Things You Learn in Therapy

Ep 107: Unveiling the Hidden Strengths of OCD: A Compassionate Approach with Dr. Michael Alcée

August 23, 2024 Beth Trammell PhD, HSPP

Unlock the hidden strengths of Obsessive-Compulsive Disorder (OCD) with our special guest, Dr. Michael Alcée. In our latest episode, we promise to change the way you perceive OCD by highlighting the unique gifts and deep emotional layers often overshadowed by the diagnosis. Gain insights into Dr. Alcée's mission to humanize this condition and discover how understanding the person behind the disorder can lead to more compassionate and effective therapy.

We explore the intense and complex emotions experienced by those with OCD, challenging the one-dimensional focus of traditional therapies like Exposure and Response Prevention (ERP). By reflecting on historical figures such as Charles Darwin, who showcased remarkable creativity alongside OCD tendencies, Dr. Alcée introduces the concept of "negative capability" — the ability to tolerate ambiguity and mystery — as a therapeutic tool. Through empathy and a broader emotional approach, this episode shines a light on the richness of human experience in those with OCD, making a case for a balanced treatment that includes both exposure and emotional exploration.

Listen as we unravel real-life examples and diverse manifestations of OCD that compel us to rethink our approach to treatment. From contamination fears to relationship anxieties, Dr. Alcée and I discuss strategies for sitting with uncertainty and understanding the deeper emotional context behind compulsive behaviors. Reframe your perspective on OCD, seeing it not just as a challenge but as a "frenemy" offering valuable messages, ultimately advocating for a therapy approach that supports and appreciates those who think and feel deeply. Don’t miss this eye-opening and compassionate take on OCD that promises hope and understanding for sufferers and therapists alike.

To learn more about Dr. Alcée, find his website here: Michael Alcée, Ph.D. | Psychotherapy in Tarrytown, NY (michaelalcee.com) or Michael Alcee (michael-alcee.com) or email him at:
drmichaelalcee@gmail.com

If you, or someone you know, is having mental health challenges and is in need of assistance, please contact 988.

This podcast is meant to be a resource for the general public, as well as fellow therapists/psychologists. It is NOT meant to replace the meaningful work of individual or family therapy. Please seek professional help in your area if you are struggling. #breakthestigma #makewordsmatter #thingsyoulearnintherapy #thingsyoulearnintherapypodcast

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Dr. Beth Trammell, PhD, HSPP:

Hello listener, welcome back. I'm your host, Dr Beth Trammell, and I'm an associate professor of psychology at Indiana University East, where I'm also the director of the master's mental health counseling program, and I am so excited for us to have our guest with us today, who is the brilliant Dr Michael Alcee. I'm so happy you said yes to being back again. I have invited you a few times. You've said yes every time. I'm just so happy that we get to talk about these topics that you're excited about, that I'm excited about. I'm excited about this topic in particular because I don't think we talk enough about OCD and I always love your take on OCD.

Dr. Michael Alcée, PhD:

And so, michael, introduce yourself and tell us one fun thing about you. Yeah, yeah, it's always great to be here, beth. We love riffing together and, as you know, and maybe some of your listeners knows, I'm a clinical psychologist and an author. And one fun fact about me is tomorrow I'm playing with a garage band in our little river fest and we're playing some Beatles, some Imagine Dragons. We're doing a little bit of everything, so it's fun as therapists to, and most of the group is all therapists as well, so it's just really fun to have the mixture between what we do in the office and getting outside in the community.

Dr. Beth Trammell, PhD, HSPP:

You know, it's interesting because the more I've been doing therapy, the more I'm in this role as a psychologist. It really is such a creative profession, and so I would think it would just lend itself beautifully to being a musician.

Dr. Michael Alcée, PhD:

All of the arts really. I mean, you know we've talked about this in some other episodes about my first book All of the arts really are what we do. We tell stories, we listen to the music of people's cadence. We are trying to make artful connections architecturally. Everything that we do as therapists is artistic and everything I think we're trying to do with helping people to live life better is to help them become more creatively open.

