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434 Sensorimotor OCD (with Max Maisel)
00:37:18
In this episode, OCD specialist Dr. Max Maisel joins Kimberley Quinlan to unpack the misunderstood experience of Sensorimotor OCD and offers empowering, evidence-based strategies to help listeners find relief and reclaim their lives.
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- [00:03]
A
Welcome back, everybody. Today we have our guest again. So happy to have him back, Doctor. Well, Max Masel, PhD. I know you don't like me to call you Doctor, but thank you for being here. Max is an OCD specialist. We're here to talk about sensory motor ocd. I'm so thrilled to have you. Thank you for being on again.
- [00:25]
B
Yes. I'm so excited for this conversation. We're going to nerd out on this stuff, and I cannot wait.
- [00:30]
A
Yeah. It's a topic that isn't talked about much in the OCD community, in my experience.
- [00:37]
B
Yeah, yeah, agreed. I mean, this is a topic where I've worked with people that have had OCD for a very long time, and people have treated OCD and they've never heard of sensory motor OCD or when it shows up. They don't really understand that that kind of fits what we think of as ocd.
- [00:51]
A
Right. So let's go straight to it. What is sensory motor ocd?
- [00:57]
B
So sensory motor ocd. So it has a couple different names. It all sort of gets at the same thing. Like, some people call it somatic OCD or somatically focused ocd. I'll probably refer to it as sensory motor ocd. It's kind of just like vibes with me more. But essentially, any given moment, there is a ton of different stuff happening within our bodies. There's different sensations, there's different bodily processes that most of the time we are totally unaware of. Right. For example, Kimberly, right now, you and I are having this conversation, and in the background, our hearts are beating, our eyes are blinking, we're salivating and swallowing the saliva. We're breathing all this stuff that probably before I said anything you weren't even aware of, but now we're talking and I'm like, oh, my gosh, I'm blinking a lot, aren't I? So essentially. Essentially what sensorimotor OCD is, is when people become aware of one or more of these different sensory experiences or bodily processes, and they kind of freak out. They don't want to be aware of it, they don't like being aware of it, and they do all this sort of stuff to try to get those sensations out of their awareness. They try to distract themselves. They question, why am I aware? They reassure themselves, they check, am I still aware? Is the awareness there yet? Is it gone? So they do all these things, and unfortunately, and paradoxically, that fight, that resistance to the awareness actually lodges those sensations into their awareness even more. So it gets to the point where people can't become Unaware of these different things. And the anxiety piece, the core fear in this is that now that I'm aware of this thing that I don't want to be aware of, whether it's blinking, breathing, heartbeat, it's going to ruin my life somehow. It's going to take away from my ability to have conversations because I'm distracted or I'm not going to be able to enjoy watching movies if every single time I blink I'm aware of blinking. So not only is it going to hurt my experience, but it's going to last forever. Like what if I never am able to get this thing out of my awareness and you could just like reflect on how dreadful and scary that could be. And in working with this, I've worked with people that range from like mildly annoyed to it all the way to like just absolutely debilitated and paralyzed by this form of ocd.
- [03:21]
A
Yeah, I have the same experience that, that hyper awareness of those sensations. And I think the thing to remember is when we use the term hyper awareness, it's both involuntary and voluntary. Like you're not asking to be hyper aware, but as you said, then when you respond it even adds to how much we hyper aware of this sensation. I've even had clients talk about where they'll just say I notice my left hand, right? So it's not even a physical sensation so much as it is like I just can't stop noticing my left hand or something about, you know, their experience. And that's a similar thing. So I think that absolutely it can be so, so debilitating. What are some of the core triggers? You've, you've already really done a great job of sharing the symptoms of somatic OCD and sensory motor ocd. What are some of the common triggers for people with this condition?
