Disordered: Anxiety Help
Disordered: Anxiety Help
Taboo OCD Themes (Episode 155)
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OCD is a difficult condition to navigate, but it becomes significantly more challenging when obsessions center on taboo topics. Themes involving harm, pedophilia (pOCD), sexual orientation (HOCD), or moral and religious failure often carry a heavy burden of shame. This shame frequently drives people into silence, preventing them from seeking the help they need.
In this episode, Drew is joined by Jess Marriner, an OCD specialist based in the UK. They discuss why the human brain can latch onto these specific themes and why having a "taboo" thought does not reflect your character or your actual desires.
Key Topics Discussed:
- The Nature of Taboo Thoughts: Recognizing that intrusive thoughts about harm or socially unacceptable acts are common mental occurrences and do not make you a dangerous person.
- The Role of Shame: How the socially unacceptable nature of these themes feeds the OCD cycle and keeps sufferers isolated.
- Common Compulsions: Identifying sneaky mental rituals like reassurance seeking, thought neutralizing, and "testing" to see if a thought feels true.
- Exposure and Response Prevention (ERP): How to approach treatment by leaning into the discomfort and uncertainty rather than fighting the content of the thoughts.
- The Goal of Recovery: Moving from a state of constant panic and checking to a place where thoughts are seen as irrelevant mental noise.
If you are struggling with taboo obsessions, this conversation highlights that you are not alone and that recovery is possible through evidence-based approaches like ERP and acceptance-based strategies.
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https://www.disordered.fm/the-disordered-guide-to-health-anxiety/
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Struggling with worry and rumination that you feel you can't stop or control? Check out Worry and Rumination Explained, a two hour pre-recorded workshop produced by Josh and Drew.
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Got questions or did it anyways to share? Send us an email or voicemail on our website.
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Disclaimer: Disordered is not therapy or a replacement for therapy. Listening to Disordered does not create a therapeutic relationship between you and the hosts or guests of the podcast. Information here is provided for psychoeducational purposes. As always, please consult your mental health and/or medical care providers. If you are having a mental health crisis, always reach out immediately for in-person help.
Person with pedophilia OCD or home OCD is not homicidal. They are not a serial killer, and they are not a pedophile. They are simply not. They're afraid that they are, but they are not.
SPEAKER_00I can't possibly be a good person if I've had that thought. I can't possibly be a good mom if I've imagined harming my child.
SPEAKER_01If you even have a thought about that, you are one of the bad guys. But that's not that's not true.
SPEAKER_00Really sneaky compulsions such as reassurance, thought neutralizing, pushing the thoughts out of your head, replacing bad thoughts with good thoughts, bad images with good images. Anything that essentially tries to kind of neutralize this stuff in their head that they don't like that makes sense to the person in the moment, is actually having the complete opposite effect. It's reinforcing this idea that they are this awful person and feeding their OCD. So they're getting more and more stuck.
SPEAKER_01Welcome to Disordered. This is episode 155. Today we're talking about taboo themes in OCD, obsessive compulsive disorder. I am Drew Linsolata, one half of Disordered. I am a therapist that specializes in the treatment of anxiety and anxiety disorders, practicing in New York. I am a former sufferer of the very things we talk about on this podcast, four-time author on the topic. Normally I would be joined by my co-host, my friend, my podcast partner, uh Josh Fletcher. But Josh is on the road today. His new book, uh Same Time Next Week, was released today. It's May 26, 2026, by the way. So he is on a book tour at the moment, promoting that book. It's a great book. You should check it out. It's called Same Time Next Week. Josh is a good dude. He wrote a really good book. I've had the privilege of reading it ahead of time, and I really enjoyed it. So Josh is not here today. The good news is we can still talk about taboo themes in OCD because Josh and I have the privilege of interacting with and getting to know many excellent, excellent clinicians and therapists around the world who share our theoretical orientation and our specialty. So I called on my friend Jess Mariner. Jess is an OCD specialist in the UK with super short notice, and Jess was great. She got on a horse, rode into town, and she's gonna join me in a minute, and we're gonna do a uh a chat about taboo themes in OCD, because OCD is hard enough to deal with when your theme is centered around a taboo topic like sex or infidelity or adultery or pedophilia or harm or faith or moral failure or sexual orientation or sexual behavior or things like bestiality. I'm full of all the like taboo terms today, right? When your OCD latches onto a theme like that, doesn't make you a bad person. You'll just be really afraid that you are, and you're more likely to suffer in shame and silence because of the taboo nature of the obsession. So let's get Jess in. Jess Mariner, I will give you Jess's links and all of her information in the show notes. If you're listening on Apple or Spotify or some podfet podcast platform or on YouTube, I'll make sure she's linked there. So without further ado, let's get Jess Mariner in here. We're gonna talk about taboo themes and then I'll come back later to wrap it up. Hello, Jess. How's it going?
SPEAKER_00I'm good, thank you. Thank you for having me.
SPEAKER_01Yeah, it was great. Very last minute, by the way. Jess, you were very gracious. Like, hey, um, how do you want to come on the podcast today?
SPEAKER_00I uh I run on last minute. Last minute works for me.
SPEAKER_01I love it. I think people think that folks that do what you and I do must be we must have it so together, right? We're just zen all the time, we're totally mindful. Like, I'm making up my days as I go along every day.
SPEAKER_00It sounds like you are I um I am a professional winger when it comes to life.
