And so I was thinking about what Tony Morrison said, if there's a book that you want to read and it hasn't been written, you must write it. So there's so many different layers of this like it. I wanted to bring this what I do in the clinical work, what I've done in my own life. And also it's sort of amash to my mom to say, look, there's so much more within this, and that's what I mean.
OCD certainly can be a very challenging, torturous, disabling condition, but at the same time, I don't want people to lose the gold. There's a lot of dirt, but it's pay dirt.
There's a lot of gold in OCD.
It's a great pleasure to have clinical psychologists, Michael, I'll see on the show. In this episode, we have a refreshing humanistic discussion about obsessive compulsive disorder. Michael is critical of the standard medical model of OCD and points out the upsides of OCD. He argues that people with OCD has a unique temperament, which includes heightened existential sensitivity and
a richer imagination. While people with OCD certainly have their struggles and tend to be obsessed, about causing harm or receiving harm. Michael also points us to all the ways that OCD have historically been channeled into some of the greatest works of art and literature, and how everyone with OCD can have a healthier relationship with their OCD. So, without further ado, I'll bring you Michael. I'll see Michael. I'll say how are you.
Oh, so good to see you.
Yeah, to meet in person finally, Yeah, I've been really looking forward to this conversation too. Yeah to Jews with OCD, sitting with a candle between us, it's.
The perfect environment. It's perfect too humanists to really have a conversation.
Yeah, yeah, let's change that identity. Yeah, to humanist humanists. Yeah yeah, Well what does it mean to be humanist? Yeah?
I think is funny thing.
The humanist thing is so interesting because creativity is the centrality I think of being human and being able to be with the contradiction and complexity and nuance, the messiness of it, but also the transcendence of it. Right, they kind of go together, right, which I think is the brilliant part. Like Leonard Cohen said, if you don't become the ocean, you'll be seasick.
Every day, almost every Leonard Cohen quote, including that one. So you are a clinical psychologist and you specialize in existential humanistic approaches. Is that right?
It's integrative. So for me, existential and humanistic and psychodynamic and.
Wow, you sneak in a little psychodynamic, it's still in.
It's still in wow, because it's all relational and anything that's human requires relationship, right, So you know that's the challenge, is being a fully embodied self and actualized self in relationship to others.
Do you bring a new union?
Oh? Completely?
Analysis? Yeah, because because i'm your patient.
Oh completely, Because young Young was so much more open to the beauty of creativity and nuance, which I think the humanists took back and I think they reclaimed it.
Which was really important.
The humanistic psychologists, Yeah, the humanistic psychologists, the existential psychologists.
You know.
You know what's interesting, I actually make a distinction between like the humanistic psychologists and the humanism movement because I feel like they're different. Like humanists tend to be like the Stephen Pinker hyperrational, you know, it's all about logic, whereas I actually think the humanistic psychologists were more about being a whole human and it's they're just separate things. Neither is better than the other. But yeah, but I think I feel like the humanism movement is different than
the humanistic psychology movement. Do you agree? I agree?
I think actually, But if you look at the threat of humanism throughout history, like you see like the Shakespearean kind of thing, right, the Shakespeare is the suber humanist, and and you know, the Renaissance, Da Vinci and all of this stuff, I think that brings it in. And I think you're right. I think one of the things that's really exciting about where psychology is right now as a field is that we're embracing more of the feeling poetic side as well as the logical linear side. Yeah,
and to be a humanist is to embrace that. So I like to think of us as sophisticated emotion regulation machines and ideas sophisticated completely as a sophisticated sentence, right, and even you know, the funny thing is we pretend not to be sophisticated, or we pretend to be. I pretend to be sophisticated all the time, all the time, but we have both. And it reminds me of like Da Vinci's Vitruvian man. You know, remember like with a square in the circle. Oh yeah, So the square is
the logic and the circle is elocean. It's the poetic and the linear, and for my money, like the humanistic is about embracing the contradictions and complexities of that.
Well, on that backdrop, let's talk about OCDE. The topic of your book is called The Upside of OCD flip the script to Reclaim your Life. Now, a lot of people who've been diagnosed with OCD, I do think feel like they are at control in their lives. That was a really deliberate phrasing in your title, obviously, and it's a very unique book you wrote, And I just want
to say upfront, I thought it was a really great book. Obviously, I invited you to be on my podcast, and it's a book that I think virtually everyone who has been diagnosed with OCD or that's part of their identity could really benefit from. To expand their identity, I would I would phrase it that way, you know, not replace, you know, but given more expansive view of who they are and what they're capable of. So, really, congratulations on this amazing book.
I wanted to ask you what is the clinical diagnostic criteria for OCD. Let's like start with the basics, and then I want to ask you why are you not so happy with how it's currently framed?
Yeah, So, I mean obviously it's obsessions and compulsions. So the obsessions are these these tendency to be have intrusive thoughts, right, They're often centered about did I potentially harm somebody by mistake?
Am I clean enough?
Did I think something blasphemous or a moral Did I count enough? Did I order things enough? All these things that kind of you ruminate on in a way that you sort of can't stop even though you'd like to. And the compulsion part of it is the side, well, I want to do something to feel more in control and to soothe the anxiety around this nagging obsession. So I'm going to wash my hands, I'm going to cancel
the thoughts with a mantra or a prayer. I'm going to try to do something that purges me this nagging feeling. And so sessions and compulsions go hand.