- [04:20]
B
Yeah, like I mean, like you were saying, Kimberly, it could really be anything. I mean the common ones, right, would be like swallowing, blinking, breathing, heart beating. But it could be. I've worked with people that have like been hyper aware of how they're holding video game controllers or, or ifloaters is a big one. As with anybody, the trigger is really gonna be something that they care about. Right. If somebody cares about playing video games, their OCD can very easily attack that. Cause they wanna be able to play video games in a way that's fun and pleasant. And if they're worried, oh, what if I never had this experience playing without this annoying awareness of how my hand is on the controller and I'll never be able to enjoy my games again. So it really just like, I think, like, with all ocd, it targets our values and it targets what people care the most about, which is, I think, why OCD is as vicious as it is, because it really kind of finds ways to get under what makes life worthwhile for people.
- [05:13]
A
Yeah. Talking about triggers, and you talked about, like, heart rate beating and breath. Do you think that. And I think there can be no right answer here is, do you think that the trigger is anxiety? Meaning, like, they're having anxiety, their heart's racing, and therefore they notice it? Or. Or could it be that they just notice the simple ba boom, boom, boom, boom, boom of their heart rate? Does there have to be a specific change in the body for them to get triggered into having OCD in your experience? Or could it be. Just like you said, one day they sat down at the office desk and all of a sudden they just started noticing.
- [05:52]
B
Yeah, more of that one. Right. Like, the specific triggers, usually that happens more with, like, panic attacks. Like, people, they. Their body reacts really strongly, and that freaks them out. But this, it could be anything. It could be a conversation somebody has, and they realize that, like, oh, am I looking at the person the right way? Like, oh, my gosh. Wait, what does it mean to look at somebody the right way? I don't know. So it really can attack people out of the blue. Although I will say that just like with all ocd, people are definitely more susceptible when they're stressed. Right. When they're stressed out or anxious, the resistances are low, and OCD has a lot more ground to be able to creep up and catch them. But. But once somebody's stuck on this and they start engaging in the compulsive behaviors and avoidances that we'll talk about, it tends to last until people understand how to break the bonds it has.
- [06:35]
A
Yeah. I've also had cases or consulted on cases where they may notice, like, the feeling of pressure in their bowel or the feeling of needing to urinate, and they've gone and had all of these tests, but they just can't stop feeling this feeling and. And being aware of this feeling and maybe even feeling like they need to empty their bowel or their. Their bladder to get rid of it, only to see that there's a sensory motor component to this.
- [07:04]
B
Yes, that's exactly right. You can see how vicious that could be when there's, like, a combination of potent, like, physical needs. But then also it's hyper awareness. And to be able to parse those out can be very nuanced stuff.
- [07:15]
A
Yeah. Yeah. And really, really painful. Really painful, yes. Let's talk about. You know, often with ocd, we misunderstand it as only having physical compulsions. What might be some of other compulsions that people are doing specific to sensory motor ocd? Like you've mentioned some, but wonder if you can share more about, like, the mental internal compulsions that happen for people with somatic or sensory motor ocd?
- [07:43]
B
Yeah, of course. I mean, the biggest one by far is resistance. Right. So, like, their brain gives them something in their awareness. It's like a gift from the brain. Like, here you go. Like, here's awareness of your eye blinking. And it's our rejection of that. We don't like it, we don't want it. So it's almost like an attitude shift of like. Like, I need this thing out of my awareness, but it entails paying attention to it, which can definitely be a compulsion, which we'll talk a lot more about when we discuss, like, how to treat sensory motor oc. But people paying attention, this thing's in their awareness. Like, they. They notice every single blink. And I'm focusing my attention on it in order to figure it out or in order to try to check to see if it's still there. Am I monitoring? Am I still aware of my eye blinking? It's still there. Is it not there? So all these things mentally first involve paying attention to it and then involve trying to do something to, like, make it removed from their awareness. Which, again, as with all ocd, unfortunately, it's a valiant effort, but it really just makes it latch its claws in even more firmly.