Dr. Beth Trammell, PhD, HSPP:

I just love the way you talk about these things. I tend to be more cognitive, behavioral in my theoretical approach, and so your approach is just so much more God. It's just so much more beautiful, frankly. So, okay, I love that. And we're talking about OCD today, and so you have a new book out that is really focused on the upside of OCD out that is really focused on the upside of OCD, and I'm guessing there are people that are sort of like huh, the upside of OCD.

Dr. Beth Trammell, PhD, HSPP:

Like, let's just start there. What is that? What is the upside of OCD? I know it exists.

Dr. Michael Alcée, PhD:

Yeah, it's funny because it's both the upside of OCD and it's actually the upside of what is there before OCD and what is there after treatment with OCD, and so it's not as clear cut as it seems. Which is really one of the thing that I'm on a mission with when it comes to OCD treatment is to help therapists and also OCD sufferers understand OCD a whole lot more, a lot more nuance. Right that there's this way in which OCD can be both meaningless, distracting, ego-dystonic noise and also meaningful information about one's deeper thoughts and feelings, right, and I think one of the reasons I really wanted to talk about the upside is that I think there are actually hidden strengths and gifts within people who develop OCD and we don't talk about that enough. With OCD in particular, we talk about a lot of other things. Introverts have these superpowers, people who are highly sensitive have these superpowers. Even people with different other kinds of quote unquote psychological disorders have these hidden gifts.

Dr. Michael Alcée, PhD:

But when it comes to OCD unfortunately, I think, because as a field we're so tethered to the dominant way of viewing it. Right, if we use CBT or exposure response prevention, well, ocd must only be something that is a problem to get rid of, and my take is it's a lot more nuanced than that, and Nancy McWilliams, the wonderful writer, said when she read an early draft of the book, something I love. She said it's nice to see someone bring back the human being into OCD. And that's really my mission.

Dr. Beth Trammell, PhD, HSPP:

Oh, I love that. Bring back the human being. You're not just those three letters. They don't define you.

Dr. Michael Alcée, PhD:

Not at all.

Dr. Beth Trammell, PhD, HSPP:

Oh, that's good. Okay, you said you know you're kind of on a mission to help therapists and OCD suffer. So I'm going to pause here for a second. I want you to sort of say, for both those audiences what is maybe one thing? I mean, I'm sure there are a lot of things that you want therapists to know about working with OCD. And then my follow-up to the other side, to that other audience, is what is it? What is one thing that you want the OCD sufferer to know?

Dr. Michael Alcée, PhD:

Yeah. So I think we've become victims of our own success as a field. Right Exposure, response, prevention and a behavioral way of looking at OCD was a real, important corrective to treatments that were largely less effective or even counter-therapeutic, and I think because of that we've leaned so far on looking at OCD in a very literal way, like you have this stuff that is anxiety producing. In other words, if you think about it, it's like allowing your house to be set on fire and watching it burn and not trying to put out the flames, because anything that you do is going to give oxygen to that fire. But there's also a lot of really interesting emotional and creative fire within OCD, and that brings me to the OCD sufferers.

Dr. Michael Alcée, PhD:

One of the things that I think OCD sufferers know in their lived experience is that they have very, very generous hearts, very, very empathically tuned in, almost so much so that that's part of the reason I think they obsess about the loss of people that they love, the fact that to know someone, as they say, is to love someone. But to know someone is to love someone and to lose someone. And people with OCD are keenly aware, often precociously aware, that they have an existential empathic sensitivity, and that's a wonderful thing. That's actually quite a poetic thing, and that's a wonderful thing. That's actually quite a poetic thing. And what I want OCD sufferers to know is that you have this wonderfully generous heart, but you also have this wonderfully rich imaginative mind, and that imaginative mind can do numbers on you in terms of what-if scenarios, but it also can do why-not scenarios as well. And I think being able to bring together that very, very generous heart with a very imaginative mind is, in my view, that the newer way of really looking at what we could do more of with OCD.

Dr. Beth Trammell, PhD, HSPP:

Okay, yeah, so you're. You're sort of you've already talked about ERP, right that that is for a long time. It was the treatment.