SPEAKER_01Oh, you are my people. That's why we get along, clearly. Yeah, yeah, yeah. All right, wing it. Wing it is my my my jam, man, winging it. So uh as I mentioned in the intro, Jess is a uh qualified psychotherapist in the UK that specialized in treating OCD, which is why she's one of our people. And we want to talk about taboo OCD things. We do those are those things that like they are socially unacceptable topics, they make us uncomfortable to talk about OCD or not, people don't like to talk about these things. We don't we don't like the words. We they are uh themes or that revolve around content that we generally all agree is unacceptable. Yes, yeah, and that's what makes them so tough.
SPEAKER_00And that's what that makes makes this type of OCD, these topics of OCD so tricky because they thrive in shame.
SPEAKER_01Oh, that's true, and there's a ton of shame around that. I remember years ago, the first time I ever posted about pedophilia OCD, P O C D on Instagram, my comment section was pull full of people who did not, I don't think they even followed me, and they came in with the pitchforks and torches. Anyone who ever has a thought anything like that should be instantly like capital punishment, put to death, you know, sent to ELBA and left to die.
SPEAKER_00Yeah.
SPEAKER_01Tough response.
SPEAKER_00I've got hundreds of comments on whenever I do talk about pedophilia OCD or harm OCD of very similar kind of responses that how dare you put these two things in the same category.
SPEAKER_01Yeah.
SPEAKER_00Kind of the words OCD and paedophilia, the words OCD and harm.
SPEAKER_01Yeah. But they are, well, they are in the same category. So I think the hard thing about that is they're just thing, they're these are just concepts that brains get stuck on sometimes. And I I guess for anybody listening who's gonna wander into this podcast and hear Jess and I talk about this stuff. An OCD theme that is a taboo theme doesn't mean that that Jess and I are here like defending the actual act of pedophilia. That's not it at all. A person with pedophilia OCD or home OCD is not homicidal, they are not a serial killer, and they are not a pedophile. They are simply not. They're afraid that they are, but they are not. That is very, very, very important.
SPEAKER_00Yeah, in fact, it's the complete opposite, isn't it? That the person is so terrified, so distressed at the thought of having this stuff land in their head that they become so obsessed with it.
SPEAKER_01Yeah.
SPEAKER_00That you know, how can I make sure I am absolutely not this person?
SPEAKER_01Oh, how can I make sure I'm not this person? That's that feared version of myself that lies at the core of that, right? So, so what happens when let's talk about some of those things. How does it start to look like? What is it, how does it develop? I mean, what's the first signs that, like, oh, not only, I mean, you may have a thought about something that disturbs you, or I might have a thought, and uh, it'll bother me, but then it'll quickly pass and I don't think about it again for the rest of the day. What's the difference between me and somebody with an active in you know, currently active OCD theme that centers around one of these things?
SPEAKER_00It's a really great question. And I guess the way I try and help explain it to my clients is that the thought itself or the image, the thing that lands in their head that they really, really don't like is fundamentally normal. That is a mental brain occurrence that you have no control over. But where we might start going down the road of ACD and obsessing about it is when we attach meaning to it. So we decide that the very presence of that thought now says something about us as a person. I can't possibly be a good person if I've had that thought. I can't possibly be a good mum if I've imagined harming my child, that somehow these two things are kind of intrinsically linked. And what we know is the stuff that pops into our brain at any given time is completely out of our control. Yeah, we have no control, therefore, to attach inherent meaning to it is fundamentally problematic when we don't have any control in the first place.
SPEAKER_01Yeah, it's a really good point. And and I think um the tough thing about that is these are concepts or or content that we all we all again socially agree are unacceptable. And I think the drive socially to make sure everybody knows that I don't like those things. I do not like harming children, I do not like murder. Like we want to make sure that we I'm gonna I'm gonna use a condescending term, but I don't mean it that way, virtue signaling. We want to make sure everybody knows that we're on board with the good guys.
SPEAKER_00Yeah, yeah, yeah.
SPEAKER_01That it goes so far as to being interpreted as if you even have a thought about that, yeah, you are one of the bad guys. But that's not that's not true.
SPEAKER_00No, absolutely not. And and I am yet to sit in a therapy room with someone who is experiencing OCD and caught up in obsessing about these types of thoughts and have any concern over a level of risk or who they are as a person. Their distress tells me everything I need to know.
SPEAKER_01Yeah. Which often makes the public look at us weirdly, you and I, for doing that kind of work.
SPEAKER_02Weirdly.
SPEAKER_01Yeah, because it's like, I don't under how could you you have to report that person. Like, no, I'm actually sleeping just fine, knowing that that person has a thought that they hate so much that it's driving them into like ruin because they hate the thought. Like that, I'm I'm okay. I know that person is a good guy, it's really okay. Um there's even an instant, I've had one instance instance where I had uh a client who it was a harm theme, but they were afraid they were gonna harm other people, like just snap into a murderous rage. And I had that person sit next to me with the biggest pair of scissors we had in the office, and she was so worried, like how I she was worried for me. And I'm like, Yeah, I'm not I'm not worried at all. I'm gonna close my eyes, I'll turn my back to you. Like, I won't even try to protect myself. And it was all good.
SPEAKER_00So yeah, we have weird jobs, right?
SPEAKER_01Very nobody who, as I'm walking through the office before that session, asking who has the biggest pair of scissors in the place. Love it. I say, what? What is going on here? But that's how we you know, that's what that's all about. We understand that that person is not a bad guy, they're not a bad person for having those thoughts.
SPEAKER_00No, yeah. Because we have them too, right? If I was to ask you, I mean, you might say you do, you might say you don't, but we're gonna know that you do because through virtue of you being a human.
SPEAKER_01Yeah.
