 Hey there, I'm Drew, and you are listening to or watching The Anxious Truth, the podcast that covers all things anxiety, anxiety disorders, and anxiety recovery. So if you're struggling with problems like panic disorder, agoraphobia, OCD, or health anxiety, well, you've come to the right place, and I'm glad you're here. Today I'm joined by two special guests, two OCD specialists from the state of California, my friends Lauren Rosen and Kelly Franke are here. We're gonna talk about the wide spectrum of exposure work that you can do from completely on your own to working with a qualified therapist and everything in between. So let's get started on that right now. Hello everybody, welcome back to The Anxious Truth. This is podcast episode number 245, recorded in February of 2023. I am Drew Lincellata, creator and host of The Anxious Truth. If this is your first time listening to the podcast or stumbling into the YouTube channel, I'm glad you're here. I hope you find it helpful. And if you're a returning viewer or a returning listener, welcome back. Of course, I'm glad you're here. So today we are joined by OCD therapists, Lauren Rosen and Kelly Franke, both practicing in California, both people I am proud to call my friends. And we got together to have a discussion about the wide range of options that people have when doing exposure and especially ERP work for OCD, whether you're working completely on your own because you have no access to a qualified professional for whatever reason, or you're sort of combining things, you maybe you're using books, maybe you're using social media content all the way to the other side of the spectrum where you are working with a trained OCD specialist, a licensed professional. And we wanted to look at the pros and cons of all of those things and how they sort of fit together. And more than anything else, we wanted to make sure that you know that even if you're having a hard time finding qualified professional help, you are not doomed. There are things that you can do when you're not doomed to be stuck there forever, I promise. So before we get to the interview with Lauren and Kelly, just a quick reminder that The Anxious Truth is more than just this podcast episode. There are 244 other podcast episodes that came before this one. There are books that I've written on anxiety and anxiety recovery. There are courses and workshops and webinars that I'm doing to help people with their recovery and educate people about these particular topics, take the mystery out of them. There's all my social media content. There's ways to support my work if you're digging it. It's all on my website at the anxioustruth.com. So I would ask you to pop on over there and avail yourself of all the resources. They're there, take advantage of them. And if you decide to support this work financially by buying a course or a webinar or a book or something out of my Etsy shop or whatever it is, I appreciate that. Thank you so much. But that sort of support is appreciated but never required. Even if you're here to just listen to the podcast or like a YouTube video or write a podcast review, I appreciate that support too. It's all good and I'm happy that you're here no matter how you're involved with the work. And I hope that you find it helpful. So let's get on to the interview with Lauren and Kelly. I think it was pretty good. We went for about 25 or 30 minutes. So not too long. I think there's a lot of good information in there, especially again, if you're struggling to find a therapist, you're having a hard time accessing that either in your state in the US or the country that you're in or maybe it's a financial thing. A lot of reasons why it can be hard to find professional help. We tried to go through this as much as we can to give you as much good information about that situation and different options and how people handle it. So let's get to it and I will come back at the end to wrap it up and give you all the links and ways to find their podcast and all this stuff. So enjoy the interview and I'll be back afterwards to wrap it up. Okay, as promised, here we are with the fabulous Lauren Rosen and Kelly Franke from the Purely OCD podcast, both practicing therapists in the state of California and beyond, at least in the case of Lauren, and beyond and specializing in OCD and Purely OCD is a great podcast that you guys should check out. So I'm gonna put that up on the screen and we're gonna put in the show notes we'll talk about it at the end. But here we are to talk about this whole idea of the pros and cons of like how to do exposure in ERP work, like that scale of like, I'm doing it all on my own because I can't find a therapist to like, I have a team of therapists that are awesome and they're helping and everything in between. So you guys have encountered this, I'm guessing in your practices. Absolutely, actually, Kelly was just mentioning something to that, you know, end. Right, so what I was talking about is that lots of times people can't afford treatment, right? Like it's expensive, it's really privileged to be able to go to therapy and also to have the access