Dr. Michael Alcée, PhD:

Yeah, and still is Even there are varieties of ERP, right, Like inhibitory learning is one concept that they have, or they even had derivatives of CBT like treatments. Maybe that tie into ERP, but ERP has always been considered the gold standard.

Dr. Beth Trammell, PhD, HSPP:

And that is still true.

Dr. Michael Alcée, PhD:

Still true.

Dr. Beth Trammell, PhD, HSPP:

Still true? Yep, okay, and so I'm going to let me pause here for a second, and then I want to hear sort of more about this idea you have about empathy and using the imaginative mind as maybe not like, oh well, let's get rid of ERP, but more like, hey, let's add this to it. But let's say I'm a therapist who has never practiced ERP. How can I go about? I don't know. I guess I'm thinking obviously we want to build competence around this. Obviously we need training in it, but are there things that you encourage? You know, maybe newer therapists, as they are considering learning about ERP?

Dr. Michael Alcée, PhD:

Yeah, I think one of the things that I think people focus on with ERP which is great is focusing on looking at fears, right, oh yeah, which is great, but you know we are much more emotionally sophisticated than just fear. So I actually think we can think you could actually take the concept of exposure and I kind of like you know how they say to actors let's try that scene again one more time. With feeling, there needs to be more focus on the range and fullness of the feelings. People with OCD tend to feel lots of very intense and conflicted feelings. They can feel fear, but they can also feel sadness, they can feel anger, all of these things, but they don't know how to put it into words, they don't know how to put it into form. And so I think that is also an exposure exercise being able to notice how difficult it is to be with feelings, especially when you feel so intensely.

Dr. Michael Alcée, PhD:

And people with OCD feel and think intensely. Right, they don't just worry about this little thing. This means, oh my gosh, if I touch that, the world is going to end. They feel on that register. And so everything that you're saying about ERP doesn't have to not apply anymore. I just think that we have to kind of almost like if this were a film. I think sometimes we need to pan out and see a little bit of the bigger picture, because ERP right now is very, very actually. You want to hear the irony of it, beth? Yes, erp right now is very obsessionally focused.

Dr. Beth Trammell, PhD, HSPP:

Oh, my goodness.

Dr. Michael Alcée, PhD:

Like Dr Heal Thyself right, it's so focused on fear and anxiety. But we know what's in anxiety. Anxiety is often a mixture of different, interesting, rich feelings that when you disentangle them, you start to get more coherence, and so a lot of ERP works at the point where anxiety is such a fever pitch. That's all you're trying to deal with, but the feelings within them have lots of power, so good.

Dr. Beth Trammell, PhD, HSPP:

Okay. So I want for us to come back here to this idea of what you said is folks with OCD feel and think intensely. I think for me, as I think about some of my students who I've supervised and some of their kind of preconceived notions around working with clients with OCD or maybe it's the loved one or a family member of a person or of an OCD sufferer I'm just thinking about how, just acknowledging that first just acknowledging like oh yeah, like you think and feel really intensely and then examining, like in the case of my supervisees, how do you tolerate and then how do you help people who think and feel intensely? Right, I'm just picturing people who are like gosh, I don't know, it makes me a little bit uncomfortable to be around people who think and feel intensely and that's like that feels, like it's the first hurdle.

Dr. Michael Alcée, PhD:

It's huge. I mean, empathy in sophisticated way is one of the most difficult things to master as an art, because it not just requires like sort of parroting back what feeling you see in the person, but being able to tolerate the feeling yourself and being able to get into it more and also to not be afraid of what you don't know yet. It's a very creative process. Empathy, right, and everything that you're saying about your supervisees. That's why I think OCD was one of the fascinating thing. That sort of it really starts Freud does. Of course, freud starts work with conversion disorder, what was known as hysteria. Right, we know that's what he started his work with. But later he really worked with OCD a lot, and the reason it's so fascinating because it gets at everything that's so very human how do we deal with such big feelings? How do we deal with the fact that we are here but we know we and our loved ones will die? These are perennial human questions, and you're right. One of the things that I'm trying to open up the dialogue about is that there's so much more richness here and we don't have to throw away anything from ERP or anything else, but we have to see that there's this fascinating combination of things and you're right, it takes a lot of sort of courage to be with that intensity, but when you are with that intensity.