- [08:46]
A
Yeah, yeah. That monitoring is the tricky one, because even I. I've had so many clients say, I'm fine, I'm not noticing it, but I keep monitoring to see if I'm noticing it, which makes you notice, like, all of a sudden now I'm talking to you, I'm thinking about my blinking. You know, I'm aware of it now. So I think that that monitoring is such a subtle compulsion, and it can be hard. I mean, what would you. Would you even say? A lot of my patients. But I'm curious to know your experience will say that self monitoring, that self check is almost automatic, that they sometimes can't feel. They don't feel like they can control that aspect of it.
- [09:27]
B
Yeah, I think that's a huge piece of it, especially early on in treatment. It is automatic, and it is like our body's natural reaction to something really scary and uncomfortable. And part of working with it is to slowly, compassionately build the tools where we can begin to bring more awareness to our kind of self monitoring and checking behaviors to start, chip away at it. But yeah, it can be its own process that can feel absolutely involuntary for a lot of people.
- [09:53]
A
Yeah. Okay, so let's talk about the evidence based treatments for sensory motor ocd. What can people do to help manage this condition or overcome this condition?
- [10:06]
B
Yeah, and I love the differentiation here between managing and overcoming. And the reason is like, for most ocd, I think we sort of have to accept that like our, our brains are gonna be wired towards OCD and we can live a full, rich, meaningful life and still kind of have to navigate the stickiness of our minds. But with sensory motor OCD in particular, like, people can very much get to a place of recovery sometimes because the trick of it, the trap of it is pretty, pretty simple to circumvent once you understand how it works, which we'll, we'll talk about. So to answer your question directly, erp, exposure and response prevention, that's what we use for this. And we want to be really nuanced with how to apply erp, because sensory motor OCD is a little bit different. It's kind of its own beast in some ways. So Kimberly, if, if you're okay with it, I was thinking maybe first I can explain how I've seen ERP potentially misused for sensory motor OCD and then talk about how to use it in ways that might be more helpful for people.
- [11:10]
A
Let's do it.
- [11:11]
B
So, and when I'm like consulting with colleagues or working with clients, have been through ERP in the past without the, the most effective benefits for their sensory motor ocd. Typically what I see going wrong is, is people do exposures to like the sensory experiences themselves. Um, for example, they'll sit there and like, for 20 minutes we're just gonna pay attention to our blinking, or for half an hour we're gonna sit there and just notice our heart beating. And like, sometimes that could be helpful for some people. But the problem with that is, as we talked about, one of the core compulsions in sensory motor OCD is paying attention.
- [11:48]
A
Right.
- [11:48]
B
It's like a hyperfocus. And the problem with doing exposures like that is we're doing more compulsions potentially we're having people focus more on something that they're already focusing heck of a lot on. And as you know, good erp, we want to open up to the discomfort, we want to allow the scary thoughts and feelings about doing anything to make it go away or to get rid of it. So ERP for this presentation of ocd, it really needs to emphasize two factors. Probably won't be surprising to you, but the RP response prevention is going to be huge and so important. So essentially what we want to do is allow whatever is in our awareness to be there. Right? Whether it's eye blinking, swallowing, heartbeat, feeling of pressure when I'm sitting, allow it to be there without doing any of the stuff our OCD wants us to do, to make a go away without resisting, without suppressing, without ruminating. Another big compulsion we get is sort of like this resentment, almost like, oh my gosh, like why am I struck with this? I wish I could go back in time before I was aware of my dang eye blinks. So all that stuff we want to be able to like let go of and just allow the experience to be the second piece, which is just as important and plays a huge role in sensory motor ERP is what you could think of as radical acceptance. So with this theme in particular, it's all about people rejecting this thing in our awareness because there's a sense that it's taking away from our life. I'm going to be more distracted, I'm not going to be able to be present. And the radical acceptance piece is approaching it like, okay, I'm okay living my life being more distracted. I'm okay living my life in a way where maybe I'm never going to enjoy watching a show as much because I'm aware of every single time I blink. I know for listeners that have sensory motor OCD, that might be a terrifying prospect to accept. But I, I can, I can promise you that if we can bring the sense of radical acceptance, of openness to can it be okay living a life that is less optimal? Can it be okay living a life that's more distracted? Like your OCD won't be able to help but become bored. Right. And that awareness won't be able to help but let go. But it does take some work to get to that place of fully opening up to it.