In hand really well put you know, as a humanistic we're both humanistic psychologists. First of all, Yes, gosh, I thought that it was like, oh god, right right between that and we're flying close to the flame there. But we're both humanistic psychologists and and and what big part of the humanistic psychology movement was was not wanting to neglect the experience aspect of what it means to be human, because they were really counter sort of the Freudian and
as well as the reductionism of Skinner BF Skinner. Yeah, so let's really discuss, you know, what it's like to have OCD and really really get into that.
Yeah, And I think you brought up a good point that you know, everywhere in psychology and the history of psychotherapy, we find something and then we feel like we're missing something. And I think, you know, that's where it's really important to be, as Howard Gardner says, a synthesizing mind, right, somebody who kind of draws from things is So I
was reading Matthew Saye. It is a British writer who's written a great book called Rebel Ideas, and he says there's something about incremental innovation, and then there's recombinant innovation, which is when you pull from different areas. So the thing that I'm not so pleased with where OCD is currently is that it's looked at like in this kind of linear literal way. Right, you have these obsessions, you
have these compulsions, right, that's it. Yeah, But I actually see it from a completely different framework, which is sort of similar to how Susan Kine looks at introverts. That people with OCD have a unique temperament and sensibility of sensitivity in empathic sensitivity. There's research out of Germany that shows that people with OCD are more empathically tuned in Wow, then not only healthy controls but people with other garden writing anxieties.
Is there a correlation between OCD diagnosis and scoring high on the Highly Sensitive Persons scale like the iron I.
Bet money on that. Yeah, completely, And I think they're very I think they're sort.
Of overlapping fascinating.
Yeah. And so the other part of the temperament, like we were joking about before we got on here, is that there's an existential sensitivity. So if you're empathic and you notice how people feel and what their experience is, if you're intuitively tuned into them, you also notice when they get hurt. You also notice when there's ruptures. This
is what makes us good therapists. That's why actually there's a lot of therapists I think who do have OCD tendencies, because it actually makes us really good at noticing we have a six of empathy and intuition. The second piece the people with OCD that is lost in the medical model version is that people with OCD have a very imaginative mind, very fertile imagination. Right, they go into what
if spirals thought spirals and rabbit holes. But if you actually look at the mind, it's not too different from the obsessional aspect of creativity. And it's no surprise that Charles Darwin struggled with OCD because if you think of the brilliance with which he looked at different angles of things and went down all sorts of different places, there's a connection.
I didn't know Charles Darwin had OCD.
He worried that his children would die, he was concerned about reassurance. There's a story of him in the middle of the night going to his friend's house to make sure he didn't offend him. He struggled with a lot of these things that we would consider classic OCD symptoms.
That's so fascinating. So what's actually neurologically going on in people who have OHB, you know what's going on.
I wish it was as up to date. I remember when I was in college, I did extra credit paper and I was looking at all the data neurologically, you know, they look at the caudate nucleus and they look at areas and try to see what kind of activity is going on in there. And I think still the jury is out on exactly, but I do think one of the things that's really fascinated about OCD is that it's
very much nature and nurture. There's certainly a biological component to the fact of having a tendency to spiral, to ruminate, but also to be empathically tuned in. And I think that's where I think that what gets missing in current ideas about OCD is not looking at I call people with OCD they have extraordinarily generous heart. You know how in The Grinch, the Grinch had a heart tenth size is too small. Yeah, people with OCD have a heart ten size is too big. But then they almost don't
keep track of them. Wow, they're much like Freud said at one point, the person with OCD is probably most of the most scrupulous member of society, though they treat themselves as if they are a mass murderer.
Oh that's so interesting.
So the lack of self compassion and self advocacy for a person with OCD is extraordinarily interesting. And so my take on it is, wait, how do we harness the beauty of that big heart but also turn it towards the self. There's a great poem by Derek Walcott, Love after Love, one of Obama's favorite poems. He says, the time will come with elation when you will greet yourself in your own mirror, sit, feast on your own life.
Wow.
Right, give back the love who you've given to another. And I think people with OCD need to give back that love. And so my mission, if it should be so, is to change the dialogue and conversation about what OCD is, what it could be, how we can understand it, how
we could treat it. And I was thinking, you remember the old Solomon ash experiment and asked for those who don't remember, he was at Swarthmore College and he did this famous social psychology experiment where he's like trying to figure out it was supposedly a vision test, which is the correct line that corresponds to this one. And of course he had all these confederates, I'd be like, oh,
hell no, yeah, I'd be like what. But of course, in maybe, like I think two thirds to seventy five percent of the people conformed to the dominant view, which they knew was wrong.
And those people ended up being less creative.
Is that completely? But he did another condition, as you recall, where he had one dissenter. Oh, that one dissenter took the conformity down eighty percent. I'm that guy. Yes, yes, So that's what I want to do for CD is to dissent, to say, wait, there's more. I know the consensus right now is that this is what OCD is or could be. But there's more, And I think that's actually really hopeful.
Yes, And your book it's very clear that you're trying to restore the humanity to OCD and say but and because your book is all about both, and that's your whole book is about both. End. I will say that for those who are in the grips of O. C. D. All this is very cold comfort, you know, so like for me, it's it takes the form of uh. One
of the biggest forms it takes is like checking. So if I'm in the airport, I have to keep and whenever I'm in a nervous state, like I'm about to board an airplane, and I have to keep making sure.
Yeah yeah, even though yes, yeah, and I ended up, I get to the point where I just I actually, like take a picture of like my apartment before I leave, so that when I worry later, did I picture of the parking spot to make sure that it was legal? Even though it's probably so.
