OCD and Anxiety

Dr. Jenny Yip on OCD, Anxiety, and Mental Health

May 16, 2019

On this week’s episode of Point of Inquiry, Dr. Jenny Yip discusses OCD and anxiety and the widespread impact these can have on our lives as well as how they’re exhibited in different people. Kavin Senapathy and Dr. Yip share their own experiences with OCD and anxiety disorders and Dr. Yip shares her insight into effective and ineffective treatments for OCD and anxiety.

Dr. Jenny Yip
Dr. Jenny Yip

Dr. Jenny Yip is a clinical psychologist, author, speaker, and nationally recognized OCD and anxiety expert. She developed the Family Systems Based Strategic CBT, integrating Mindfulness Training and Strategic Paradoxical Techniques with Cognitive Behavior Therapy (CBT). In 2008, Dr. Yip established the Renewed Freedom Center in Los Angeles to help those suffering from OCD and anxiety disorders.

She has published numerous articles, presented at more than 50 national and international conferences, and continually provides training in her areas of expertise. She has been featured in various media venues, and often consults on documentaries and film productions about OCD and anxiety. In an effort to raise public awareness and eliminate negative stigmas about mental health, Dr. Yip is tirelessly involved in a range of organizational, educational, and media projects to provide effective strategies for defeating the OCD/anxiety monster.

You can find out more about Dr. Yip’s work by listening to her podcast, The Stress-Less Life. You can also follow her on Twitter: @DrJennyYip

New music heard on this episode

“Paper Feather” by Blue Dot Sessions / CC BY-NC 4.0

“Building the Sled” by Blue Dot Sessions / CC BY-NC 4.0

Hi, everyone. It’s me or Point of Inquiry co-host Kavin Senapathy, as some of you may know, I have OCD, which stands for obsessive compulsive disorder. 

In retrospect, I’m sure I started developing OCD many, many years before I was diagnosed. And I also have generalized anxiety disorder. There are so many misconceptions about these conditions. So I decided to invite Dr. Jenny Yepp. A nationally recognized OCD anxiety expert. If anything, this episode is just the tip of the iceberg on OCD and anxiety. I realized that it was probably a little too ambitious to try and cover misconceptions and facts about these conditions, all in one episode, because there’s so much to say. And I could spend hours talking to Dr. Yepp about it. So let’s just say this won’t be my only episode on OCD, anxiety and mental health. 

Hi, everyone. I’m delighted to be joined today by Dr. Jenny. She is the executive director of the Renewed Freedom Center in Los Angeles, as well as the Little Thinkers Center when I was working on a piece on postpartum OCD for Self magazine. Dr. Yip is a clinical psychologist, author, speaker and nationally recognized OCD and anxiety expert. And she hosts a podcast called The Stressless Life, which I highly recommend. And today we’re going to talk all about OCD and anxiety. Thanks for joining me today, Doctor. Thanks for having me, Robin. So it seems like the typical person’s understanding of anxiety disorders and OCD doesn’t really capture how OCD and anxiety actually manifest. Could you give our listeners kind of the basic overview of OCD and anxiety and anxiety disorders? And what would you say are the most common misconceptions when it comes to anxiety and OCD? 

Well, I guess if I may start out my there is a very huge misconception about what an anxiety disorder is now. We all experience anxiety and we all experience stress. 

And that’s normal. That’s natural. 

It’s natural for you to experience stress and anxiety when you are overwhelmed or when you’re under a lot of pressure. However, that’s not the same as experiencing an anxiety disorder that is diagnosable because it’s chronic enough to affect your life, to affect your work, to affect your social activities, your hobbies, your interests. So that is very, very different. 

The difference between anxiety that a typical person would experience and an anxiety disorder is fundamentally how much it affects that person’s life. And it’s whether whether it’s interfering with their life. 

Absolutely. And, you know, I remember going to the market once and I’m standing behind a mother and her daughter. And this daughter probably looked about four years old and she was just exasperated and told her, mom, I’m just so stressed out today, you know, I’m chuckling under my breath. What in the world does a four year old have to be stressed about? And we’ve come to this society where we are believing that stress and anxiety is a bad thing. 

