Episode 15: What 'Real Recovery' Means to Me

Episode 15: What 'Real Recovery' Means to Me

In today's episode, we have 4 guests who live with OCD sharing what 'real recovery' means to them. What does real recovery even mean? The actuality of being in recovery with OCD can often be vastly different than what we imagine, and this can sometimes cause confusion, distress, and even grief. We sometimes look at OCD as a problem to be 'fixed', or something we can just find 'the key' to and it will all go away. And when we realize that OCD is part of how our brain operates, and we need to work within that reality and within ourselves to create a life with OCD, this may feel overwhelming. This is SO common! And this is why this episode is so important. 

You will hear four different accounts of recovery evolution, and what has helped each individual get where they are today. One of the things I love about this episode is how each person stresses the importance of individuality. How are you framing your recovery, and what do you need to work through to continue to push farther into it? These are individual questions and the answers can take us in so many incredible directions. Because recovery from OCD is about discovery - the discovery of who we are with OCD, and knowing that we are still worthy and deserving regardless.

Recovery for OCD isn't about 'fixing' our brain, it's about adapting and finding out who we are with it. And I hope this episode inspires you to believe that about yourself!

If you are in need of a community of people who can help you feel more accepted, less alone, and more connected to people who understand, please check out my online community for weekly support, monthly classes and events at https://the-ocd-support-community.co.mn

If this podcast inspires, supports, and gives you hope and you'd like to support us monthly or sponsor us, please visit our patreon page and become a member. Your contribution will help us continue the podcast and help us provide even more resources for our community! https://www.patreon.com/intrusivethoughtsunmasked

Transcript

SPEAKER_02 0:05

Welcome to Intrusive Thoughts Unmasked, the podcast where we explore what it's really like to live with intrusions, the emotional landscape that comes with them, and the common experiences so many of us share. I'm Chrissy Hodges. I created this podcast to bring lived experience into the light for those navigating intrusions and mental rituals with OCD. My hope is that here you can finally take off the mask we so often wear to hide this disorder. I want you to feel seen, understood, and accepted exactly as you are. Welcome to episode 15. In this episode, we have four guests that talk about what real recovery means to them. This is such an important topic because we often think of recovery as this imaginary illusion that we're going to finally cross the finish line and have. When in reality, recovery is complex. It can be painful, it can be beautiful, it can be discovery, it can be breaking us down. But overall, each of us has our own personal journey. And today you're going to hear four different accounts of what real recovery means to individuals living with OCD. I hope you enjoy the show.