and to have a specialist in your states because there's a lot of laws that restrict MFCs to treat outside of your state. And so when people reach out to me and we've run down all the avenues and none of those are viable options, I will give them referral books, self-help OCD books that I rely on and I trust. And I will say you can start here because they show you how to build hierarchies. They give you sample exposures, sample, imaginal exposures, response prevention, all the basics. But at the end of the day, this treatment can be very nuanced, right? Like it's, there's a lot of nuance in OCD and it's not to be missed and it can easily be missed with some of it if you're not a trained professional. And like I was asking Lauren, if she'd ever experienced this and turns out she has as well where people have done a lot of work on their own and then come to us for the last stretch. Yeah, which is, it's way cool. And as, because Kelly was saying that it, it's amazing what people are capable of and learn so much learning can be done outside of the therapeutic relationship. That being said, there are lots of different approaches too. And so I love, I do the same thing and not just states, but different countries. There are places all over the world where there is no access to specialized care. And there are laws that prohibit us from working there, you know, because it's regulated in the country for instance and we don't have all of the credentialing behind us to offer support. But I think one of the things, so yes, there's lots of different ways to go about treating. And obviously there are lots of people out there who are selling things that you don't wanna be buying like the guy on Instagram who, I don't even remember, was that a year ago where he was like, celery cures OCD. It's like, oh my God. He's my favorite. Yeah, really though. It's just, it's so upsetting because it is so many people are looking for something to hold on to. And, you know, understandably they're like, oh, great, sign me up for that. So first, I think, obviously there are a lot of resources online you can get to know different clinicians and their style and if you relate to it, oftentimes we'll have resources linked on our websites and stuff like that. I know Kelly and I both do. So there's that. But also what tends to happen is Kelly said, and I'd love to get both of your thoughts on this, that the nuance in treatment is something that sometimes gets lost. And so what we'll see is I'll see on my Instagram account people saying, well, but what about this? And I can't respond to your personal queries on Instagram because it's not therapy. And I don't know the whole context of your story. And so that's where I think therapy becomes really important as you have these sort of followup questions that aren't necessarily going to be answered by a book. Yeah, I would agree with that. I think what I see most often in the community I'm fortunate to have around this podcast is exactly that. So things like Instagram and the content we all produce can provide general guidelines, and but everybody gets very focused on their specific fear or their specific thought or their specific compulsion or whatever it happens to be. And then they want specific instruction on that, which is where this falls down and where a book probably falls down. But what I always try to tell people like, well, just think of the principles at play here. And I know that you think your specific thing is different and special and needs its own instruction, but you can try to go back to the guiding principles that are in that book that you read and how can you apply them? But I think that's where it becomes really tricky to do some of this work without professional help. There's that and then there's the interpretation of how they feel when they do it without that person to sort of coach them through that. No, no, no, you're supposed to really feel uncomfortable right now. Often I find that this isn't gonna work for me because it may be worse, which I'm sure you guys come to every day. Absolutely. We even find I don't feel anything. Is that a problem? Like when there's many exposures, right? So it can go either way. And so that's why it's really helpful if somebody who has OCD and is worried about harming their child and they're doing an exposure that's out of a book and they don't feel scared. Oh, backfire. We're gonna call. Yeah, does this mean I wanna do it? Right. So it can happen that quickly where things can go kind of sideways. But I think the bigger picture to take away is like compulsions are the problem. You know, if focusing on removing compulsions usually doesn't require a ton of like nuance per se. Well, it can but cause we can scale it therapist can scale it better and just verbally going through it and emotionally. But yeah, I mean, I think if you can say remove the compulsions work on exposures through a therapist, I don't know. It's hard, it's hard. Yeah. Actually, I appreciate and Kelly knows there's a quote that recently that came out from John Hirschfield. He wrote this wonderful article and this is why I wanted to bring it