And the reality is we all need some levels of stress, positive stress. We call that in psychobabble terms. You stress to keep bus driven, to keep bus growing, to keep us evolving. If you think about any organism, right. An organism needs some sort of pressure in order to adapt and grow. And as humans, we are no different. We need pressure and and stress in order to adapt and grow. Otherwise, there wouldn’t be any growth within us. So, for example, when you were a kid and you saw all of your friends playing in the jungle gym, went back in the days when we were still playing outside. 

Yeah, right. And back in the days when we had jungle gyms. 

And you’re you’re thinking, wow, I wish I can do that. Right. And then you try and then you fall down and you try again. You fall down. Well, those experiences are the little little bits of stress that allows us to keep trying and again and adapt and grow and learn no different than if you had to take a test at school and the stress of having to study and understand. And hopefully you’re not just memorizing this stuff, you’re actually comprehending the material. Well, that is also stressful. However, it got us to where we are today by artists to be able to achieve our classes to get to college. For those of us went to college to tolerate the stresses that will continue to exist in our lives, those are the experiences that are necessary. And those are the experience that actually adds to our our livelihood. 

What you’re saying is everyone experiences this, the stress that drives us to achieve, but sometimes that that kind of goes awry. My understanding is that about an estimated two to three percent of the population is thought to experience OCD. And I know that you specialize in an OCD, although you deal with other anxiety disorders. So, I mean, could you tell us about anxiety disorders and some of the most common ones, as well as OCD and maybe what the difference is between. What people believe OCD and anxiety to be, especially with OCD. And how does it how does it tend to manifest? And you can’t really put how these how these manifest into neat boxes. Right. As the way it plays out, of course. 

So, you know, the reality is there are a lot of people who are truly diagnosed with anxiety disorders. 

And we’re not talking about just your typical experience of stress and anxiety anymore. These are people who are experiencing chronic levels of anxiety that is interfering with their lives that are, you know, that is interfering with their with their ability to function on a day to day basis. 

And anxiety disorders as a whole is the most common mental health disorder that exists. So about 18 percent of adults in our population has a diagnosable anxiety disorder. And more importantly, twenty five percent of kids are diagnosed with an anxiety disorder. That means one out of every four teen adolescents has a diagnosable anxiety. 

Would you would you say that the diagnosis rate has gone up in the last decade, two decades? Because I know when I was a kid, I grew up in the 80s and 90s. You know, I don’t remember my my classmates being diagnosed with this. And I think now it’s almost as if people talk about it more openly. And I myself, I think looking back, I’m almost sure that I must’ve had an anxiety anxiety disorder as a child does kind of like a catch. 

Twenty two. Right. 

Is it that there are actually more people today with a diagnosable anxiety disorder? 

Or is it that we are just more informed and we are more aware of this and therefore we are more open to speaking up about it? Right. 

So it’s kind of a catch 22 and we don’t have any specific research that’s comparing the population today versus the population 30 or 40 years ago to compare. Well. Is it really because we’re just better able to assess and diagnose because people are coming out more openly about it? Or is it really that, you know, anxiety disorders didn’t happen in the in the 80s and 90s and it’s just happening right now? I wouldn’t say that it’s more likely that the prevalence rate hasn’t really change, and it’s just that they are more open. We’re more. I mean, just by doing this podcast, you’re informing your audience about what an anxiety disorder is. Right. 

So even though we are doing our our best to inform the public, the reality is there is a big portion of sufferers who actually don’t receive treatment. So, you know, when I said that about 40 million adults experience anxiety disorder. Well, guess what? Only about 40 percent of them receive treatment. That leaves the other 60 percent who are sufferers of anxiety, who isn’t receiving any treatment at all. 

Right. And you would say it’s kind of like a wonder. Why aren’t they receiving treatment? Is it because they themselves don’t recognize that they’re going through this? Is it lack of access to health insurance, medical care, all of the above? 

Definitely all of the above. 

Number one, there is still a lack of awareness about what an anxiety disorder is. Number two, there is a lack of health care professionals who can actually treat an anxiety disorder with evidence. These treatment. Number three, you have insurance companies that are putting limits on the type of treatment or the length of treatment that you can we can we see. So and then, you know, there is misinformation in our media. If you go online and you type of anxiety disorder, you will get all this this information about cures, about immediate cures that doesn’t have any evidence. As an anxiety sufferer, if I am desperate for treatment and I don’t want to disclose what I’m feeling. Do you remember the movie? Analyze this or analyze that with Robert De Niro? 