SPEAKER_01 1:28

This time from Emma Chadran, a renowned American Tibetan Buddhist monk, author, and beloved teacher. She says, loving kindness towards ourselves doesn't mean getting rid of anything. It means we can still be crazy after all these years. We can still be angry after all these years. We can still be timid or jealous or full of feelings of unworthiness. The point is not to try to throw ourselves away and become something better. It's about befriending who we already are. It has taken me 50 years to finally understand that there is no undertaking more important in this life than that of cultivating kindness. Kindness first and foremost towards ourselves. Because we are all worthy of it, and because only when we're kind to ourselves do we have the ability to be kind and compassionate towards others. As I approach my 50th birthday this February, I look upon my life with absolute clarity. And I have an unshakable knowing that all the trials and tribulations, all the pain and suffering that I have experienced have been there to teach me how to be kind to all parts of myself: the good, the bad, and the ugly. One of my earliest memories is me standing in the playroom in kindergarten when I was maybe four or five years old, and feeling like everyone's watching me. I have this feeling that there's something wrong with me, that I have done something bad, although I don't know what it is. This feeling of guilt, of isolation, the fear that I don't belong, that I'm inadequate and bad in so many ways accompanied me all through my childhood, adolescence, young adulthood, and into my early 30s. And then it turned into something else. A few days after I found out that I was expecting my first child, a surprise that had filled me with limitless joy. I had an experience that frightened me to the core of my being. Even though it happened 20 years ago, I still remember it very clearly. I was alone in the home that I shared with my husband. He was down on the farm doing his usual jobs. I was thinking about a little baby growing in my belly when I had the thought, what if something goes wrong with this pregnancy and I lose the baby? Then the next one, what if I do something that kills the baby within a split second? My heart started beating fast, and I felt like I got punched in the stomach. But the worst part of it was this sense of doom that this is going to end very badly. This did not feel like the anxiety and fear I've known all through my younger years. This was a level of dread that I had never experienced before. This was the start of my journey with obsessive compulsive disorder. That day marked the beginning of my having to face my inner demons in a whole new way. Unlike in the past, when I reacted to my feelings of anxiety and fear by isolating myself in a cocoon and escaping into fantasies of a different life. All those demons, the shadows that have accompanied me since childhood, were now standing right in front of me, forcing me to back up against the wall and tying me up so I couldn't move. Then they transformed everything I had known to be true of myself and my relationship with the world around me into something that I could now compare to a simulated reality with loud sounds and vivid colors and details that were so convincing and so in my face that they made me believe that all those images and mental noise was actually who I really was. This is what OCD has made me feel like. However, this relief was short-lived. Through the months that followed, leading up to the birth of our precious baby girl, and for the first few months after, as well as during my relapse over two years ago, I was experiencing a never-ending loop of intrusive thoughts of committing suicide, killing my husband, my mom, my beautiful newborn, and later our three teenage kids that are the love of my life. These thoughts were accompanied by very high levels of anxiety and distress. And this horrifying experience resulted in me sinking into deep depression. Help arrived in the form of antidepressants, and then there was the constant, unwavering support of my husband and my mom. I did some exposure and response prevention therapy. I say some because almost as soon as I started therapy, I realized that instead of making me feel better, it made me feel a whole lot worse. So I gave it up. Although I now understand that OCD has nothing to do with who I am. It has never been more than a bully that attacked my core values and what I cherished the most, and that targeted the very things I was trying to protect. During those challenging times, I believed that those thoughts were me. OCD made me believe that I was a monster, that I was someone my loved ones needed to be protected from. And when it so pleased, it made me believe that I even needed protection from my own self. In this crazy simulation, I turned into one of those vicious murderers that you hear about or see in the news. Because now I had proof that I was bad. And no one could fix me. So after all that, how did I end up with the belief that I was worthy of my own love, kindness, and self-compassion? First of all, all those horrific, unspeakable acts I fear that I would carry out well, they never happened. It turns out that no matter how convincing that bully OCD is, no matter how real the simulation seems, it can never make a person suffering from this mental disorder change their true colours. Someone that always abhorred violence, that made sure she never intentionally caused harm to anyone, that had great love for animals and people in her life, would never be turned into a person capable of murdering the ones she cared about the most. That's great news for me and for all of us. But after decades of wrong patterning, a new attitude of kindness towards oneself doesn't develop in a day. For me personally, it is an ongoing journey, a work in progress, one that will probably take up the rest of my life. This process of cultivating kindness and self-compassion is one that is nourished by a lot of support from people who love you and guidance from those who have already walked this path before you. It also requires a willingness to look at oneself through fresh eyes. This willingness is born out of suffering. It is born out of a personal, very raw experience of trauma. When you get to a point in your life that you finally can lift your head over the troubled waters and breathe again, you realize that you do not want to cause any more suffering. Not to others and not to yourself. Never again. That loving kindness towards self and others is the single most important mission of this lifetime. I need to add something important here. Just because you have this willingness to treat yourself with kindness and self-compassion, and you have this newfound wisdom and clarity born out of your own suffering, it does not mean that your shadows and ugly parts stop existing. I still have feelings of inadequacy, of not being good enough, good enough as a mom, as a wife, as a daughter, or as a sister, of being a failure or feeling of guilt when I choose to prioritize my own needs over others. Yes, those parts are still there for me. And I still feel the weight of them from time to time. I feel the pain they carry, but I choose not to suffer. What does that mean? It means that when I have a negative thought about myself and I feel the discomfort that arises with that, I choose to stay with the emotion instead of running away from it and say to myself, it's okay. Everyone feels like this from time to time. I love that saying. It's okay to have all kinds of thoughts. It's okay to have all kinds of emotions, it's all part of the human experience. Sometimes in inspired moments, I am now able to look at these old thought patterns and the emotions of sadness and guilt and inferiority and all of that. And I see them as little scared parts of me that just need to be acknowledged and brought into light. Other times, though, especially when I'm tired or sick, or it's one of those weeks that it just keeps raining and it's gray and dark outside, it happens that I simply get pulled down by the weight of unkind thoughts. And then I just have to let myself go down that spiral because pain is part of life. And sometimes you just have to let yourself sink deep into it, but without abandoning yourself. Feeling kindness and compassion towards some parts of myself still doesn't come naturally to me. What I think what really matters is the intention to be kind to ourselves in challenging moments. As the wise monk says, it's not what happens to you that matters, but how you choose to respond to it. This is something I learned through my meditation practice. You see, I used to believe that the goal of having a regular meditation practice was to achieve a mind with no thoughts. Given my history of intrusive obsessive thoughts, I craved to reach that state of a quiet mind. Yet every time I sat down to meditate, I inevitably got carried away by my thoughts. Sometimes I found myself completely absorbed by my mental chatter, so much so that I spent nearly a whole meditation session following my mind, moving down all sorts of rabbit holes. It was only very recently, after a year and a half of meditating daily and consistently, and leaving the practice, feeling disappointed in myself and judging myself for having such a strong attachment to my mind's activity, that something occurred to me. What am I doing? I realized that during my quest to achieve a perfect mental and emotional state, I returned to the exact same patterns that I had been seeking refuge from through mindfulness in the first place. I was judging myself in the same way I used to growing up. Then it dawned on me. What if mindfulness isn't about achieving perfection, but about learning to acknowledge all the imperfect parts of me instead? What if it's here to teach me to see the whole of myself clearly and non-judgmentally? Holding space for and being kind to all the different parts of myself, even the scary and ugly ones. We need to let go of this idea of perfection, a perfect life, a perfectly functioning and happy mind, a perfectly healthy and fit body, achieving eternal youth and bliss, or even the ability to always feel compassion and kindness towards ourselves and others. I now truly believe that we are here in this world to learn to develop unconditional love for the million different facets of life and ourselves. And those of us who are walking through life accompanied by OCD, we need to know that OCD is not who we are. It's something that we're experiencing for whatever reason. And then we must face our shame and guilt and grief and simply hold them with loving kindness, as if we were holding an innocent young child broken by trauma. My wish for all those that are listening now and are going through suffering is to be blessed with light and compassion for all of themselves. Thank you.

