Episode 39: Obsessive Compulsive Disorder: What You Need to Know with Gina Abbondante, LCSW
Episode 39: Obsessive Compulsive Disorder: What You Need to Know with Gina Abbondante, LCSW
Obsessive Compulsive Disorder (OCD) is a widely misrepresented mental health disorder. Many people do not know of the debilitating effects OCD can have on those who struggle with it. In this episode, Alyssa sits down with Gina Abbondante, LCSW, as she shares about her own battle with OCD. Gina explains the various types of OCD, the ways in which the disorder can become traumatizing in itself, and expectations people can have as they begin their recovery journey.
Alyssa Scolari: [00:00:23]
Hello folks. Welcome back for another episode of the Light After Trauma podcast. I’m your host, Alyssa Scolari. And this is going to be a good episode. I am saying this right out of the gate because I adore our guests today. And let’s just take a minute to talk about the imposter syndrome, right?
Yeah. This imposter syndrome that so many of us feel like we have. Our guest today is Gina Abbondante. I met Gina through actually as a result of the pandemic through a peer consultation group. Gina is a colleague, fellow therapist, incredible human being. So she has her own group practice that she actually just started up this year and she…
So she does a lot, but her specialty is treating anxiety disorders and obsessive compulsive disorder, particularly in pregnancy and postpartum. So when we talk about imposter syndrome, when I met Gina over a year ago, I was so intimidated. This was like before the podcast is even like a blip on my radar because Gina.
Is just a bad ass at what she does. And each just radiates. When we first started the peer supervision group, I would just sit back and like listen to like the stuff that she would say. And I have been thinking a while about asking Gina to come on the podcast. But I was scared, like imposter syndrome took over and I was like, she’s not going to have time for me.
She’s way too busy. Shotgun would come on my podcast. And then I wrote this blog post, which I think is ultimately what prompted you to reach out to me, right?
Gina Abbondante: [00:02:44]
It was, yeah.
Alyssa Scolari: [00:02:46]
So I wrote this blog post on obsessive compulsive disorder and after writing that Gina reached out to me and I of course giggled like a school child.
Cause I was so excited and she was like, wow: “I thought that you were going to reject me.”
Gina Abbondante: [00:03:08]
Talk about imposter syndrome.
Alyssa Scolari: [00:03:10]
I know. Right. So like here we go. So welcome. Thank you for being here.
Gina Abbondante: [00:03:17]
Yeah. Thanks for having me.
Alyssa Scolari: [00:03:19]
I’m glad that you reached out because I was terrified.
So, can you elaborate a little bit more on like what you do, who you are, what life is like for you? Cause you dabble in so many different things.
Gina Abbondante: [00:03:37]
Yeah. I mean, it’s definitely been, it’s a journey. So I originally started in solo practice just as my own doing my own thing in 2014, I think, and at the time I’ve kind of always specialized in pregnancy and postpartum, mental health, mood disorders, things like that.
And also infertility pregnancy loss, birth trauma, infant loss, all that stuff. And I love it. I just love the population. They’ve just always been really near and dear to my heart. I have two kids, so that probably also plays into it as well. I love it. So I have been in solo practice and then moved into group practice in the beginning of like May 2020 ish, the height of the pandemic, which was nuts.
But you know, here we are. And I do, you know, I specialize in anxiety disorders and OCD. I see a lot of it. I mean, I think anxiety is pretty universal. We all experience anxiety at some point in our life. And for some of us, it does turn into a disorder, which it kind of takes on a life of its own and it becomes a whole other thing.
And for some reason, I think, you know, there are a lot of factors that play into it, but, I see a lot of anxiety disorders and OCD during pregnancy and postpartum, and then add on top of it, (the) pandemic. It’s been a lot. So that is my specialty. I love working with this population. It’s so rewarding to see people when they realize and make that click of like, wow, I really can control this.
There’s nothing wrong with my brain. It’s not broken. I can do this. And to really see people get that empowerment and that sense of agency back that they can do it.
