Breaking the Rules: A Clinician's Guide to Treating OCD

Sex & OCD: The Theme No One Wants to Talk About

SEX & OCD: THE THEME NO ONE WANTS TO TALK ABOUT Sex is one of the most misunderstood and least talked about themes in OCD - but it's also one of the most common. In this episode of Breaking the Rules, Dr Tori Miller and Dr Celine Gresham explore how OCD can latch onto sex, relationships, identity and intimacy, creating overwhelming shame, fear and uncertainty for people of all ages. From sexual orientation OCD, relationship OCD and contamination fears around intimacy, to intrusive thoughts about loved ones, children or animals, they explain why these thoughts say nothing about who you are—and everything about how OCD operates. This episode is also a practical conversation for clinicians. Dr Tori and Dr Celine discuss how to ask the difficult questions, build enough trust for clients to disclose taboo themes, and create a therapy space where shame no longer has to be carried alone. They also explore how trauma can intersect with sexual-themed OCD, why careful assessment matters, and how Exposure and Response Prevention (ERP) can be adapted to support recovery. Whether you're living with OCD, supporting someone who is, or working as a mental health professional, this episode offers reassurance, practical guidance and a powerful reminder: intrusive thoughts are not intentions, and you are not defined by the content of your mind. In this episode you'll learn: * Why sexual-themed OCD is far more common than most people realise. * How shame keeps people trapped in silence and delays treatment. * How clinicians can confidently assess and treat taboo OCD themes using evidence-based approaches. Learn more about Melbourne Wellbeing Group: https://melbournewellbeinggroup.com.au [https://melbournewellbeinggroup.com.au/] ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

When OCD Looks Like An Eating Disorder with Dr Alissa Knight: Part 2

OCD, EATING DISORDERS & ARFID: WHERE DO YOU START? | DR ALISSA KNIGHT (PART 2) In Part 2 of our conversation with eating disorder specialist with Dr Alissa Knight, we dive deeper into one of the most complex areas of mental health treatment: the overlap between OCD, eating disorders, autism, trauma, and ARFID. How do clinicians untangle symptoms when OCD and eating disorders are working together? What happens when OCD disguises itself as an eating disorder, or when an eating disorder hides behind OCD? And how do you know where to begin treatment when both conditions are causing significant distress? Dr Alissa shares her unique, person-centred approach to formulation, treatment planning, and building trust with clients who have often been misunderstood, misdiagnosed, or passed between services. She also provides practical insights into working with ARFID, including how Exposure and Response Prevention (ERP) can be adapted to help people gradually overcome intense fears around food. This episode is packed with clinical wisdom for psychologists, therapists, students, families, and anyone interested in understanding the deeper relationship between OCD and eating disorders. In this episode, you'll learn: • Why OCD and eating disorders so commonly occur together • How OCD can unintentionally protect and reinforce eating disorder behaviours • The difference between OCD-driven food restriction and eating disorder pathology • How to determine which condition to treat first • Why collaboration and client buy-in are essential for successful treatment • The role of trauma, autism and nervous system dysregulation in eating disorders • Practical ways to adapt ERP for ARFID treatment • Why rapport is often more important than any therapy model • The biggest mistakes clinicians make when working with eating disorders • How to help clients feel safe, understood and empowered in treatment Dr Alissa also shares a powerful reminder for clinicians: your greatest therapeutic tool isn't a treatment manual, it's your ability to connect with another human being. Whether you're treating OCD, ARFID, anorexia nervosa, or working with complex presentations, this episode offers a refreshing perspective on what effective and compassionate care can look like. To learn more about Dr Alissa Knight follow this link [https://thecalmingsuite.com.au/] www.melbournewellbeinggroup.com.au ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

The Truth About Eating Disorder Treatment with Dr Alissa Knight: Part 1

EATING DISORDERS, OCD & THE PROBLEM WITH TRADITIONAL TREATMENT | DR ALISSA KNIGHT For the Season Premiere of Breaking the Rules, Dr Celine Gelgec and Dr Tori Miller are joined by eating disorder specialist Dr Alissa Knight from Calming Suite Psychology Clinic in Adelaide for a powerful and thought-provoking conversation about eating disorders, trauma, OCD, and why traditional treatment approaches may be failing many young people. After seeing Dr Alissa present at the Child and Adolescent Mental Health Conference, Celine and Tori knew they had to bring her onto the podcast. What follows is an honest discussion about the realities of eating disorder treatment, the fear-based messages many clinicians receive, and why genuine connection, trust, and understanding a person's full story may be far more important than rigid treatment manuals. Together, they explore the complex relationship between eating disorders and OCD, the role of trauma and attachment, why relapse rates remain so high, and how a more collaborative and compassionate approach can help people move towards true wellness rather than simply chasing "recovery." In this episode, you'll learn: • Why eating disorders are far more than food and weight • The hidden links between OCD, trauma, anxiety and eating disorders • How traditional treatment approaches can unintentionally damage trust • Why rapport and connection are often the most important therapeutic tools • The dangers of fear-based treatment and clinician burnout • How trauma-informed care can change outcomes for young people • Why wellness may be a more helpful goal than "recovery" • The challenges clinicians face when balancing medical risk and compassion This conversation challenges long-held assumptions about eating disorder treatment and offers a hopeful, human-centred perspective for clinicians, families, and anyone supporting a loved one through recovery. If you're a clinician, parent, educator, or someone living with OCD or an eating disorder, this is an episode you won't want to miss. To learn more about Dr Alissa Knight follow this link [https://thecalmingsuite.com.au/] ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Exposure Therapy in a Public Bathroom