SPEAKER_00 17:04

Hi there, I'm uh Andrew Cohen. I'm a licensed marriage and family therapist uh out in Westlake Village, California. I um have a practice specializing in OCD and anxiety, uh, and I also have OCD and anxiety. So so I'm here to talk about real recovery today, and I think you know that looks different for everyone. So hopefully me sharing this will give you a little insight into what that's like and uh hopefully help you in your journey because OCD sucks, as I'm sure you uh know. My kind of first experience with I would say anxiety, because OCD showed up you know a couple years, I would say a year or two after just truly anxiety showed up. Uh I was about five years old and you know was dealing with I you know looking back, I didn't have a name for it or know what was going on, but very significant separation anxiety um for my parents. Uh, you know, school drop-offs were a nightmare. You know, I remember one drop-off in particular where really, really crying and screaming, and my parents, my mom left, and you know, they couldn't calm me down in kindergarten, and uh they were trying to console me. They they even brought my brother who was in fifth grade at the time to try to calm me down, and the principal came too, and uh, I was like so panicked and you know, so scared that I ended up kicking him uh in the uh in the balls. Uh, you know, and that that's always that story has actually followed me throughout my my schooling years, my K through 12 in the school district. So that's a fun one I like to start with. But um, yeah, and you know, ever since then anxiety uh became very familiar to me around seven, eight years old is when OCD, um and I name my OCD bitumen. Um so bitumen showed up uh in in more of the form of a lot of what if harm comes to me or to my family. Um I won't get too into the specifics of it um just for the sake of time, but it was a lot of intrusive, unwanted thoughts of you know really bad things happening to myself, and it was terrifying. And you know, looking back, I didn't know at the time what was going on. It was really scary. There was a lot of reassurance seeking, there was a lot of avoidance. I think avoidance was kind of the main, main compulsion or safety behavior that was happening. And then OCD Bitumin kind of morphed uh for me into a more kind of just right and sensory motor related things, also still significantly dealing with the separation anxiety. Uh, this was probably around, I would say, late middle school, early high school, where this kind of showed up or continued to happen. And you know, I was unable to, you know, spend time and then do like sleepovers and um go to like sleepway camps or anything like that, missed out on a lot of really cool opportunities, unfortunately, because of the anxiety in the OCD. Around this time, actually, is when I when I started going to I think I was 15, went to talk therapy. Um and you know, I I I liked it. Um, you know, my therapist was really kind and sweet, and he was actually the reason I became a therapist. But you know, looking back, unfortunately, the OCD was was not uh you know, I I wasn't washing my hands and checking door locks and things like that. So OCD was really never a word that was thrown around. Um so you know, I was kind of just I felt like I I was kind of just someone who dealt with significant anxiety. Um meanwhile, you know, I was engaging in all these kind of rituals that were not as uh outwardly visible, you know, kind of flew under the radar. I would say for me, yeah, Bitamen got really, really loud last year at UCLA. Um I was in a you know relationship at the time that was pretty serious and stuff happened, and uh it ended up really morphing into kind of moral scrupulosity and relationship-related OCD, where you know there were real events that happened that I'm not proud of, um, but then kind of just grew into this horrible non-stop being bombarded by these obsessions, um, and needing to confess all these intrusive thoughts I was having to my partner at the time, and needing constant reassurance and constantly confessing and going through these wild ups and downs of you know, feeling super anxious and the urgency and the fear and the just all all the stuff OCD throws at you, and then doing the compulsions and feeling relief. And then that would last for maybe I don't know, a couple of seconds, uh couple of hours, maybe sometimes a whole day if I was lucky. But you know, it would always just creep back in. You know, got to the place where, you know, I was, I was pretty much, I have no idea how I ended up graduating. I was, I was very much just like, you know, living in my fraternity house in the bedroom by myself and like not really interacting much with people. And um, you know, thankfully, like I said at the time, someone did recognize it as OCD after I graduated college and found my way to a wonderful therapist, um, Laura Yokum over at OCD Center of Los Angeles, who you know diagnosed me, gave me the whole rundown of what OCD is, and hearing all everything that she was was saying about it, everything just kind of rang true of like, wow, you you know my brain. This is what I've been dealing with my entire life, and and and finally getting that diagnosis and learning about ERP and act, acceptance of commitment therapy, you know, really led me down this amazing life-saving path. And I I I'm serious about the life-saving part because when you don't know what's going on and it's just constant in your head, and you don't know how to, you know, get through that without getting sucked into the vortex of OCD, it would drive anyone to want to end their life. And um, you know, I'm really, really happy and grateful that I was able to find such excellent care and kind of leading to like what real recovery looks like. Yeah. So for me, you know, I think real recovery, being human, regardless of any diagnosis you have, whether you have OCD, PTSD, depression, anxiety, whatever it might be, being human is is a wonderful thing and also comes with a lot of really, really challenging times. You know, if we live long enough, we do get to experience some amazing highs, some amazing, you know, connections with people and passions and just living by your values and figuring those things out. But then at the same time, you're gonna experience immense pain, loss of friendships and loved ones and all that kind of stuff. And real recovery, it's not so much about if OCD tries to jump in or obsessions get thrown at you, it's more of about when it