Podcast Summary

Podcast: What Your Therapist Thinks

Episode: Are My Intrusive Thoughts "Normal" Or Do I Have OCD?
Hosts: Felicia Keller Boyle & Kristie Plantinga
Guest: Katherine Wood (multicertified, licensed therapist specializing in anxiety, OCD, and PTSD; also a musician)
Release Date: October 1, 2025

Episode Overview

This episode delves deeply into the concepts of intrusive thoughts and Obsessive Compulsive Disorder (OCD)—two often misunderstood mental health topics that are frequently conflated in pop culture and online forums. Hosts Felicia and Kristie, alongside therapist Katherine Wood, clarify the differences between normal intrusive thoughts and clinical OCD, debunk common misconceptions, and respond to real-life questions sourced from Reddit’s OCD community.

The conversation is candid and compassionate, offering expert explanations, relatable examples, and practical guidance for those living with OCD or supporting someone who is. Thoughtful Reddit posts serve as springboards to further discussion, and the episode concludes with hope, humor, and expert validation.

Key Discussion Points & Insights

1. Defining OCD: What It Is—and What It Isn’t

[02:06–06:13]

• OCD (Obsessive Compulsive Disorder) is a serious mental health condition, not simply a desire for order or cleanliness.
• Katherine explains:

  "OCD itself is when those habits, needs, or preferences start to really affect how you live your life... The difference is, if you cannot have a spot on the floor, you will not leave your house on time for an appointment... those thoughts are so repetitive. There comes the intrusive thought piece that you kind of hook into." (03:03)

• It manifests in diverse ways, not always cleanliness—can be perfectionism, checking behaviors, mental rituals, etc.
• Compulsions (repetitive acts done to neutralize anxiety) may be physical or entirely internal (mental checking, reassurance seeking).
• People's experiences of OCD are unique:

  "No two people's obsessive thoughts or compulsions are going to be exactly the same." (05:12)

2. OCD Themes & ‘Magical Thinking’

[06:13–09:55]

• OCD often targets what individuals value most (relationships, morality, harm, etc.).
• “Magical thinking” OCD: belief that specific actions can prevent catastrophic events.
• Common intrusive themes include harm, pedophilia, religious fears, and morality—even when unwanted and inconsistent with one's values.
• Katherine notes:

  "OCD preys oftentimes when the things you value most or care about the most." (06:13)

• Hoarding, trichotillomania (hair-pulling), dermatillomania (skin-picking), and similar compulsive behaviors are now classified under the OCD spectrum.

3. Diagnosis and Recognizing OCD

[09:55–12:58]

• Excessive research and reassurance seeking can themselves be compulsions.
• Katherine recommends starting with trusted resources:
  • International OCD Foundation
  • TreatMyOCD.com (provides clinically sound free screeners)
• Symptoms can be situational—e.g., postpartum OCD, trauma-induced patterns.
• Important to discern if symptoms are chronic, severe, or situational.

"Curiosity is where it goes. Then as you read things or take some screeners... then it’s time for you to start working with a professional..." (11:01)

4. Impulsive vs. Intrusive Thoughts

[14:07–17:50]

• Impulsive thoughts: fleeting, random, not distressing ("What if I jumped...?" and never thought again).
• Intrusive thoughts: repetitive, distressing, unwanted, disrupt daily focus; trigger compulsions.
• Example:
  • Impulsive: "What if I crashed my car?" [moves on]
  • Intrusive: "What if I crash my car? Does this mean I want to die? I can’t drive anymore..."

"Intrusive thoughts are repetitive, excessive. They’re not willed to exist. No one’s saying, I think a relationship. OCD is a really tricky one." (14:49)

5. The Emotional Core of OCD

[17:53–21:16]

• Core component: not trusting oneself, overwhelming fear of being ‘bad’ or unsafe.
• Treatment involves exploring these core beliefs before exposure work:

  "Almost always... I start... peeling the layers of how the OCD is presenting. What’s the core drive?" (19:29)

• Healing often requires addressing underlying trauma or developmental experiences.

6. Children, Stigma, and Isolation

[21:16–24:45]

• OCD can manifest in early childhood; children may self-stigmatize or not be able to express their worries.
• Reassurance from adults (e.g., "You're fine") is usually unhelpful and can reinforce the cycle.
• Compulsive reassurance-seeking gives a brief dopamine hit but worsens the cycle.

"Reassurance is kind of one of the worst things people with OCD can receive from others." (23:49)

7. OCD and the Dopamine Cycle

[25:29–28:42]

• Compulsions (checking, skin-picking, mental rituals) are reinforced like process addictions.
• OCD shares features with other behavioral cycles (addiction, eating disorders).
• Most humans experience mild, transient versions but the disorder is defined by intensity and dysfunction.

8. The Value of Therapy and Finding the Right Therapist

[28:45–33:22]

• Therapy provides a non-judgmental, expert space where nothing is ‘too weird’—clinicians have ‘seen it all.’

"Your therapist has heard it all." (28:45)

• Finding an OCD specialist is crucial due to common clinical misunderstanding.
• Be willing to leave a therapist who isn’t a fit.

"It’s your time, it’s your money. You are the customer. It should be working for you." (32:18)

Reddit Q&A Highlights

Reddit Q1: How are OCD Intrusive Thoughts Different from Normal Ones?