This is normal, normal, normal, not normal welcome to the club. So when my point is, like, you know, experientially, when I'm in the grips of that, you know you could come up to and be like, hey Scott, but you have great existential sense too, I like, go fuck off. You know, I'm trying to get over this moment I'm having right now totally. So what is your advice? You know, when you have clients who come sit down and are really, we're suffering so much, how can they hold both of
these things? Because don't get me wrong, I'm not saying go fuck off in general, right because I think your message is amazing. I'll be very clear.
No, that was in New Jersey.
Hello.
I get that you know it's all.
Good, but you know what I'm saying, not in general, like your message is wonderful and it needs to be said.
No, but you bring up a really good point which I think is really important. And the title is a little deceiving, which is it's actually as much about the downsize as it is about the upside. Yeah, so this book isn't meant to glorify or glamorize these other wonderful facets behind OCD. I actually think these facets exist before OCD hits the scene. I think OCD comes about by lack of mentorship with how.
To work with this.
Oh right, So if you were like I'm going to steal from Elizabeth Gilbert, the writer, she talks about being a creative person is like being a border collie, and if a border collie doesn't have an good.
Activity, they'll tear the place apart.
No, personally, those cd A is a border calling in terms of how active their heart is and how active their mind is. If they don't understand that they had to train that, they're going to tear themselves apart.
Right, But what you said too.
About what hey, this isn't this is cold comfort when I'm.
In the middle of a spiral.
Yeah, So I'll share with you a funny example of when I got into a spiral. So during COVID, about six to eight weeks in, I started to get haunted by an obsession. So maybe I had a cavity and maybe I was going to need a filling or a crown or root canal. And then all of a sudden, I started to obsess what if I go to the dentist and I get COVID and I give it to my family and they all die. Or what if I stay home and don't get this taken care of and then I'm in slow agony?
Right?
And then what if because I have this cavity and it's not treated, I get something and then ironically I don't even die from COVID, I die from something else. Right, So having OCD is like that's the spiral, right, And it's a lot like a Law and Order episode, you.
Know how degree toree, you know.
And you go to the degree and then like a Lawn Order episode, you know how, like you always think the guy, that first guy in the first fifteen minutes, that's that's the guy, that's the guy, so I thought, it's never that guy.
It's never that guy, so I thought it was a two years girl.
It's it's also like the person who doesn't look like yeah, the jerk.
Yeah.
So as I'm going down with this, I say to myself, Mike, Mike, you're spiraling. Yeah, and you know you're spiraling. But I was like, wait a minute. So you know how they do exposure exercises. The typical thing would be all right, just embrace the uncertainty that the shitty thing is happening and you're not going to give it too much credence, right, Yeah, But I said, wait a minute, let me like check
in with my feelings, like what else are you feeling? Yeah, maybe that you're not focusing on because OCD is really interesting. It tries to distract us while it's also trying to focus us.
So then I said, wait, Mike, it's two.
Months into COVID.
Great point.
This is creeping there, this is scaring me, this is terrifying me. And watching my son pretend to be at the places that he would be out in the world, rolled down to the basement was making me sad. So it's feeling sad. I was feeling scared. I was feeling like I should be tough, but I'm not feeling tough. And as soon as I let that motion come out.
The too side bar.
And bothering me, the obsession started to vanish. Really yeah, because again I found the real purp. The real PURP was understanding wait and again it's an existential concern. Notice, I was worried about death, I was worried about loss, I was worried about all these things. And of course what is it. The side show is it's a toothache, But it really it was a toothache signaling something but also concealing. It's everything that Freud said about a compromise formation.
It both expresses and conceals. It's very, very sophisticated. And the reason I say that is because most ERP exposure response prevention, right, which is the main gold Standards Golding CD, which is to basically not seek re assurance, to allow whatever like, so allow the thought that you have a tooth and you might and you might not get it fixed or you know whatever, and try not to look
for reassurance and all that stuff. But instead, I also think there's a way of actually being an exposure to the feelings of them more human and the context what was the con So people with who in the EUERP world, you know what, they say, the content doesn't matter because it's just going to morph to anything else. But I think, actually, I'll grant you. Maybe the content doesn't matter, the context does. And that's where I think it actually brings it back
to humanism. That So, there's an interesting meme in the OCD recovery world which some people find very comforting. I find it actually surprisingly strange.
But I'll explain why.
They say OCD is like sound and fury signifying nothing. You know that quote from Macbeth, Yeah, yeah, which is to say, all this stuff is not really real. Don't let it get to you, it's just bullshit.
Yeah.
Now that's comfort in some ways, right, yeah, but what if there's some healthy meaning this. So the meaning that was trying to be a messenger to me was trying to say, Mike, you're scared and you have a hard time being with that. Right, Wow, COVID is you're feeling this existential concern and you're sensitive to that, so you're going to feel it, right, How does that.
Apply to checking what's the upside of being in an airport store and not willing to leave the store and board the airplane because you think, did I leave something in the store.
Yeah, well think about this. It's also again free therapy for Scott right here.
Right, It's also because if.
You think of it, it's a place where I don't feel in control. That's the root is I don't feel in control. And you know what the other thing is people with OCD actually, and just people in general, wherewhere of change, change is happening all the time, and when you're sensitive to how easy change can happen. So I think actually people with OCD are using rituals to hold on to some stability when they're recognize that everything is changing, but nailed it. And that's why when you say you're right,
this is weird. I don't know. There's a little bit of shifting here. I don't like. That's what can I hold on to? That's right, right again, that's the existential thing. What can I hold on to? Right? It's like facing death. I can't hold on life this year, but I know that it's going to be taken away totally.
Yeah, So what do I do? So?
Yeah, you know, there you go.
