't create ocd. So what creates OCD then? Ocd. What creates OCD is by confusing them with something else, by elevating abstract possibilities into something that's relevant to the here and now.
- [21:54]
Christina Orlova
So as I'm listening, and I know as people are listening and trying to conceptualize and get this, because I certainly know when I was first learning icbt, at first I thought, oh yeah, I do this. And then I realized later, oh no, I Don't do this. Then I have ocd. And I've definitely will say I've strongly benefited from once I fully conceptualize this, at realizing and noticing exactly when I just start to go off into my head and start to create a lot of what if scenarios and start to run them through my mind. And then of course I'll remember something from some place before and things like that. And it's been really quite fascinating to see, see and experience it and feel that pull and start to learn how to dismiss that. Because you do come to this realization, okay, that's literally irrelevant. All that whole entire process is not relevant. And so one of the things that I've heard and I know has been discussed through ICBT specifically is really coming back to the state of this concept of functional certainty. And I think this is such an interesting and drastic difference, right, Because a lot of the other modalities is all around embrace uncertainty, entertain uncertainty, radical acceptance of uncertainty. But here this is a big bold statement to say, no, we actually want to come back to functional certainty. Can you speak a little bit about that?
- [23:12]
Dr. Frederik Ardema
They want to get back to natural trust, right? Natural trust, functional uncertainty. To how you trust reality in the here and now. Naturally. For example, when you cross the street, you look left, you look right, you don't see a car and you cross the street with trust. You don't start asking yourself, maybe I, maybe the light was flickering in my eye, so therefore there might be something that I didn't see. You don't say, oh, maybe a car is suddenly going to come by speeding around the corner and won't be able to jump aside, aside on time. These are all possibilities that go beyond what you actually see and they go beyond natural trust. OCD is no different. You trust yourself in many situations with OCD and views infuses doubt in situations where it does not belong. Let me give a metaphor, like what OCD does. OCD is like gives the illusion that you have augmented reality goggles, gives the illusion that you actually see more than there actually is. Sometimes it acts as a, of X ray vision that you know what is there microscopically and everything else. That's what OCD tries to tell you. It sort of layers this, it gives this layer of the imagination that it imposes upon reality and then you start to see reality through that layer of the imagination. OCD will tell you the opposite. It will actually see value seeing something that, that, that, that keeps you safe. It's the opposite. It's the opposite. It actually takes you further away from reality. And there's nothing to tolerate there. There's nothing to tolerate there. In terms of uncertainty. You don't have to tolerate OCD telling you that you cannot trust yourself in these situations, or you don't have to tolerate the fact that things are possible, are probable. Yeah, sure, maybe you have to tolerate possibilities, but I don't think the point is that. That is not really, according to igbt, what causes OCD to begin with? We all differ in our ability to tolerate uncertainties, but there's no particular evidence that's specifically relevant to people with ocd, and it doesn't cause OCD either. So therein can also not lie. The solution because of that, because it doesn't characterize ocd, but does appear to characterize ocd, is that they seem to misapply or transform these abstract possibilities into something entirely different, into something again, that makes it seem relevant to the era now, even though it's not. It's like a sleight of mind. Right. In the same way we have this metaphor that people often use. OCD is a magician. I myself, in the books, in the manual, we talk about OCD as a con artist, but OCD makes you believe there's something there. As a con artist, you, even though it makes you believe you're actually closer, getting closer to reality, when in fact you're only going deeper into the imagination and you're going deeper into doubt.
- [25:51]
Christina Orlova
Yeah. And then as you're doing it, the thing I hear from clients too, it's usually this internalization of, oh, I'm somehow being more responsible or I'm being more, I'm being more careful, I'm being more thoughtful. The rest of the people are just not as with it. But I am. And I just wish everybody else would really be more attuned but not noticing that hyper awareness, hyper vigilance sounds like. And from what I've certainly seen and learned is misapplied because you think you're being more responsible, but you're not really.
- [26:20]
Dr. Frederik Ardema
Yeah, it's easy to look at OCD and say, okay, I'm just being perfectionistic or I'm being over responsible or I want to be responsible. And to confuse those sort of traits with ogd, I, I don't think those traits are particularly relevant to ogd and it operates separately from it. And it's also not what drives ocd. It's sure people may differ in certain standards that they have, but personal standards in themselves don't explain why you're in the shower for three hours. There's something else going on there.
