173. How long does OCD RECOVERY take? The 4 to 8 month roadmap EXPLAINED!

Summary

Podcast Summary: The OCD Whisperer Podcast with Kristina Orlova

Episode 173: "How long does OCD RECOVERY take? The 4 to 8 month roadmap EXPLAINED!"
Date: February 27, 2026
Guests:

• Host: Kristina Orlova
• Guest: Dr. Marisa Maza (licensed psychologist, ACT and ERP specialist)

---

Episode Overview

This episode, the fourth and final in a series on Acceptance and Commitment Therapy (ACT) for OCD, dives deep into two essential ACT processes: identifying values and taking committed action. Kristina and Dr. Maza unravel common OCD roadblocks (like perfectionism and rigidity), discuss practical strategies for clarifying values, and break down what a typical ACT-based OCD recovery roadmap looks like—including average therapy timelines.

The conversation is human, reflective, and hands-on, offering valuable insight for listeners curious about the lived experience of OCD recovery and how acceptance-based tools work in real life.

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Key Discussion Points

Defining Values vs. Goals in OCD Recovery

[Timestamps: 03:10–07:42]

• Values are direction, not destination:

  • "They're guiding principles that lead to living a more purposeful, meaningful life. They're less about specific behaviors and specific actions, and they're more about the quality in how you show up..." – Dr. Marisa Maza (03:10)
  • Example: Education as a value means lifelong learning, not a specific degree.

• OCD's rigidity vs. the flexibility of values:

  • "OCD likes to be very rigid and say things have to be done in a certain way, especially if perfectionism is on board." – Dr. Marisa Maza (05:16)

• Pitfalls: Perfectionism hijacking values

  • Focus on "good enough" rather than 100%
  • Gentle striving; investing balanced energy in life's 'baskets' (relationships, hobbies, work)

Clarifying and Applying Personal Values

[Timestamps: 07:42–11:44]

• Exercise: Name multiple ways to live a value

  • Kristina names ways to "contribute"—from sharing at social events to checking in with her husband. (08:00–08:34)
  • "There's more than one way you can show up in a loving way towards yourself as well as towards other people." – Dr. Marisa Maza (09:04)

• Questions to explore values:

  • "If you were to wake up tomorrow and... your OCD were gone, what would you be doing? ... Notice the quality of how you show up." – Dr. Marisa Maza (09:54)

• Self-reflection vs. compulsive rumination

  • Encourage "real self-reflection... Not that compulsive rumination" – Christina Orlova (11:03)

Committed Action in ACT: Taking Values into Real Life

[Timestamps: 13:05–18:17]

• Start small—itty bitty baby steps

  • "What's the first itty bitty baby thing you could do to take a step towards your value? I don't care how small it is..." – Dr. Marisa Maza (13:05)

• Example from Kristina:

  • Sending her husband a caring text as a mini-act of contribution (14:10)
  • Discussing potential blocks—fear of annoyance, overthinking consequences

• Doing with discomfort

  • "Committed action includes doing things with discomfort. It includes that willingness to do it anyway, even with the anxiety, even with the doubt." – Dr. Marisa Maza (16:44)
  • "Courage is fear walking." – Dr. Marisa Maza (17:14)

• "You don't have to be ready" mantra

  • "It's not like I have to be ready, then I can commit. It's more like I'm not ready and I'm still going to commit." – Dr. Marisa Maza (17:15)
  • Kristina: "The motivation may never come... but you can definitely do the thing." (17:25)

• Values as a “carrot” for exposures

  • Example: Facing contamination fears (touching doorknobs) connects to the value of seeing a granddaughter or holding a baby (18:17–19:30)

The Importance of Self-Compassion and Acceptance

[Timestamps: 22:42–26:39]

• Living with discomfort

  • "It gets easier with practice and with taking the anxiety along for the ride." – Dr. Marisa Maza (22:46)
  • "You learn that you're capable of doing hard things no matter how anxious you feel." – Dr. Marisa Maza (22:46)

• Failing is expected and normal

  • "You will fail. Like, as human beings, we all fail. It's a normal, natural part of being a human being." – Dr. Marisa Maza (25:00)

• Treat yourself with kindness after setbacks

  • "When we do mess up, when we do fail. ... That's a moment of suffering. ... We need extra love and kindness, not criticism." – Dr. Marisa Maza (26:18)

Putting It All Together: What Does ACT-Based OCD Therapy Look Like?