happens. Um, because it it is gonna happen. And that's that's a normal human mind. For me, if I I kind of like to go by this mantra for myself of, you know, I want to judge my successes by how I respond to these thoughts and feelings when they show up, rather than if they're there or not. Because, you know, early on in my treatment, and I think like anyone, understandably so, I was so desperately just wanting the thoughts and feelings to stop. And I think that was why ultimately we turned to do compulsions or drink or use drugs or whatever it may be to try to just shut the thoughts up, ultimately kind of getting to a place of real recovery is not not the absence of these thoughts and feelings and sensations. It's learning how to change our relationship with them. One from from from one of you know fear and unwillingness to have to one of curiousness and openness and willingness to experience them in a way that is, you know, we're able to kind of take a step back into what I like to call like an observer mode where we can kind of sit back and experience them coming through rather than getting sucked or hooked into the vortex, if you will, that OCD wants to get you into. I'm 33 now, so it's been about 10 years post-treatment, I guess, if you will. It's been an up and down, you know. I think uh for me, you know, relationship-related obsessions can still get pretty loud. Thankfully, I have a great support system. My wife, who also works and practices with me, is is is very understanding and you know, doesn't accommodate my OCD, but is very supportive through the whole process of dealing with some of the ups and downs. Something that's really important and I think for me, really humbling was I I recently, I would say in the past two and a half weeks or so, about two and a half weeks ago, probably experienced one of my the biggest laps that I've had since being done with treat since like discharging from treatment and in when I was 23 or 24. It it really hooked me in. Um, you know, and for me, my my OCD was really trying to latch on to a lot of like physical sensations and to analyze them and you know, feelings of being dissociated and those kinds of things. And you know, I I it was really frustrating because as an OCD specialist who's been through treatment and does this stuff all day, every day, and talks about this with patients. I was trying to go through my repertoire, if you will, of tools to help me get through it. And it was it was almost, you know, OCD that is bitumen, you know, is almost kind of using that against me and and trying to convince me that you know all that is just compulsions and all these kinds of stuff. Um, and and for me, it was scary as hell because I was starting to feel similar feelings to when I was back at UCLA in terms of just fear and those uncomfortable physical sensations that that that come along with that. But I I I think what what ultimately kind of got me through the lapse lasted, I would say, about three to four, maybe five days, was really coming back to the basics, you know, of my OCD treatment and you know, being able to go back to what OCD is ultimately looking for, which is certainty. And it and it brings up this anything that elicits this need for certainty and this this urgency, if you will, is it's fair game for OCD to latch onto. And I really had to like lock into this idea of okay, any questions that pop up in my mind we're gonna leave unanswered. I'm gonna be open and willing to experience the accompanying difficult feelings and thoughts and sensations that arise with that. And I am going to practice putting my attention on what I do care about. You know, there was a moment during that lapse I took my two and a half-year-old son bowling, and you know, just for some reason being in the bowling alley with everything going on, my fight or flight was going off for sure. And um, you know, it was really OCD was really wanting me to ruminate on all of that. And I really, that was, I think, a really pivotal moment in kind of shifting me out from that lapse because I was able to like create space and and and and coexist with all that noise and also then put my attention and energy into my kid bowling for the first time. Um, and it wasn't easy, and it's you know, I was definitely not as present as I would have liked to have been. Um, but it was it was, I think, a really pivotal moment and one where I got to also practice a lot with what I preach, with it's uh going for progress and not perfection with this, and also you know, being kind with myself. And and what what helped me also get through this is you know, I talk a lot about with my clients that like the content of OCD is is infinite. Our brains are a content creating machine, you know, and whatever we give attention, whatever thoughts pop in that gets our attention, it's fair game. And we can know that logically, but then when you experience a new theme, you know, it's a whole different ball game when it actually happens. I I I I kind of liken it to like I've been playing guitar since I was eight, you know, played in bands and stuff and still play. And I like to think I'm pretty decent and can play a lot of different songs, um, and and have you know a lot of the skills pretty much mastered. However, there are still songs that one learns to play that are really difficult songs. And when you really have to actively think about how to play that song at first, it can be really frustrating and humbling and annoying, but you kind of the persistency of the practice, practice, practice, you eventually get to a place where that really, really hard song becomes second nature. And I kind of I think anytime we experience a lapse or you know an influx of obsessions, you know, it's it's really important to kind of go back to that idea of like, yeah, this is hard, and I also know what to do, and I can handle this, and I'm willing to experience this difficulty right now and work my way through this and not leave these, I'm gonna, I'm gonna leave these questions unanswered, if you will. And so I think to kind of sum it all up is you know, real recovery is being flexible and compassionate with yourself, being willing to experience obsessions, being willing to experience being human, you know, difficult thoughts, feelings, sensations, memories, urges, ideas, all these things that come in are completely normal. And we don't have to do anything in response to them. We can truly allow it to be there and also do the things that matter to us, show up how we want to show up.