up. Of course, now I can't find it but it was something to the effect of like an update on the poetry of OCD therapy. He said like cut to the chase, right? At the end of it, he said something like cut to the chase like compulsions bad. Like if there's your ear, yes. An update on the poetry of evidence-based psychotherapy I'll send through the link. But yeah, at the very end of the article, he's like, that's your, there's your, yeah. Let's cut to the chase compulsions bad. That's your OCD treatment protocol. It's just so perfect. But I love that somebody with his stature too can combine a silly line like here's cut to the chase compulsions bad with also the words poetry and recognizing how complicated and nuanced this could be because it is, it's flat-out. Yeah, yeah. Absolutely. So yeah, actually great resource too if you're interested in understanding more about the different treatment modalities used so that you can be an informed consumer when you're looking for, if you happen to be on the lookout for a therapist. And the other thing I wanted to say is one of the areas that I often see people get stuck in independent of being in therapy is the obsessions related to doing treatment, right? Yeah. And so the tendency to bring this worldview that really, I don't know, exemplifies OCD where everything is black and white and I have to do it correctly or else it sort of gets moved on to treatment if you don't have somebody there going, aha, you're trying to do treatment perfectly. Okay, well, we're not gonna do that and here's why and here are the, look, see you have thoughts about that and you have feelings about that too and there are the compulsions that you might be doing in order to make sure and that's not gonna help you. Yeah, that makes sense. There's also the other thing that comes up and so it's funny cause we have the spectrum here like you can be completely on your own cause you have no access to anybody. You can use books, then there's a social media thing then there's actually working with a therapist. So there's multiple, you know, the steps you can take in the middle of that is the big old social media pond where there are not just people like you guys but there are also the people who are consuming the content who then interact with each other. Oh yeah. Yeah. I'm always curious what that is. Yeah. I'm always curious like, are my clients talking to other people in this world? Well, I will tell you here I can answer that question for you, not you specifically cause no one's ever said my therapist Kelly said, no, I mean, maybe they are your client but I don't know. Sure, drill, sure. But I will at least a few times a week in a very large Facebook discussion group I will get people who will come in because their therapist said a thing and instead of asking the therapist or asking for clarification or texting or setting it up for the next session they come to me and want me to confirm or deny that what the therapist said is correct. Oh, Drew, they asked us, I guarantee it. Now they're getting caught second. Well, I didn't wanna go there but I'm pretty sure, but I get that. Like, Kelly didn't give me the answer I want so let me ask Drew now or someone else on social media because I'm really hoping for a different answer. I get that, that's probably part of it but it is fascinating to see how like this thing that didn't exist 15 years ago is probably changing that dynamic a lot as well. Yeah. In a good way and a tricky way. Yes, I agree. Without it, we wouldn't have as much community. We also wouldn't be able to get access to resources and it's kind of also, it's a Kelly's heel because then you have people who are just like compulsively consuming stuff. They're using language that's tweaked just a little enough that it sounds different than what a therapist is saying and then they get stuck on that and is like, well, isn't asking for reassurance all bad? Like I should never ask for reassurance is a common one. It's like, well, it's only if it's compulsive that's the only time it ever is. Right, well, meaning reassurance again and again and again. Like I've had to address that. You're right, that gets convoluted sometimes. But I could be like, hey Drew, do you think that guy thinks I'm an asshole? And you could be like, probably and I'll be like, all right, cool. And then we drop it. But if I'm like revisiting it over and over, you'd be like, you need to call your therapist. Like this is the problem. Kelly, this is an intervention. It's an intervention. This is not a podcast. We're actually, it's an intervention. We didn't wanna tell you. You knew it. No, I get that. And I think the other thing that comes into it if you're looking at the spectrum of how you do your exposures, whether on your own and all the way up to working with professionals, then there's this support. And I'm gonna use that lovingly because I love that people can support each other. But there's also pitfalls to air quotes support. And I get all of that. Like, well, I want an accountability partner. Well, that's a great idea, except if the other person isn't prepared to shrug their shoulders at your