SPEAKER_00And I do too.
SPEAKER_01Absolutely. Yeah, there's no and you do I often try to tell people you can control, you can decide what to think. You can never decide what not to think, ever. So it is such an important distinction because I think we some of this goes off the rails and we stigmatize these OCD themes more than others because somehow or other we think that you can choose your thoughts. And we, I mean the royal we, like all people seem to think that thoughts are something we pick, just pick positive thoughts, pick happiness, pick positively. Yeah, oh yeah, we'd all love to do that, and we can try to think positive thoughts, but we can't stop thoughts from happening, it just doesn't work that way ever.
SPEAKER_00No, yeah, and I think when when you can really help someone understand that and really kind of experiment with that and go, okay, well, that's what happens when we try not to have a thought by virtue of trying not to have it, it's already landed in our head. It's very freeing when you can really help someone understand that you've never been in control of this, and you never will be, and our job is to accept that.
SPEAKER_01Because none of us are, no, right. So, uh what's the difference between the person who has a taboo thought during their waking hours and the running gag? You know, you wake up in the morning and you know, what's the and we laugh at that. Like, I was so angry at my husband because I dreamt that he cheated on me. I was angry at my wife because I dreamt that she cheated on me. And we laugh. Like, why are you angry? It was just a dream. Yeah, I know, because we all recognize that it's a jud that's a mental event that happens when you sleep that you can't control or didn't ask for. So why are you angry at that person? We we would all agree on that. So why can't we?
SPEAKER_00But there's something about with waking consciousness, we we assume more responsibility for what comes into our head.
SPEAKER_01Which doesn't seem right. So in that situation, you now you have somebody, and these people are it's it's heartbreaking because they're often beside themselves. Because it strikes at the the core of what they hold most dear.
SPEAKER_00Yes, terrifying.
SPEAKER_01Yeah, very, very difficult. I I had one woman at one point who she was a school nurse for many years and exceptional at her job, just loved the kids, the kids loved her, and she was afraid that she might actually have lustful thoughts about the kids, even though she never did. And she was fine, but she got terrified to go to her own job. It was it was awful. Poor woman was suffering.
SPEAKER_00So, how do you it completely shrinks people's worlds, doesn't it?
SPEAKER_01Yeah.
SPEAKER_00But how do we deal with that? We well, I guess we first of all start to help someone understand that these thoughts are not in their control, and also a testament to who their character actually is. So someone that is loves children or works with children, who becomes incredibly distressed about thoughts about harming children, that speaks far more too about who they're they are as a person and their character and their values. So really helping someone understand that initially, but then helping someone understand that OCD's whole kind of MO is to get your attention, and it's gonna use that with these types of thoughts. I often say to people, if OCD plays two thoughts in front of you, what if I don't like cocoa pops anymore? And what if I harm my child? Which one's gonna get you on your head more? Probably what if I harm my child? It's doing exactly what it wants to do to get your attention, and we have to start to see the kind of game that it's playing, that this is targeted in terms of attaching and attacking your values and who you are as a person. And when we can take a step back and start to see this, to see that you are not your thoughts, and this is a kind of essentially an OCD is attacking your values, we can start to detach ourselves a little bit from from the things that are going in our head.
SPEAKER_01Yeah. What is the usual response? So a person before they walk in your into your practice and and you know start treatment, what are they trying to do when they have these thoughts or images or you know, ideas that they can't control? They can't, I'm trying, I can't get them out of my head. Oh my god, this is terrible. What if I'm really that person? What are they typically trying to do before they go to therapy and learn another way?
SPEAKER_00Yeah, well, kind of understandably initially, people start to get rid of these thoughts. They start to try and figure them out, they start to reassure themselves. You know, if I had a thought land in my head about harming my child or acting inappropriate with my child, I'm gonna reassure myself that I would absolutely never do that. Yeah, of course I'm not that person. They might start to take avoidance actions. So let's make sure I'm never alone with a child, let's make sure I'm never in a position where I could act on these thoughts, or there is a potential that these thoughts could come true. So there's a lot of avoidance but also protective measures put in place. And I say protective in the vertical commerce because we know that the protection is not actually in relation to any risk. But in their minds, they believe that they need to now take every action under the sun to make sure that they never act on these thoughts, that these thoughts don't come true, or images. We're always talking about images as well. So lots of treating the thoughts and the images as valid and important and true and factual.
SPEAKER_01Yeah, so they're they're probably taking some sort of evasive action. I either need to go through all kinds of mental gyrations to prove that the thought is not true or won't come true, or I'm taking behavioral actions to make sure that I can't act on this thought.
SPEAKER_00Yes, yeah, yeah, yeah. And there's often a lot of internal reassurance and mental compulsions going on that we often really miss. The like as you said, the over behavioral stuff is is more obvious.
SPEAKER_02Yeah.
SPEAKER_00But it's often those really sneaky compulsions such as reassurance, um, maybe thought neutralizing, pushing the thoughts out of your head, replacing good thoughts, um, bad thoughts with good thoughts, bad images with good images, anything that essentially tries to kind of neutralize this stuff in their head that they don't like.
SPEAKER_02Yeah.
SPEAKER_00And we know with OCD that whilst that that that makes sense to the person in the moment, it's actually having the complete opposite effect in terms of it's reinforcing this idea that they are this awful person and feeding their OCD. So they're getting more and more stuck.
