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Restoration Beyond the Couch
The Beyond the Couch with Dr. Lee Long podcast is intended solely for general informational purposes and does not represent the practice of medicine, therapeutic and psychiatric services, nursing, or other professional health care services. It also does not constitute the provision of medical, therapeutic or psychiatric advice, and no doctor/patient relationship is established. The information on this podcast and any materials linked from it are used at the user's own risk. The content provided through this podcast should not be considered a replacement for professional medical, therapeutic, or psychiatric advice, diagnosis, or treatment. It is important that users do not ignore or postpone seeking medical, therapeutic, or psychiatric advice for any health or mental health condition they might have, and should always consult with their health care professionals regarding such conditions.
Restoration Beyond the Couch
The OCD Revolution: Breaking Stigma, Cycles, and Building Resilience
Have you ever tossed around the phrase “I have OCD” or “They must be OCD simply because you like things organized? Let’s take a deeper dive into the actual meaning of OCD and the relentless cycle of obsessions and compulsions that define Obsessive-Compulsive Disorder. This episode brings that reality into sharp focus, as Dr. Lee Long and OCD specialist Brandon Stewart join us to dissect the complexities of this often-misunderstood condition. We promise that by the end, you'll have a richer understanding of both rituals that people with OCD endure and the hope that effective treatments can offer. With poignant clarity, we confront the myths that trivialize OCD, painting a vivid picture of the spectrum it covers, from manageable quirks to life-altering severities that can isolate and debilitate.
But knowledge alone isn't enough. We then pivot to the instrumental role of support from family and friends, underscoring the delicate balance of providing encouragement without enabling. We share invaluable insights on how the nonjudgmental embrace of loved ones can fortify the walls against OCD's relentless siege, especially through methods like Exposure and Response Prevention (ERP). And for those bearing the brunt of this disorder, we explore CBT strategies such as mindfulness and acceptance, which arm individuals with the resilience to let intrusive thoughts pass like clouds in a stormy sky. This discussion isn't just a beacon for those with OCD—it's a heartfelt guide for anyone who stands by their side, aiming to foster an environment of growth, compassion, and understanding.
Welcome to Episode 6 of Restoration Beyond the Couch, brought to you by Restoration Counseling. Today, we're thrilled to have an enlightening conversation with Dr Lee Long, visionary author and founder of Restoration Counseling, alongside Brandon Stewart, an expert in OCD treatment and restoration. Together, we'll delve into the complexities of obsessive-compulsive disorder, or OCD, and explore effective strategies and therapies to manage this condition. Join us as we discuss the core principles of OCD treatment, share valuable insights and provide actionable advice that you can apply in your daily life. Your path to mental wellness starts here.
Dr. Lee Long:Welcome, brandon, it is good to have you back on the podcast. Thank you, good to be here. Well, we are going to talk about OCD obsessive compulsive disorder and I think there's a bit of a misconception about what OCD is. I think it's kind of turned into a little bit of a colloquial term where we say oh yeah, I like things straight, I have a bout of OCD or things like that. But for those who are unfamiliar with the clinical aspect of OCD, could you explain what it is and how it manifests?
Brandon Stewart:Yeah, absolutely. I think the easiest way to understand OCD is just to define what is the O and what is the C, so obsessive and compulsive. Those are two very different things. They're separate. The obsessions part of OCD. Obsessions part of OCD. Obsessions are unwanted intrusive thoughts, images, urges or impulses. So that's what's going on mentally within a person's head. It's what they're thinking about and they don't want to think about about it, but it is going on in their head. So, um, the obsession part is not visible to other people okay, so that's you said the thoughts, images, impulses, urges, yeah uh-huh, um.
Brandon Stewart:And then compulsions are. What do I do to reduce the anxiety that is being caused by those thoughts, urges, impulses, images? So the compulsion is more so of a behavior and it's a behavior that I do to calm down my anxiety.
Dr. Lee Long:And um so, so an example might be that if I feel like I have germs on my hands that would be the obsession, the compulsion would be then I would wash my hands, exactly, yeah.
Brandon Stewart:Yeah, so yeah, you're exactly right, and hand washing is an easy one to think about. So it's. The obsessional part of that is I could be thinking in my head, okay, what did I just touch? Okay, oh my gosh, I think I touched the bottom of my shoe and oh, I just left the bathroom and that bathroom was so dirty, and so I've touched the bottom of my shoe and now that's on my hands and I've maybe have some sort of fecal matter on my hand and I just touched my jacket and I just touched my ear, and all of those images of thinking about germs going through my head. And then the compulsion, as you said, I'm washing my hands, I may be taking off my jacket now that I think is dirty, I'm going to go and wash it, but doing those types of behaviors for me to feel better.