Dr. Michael Alcée, PhD:

So, for example, one of the people that I write about in the book, who I just recently discovered had a lot of OCD tendencies, is Charles Darwin. Darwin was very keenly aware of loss. He lost his mom quite early when he was very young and he was also extremely sensitive by nature. He constantly asked people for reassurance. In the middle of the night he'd go to a friend's house to make sure he didn't say something that was hurtful. He worried about being too immodest, he worried about his children's health A lot of things that you would see as classic OCD signs. But Darwin also had all of these wonderful qualities of a roving, curious, imaginative mind. And isn't it ironic for someone who was so aware of loss. He found a way to make that creative of ooh, how do we keep on going on?

Dr. Michael Alcée, PhD:

And the thing that's also fascinating about Darwin, with not only just that loss that he tracks but that creativity, he also allowed himself to have something that I think we need in therapy, like you said, for those supervisees, but also for people with OCD, which is something that the poet John Keats called negative capability. Negative capability is the capacity to allow certain ambiguity and mystery to be there without grasping too much, because it will open up more. That's actually very similar to what ERP people say about tolerating uncertainty, but it brings in a feeling place of it too. And this is what I really want to do for OCD, and that when you look at a person like Darwin, for example, imagine if people said to him you know, darwin, you just think too much, you just feel too much, darwin, you just think too much, you just feel too much.

Dr. Michael Alcée, PhD:

How much richness of contributions to society, how much would we be losing out on of this wonderful person? And it's not just about the innovation or technical achievement, it's also that Darwin was supported as a human being. In Dacher Keltner, who writes a lot about awe, wrote about Darwin and he said you know, we've given Darwin the wrong moniker. They gave him the moniker, which wasn't his, of survival of the fittest. Darwin's philosophy really was saying survival of the kindest and of animals was being able to care for one another. That is the heightened empathy that is within OCD, that is there before OCD, and OCD is just a symptom of not being able to integrate this, in my opinion.

Dr. Beth Trammell, PhD, HSPP:

Oh, my goodness, I love everything you're saying. I have been taking so many notes and, as I was reading an excerpt from your book which I'm excited, at the end we're going to tell people how they can reach it. I want to read this quote for you, for the audience too, because I think at the heart of what you do so well and what has been true, every episode and you alluded to this earlier is how you do remind us of humanness, right, and so I'm going to read this quote. So this is from the introduction of your new book. Trusting ourselves with OCD is among the hardest things to do, because we are perpetually afflicted with doubt, doubt about hurting the ones we love the most, doubt about whether we said or did the right thing, and a malignant worry that requires constant reassurance that everything is good and we're truly okay. That is brilliant and truthful, and what an empowering sentence.

Dr. Michael Alcée, PhD:

Thank you so much. You know it's so funny, Isn't that what we all feel at our root? That's what I think is missed. I think there's so much more humanity in OCD. That's also everybody. So it's funny. In the CBT world they sometimes jokingly talk about this Shakespeare quote that OCD is just sound and fury, signifying nothing. That's Macbeth, and remember that's after Macbeth has done a lot of murdering. But the better question for OCD is exactly what you just said, which is Hamlet to be or not to be. That is the question, and the person with OCD is very keenly aware of that very fundamental human question and that's not something that could be exposure in a way.

Dr. Beth Trammell, PhD, HSPP:

Bringing this to such a realistic level for both the person with OCD but also their loved one, and I think that that is what I hear as also a part of your mission right Helping people who are in relationship with other people and so I want to ask about all the things that are out there to help people who love someone with OCD. I don't know that there is a wide range of information out there for folks, so what do you think is missing in terms of helping people who love someone who has OCD?