- [14:14]
A
Yeah. So how might that look? Let's play out a case. So let's say somebody has, we talked about a hyper awareness or a hyper, you know, really noticing their blinking and they're both distressed by the awareness of it and they're distressed by the fear. Like that kind of metaphor, like, what if I never stop thinking about this?
- [14:40]
B
Yes.
- [14:41]
A
How might you use ERP in that case in a day to day practice for them?
- [14:49]
B
Oh, I love, love that question. So first I would start with a little exercise Like, I have a white noise machine in my office, so I would say something like, client. Like, I want you to notice that there's a white noise machine in the background right now. Do you hear that? Yes, I do hear it. Max, did you. Were you noticing it, like, two seconds before? Is anything. No, I wasn't. So, Kimberly, for you, and maybe even your listeners, just want you to take a moment and see if you notice any background noises right now happening outside. Could be maybe music or air conditioning or traffic. Just notice if there's anything that comes up, right? So if there was, you probably weren't paying attention to that before I directed your attention there, but now you are. So once we kind of notice that there's this background noise that wasn't in my awareness a second ago, the question is, like, if you wanted to forget about it, if you wanted to not be aware, what would you have to do? And a lot of people intuitively have a sense of like, oh, well, I would need to, like, allow it to be there and, like, not worry about it and shift my attention to the conversation, right? And kind of gently focus on something I do have control over. And with sensory, motor, ocd, that's a lot harder than a white noise machine, since we're going to be sitting the exposure, sitting with the anxiety and discomfort and the fear. But mentally, it's the exact same shift, right? It's like, can I allow this background thing to be there without making a go away, without doing anything about it? And then gently, easily shift my attention to things I can control, not in a way that's like trying to drown out the background noise, but in a way that's like, taking control back. So I think that's a pretty cool way to do it. And then usually for exposures, I'll start off having a conversation with people. Be like, okay, Kimberly, saying, you're my client. Like, I want to have a conversation with you about something really cool, like whatever you want. It could be maybe a Hawaii vacation you're going to take or what you did for summer break or anything that feels fun. But starting right now and throughout the conversation, I want you, with every brain cell in your head, to will for OCD to give you awareness of your eye blinking. I want you to just sort of like, if you're. If you're religious, like, pray to whatever deity you play, you pray to just Will with all your heart and soul that not for a millisecond of this conversation, you will have no awareness. I want it to be there every single millisecond now, that doesn't mean pay attention to it. That doesn't mean purposely focus on it. That just means, like, hope and an attitude shift where you're really inviting OCD to give you its worst. And after five minutes of conversations like that, can you guess what typically happens?
- [17:37]
A
You. You're having a hot. You're not. That's not happening.
- [17:40]
B
You forget. Yeah. And because once we invite and allow, we stop fearing it.
- [17:45]
A
Yeah.
- [17:46]
B
And it just naturally falls back to the background. And then the homework I'll give to clients, usually with this form of OCD has to do with reminders. Right. So random app reminders. Yes.
- [17:59]
A
I was just about to ask you about that.
- [18:00]
B
Oh, man, that's. That's my favorite thing. Because the reminders, they're not, like, having people intentionally focus on the sensation, but they're purposely bringing up this unwanted thing in their awareness. For example, the reminder might be, remember, Kimberly, you're blinking right now. Right. Or blinking. And the goal, once you are aware of that reminds her, which then brings the blinking into your awareness, will be to practice radical acceptance. Practice. I'm blinking. It's distracting. I'm going to live my life being distracted. Thank you, ocd. If you want to take it a step further, I hope I never get this blinking out of my awareness. I want to live life full of always being aware of my blinking.