[Timestamps: 27:27–35:46]

• Six core ACT processes summarized:

  • Present Moment: “Can I be in the here and now?”
  • Values: “Can I be aware of what’s important to me?”
  • Committed Action: “Am I willing to engage in those behaviors?”
  • Self as Context: “There’s a part of me that’s bigger than any one of my experiences. I am not my OCD.” – Dr. Marisa Maza (28:03)
  • Cognitive Defusion: “Thoughts are faulty—not all accurate.”
  • Willingness: “Am I willing to accept obsessions and uncertainty, while living my life fully?”

• Therapy roadmap:

  • First 6–8 sessions (1–2 months):

    • Learning about OCD cycles, values exploration, identifying behaviors, practicing defusion, and examining compulsions’ functions (30:16)
    • Lots of experiential exercises and mini-exposures

  • Middle phase (next 2–6 months):

    • Practicing exposures in session and at home, shifting focus from controlling anxiety to living out values, building behavioral momentum

  • Markers for readiness to finish therapy:

    • "When they feel fairly confident that they can continue to go out there and have their experiences and live their life." – Dr. Marisa Maza (32:28)

• Timeframes:

  • Mild OCD: ~4 months (32:37)
  • Moderate: 4–8 months
  • Severe: 8–12+ months (depending on severity and between-session effort)
  • “ACT is like slow food... it takes a little longer, but when people understand why avoidance is a problem, they're more motivated for exposures.” – Dr. Marisa Maza (33:53)

Memorable Quotes & Moments

• On values and flexibility:
  "Our goal is to put energy into all of these baskets... It's a very gentle type of striving." – Dr. Marisa Maza (05:34)

• On readiness and motivation:
  "It's not like I have to be ready, then I can commit. It's more like I'm not ready and I'm still going to commit." – Dr. Marisa Maza (17:15)

  “The motivation may never come... but you can definitely do the thing.” – Kristina Orlova (17:25)

• On the purpose of discomfort:
  "Why bother doing really hard things unless it's really important to you?" – Dr. Marisa Maza (20:22)

• On the promise of ACT:
  "ACT isn’t a cure… but it does teach people how to have their experiences and live well with them." – Dr. Marisa Maza (35:30)

---

Timestamps for Core Segments

• Values clarification: 03:10–11:44
• Committed action: 13:05–20:22
• Therapy roadmap & recovery timeline: 27:27–35:46

---

Resources Mentioned

• Dr. Maza’s values cards: [choicetherapy.net under resources] (09:54)
• OCD Survival Kit: www.corresults.com
• Contact Dr. Marisa Maza: choicetherapy.net (36:13)

---

Closing Thoughts

Kristina and Dr. Maza’s conversation underscores that OCD recovery is deeply individual but absolutely possible. ACT focuses on changing your relationship with anxiety and uncertainty, not eliminating them. It’s about living well, taking small steps, and letting values—not OCD—steer your ship. The recovery roadmap is rarely linear, but progress builds as you practice self-compassion and keep moving toward what truly matters.

---

Transcript

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[Christina Orlova]

Welcome to OCD Whisper podcast. So welcome back, guys. This is our fourth and final episode in our ACT series with Dr. Marisa Maza. And she is back today where we are going to discuss values and committed action. And we're going to also talk about how to put the whole thing together, what to expect from therapy, what will it look like so that you will walk away with a better and clearer picture of all of this. Welcome back to the show, Dr. Marisa Maza.

[Dr. Marisa Maza]

Thank you. It's been a pleasure being here.