Dr. Michael Alcée, PhD:

Yeah, you know, actually it's funny you stumbled on something really important, which is when we look at books about OCD and relationships often they have. The take of your job is to support them in their treatment and be careful of them pulling you into their compulsions, and providing reassurance. There's very little and usually there's no focus on how relationships affect this. Now just think about this People with OCD are so tuned into others that they're picking up on a lot and they are affected by their relationships. But that's not just because they have a problem, it's because they have a gift, and part of the other strategy, in addition to integrating this generous heart and imaginative mind, is helping people with OCD work on establishing healthier boundaries, because it's easy for them to get blurred with others. It's easier for them to lose track of themselves, to doubt themselves right, because if I bleed into others who am I and I have a client who came up with this great term people with OCD need to have what he called selfish empathy. They are very good at being overly empathic towards others, but they're very reluctant to be too self-interested, as if that is too aggressive, and it takes a little healthy aggression to have a self. And so one of the things with the relationships piece is that I wish that people would see more of the gifts of this sort of sensitivity that people with OCD have and helping them to take on their voice a bit more, because sometimes people with OCD are actually unwittingly used by others in families and relationships because of the sensibility and you know, it's really, really important that to bring it back is I think it's really important to get clear on what is happening in relationships with people with OCD. Like I've seen people.

Dr. Michael Alcée, PhD:

I write about this in the book. I had this one client when I was really young in my training and I was doing an ERP kind of based field placement. I was working with a client who developed instantly a fear that she was going to have brain damage and she didn't tell me at first where it came from and I just asked about when did it start? And we followed the emotional story of it and it really made a lot of sense because she was trying to set a boundary with somebody and instead of being able to feel like she was justified well, the OCD made a boundary you can't touch me now because if you do I'm going to get brain damage. So that's where there's sometimes a method to the madness, a rhyme to the reason. You know, like a reason to the rhyme, so to speak.

Dr. Beth Trammell, PhD, HSPP:

Yeah, yeah.

Dr. Michael Alcée, PhD:

And rhyme to the reason. You know that reason to the rhyme, so to speak, and I think you know one of the things that I would like to disabuse both the public about in our field about, is that we have to start looking at relationships. I've had a lot of people contact me, email me, call me, say I've done work with ERP and it helped, but you know what? They didn't let me talk about any of the full context of what was going on for me. They didn't let me talk more about my relationship with my boyfriend, or they didn't let me talk about more of the meaning that I felt about these things. And we can do both, both and we can make sure we're not giving reassurance and talk about some of the relational details. And my hope is that in the future when we look at OCD treatment, it'll be coming from that place, just as if you look at OCD.

Dr. Michael Alcée, PhD:

I was surprised when I was doing research from this book. I was like surely they're going to say that OCD is primarily driven biologically. And I read all these books of these people who are like hardcore ERP people and they're like we don't really know how much is nature, how much is nurture. I'm like wait if we don't really know? Why aren't we like hitting every possible way? And my take, honestly, is that people with OCD have a hardwired temperament to be very sensitive and very imaginative and without proper support that can degenerate. We also know that there's some pathways to OCD, that people get like something called pandas right, an autoimmune thing and that could lead to it. So there's definitely environmental and biological contributors. We know that this is biologically driven it certainly has that but it's not just biologically driven. So again, everything that I talked about in the beginning of our conversation is how do we really embrace a extremely nuanced picture? Because if we embrace a nuanced picture of OCD, we embrace a more nuanced picture of our humanity.

Dr. Beth Trammell, PhD, HSPP:

Can I throw an example at you?

Dr. Michael Alcée, PhD:

Please.

Dr. Beth Trammell, PhD, HSPP:

So I'm imagining I had I'm thinking about a client that I had many years ago and it was a mother and son scenario where and I guess we probably could back up here for a second and say I think a lot of the general public might think you know about OCD and like the what About Bob movie, where he's, you know, just washing his hands a lot or he doesn't want to touch things and while that that depiction is comical and quite exaggerated in a lot of ways. But anyway, I think a lot of people have this idea that it is always a kind of physical checking scenario.

Dr. Beth Trammell, PhD, HSPP:

But in in this case, and what we're talking about here is, there is also this part of OCD where the compulsion is to check for reassurance, right, maybe I should pause there and ask you to clarify some of those manifestations of how-.