fear sometimes and not try to be kind and sooty, then they're not gonna really help you. So people get that. But then also it's like, I don't understand, we should have a support group. And then the support group devolves quickly into, don't you hate it? It's gonna be fine. It's gonna be fine. This feels so real. I know I hate it. No one understands it. Quickly it's not useful anymore. It's co-rumination on steroids. So it's so hard. Yeah. We actually just did a podcast episode on this last week about how to seek support without seeking reassurance because it's super important and support is, but again, the nuance there. And so much nuance gets lost in social media anyway. And then you have a treatment, or on any sort of written platform, but then you have a treatment that, there are so many paradoxes or seeming paradoxes and dialectics that are involved, where we're, to anyone who's listening, who doesn't know about dialectics, you're holding two things that seem opposite to one another, but in fact or not. So you could post something and then somebody says, well, but my therapist said this and they're not mutually exclusive. But again, that sort of narrow viewpoint on, I'm trying to do it right interferes with the ability to understand and implement. Yeah. Doing it right. Kelly, what are your thoughts on, I'm gonna put you on the spot in a big way here, because I think human nature, if two people are going to try to support each other or 10 people or 10,000 people, human nature is, I see you in distress, my friend, and I want to ease your pain right now and I wanna make you feel better and fix it. That's generally human nature. Whereas in the training you have gone, undergone, you are almost taking a vow to not do that when you know it's counterproductive and that looks so wrong unless you are willing to go down that road. How do you address that? Because that's a tough one too. I've been abandoned, I'm not getting support. Yeah. Yeah. I have so much to say on it, so. Bring it. And I'm sure Lauren will too. But honestly, just to pull apart some of the first things you were saying is, when somebody early on comes into treatment and they're really stuck, like you better believe I am giving them reassurance, right? Like I'm explaining to them, this is OCD. This sounds like OCD. These are the reasons why. And then I'm testing like they're, I'm doing reality testing really when I'm doing like restructuring of thoughts is like do they know that cognitively this is off? Like do they know that there's something about, like they reached out to me, right? Or if you have a client who's so fused with the thoughts that they're not willing to do anything, sometimes there's a little bit of coaching of reassurance giving, it's a sliver, but it's more of like, hey, I know this is hard, reframing it, you're restructuring it and going from there. So it's kind of like, you're building this tolerance of it, if you will. Some clients are ready to go. They're like, I already know when I met with you, like I already know it's uncertainty. I know you can't get rid of my anxiety. I'm like, obviously they've been on social media or they've read a hundred books. So, okay, great start. But yeah, I mean, like Lauren and I are good friends and we have OCD. And when I'm stuck or she's stuck, we are very careful, because we're both obviously professionals too, in, hey, how can I support you right now? Can I help you reframe this? Like, do you need just to talk about it and just get it out and I listen? Like, can I offer you a reframe, right? One of my favorite lines you guys have ever said. Yeah. Can I offer you? It is the OCD equivalent to, can I get you something to drink? Yeah, just, I mean, right? Cause that person is gonna be like, there's so many times where Lauren and I are like, we just have to say it and then like, I know I have to, this sucks and this is super scary. And then the person just like owns it and you're just witnessing it, right? Like I might come to my phone an hour later or she comes to her phone an hour later and it's like, oh wow, that person just worked through it without, they just needed a witness. Yeah. But I think one of the things that's so important in that is that we're both in a place where we recognize that certainty is a total illusion. So we're not actually seeking certainty from either, each other, we're just saying, wow, it's really hard to be with this uncertainty sometimes and it's scary. And right now I'm feeling a lot of things and I'm gonna pivot toward what's important to me in my life. I love you, right? I just want to be held in this experience and know that there are other human beings on this planet who understand that it's very, very challenging to live with this disorder. Which is, that is one of the powerful things about if you have to do it on your own or partially on your own, you get to access a community like that, tremendous power in that. I think one of the things that would be interesting, not that we're gonna subpoena your text messages, we might if things get out of hand, but I would guess that in those exchanges as friends but also trained