[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. Absolutely. I love that you said yes, and I really appreciate your time and expertise in talking about acceptance, movement therapy. I know there's been so much confusion how to apply it, but I'm really hoping that people, through listening to this, are getting a better grasp of this. So today, let's, let's dive right on in about values. Okay? So similarly, like before, I have three questions I'm going to ask you, and I'm going to just Dive right on in. So people with OCD often confuse values with goals, and I definitely want to hear your opinion on this. So I know people with OCD can also get stuck on rules and maybe even confused of values and rules of what I should be or how I should be living or what I should be doing. So I. How do you help someone clarify values? Kind of in an acceptance, community, therapy, Len. Or from that lens or in that way without turning this into, like, another thing that they might feel they have to do perfectly?

[Dr. Marisa Maza]

Yes, great question. And so let's start by defining values. So the way I view values is that they're guiding principles that lead to living a more purposeful, meaningful life. They're less about specific behaviors and specific actions, and they're more about the quality in how you show up towards yourself in your life, towards the people you love and care about. So it's not just about being a parent. It's about what type of a parent do you want to be. A loving, supportive parent. Right. It's not just about being a worker. It's about what type of a worker do you want to be. So things like courage, helpful, contributing. Right. So it's really about the quality of, like, how do you want to show up in moments? And values, it's more like a direction than it is a specific outcome. So, for example, it's like I want to head north.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

Versus saying, I'm going to New York. So values are a continuous process. We'll never get there a hundred percent. So, for example, if one of my values is education, I'll never be a hundred percent educated. I can always continue to learn.

[Christina Orlova]

Okay, okay. Because that was going to be my kind of question. Like, what would be an example? If, let's say, you know, a value is to be, I don't know, to contribute, you know, to the world by my OCD maybe gets in the way, perfectionism, morality, whatever. And so how would I apply that? Right. How would I use that and not make it a rule or not make it a goal, but make it, like you said, a guiding principle. So how would I do that?

[Dr. Marisa Maza]

Yes. And so the beautiful thing about values is that they're flexible, which is kind of the opposite of ocd.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

So OCD likes to be very rigid and say things have to be done in a. In a certain way, especially if perfectionism is on board. And it's not uncommon for perfectionism to hijack values and say you have to do it 110 or you have to do it the right way.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

So One, I think it's important to, to, to recognize if and when perfectionism is on board and get clear on, like, what is it saying and how does it impact how you show up in your life, how you do values, how you do your work, you know, how you do therapy. And one of the things I like to sort of encourage is a mindset of good enough, right? So if perfectionism comes in and says you have to live your values 110% of the time, that's not all bad, right? Like, it's encouraging you to do something important to you. It's. That's just that 100%, 110% of the time is not always realistic. It leads to burnout and there's all sorts of costs associated with that, right? So really what we're saying is good enough, we're not going to put too much energy into it or too little somewhere in the middle. So we're aiming for 60 to 70% of that type of energy towards this. And if we really zoom out, I like to think of it as like, we have lots of different baskets in our lives, right? We have like a relationships basket. We have our own personal hobbies basket. We have our work basket. We have perhaps a caretaking basket, right? And our goal is to put energy into all of these baskets, right? Which means we don't want to exert too much energy in anyone, sacrificing all of the others. So we're really. It's a very gentle type of striving. I don't even like the word striving. It's just a very gentle.

[Christina Orlova]

So like it. So like, if I have my example with being with contributing, right? Are you saying that like, then for me to pause and think about, okay, well what would that actually look like? Or what are the ways that. Or how I would like to do that so that it doesn't turn into, you know, some concrete hard thing because, you know. Exactly. OCD is going to want to grab it and say, oh, now this is a concrete thing you must do. And it makes it this fixated thing, which is the opposite of what we're wanting.

[Dr. Marisa Maza]

Right? So values. And the thing you're pointing out here is that there's a lot of different ways to that you can contribute. So name like five different ways you can contribute.

[Christina Orlova]

I love these on the spot.

[Dr. Marisa Maza]

Sorry.