- [18:39]
A
Yes. I love that you brought that up. I was just about to ask. Because that's a huge piece of the work that I do with my patients. And then we even go one step further, because just like any subtype of ocd, we're as distressed by the obsession as we are by the fact that it's taking us away from the meaningful life that we want. So I'll say, okay, now I want you to go back to doing the things that you love doing that OCD took you away from. Like, if you love painting, I want you to go back and start painting again. But I also want you to set a reminder while you're painting to remember to blink. And often clients will go, no, I don't want blinking to, like, take away from my joy.
- [19:21]
B
Again.
- [19:21]
A
Taken already. Enough from me. And I totally get that there's so much grief involved, but that reminder is sort of a. A metaphor for saying, I radically accept you in my life.
- [19:33]
B
Yeah. Yeah. I'm gonna paint and be aware of my blinking. And it's okay to feel grief and it's okay to feel lost, that I'm not painting in the way that I want to or used to and, okay, can I accept that this is my new reality? And I'm gonna paint with awareness and, and if people can accept that this is the paradoxical thing is like, they will not be aware of it, but you can't try to get it out of here. You have to fully accept that this is my experience. I'm going to be okay. For every single time I paint, I'm going to notice my swallowing. And can that be my life?
- [20:04]
A
Yeah. Let's talk about really tough cases. What about people who say, oh, like, Max, there is not a minute of this day where I don't notice my breathing, my blinking, my heart rate, my arm, my ear, whatever it might be, my urinary tract, whatever it might be. What would you say to them where they're saying, there's literally not a minute where it's not 99% of what I'm aware of?
- [20:31]
B
I mean, first off, I would give all the validation and compassion in the world, because that just sounds like torture. And it is this form of ocd, it is torturous, even more so than others. I feel like, not to compare, but for contamination, OCD people can avoid going to the bathroom or harm OCD people can avoid cutting vegetables with a knife. Those aren't. It's not good for the long term health, but they can get like a reprieve from. Not so much with this stuff. You can't avoid blinking, you can't avoid swallowing, you can't avoid breathing. So I think it's like, yeah, it's so, so vicious. But I would also really want to encourage them that, you know, like, your OCD is giving you hell of a lot of opportunities to practice.
- [21:13]
A
Right.
- [21:13]
B
It's like if. If it's happening all the time, there's a lot of inroads that OC is handing us. And. And if we could start small and start very gently, but use at least one or two of those opportunities as a way to practice radical acceptance, as a way for them to really see that if you can lean in, if you can allow it to be in your awareness, change happens and to start building off of that. But, yeah, it will. Some of those cases will take time and I think compassion for oneself and patience.
- [21:44]
A
Yes.
- [21:45]
B
Utmost importance.
- [21:46]
A
Yeah. It's a mindset game, really. It's like, I will always say to people, like, it's really just 1% shifts every day. So I know that all day. But even if you made a 1 or 3%, like you were talking about some of these skills, and I will also add, you you and I previously did an episode on attention control which can be so helpful. Like even a 1% shift is a massive, massive step in the right direction, even if it's taking up all of that time. So absolutely, yeah.
- [22:21]
B
Even just like noticing that I'm resisting without having to stop resisting, but just noticing, oh, I'm engaged in this battle right now, and that's actually not helping me. That awareness is like such a awesome foundational place to start without having to do anything other than, like, notice it.
- [22:39]
A
Right, so we're going to talk now about some of the roadblocks with treatment for sensory motor OCD and sensory motor obsessions. One question that I have gotten quite a bit in our online course for ocd, because in our course there's a sub module for this is sort of the trying to weed apart how to use exposure and response prevention in an effective way, not a compulsive way. So I'll often talk about mindfulness, right. Where you bring your attention back to the present, not the sensation. And they'll say, yeah, but that's what I've been doing as a compulsion.
- [23:21]
B
Ooh, I love this question. Yes.
- [23:23]
A
Right, so. So this is where I think it's important we do get. Everyone is going to have a different plan. Can you sort of speak to when we bring our attention to other sensations or what's presently happening, how might we modify that to be effective treatment?