SPEAKER_01Yeah, because the lesson you learn, and I got stuck in a self-harm theme at my worst. And I would it was urgent, it was it was very important and urgent for me to look out the window and see a bird and try desperately to appreciate the bird and be grateful for the fact that I got to witness this this nature, and but I could but I couldn't, I couldn't generate enough positivity on demand to like convince myself that I won't somehow against my will harm myself. So yeah, and and so but I kept having to try to do it because not doing it would mean that I'm letting the thought run wild and it will make me do it, and so that's where people get stuck. Like, no, no, I have to do that, I can't just leave that.
SPEAKER_00And and what you said there about that sense of urgency is really helpful for someone to kind of spot when we're thinking about this is how urgent does it feel?
SPEAKER_02Yeah.
SPEAKER_00Do you feel like you've got to kind of stop everything that you're doing in your life, whatever your focus was on, and when this thought lands in your head, this is now the priority. That's often something that helps kind of us consider whether maybe we are dealing with OC.
SPEAKER_01Yep. There was the testing compulsion, which would be like walk into the kitchen, but I would never do that when nobody else was home, which I was terrified to be alone anyway. And I would grab a knife out of the drawer and just hold it in my hand, terrified, but testing, am I gonna do this? But I would know that somebody was an earshot so I could scream in case I started cutting myself. It was insane because I kept doing it again and again and again. Like I never lasted, and that becomes part of the problem too. Yeah, absolutely. The lesson to my brain at that point, I think, was keep testing to make sure, because you are gonna do that. Keep testing to make sure you're not gonna do it.
SPEAKER_00Keep yeah, it was and avoidance has the same impact, doesn't it? In terms of the lesson that you're sending your brain. I got caught up in very compulsive cycles of avoidance when my daughter was born. So thoughts around harming her, thoughts around acting inappropriate with her. And for me, my solution was to avoid bath times, being alone with her at night time, um, wherever possible, being alone with her. And so my brain learned that well, the only reason nothing bad has happened is because you've not been on ORM with her.
SPEAKER_02Yeah.
SPEAKER_00And what we what I needed to learn was actually chances are nothing bad was gonna happen anyway.
SPEAKER_01Yeah, that was never true.
SPEAKER_00That's terrifying.
SPEAKER_01It is very terrifying. I had with my my kids were not infant, they were small at the time that I was at my worst, and then it got latched on to it. Wasn't really what if I harm them, but what if I don't actually love what if I don't actually love them? How do I know I really love them? And in a way that, and then therefore, if I'm alone with them and I don't, I'm not, I won't pay attention and they'll get hurt, or maybe I will get so upset that I'll hurt them instead of me.
SPEAKER_02Yes.
SPEAKER_01And yeah, that's what Yeah, that's tough because it's hard to talk about like, is it possible that I don't love my kids? That's a taboo theme. Yes, and I I would even include that relationship OCD sometimes in the taboo themes. What if I don't actually love my partner? What if I've been unfaithful and I don't know it? What if they don't actually yeah, that that's really difficult.
SPEAKER_00So the not knowing, that's a big one for me. Yeah, I spent years and I still sometimes go down the rabbit hole, um, trying to figure out if I murdered someone once. What if I murdered someone, chopped up their body and hid it in a river?
SPEAKER_02But don't remember.
SPEAKER_00I have spent, I don't remember, yeah, 99.9% sure I didn't, but that 0.1% of possibility, yeah, OCD gets me going back and back and back.
SPEAKER_01Yeah, an OCD brain will not, and a taboo theme that's especially difficult, will not accept 0.01%. That's not that's not okay. 0.1% that's not okay. That's not zero. We need zero.
SPEAKER_00So I need zero.
SPEAKER_01Yeah, I need zero.
SPEAKER_00Or I did need zero.
SPEAKER_01Oh, that's tough because now you're plumbing memories that you don't actually have to find a memory that you don't actually have.
SPEAKER_00Yeah, yeah, yeah. I've spent hours searching through memories of being near rivers, trying to recall times when I was near a river, just if I could get that bit of information to confirm that I didn't do that.
SPEAKER_01Yep.
SPEAKER_00And guess what? I've never got there.
SPEAKER_01Yeah, amazing.
SPEAKER_00I've got to be willing to stop looking.
SPEAKER_01Yeah, yeah, that's exactly right. Okay, so now this is all the things that people might be doing if they have a tab any OCD theme, but the taboo themes especially. They and they likely are suffering in isolation or silence because the taboo themes are taboo, so we don't want to talk about them.
SPEAKER_00Exactly. Yeah, and I yeah the amount of times that I've had people sit in my therapy room with me, and they've taken so much bravery to get to the point of sharing their thoughts with me. And it's almost that bracing, it's like, I'm gonna tell you, I'm gonna tell you what's going on. And so they'll say it and they'll wait for me to recoil in horror or ring the police, or you know, yeah. And my response is pretty like yeah, okay.
SPEAKER_02Yeah.
SPEAKER_00Okay. And and it's that sense of like you are normal.
SPEAKER_01Yep.
SPEAKER_00Your brain is not broken for having these thoughts.
SPEAKER_01Yeah, you're just getting a little stuck on them, which is what winds up happening. Yeah, I get it. Or I've had people who ask, Do you have to I I want to tell you, but uh what Do you have tell me again what you have to report to the authorities? Yes. Or if I tell you about a person with ROCD, and and she was lovely and did great work with it, by the way. Who asked first, do you have to tell him? Are you like you're required? Would you have to tell him about that? There was nothing to tell. She was just having thoughts and doubt. Right. But like that, there was nothing to tell, and they were very, very concerned. Because I think it's really hard. You can't really go to your partner or a friend or anybody and say, hey, let me tell you this thought that I'm having. Ooh. No. It's so embarrassing, right? And shameful.