[Christina Orlova]

Well, one way could be contributing by, let's say like if going to social things like sharing and bringing something to share with the group. Right. Another way could be like creating, which I do free content for education and continued, you know, awareness. Yes. Another might be, like, remembering that, you know, a way to contribute to, like, my husband's well being is like, check in with how has his day gone? And, and actually pause and really listen. Even if I'm tired.

[Dr. Marisa Maza]

Absolutely. So notice, like, none of these are. Are wrong or right, but these are just examples of how you can contribute in your life.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

And, and the reality is, like, sometimes we're going to be living certain values more than others, and that's okay. It's just a matter of noticing, like, hey, you know what?

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[Dr. Marisa Maza]

I really haven't asked my husband in a while, like, how he's doing. Like, maybe that's something I want to. I might want to put a little bit more energy into.

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Right.

[Dr. Marisa Maza]

But knowing that there's, there's, there's more than one way to live our values. There's more than one way you can educate yourself. There's more than one way you can show. You can show up in a loving way towards yourself as well as towards other people.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

So it allows for a more flexible array of behaviors to engage in instead of just one right way.

[Christina Orlova]

Yeah. So would you, like, if you're working with somebody or if somebody's listening right now, like, is that something that they could do is like, spend a little time to kind of first look at what are the things that seem important to them? And like, like you asked me, like, what are different ways that they could engage with that? Or what are different things that they would like to emulate or they maybe look up to from others? How would you go about it?

[Dr. Marisa Maza]

Absolutely. There's many different ways of exploring values. If you go to my website, choicetherapy.net under resources, I actually have values cards that you can go through and identify in a very concrete way. What are the things that give you a sense of meaning and purpose in your life? What. Or you could just sort of simply reflect on the following question, which is like, if you were to wake up tomorrow and let's just say some miracle happened and your OCD were gone, what would you be doing? What would be different in your life? What would you be focused on? What actions would you be taking? And then I'm going to ask you take it a step further and notice the quality of how you show up in, in those actions.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

Notice what's most important to you in terms of how you are in those moments as you're taking those actions. And oftentimes I hear things like present or connected. Engaged, Courageous.

[Christina Orlova]

Yeah, I love that those are such great questions to really pause and really truly ponder. Like, like a real self reflection moment. Not that compulsive rumination kind of badgering yourself, but really pause and, and kind of widen, widen your stance a little bit and re. Notice those things and, and kind of bring them back in to, well, really reconnect. That's really what I'm getting out of this, is really reconnect to yourself more deeply to those things. So you can actually be like, oh, yeah, this is what that's like. Or, oh yeah, that's what I like. Or this, like you said, I love it because I hear that too. Like, oh, I'm more present and more connected. Like, yeah, doesn't that light you up?

[Dr. Marisa Maza]

Right? And notice, like, I love how you said it. It's like in a, it's a very soft kind of way to speak to yourself. Right? It's. It, it doesn't have the harshness that sometimes perfectionism or inner critics can have, which is like, what's wrong with you? Why aren't you doing this? Why aren't you doing more of this? Right? But often most of us have values of like, love, kindness, being supportive. Right? And those values don't just apply to others, but they also apply to you.

[Christina Orlova]

Oh, a hundred percent. I, I think we're so good at forgetting ourselves while we're in the thick of it and gotta go, wait a second. Like, I also deserve this. I also have this. And if I may, this kind of, I think beautifully even leads to the next question. It's all related, but the question is like, okay, you're having these moments, you're reconnecting. Well, how do you then translate this into committed action? Right? Because people might feel maybe scared or not ready, or people can be anywhere on the spectrum of things. Right? Like, I'm gung ho, I'm all into. I'm not sure. Like, okay, I kind of have an idea of these things that are important for me, but, you know, I'm still feeling blocked. So what would committed action look like from the act perspective?

[Dr. Marisa Maza]

Sure. So, like, once you've brainstormed some of the ways in which you can live your values, it's really about like, what's the first itty bitty baby step you can take towards that value? Right? So if OCD is kind of telling you to go left and your values are to the right, what's the first itty bitty baby thing you could do to take a step towards the right? I don't care how small it is, just anything different than what OCD is saying.