SPEAKER_03 31:28

Thank y'all so much for having me, Chrissy. I'm always so in awe of all the work you do and just have done for so long and for so many people. So um I know you and I have had a long-standing relationship and we've been doing this work in different ways for a long time. So it's just amazing to see so many people who are still in the fight and still doing the work. Today, you and I talked about my topic, which is going to be real recovery. And this topic just it means so much to me, and it's kind of like my soapbox for 2026. Um, so my name is Dr. Elizabeth MacIngel, and I am the director of one of the few OCD-specific residential programs in the country, OCDI here in Texas. I'm also a patient who has lived experience with OCD and an advocate who spends my life advocating for patients with OCD. And my goal is always twofold. It's to help individuals get the treatment that they need. So get access to evidence-based treatment for us to help disseminate evidence-based treatment and what that is. And then, more importantly, which actually leads exactly into what I'm going to talk about today, to help individuals know what they should expect, what should they plan for when they think about recovery from OCD. And this is something that is a topic that's really dear to my heart because it has evolved for me, right? The thought of recovery and what recovery looks like has transitioned and changed so much over the past couple of decades in my own life, both clinically and personally and professionally, that I feel like my perspective has just shifted so much. And so I want to kind of walk you through what my original perspective was, what it is now, and how patients can get there. So when I was first diagnosed with OCD, like many people, the way I understood OCD and the way it was described to me is OCD is obsessive compulsive disorder, which is a disorder that is filled with unwanted intrusive thoughts. Those are the obsessions, followed by repetitive rituals, which are the behaviors or compulsions. And we can all agree universally that hasn't changed, right? That is still what OCD is. As Chrissy's done a ton of work in pure O arena, right? We know that compulsions can be mental compulsions. We know that they can be external compulsions. But OCD, in and of itself, the fact that there's obsessions and some sort of presence of mental or external compulsions exists and it causes a lot of us, causes us, a lot of distress, is the same. But what used to follow, and maybe what still does for a lot of people, is the definition of OCD was then followed with OCD is a chronic debilitating lifelong condition that individuals can learn how to manage their symptoms. A lot of people will disagree with me, especially those that are still struggling with their OCD. And that's fair because listen, for a couple decades of my life, when I kind of survived with OCD and was, you know, functional but really struggling, I would have been in that same camp and I would have had a really strong disagreement with you on this. But what I will say is that the description of OCD being a lifelong chronic illness is so negatively detrimental to individuals with OCD. Think about it. If I understand my OCD as something that's lifelong, then I'm under the assumption and belief that I'm gonna have OCD forever, that I'm always gonna struggle. If I understand it to be this detrimental, disabling disorder when it's left untreated, I understand it as just this chronic illness and disease that I will always have. But with treatment, I can learn to manage. And the word that comes to mind for me that I talk about all the time is functioning. You know, I think for decades of my life, I thought I will always have OCD, I will always struggle. This is kind of my burden to bear, so to say, and that with effective treatment, I can learn how to manage my symptoms, meaning I can learn how to be more functional. And so, because of that, when I first went to treatment and did outpatient, ended up doing residential treatment when I was 15, I stopped at being more functional. Right. So when I could take a quicker shower again, wear clothes that I wasn't able to wear, I could do simple tasks that I had no longer been able to do, it was empowering and amazing and freeing because these simple everyday tasks had been completely ripped away from my life because of my OCD. But the problem is that because of the way I understood OCD or what I thought treatment, like all that treatment could do was make me more functional, I stopped at being more functional. Meaning, yes, I could function way better than I previously had. However, even though I was functioning better, I was still struggling, right? Maybe from the outside, you're like, oh, Liz is doing well because I was going to college or I was working or I was advocating or being with friends or family or whatever it might have been during this time in my life. But guess what? If you saw me behind closed doors, you knew I was still struggling with OCD, but I was more functional. And I was living what I had been told, what I understood, what I had accepted as my recovery reality. I accepted and understood that my recovery reality, if it was going well, meant functioning with OCD. It meant still struggling, but pushing through. And you guys, I'm here to tell you that that does not have to be the truth. You can get to a place where you wouldn't meet diagnostic criteria, to a place that I hope every patient I work with can get to where yes, you'll still have thoughts, but imagine if they never become a trigger. Imagine if you get to a place in your life where you have thoughts, but you don't have triggers. Not I will always have thoughts that become triggers, and I have to learn how to deal with those triggers for the rest of my life. That is functional. That is using ERP to become more functional versus I'm using ERP to get to freedom. And so today, when I got asked to talk about real recovery, I was so excited because I want to talk about what recovery actually can be, what you should actually be fighting. And it isn't functioning while struggling with OCD. And yes, you guys, I'm not here to tell you that that is easy and that you're gonna go to ERP for four weeks and get that, right? Like that's not the reality. And guess what? For most of us, functioning comes first. I call it the 70-30 rule because what I've learned and I've seen clinically is that most patients, a lot of patients, they will get about 70% better with ERP, right? They're they're doing way better. And that's amazing. If you imagine if you're struggling and you're 70% better, you can go back to work and life and functioning. Yes, you still have some OCD symptoms, but you're doing so much, you're gonna be so grateful and excited for that. And so most of us kind of stop or pause treatment there because it's what we expect. Oh, I've learned 70% is probably considered symptom management, right? So you're like, oh, I'm managing my symptoms better, I'm doing better. But then my goal is that you start going and living your life. You go back to work, you go back to life, you go back to the things that you love that drive you, that excite you. And when you do, can you start saying to yourself, I don't want this 30%? Even though at one point only 30% left seem great, there will come a point when life gets louder that the 30% feels exhausting, feels frustrating, isn't something you're willing to tolerate. And that is when you get to do that final work, really starting to address core fears and all the other things that come along so that you can use ERP to get to freedom. And so when people ask me, what does ERP look like for me now? I don't do ERP, I just live my life. And yeah, sure, in the past living my life was ERP because I had to do ERP all the time. But if I've used ERP to actually address all my core fears, I don't have to do quote unquote scheduled or timed ERP anymore. I just get to live my life. And the notion or the act of living my life in turn becomes my ERP, right? It keeps my OCD at bay because there's no avoidance behaviors anymore, there's no compulsions. And so even if I get an intrusive thought or a trigger that's a little bit stickier because I'm still a human and I still am predisposed for OCD, I can automatically deploy techniques that include living my life and not reinforcing OCD so that I stay in that freedom realm. And so I actually want to push you guys to think about and to understand what recovery really can be. And I want us to ask ourselves: are we selling ourselves short? Are we accepting a life of struggling with anxiety and OCD when that isn't something we have to accept? I think that for a long time in my own life and in my own recovery, you know, I understood ERP as something I would have to do forever, as something that I would always have to like push through and be on top of. If someone would have said, what does recovery look like? Or if I would have asked someone else, I wish I would have been told. Am I choosing to attach meaning still to my anxiety and OCD? Have I chosen to not do some of the ERP and work that I know I need to do deep down, but that I can like justify why I'm not, or you know, that I keep putting off. What are the choices and things that I'm doing that are actually stopping my recovery from being what it could be? And what things can I do different? The question I always ask, and I always want to know from every patient is what are you holding on to? And guess what? I think almost all of us, when we're struggling, we can identify what we're holding on to, or we can identify what we haven't been willing to do yet, or what we know we need to do, but we're afraid. And it's okay, like no one expects it to be easy and for us to say, Oh, just go do it and act like it's not a big deal. But you're selling yourself short if you don't spend time figuring out why am I holding on? What is the work I still need to do? And how can I transition from using ERP to be more functional to start using ERP to obtain true freedom? And I want to encourage you to think about, to know, to understand, to believe that freedom is possible. It's okay if you're listening to this podcast and you're like, I'm pretty skeptical of that. I think that's the thought that I could not have OCD be impacting my life every day, or that I would no longer have triggers and only have thoughts, that that doesn't feel real, like I disagree with Liz. Good. Be skeptical. It would be strange if you weren't. I was skeptical myself. And what I will tell you is that the choice to use ERP for freedom for OCD is a choice we have to make. And yes, of course, that choice is hard because it also means doing the harder work, doing the deeper work, facing the fears all the way, really addressing our core fears that keep our OCD alive and at bay. And that's not something most of us are like, please sign me up. So, what is real recovery? Real recovery is it's a journey. You know, real recovery for me wasn't that I did treatment and got to freedom. I'm talking 20 years later is when I figured out what freedom could look like. Don't stop at functioning, fight for freedom and spend time understanding and thinking about what you're holding on to, what's the work you need to do, and how can you get to a place to do it? Because what I want to say today is that freedom is possible for everyone. And don't stop recovery at being more functional.

