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

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 togeth...

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 approac...

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 effortl...

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...

In this episode of Breaking the Rules , we do something a little different — we guide you through a live experiential exercise used in therapy to demonstrate how Exposure and Response Prevention (ERP) actually feels in the moment. Using a simple jelly bean (or Mentos), we walk through an exercise that highlights one of the most important lessons in OCD treatment: the urge to escape discomfort can...

In this episode of Breaking the Rules , we explore one of the most frustrating and often misunderstood impacts of OCD - how it interferes with studying, productivity, and performance at work . For many people, OCD hides behind traits that are often praised: diligence, responsibility, perfectionism, and attention to detail. But beneath the surface, what may look like hard work or conscientiousness...

In this episode of Breaking the Rules, we’re joined by researcher and clinician Dr. Clarissa Ong to unpack the complex relationship between perfectionism, anxiety, and OCD — and to explore how process-based therapy, particularly ACT, offers a powerful lens for understanding and treating these patterns. Drawing on her research and her book The Anxious Perfectionist, Clarissa helps us move beyond su...

In this episode of Breaking the Rules , we explore when and why OCD tends to peak across the lifespan — and why symptoms often intensify during moments of growth, change, and meaning rather than out of nowhere. Drawing on clinical experience and developmental theory, this conversation looks at the predictable windows of vulnerability where OCD commonly emerges or flares: childhood and puberty, lat...

In this long-awaited episode of Breaking the Rules , we finally do a deep dive into contamination-themed OCD — one of the most common, misunderstood, and physically debilitating OCD presentations. This conversation goes far beyond clichés about handwashing and cleanliness. We unpack what contamination OCD actually looks like day-to-day: the pain, the exhaustion, the food avoidance, the disrupted r...

In this reflective and practical episode of Breaking the Rules , the hosts unpack a phrase that shows up constantly in therapy rooms: “I don’t feel ready.” What does it actually mean? Is readiness a feeling—or is it a decision we make in the presence of fear, uncertainty, and discomfort? Using OCD as the primary lens, this conversation explores how clients often wait for certainty, calm, or clarit...

In this in-depth episode of Breaking the Rules , we unpack two commonly confused but fundamentally different clinical presentations: moral scrupulosity (OCD) and Obsessive Compulsive Personality Disorder (OCPD) . While they may look similar on the surface—perfectionism, rigid values, intense guilt—the treatment implications couldn’t be more different. The conversation explores how moral scrupulosi...

In this thought-provoking episode of Breaking the Rules, the hosts explore how values and paradox show up in the therapy room—especially when working with clients who experience OCD. Drawing from Acceptance and Commitment Therapy (ACT) principles, they discuss how being “fused” with one’s values can keep clients stuck in rigidity, perfectionism, and fear of imperfection. The conversation dives int...

In this powerful and insightful episode, we explore the connection between PTSD and OCD, two conditions that often intersect in complex and misunderstood ways. The discussion dives into how trauma can shape obsessive-compulsive patterns, how compulsions can emerge as coping mechanisms, and why a trauma-informed approach is essential for effective treatment. The speakers unpack the challenges of wo...

In this insightful episode, we explore the concept of parental accommodation — the well-intentioned ways family members and loved ones may unknowingly reinforce OCD behaviours. Drawing from the research of Professor Eli Liebowitz (Yale) and real-world clinical experience, the hosts unpack how accommodation develops, why it’s so hard to stop, and how families can begin to make meaningful change. Fr...

The perinatal period is one of the most vulnerable—and transformative—times in a parent’s life. In this episode, we explore the challenges of perinatal mental health , with a particular focus on OCD and how intrusive thoughts can impact new parents during this stage. Our speakers discuss the role of psychoeducation , the importance of therapeutic trust , and how clinicians can best support parents...

This honest and reflective episode takes listeners inside the therapy room—where clinical learnings, vulnerability, and growth unfold in real time. Ms Catherine McGrath (Clinical Team Lead and Senior Psychologist) sharea hard-earned lessons from working with OCD clients using ERP (Exposure and Response Prevention), and open up about the emotional toll, missed opportunities, and the courage it take...

In this episode, we explore the often misunderstood world of Meta OCD—a subtype of obsessive-compulsive disorder where the obsession becomes the diagnosis itself. Clients plagued by questions like "Do I really have OCD?" or "Is this the right treatment?" can become trapped in a mental loop that stalls progress and fuels perfectionism, self-doubt, and avoidance. We discuss how Meta OCD complicates...

In this insightful episode, we explore the tangled web of health anxiety , OCD , and death anxiety , unpacking how these psychological disorders often overlap and feed into each other. From obsessive thought patterns and compulsions to the deep-rooted fear of mortality, our speakers dive deep into the inner workings of anxiety disorders and what makes treatment so complex—and so crucial. 💬 We dis...

In this episode, we dive deep into the world of Exposure and Response Prevention (ERP) —the gold standard treatment for Obsessive-Compulsive Disorder (OCD) —through a clinical and ethical lens. We unpack the delicate balance between challenging clients and protecting their autonomy, exploring how therapeutic trust , client consent , and collaborative exposure tasks shape the success of ERP. This c...

With suicide remaining a leading cause of death for people aged between 15-44 in Australia, clinicians in the OCD space need to ask the question: How do we differentiate between suicidal ideation and obsessive intrusive suicidal thoughts? In this episode, we discuss how to work with a client when they come to you with suicidal thoughts, why it is critical to take all mentions of suicide seriously,...

Felicity Phillips is the Founder of Weight of the World, a community-driven organisation supporting people with eating disorders and their carers through recovery. Weight of the World aims to provide peer support and education while challenging diet culture and promoting body neutrality. In this episode, Felicity shares her personal journey from pre-professional ballet to developing an eating diso...

It's normal to have doubts and questions about our relationships sometimes. Am I in love with my partner? Am I spending enough time with my parents? Are my friends mad at me? But what happens when those normal, passing concerns turn into an obsession? In this episode, we explain the difference between ordinary relationship concerns and relationship OCD (ROCD), how to identify when ROCD is showing...

This is the final part of our two-part chat with Dr Bianca Mastromanno. In the last episode, Bianca discussed how she works with parents to process their childhood experiences and help them navigate parenthood themselves. In this episode, Bianca opens up about her personal experiences with parenting anxiety, digs into the challenges faced by parents with OCD, the impact of OCD on early parenthood,...

Dr Bianca Mastromanno is a Clinical Psychologist who works extensively in the perinatal space. Bianca uses a trauma-informed, evidence-based approach to support parents and children living with mental health concerns. In this episode, Bianca explains how she works with parents with OCD or other mental health challenges to explore and process their own childhood experiences to help them navigate th...

This is the final part of our two-part chat with Lindsay and Emily Stetzer. In the last episode, Lindsay and Emily opened up about their early experiences with OCD and how their lived experiences led them to create Presently Bracelets. In this episode, Lindsay and Emily discuss the household dynamics of living in a family with OCD, the significance of non-accommodating support, and the role of exp...