Who? No, I don’t. But I’m sure some of the listeners have seen it. 

So how he was suffering from an anxiety disorder. 

However, he wasn’t going to disclose that he had an anxiety disorder. Right. So there is still a high stigma with having a mental health disorder. 

So I know if you are desperate and you’re not really willing to go see professional services and you go online and you see some website that says all you have to do is read this and you’ll be cured. Well, there are a lot of people who fall prey or who fall victim to this type of argument. 

Since I’ve talked to you about OCD a couple times and since I myself have OCD. Could we go into OCD and unpack it a little more in terms of what it actually is? What are some misconceptions? And then later on, I would I would like to go in to some questions about treatment and evidence based treatment that you touched on. And I would love to also talk about kids, but I guess we may not have time today, so maybe we can do that next time. 

Well, OCD is not what you typically see in the media, where all you see is, you know, a person who is stepping in and out of doors were just repeating behaviors or they’re washing. You know, the. The reality is that you don’t see what’s actually going on in a person’s mom. So the best metaphor that I can give, it’s like having a nightmare that keeps replaying in your mind like a broken record and you can’t wake up from it. And that’s what having an obsession is. So there are two parts to OCD. You’re so obsession and there’s a compulsion. The obsession. Is that nightmare. That nightmare can involve anything. It can involve whatever it is that you see. And the thing about OCD is that it will attack whatever it is. 

And so if you care about the well-being of your pet, well, guess what? 

OCD fears will attack that if you care about making sure that you are living a righteous moral life, well, guess what? OCD obsessions will attack that. So that’s just one part of OCD and that triggers anxiety. 

So obsessions, trigger anxiety, discomfort. And we as a society don’t like to experience this. 

Right. Right. 

So we engage in something called compulsions. The set, the C in OCD. 

So or compulsions. These are any type of behaviors or actions that we engage in in order to reduce the distress, in order to neutralize that this. 

Right. And that can look like a lot of different things, right? Of course. So, for example, of your fear is of getting a heart attack. OK. 

And you fear any type of germs or illnesses that might compromise your immune system or any type of bad food or not exercising a knife. Not exercising enough. 

Then nothing that you would do to feel better about it is by avoiding specific situations. 

So avoiding situations that might be stressful, avoiding contaminants, avoiding people with germs, avoiding the hospitals, you might start washing a lot in order to get get rid of the germs that are that is on your skin. You might seek a lot of reassurance from family members and asking them. Am I okay? Do you think I’m going to have a heart attack? 

Can you check my heart out? That’s all. It’s just I mean, it sounds so familiar to me because I. I have OCD and I specially experienced it or I think first started to fully understand what was happening with regard to OCD. After I had my older child, after I gave birth and I became so concerned about her well-being as a as a baby. And you know how this is to because you went through postpartum OCD, too, if I recall correctly. But I would I would do things like have thoughts of harm, like really, really, really vivid thoughts of harm coming to her. And I would I would tap on objects and I and I’m tapping right now on my desk because I’m remembering it so clearly. But, you know. So that’s like the obsession and the compulsion. And one wouldn’t think that, oh, my God, this woman is right now thinking of her of her kid dying. It’s so very disturbing. But you wouldn’t put those two things together. But, you know, my listeners strive to form their world views based on evidence. And on science when available. And they try to think critically. And I I would like to think that I’m also a critical thinker. But I mean, that kind of behavior is really kind of superstitious. So how are otherwise reasonable people like like you and I, doctor, yet doing something as superstitious as these types of compulsions? 

Well, first of all, I want to say that as you’re describing your obsessions, your intrusive thoughts of harm of your child and the things that you would do, the behaviors such as tapping, you know, people outside of you wouldn’t be able to see the thoughts that you have. Right. 

And so all they would see is the tapping. And obviously, because they’re not making any connection and they can’t read your mind, you’re going to attribute your tapping as some sort of quirky nonsense behaviors. Right. And that is the most one of the main misconceptions out there is that, you know, people those are just quirky people and they have these behaviors. And why don’t they just stop these behaviors? And like your experience, if you stop the tapping, what would have been your worst fear? Ray. Yeah. Something awful happening to my kid. And then picture it. All right. So like you said, superstition is a very close analogy to having OCD. Right. So you have a superstition of, let’s say, the number 13. 

Right. And your your fear is if you interact with the number 30 or if you interact with the number six six six, those are the bad numbers. Those are the evil numbers. 