SPEAKER_04 44:10

Hi everybody. Thank you so much to Chrissy for having me on this uh excellent conversation about what it means to be recovered, uh, to talk a little bit about what recovery truly looks like in OCD and with anxiety disorders. It's a topic I'm really passionate about because of course, um, you know, people get to a point where they think, great, I am at a place of recovery. And some people think, well, that's the end of the work. And in so many ways, that's the beginning of it. Um, there's so many fantastic tools and um exposures that we can give as uh specialists, as OCD specialists, but there is so much to be said about what comes after you, you know, complete a course of therapy. So in this chat today, Chrissy has been so kind as to invite me to talk to you all about real recovery. I am going to explain a little bit more about what I think are important components in a good recovery. And for anybody who doesn't know me, my name is Shiva Rajay. I am a licensed marriage and family therapist and the director of the Center for Anxiety and OCD, located in Southern California. I'm also the author of Relationship OCD, a book that explores um relationship-focused obsessions and compulsions. And I am grateful to be here with you all today. What we want to do is we want to think about what constitutes good recovery and what are some of the components that maybe we wouldn't think about. I think it's really normal for people to think about, well, recovery is the absence of compulsive behavior. And that is certainly one aspect of what it takes to have good recovery. Sometimes I have individuals who come in and they're looking to get recovered-ish. And I make this analogy of, you know, if you had a mold outgrowth in your basement, why would you only treat 70% of the mold? Right. So some people will say, well, look, I'm going to do this much ERP, for example, or I'm going to work on these compulsions. And these ones I'm not going to touch. They're too scary. They're not, or they're, oh, they're not that big of a deal. That's fine. Never going to push someone past, you know, where they want to be in their recovery, but I am always real. And what I want to say to people is, would you leave a 30% mold growth in your garage? Of course you wouldn't. Why not? Because that 30% very quickly overgrows back into a big problem. When you sort of allow a little bit of compulsivity, right? Some people say, oh, I'm going to do 80% of it, I'm going to do 7% of it. When you allow that little bit of compulsivity to sort of just live there, what you're really saying is, I am willing, ish. I am accepting-ish. And then what you're going to get is good-ish recovery. I am super here for where anybody wants to be in their recovery journey, but just know you're going to get out what you put in. My favorite head space for somebody to be in as they head into OCD treatment and recovery. It's a funny word I'm going to use. It's actually desperation. Okay. So let's talk about what that means. Um, of course, I'm not happy that anyone comes to therapy suffering. That's not at all what I mean. But I think that you have to want recovery more than you want comfort. Okay, I'm going to say that again. You have to want to get better more than you want to be comfortable and safe. It has to be that you are at a point where you want it more than anything. And that is where we oftentimes get the most quality recovery from people. They work well, they work fast, their their, you know, their willingness is through the roof, their trusting of the process. This is not to say that if you have not hit rock bottom, you're not going to have recovery, but I'm speaking in generalities. Um, sometimes when we work with, for example, young, not often young adults, it's actually more teens. Teens sometimes will come to therapy because they are mandated by their parents. And so naturally their willingness is lower. This is also a population that, you know, they have not experienced as much loss yet as a result of their behaviors. They just haven't lived long enough to see how much OCD can take from their life. So sometimes when we're working with what we'd call like a mandated client, which is many times a teen, um, sometimes not a teen, we've got a cap on the willingness. They'll want to do some, but not all. They'll want to do a little, but with resistance. And sometimes what I will say, and what we sort of talk about at our in our center, is this might be a client that is best served by doing some of the work now, sure, but then actually going off, living some life and suffering some consequences. Because when they come back to treatment, maybe now they're 25, maybe now they're 27, they're ready to put 100% into the work. They are hungry, they are desperate. So it's not my favorite word to use there, but I just want to give an idea of the mindset and the um level of buy-in that produces the best results. Okay. You gotta be more afraid of what you're losing to OCD than what it tells you will happen, you know, all the bad things that will happen. So pardon me, I have a little bit of a cough today. So you guys are gonna hear me clear my throat quite a bit. The next piece that I think constitutes good recovery, great recovery, is this idea of truly accepting where you are at, truly accepting that we are working with a mental illness and that there is a chronic nature to the experience of OCD. I want to get really clear about what I mean when I say OCD is chronic, because I understand there are many people, you know, there's many thinkers out there, there's many clinicians who would argue one way or another. So this is my chance to share with you my thoughts on this. When I say that OCD is chronic, I am not saying that I believe that you would qualify for a diagnosis forever. I have OCD myself. I'm very open with that in my work. And I think that if a clinician were to assess me right now, I would actually not qualify for an OCD diagnosis. I don't meet diagnostic criteria anymore. I've worked so hard on my OCD that it doesn't impair me enough to meet diagnostic criteria. However, the fabric of who I am as a person, the nature of my thought process, the way in which I scan a situation for what is wrong, for what could be better, for what is the 1% inconsistency, whether that be in my relationship, my work, my friendships, my jobs, myself, that never goes away. And that way of being is chronic. There's another way to talk about it, which is that that way of thinking is part of what I love most about myself and what you likely find most successful