Dr. Michael Alcée, PhD:

There's so many sub-varieties.

Dr. Michael Alcée, PhD:

you're so like the classic, like you said. It's like the washing or contamination OCD right, I need to make sure I wash my hands or not touch things. There's the checking, like I need to check that the stove is turned off like 500 times to say something. So here let me give you an actual, easy example that just that just struck me the other day. And this is you know it's going to sound like a client, but it isn't Ready for this. So this is the example Hug my parents for 11 seconds, or else they'll die. Yeah, pray to God. Then kiss your fingers or else you'll have cancer. And then this last one is really interesting. I had one time where I didn't have my period for a year and then I thought I was the Virgin Mary and then I'd pray every night for God to take away the new Jesus Christ that was being born in me. Now that's a real person. That's pop singer Camila Cabello, and she talks very openly about her OCD.

Dr. Michael Alcée, PhD:

Ocd can also come in. Worries about is this the right relationship for me? Oh, am I? Do I secretly want to harm somebody? Is this the right relationship for me? Oh, am I? Do I secretly want to harm somebody? So any of which like sneaky way. Usually, again, the themes are always around something destructive happening, some loss or falling, and at the heart of it is always death, even if it's not physical death. A relationship is like a death too. If my relationship isn't good for me, where will I be? So all of these things kind of bring them together Exactly.

Dr. Beth Trammell, PhD, HSPP:

Okay. So I'm thinking about the parent, the loved one, and I would imagine the tendency, right. So if I'm a mom and my son is coming to me saying I had this thought where when I look into the sun, then you're going to get sick and die, and so the son comes to the mom for reassurance.

Dr. Beth Trammell, PhD, HSPP:

And so how do we as parents or how do we as loved ones, not sort of give in you know, I'm putting those in air quotes sort of like give in to the reassurance which kind of continues the cycle, and what else might we do?

Dr. Michael Alcée, PhD:

Yeah. So I think we're bobbling two things right, which is why it's tricky, right, Literally, we don't want to just instantly give gratification right, Sort of like the old remember the old classical analytic don't gratify your patient, and if they ask you like, are you married, Don't answer.

Dr. Michael Alcée, PhD:

Yeah, right so there's some part of it that we want to be mindful of that. But also one of the beautiful and brilliant things we do in therapy all the time is say tell me a little bit more about that. What makes that so important to you right now? What's been happening? In other words, help them to explore more the feeling, story, the relationship, the context. When did this start? What was going on? In other words, I like it in the book too.

Dr. Michael Alcée, PhD:

It's like a Law Order episode where sometimes the obsession often is the perpetrator we think is the real one. But then we have to go a little further. That's what I mean about having a little bit more of a symbolic, metaphorical openness. Right when somebody is asking you for your assurance, they're saying I'm scared, but I don't know why. But this is what my mind has latched onto to represent it. And yes, we don't want to just say no, everything's going to be fine. We want to say what's wait, let me see the fuller story here, so you can actually do both. It's sort of like remember Irvin Yalom, like, like his sort of style is when a patient asks, when a client asks, like I'm really curious, like if you ever struggle with depression like I do and Yalom would say I'm totally going to answer that question. But before I do I was wondering what makes you ask yeah, what are you most hoping I will say, or most fearing that I'll say? So that's also not providing reassurance instantly, and engaging that process is as important of anything.

Dr. Michael Alcée, PhD:

It says hey, I may not be giving you this immediate reassurance but I, I am gonna sit with you for a minute as you figure it out and I'm taking you seriously. Whatever this is, I'm taking it seriously and that also so. In other words, if, when freud was talking about early like psychological symptoms, as being messengers, they're trying to communicate something in a different register. Yeah, yeah, yeah. I mean, one of the important things is for us to realize everything is trying to communicate something in multiple layers, in multiple levels, and that's what I mean about being sophisticated about it. Yes, the person is saying please give me a reassurance that everything's being okay, but they're also saying I don't understand why this is haunting me right now. Can you help me?