And something bad or horrific will happen to some catastrophic consequences will happen. Right. 

And therefore, you’re going to purposely avoid any 30 and any sixes in your life. 

And if you don’t, then your fear is that these bad things will happen. And that is exactly what a person with OCD would experience. And as you were speaking about your postpartum OCD. Well, you know me. I actually come from a family where many of us suffered from OCD. However, the thing about OCD, it’s very, very tricky. 

No two people will have the exact same symptoms. You might have similar symptoms and you might have similar reasonings behind those compulsive behaviors, such as preventing a bad thing from happening or keeping yourself from being contaminated. However, you’re not going to find two people with exactly the same symptoms. So when I was growing up, I did not I did not know that any of us had OCD, even though I had OCD. My my grandmother had a lot of arranging and cleaning compulsions. She would need to have everything in this place. My dad was the checker. He would check doorknobs, light switches, faucets. So to make sure that nothing bad happened. I remember being a kid and you would leave the house and, you know, come back and come back and check. 

Gosh, I did that. 

I did all the that we would be kids just thinking like. Okay. All right. 

He shows a very safe person. 

That’s what I thought about myself, too. And then one day I’m like, wait a minute. 

And and, you know, and for me, I had I had so many different ones. I went from symmetry and needing everything to feel even to contamination to. 

I had some of the tapping as well, though. 

You know, I consider myself a very logical person. 

Right. That’s. And that’s what I was getting at. We both seem like very reasonable people. And I think anybody with these sorts of with OCD, especially maybe even before they realize it would think at least I thought, you know, I’m I’m a smart person and I I am a critical thinker. And then. But at the same time, when you’re engaging in some of those compulsions, at least for me, I kind of I kind of knew in one part of my head that that none of this made sense. Right. 

And that’s that’s the thing. 

People with OCD have the awareness that their fears, their behaviors are irrational or that they’re excessive. 

I knew when I was you know, I remember my 16th birthday party. I was three hours late to my own 16th birthday party. My sweet 16. Because I could not get out the house until I felt symmetrical. And I kept repeating things to the right side. I would do with the left side and it wouldn’t feel even I had to be do it over again. And, you know, I was a very logical person. However, I also couldn’t help what I felt. All right. So, you know, I think the best explanation that I can give in from my own experience, it’s kind of like when I had postpartum OCD by this point, by time I had postpartum OCD, which actually wasn’t long ago. I had been treating OCD for almost two decades. So. So I knew what OCD was and I knew what to do with it. And even while I was experiencing postpartum OCD, I kind of knew what I was doing was excessive. 


I mean, it got to the point where I was washing the sanitizing the baby bottles and all of the baby items with water that was scalding hot to the point that my my skin became dry. 

Chad all cracking bloody. Once again, you know, and I knew it was excessive. But then the thoughts of if I didn’t do it and not something bad might happen to my helpless children, to my health babies that I thought was some sweetly unbearable. And therefore, it was just easier for me to do to harm my hands than it was to then than it was to exist with the idea that something bad might end up happening with my child. 

Yeah, and I can just kind of feel that when you say that the thought, the intrusive thought was completely unbearable because I was I was there and it was just overwhelming. And I and I did all of those a few of those behaviors that you mentioned from your family members. I did several of those with the postpartum. I would I would leave the house I lived in. We lived in a condo at the time on the second floor. This is this is about eight years ago now. And I would walk down to the garage with my baby in her carrier. And then I would think I left the door unlocked and left the door unlocked. Then an intruder was going to be in there and attack me and my baby when we came back. So I go back, like three or four times, but, you know. 

So when it comes to these intrusive thoughts, I think you’ve told me this and I’ve heard others say others say it as well. 

Excuse me. And I’ve also read it in some of the literature that everyone has occasional intrusive thoughts. And then some of them can be disturbing, right? So how can someone tell if what they’re experiencing is is OCD or some other anxiety disorder when it comes to intrusive thoughts? And how do you differentiate that from normal worries? And also, is there any are there any behaviors that are observable by loved ones or coworkers or signs that people could look out for? If they suspect maybe someone that they know is going through this? 

Well, first of all, let’s talk about the what thoughts are normal? 

Well, to tell you the truth, love and I don’t know any faults are normal or abnormal. Right. 