about yourself. When we use the word chronic, there's a note of you know negativity to that word. But I think that we could adjust to the word chronic for you know a way of thinking. Because the way that our brains function, when we are symptomatic, gets classified as OCD. It's a, it's a, you know, it's a dysfunction. However, when we are well treated and well-managed, we still have aspects of an OCD thought process. It never goes away. We will always have hypervigilance, we will always have an active amygdala that scans for inconsistencies in any arena, morality, relationships, harm, you know, you name it, cleanliness, purity. And that never goes away. And that is why I say that OCD is chronic, right? With a little caveat of what do I mean when I'm saying that? Okay. And I think it's very important to think about your OCD in this way. Not because I want to saddle you guys with some burden of, oh, I'm sick forever. That's not what I'm saying. Again, I think with the right treatment, many people drop under diagnostic criteria and might not receive a diagnosis of OCD. But do we fundamentally change as humans? Absolutely not. No, I've never seen it. I don't think I will see it. The wiring stays the same. The way that you manage that wiring is success and real recovery. When I talk about the importance of acceptance, a big part of that is that we must fundamentally accept that our brains work in a divergent way, that we are always, you know, we are the members of the tribe that might sometimes cry wolf when there is no wolf. But we're the ones on the lookout. We're the ones noticing if something's amiss. We're the ones who are optimizing. There was an evolutionary advantage to this type of thinking. There really was within reason. Acceptance is not just we want to accept the presence of intrusive thoughts. But philosophically speaking, when I say true acceptance or radical acceptance, I'm thinking about a quote by Pemachodron. She says quite simply, abandon hope. It gives me goosebumps to say it. Abandon hope. Oof. I mean, that hit so hard for me because she's not trying to be a buzzkill. Okay, Pemachodron is not interested in being a buzzkill. That's not what she's talking about. She's talking about the danger of wanting things to be a way that they are not. And I think that that is truly, in my opinion, one of the, if not the most important component to good, real, and lasting recovery is that you must abandon the hope that you are going to be a different type of brain, that you're gonna wake up one day and be like your husband, your wife, your friend, coworker, somebody whose brain is wired differently. That's not gonna happen. And that, again, is where I say the experience of being someone with OC, you know, OCD or an OCD brain, that's chronic. That's for life. The sooner that we let go of wanting to be a different type of brain and accept that this is a brain that wakes up in the morning and is on, that this is a brain that scans, that this is a brain that needs management, that this is a brain that responds well to structure and routines and health and wellness, um, that this is a brain that requires a lot of compassion. But it's also a supercar. Um, Chrissy and I were speaking right before we jumped on this, where I jumped on this chat here about what a super engine we have in our minds and how at the best of us is like the best. The worst of us is pretty dysfunctional. But when we're at our best, we are my clients are some of the most impressive people I've ever met. They are the top of their game in the worlds of entertainment and in the worlds of philanthropy and the worlds of business. Like it's some of the coolest brains, brain stuff you can get. The sooner you make this radical philosophical shift to these are the cards that I have been dealt. This is my genetics. The sooner you move into the best possible recovery imaginable, truly. People get stuck in recovery when they, you know, we we have sessions where we'll process the um the disappointment, the grief of, oh, this is not, you know, recovery doesn't make me a different person. Recovery doesn't take away the activity in my mind. You know, recovery doesn't take away, doesn't make me feel feel 100% sure. That's not what recovery is meant to do. That's not real recovery. We all know by now, if you're listening to this podcast and you're steeped in the world of our wonderful OCD world, you know that good recovery is largely about willingness to tolerate feeling uncomfortable. And our brains make us very uncomfortable. And they don't stop doing that. They might quiet down. They, you know, you will get better, but let's not lie to ourselves here. This is the brain we have. That is what I mean when I say the experience of OCD is chronic. And I think that when we accept that, we are no longer surprised when OCD pops up, you know, on a Thursday morning. It's not, what? I thought I solved this, or oh, I thought I was over that. No. OCD comes in, it's who we are. So depending on how well managed we are, depending on lifestyle aspects, where are we at in our cycle as women? How has our sleep been? Where are we at in in our life with stressors? All of these things are going to affect how uh active and reactive we are in our minds. And that does take me to my next point, which is around management and lifestyle. I do not believe that when we have a brain like this, we need to worry about, oh, I was up late, oh, I drank too much caffeine, oh, I need to protect myself. That's not at all what I mean when I bring up the point of lifestyle. However, the reality is that when you take good care of your system, you are gonna have an easier time managing. So exercise really helps. Um, I have really truly yet to see a body that does not benefit from adding in exercise to their routine. It just really helps. Likewise, good sleep, not in a way where we're worried about the sleep. It's totally okay if you have some nights of bad sleep. That's part of the deal, right? We don't want to get grippy on that. But that, you know, we tend to do better when we are well. And rest is a big part of that. Uh, caffeine consumption typically works best in moderation. It just jacks us up, makes a supercar more super to have a lot of caffeine in the system. An acknowledgement of the effect of stressors. Again, we cannot avoid life happening to us. In fact, that's the exact opposite orientation. But just know that if something big is happening, it's going to affect your OCD. Your brain's going to be louder, and your desire to grip and control is going to be increased. So your