SPEAKER_00And I think this keeps the shame going because when we talk about everyone has to be thoughts. But if you ask someone, do you have to be thoughts?
SPEAKER_02Yeah.
SPEAKER_00I'm going to hazard a guess that a lot of people will say no.
SPEAKER_02Right.
SPEAKER_00And my kind of my two takes on that are number one, that they are too embarrassed, too ashamed, too like why would you admit this if you don't understand that it's normal? And then the other take on it is that yes, they are, but they're paying so little attention to it that these thoughts are coming and going, as they do for so many people, and they genuinely don't remember.
SPEAKER_02Yeah.
SPEAKER_00And that keeps that shame alive because people then believe that they are on their own with this, that they're the only ones experiencing it.
SPEAKER_01Yeah. Often I'll hear like, okay, fine, every brain makes them, but why does my brain make them so often? That must mean something, right? Yeah, yeah. And it's a tough sell. And by the way, we're not going to stop here. It's not just explaining, like, oh, it's just a thought. I know, yes, that's true. That underlies all of this treatment. It's okay, it's safe to have a thought, and we're going to work from from there, but we don't end there. And it's the whole like, no, no, but the thought must mean something. We always try and frame it as like, it doesn't confirm that you are that. It confirms that you hate that, or you you all it confirms is what you fear. That's all the thought confirms.
SPEAKER_00Yes. So your kind of deepest, darkest fears. What if I'm a bad person? What if I'm a dangerous person?
SPEAKER_02Sure.
SPEAKER_00Are quite often help people try and understand that actually that's what C D is going after.
SPEAKER_02Yep.
SPEAKER_00It's going after these deepest, darkest fears. And it's essentially using bait. It's lobbing stuff into your head that's going to get your attention as bait to kind of get you in your head obsessing or avoiding or whatever your compulsions might be.
SPEAKER_01Yeah. Yeah. So quickly, I mean, we'll do a quick rundown. Then I'm going to talk about the actual, the active part of treatment as opposed to just talking about how thoughts are just thoughts.
SPEAKER_00Yeah, the good stuff.
SPEAKER_01Yeah, exactly. So we have uh harm of self, harm of others, children, of course, physical harm, sexual harm, animals, harm of animals. What else? What are we missing? Let's throw some more.
SPEAKER_00Uh we've got pedophilia.
SPEAKER_01Yeah.
SPEAKER_00Um, what are we missing?
SPEAKER_01I I I might put things like religious and moral scrupulosity because it feels very taboo to fail your faith in some circles or or think you're failing your faith.
SPEAKER_00Yeah.
SPEAKER_01Yeah.
SPEAKER_00Quite often obsessions about sexuality.
SPEAKER_01Yep. Oh, true.
SPEAKER_00Am I straight? Am I gay? Yeah. How do I know for sure? That's quite a common one.
SPEAKER_01Yeah. Um relationship OCD focused on things like infidelity or adultery. Yeah, those are taboo. Can't tell anybody. I'm thinking about that. So that's a tough one too. We might be missing some if anybody. Yeah, but I'm sure people will remind us if we are. But uh yeah, the because again, these are just very difficult topics to talk about. So people tend to suffer in silence and go through their avoidance and their compulsions by themselves and buried in shame and stigma. So now you've you've I'm your new therapy client, and I tell you about my problem, and you explain it to me, give me the psychoeducation, that rationale for treatment. Here's why it's okay to have those thoughts. Now, what are we gonna do? Now, what are you gonna do with this taboo theme of mine?
SPEAKER_00We're gonna have to do some, we're gonna have to test some stuff out. We're gonna have to find out whether you can respond to these thoughts differently. Can you start living your life as if these thoughts are actually irrelevant, that they are just mental brain occurrences? And this is where so I use exposure and response prevention. That's my main morality, kind of treatment modality when treating OCD. And essentially, what we want to do is reteach the brain that these thoughts or these images that you've been treating as a threat, and therefore have kind of taught your brain that they're dangerous. We now need to reteach your brain that they're just mental occurrences, they're they're mental brain occurrences that don't say anything about you as a person. We need to start treating them like random thoughts, and that's going to involve changing your responses. And it sounds terrifying, right? Yeah, I am yet to meet anyone that when we talk about ERP, that they're delighted.
SPEAKER_01Yeah, let's do it. No, nobody does that. I know.
SPEAKER_00But it's also really misunderstood, I think. I don't know about you, but I think ERP is massively misunderstood.
SPEAKER_01Oh, I I think so too. And some of it, especially in the two the taboo themes, this whole thing, and then listen, I understand the criticism. Like, what do you mean? You have to you have to tell somebody to accept the uncertainty that they might be a pedophile or might have uh murdered somebody without knowing it. Like, no, no, no, that's not what we're saying. That's not it at all. So I know it sounds like that sometimes, though.
SPEAKER_00Yeah, absolutely. And I can I can understand the apprehension about, but actually, what we're trying to do is help you understand that it's the fear that you feel when you have these thoughts or these images that is driving you to do the compulsions, right? And so we've got to get better at being anxious, we've got to get better at handling feeling uncomfortable so that we don't rely on a compulsion to reduce that anxiety. And so with ERP, what we're gonna do is we're gonna deliberately bring on some of these thoughts and images to give you deliberate opportunities to practice responding differently. Yeah, and again, it it's it's so misunderstood because sometimes people will say to me, Well, how am I gonna do an exposure to right harm, killing them?
SPEAKER_01Right, okay.