Then you remind yourself like, and then you come to your feelings because remember OCD likes to take us into our worried mind and we get this embodied Oh wait, am I feeling like I'm afraid I'm going to forget something? And you know, I'm in the middle of this transit and I feel like, great, what am I feeling? Am I feeling stressed from how much I've had to wait for this plane to get all this stuff?
So it's so good, you know, because when I'm in a relaxed state, I would care less about what I left at an airport tru completely And that's where stinking or state because I you know, I've had to spend many years overcome my fear of flying, and I've overcome it, but there's still residual sort of nerves right before I bord.
Yeah, well that's the context.
See, that's where I think meaning is important.
Get it, I get it.
Cont That's why the textasue like, you'll grant them that content doesn't matter, but you're not going to grant them that context doesn't.
The funny thing is content does and doesn't matter. Right, It really wasn't my toothache that was the issue. Yeah, but it really was pointing to something that was an issue.
Yeah, sometimes the cigar is not not it's just exactly we're redoing that quote.
We're doing that.
You know. It's funny too, Scott. It's interesting because I think one of the reasons why there is such an interest and movement towards the behavioral is because I think there was sort of you know, in the early days of OCD treatment, it could be analytic and very cerebral, and sometimes it wasn't focusing enough on that really concrete stuff and how this was affecting. And I also think there was a sort of trauma response in the field to how that hurt people and made them feel like
they weren't getting what they want. But appere's to quote Drew Weston, it's we're at that was a different vintage of psychoanalysis. That's like nineteen twelve. Yeah, twenty twenty four is a much more relational, interpersonal, also intra psychic, but in a really kind of nuanced way.
And I really would love.
CBT people to see that actually talking about affect talking about meaning.
Is exposure too.
There's we're you know, it's I really think it's important for us to be multilingual as therapist.
What do you think of the ACT approach?
I think the actor approach is lovely, you know, I think I think you know again, like I said with that Leonard Cohen quote, if you know, if you if you can't become the ocean, you'll be sea sick. Right, It's wonderful to embrace stuff. So the only thing that I think is missing. I think ACT is like Buddhism. Right, it's great for you to be zen about accepting things and not being too attached. But I think what we need with that is also the meaning says But what
am I making of this? Because remember we're meaning creatures. Yeah, we need to make stories. Yeah, we need to have coherence. And that's the other thing is I don't think of OCD as just this alien thing that is like a sickness that descends upon you. I also think of it as trying to tell you stuff about what you're experiencing yourself and your world, which is about making meaning.
Right.
I made meaning when I was like, wait, this isn't.
About the toothache.
This is about these deep feelings, these deep thoughts that I'm having. So I really don't see I don't see it contradictory to have it be both meaningless and meaningful.
Yeah, fair enough. You talked a little bit about the traditional approach ERP. Yeah, and you have a response a quote I have here respond to that later in your book, but I highlighted it and I love it. I just want to double click on this quote of yours quote.
Does the treatment out there really appreciate, understand and explain the overly generous and empathic heart of those with those Does it see the creative possibility and power within the expanse of mind and creative prowess of the OCD suffer? Does it pay heed to the inner story and potential trauma that can originate or exacerbates OCD. That is a beautiful poetic quote. It like you're a poet yourself, you know, Like that was really poetic.
I didn't even realize I wrote that, So that's really okay.
Wow, that encapsulates a lot of the upsides of OCD right there. Well, a lot of writers must have had OCD.
John Green is a really phenomenal example. You know, he wrote a novel called Turtles All the Way Down, which is a protagonist as a young girl with OCD. But any of his other books. The thing that I always think is interesting about John Green is he he talks about I'm good. I'm good now because my OCD is treated with medication or with you know, CBT, and I'm like John, John, Buddy, buddy.
Wait.
The nuance in sophistication and sensitivity of your work is because of all this. I haven't John. If you're watching John, I think your writing is brilliant. And also the other thing about Green's writing is.
They just broke the third wall.
I wrote, oh my god.
Sorry.
So the thing is, you know, uh, if you look at John Green's books, so much about his existential issues.
Right.
Faulton Our Stars is about two characters who have cancer who are dealing with looking death in the eye. Right, so there, And you know, if you look at like, there's so many creative people and scientific people like I said, Charles Starw and Nicola Tesla had this funny counting obsessions. He needed to do things in threes, and if he didn't go around the block three times, he'd have to continue it. He needed to live in an apartment that was a multiple of three.
Right, you know, we have you.
Know, the musician and producer Jack Antonoff talks openly about his OCD and but also he doesn't see it as just a detrimental thing. Camila Cabello talks about she was on an Armchair Expert with Dacupard and she said, listen,
I don't even call it OCD with my therapist. We call it my obsessionality, right, And she had all sorts of classic like she thought when she was young that because she didn't ever period for the year, that she was the virgin Mary, and and you know, like she had all of the things that you'd expect in classic OCD.
But she also I think sees this.
Hidden upside that we're talking about, and that's what I think is really extraordinary, and that imaginative mind, that nuanced intuitive, emotional sixth sense, like just like what Susan Kane did for introverts, and saying, we we just don't know how to approach people with this and to support them best, and there's so much strength and we can also work on the difficulties right at the same time.
I mean, it's fascinating. This is news to me that OCD is correlated with the virgin thinking ability. And I actually haven't seen studies on that. I've seen studies linking ad D with creative thinking, but OCD, I think.
Yeah, there's some studies OCD. There's some studies about OCD and creativity.
You send them to me, Yeah, because I think that that's a missing part of the creativity literature.
And I'm gonna do a plug for you moment.