professionals, you probably have that time when it's like, man, this really sucks, says Lauren and Kelly says, I hear you, this sucks on ice in a big way, no lie there. But I'm guessing that that conversation does not continue that way for eight hours that day. That's the pitfall of when you're on your own and you're trying to rely on the internet to support you. That's one of the things that can go wrong. Right, and honestly, we're so busy that half the time we don't get to our, like we don't see it right away, right? So people going into like a support group, they're like, I need an answer, I need to know it now. And I'm gonna throw it out to 1,000 people so I can get somebody to say something right now. And also when people are like in their recovery well in or and they feel like they're really like confident and they trust everything that their therapist has said, I've seen this a few times and like they know how to do ERP, they know how to do exposures. And then they go in and kind of try to be an expert to somebody else, not realizing like, they saw it through their lens of OCD and that can be really getting in somebody's way of progress. That's where I see the, that's reassurance seeking and people get shut down instantly. And like, well, wait a minute, this might be the person's very first day. You don't know that, but I know people have the best of intentions. So I think the million dollar question here that everybody's gonna ask when they listen to this podcast because I know they're gonna ask it even without the podcast. Have you seen people recover without, I'm not saying that you're suggesting they do it alone or without a therapist, but is it possible? And you might say, I don't know. I've never seen it because I'm a therapist. So people are like, it's all the point right there. Reporting bias for the win. Unfortunately, you're talking to a very biased sample. Good point. I could see where, like I was saying earlier though and Lauren as well is like, we've seen people do a lot of, and honestly these were people that were pretty straightforward OCD and they've come back, they've done a bulk of the work and now they're like stuck on a few bits and pieces and we're gonna work through it and maybe clarify some other things, but I've seen that. I've seen it a few times. Yeah. Or where they just latch onto treatment really quickly even if they haven't done a bunch of research in advance and it just, it goes quickly. They know what's up, they do it. It's, you know, but I will say too that once you've been through treatment you can support yourself. And I think any good, hopefully OCD therapist or anxiety therapist is gonna say like, it's okay, like try your skills out on this. I'm here, you know, you can reach out to me. I'm here as a support, but you have so much more capacity than you sometimes give yourself credit for. I like it. Yeah, and we'll start to say like near the end of treatment is like, okay, so what do you, what would you do in this situation? Right, as we're preparing them to launch is like, let's have you do this hierarchy. Let's have you do the exposures and assign it to yourself. And what do you think, right? So we're trying to empower them and move them into being responsible for their own treatment and recovery longterm instead of relying on us. And oftentimes they'll say things like, Kelly, I heard your voice and I'm like, oh, sorry. I'm never gonna get used to that. I heard you saying, no, don't hear me saying. Yeah, don't. So sorry, I live in your head now. Yeah. I live in Bahrain and it's not always pretty. I'm just kidding. No, I get that. But it's good news though. The good news in that statement is like, you know, well, I can't find a therapist or can't afford a therapist, is it impossible? Well, not necessarily but difficult, but you also see people respond so well. Post-treatment and like, it's not hopeless. I think. No. People feel like I can't find a therapist, especially in other countries where there's access is so limited. I'm done, I'm never gonna get better. I don't think it means you have to stay where you are. So there might be disadvantage there but you're not stuck where you are. That's right. Yeah. Yeah. Big old debtor. Job drew. No, I was just gonna say even when you're in therapy, there's so much that most of what you're doing is outside of therapy. So yes, the therapist guidance is gonna help you to navigate, it's going, it's like going to, oh my gosh, why can't I think the name of the tallest mountain in the world? Everest. Thank you. Oh my gosh, that is, wow. So you're going to Everest. I don't think you can do this but you could in theory like actually do it alone. You could bring your oxygen tanks and carry what you need. I'm sure it's, somebody did it at some point. You probably lived there for a while and you acclimated to the weather first but I'm not the weather altitude but I swear this is going somewhere. So if that said, it's a lot easier to do it with a guide and there's a lot less risk involved if you, well, I mean, I'm sure that there's plenty of risk anyway because it's Everest and yeah, but yeah, it's