SPEAKER_00What have I got to go and start stabbing people? And we're like, no, no, no, we want to think about the situations and the triggers that might bring on these thoughts. So essentially, what are you avoiding? Or what are you doing too much of that you've you've you're doing because you're so scared of having these thoughts? Let's use those to develop some really good exposures, and then let's get you better at kind of tolerating that uncomfortable feeling that comes up. And the reason we do this because it isn't fun at times, is because it's so effective. The your brain learns through observing your behaviors, and if your brain observes you having these thoughts or images, and now you're no longer responding from a place of fear and panic, but you're responding from a place of like, okay, cool. Yeah, this is a thought and image, we're not gonna treat it as fact or real, we're gonna do the opposite essentially. Your brain will very, very quickly learn that this is just a thought, and it doesn't need to fire off the threat response every time. Yeah. And it's really effective.
SPEAKER_01It's kind of it's almost like getting out of the way of the content to let the process actually complete. So when you have that taboo thought or image or idea pops in your head, or you see something on TV, whatever triggers you, the object of the game is like, okay, now there's a process by which fear is created, it rises, and then you think you have to insert a compulsion to knock the fear down, but and and the compulsion is always content-based. So we're gonna back away from that and just be afraid. So, like, we're not sitting there being a murderer, a secret murderer. We're not being an adulterer or a blasphemer or something like that or a pedophile. We're sitting there just being afraid that I might be and letting that fear naturally ebb and flow like it does if you leave it alone. And that's the lesson your brain needs. Oh, we didn't do any of the things. And look, I I'm gonna the fear doesn't last because it's not a forever fear.
SPEAKER_00Yeah, it's not a forever fear. That's such an important piece of learning, isn't it?
SPEAKER_01Yeah.
SPEAKER_00That if we do, or if we don't intervene with anxiety, if we don't jump in with a compulsion, that feeling will pass.
SPEAKER_02Yeah.
SPEAKER_00It may take longer than you would like it to pass initially.
SPEAKER_02Yep.
SPEAKER_00And that's the bit we've got to then be willingly tolerating, but it will pass.
SPEAKER_02Yep.
SPEAKER_00And it's so I think the the most brilliant bit about my job is when you get someone to that point where they're like, I had the thought, I didn't do my compulsion, nothing bad happened, I survived. Yeah, maybe this is how I get my life back. Yeah it's so amazing.
SPEAKER_01It's really great, isn't it? So now uh I'm your new therapy client. So in week two, my I'm gonna give you now everybody with OCD, everybody with an anxiety disorder is gonna raise this objection, of course, when it's time to face the fear, but in a taboo theme, I think it's particularly nasty. What do you mean, like treat it like it's irrelevant? Clearly, harming my children is important. What do you mean, treat it like it's yeah? How do you respond to that?
SPEAKER_00How do we respond to that? I want you to treat your thoughts about what if I harm my children as irrelevant.
SPEAKER_02Yeah.
SPEAKER_00Essentially, we want to respond in a way that someone without OCD would respond. So, yes, you've had this thought. It's telling us through the level of distress that you're experiencing that actually really care about your kids. Responding to that thought and trying to figure that thought out is gonna mean you're gonna get that thought more. So we've got two options on the table. We can continue to respond to that thought as if it's meaningful and important, and stay stuck in OCD, or we can start to see OCD as a process that actually what I often say to people is everyone with OCD wants a book. They want a book of what are good thoughts and what are bad thoughts. Okay, so this is a bad thought. What if I harm my kids as a bad thought? And actually, that doesn't exist. There is no such thing as good and bad thoughts, they're just thoughts that you've attached meaning to because you don't like it. So when we talk about treating thoughts as irrelevant, we're zooming out, we're saying actually, no, that thought is still just a thought, regardless of the content. An OCD is the process, it's the obsessing, it's what we're doing with it. So I need you to now not see that as a good or a bad thought. The content, the content was always out of your control. But if we want to get out of OCD, we have to start leaving this stuff alone.
SPEAKER_02Yeah.
SPEAKER_00Because everyone who's not experiencing OCD is also leaving this stuff alone. Yeah.
SPEAKER_01Yeah. And I think it's a hard sell for people with taboo. It's a really hard sell. Yeah, to recognize that, like, well, listen, you know, I'll I'll often validate that. Like, yeah, what's I'm in the room with you. I agree that the safety of your children is important too. I'm in 100% agreement with that. So I'm not telling you to ignore the idea that your children should be safe, but we need to recognize that a thought, especially one that triggers you and you hate so much, about doing something terrible, is not the same as doing something terrible. It's simply not the same. So, yeah.
SPEAKER_00I sometimes quite like to think of this as if I thought about being a pilot and flying a plane, that doesn't mean I'm suddenly a pilot and I can fly a plane.
SPEAKER_01If I get in a plane and you're in the pilot seat, I'm getting off the plane. Just like just to tell you right now. I dig you, but yeah, I'm not letting you fly me anywhere.
SPEAKER_00But I thought about it, Drew.
SPEAKER_01I'm not a pilot, but I did think about it last night. You just described the entire do your own research crowd. I thought about it, so now I'm an expert. Anyway. Yeah. And then see how we can dismiss that and make fun of that sort of process because we know it's ridiculous. Yet if you have a thought and it disturbs you.
SPEAKER_00If it goes against your values, if it goes against who you are as a person, suddenly we're less willing to treat that as irrelevant.
SPEAKER_01Yeah, that's exactly right.
unknownYeah.
SPEAKER_00And we've got to see the same, we've got to see them both as the same thing.