Alyssa Scolari: [00:05:41]
Yeah. And it’s,one of the things that I remember so clearly on like one of our first peer consultation groups, where we were introducing ourselves and you had said like, you know, OCD is a beast and it really resonated with me then, but,
lately as my OCD symptoms, as I wrote in the blog post, have really been exacerbated. I’m like, Oh God, this is a beast. And I think that OCD is portrayed one way, but I don’t think that people truly have a grasp on like its entirety. Like it is not just needing to have an even number on the heat and air or the volume, so could you just first start by like breaking down?
Like what is OCD?
Gina Abbondante: [00:06:45]
Yeah, absolutely. So OCD, obsessive compulsive disorder. It is characterized by having obsessive intrusive thoughts that create anxiety essentially and compulsive actions that we do to neutralize the anxiety. And that is, if we’re talking about how OCD is ever sort of miscategorized or mis-seen that’s it. Is like we often only from the outside, people categorize OCD as just your compulsion’s and it’s really not.
So it’s not just needing things orderly or needing things clean, or it’s not just that. Compulsion’s take up such a range of things. It’s not just physical. Compulsion’s, there’s also a mental compulsions, which are a huge aspect. And I think not seeing quite as much to me, no matter what the DSM says and where it is in the DSM, it is an anxiety disorder.
It originally was seen and characterized as an anxiety disorder. At some point along the line, the powers that be decided it needed its own part in the DSM and I still think that’s nuts. It’s just, it’s an anxiety disorder. So it is characterized by obsessive intrusive thoughts and the compulsive actions that we take to neutralize or get away from that anxiety.
OCD has a few different subtypes or sort of categories underneath of it, there is the straight up OCD. And then there’s something called pure O or pure OCD, which usually is seen as someone doesn’t have physical compulsion’s they just solely have mental compulsions. A lot of times it’s seen as just having intrusive thoughts.
That’s baloney, everyone that has OCD has some kind of compulsion, even if it is a rumination or it’s the mental checking or things like that.
Alyssa Scolari: [00:08:53]
So when you say a mental compulsion, can you give an example of what a mental compulsion is? Cause I have not heard that term before.
Gina Abbondante: [00:09:02]
Yeah, absolutely. So mental compulsions, are there things that we do to try to get away from…
when we have physical compulsion’s, there’s the things that we do with our hands or the things that we say, but mental compulsion’s usually. It’s mostly around rumination. So we ruminate over a problem. Mostly the thoughts that we have, meaning we try to figure out our thoughts. We try to figure out if they’re going to happen, or if they’re going to come true.
We try to prove them true or false. We try to analyze how we feel about the thoughts. Other mental compulsion’s can look like checking. So we check on our sensations inside of our body. Like, do I feel anxious now? Do I feel more anxious now? It can be really just anything that draws attention to, or brings the focus back to the anxiety and the thoughts that we’re having.
And they are very, I have to tell you, they’re very, very challenging to treat because it becomes a habit. And a lot of times those mental compulsions that we have, end up…they’re a habit, they’re things that we’ve been doing for long before the anxiety was and the intrusive thoughts were ever present.
Alyssa Scolari: [00:10:24]
Right. Right. So it’s very, very difficult to treat. Okay. So then you were saying, so there’s two different subsets of OCD.
Gina Abbondante: [00:10:34]
Yeah. So those would be like the, I still categorize it as OCD. I don’t really delineate between OCD and pure O, I think they’re all the same. But underneath of that, in the OCD community, there is a tendency to look at the subtypes of OCD.
Again, it’s all OCD. One is not better than the other, but we look at the different subtypes. So there’s a bunch. We see contamination, OCD, which is, that’s actually broken down into two categories also. So it would be the thinking of I’m going to be contaminated and get sick or be poisoned or something like that.
And then there’s also the contamination of I’m going to feel disgusting or that disgust based contamination. And I won’t be able to shake that feeling of being disgusting. There is sexuality OCD, where people get caught up on thoughts on whether or not they are straight or gay. If they’re a transsexual or not. There is scrupulosity or religious OCD where that really focuses on the morals, whether we’re doing something right or wrong.