Like when I was reading about your your background, I was talking to you before about the dual theory of intelligence.
Like the only one who knows about it, I'm.
The only Yeah, it's it's what's so cool about it is because the dual theory, the part that you're focusing on, is exactly the part that I think is missing in OCD treatment, which is the metaphorical the intuitive. Yeah, right, so right now, treatment is like literal, which is one I we need the metaphorical to get real depth perception.
Well, I really appreciate you appreciating that My dual was called it was called the dual process Theory of Human Intelligence. A big part of my dissertation was arguing that the field has really ignored the cognitive processeds that contribute to artistic creativity. So that was a big impetus of my dissertation because they's focused so much on IQ and at
conscious logical reasoning that correlated the creative achievement. But researchers were starting to act as though, like, to the extent to which it deviates from its correlation with the creative achievement is the extent to which it's will or and intelligence.
And I was like, oh, hell, hell no, yeah, I got to get in on this.
You all are missing missing at least fifty percent of human cognition or the benefits of It's huge. Thank you so much for it's huge.
And I mean, I think Antonio Dimasio has done a brilliant job of really showcasing that. I think, you know, in terms of looking at the contributions of this stuff, it's super important.
Actually, you know what I think is.
A cultural piece that's really interesting. So I think actually part of our movement towards this is the way things have shifted in their landscape. Right If you think about technology, it's allowed a lot more introverts to get into the mix. You've gotten a lot more imaginative stuff going on. There's
more if you think about it. In the old computer days or an old post industrial revolution, left brain linear thinking was priority ties and I think now you're seeing just like Daniel Pink says, right, the right brain stuff is really important now because we've also moved computers to do all that left brain stuff better than us. So I think actually one of the reasons why this is super important is because I think the field is still staying with the cultural thing of the left brain because.
They're all nerds. I mean, the people who are in the the research themselves aren't artists.
Yeah, and I think you need both.
And so so you know how they talk about an OCD treatment embracing uncertainty, Yeah, right, right, which is a lovely is a wonderful concept. So John Keats, the poet romantic poet, had this lovely concept called negative capability. Negative capability is basically allowing yourself not to let reason just take you where you go, but to allow the openness to ambiguity and mystery.
Right.
Love that. That's so Susan Kane, That's so Kinge right when she loved that her book Bittersweet. Yeah, totally, No, I mean it's so me too. I I love it. I absolutely love it, you say. My paradoxical take on OCD is captured beautifully by Carl Young. Quote it seems that all true things must change, and only that which changes remains true.
Yeah.
Yeah, that blew my mind.
You said this is the embodiment and essence of Ocd's upside.
Can you that's completely it?
Yeah, and I thought that one audience.
Yeah, and I stole that from Brad Stolberg, who wrote a beautiful book.
Called Master, a friend of mine.
Yeah, he's wonderful. And the reason I said is because actually, what you even write about it's it's a kind of kind of connection here is what you know? Change is the central thing. So I don't know if I stole this from somewhere, So just if I stole this from you, I apologize. But my definition of creativity, or my stolen one is it's the art of creativity is the art of changing while staying the same. That's what psychological creativity is, right right. And Tony Robbins once said in a talk
that I heard humanists love two things. They love stability and they love change. Yes, so, but to be a creative person not just in the arts or in the sciences, but psychologically, And that's what we do as therapists. We allow people to experiment with changing while still saying, well, you're still the same, right, And so the paradox of being able to work with that in fluid and interesting
ways is the thing. And for people with OCD, they're super aware of change, and that's why they need to keep things controlled, because they're aware of the essence of how you can never step in the same river twice.
Right.
But the beautiful thing and that's what I meant about the Leonard Cohen quote. But if you can be like that ocean.
Yeah, right, that's your golden you know you're trying to about selling like bruce Leaf or second right, Yeah, the wild Yeah, but there's a lot of commentant you know. Oh see these interesting one out of all of them. Yeah, if you view it as a constellation of stars, OCD seems to pair nicely. It's like the one that pairs nicely with everything else, all the other disorders you tend to see. Autism has a lot of co morbidity, you see,
schizophrenia has the co morbidities. It's like OCD tags onto everything. I don't know what to make of that, but it's
something I noticed in the psychiatric literature. It's like OCD is really a really high comorbid one with lots of other things, you know, because maybe part of it, and I'd love to hear your thought is, you know the thread there is well, high anxiety runs through everything, high neuronym and the need for control, right, which is the personal I treate Neuroticism has been found to be the
thread personality trait that runs through every semblemental disorder. You know, the person who has like a zero neuroticism score tends to be emotionally they're boring.
I was gonna say, do you want bee friends with that person? I don't know whether they're saying gradually I'm.
Sorry, zero or one hundred percent emotional stability. You know, they're they're always practical, they make the right choices, they never worry, They have no conscience, they have no guilt anyway.
Yeah, but it's just as interesting that you know, you can OCD shows up in lots of different packages, a lot of different NERD in the whole nerd diversity world. Yeah, you can have different profiles. If you if you met one person with OCD, you've met one person of OCD, right, just like I you've met one personalitism, you met one personaltism. Because you know you can have you know, all sorts of ways that it combines and mixes together and yeah, anyway.
Yeah, And I think another thing that people forget about OCD is that it actually kind of showcases the quintessential dilemma of being human.
Oh great, great.