[Christina Orlova]

So give us an example.

[Dr. Marisa Maza]

Yeah, so let's maybe stick with your example of contribution. Right? And so out of all of those examples you gave, which one of those do you feel most willing to do?

[Christina Orlova]

Let's say today, let's go with the husband.

[Dr. Marisa Maza]

Okay. So being a, a more kind of contributing partner. Right. And so what's one itty bitty step do you feel like you could take to be a more contributing partner?

[Christina Orlova]

First thing that comes to mind probably is like once there's a break, send a text. Not like asking for anything or going in with my stuff, but more like hey, like just thinking of you or checking in or you know, I hope your day's going okay or can't wait to see or something like that that can more just contribute again to his well being.

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[Christina Orlova]

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[Christina Orlova]

You know, like I check in about him, I'm Prioritizing him and not. And kind of just holding my stuff on the side.

[Dr. Marisa Maza]

Okay, beautiful. And so if I were to say, christina, let's bust out your phone and do it right now, what sorts of thoughts and feelings might show up that can possibly get in the way?

[Christina Orlova]

Well, right now I'd be okay, but, you know, if I'm thinking how I was before, I might be things like, oh, am I going to bother him? Is it going to be too much? Or am I going to interrupt his work? Or what if. Then he's gonna be, you know, annoyed or pissed? Or what if. Then he doesn't like me? Or what if we end up fighting? And then I can start to spiral out into 50,000, you know, irrelevant possibilities. But, you know, yeah, for sure.

[Dr. Marisa Maza]

For sure. And. And so committed action includes doing things with discomfort. Right. It includes that willingness to. To sort of do it anyway, even with the anxiety, even with the doubt. Bring it along for the ride. Right. I love. I love the saying, courage is fear walking.

[Christina Orlova]

Good one. Right.

[Dr. Marisa Maza]

And so it's not like I have to be ready, then I can commit. It's more like I'm not ready and I'm still going to commit.

[Christina Orlova]

I actually love that. I think that's so important. I'm sorry, I want to jump in, because that just lit me up. I think that's. That's such an important concept. It's like. It's like when people talk about, you know, get ready to be. To get motivated to do something. And it's like, look, man, the motivation may never come. Who knows? But you can definitely do the thing. And while doing the thing, you get to actually learn something. Something real is happening. And that in itself either can suddenly give you motivation or you suddenly have some new experience and awareness. Like, you actually get something real as an outcome from that than just sitting and waiting. So I love that you. You changed that. And you said, yeah, like, ready or not. That's not. That's actually not the first step. The first step is I'm gonna take. Take a step regardless.

[Dr. Marisa Maza]

Exactly, exactly. And we can kind of think of this during exposures in that, like, if. If we're doing it, let's say a contamination exposure, right. And maybe the goal is for the person to, like, touch the doorknob without washing their hands. Right. Like in session, I can kind of go at it with this idea of, like, you just need to touch that doorknob and not wash your hands.

[Christina Orlova]

Right.

[Dr. Marisa Maza]

Like, let's practice that. Let's practice over and over again of like, not, you know, touching the doorknob and not washing your hands. And that's the focus of the session. That's the focus of the ERP and that's one way to do it. And it's not that that can't or won't work. For some folks, it does, and that's wonderful. And for others, they need more of a carrot. They need a little bit more of a bigger purpose. Right. So touching that doorknob is what's going to get you closer to seeing your granddaughter. Right. Because you're gonna have to fly across the country and get on that dirty plane. Right. Or having that awful, scary thought. Right. Is what's going to help you be able to, like, hold your baby.