Dr. Beth Trammell, PhD, HSPP:

I love that reminder right that it is so true if we can, in the moment, train ourselves to pause. I'm thinking as a parent or I'm thinking as a loved one, and if somebody is coming to me with kind of a logically oriented question, they're asking is this a yes or no Like? Is this, you know? I just need reassurance about this. If I can pause long enough to say these things, I can imagine how empowering it will become over time as the person learns to sort of sit with it a little bit and maybe dig into it a little bit. Sort of sit with it a little bit and maybe dig into it a little bit.

Dr. Michael Alcée, PhD:

Yeah, and exactly what you said. We need relational partners to be with us to say, hey, I can be with you with these big feelings and these scary thoughts, yeah, yeah, and together. That's where we engage a process. This is what we do for all of our therapy and this is where you're not going to be surprised at this. While I do appreciate all that behavioral therapy has done, cognitive behavioral therapy has done for OCD, I think it makes a false dichotomy between talk therapy and behavior therapy. It is perfectly fine to do this kind of depth work and processing, and you're also doing an exposure by saying I want you to tolerate the uncertainty that I'm not giving you the immediate answer. That, to me, is a lot, is a really important thing that we all can do as therapists, and even there's interesting work.

Dr. Michael Alcée, PhD:

Now I have a colleague her name is Melissa Mose, she's out in California and she's writing a book on OCD and internal family systems. And instead of just looking and I write about this in the book too that instead of just looking at OCD as an enemy, there's also some part of it that's a friend trying to give you a message. I call it a frenemy and we've moved towards OCD as an enemy to be vanquished and conquered. But there's also when this woman I told you had the obsession about having brain damage. She was also upset that a colleague felt like he was a little too close to her and she needed her space. There were some good reasons this obsession was popping up. So part of I, I think our work is also decoding things. Yeah, and that's what I mean. Some of the, by the way, was the brain damage thing meaningful? Yes, was it meaningless? Was she really going to get brain damaged? No, both of those things can coexist yeah, I love.

Dr. Beth Trammell, PhD, HSPP:

I love that you clarify kind of that that meaningful and meaningless, and that they're both. They're both true. I can both be true.

Dr. Michael Alcée, PhD:

And they can both be true all the time for us right.

Dr. Beth Trammell, PhD, HSPP:

That's right and it's our. It would be our gift to the people we encounter if we can slow ourselves down to see both of them.

Dr. Michael Alcée, PhD:

And you know what's interesting too, as we're talking about this, to like widen the frame even I think this is also a cultural thing that we all need to work on is expanding the capacity to embrace and contain and share nuance. It's easy for us all to get polarized or kind of only value certain aspects of ourselves or others. It takes a lot of heart, it takes a lot of openness, it takes a lot of clarity to be able to try and open yourself to more of that nuance. It's not easy, but it's worth it.

Dr. Beth Trammell, PhD, HSPP:

It's not easy. I mean, I think it's. I know personally it's something that I have to really slow my brain down for and it's what I'm trying to train, you know, therapists to be able to do to tolerate those nuances, because that is basically our whole job.

Dr. Michael Alcée, PhD:

It's our whole job and that's actually where we get so rewarded. By the way, and you know it's so funny I was listening to Susan Cain. She spoke about that movie Inside Out you know the Pixar movie, which they have a new one coming out, and the guy who wrote that originally wrote joy, as the hero was going to be joy or something like that, something totally conventional. But it really wasn't working and he realized that the hero really needed to be sadness. But he was like, wait a minute, the studios are never going to accept that. But he decided eventually no, this is what's right. As a culture, we have a difficult time going in to some of the things that consider not as valuable. That's often where we're rewarded the most.

Dr. Beth Trammell, PhD, HSPP:

As a society, we are very focused on fame, celebrities, following, likes, things like that, and part of what you have already talked about are some celebrities who have OCD or had OCD or are kind of outward with talking about OCD. And so is there some I don't know how to say this, but like is there some hope that OCD is building momentum in terms of getting a broader picture of how we can understand this, because there are some celebrities who have OCD and are talking about it.