Poetic So to think about it, like the real quote for OCD is not life is you know, full of sound and fury signifying nothing. It's to be or not to be. The question that a person with OCD is always asking is what's it like to be? And to
realize that we're not going to be? So if I like to think of people with OCD as existentials from the start who never read Kirkgarter startra and didn't have the lexicon and the support with understanding how to hold and carry that fire of those feelings, right, And I think that's why actually when we forget this, But when Freud was studying, he studied like the ratman was his
quicst intential OCD cases. That's where he develops this this conflict between this moral side of us, the super ego, and the ID which is the aggressive side.
Because people with OCD are.
Really cagy around their wild side.
Oh what do you mean? Tonal? Well being you're afraid of it going out of control.
Yeah, and so what are they obsessed about? I'm really out of control right right, I'm going to kill somebody. I'm going to do something obscene. I'm going to do something horrific. I am something horrific. That's so interesting, right,
And Freud was onto that very early. And the point of that, I think that's really crucial here is that it's not easy being human to reconcile these full throated feelings sometimes, of which the other reason that people of those are so concerned is because they're worried about being harmful.
They're so worried about harm.
Because because feelings, it's hard to take up space. It takes a little ai of a mentor who said to me, it takes a little aggression to have a self.
Wow, you're blowing my mind. I need to process that last night because I was already processing what you said the sentence before, and then you're throwing one thing to process after another. You know it is It is so profound what you're talking about. My one of my favorite psychotherapist, Carl Rogers, a humanistic part of the original Humanist Psychologist group. He wrote in his book on becoming a person. He said, most of my patients, if not all, my patients, are
constantly terrified that they're going to release the beast. Here's a whole section of his book on releasing the beast. I always think about that because there's something very human about that fear. So, yes, people with OCD might that might be that fear in steroids, but I think there And he says, in virtually all the cases, no one's released the beast. When they have started the integration process, they if anything, they become more socialized, they become more
in control of themselves. And I'm going to yes and Carl Rodgers and also say, you know, the mentality of the kind of person that they're fearing, you know, is the opposite actually of a psychopath. Because if you've ever hung out with a psychopath many times, you know, and they're fun to party with, but they never ask themselves. They're never never asking themselves. They're not wrestling with the questions.
Ever they nailed it.
Ever, you know, when you hang out with psychopaths, you never hear a psychopath say, oh my gosh, what if I release the beast? They're like, how can I give me the context? So I can release the beast. Yeah, and you know what I'm saying, that's right.
And there's two other things I was thinking about that. Right, So you said something about the psychopath versus the person of OCD.
Right.
So the other thing is you're right about this wild side. Right, So people with OCD fear this wild side, fear it. But I like to think of where the wild things are. Remember that story about little Max, like he actually is just getting to use his power. He's excited about Ooh, I'm powerful, I'm a wolf and I'm chasing after the dog with a fork. Because he doesn't really want to eat up the dog in terms of like literally doing.
He wants to eat up the world, but he doesn't know how to carry that along with being moral, right, right, But that's why he needs to befriend the wild things to say no, no, that's good. You can integrate the wild things. But then his mom leads the know the bowl of soup to say, I still love you even though you have this propensity to use power. Right, that's healthy aggression and it's important.
And again you're right.
The worry is that it will be oh my gosh, I'm going to be the psychopath, right, if I have that No, it's hard to carry that. I call it like carrying a fire. It's hard to carry that fire.
The whole release of the beast thing is interesting because another one of my favorite humanistic psychologists, Roald May, means I mean, I know we can talk the same language. Here. He has in one of his books, I forget which book, he talks about how he had this patient who was so terrified every time he walked past a window.
He was he was.
Scared, he was going to jump out the window. He had these intrusive thoughts. And he was walking with the patient one day and they passed a open window and and Roald May goes jump to jump, like what's stopping you? And in that moment he said that the guy's fear dissipated.
You need you need freedom.
Isn't that fascinating?
It's fascinating. And that's in exposure exercise right there.
Right.
It's funny. No people, nobody would say Roalde is a behaviorist.
Right.
And you know another Rogers that I love to think of is mister Rogers because you know, one of the things that's brilliant about Rogers is he was he was an artist. He was a rebel. He took on consumer culture and said, okay, media, I'm going to use.
You for humanistic purposes.
And the thing with Rogers is that you think about think of the thing is talked about. He talked about divorce, he talked about assassinations, he talked about race relations.
Oh yeah, he talked about his daughter. Made him be more interested in feminism towards.
I mean, he talked about the most difficult things. But because he approached it in that way, right, and again, I think there's a way of being with the wild stuff while also being very thoughtful. And I think that's the thing, and that's what I want to bring back to the looking at the OCD treatment, is.
That you could do both these things.
Yeah, totally. Yeah. I like that you're you're also breaking stereotypes because you know, just to circle back to the psychopath thing, there is a stereotype. I think that psychopaths are OCD right, like they like when depicted in there's that famous movie.
I forget the what it is, but American psycho or American psycho.
I think you maybe you know they all they always have to have everything in order, you know.
They there's also a difference between the personality disorder obsessive compulsive personality disorder and OCD. So the person obsessive personality disorder has a very different sensibility. I do not think they have the deep empathy that the person of OCD has.
I didn't even know there was a difference between the two. Yes, they're saying there's a clinical version on clinical version.
So there's the personality obsessive compulsive personality. So that's the person who's very type A who thinks, you know what, if you don't do this my way and line it up or do this, you're wrong, right, And there's a self righteousness about it. You know, it's not uncommon for people with OCD to find people with OCD personality disorders because they compliment each other. Well, right, because those people of th o CD personality disorder are very short of themselves,
almost too short of themselves. And and you're right that that psychopath has some dimensions of that because they're a little bit.
Of a narcissism.
They want to control everything, like this obsessive need to control.