[Christina Orlova]

Oh, yeah, absolutely. I love your connection. I'm just thinking of somebody, too. I've been working with that, like, this feeling of, like, things don't feel right. Like, it just feels bad and often getting stuck, and it's like, well, if I let that feeling be and. And move on anyway, like, what do I. What's the. What's bigger than that? Right. Like you said, it's like, well, the. The bigger than that, it's like, oh, I get to go hang out with my friends. I get to actually be more present with them. I get to, like, have time with them instead of time spent on this feeling and trying to get this right feeling and the sense of completion. And I can, like, move on only after I do these things a certain way and realizing, you know what? I'm just gonna take that feel with me and. And, like, I'll go through this nasty, dirty swamp because on the other side, I get to go hang out with my friends. And that's way. But way more fun and way better.

[Dr. Marisa Maza]

Absolutely. Because why bother doing really hard things unless it's really important to you?

[Christina Orlova]

I mean, if you think about it, it's true, right? I mean, like, any person without ocd, like, people are. People are not going to sit there and be like, yeah, let me go do, like, whatever most difficult or uncomfortable scary thing. Why most. Most of us are not going to actively sit there and let me go feel uncomfortable. Right. Like, let me go do something that causes me some degree of pain and discomfort. Like, that's not our general, you know, way we operate. But when we have OCD brain, it's like, okay, we're getting signals happening internally that we have to kind of restructure a little bit, and. And then we start to have, you know, which I love that you're sharing that. Like, hey, you can get back into your life and connect.

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[Christina Orlova]

Something so much more meaningful. Of what is that thing, like these reps you're going to put in to feel that discomfort and distress? What is it getting you? Because it's getting you something really cool.

[Dr. Marisa Maza]

Absolutely.

[Christina Orlova]

And it gets easier with time, with

[Dr. Marisa Maza]

practice and with taking the anxiety along for the ride. Right. You learn that you're capable of doing hard things no matter how anxious you feel.

[Christina Orlova]

Yeah, a hundred percent.

[Dr. Marisa Maza]

And that, that's like the beauty I think of, of this work because I can tell my clients, you know, over and over again, you got this, you can do this. But really, it's not until they experience it in a connected way. They feel the feels, they embrace the uncertainty and still head in the direction of what matters to them. Until they do that, they don't know what they're truly capable of.

[Christina Orlova]

Yeah. Isn't amazing how we can get so confused and forget. Like, first of all, you've survived all your other hard moments of your life. Okay. So, like, you're here, you're still here. Like, outside of your anxiety, I guarantee you, you've had hard moments in other places. Right. So how did it. So you kind of already kind of did it. So. Yes, let's translate that skill here. You could do it like it's there. Right. But like you said, we, we. I think you know, we. We forget. Right. We stop believing ourselves.

[Dr. Marisa Maza]

Yeah. And our minds are programmed to, you know, hang on to the negatives. All the times we couldn't or had difficulty doing.

[Christina Orlova]

Oh, my God.

[Dr. Marisa Maza]

Right. And so that, you know, reinforces that message of, see, I can't. Right. I've been avoiding. Therefore. Therefore I can, of course, the couple

[Christina Orlova]

of times I made this mistake or the.

[Advertisement Voice]

The.

[Christina Orlova]

The handful of times I put my foot in my mouth, like, oh, that's it. Now I'm a permanent, you know, bad apple or whatever. It's like, no, you're human. And sometimes we put our foot in my mouth and you learn, hopefully, and not do it again.

[Dr. Marisa Maza]

Absolutely. And you're reminding us. Something I wanted to say earlier, which is like, you know, the main thought in perfectionism is that you're. You're gonna fail or be incompetent in some way, do it wrong. I think there is some certainty here in that you will fail. Like, as human beings, we all fail. It's a normal, natural part of being a human being.

[Christina Orlova]

Yes.

[Dr. Marisa Maza]

Right. So that is certain, right? Like, we will fail. We're. It's a normal part of being a human being. So let's get good at failing.

[Christina Orlova]

Yeah, yeah. Let's get good at having these experiences because they are also part of, like you said, natural, human, just experience. And, And I think, like, we gotta remember we're not some robots here. Like.

[Dr. Marisa Maza]

Right.

[Christina Orlova]

We learn a certain way, we experience things a certain way. Sometimes we need a moment to kind of think through something because it was maybe a little bit intense or we can't figure out what we feel about it. So that's just a human. The human condition, if you will.

