Unpacking OCD Part 2 with Dr. Patrick McGrath

**Dr. Drew Pinsky** (0:10)
Hey, welcome to The Dr. Drew Podcast, everybody. Appreciate you all supporting the people who support us. Any suggestions, contact to drdrew.com. Don't forget the streaming show, Ask Dr. Drew, Tuesdays and Wednesdays, Thursdays at 3 o'clock. Check out the Rumble channel. We are almost at 300,000 followers. Do get us over the top there, and sign up and subscribe. We appreciate it. Today is part two with Dr. McGrath, with Dr. Patrick McGrath, Chief Clinical Officer at NOCD, Clinical Protocols, OCD Specialist, one of the world's leading provider, Virtual Therapy for OCD. And we had such a great conversation last time, in spite of, Dr. McGrath has already given me shit about the fact that I'm in the background, which I don't think, I really didn't disturb me, and I'd be shocked if it disturbed any of you. Alan, our tech person, insisted that it wasn't bad, except one time. Secondly, Dr. McGrath was so interesting that I'm going to bet that you were more focused on that than anything technically that was going on in this room.

**Dr. Patrick McGrath** (1:13)
Well, let's hope, yes.

**Dr. Drew Pinsky** (1:17)
Tell everybody who may be people who did not catch the last episode about NoCD.

**Dr. Patrick McGrath** (1:22)
NoCD is an online platform for the treatment of OCD and related conditions, so we work with hoarding, body-focused repetitive behaviors, tics. We'll do exposure and response prevention therapy, the gold standard of treatment for OCD. We do habit reversal training, and we'll do CBT for hoarding. And we do all of this virtually. And we also have for our members support groups that they can attend. And there's an OCD app, which is free, and people can download and join the largest community of people with OCD in the world.

**Dr. Drew Pinsky** (1:53)
And good outcomes, this is evidence based through and through. And do you deal with generalized anxiety disorder also?

**Dr. Patrick McGrath** (2:01)
Sure. We see that happening a lot with people who have OCD. Or there's a lot of people who come in who said they've been diagnosed with that. Because as you know, a lot of people, the first person they'll tell their anxiety to is maybe a general practitioner. And most of them will hear that there's some worries that they have.
The person may not share their compulsion. And so GAD is kind of a standard give. And so we'll do a diagnostic assessment to really kind of ferret out what's actually going on in that situation.

**Dr. Drew Pinsky** (2:28)
Right. And for people that, again, might have missed the last show, talk a little bit about exposure therapies and how people with OCD and these disorders have been sort of mistreated for many years and how effective it is if you do this properly.

**Dr. Patrick McGrath** (2:43)
Yeah, obviously talking about OCD is only going to make OCD worse over time instead of better, because you're going to go into safety behaviors. You're going to be providing a lot of reassurance, probably teaching people distraction techniques. And OCD loves a compulsion and a safety behavior. So we want to work on eliminating avoidance of things. We want people to do things without being told constantly they're going to be fine or OK. We want them to fully engage in it without distractions. We don't want them using substances as a way to try to manage the feelings. And we're here to help people learn to eliminate compulsions. So that's why we need people to do the things they fear and learn that they can handle it. You don't have to become comfortable with everything. As long as you know you can handle something, it doesn't have to then control your life.

**Dr. Drew Pinsky** (3:26)
And tell me again about hoarding and how you guys approach that, because hoarding is that we've discussed is a constellation of disorders that have a common expression.

**Dr. Patrick McGrath** (3:36)
Yes, I did some of the hoarding TV shows that was always fascinating to be in people's homes.
And I'm a big fan of the four box method. So you'll get a keep box, a donate box, a recycle box, and a trash box. And we can effectively take all things you have and kind of reduce them to a quarter of what you have. Because once you fill the keep box, the first thing someone with hoarding does and says, I filled the keep box, I need another one. And we say, Nope, you got to fill the other three boxes too. And then as a therapist, or if you're working with someone who's there in the home with them, as we do this virtually, you have to make sure that that other person takes the donate, the recycle and the trash boxes away from the home. Otherwise, I don't know, Drew, if you've seen them, but these gnomes at three in the morning, go outside, grab everything, and just bring them back in the house again. And so we want to make sure that that doesn't actually happen and that you are reducing the things in the home.