less risk than it would be otherwise. And so, and it's gonna go probably a lot smoother. I think that's the way to look at it because we've climbed this mountain a lot of times with a lot of people and if this is your first time climbing it, you might get stuck places and not be aware of how to walk through it and all of that. Let me put up your stuff on the screen here. First of all, in terms of getting at these two lovely human beings in general, if you're watching on YouTube, here are their Instagram handles that I'm putting up on the screen, Kelly and Lauren. And then your podcast, you've been doing it for a while now it's an outgrowth of your Instagram lives, right? It's called purely OCD. Mm-hmm, yeah, it's been a couple years now that we've been recording maybe a year since we officially took it to podcast platforms. Somewhere around like 60 something episodes, which is wild. That's more than I thought you had. I'm clearly not listening enough. Well, in fairness, some of the very early episodes, the audio is just, it's atrocious. Yeah, and we don't know. We're just having fun. We didn't think it would be a podcast. And then we just ripped the audio from it and said, screw it. The best way to start a podcast is just have something to say, I guess. It's lost, that's all. Anyway, if you guys want to find, you can just search purely OCD podcast in any podcast platform or on Google, or if you go to the anxioustruth.com slash 246 because this is episode 246, I will put all the links on the page so you can get to everything and good conversation. Thank you guys, I appreciate you coming by to hang out. So thanks for having us. We will do it again sometime. We can do it again every month anyway because if you guys have not seen our YouTube videos that we do every month, we're gonna be back next month to do another one of these. So, I feel like you're never gonna see it again. Come hang with us, we all entertain ourselves at least on Friday mornings as we watch this. That is true. If nothing else, we think we're hilarious, if nothing else. And there are lots of Lebowski quotes that you won't understand if you haven't watched it in, I don't know, the last decade. I blame Kelly for rolling in with that and pushing my buttons and she gets me going. Anyway, all right guys, I'll come back in two minutes to wrap this up as you usually do, so hang in there. Okay, we are back. That was great. I enjoyed having the conversation. I hope you guys enjoyed listening to it. Hope there was something useful in there for you. Hey listen, trying to find professional help when you really want it can be really challenging. Clearly, there is issues in mental health. Here in the States and other countries that we have to address, it's really important. It can be very difficult to find the kind of help that you need, especially if you're dealing with OCD, which is kind of its own thing even within the anxiety disorder community. So hopefully you've gotten some useful information out of that and if nothing else, the message that you're not completely screwed if you're having a hard time finding a therapist. You can stitch together a bunch of other resources and if you want to find several of the resources that Lauren and Kelly mentioned, they mentioned books, they mentioned things like that, I will put them in the show notes of this podcast episode. So just go to theanxiustruth.com slash 246 and I will have links to Kelly Lauren's podcast, purely OCD, I will have links to their individual Instagram accounts and I will have links to some of the resources that came up in this episode so that you can find them. So that is it, that is episode 246 of the Anxious Truth in the books. You know it is over because the music is playing. That music is Afterglow by my friend Ben Drake. You hear it at the end of every podcast episode. He wrote the song at least in part inspired by this podcast several years ago and I've been fortunate enough to be able to use it in the podcast ever since with his permission. Thank you, Ben. You can find more about Ben and his music on his website at bendrakemusic.com so go check him out. Tell him I said hi if you do that. I'm going to ask you the same favors that I always do if you are listening to this podcast on Spotify or Apple Podcasts or some platform that lets you rate and review the podcast. Leave a five star rating if you dig it. Maybe take a minute, write a quick review because it helps other people find the podcast. Then we can help more and more people which is why I started doing this to begin with. If you're watching on YouTube, subscribe to the channel, hit the notification bell so you know when I upload more videos. Maybe leave a comment on this video because I do loop back a couple of times a week to answer my YouTube comments. I always enjoy interacting with you guys. And that is it. We are out the door. I hope you found it useful. I will be back next week. I do not know what I'm going to be talking about but I will be here. And remember, as always, this is the way. You got the feeling that you're gonna win but it's fast. No looking back but sweating on the pad.