[Dr. Marisa Maza]

Absolutely, absolutely. And I think being with this idea of, like, we will fail will help when you're trying to live those values and perfectionism is hijacking them. Right. Because we're not meant to live those values perfectly or a hundred percent all the time. We're meant to mess up and not be doing things a hundred percent of the time. And we. When we do mess up, when we do fail. Right. That's a moment of suffering. It's hard to not do the things that are important to you. And it's in those moments we need extra love and kindness, not criticism 100%.

[Christina Orlova]

I mean, I think humans are not that great at that. Right. Let's be honest. We are not. However, I think that's an important thing to be aware of, is that that is a tendency. But you can practice another way until that way becomes Kind of your new baseline.

[Dr. Marisa Maza]

Absolutely.

[Christina Orlova]

So I want to ask you from. From these conversations we're having, right. About these different pieces, because I want to kind of help. Help folks who are listening, right. We've talked about so many different kind of big concepts and specific ideas and strategies, but now let's bring it together. So here's the thing. If someone is starting ACT for ocd, so what would therapy typically look like? So I kind of want folks to kind of hear and understand. How would you put all this together? Like, what would. Like how many sessions on average would you say it takes? Again, average. Obviously, we know everybody's different, but on average, what would you say it looks like in the very beginning of treatment? What can they expect in the first BB handful of sessions? What would the middle look like? And how would you know, like, okay, we're successful. It's. It's time to end.

[Dr. Marisa Maza]

Absolutely. So before I give a layout of what it looks like in therapy, I'm just going to summarize the core processes in act. Right? And so it starts with, like, present moment. Can I be in the here and now values? Can I be aware of what's important to me? What gives me meaning and purpose? Committed action. Am I willing to really engage in the behaviors that give me meaning and purpose? Self as context. Am I able to sort of step back and recognize the observer in me and that I am. There's a part of me that's bigger than any one of my experiences. I am not my ocd. I'm so much more than that. Right. Diffusion. Recognizing that thoughts are faulty. Right. They're not all accurate. Even though it may feel real, the reality is our minds are faulty. And when we hook on to narratives that are unhelpful, it will produce more unhelpful behaviors. Right. And last but not least, willingness. Right. Which is kind of like I think of, like, Leonardo DiCaprio in the Titanic when he's got his, like, arms open at the end of the ship, right? Is like, am I willing to just accept experience, the obsessions, the uncertainty, the emotional discomfort that comes along with it, while trying to engage in these other flexible behaviors, living my life fully, right? And so what this can look like in therapy, and obviously, every therapist is different. And I'm, you know, I do integrate ERP and act, and so I. What I do is I spend the first probably six months to eight sessions hitting folks really hard with act. And so I like to focus a lot on building awareness around OCD cycles, getting really clear on what are the thoughts what are the emotions? What are the responses on a day to day basis? What are the person's values? Right. Getting really concrete. How would you define loving? How would you define courage? What would it look like in action? What were the behaviors in line with those values? Then we began to practice diffusion, naming the ocd, practicing different ways of stepping back and noticing it. Like as though, for example, noticing the thought, like passing you by on a cloud. Right. I also like to spend some time on really looking at the function of the compulsions. So in what ways have compulsions served you and in what ways have they not served you?

[Christina Orlova]

Right.

[Dr. Marisa Maza]