In this episode of Breaking the Rules, we record from an unusual location — the bathroom floor of a public restroom — as we explore an increasingly popular social media trend: “clean girl culture.” Across platforms like TikTok and Instagram, the clean girl aesthetic promotes a polished, minimalist lifestyle — natural makeup, tidy wardrobes, “clean” eating, and curated routines that appear effortless and healthy. But when does a healthy routine become rigidity, anxiety, or compulsive behavior? In this conversation we unpack how trends like clean girl culture can blur the line between wellbeing and preoccupation, and how certain aspects of the aesthetic can overlap with OCD patterns, particularly around contamination, checking, perfectionism, and the need for control. We also explore the broader question clinicians and individuals often face: how do we know when something has gone too far? In this episode we discuss: * What “clean girl culture” is and why it’s trending on social media * The appeal of curated lifestyles and polished aesthetics * When healthy habits start becoming rigid or anxiety-driven * Parallels with orthorexia and other wellness trends * How social media trends can reinforce perfectionism and control * When checking, reassurance seeking, and contamination fears creep in * How compulsive behaviours can sometimes hide behind socially rewarded habits * The importance of flexibility, connection, and values when evaluating lifestyle choices * Questions clinicians can ask when assessing whether a habit has become unhealthy * Ultimately, this episode isn’t about criticising trends — it’s about helping people reflect on the “why” behind their behaviours and recognizing when something that started as self-care begins to shrink a person’s life instead of expanding it. 🔖 Chapters 00:00 Recording From a Public Bathroom 01:30 Using Location as an Exposure Exercise 03:00 Introducing Clean Girl Culture 05:00 The Appeal of Polished Aesthetics 07:00 When Wellness Trends Go Too Far 09:00 Orthorexia and the Pursuit of Health 11:00 Perfectionism, Checking & Social Media 13:00 How OCD Can Hide Behind Trends 14:30 When Habits Start Shrinking Your Life 16:00 Values, Flexibility & Mental Health 17:30 Questions to Ask Yourself or Clients ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.

Why OCD Gets Worse Before It Gets Better (Extinction Bursts)

In this episode of Breaking the Rules, we unpack one of the most confusing and frustrating parts of OCD treatment: extinction bursts. If you’ve ever started exposure therapy and felt like your intrusive thoughts suddenly became louder, more intense, or more frequent, you’re not alone. Many people interpret this spike in discomfort as proof that therapy isn’t working — when in reality, it can be evidence that change is actually happening. We explore what extinction bursts are, why they occur when people begin changing compulsive behaviors, and why the brain often reacts with a kind of “hissy fit” when long-standing patterns are challenged. This episode focuses on helping both clinicians and individuals understand that the initial surge in anxiety, intrusive thoughts, or urges isn’t failure — it’s often the brain’s attempt to pull you back into familiar safety behaviors. We also discuss practical ways clinicians can prepare clients for extinction bursts, coach them through these moments, and help them recognize these experiences as part of the change process rather than a sign that treatment is going wrong. In this episode we discuss: * What extinction bursts are and why they happen * Why OCD often gets louder when compulsions start changing * How long-standing habits create powerful neural patterns * Why many people misinterpret extinction bursts as therapy failure * The role of psychoeducation in preparing clients for this phase of treatment * Coaching clients to observe and ride out the “burst” * Using curiosity instead of self-judgment during difficult moments * Why discomfort during treatment can actually be evidence of progress * Helping clients track patterns without becoming trapped in distress monitoring * Reframing extinction bursts as a sign of meaningful change 🔖 Chapters 00:00 Introduction 01:20 What Is an Extinction Burst? 03:00 Why the Brain Reacts When Habits Change 05:10 Why ERP Can Feel Worse Before It Feels Better 07:00 How Clients Misinterpret Extinction Bursts 09:00 Why Psychoeducation Is So Important 11:00 Coaching Clients Through the “Hissy Fit” Phase 13:30 Curiosity vs Resistance During ERP 15:00 Using Data Carefully in OCD Treatment 17:00 Measuring Coping Rather Than Distress 18:30 Reframing Extinction Bursts as Evidence of Change ---------------------------------------- Hosted on Acast. See acast.com/privacy [https://acast.com/privacy] for more information.