SPEAKER_01Sure. Okay, so now it's week 12. Uh, and you're doing a great job, thank you, Jess. Best therapist I've ever had. I'm feeling so much better. The other day I was watching whatever. I was watching the news and I saw a horrible story about a woman who murdered her whole family. And I and it I didn't it didn't trigger me. Do I uh what is why didn't I get anxious over that? That's terrible. Do I am I starting to like that?
SPEAKER_00Yeah, really common objection.
SPEAKER_01Yep.
SPEAKER_00Because we absolutely want you get to a point where your content that was triggering you no longer triggers you, and that's really hard, isn't it? If you've attached so much meaning and importance to I must be a good person because I find this stuff horrifying. No longer horrifies me. What does that say about me? And essentially we're saying it doesn't say anything about you. You are able to separate yourself from the world externally and who you are as a person. The example I often give is every single day when I drive my daughter to school, we stop at a particular set of traffic lights, and my brain says to me, Why don't you just run that person over? And my brain will usually pick the most vulnerable looking person, either the old person or the child. I don't know why my brain does that. Every single day. Yeah. Oh Jess, just run them over. Yeah, I don't feel anxious about that. When that comes into my head, I am willing to roll my eyes at my brain, shrug my shoulders and get on with my day. Not because I'm secretly this dangerous person that wants to run people over, but because I recognize that just because my brain says that and I'm not responding to it from fear and panic doesn't say anything about me as a person. Right. And it's okay to observe the world events and life events and horrifying stuff, and respond how you respond, whether that's with panic, we're not in control of that anyway.
SPEAKER_01Right. And I think that it's a hard one, though. Yeah, the fear that, like, well, I'm not being triggered anymore. So does that mean I'm learning to like the thought, and now I actually like that? No, it doesn't. The fact that you can ask the question tells me that you do not condone murdering your family. There you go, that's all you need to know. So you recognize that was a horrible story on the news, but I'm not panicking. Yeah, I know. Your level of disgust or repulsion or disapproval is now back to its normal place. How could somebody possibly do that? That's awful. That woman needs to be brought to justice. Yeah, that's the way we all respond. Maybe we'll protest, maybe we'll contact our legislators for you know stricter laws or something like that. We won't panic. That's the difference. So you're just because you're not having that egregious, giant, urgent, in-the-moment response that's personal to you does not mean that you now agree with that terrible concept.
SPEAKER_00Yeah.
SPEAKER_01Yeah.
SPEAKER_00Essentially, the way I often like to describe this to clients is your smoke alarm is now working appropriately.
SPEAKER_01That's right.
SPEAKER_00So instead of firing off every time you boil the kettle, and there's a hint of smoke, which would be really annoying, your internal smoke alarm is now working effectively. It's not so sensitized, it's it's not firing off at every grain of fear or possibility. It's treating stuff that isn't actually dangerous, that's not dangerous.
SPEAKER_01Yeah. That's a good point because a smoke alarm isn't a guarantee that your house is burning, it's a hint that you might want to take a look. So, same thing. A thought is a hint. You might want to take a look. All right, well, this doesn't even, yeah, that's a terrible story on the news, but like there's nothing going on around me right now that means I should panic. But if every single time you hear the you know the battery's dying and you hear the blip, and you you call the fire department and get everybody out of the house and sell the house because it's clearly on fire, yeah, that's not the way you do that. So that's the change. Love it. Okay. So, and there are always those big objections, though. We can't talk about this, it must be important. I cannot do ERP because I can't take a risk.
SPEAKER_00Yeah.
SPEAKER_01Yeah. Let's validate that for a second. I don't care what kind of OCD you have, taboo or otherwise, or even in any anxiety disorder. I can't take that kind of risk when it's time to do the homework. Is an almost universal experience, no? In your and I mean I'm feeding you words, that's not fair, but what's your experience there? I can't take that kind of risk.
SPEAKER_00Yeah. And I get it because I was there. The risk feels so real. You the perceived risk. It's a perceived risk. And I think often we have to take a step back and think about what's my life gonna look like if I don't take this? Am I willing to continue living my life like this with OCD in the driving seat and anxiety in the driving seat? Or am I willing to find out whether this possibility that this is all OCD and perhaps I don't have to be doing these compulsions and I don't have to be living my life this way? Am I willing to find that out? And it does feel like a risk. And I think it's really important to acknowledge that that everyone who is willing to do this work has to take a leap of faith. Yeah, it's a leap of faith in yourself, in the process, in your therapist to find out whether I am actually experiencing OCD. And no one's gonna be able to give you that cast iron 100% guarantee that you want. Yeah, and that's why it's such a tricky disorder. Yeah, because we're working on possibility.
SPEAKER_01Yep, it's the worst.
SPEAKER_00What I can say is every single that I've person that I've worked with who has taken the risk, taking that leap of faith, has not regretted it.
SPEAKER_01Yeah. It's the sad part about it though, and it's not sad, it's wonderful, but the difficult part about that is the hard sell is no, no, no, but what about all these people that got better? Like, yeah, when they got better or recovered or whatever, went into remission, I don't care the words you want to use, then can look back because they had all of those experiences, actual experiences, not just thinking and trying to figure it out or prove it wrong in their heads, actual experience, and look back and say, Oh, that was OCD. Oh boy, was that OCD? That was my OCD raging, right? So, but in the moment they weren't sure. Is this really OCD? Or can I do I really want to take that risk? I hear you.