Yeah, but again in an ecosyntonic way, yes, correct, right, not something that I feel bad. I'm not wrestling with that. So the difference is the wrestling. So that's the that's actually the saving grace of the person with OCD that they wrestle.
I didn't you just be in my mind because I didn't know that there's a in the clinical literature there's a real important difference between OCD and obscac disorder.
Yeah, well, personality disorder yeap O CPD.
I see.
No, So the reason is because nobody thinks about the personality style of the person with OCD. Yeah, it was actually a really interesting that it would be confusing because we just think about the clinical symptoms of OCD without looking at what's the character.
What's the what the upsides that you're referring to. Are you saying that's more along the lines of the personality one?
No, it's only for this is only for the disorder, for the disorder. So there's actually it's funny. In the series that book is published in, another author wrote about the personality disorder, which I haven't read, but sort.
Of personality disorders where you see maybe more than narcissism.
I see, And that's why the correlation. It's not surprising to have a psychopath who has a CPD tendencies.
I totally get it now, right, there could be overlap, right, I totally get it now. I thought you were doing the reverse. So no, that makes that makes sense because yeah, I mean you see that almost by definition, extreme narcissism is OCD to a certain extent because everything can become obsessive need to control uh and have power over others.
But you know what, Scott, you actually brought up a really good point that two good points. One that I think that we don't think about the personality of somebody with obsessive compulsive disorder because we think, oh, wait, it's just these things, as if it's just symptoms onto glom onto a person. But what if there's more about the personality and the style, just like when you look at like a psychoanalysis, like what is the character organization?
Right?
Is it a borderline organization? Is it a schizoid organization? So I think there's actually more to mine there, right about the psychopath thing. So the difference with someone with OCD. One of my exercises for people with OCD is basically is how to.
Be an asshole?
Oh, not really be an asshole, because people with OCD are worried about being an asshole. But if you're really worried about being an asshole, you're not really an asshole, and you're certainly not a certifiable asshole. And the fact that you grapple with that so good. Right, So that's the difference. That's OCD, that's ego dystnic right. I don't
really want to be this. And the funny thing is, you know how I said that people with OCD have a hard time being assertive and selfish, you know, when they can be when well, you have to wash your hands now, you see, and you have to do this because I'm stressing. It's not me that's doing it. It's
my OCD. So I'm not blaming myself. So I think actually OCD is a way of regulating boundaries because the person with OCD is a hard time just holding their boundaries and they get blurred with others and so then they need the OCD to come in to help them.
Right.
So Robert Frost, you know I love poetry, said first you be a person, then I'll be a person, and then we'll be as interpersonal as we please.
Wonderful.
The person with OCD is so tuned into others they almost get to they lose sense of themselves, and then the OCD in a way comes in to say, okay, that's how it's a messenger.
Wow, you've described my mom to a t.
I don't know whether say I'm sorry congratulations on that money.
Either, but that's but that's what it is. Yeah, right, yeah, now your mother, Yes, there is a little michugarnto.
Right, she did, and my mom had contamination OCD. Also, when I was a child, like my mom, I worried that something was going to happen like terrible to my mom, like like third grade. It hit me like out of nowhere, and this worry that's something if I didn't do my prayers correctly in religious school, that something would happen. My mom had the same yier. So there's clearly a genetic link.
But what I never understood because there was no language for it at the time within OCD research or anything. There was sensitivity. My mom was extraordinarily sensitive.
For sure.
She was a therapist as well. She was a literature buff because she was tuned into that stuff. But there was nothing out there. So when people say ask me like I forgot to tell you this, I didn't think I was going to write this book. I didn't think
I was going to need to write this book. So I did my dissertation on something alike this, like fifteen twenty years ago, and my mentor was a big OCD researcher named Dean McKay, and he was cool enough to take a gamble on me looking at cognitive behavioral and psychoanalysis and attachment theory and bringing it all together. And I thought, cool, this was a cool project. Someone's going to put this together. I don't have to worry about it.
Twenty years later, I'm like why, And so I was thinking about what Tony Morrison said, if if there's a book that you want to read and it hasn't been written, you.
Must write it.
So so there's there's so many different layers of this, Like it's I wanted to bring this this what I do in the clinical work, what I've done in my own life, and also sort of amach to my mom to say, look, there's so much more within this, and that's what I mean. OCD certainly can be a very challenging, torturous, disabling condition, but at the same time, I don't want people to lose the gold. There's a lot of there's a lot of dirt, but it's pay dirt.
There's a lot of gold in OCD.
I mean, it's a real, really expansive view of it that's been neglected in the psychological Well, it's definitely psychiatric literature. Yeah, psychiatricalist, social psychiatrical literate. They don't like upsides of anything.
You know, it's funny. I also, also, I've been pushing, I've been so I wrote this book also to be really sensitive to what I think are the wonderful contributions of CBT and Europe and A and all that stuff. And my point is not to say we get rid of that. I say is to blend it all together. But the other thing is that I want to say to clinicians out there and researchers out there, let's let's keep on looking at all these different angles of it.
Because every I was looking while I was researching the book, it was like, what do they say out there in the book about the origins of OCD? And I thought they were going to say, like, yeah, it's biological or it's environmental. We really don't know how much isot. I'm like, you really don't know, but you're saying there's only a gold standard. We don't have a gold standard yet if we don't really know all the ins and outs.
It's a great point. It's a great point you. I like in your book you talk about how OCD presents slights of hand that are possible in cover if you know how to spot them. Yeah. You call this performing upside magic. Tell me a little bit upside magic.
