Melody sent me an audio question recently. She wants to know what she can do to best help her boyfriend who is struggling with health anxiety. He is just starting therapy, but she wants to know some best practices on what she can do to be a helpful partner. How great is that?! To answer this, I try to highlight the importance of communication between her and her boyfriend and working together to establish clear boundaries of what she can do and what she’s not willing to do to be supportive. I also discuss the importance of knowing about health anxiety so she isn’t surprised when anxiety tries to weasel its way into the relationship.




For more on Hypochondria and Health Anxiety, check out this article from the California OCD and Anxiety Treatment Center.

I got an audio question from Burrito John who wanted to know he can deal with a situation. He’s obsessing about whether he actually liked someone, or whether he was just obsessing and didn’t. He is worried he made it awkward with his co-worker and now wonders whether he and trust his intuition about whether he genuinely likes someone or whether OCD is just clouding his judgment. This question comes up in a lot of different ways so I’m glad John asked it.

Jeffrey messaged me and wanted to know how to forgive himself for his obsessions and past choices so he can finally move on with his life past the grip of SO-OCD. His question has a lot going on, and includes elements of shame and guilt from his past behaviors, doubt and confusion about motivations for said actions, confusion about titles and identity, and a struggle with a sticky comment made by someone when young that served as the basis for his obsession. I do my best to address some of these issues and help him see how his obsession was created, how it persists, and how he can try to let himself off the hook and move on with his life.




For more about Sexual Orientation OCD (SO-OCD), check out this article from the California OCD and Anxiety Treatment Center

Dan reached out with an audio question to ask about what he can do when his interests and values happen to also be the focus of his obsession. Hijacking your values, hobbies, and interests is a really common tactic of OCD, but does that mean you have to give it all up to get better? What happens then if you value intimacy in a relationship? Is Dan doomed? I discuss what people can do to grow their awareness about their obsessions and how to short circuit the obsession/ compulsion cycle when it hits. However, I also discuss some other, broader, relationship considerations that may be at play.

Just in case the threats of the Rapture didn’t get you down (or amped up with anxiety) enough, GS comes along to ask the question about what to do, and how to move on with life, now that, apparently, science proves that we have no free will. So, GS struggles to know what to do with this information. Luckily, this isn’t my first rodeo, and I’ve got just the right chaps and spurs for this question. We talk about Existential OCD, what to do with scary information like this, how to challenge the thoughts, and how to live a meaningful life with the looming threat of meaninglessness.




For more about Existential OCD, check out this article from the California OCD and Anxiety Treatment Center.

For today’s episode, I got a relatively simple question; what are the differences between the compulsions and other behaviors found in Generalized Anxiety Disorder (GAD) and how do they differ from those in Obsessive Compulsive Disorder (OCD). While this was a pretty quick answer, it spun out into a comparison between OCD and GAD, how they differ diagnostically, and how they are really similar! You can have both, and sometimes it’s hard to see the differences between the two.








For more on Generalized Anxiety Disorder (GAD), check out this article from the California OCD and Anxiety Treatment Center

Dr Jeremy Shuman, PsyD, joins me today to discuss OCD treatment for those on the Autism Spectrum. Dr. Shuman offers a wealth of knowledge, insights, and encouragement to clinicians, families, and individuals alike. We discuss some of the diagnostic complications with the overlap of OCD and Autism symptoms, obstacles in the way of using CBT and ERP, and ways to adapt common treatment methods for OCD to meet the unique needs of the Autism community.

Alan sent me a message asking me about how he can deal with a spike in Real-Event OCD themes. He’s a reporter who used AI to help with his grammar, but his anxiety latched on about violating AI policies at work. He struggles to let go of the obsession and get back to appreciating his craft again. We go over Real-Event OCD and how it differs from other obsessions, the use of AI in treatment, and some ways he can disconnect from his guilt through acceptance and compassionately making space for his anxiety.








For more on Real Event OCD, check out this article from the California OCD and Anxiety Treatment Center

Annie reached out to me as a follow up to a previous question she had about her toenail fungus and her obsession about it. She noticed that after all her ERP treatment she continues to have an obsession because she continues to get infections! How frustrating!? I talk about the expectations of ERP and anxiety treatment, how we can deal with the possibility (and reality) that bad/ unwanted things happen no matter how much exposure we do, and how to practice acceptance with situations we really don’t want to accept.

I recently got a follow up question from the Emotional Contamination episode (#240) asking about what to do if/ when someone actually believes their OCD fear is absolutely real. In Therapy-Land, we call this a high Fixity of Beliefs, or their thoughts are highly rigid or fixed. I know a word that doesnt sound like a word. I talk about what can be done when someone has high Fixity of Beliefs, what it looks like, and how treatment is the same and different than in typical OCD/ CBT/ ERP treatment.

Today’s episode feature Dr. Caitlin Pinciotti, PhD, and Jon Hershfield, MFT in our discussion of the National OCD Survey. The goal of the National OCD Survey is to gather information about the demographic differences in OCD subtypes across the United States in alignment with identified cultural groupings within the United States. This was a really fun episode to record and is full of fascinating information about OCD and the way people experience it differently.

Ellie reached out to ask about how to help her 14 year old who is struggling with a fear of becoming like other people. Emotional Contamination the name we often apply to the OCD subtype where someone is afraid they will take on the unwanted characteristics of other, or specific, people. To help, I discuss what Emotional Contamination is, how obsessions and compulsions sometimes present, and what Exposure and Response Prevention looks like in these cases.

Ward emailed me to share a struggle he’s going through related to his SO-OCD. He notes that he’s in therapy and making progress, but the anxiety is impacting his performance in the bedroom and his libido is much lower than he wants. Anxiety can have serious negative impacts on someone’s sexual life. I discuss how the expectations of sexual performance impacts performance, how health and lifestyle changes can help with overall anxiety and subsequently sexual performance, and some exposure ideas to help him along the way.








For more about Sexual Orientation OCD (SO-OCD), check out this article from the California OCD and Anxiety Treatment Center

Payton reached out with a voice question on Instagram with a question that a lot of people who listen to this podcast can understand. She struggles with what she believes is Hyperawareness OCD/ Sensorimotor OCD and is fixated on the fact that she can see the tip of her nose. While it may seem harmless, like all other obsessions in the category, she agonizes over her awareness of it, when it will go away, and whether it will ruin her future. So, it’s hardly just about her nose being there, it’s about her future not being there.








For more on Sensorimotor OCD and Hyperawareness OCD, check out this article from the California OCD and Anxiety Treatment Center

Alana messaged me recently and asked about how she can tackle her perfectionism. It’s stopping her from sending in assignments, writing papers, and even makes her write down all the words she hears to make sure she knows them. Perfectionism can be awful, time consuming, and shame inducing. To try to help, I discuss perfectionism, some things to think about when challenging the thoughts that support perfectionism, and offer some exposure ideas.