- [23:40]
B
Oh, it's so good. So it reminds me of sort of like a two tailed spike. Right. So Stephen Phillipson, he's like a big OCD expert guy. That's awesome. And I love how he talks about the two tailed spike, especially with this theme in particular. And Kimberly, it's pretty much exactly what, what you were saying. It's like, okay, if I swallow, then I'm giving in to the compulsion, but if I don't swallow, I'm avoiding.
- [24:07]
A
Yeah.
- [24:08]
B
Or if I'm mindful of the present moment, to be mindful of the present moment. But is that avoiding? Or do I, like, focus on the sensation and do some exposure with, like, what do I do with that? Right. How do I, like, focus out getting caught up in this bout of like, what am I doing? Am I running away? Am I leaning in this, that or the. I mean, like, the answer is simple but also really tricky. And it does take that 1% shifts to do. But essentially it's sort of like making a decision, like committing to doing something. And honestly, it really doesn't matter what you do. Right. It doesn't matter whether you swallow or you don't swallow, it's committing. Just because you're a person, you have agency, you can choose to do something regardless of having a reason and then being okay with the fact that you might have done the wrong thing.
- [24:55]
A
Yes.
- [24:55]
B
Or even accepting that you did do the wrong thing and not ruminating about it, not questioning it, not focusing on it. And that's exposure too. That's sitting with the discomfort that I just did the wrong thing. Yeah. I focused on the present moment and oh, that's not the right move. Okay, can I sit with uncertainty that I did it quote unquote wrong and then get on with my life?
- [25:17]
A
And that's such a key point. And I'm so grateful for you slowing down and articulating that is we can get in the weeds on. We can almost do compulsions about whether we're doing compulsions.
- [25:29]
B
Oh, yeah.
- [25:31]
A
And I think that you could even maybe just have a little bit of a sense of awareness of yourself. If you're spending time trying to figure out what, like, and you're really anxious about whether you're doing compulsions or not, you're probably best just to move forward and do that radical acceptance and let it be messy as an exposure and return to back to some value based behavior. Right. Like, I always ask myself, like, what would I be doing if I didn't have this anxiety or this fear or this uncertainty? Okay, I'll go and do that thing. What are your thoughts?
- [26:03]
B
Yeah, I love that so much. And I think it really does get back into our last podcast episode where we talked about the difference between awareness and attention. Right. Like, all the thoughts about doing it wrong, messing up, doing the compulsions. Like, can we let all that stuff be in our awareness? Just sort of like noticing it, but then control what we can control what we focus our attention on in terms of like, how do I want to live life in this moment? Can I allow the thoughts and the feelings and discomfort to be in the background and then control what I can? And it could be anything. It could be values based action. It could be, I don't like watching tv. It doesn't matter. Like, you get to choose. You're the one that has agency over your life.
- [26:42]
A
Yeah. Yeah. Okay. Another roadblock. And you can actually give other roadblocks if you like, but just another one that often gets asked in our online program is what if my specific sensory motor obsession flip flops. So I'm noticing my blinking and then I use the skills, but then all of a sudden I'm noticing my swallowing and then I use the skills, but then all of a sudden, I'm. I'm noticing my heart rate and so forth.
- [27:06]
B
Yeah. I mean, OCD is so good at that. Right. As soon as, like, you feel like you've got on a hand, like, it, like, throws out something else to get to. I mean, it's. It's all the same thing. Right. And I think one of the. We talk about rising above the content, right? It's not about. I'm certainly. I get it feels like that, but at the end, it's not about blinking. It's not about swallowing. It's not about heartbeat. It's about, like, something. Anything is in our awareness and our rejection of that which we can't control. Right. So whether it's your eyes or a feeling or a thought or blinking, swallowing, whatever, it's all the same thing. It's. Can we accept that our brain just gave us this thing? We have no control over what our brain gives us. And can we be okay with that? Can we allow it to be in our awareness? And then, like we said, like, choose to do something that's in line with the life that you want to live?