Any thought is is simply a false right. However, what differentiates a person with OCD versus any other person without OCD or anxiety is that a person with OCD will have this intrusive thoughts and go, oh, mom, what in the world is that me? Why would I have such a thought? What kind of person would I be to have such a thought? Right. 

So a person with anxiety or OCD would experience the thoughts as meaningful and significant. However, as I’ve said, we all have intrusive thoughts, I mean, how many of us have thought about strangling our our boss, right, or our spouse? 

How many of us have thought about strengthening our spouse? I was definitely thought about shaking him. And when I have a bad guy. Hey, hey, wake up. 

And for those of us, we’ll have a phone and we’ll go. It’s all right. It’s just a thought. It’s not like I’m going to act on my thoughts. However, a person with OCD will have a thought and again, attribute significance to it and fear that they might actually act out the plot. 

Now, how do we know that a person with OCD actually isn’t harmful? Well, because the thoughts themselves are ego dystonic. And that’s another psychobabble term for the thought doesn’t really fit with my values. 

The thought doesn’t really make sense. The thoughts are illogical and it doesn’t leave that with my world view. OK. And therefore, I actually don’t want to have these thoughts because I don’t want to think about them and I don’t want to act out these thoughts. Right. So for people who have thoughts and here’s a thing again, OCD will thrive on anything that you hear about. 

So if you care about being a moral person, well, guess what? You’re going to have a lot of intrusive thoughts about being immoral in moral, whether they’re forbidden thoughts about incest or forbidden thoughts about harming someone and harming something, harming, stealing, stealing, running someone over with a car. 

I yeah, I still sometimes get those. 

I, I sort of deal with them, although I’ve gone through behavioral therapy as well as I take medication for my OCD, but I know that behavioral therapy is often the first line of treatment. Right. 

What are the best science based methods to help with anxiety? But also do you have any thoughts on MDR? 

Well, first of all, I’m not even sure that I’ve answered the line or questions from the line of questions. But moving forward, if we’re talking about treatment, you know, the evidence based treatment for OCD and anxiety disorder is cognitive behavior therapy. More specifically, exposure and response prevention therapy. So let’s talk about what exposure and response prevention therapy is. So when we experience a fear, what we have are these intrusive thoughts. 

And in order to in order to realize that our thoughts don’t have the credence that we’re attributing to them, we have to be able to confront those fears. And that’s what exposure means. Exposure means giving yourself the opportunity in a safe environment to actually confront the fears so that you get the feedback that the thoughts are not that threaten. Hey, now, remember, there are two parts to OCD. And I would say this is true for all anxiety disorders, because in any anxiety disorder, as long as you’re experiencing a fear or an intrusive trigger to whatever that fear is, you’re going to experience discomfort and anxiety and you’re going to respond in a way to get rid of the discomfort. And in other anxiety disorders, you might respond by avoidance or other safety behaviors or even seeking reassurance from loved ones, family, friends. And those are all serve as compulsive safety. 

So I wish I could draw out a diagram for you right now, which would really help to explain this. However, the problem with engaging in the safety or compulsive behaviors is that you get relief. I feel better. And the problem with the relief is that every time you experience relief, you will actually engage in the whole vicious cycle again. 

So relief actually is negatively reinforcing. It reinforces whatever behavior that got you believe to begin with. 

So, for example, addiction addiction is hard to treat because not only is there a negative reinforcement, there’s also positive reinforcement. So you’re able to escape the discomfort from the substance. 

However, the substance actually feels good, too. So that’s the positive reinforcement. In addition to the. So you just have to understand that whenever you are experiencing relief, you’re getting negative reports. So the response prevention piece of ERP is the part that keeps you from engaging in your safety or compulsive behaviors so that you don’t get the relief, so that you learn to tolerate the discomfort. And the reality is that your fight or flight trigger, your firefly alarm is basically the bodily action that you feel that you perceive as anxiety. And that’s that’s like your adrenaline that you feel. And when you have an anxiety trigger and your firefly alarm is set off, it can only last for so long. It doesn’t last for ever and ever and ever tell you. Exactly, and certainly won’t for you. So if you are able to tolerate the discomfort and not do anything at all. Guess what? That discomfort level will subside by itself on its own without doing any. 

And by doing that, what you’re actually doing is you’re retraining your brain, you’re retraining your neural pathways, your neurochemistry, that by not engaging in the behaviors, you’re so okay and you’re getting the corrective feedback that the the threat actually is not that certain. 