willingness tends to be lower. What do I mean by that? I have clients who will start sessions and they're having a uniquely hard month or week or whatever it is. And one of the first things I always check in on is context. Before I even get into, well, what's going on and what do we do about it? I'll say, what's been happening for you? And nine times out of 10, the client is describing some massive life shift. They're moving, there's a job change, there's a life transition. You know, a best friend got married, somebody had a baby, someone died. And it doesn't even always have to be that dramatic. But what I mean by that is recognizing that we are typically very, you know, we're highly sensitive people. We're like instruments, and when the wind, you know, plays over our strings, we make noise. We're super we're super tuned up and sensitive. And of course, on hard days, that's something that we can bemoan. And on the good days, we make beautiful music. But when life is happening, when life is life, we have more to say. Our brains are louder, the music is louder, the intensity is louder. So it's always a good idea when you are feeling more reactive and your OCD is louder, that you stop for a minute and you go, probably there's a good reason why. Let me like look around and see what's happening in my world. And that's not an excuse to engage in compulsions, certainly not. But I think it offers compassion and understanding. And it also reduces the grippiness that we have when we think about, oh, why is it happening to me again? Well, it's happening because you're in a tough season of life. And your brain's gonna be seeking more control. So, really thinking about how context affects your anxiety will increase the quality of your recovery because you're gonna be far less reactive. You're gonna go, oh, yeah, of course, that's why. Okay, well, we'll duh, that's why. And now what do I need to do about it to get back in balance, uh, to get back into acceptance, to get back into openness. And I think the last piece that I want to share with you guys is the importance of grieving to good and real recovery. I don't think we ever talk about this enough. I think you know it's being talked about more, but it's not um, you know, grief is not something that behavioral behaviorists are typically trained to spend much time on. And perhaps they worry it can become compulsive to get stuck in a grief cycle. But the reality of having OCD for a lifetime, or however long it's been in your sphere, the reality of what it's taken from you, the reality of what it takes to manage, the reality of the effect of anxiety on our loved ones, on our partners, on our parents, on our children, there is grief. And there are multiple, hundreds, hundreds of moments in recovery where talking about grief and acknowledging what we've lost does the opposite of keeping us stuck. And that's to say that often I think people are afraid that if I let myself cry or mourn or honor what I've lost, or that I wish it were different, or that OCD took this from me, or that I have to do more work to stay balanced. If we honor that piece, we can release it. When we release it, we move into acceptance. And truly, there's rarely a session that goes on that I am not touching on grief with a client in some way, shape, or form. And that's just to show you all as we're talking how much there is to grief and how important I believe it is to unhook those moments by tending to them. Because it's crazy to think that we would go through this massive experience of OCD and anxiety and not feel a lot of ways about it, right? It's not fair, it's not cool, it's not easy. All of those are opportunities to grieve well. And when you allow yourself to grieve and then move through and then move forward, you will experience a significant stability in your recovery. There is not things that have been ungrieved that are bothering you, that are coming up as anxiety, that are coming up as resentments, that are coming up in different ways. Do the work. Cry. Meet the sadness. Don't live there. That's not what I'm saying, but go there and see what that does to the quality of your recovery. Because real and true recovery, good recovery, is a constant contact with and a constant stretch into a position of openness and willingness vis-a-vis the unknown. And it's not a comfortable thing. It's like being in the splits your whole life, right? You gotta constantly remember, hey, push a little, push a little. It's just much easier to maintain that stance if we do a little bit every day and we stay in a mindset of this is never going to be easy, this is never meant to be easy. Rather than saying, great, I did the splits once, I'm not gonna do it again for three weeks, and then I'm baffled at why it's hard for me again. This is truly what I mean when I say acceptance, and what I mean when I say life, like a lifelong relationship, an exposure mindset. I truly hope that comes off the way that I intend it to, as an invitation, because I think real and true recovery is so possible when it is partnered with reality and acceptance. Thank you all so much for spending some time with me today on this chat. I uh I commend you all for wherever you are in this journey. And I just um want you to know that truly getting to a place where you have a positive relationship and a comfortable relationship with this experience, this wild. Magical, crazy making brain of ours is possible. Thank you for listening.

SPEAKER_02 1:06:09

Thank you so much for being here and for unmasking with me today. Wow, four different takes on recovery, four different types of experiences where people have been down in the depths with OCD and have risen from the ashes and at different places in their own recovery. I took so many different gems away from this episode, and I hope that you did too. I also want to remind you that wherever you are at in recovery, wherever you are going, and whatever goals you have are yours and yours alone. Everybody's recovery is different, and wherever you are on that recovery journey should be honored and celebrated. If this podcast supports you, inspires you, or helps you feel a little less alone, I'd love for you to consider supporting it on Patreon. Your monthly pledge helps me to keep these conversations going and to create even more resources for this wonderful community. You can join us at patreon.com slash intrusive thoughts unmasked. And remember, when you're here, you do not have to wear the mask because you're seen, you're understood, and you're accepted exactly as you are. See you next week.