Dr. Lee Long:And I mean that sounds like it could be quite torturing to those who experience this. Oh yeah, your mind takes you on a journey, so to speak, that you're going through every possibility of what you may have come in contact with yeah, every possibility of what you may have come in contact with and then trying to undo the, the exposure to the uh, to the germs, so to speak is could could really be a torturous place, Absolutely. At the same time, I think that I'm I think that everything operates well, not everything, but I think most things operate on a spectrum. So do you see that there are some people that have this, uh, this struggle where it's debilitating, and others who have this struggle where it's just a minor annoyance, Uh, yes, yeah, overall, um, I was the minor annoyance I was getting hung up on that, um, the minor annoyance I was getting hung up on that.
Brandon Stewart:But yes, there's a scale where they have people rate their obsessions and compulsions. One level is non-significant and that would be kind of eh, it's a mild annoyance, like you're saying, not a big deal. It's almost maybe like a quirk, but it really doesn't cause much distress or interference. But it can go from non-significant to mild, to moderate, to severe, to extreme, where it is absolutely disabling, where a person cannot work, cannot leave their house, is not engaging in any sort of relationships, really sad, tough place that a person could be with OCD.
Brandon Stewart:And you mentioned earlier about common misconceptions about OCD and I think one main misconception that I often encounter is that OCD is a? Um, a cute little quirk and it's kind of funny and it's, you know, not that big of a deal and, um, you know, oh, it's, if I were to have anything I'll take OCD kind of thing. Um, and that that couldn't be farther from the truth of meeting with a lot of people with OCD. It is very distressing, it's not cute, it's not fun, it takes up so much mental space and mental energy and can really wear a person down, can lead to depression, can shrink their world and prevent them from living a life that they enjoy or want.
Dr. Lee Long:It almost is like you're describing a loss of a sense of freedom, oh yeah, that the world feels very shackling to them, absolutely. You know, and I think about what you're, what you're talking about here, and it's, it's hard to raise, like when you were, you were saying, I got hung up on the idea of you saying that it's just a minor inconvenience or something to the light, and I, I, I almost joked and said, oh, so do you have OCD about my words here? But I, I, I also recognize and I know OCD is not a joking matter In every sense of the word, it is not a joking matter. But I do think that we do have this misconception in our culture that we think, oh, I'm depressed. Well, clinical depression is very, very different than saying I'm sad about something. We don't have full language around how to describe that Right.
Dr. Lee Long:And with OCD, when someone is particular about something, or when somebody is a neat Nick, or when somebody is, um, you know, wanting their their, you know, shirt, just so we have these things. We say, oh, that's OCD, but in truth it could be. But more likely is the sense that that's just a particular. Yeah, there's just somebody being particular about something, right, a temperament, right. But when you have OCD, you're really looking at something that can be like depression, like real clinical depression can be severely debilitating to someone. That OCD like clinical, true OCD can really be debilitating and have a really hard impact on the person struggling with that. Oh yeah, absolutely Absolutely.
Brandon Stewart:Another common misconception kind of piggybacking off of what you said is that OCD is only about being orderly, or liking your desk straight and things lined up, or is only about germs. So that can be, as we're saying, one that can just be hey, you're particular and specific and that's just your temperament or it can go into a disorder and be truly clinically OCD. But there's actually a lot of other types of obsessions that a person can have within OCD that are not talked about as much. So we know about the hand washing, we know about the hand-washing, we know about, maybe, symmetry and orderliness. But there's also many other obsessions that are related to violent intrusive thoughts, sexual intrusive thoughts, religious thoughts, kind of what some people call bad thoughts or dark thoughts, to where those can actually go very much so undetected because you're not seeing them and a person's not going to be just like willingly open to talk about that thing.
Dr. Lee Long:Yeah, I'm glad you're bringing these up, brandon, because one of the hopes that we have in talking about this is bringing light to this subject, that these internal dark thoughts can really plague someone and they don't know if it's appropriate to share them somewhere because of the judgment they are fearful that they will receive as a result.
Brandon Stewart:But you're saying and I think saying it well that this is really woven into part of what is classified as an obsession as a part of OCD, and the tricky thing about those is that a lot of times the compulsion is not an outward behavior like washing hands, right. It's an internal thought pattern, right. So I could have a violent, intrusive thought. That's the obsession of. This is graphic, but this is what it can be, of me stabbing my friend and I've got that violent image in my mind. I don't want to have that.