Right. And that and that the behavior wasn’t actually helping you. 

Exactly. And is necessary. Right. So another example, you know, that might help people understand this more. It’s kind of like if you experienced a headache. Right. The headache is your intrusive, uncomparable sensation. Right. And nobody likes headaches. Headaches lead to discomfort. Now, what is it that most of us will do to get relief from a headache? 

Take medication or rest? Well, most people will take medication unless you’re phobic to take medication. Right. 

So let’s say you’re taking Advil and by taking Advil, you get relief and feel better. Does that mean you will never, ever have another headache again? No. It doesn’t mean that headaches will come and go. Right. Just like thoughts will come and go. So when you have another headache, what is it that you’re going to do? 

Yeah, you’re gonna take it again. Why? 

Because you felt better the last time you took it. Right. Even though it’s not. It was only a temporary fix. So what if this time you’re out of Advil and your medicine cabinet and you look inside, you see Tylenol or let’s just say aspirin. And you take aspirin and it didn’t give you the relief that you you expected. So the next time when you experience a headache again and let’s say now you’ve replenished your medicine cabinet with Advo and you have a choice now you can take aspirin or you can take Advil. Which one is it that you will likely take? You take the Advil because they work, right? You wouldn’t take the thing that didn’t work. You will take that work. 

So that’s to show you how engaging in your compulsive behaviors can be devastating for your fears, because it actually reinforces the fears. It actually minimizes your believe in your own ability to tolerate the fever. And it gives credence to the fear itself. 

Right. Right. So. 

A lot of people with with ERP when it comes to OCD can kind of break out of the cycle, right, without medication necessarily, or is do more people benefit with medication and ERP? And when it comes to OCD alone, are the two of those. 

The only evidence based approaches? 

Right. So with anxiety disorders and OCD, the medications can be useful. However, we also know that medications. It’s it’s kind of a life long approach. As soon as you stop the medication, you’ll just experience all of the symptoms. Right. I say on top of that, medications don’t provide you complete relief. So most people who are taking medications don’t experience complete. They still experience symptoms. They just experience it to a more dulled degree. 

So to be the most beneficial, you really do need cognitive behavioral therapy, specifically exposure and response, prevention, therapy and if necessary, medication. A lot of people who come through our treatment center at the Reading Freedom Center might come in with a whole host of medications to patients. 

And after they engage in exposure, response, prevention or therapy and they start to improve. 

We actually work to start taking them off of their medications. And that goes to show you that exposure and response prevention therapy is really a necessary part of treatment. 

Right. And then what about for other anxiety disorders, behavioral therapies and medications, specifically SSRI? Is there anything else you considered to be evidence based? For those as well. And I know I asked earlier, I touched on this mostly because a few listeners specifically were curious if you had thoughts on MDR. 

I’m not sure you want to hear my thoughts here are to be. 

Oh, no, I would I would like to hear even if they’re because I’ve seen mixed you know, I’ve seen mixed information on whether it is evidence based or not or if it’s, you know, if it if it can actually help people. 

So what I would actually say, you know, you have to really look at the sorts of research, you know, and a lot of MDR research is is actually supported by organizations that support MDR. 

And therefore the research a lot of the research is biased. And if we are to look at real, you know, unbiased research by independent researchers and by the way, I should interrupt really quickly, because I don’t think we mentioned MDR as eye movement desensitization and reprocessing. 

And a couple of listeners were curious because they had kind of seen mixed information and saw it continue. Right. 

And therefore, if you are looking at research by independent researchers who are not biased by any type of organizations comparing exposure and response, prevention, therapy or cognitive behavioral therapy with MDR, those research doesn’t really support MDR as being more effective. 

In fact, you know, this the thing about MDR is that. 

You’re you’re you’re really not learning to change your behavior and you’re not really learning to change your response to the fears and with anxiety disorders. 

It is a behavioral disorder, right? You are behaving in ways that reinforces it, reinforces the fears, reinforces the the misconceptions of potential threat to you, to your loved ones in your world. And in MDR, it doesn’t help you change those specific behaviors. OK. 

So with if if any efficacy has been shown for you, MDR, you would say that it’s because there’s also ERP going on. I know I’ve seen that there has been some buzz about MDR specifically for PTSD. Would you say that that it might be effective for PTSD or that still you don’t see evidence that would at least have you recommending it? 