- [27:57]
A
Yeah. So you're like, okay, now I'm thinking about this. That will be what I'm aware of. And how can I. You know, that's the. Like the soup du jour. It's the noticing du jour.
- [28:08]
B
Yeah. Or even better, like, good. Yeah, thank you. Keep it coming. Ocd, like, this is awesome. I want to be aware of every single thing. Like, bring it on and. Yeah. And eventually OCD will get bored. And I mean, I always like to use humor. Like, dang, ocd. Wow, that's a new one. Like, I'm aware of my. The tip of my nose that I'm looking at my face like, wow, you're tricky. Ocd. Thanks for that. So really approaching, I think, with humor, if that works for you, can be helpful.
- [28:35]
A
Yeah, for sure. I've even had clients say they, like, if their brain gets stuck on a specific sensation, they just for. As an exposure, like, imagine their blinking goes out of control so much that they, like, fly away. Or they're just, like, playing with it instead of treating it like it's so important. They just make, like, they just imagine it being silly or however, you know, you know, a joke or even making a song out of it or so forth. Okay.
- [29:04]
B
Yes.
- [29:05]
A
What advice would you give someone who is hopeless or stuck or feeling hopeless or stuck because of their sensory motor ocd?
- [29:17]
B
I was wondering if I could answer that with like, a personal story that I think could be helpful.
- [29:24]
A
I'd love that.
- [29:25]
B
So I haven't, like, met criteria personally for OCD in a very long time. It's like kind of teen, young adult. But I do get spikes occasionally, especially when I'm stressed. So my last bike happened a couple months ago, and it happens to be a gnarly sensory motor OCD spike. And I was thinking about this podcast. I was like, oh, that could be potentially a. A helpful thing to. To share with people. So here's what happened. I was at the park with my little three year old. Um, she was playing on the playground. And it was like literally the perfect day in the South Bay of Los Angeles. Blue sky, expansive, not a cloud in sight. It was so, so nice. And I was just like sitting, hanging out, enjoying being with my daughter, looking at the sky. And all of a sudden I noticed a little floater in my vision. It was like a little kind of green, squiggly. It's like, oh, okay, that's okay, it's a floater. And then I noticed another floater, another floater. And after a couple minutes, it was sort of like floaters everywhere. That was all I was seeing. And almost instantly I got that sort of guttural sense of dread. Like, oh, oh my gosh, this isn't good. What if I can never appreciate another beautiful sky without seeing these dang floaters in my vision? Or what if there's something. What if? All the what if stories. And I tried taking a breath, wiping off my sunglasses, looking at the sky again. Boom, floaters. And I had a moment of panic. I was like, oh, no. Like, this isn't good. This would be horrible. I want to enjoy time with my daughter. What if I'm with clients and I see floaters and they can't concentrate? The classic thing. But fortunately, I don't know much in life, but I do know OCD very well. So I was able to step back and be like, oh, wait a minute, I know exactly what's happening. I know exactly what to do here. So what I ended up doing, which I would encourage anybody to do when they're stuck in a cycle like this. The self talk was something like this. Okay, good. You know what, Max? I hope I never am able to look at the sky without floaters again. Like that. What a cool experience to be able to see floaters in the sky every time you look. That's not something that most humans get to experience. And yeah, it sort of sucks. You know, it's a nice day. And, like, I'll miss looking at the sky without floaters, but this is my life now, and that's okay. And in fact, I hope every single time I look at the sky, there's floaters. Like, oh, cd, give me all the floaters you got. Like, I never, ever want to be unaware of those floaters. And after about 20 minutes gone, nothing. Right. Because I lost the fear and my ocd, my brain got bored. And I haven't thought about floaters until I was thinking about this podcast episode. So my words of hope would be, if I can do it, you can certainly do it too. It really comes down to understanding that trap of, like, you're brain giving you something in your awareness. And can we be okay with that? Right? Can we bring the sense of acceptance and openness to it? And your brain will get bored. It has to get bored. OCD thrives off of our fight and our resistance. And if we can, like, step out of that process, you'll get to exactly where you want to go.