- [26:51]
Christina Orlova
Yeah. Okay, so we've talked about a lot of different things, and one thing when you said, like the metaphor of augmented reality leads me to my last question for you, which is in this current day and age, AI is at the front, front of everything, at the forefront with the rise of digital health platforms and everything else. Love to know how you see ICBT being adapted to maybe online or digitizing this therapy or. I know there's AI scientist bots and things like that that are getting built chatgpt. So I'd love to hear your thoughts.
- [27:23]
Dr. Frederik Ardema
Yeah, AI is obviously very interesting. It's a revolutionary development. I think it's hard to say at this point where it's going exactly. Will it replace the therapy, will replace therapists? I don't know. I have a difficult time seeing that. But I do think AI and all these things have a role in psychotherapy, including icbt. But I think we have to be careful or at least make sure that it enhances the methods rather than dilutes it. And we've seen that in online platforms for psychotherapy or apps for psychotherapy, it tends to dilute the models, it tends to dilute the therapy itself. In that respect, I'm a little bit skeptical. Apps generally lead to less engagement, not more. If a person has a mental health app on their phone and they have to choose between a notification of Facebook and a mental health app, then they usually choose Facebook. And we already have too many notifications as it is on our phones. So that's an example of where technology can dilute the original principles of a therapy.
- [28:32]
Christina Orlova
If a ChatGPT can be trained with ICBT because I know some folks have talked about also training AI for to do ERP well or acceptance commitment therapy, but if it can be prompted and trained to do I CBT well and properly and not reassurance, but really come back to ask, okay, it sounds like what you're saying right now sounds like an obsessional doubt. Can we go back and trace how did you arrive there? Do you think that would be helpful to. To have something like that in conjunction with a live therapist who.
- [29:00]
Dr. Frederik Ardema
Yeah, that's already ongoing, especially in the area of training therapists through, for example, you get a thousand sessions, you put together, you put them in a database and you can use those conversations between client and therapist as a training for therapists and for new therapists. So those things are already happening and are definitely going to happen. There's no doubt about that.
- [29:23]
Christina Orlova
Yeah, we're at a whole new frontier Absolutely. With all this stuff, that's everybody's question. How much is this going to replace or be an adjunct or. Because this thing can think so much faster and access and digest so much material that just human brains just can't do that.
- [29:41]
Dr. Frederik Ardema
Exactly. I mean, that's the processing power. I think the main thing to keep in mind is like, does it add to it? Does it have an additive effect rather than a dilutive effect? That would be the main thing I would keep my eyes on.
- [29:55]
Christina Orlova
Awesome. I thank you so much for coming on the show. And before we end, I do want to just give a shout out to folks. So resolving ocd. This is volume one and this is volume two. Two. It's available on Amazon. And these books. Don't be scared, people. What's beautiful is that there's a wealth of examples and the amount of examples really hit on such a big, vast array of all the different ways OCD manifests. So I think for anybody who really wants to jump in using ICBT and really understand and start working on their own, grab, grab one of these books. I will of course include all this in the show notes and absolutely check out ICBT online. There's so much information. You've been gracious with, the amount of worksheets and everything that you have available there that's completely free of charge for folks who really want to dive into this. And then of course there's a resource list of folks who have been trained in icbt. And I just want to thank you so much for coming on, for taking your time and talking about all the different aspects and yeah, I look forward to having this episode be out soon.
- [30:57]
Dr. Frederik Ardema
Thank you Christina. It was great to be here. Thank you for the questions and the opportunity to be here.
- [31:04]
Podcast Host (Christina Orlova)
Thanks for listening to the OCD Whisperer podcast. Remember, freedom from OCD is a journey and you're not alone. Visit www.coraresults.com to explore self help masterclasses like Sneaky Rituals with Jenna Overbaugh or ICBT Masterclass with Christine. Don't forget to grab your OCD CBT journal tracker and planner while you're there. If you found this episode helpful, please subscribe, share and leave a five star review to help others find the podcast. Together we can make a difference. Keep going and I'll see you in the next episode.