If I had a family member suffering from PTSD, my recommendation would be prolonged exposure. And there is tons and tons of research done, which was pioneered by Dr. Edna Folha in Philadelphia on prolonged exposure and prolonged exposure, basically helps a person, again, confront the trauma in a way that is safe in a way that allows them to realize that they are still OK. That, yes, the trauma exists. It and the trauma was you know, it was life threatening. However, it. Allows you to habituate to the sphere. So what does habituation do, you know? And here’s the thing. Some people believe that if I don’t want to think of if I don’t want to experience a fear or experience anxiety, then I just have to not think about it. And some people will use thoughts stopping as a method. And you have to realize that if you are trying not to think about a thought, you’re actually focusing attention on, too. 

That is exactly why diets don’t work, right. Like, I’m not suggesting to eat chocolate, but hey, now I’m thinking about chocolate. 

So in MDR, when people when they’re when people are being told that they’re getting it and they’re they’re being told to think about their trauma. Right. While these eye movements are being guided by the therapist. And so, I mean, do you think there’s a placebo effect there? 

Possibly you’re suddenly see the effect because just by going to therapy, there’s a placebo. Right. 

So we know that a person just going to therapy, whether it’s traditional talk therapy or light therapy or EMG or any type of therapy, there’s going to be some improvement. 

What can someone. A person who is in the life of someone who they believe has anxiety or has something going on. 

Maybe it’s a coworker is is acting in a way that makes you worry about them or a family member or a spouse. What are some signs that that you can spot or that you can kind of look out for our red flags? 

And if you see a red flag and think that a loved one or a coworker or someone else might be going through an anxiety disorder or OCD. And what can you do? 

Let’s just go through some of the signs first. Right. So anytime you see a person who is distracted, they might be distracted because they are dealing with intrusive thoughts that they have, not necessarily because they are just inattentive or not paying attention. So this is like someone who is chronically dis distressed by not being able to focus in attention. Anyone who is taking a lot of time to complete tasks, any one who takes a long time, especially in the mornings or at nighttime, anyone having trouble sleeping, their mood is disrupted. There they. They lost interest in activities and hobbies that they previously enjoy. They’re starting to avoid specific things. If they have specific rules around what the person or even family members can or cannot do, that must be originally followed if they fear going to certain places or they fear stepping out of their house or if they fear. Unions, social places. Those are just some of the more common signs of a person suffering from anxiety disorders and an anxiety disorder can be anything from social anxiety, which doesn’t mean the person is just anxious. 

In social situations. A person with social anxiety means that they actually fear being judged and perceived negatively being criticized, which, you know, a lot of the more popular social people actually have social anxiety disorder. 

Just Mr. Popular and their social doesn’t mean that they’re caught. They’re not constantly thinking about what other people are thinking of them. 

So social anxiety disorder, we can have a whole complete different segment just on that. Phobias, phobias is basically when you have a specific fear, such as flying spiders or being up in high places. And that will cause the person to avoid those things on someone with panic disorder. 

This is basically someone who fears their body experiencing that fight or flight trigger. So they fear their heart palpitating. They fear them feeling noshes, having dizzy spells, feeling hot or cold to angry sensation, not being able to breathe, hyperventilating. 

And that’s panic disorder for kids. There’s also separation anxiety. This is where they fear something bad will happen to either them or their loved ones if they are separate from the person. And then there’s also generalized anxiety disorder, which is often a catchall diagnosis for clinicians, you know. You know, I’m just going I just have to say this. There are a lot of patients who are mis diagnosed with generalized anxiety disorder when they actually have something more specific. Like I have a disorder or OCD. 

And the rationale for some of these clinicians is that, well, OCD is more is a more severe diagnosis. So I’m going to give you a less severe diagnosis, which doesn’t help the person at all. 

Shahir, what’s what would be the motivation behind giving a less severe diagnosis if the clinician suspects something more specific? 

Maybe because if it’s a more severe diagnosis, then the treatment is more challenging or difficult, or maybe the clinician actually doesn’t have awareness and is a really see the you know, the present symptom presentation of obsessive compulsive. 

Would would you say that generalized anxiety is necessarily less severe than the rest or just that perhaps that’s the perception. 

I would say that’s the perception, but it’s not less severe. 