Dr. Lee Long:I think that's the important thing to note. It's not somebody who is violent, who is angry at their friend, who's thinking that they want to kill someone. This is an intrusive thought.
Brandon Stewart:And they're usually the nicest, most conscientious people, and so that image really scares them. They don't like that at all, that's not in their character and it disturbs them, it upsets them, sure. And so, for their compulsion, it might be visually in their mind trying to erase that like an eraser You're erasing a drawing, or it could be analyzing it and figuring it out of reassuring myself. No, I don't want to do that, that's not me. Take it back, I take it back. Or like a special prayer, me, right, take it back, I take it back. Or like a special prayer.
Dr. Lee Long:And then they get stuck in this loop, um, trying to calm that down, trying to make it go away, but all of its internal, so you're never going to see it, and it's to me as I've, as I've conceptualized this in my own mind, walking through learning all of this is it's it's almost like blowing out trick candles it works for a moment but then it comes right back on, yeah, or or lights right back up and we constantly, and so we get fixated on blowing that candle out, because that candle, understandably, so yeah, is extremely internally undoing, yeah, yeah.
Dr. Lee Long:And so we get focused on blowing that candle out over and over and over and trying to live life as a result with when we're just focused on that candle, which is very disturbing, it, like you said earlier, it does shrink the, the world.
Brandon Stewart:Yeah, that's a good analogy.
Dr. Lee Long:I like that yeah, that makes sense. What, as you, as we think about OCD and we think about, you know, the the, the role of the family or friends. What is something that we could share with our, with our listeners, like that may have someone who's struggling with OCD, what, what role could they play in supporting their loved one that has this struggle?
Brandon Stewart:First, right off the bat. I think the most helpful thing is getting educated on it, learning about OCD, so listening to this podcast is step one.
Dr. Lee Long:Exactly yes, well done.
Brandon Stewart:Check, yes, education, learning about OCD as we're talking, there's a lot of misconceptions about it, and so if a family member or a loved one really learns about the intricacies and nuances of OCD, that is huge. Um, that is huge. And now, all of a sudden, the person suffering from OCD um has an advocate who gets it, who understands it and doesn't think they're crazy. Um, that, that's a, that's just so much. Uh, helpful connection there. If someone is, uh is meeting you there in that spot.
Dr. Lee Long:I think that's a great point is that you're pointing out the sense of curiosity, which curiosity in any relationship is paramount In relationship to yourself, in relationship to others, having that sense of curiosity is big. So curiosity as a family member, to learn more about this, I think, decently misunderstood issue. Secondly, you're saying that it's to to approach that loved one, that family member or friend, with a nonjudgmental stance, like, like they're not crazy. No, that there's not something here that this is something that is. It's like, it's like the. Going back to the analogy of the, uh, the the trick candle yeah, it's like they're really trying to extinguish this, but extinguishing it in the manner that it's being attempted is just simply unsuccessful. Right, much to the chagrin of the person trying to blow the candle. Yeah, right, much to the chagrin of the person trying to blow the candle. Yeah, but they really are trying to to uh be effective in in extinguishing this and so meeting them in a non-judgmental fashion. So, curiosity, non-judgmental. Any other tips for families or friends?
Brandon Stewart:so education is a big piece. And then also I I would say, when the person is ready, that you can support them in doing the treatment that they're receiving for OCD, and mainly what I'm thinking there is supporting them in their exposure work. Will you tell us a little bit about what exposure work is? Yes, yeah, so the technical definition is exposure and response prevention. So again, easiest one to explain and understand is the germs and hand washing. So if I'm struggling with that, then I would expose myself to a contaminated object, such as a doorknob, so I expose myself and I touch the doorknob with my bare hands. Then response prevention meaning my typical response is prevented. So I'm not going to do what I typically do, ie wash my hands. So I'm exposing myself to a contaminated object on my bare hands and then I am not going to wash my hands, and maybe I would do that for 30 minutes. I've touched a doorknob, I don't wash my hands and then I just kind of sit with that for 30 minutes. I keep going about my day and I have contaminated hands for 30 minutes. That could be an example of what exposure is. So that's very difficult, that's really hard work. So let's say, the loved one can encourage them in that, support them in that, because they have learned about OCD, they know that that's really hard, that's not just something simple to do. So they can give them a genuine pat on the back because they know how hard that is. And also in supporting with exposure.