Dr. Michael Alcée, PhD:

Yeah, there's loads of them. Just you know, camila Cabello is interesting because she said that with her therapist on Dax Shepard's podcast recently. She said they don't even call it OCD, they call it obsessionality, because I think she doesn't just see the negative sides of being an obsessional person. There's a lot of nuance and richness and feeling and creativity, which I think is really really good. Another person who's doing interesting stuff is most people know Taylor Swift, but they forgot about Jack Antonoff, who is the music producer and musician that works with her. He also struggles with OCD and he talks really beautifully about the nuance of OCD. I think you're right that people in the public eye are doing that, but I think what's really important is that, as a culture, if we can create more room for nuance in general, I think it'll help for OCD in particular. And you know, I do think that's why I think Darwin's a great example, because look at a guy who could see so much.

Dr. Beth Trammell, PhD, HSPP:

Yeah.

Dr. Michael Alcée, PhD:

Like I said, there's so many people Author John Green is somebody who just came out with a movie version of his book Turtles All the Way Down, which is yeah, dies unexpectedly of a heart attack. That hardly gets discussed as a really interesting kind of trigger, but, yes, there's so many people within the public eye that I think and actually there's a lot more advocacy for OCD. There's a lot more people sharing about what the experience is like. There was a child actress named Mara Wilson who used to play Matilda and was in Mrs Doubtfire. She's written a memoir about her life, but also a lot of it talks about her OCD experience. Wow, I think we're seeing a lot of human dimensions. I hope that the field of psychology and social work and counseling and therapy catches up with embracing more of the richness and the nuance and the beauty and the poetry and the music behind OCD.

Dr. Beth Trammell, PhD, HSPP:

Well, look, you're certainly a celebrity to me, so you are one celebrity who is out there trying to bring yeah, just bring light to this. So, as we wrap up, I want to ask if there's anything else that you wanted to share with listeners and then let folks know how they can find you and get your book either this one, or you know other books that you have, things that you do. How can people follow more of the stuff you're doing?

Dr. Michael Alcée, PhD:

Yeah, I'm trying to think if there's anything else I forgot. Well, there's always new stuff, but I think you hit it on the head when I think it's so important for our field to be championing the fullness of our humanity.

Dr. Beth Trammell, PhD, HSPP:

Yeah.

Dr. Michael Alcée, PhD:

And the fullness of our humanity in every which way. When it comes to every disorder, every psychological issue is the place, and for me, ocd is just one of those places which I find interestingly glaring as to where there's so much more nuance and goodness there. Yeah, as for how to find me, you could find me online. I just started a new website, michael-alsicom, which has all the information for my new book, with some reviews, and, if any therapists out there are interested, I'm going to be starting a consultation group to work on this special way of working with OCD, and I'm also going to have a special group for people with OCD. So I'm really excited about that. And then, of course, the book so easy to find there, and the book is published by Roman and Littlefield, so it should be out November 19th, but you can pre-order it now, so it's out there.

Dr. Beth Trammell, PhD, HSPP:

Amazing, michael. Every time I look forward to just sharing space with you, because the brilliance of you I mean just the way your brain thinks, how connected you are to this idea of humanity is always so refreshing, and I think the beauty in what you do is that you take all that brilliance and you turn it into something meaningful for people who are listening, and so bravo to you and thank you for saying yes to being here again. What a gift.

Dr. Michael Alcée, PhD:

Thanks, as they do in SNL. I look forward to getting a jacket soon.

Dr. Beth Trammell, PhD, HSPP:

You know what? As soon as I have jackets out, I'm sending one to you.

Dr. Michael Alcée, PhD:

It's always so much fun. It's so easy to riff together. I love this experience. I can't wait to do it again.

Dr. Beth Trammell, PhD, HSPP:

I can't wait to, I mean, and we don't have to wait for your next book, although you are cranking them out.

Dr. Michael Alcée, PhD:

Yeah, we'll find something new to talk about. You pick this one next time.

Dr. Beth Trammell, PhD, HSPP:

We always do. All right, michael, thanks for being here. Pleasure, ciao, y'all.

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