More clinicians are are trained to treat generalized anxiety disorder, whereas there are very few clinicians in the world that are trained or experienced in treating obsessive compulsive disorder and related anxiety disorders. However, it doesn’t mean that it’s not treatable. 

It is actually very, very treatable with. And treatment is usually very short term. So if you’ve been going to therapy for years and years and years and your symptoms have not decreased and you’re talking about your childhood, that is not the space treatment. 

You know, I had that same experience. I had a few years of my life. Well, like I said, I think I’ve had OCD like behaviors and thought patterns for many years. But I spent a couple years doing talk therapy, wondering if that would help. It did not help at all. So, you know. But I’m glad that I finally I mean, I actually kind of figured it out myself. And I don’t know how common that is because I went to my my pee pee and I said, you know, I think I have OCD. 

And she said, I don’t think people usually self-diagnosis with that. But then she checked my symptoms are she did a screening kind of discussion and then she referred me. 

And then lo and behold, I had OCD and I it took me years to figure it out. 

Right. And, you know, the thing that people have to realize is that. 

Is it daunting to experience exposure or to go through exposure and response, prevention, therapy? Of course it is. Right. Because the whole point is to confront your fears and nobody. Confront their fears if they were able to. They wouldn’t have an anxiety disorder or OCD. Right. However, the reality is if you don’t confront your fears, then you’re just giving your fears credence and you’re not learning the skills suit to manage your behaviors. 

That actually reinforces your fears and your you know, the if you experience. If you go through exposure and response, prevention, therapy, that is short term, you’re not going to be experiencing you’re not going to be doing exposures for forever. Ever. Right. Short term. Because again, you’ll find your flight discomfort does not last forever. In fact, in 60 to 90 minutes, your discomfort will go away on its own, will subside on its own without doing. 

It’s true. It was surprising the first time you hit them and like, really, it could be this way. But, you know, Dr. Yip, we’ve we’ve already gone over time. And I like I said, we can talk about this for so many episodes. You know, I think I was it was a little ambitious of me to want to talk to you in 40 minutes and talk about anxiety and OCD, but hopefully we can do this again because we didn’t get into the details. I mean, we could potentially do many more, but it’s all up to how much time you’re willing to share with me because you’ve already been so generous. And we didn’t get to cognitive distortions. I wanted to ask you about those. So we’ll have to save it for next time. But can you can you tell the listeners where to find you? I know you’re on Twitter and I believe you have a Facebook page, don’t you? I do. 

I have a Facebook page and Twitter and Instagram. And the easiest way is just to go directly to our Web site, which is renewed Freedom Center dot com. 

Also little thinkers, center dot com. 

And, you know, as listeners want to find out more details about OCD or related anxiety disorders, they can also get information, which is which is factual information from two specific non-profits. 

One is the International OCD Foundation, which is I OCD, F-stop or. And the second one is Anxiety and Depression. Association of America, which is a D.. A. a dark or. 

Thank you so much, Dr. Yepp, in the end. I know IOC, D.F. was so helpful for me when I first realized I had OCD and they also connected me with you a few years ago when I needed some expert input for a piece. 

So they are great. I agree. Thanks again, Doctor. Yep. For joining me, because I think we love. 

Thanks, everyone, for listening. Point of Inquiry is a production of the Center for Inquiry CFI is this five oh one see three charitable nonprofit organization whose vision is a world in which evidence, science and compassion rather than superstition, pseudoscience or prejudice guide public policy. You can visit our set point of inquiry dot org. Follow us on Twitter at point of inquiry or hit us up on our Facebook page to let us know your feedback. Or you can find me on Twitter at Case Napperby. My dreams are open. Don’t make me regret that. And remember to subscribe. We’re available on iTunes, Google Play, Spotify and your favorite podcast app. And please remember to share episodes on social media, email or whatever app you’re into. Thanks again, everyone. And I’ll talk to you again in a couple weeks. 

Kavin Senapathy

Kavin Senapathy

Kavin is an author and public speaker covering science, health, food, parenting and their intersection. Her work appears regularly at various outlets including Forbes, SELF Magazine, Slate, her "Woo Watch" column for Skeptical Inquirer online, and more. When she’s not writing and tweeting, she’s busy being a “Science Mom”—also the name of a recent documentary film in which she’s featured. Follow her on Twitter @ksenapathy and Facebook.