- [32:34]
A
I love that story. It made me think of Stephen Hayes. We had on was talking about how he has tinnitus.
- [32:42]
B
Yes.
- [32:42]
A
And how that's sort of similar. Right. Like, if you have tinnitus, it's a constant ringing in your ear. You just have to accept it radically and then it bothers you less, even though for him it's still ringing. I'm so glad that you had, you know, you could get back to your daily life. Now. I also want to recognize, because I love this story so much and it brings so much hope and clarity to what can be. But you also know OCD really, really well. You're an OCD specialist. How long might it take someone who's new to this to be able to implement that strategy and get some relief?
- [33:22]
B
Yeah. I mean, it's such a good question. And I would encourage anybody working on this stuff to really focus on the process and to let go of having to get to a certain place. Like you said, I've been doing this for a very long time. I mean, and it's not just erp. I didn't like, expose myself to the floaters. It's. It's really like this attitude shift.
- [33:43]
A
Yes.
- [33:43]
B
From resistance to acceptance. And that, I mean, that takes a lot of practice and a lot of, like, attention and patience. So, I mean, some, some people be, I think, be able to get there quicker than others. Others, it might take a very long time. But I think the most important thing for anybody to know is just like you said, it's like 1% shifts. Right. Like trusting the process, understanding how OCD works and applying it on a day to day and slowly over time, things will get better. But that, that's another kind of paradoxical piece too, is because the last thing we want to do is check, am I better yet? Am I better so. Cause that, that's exactly like part of oecd. So I really would encourage people to, like, as scary as this may sound, like, let go of needing to go anywhere.
- [34:28]
A
Yes.
- [34:29]
B
Work with a competent like OCD therapist. Know that you're doing the right work, but then sort of like just trusting the process, trusting yourself, knowing that like when it's ready, you'll get back to where you want to be.
- [34:41]
A
Yes. And I love that you mentioned that because so often a big part of the first, like psychoeducation that I do with clients is our goal isn't to get rid of your awareness of it. Meaning, like, if your only goal is that I don't have to notice this anymore, you will keep noticing it. Like the recovery is that you don't do those compulsions or you're not, you know, getting really negative on yourself for having it or spending a lot of time like being hyper aware, like the removal of the obsession. If that's your only goal, that's going to probably trick you back into doing a lot of compulsions.
- [35:19]
B
Yeah, that was very well said. And yeah. And to bring this acceptance, like, it's okay having this in my awareness. It's okay to not be optimal. Right. It's okay to be more distracted. It's okay to not have as much enjoyment in life. And as soon as people can get there. Yeah, it does. It will melt away. But without checking or monitoring or doing the things that our OCD wants us to do.
- [35:39]
A
Yeah. Yeah, I love that. Thank you. Yeah. Max Maisel, please tell us where people can hear more about you, get in touch with you, work with you. I want to know all the things.
- [35:51]
B
Yes. Thank you so much, Kimberly. So our, our website is beachfrontanxiety.com uh, it's myself and a couple clinicians on our team and we all do this stuff like OCD and OCD related concerns. And I also have an instagram page at Dr. Max OCD. So you can also follow me there, try to make videos, post together little kind of canva things for kind of.
- [36:13]
A
It's a great account.
- [36:15]
B
Yes, exactly. Um, so those would probably be the two big places to find out more and to reach out.
- [36:21]
A
Wonderful. Thank you. I'm so grateful that we had this conversation. I think it gives a lot of hope to people with this specific condition and some really applicable tools that they can use right in, like, immediately, which I always love to give. So thank you so much for coming on again.
- [36:41]
B
Yeah. Oh my gosh, my pleasure. Your podcast is my favorite one of all, so I'm just so honored to be here with you and you do such incredible work. So thank you so much for having me again.
- [36:50]
A
Oh, thank you. Please note that this podcast or any other resources from CBTSchool.com should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area. Have a wonderful day and thank you for supporting CBTSchool.com.