Oftentimes compulsions work in the short term. They either neutralize or give the person a sense of relief. But the problem is in the long term, uncertainty or anxiety shows up in one way or another. Right. So it doesn't solve the problem. And it takes time and attention away from their values. Right. So the more they're trying to control their experiences through compulsions, avoidance. Right. The, the less time they have to spend on those values. And so I like to get really clear on those kinds of things and do a lot of experiential exercises. So it's not just like a, oh, I get it conceptually, it's more like I have a felt sense of this. And so there's lots of wacky experiential exercises. I like to have my clients do that, feel uncomfortable, and I consider them mini exposures. And, and then, you know, we brainstorm together. What are all the ways we can practice having uncertainty and emotional discomfort in your life when your triggers show up? And so once we have a nice list of all the different ways we can practice this, I'll ask them, where are you willing to begin and how can we practice this together? And we do like, I like to practice exposures with my clients in session, modeling the behaviors for them. And then with time and practice, they go out there and do it, do it on their own. And you know, over time I check in with how things are going in terms of symptoms, but also just in terms of behaviors. Are they doing more of the things that are important to them? Are they spending less time on ocd, more time on values and committed action? And really it's a collaboration in terms of when therapy is done, like when they feel fairly confident that they can continue to go out there and have their experience, experiences and live their life. That's for me, is a great time for them to graduate on.

[Christina Orlova]

I love that. And again, I know everybody's different, but on average, what would you say like four months, six months.

[Dr. Marisa Maza]

Honestly, Christine, I think it's highly dependent on the severity of the ocd. So I think with someone with like a mild type of OCD coming to see me like once a week, you know, maybe like four. Four is months, right? Moderate. Anywhere between like four and let's say eight more severe. It could be eight months to a year, really, depending on, you know, how motivated are, how much work they're doing in between sessions. I like to think of, act as kind of like slow food, if you will. The slow food movement in that it, it's like it does. I do, I feel like I do take a little bit more time to get to some of maybe the traditional ERP exposures. But what I notice is when I do take my time to make sure folks really understand why control and avoidance is a problem later on. We don't run into as many motivational issues and struggles when we're actually doing exposures. And, and when I know what their carrot is. Right. Like when I know and have a strong sense of like, what's important to them. Again, like, I think that helps with that motivation later down. Down the road.

[Christina Orlova]

Yeah, I mean, that sounds really awesome, right? Like you're building a really solid foundation on the front end and that way you can get into kind of the, the midst of it, the meat of the work of, of. Okay, now let's actually like, like you said, make a plan for what are all the things that activate that I'm willing to work on. And then clearly they have, you know, autonomy to say, okay, I want to start here and then you go practice. And you're totally right. I mean, it does depend on kind of how intense it's experienced. It could be shorter, it could be longer that you're in therapy. So, you know, folks, listening, you know, this is not. Again, these are not hard and fast rules like Dr. Maza said. These are more just kind of ways it can look. There are a lot of variables partially as, you know, how much are you putting in between sessions and Right. How much you're practicing or not. And. But I think generally it's just something good to consider that this approach is going to be a little different and there's a little more kind of robustness in the different things that you're bringing to this, especially when you're front loading it with that, so that you're already getting some great skills of observing and naming and, you know, diffusing a bit. Um, so I just want to say thank you so much for kind of sharing that, you know, layout, if you will, of, of a rough, roughly kind of what it can look like. And like you said, of course every therapist is different. They'll do it a little differently. But you know, this is going to be like everything, right. Case by case, person by person. And you get to learn together how you're going to go and what's your speed and how are you learning, how are you practicing?

[Dr. Marisa Maza]

Absolutely, absolutely. And you know, act isn't, it's not a cure. Right. It won't necessarily make all the thoughts and the feelings go away, but it does teach people how to have their experiences and live well with them.

[Christina Orlova]

I love that. I think that's such an important point and I don't even want to say anything else. I want folks to be left with that because I think that's, that's crucial, frankly. It's, it's not like you're not going to have discomfort, but you, you learn to change how you look at it. Yeah.

[Dr. Marisa Maza]

Your relationship with it.

[Christina Orlova]

Yeah.

[Dr. Marisa Maza]

Yeah.

[Christina Orlova]

Love that. Thank you so much for coming on the show, for giving us your time, sharing your expertise and how can people find you if they'd like to find you?

[Dr. Marisa Maza]

Absolutely. It's such a pleasure to chat with you, Christina. And folks can find me at my website, choicetherapy.net.

[Christina Orlova]

thanks for coming on the show.

[Dr. Marisa Maza]

Foreign

[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 Christina Inabe. Don't forget to grab your OCD CBT journal, training 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.