Yeah, I mean exactly what I did with that Law and Order episode of me right so so OCD. So. I once had this client who came into me. This was like when I was a grad student. I was like twenty five, and she was extremely like altruistic, kind, sweetest pie woman, and she said, Mike, I have this relentless obsession that I'm going to get brain damage. And at first I was like, you know, trying to do
the ERP with her and thinking, well, it's okay. We can tolerate the uncertainty that you know, if something is wrong, it's gonna be okay. But then I was like, tell me a little bit more about the context. And as she was telling me, she told me that at work someone playfully hit her on her arm, and she wanted to say she didn't like it. Oh, she didn't and
all of a sudden her OCD came in. Yeah. Now, the distraction the sleight of hand is that it's make her think that she has brain damage when the real thing that it's really getting at is that she wants to say no, stop it having a voice right, yeah, And so being able to decode that yeah, and to look at the nuance of what's happening is super important. And that's what I think. OCD is very magical in that way. It performs this sleight of hand to say, oh no, you say I did the trick, but you
don't see where the slide. So I think our job is therapist is to help people see the sleight of hand. Wow, which is actually really fun.
Isn't it. It's fun in that context. Yeah, it's also fun. And I'm gonna do some magic for you later.
Perfect.
I love it.
Yeah, it's fun in a real magic context as well. Both of us are fans of Irving Yaum, who has been a guest on this podcast.
Oh my gosh.
Yeah, I've hung out with him at his home. At his home, you know.
I once I once saw him at the Networker conference and I thanked him for showing all of a therapists how to be artists, And he said, I'm not an artist, Yes, I said, luckily. Sue Johnson said, I think the guy has point. And I sent him the book that I wrote about it, which is about how we're artists therapist and he's like, I hear you now, good And I was like, okay, good, you're right. Yeah, you're right.
As he suggests, existentialism is what allows us to be more alive and creative as human beings. Yeah, you say, having such a keen imagination and open heart makes those with OCD very susceptible to these existential concerns at nearly every turn. So would you argue that in his book, you know, existential Psychotherapy, which is the bible for people like us. Yeah, fools like that, big. Yeah, he has
section the givens of human existence. Do you think people with OCD are more sensitive to each of those givens?
Yeah? I think they know about those givens. I think they're aware of them precociously, very early. And also adults don't expect them to understand them and don't necessarily talk both in a way that's age appropriate and also that's a way that takes the sophistication, So you know, I think so. I have a story in the book about
my son. Once we were downstairs during the pandemic, and my eyes flashed upon my old piano bench, and I started to think about my mom, who passed away several many years back and didn't get to meet my son, and both the wistfulness of my mom prized my playing as a pianist. She encouraged it. And then I was thinking, how I missed my mom being able to meet my child, my son, and my son without missing a beat.
He was about three, said, Danta, why are you sad?
Now he could pick up with that emotional sensitivity, he could tune into it.
Do you think he has OCD?
Tennis, I think he has the sensitivity part of it, because he misses nothing. I mean, his preschool teacher said, Aiden is lovely, he's smart, he's cute, but nothing.
He misses nothing.
And I wanted to say, and he misses nothing?
Right, good?
And exactly what you're saying is that I do think that people with OCD are keenly aware of the existential givens. And that's what I think is the beauty is that. So I joke in the book that OCD is like playing six Degrees of Kevin Bacon.
Yeah, I was going to ask you.
That, and Kevin Bacon is is the death. But if you can focus, if you can actually face death as Yallam talks about, then you're really living and making meaning out of life.
Yes, well, how do you think Kevin Bacon would feel that you likened him to death at the court?
Yeah, you know, I think he's been successful and still looks young enough to not not really get to bother by it. I consider an homage Kevin. I mean really, you know.
Okay, okay, because if you think about it, if I'm gonna get it, I'm gonna rationalize this one because if you think about it, when I'm talking about the Kevin Bacon, actually, when you're talking about.
Death, you're actually really talking about life, right, So fear of death is really the fear of not being fully alive.
It's completely that's it, And that's what so poetry, like I was once taught, is both about love and loss. It's about the line ending, but but what we do with the breaks, and it's about kind of being in that contradiction. So I really see Kevin Bacon. I really see it's about life by facing death, exactly what Yam would say, Like Joan doesn't write about existentialism being like oh my gosh, like I'm a morbid goth.
He write a whole book on the importance of facing death. Yeah right, yeah, yeah, really beautiful.
So Kevin Bacon is the son, Yeah, I get it.
I think that's a good rationalization for making Kevin Bacon feel good about himself. Yeah, because he's going to listen to this.
He's also a great musician too, by the way, you know, I mean.
Yeah, don't let's not flatter a Kevin Bacon too much. Yeah, true, he don't want his ego to get too out of control. Let's end this interview today with a point you made in your book at his essence. What you did in your book is you drilled down to the core of OCD, which you conceptualize as a profound and precocious existential awareness that sensitizes you not only to loss, but also to
the fragile beauty of life itself. You also explored how being in touch with these questions in a creative way with proper support, could make it possible to make this experience of OCD creative and all inspiring rather than terrifying. So I just want to thank you so much for stripping some of that terrifying nature of it and expanding our views of OCD. You've helped me personally and reading
this book. I want to send a copy of this book to my mom and to anyone I know who has OCD and really humanize this in a really important way. And this was also my first time ever coming out as having OCD, so I thought it was a be a good place to do that.
Welcome to the club.
It's a good club to be a part of.
Yeah, So thank you so much, Michael. I am really so deeply appreciative of you being here.
Thanks so much, Scott. This has just been a pleasure.