This afternoon, I was listening to a podcast called This is Actually Happening. Each episode features an individual telling a long-form, often intense, story about something they’ve experienced in life.
I was originally listening to the most recent episode, when I saw the title of a slightly older episode from April: “What if you had thoughts of harming those you love most?” When I saw this title, I immediately wondered if the episode was about OCD.
I started listening to the episode, and it was about the “flavor” of OCD known as Harm OCD specifically. Though I was grateful someone was talking so openly about OCD and this lesser-known type, I did worry about how treatment would be portrayed, if at all.
Exposure and Response Prevention (ERP) therapy was kind of subtly mentioned, but not by name and not quite accurately. This podcast will likely help many feel less alone in their struggles with intrusive thoughts and may help them realize what they’re experiencing has a name: OCD. Still, I wish ERP, the International OCD Foundation, and other resources had been mentioned.
So, I emailed the podcast! My email is below, and I will likely update if I get a response.
Hello. My name is Morgan Rondinelli, and I recently listened to Episode 130 about one woman’s struggle with Harm OCD. I’m reaching out because I also have OCD. I’ve had it since I was a young child, and thanks to therapy and medication I am also in what I call for myself recovery.
After figuring out I had OCD at age nineteen, I gradually became an increasingly public mental health advocate. I have written a blog about OCD for over five years and got heavily involved with the international OCD Foundation (IOCDF). I am an Ambassador for the IOCDF which means I do things like make videos for OCD awareness campaigns, write for their website, attend charity walks, and speak at the Annual OCD Conference each summer.
I appreciate the woman’s openness with sharing her story and thoughts. There can be so much shame and stigma associated with this “flavor” of OCD, so I hope this will help others feel less alone.
One thing I wanted to comment on though was her mention of the therapy where you hold a knife to a loved one’s neck. I worry this was misrepresented and will scare people away from the treatment.
This type of therapy is called Exposure and Response Prevention (ERP) therapy, and according to the IOCDF and research, ERP and/or medication are the gold-standards treatments for OCD. In a way, the woman was kind of doing ERP on her own. She learned to not give weight to her thoughts and to let them pass. A thought is just a thought, and she figured this out on her own. She also, however, was continually reassuring herself that she wouldn’t do these things. ERP teaches that this only makes the OCD worse. Reassurance is just another type of compulsion.
What ERP actually involves is gradually facing your fears and resisting doing compulsions. You start incredibly small, or low on what’s called your fear hierarchy. For example, I had a fear of causing a fire by not taping light switches. I started small by not tapping the light switch and leaving the house for only a few minutes while intentionally thinking, “Maybe the house will burn down because of me.” I gradually increased how long I would leave and how “hard” I thought about the fire starting. Others, with a fear of directly harming others, might sit in a room with their loved one and just a picture of a knife, then a real knife far away, then gradually bringing it closer. You never do anything actually dangerous or that violates your personal values. That is of upmost importance.
The goal with ERP is as you habituate to the anxiety and can gradually increase the difficulty of the exposures. They become easier until you learn you don’t have to do the compulsions or avoid to feel safe. You can sit with the anxiety as it rises and falls on its natural course. A key point is you aren’t showing yourself the bad thing won’t happen; you are showing yourself you can sit with the anxiety and uncertainty.
I’d love to connect the podcast with the International OCD Foundation or other resources about OCD. I think it’s incredibly important, when talking about a topic like OCD, to then provide a multitude of resources. I’d also be glad to chat with the woman who shared her story if she’s interested and comfortable. I’m always happy to talk about my story with OCD and mental health.