[33:22–40:44]

• Distress, frequency, and attempts to neutralize differentiate OCD intrusive thoughts from normal ones.
• Mental compulsions (rumination, reassurance seeking) count as much as physical rituals.
• Notable Reddit comment:

  "Any given intrusive thought tends to be a lot stickier... for someone with OCD... often leading to compulsions to try to get rid of it... You fall further on the 'Pure O' side..." [Tommy151, paraphrased at 37:36]

Reddit Q2: Are All Intrusive or Obsessive Thoughts Lies?

[40:44–43:50]

• It isn’t helpful to label all intrusive thoughts as ‘lies’; some may contain kernels of truth, but the key is learning to tolerate uncertainty.
• Over-simplifying leads to more reassurance seeking.
• Exposure therapy often involves learning to “sit” with uncertainty, rather than resolving the thought.

Reddit Q3: How Do I “Let an Intrusive Thought Be”?

[54:43–66:00]

• Allowing thoughts to exist without engaging compulsion is central to recovery—but anxiety may persist for a while; progress is often slow.
• “Fake it till you make it” and neutral mantras (e.g., “Maybe, maybe not”; “I don’t care”) can help some people.
• Building the capacity to tolerate distress is itself a vital part of healing.
• Analogy: The process is like breaking old neural ‘paths’ and forging new ones—it’s repetitive, difficult, but achievable given time and support.

"The thoughts are here. I’m still anxious. It’s not fixing it. The thoughts are here. Am I screwing up? ... The point of this work... is not to say I'm definitely not going to feel anxious anymore..." (55:52)

Notable Quotes & Memorable Moments

• Katherine Wood:

  "OCD boils down to [distrust of self] 98% of the time. It’s not trusting in oneself and kind of your inner compass..." (17:53)
  "Reassurance is kind of one of the worst things people with OCD can receive from others." (23:49)
  "Your brain gets dopamine chemicals worrying... That reassurance seeking, which is a compulsion, is... one way you get the dopamine boost..." (24:00)
  "It is treating that, the intrusive thoughts... in a way of, like, 'That’s a thought. Just as much as I can think the sky is purple. Maybe it is, maybe it isn’t.' " (21:16)

• Felicia Keller Boyle:

  "So what I always said to my clients is like, this is a relationship and if anything happens that is hard for you or is a disturbance, like, please do bring it up. And the cool thing about that happening in the context of a therapeutic relationship is I have a vested interest in your well being..." (52:38)

• On the Process of Progress:

  "It’s like walking down a street with, like, freshly paved sidewalks... [changing behaviors] is like you’re trudging through the jungle with a machete... but the more you walk down it, new trails are much harder to walk on than trails where they’ve been walked on many, many, many times." (46:00)

• On Sitting with Uncertainty:

  "The more I say 'maybe, maybe not' to try and quell my disorder... the more it just stays locked in my head... I’ve been two days resisting any compulsions, yet my anxiety is still here all the time. It just makes me want to give in." [Reddit user Trushvesti, paraphrased at 55:52]

Practical Takeaways

• OCD is about much more than external organization or cleanliness—mental rituals and doubt can be just as disruptive.
• The line between normal intrusive thoughts and clinical OCD lies in distress, frequency, and how much it interferes with life.
• Reassurance (internal or external) can be counterproductive and reinforce OCD.
• Community support, especially in anonymous, understanding spaces (like certain subreddits), can offer validation and reduce isolation.
• Progress requires repeated, often uncomfortable practice, with therapy as a key tool to build tolerance and self-compassion.
• It’s crucial to find a therapist who truly understands OCD—not just ‘pop psychology’ approaches.

Closing Message (Katherine’s Mini TED Talk)

[67:30–68:58]

"OCD is a serious and real illness that can gravely affect lives. It does encompass many themes... But it is also very treatable. It is very accessible to live a lighter way of being, to feel more confident, to feel more calm... no matter how gnarly, gruesome, whatever self-judgment you’re telling yourself... maybe that is true and maybe it’s not and this is a time to not perpetuate the self-judgment cycles, the isolation, the loneliness. Please, like start talking with someone. It is so possible to feel another way about yourself and the world and to reduce this anxiety. ... You are not doomed." (67:30)

Timestamps for Key Segments

| Segment | Timestamp | |--------------------------------------|-------------| | What is OCD & Common Misconceptions | 02:06–06:13 | | OCD Themes + ‘Magical Thinking’ | 06:13–09:55 | | Diagnosis, Research, and Resources | 09:55–12:58 | | Impulsive vs. Intrusive Thoughts | 14:07–17:50 | | OCD’s Emotional Core & Therapy Approach | 17:53–21:16 | | Children, Stigma & Reassurance | 21:16–24:45 | | Dopamine Cycle, Addictions | 25:29–28:42 | | Therapist Selection & Value of Expertise | 28:45–33:22 | | Reddit Q&A | 33:22–66:00 | | Closing Thoughts & Hope | 67:30–68:58 |

Overall Tone

Engaging, affirming, and honest—combining expert insight with relatable stories, a dose of dark humor, and warmth. The hosts and guest create a safe, welcoming space for nuanced discussion about a heavy topic—balancing clinical accuracy with hope and humanity.