Brandon Stewart:Sometimes a family member or loved one can get pulled into a compulsion, which is common, of reassurance, and so I might. So I've touched the door knob and I might ask my friend you think that's okay? Do you think my hand is okay? There aren't actually germs on my hands. You don't think I have cancer now, do you? If they give reassurance, no, you're fine, it's okay. Being technical, that's a compulsion.
Dr. Lee Long:So if your friend would be willing to do it and the person suffering from OCD is willing to do it, to have your friend no longer give you that reassurance, right, because that is as loving as it feels to reassure someone. You're participating in the attempt to neutralize that, that angst, yeah, yeah, and it's it that turns into a trick candle over and over and over again. And now you're saying, well, let's blow on this together, right? And now we're looped into, uh, trying to, we're compulsively looped into neutralizing this anxiety, when I think what you're proposing here, which I think is a brilliant proposal, is the idea that we just have to be exposed to it and understand that we can be okay in the midst of our pain.
Dr. Lee Long:Now, it is painful and I'm I love how you're describing this, because we don't want to take anything away from those who are struggling with that. That obsession of, of germs or dark thoughts or or whatever the obsession is paired with, but are paired to. I should say it's. It's that place of being really meeting them. And you're saying that for the loved ones, and the way that this all works out is that we meet them in that place of encouraging them in the sense that you did it. Yeah, this is, this is really exciting or powerful, right, congratulations, or however. You want to meet them, but it's really truly encouraging the work.
Brandon Stewart:Yeah, yeah. And they're not alone in it. Right, Because with OCD there commonly is a lot of shame of again, what's wrong with me? I'm crazy. I'm weird, you know. No one else has this. I'm different.
Dr. Lee Long:And, as you're saying, someone who's partnering with you allows you to show up authentically. You, yeah, yeah, yeah, I love that. I think that's great, absolutely. So you've already talked about the. You talked about, well, the some of the treatment that's been effective for the for O, the whole exposure response prevention, the ERP work. Are there other strategies that you want to comment on that are helpful? Manage, effectively?
Outro Speaker:managing OCD.
Brandon Stewart:Yeah, yeah, I mean the most common treatment is cognitive behavioral therapy with exposure response prevention. Part of what a person's going to get with CBT is understanding thinking mistakes. Ocd has a lot of tricky ways that it sees your thoughts. That can kind of get you confused, and so with cbt you're going to learn about hey, here's, here's the trick that's happening and you kind of get behind the curtains and that that can help with some of the um, confusion and mystery with it. Uh, also within, also within CBT, various relaxation techniques can be helpful Breathing, progressive muscle relaxation, self-soothe in some places distract. So that's common. Then there's also, to your question, mindfulness techniques and acceptance techniques. I often find these helpful for the darker thoughts and it's kind of complicated. But when it comes to the darker thoughts that a person hates they don't want to have those A common compulsion is to avoid them and to wrestle with them and try to make them go away, which is a completely understandable response.
Dr. Lee Long:Sure, and to me it's the exact same response as trying to make the germs go away by going straight to the sink Right when that's ineffective in the end.
Brandon Stewart:Yeah I wish it worked, but unfortunately it doesn't correct um, so it doesn't work to try to fight with it, um. An analogy I've heard is, uh, that old school cartoon, um briar rabbit with the tar baby, where he, you know, punches the tar baby to make it go away, but now he's got one hand stuck on it, uses his other hand now he's stuck on it with both hands, uses his feet and before he knows it he's completely covered in it. So trying to make those thoughts go away can often result in something similar to that. So, in short, mindfulness and acceptance principles have to do with learning to observe a thought, just as a thought that it's going to come up and let it pass. Naturally it will do that, like all the other thoughts that we have. You know we have hundreds of thousands of thoughts a day and if we can learn to step back just as an observer, watch them and watch it come and go um without assigning meaning to it.
Dr. Lee Long:That's the power. It's interesting because any grad students out there that are are studying counseling or mental health. Uh, when, when you know, I wonder if this was the same for you. When, when you go through abnormal psychology, you you read those, you read the DSM and you're studying it and you think, oh my gosh, I have everything here, or loved ones have everything here. And one of the comforting things was to come back to class and realize everybody in the class kind of felt the same way.
Dr. Lee Long:Um, but the the interesting thing that I learned way, way back when was that we all have these strange or unusual thoughts that fly over our head, but it's when we entertain them or try to get to the origin of why the thought is there is when that thought becomes very problematic. Yes, exactly, when you're talking about the just observe and accept and using mindfulness in this, that really does shed light on the fact that the thought can come and go.