SPEAKER_00And so and it's about being willing. It's you what I would say, you don't think your way out. Yeah, there's no logic in way out, there's no no amount of thinking is gonna get you out of this. You have to be willing to act your way out, to live your life as if this is OCD, to find out that it is OCD. Sure. And every person has to take that leap of faith.
SPEAKER_01And I think they get there when they get there. We'll kind of wrap it up that way, I guess. It you know, I I think in the end, and I I Jess, I I'm interested in your take on this too. I always try to tell people you get there when you get there, however way you get there, for your own reasons, because I think ultimately what winds up happening is before somebody jumps in and says, Okay, I'm gonna do the treatment, I'm gonna take the risk because I know it feels like a risk. So we'll say risk because it feels like a risk until you look back and say it was never a risk. Okay. Yeah, you will take the risk when the cost of not taking the risk becomes too great. Outweighs. Right. And I hate that part because it means that we get just jammed, we're we're pinned to the ground, and then we have no other way out, and then okay, fine, I can't do it like this anymore. But that is usually in some way, shape, or form, how somebody gets to the point, like, okay, fine, I will challenge it. Let's do it.
SPEAKER_00Yeah, yeah, and I often it is really sad because a lot of the people I work with, the majority, have got to that point. Yeah, I'm not willing to live my life like this anymore. Yeah, and as sad as that is, that's such an amazing springboard for treatment. Yeah, because we take that I'm done. I am done living my life with that, and we harness it. And together we're like, okay, great. Let's let's find a different way of living life. Let's take that dumbness and you know, frustration and sadness, and everything that comes with that, and let's take your life back.
SPEAKER_01Yeah, absolutely. It's either sometimes it's either anger, I'm just I am so angry at this. So that's I'm done with this, or sometimes you just run out of gas to fight. It is so exhausting to try to prove to myself during every waking hour that I will not harm my children or engage in some other taboo thing. Yeah, and I just I've lost the ability to fight anymore. I gotta give up. And as it turns out, that's a good moment. It's a really pivotal moment. Yes, then the experience of not fighting it anymore. Wait, I I'm out of gas, I'm not fighting, I'm surrendering to it, and nothing is happening. What's up with that? I know, yeah, yeah. So anyway, well, thank you, Jess. I appreciate that.
SPEAKER_00You're very welcome.
SPEAKER_01Yeah, short notice coming on, rescuing disordered. We appreciate you.
SPEAKER_00Josh is up promoting his book.
SPEAKER_01He's up promoting his book, and I'm like, I'm gonna call Jess and let's see what happens. I appreciate you being so cool and responding so quickly. We'll have you back on again for sure when Josh is here, but um, I will cut anything you want people to know before we we go. I'm gonna come back in a minute and give you Jess's links and in the show notes and all that stuff. But anything you want to sign off with as we as we wrap it up?
SPEAKER_00I think the one thing I'd like People to know is that if you are struggling with taboo thoughts or images, know that any therapist who is trained in treating OCD is not going to record in horror. They are going to sit there and help you figure this out, and it is safe for you to share what's going on.
SPEAKER_01Yeah. By the way, you don't ever have to give your therapist a trigger warning. Let me just tack that on to what you said. I've had people say that too. Like, I'm so sorry, I don't mean to trigger you. I'm like, you know what I hear every day? No trigger view. It's all good. Bring it. Yeah. So anyway. All right, Jess, thank you so much. We'll have you on again real soon.
SPEAKER_00Thanks, James.
SPEAKER_01Enjoy the rest of your day. Okay, we are back. Special thanks to Jess for writing in at the 11th, the 11th hour and saving our episode this week and adding her expertise. Uh, this is something she deals with clearly on a daily basis, as you can see in the interview. She has a lot of experience with this. And I really love the way that she spoke so compassionately and in such an accepting way about these taboo themes, because anybody who's struggling with a taboo OCD theme knows that what you really need is somebody who's going to fully unconditionally accept you, not judge you, not reject you, not criticize you, and not sort of play into the crazy hype that OCD creates that you might be a terrible person, because we promise you're not. And we know that because you're really scared of the thoughts, which tells us everything we need to know about who you really are, which is you're not the person you fear that you are. So you can find all of Jess's links in the show notes, whether you're on Apple or Spotify or you're on YouTube listening or wherever you happen to be. I will make sure wherever this episode appears, you can find links to Jess Mariner. Uh JessMarinerTherapy.com is her website, but I'll link her Instagram and all that stuff so you can go check her out. I strongly suggest you follow along because Jess is one of those really great social media people who does not promise you the world. It's not crazy mic drop moments, it's not crazy misapplied neuroscience hacks and biohacking and nonsense. She's very consistent in her messaging. It's all empirically validated stuff. It might not be the most glamorous stuff, but but Jess is a trusted source that you can you can lean on when you need to. So check her out. Uh, that is it. Episode 155, we are done. We'll be back again next week. Josh will be back next week. So we'll be back to our regular podcast schedule. If you want to participate uh in a episode of Disordered by sending in a did it anyway or a question, you could do that on our website at disordered.fm. If you actually wanted to really participate in an episode and watch us record these live, you could check out the disordered community space. It's not required. We're not gatekeeping, it's not a cult. We're not promising you some sort of freedom from anxiety if you join the in the community. But if you want to watch us do these live, you want to interact with us a little more, interact with a very supportive community just to get a little extra boost when you need it, you could check that out. That's also at disordered.fm. Uh thanks for listening. Appreciate it. Thank you for all the kind reviews and the suggestions and the recommendations you guys are making. It's really helping the podcast grow, which we appreciate. And uh that's it. Thanks for listening. We'll be back next week. We are out of