Brandon Stewart:We just don't need to judge the thought, yeah, yeah, exactly, and I I share with people who are having these dark thoughts that all those thoughts that you have had, I have had them as well. Like you're saying, we've all had those dark thoughts. The, as I call it, the OCD bully, or I like the OCD troll, like an internet troll, will jump on that and be like, well, what does that mean about you? Why are you having that? Do you want to do that? And when we start trying to answer those questions, now we're you know that's like hitting the tar baby, yeah, and we're getting stuck in it, so the acceptance can be very difficult, but can be really helpful.
Dr. Lee Long:I love the principles that you're throwing out here, brandon, that, just as a community, that we could be more curious with folks regard OCD, depression, anxiety, anything we can be more curious with folks, I think it's it's that idea of being being slow to judge. You know, yes, we do have to make you know, we do have to understand things, which is that curiosity piece. But judging people, I mean, I think that's where we have to be very careful and step back and be be slow to judge, nonjudgmental towards people and being, you know, like these thoughts that are that are plaguing people. Yeah, I mean, is that, oh, that's too strong of a word? No, not at all.
Dr. Lee Long:These thoughts that are plaguing people, that we, that we can be supportive and and and understanding how they're walking through these things and learning, as they're learning to accept, or they're walking through this, that we can offer them some sort of support? Yeah, the tricky thing is, is that we offer support without being a neutralizer? Yes, who's saying no, no, no, no, it's okay, you're fine, right, and so having that blend of it being helpful, yeah, so what would be a tip that you would give somebody? I'd love to hear a tip that you'd give somebody at home listening to this. What tip would you give somebody that has a loved one struggling with OCD? And what would be a tip that you would give somebody that they could do at home that feels like they struggle with OCD?
Brandon Stewart:The thing that comes to my mind is actually for either of these people to first go out and seek some education. There's an organization, a foundation, called International OCD Foundation and they have a website called iocdforg. Or if you just Google International OCD Foundation, or if you just Google International OCD Foundation, they've got a lot of great resources that would help either of these people to see is this OCD, am I relating to a lot of this? And okay, now I've got a name for it. This is something that's out there. This is enough people have it that there's an international foundation for it.
Brandon Stewart:I'm no longer all by myself and quote crazy for having this. That can really tamp down the shame. So you normalize it. Yeah, normalize it and I think, open up a person to then now get more, so formalized treatment and then again, for the family member, a helpful website like that is. I mean, they've got a whole section of four friends and family um where they can start learning about OCD and um getting educated and if their loved one doesn't know, they can start kind of gently encouraging them of hey, check this out.
Brandon Stewart:I just read this, or I just saw this video. Uh, I'd be curious, if you watch it, what you thought, um, kind of greasing the wheels for them to then, um, go get some help. And there's also a lot of helpful books out there. Um, uh, one book that I've really enjoyed is called freedom from OCD by Jonathan Grayson. And uh, one book that I've really enjoyed is called freedom from OCD by Jonathan Grayson and, uh, it's got a whole like uh treatment outline for a person to do on their own. I think it's a little bit harder to do that, but, um, it will start giving a person really helpful tips and tricks to begin back and learning that they don't have to be controlled by this.
Dr. Lee Long:I love that. I love the sense that we can leave the message that you do not have to be controlled by this, that there is a space where people could get to the point to where they could celebrate a restored freedom from feeling like as you said and then I love this phrase that the OCD bully no longer has a hold over them. I think that's brilliant. Yeah Well, brandon, thank you so much for being with us today and for enlightening us in OCD which is no, it's it's no joking matter. It's a which is no, it's it's no joking matter. It's a, it's not a colloquial thing. There really is a true struggle with this that we want to shine a light on, to illuminate, to say, if you're struggling with this, or if you have a family member struggling with this, you are not alone and there is help. We just want to shine a light on how you might get to that help.
Brandon Stewart:Yeah, so thank you, brandon, absolutely Thanks for having me.
Outro Speaker:If you found value in our discussion and wish to uncover more about the fascinating world of mental wellness, don't forget to subscribe to the podcast. Stay tuned for our upcoming episodes, where Dr Long will continue to delve into empowering therapies and strategies for mental wellness. Your journey to understanding and embracing mental health is just beginning and we're excited to have you with us every step of the way. Until next time, keep exploring, keep growing and remember to celebrate restored freedom as you uncover it. You Thank you.
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