Have we broken the law? Are we sending that sort of thing? There’s harm OCD, which is intrusive thoughts about harm coming to us or people that we love either by ourselves or the world at large, that would be things like, am I going to drive and get in a car accident? Am I going to hurt my child? There’s a knife.
Am I going to stab my child? Am I going to stab my loved one? There’s also suicidal OCD that falls under the harm OCD. There’s pedophilia OCD where people worry that they’re a pedophile or not. There’s existential OCD where we have thoughts, these existential thoughts of am I stuck in a glitch? Am I in a video game?
Is this life real? Am I alive really right now? Or am I dreaming? So there’s quite a few different, really anything that can create anxiety can be categorized into something, some sort of a subtype.
Alyssa Scolari: [00:12:53]
Wow. I had no clue that there were so many subtypes and I’ve, I realized that it’s such a huge beast, but I think that the way they teach it or the way it’s in the DSM, which for the listeners out there, as I’m sure many of you know, is like the Holy Grail of where we find mental health disorders, it’s a human being or a group of human beings decided that this is:
“if you have these symptoms, this is what disorder you have.”
Gina Abbondante: [00:13:23]
Yes, a Bible, so to speak.
Alyssa Scolari: [00:13:26]
Right. Exactly. So we take it with a grain of salt, but when it’s in the DSM, it is not like that. It is not described to be as what’s the word I’m looking for, like debilitating as it truly is. Can you speak a little bit on how, I know for me when I was younger, it started out just like washing my hands, like to the point where my skin was just bleeding all of the time.
And then as I got older, my OCD shifted and it became much more debilitating. So, can you talk about some of the ways in which it can be like. I mean, really like knock you off your feet in terms of like your ability to function.
Gina Abbondante: [00:14:17]
Oh yeah, absolutely. So I look at the debilitating factor in two ways. It’s the anxiety and then it’s the actual compulsions.
So. I think the anxiety alone can be debilitating where people feel so overcome with fear of they’re really their own mind. Their thoughts become afraid of the things that we think that that alone can become debilitating and cause people to feel like they just get sucked into their own thoughts.
And then on top of that is the compulsions that some compulsions are so time consuming that people can’t leave the house, you know, that they can’t function on a day-to-day basis. Somebody has a contamination OCD issue where they are concerned that they’re going to pick up AIDS from a drawer handle.
And so they’re sanitizing the door handles in their house repeatedly, but they have to get it just right. And if they don’t do it just right, they have to start all over again. I’ve had clients that it takes several hours to leave their house because of all of the compulsion’s and the things that they have to do physically.
And for those that have more mental compulsions versus physical compulsions, It literally pulls you away from your life. You just get this feeling of like you’re locked in your brain in all of these thoughts and trying to prove whether or not they’re going to happen. And what does this mean about me?
And I feel differently about that thought. Now, what does that mean? Like you just get so stuck in your own brain. You just really lose touch with your own life. It’s awful,
Alyssa Scolari: [00:16:13]
Yeah, it’s like the world is happening in front of you, but you are disconnected and stuck in your own mental compulsions.
Gina Abbondante: [00:16:23]
Yeah. I mean, I can look at it. So from my own aspect, I have anxiety. I have OCD. I’ve had anxiety my whole life. I mean, since I was a child, the first panic attack I remember having was when I was in kindergarten. So it’s been a feature of my life since I was really young. Mostly it would be sort of like pegged on to things, things that created stress.
So school was really hard for me when I was younger, going to school, tests were really hard for me. Anything that required me to perform or do something really proved to be difficult for me. I didn’t develop OCD until really just a few years ago, which is hard. It’s hard to be one thing or be one way your whole life and then wake up and be like a completely different person.
And it really rattles you.
Alyssa Scolari: [00:17:23]
Wow. So you only just developed OCD a few years ago?
Gina Abbondante: [00:17:27]
Yeah. I mean, I’ve had. Listen, we all have intrusive thoughts. That’s just sort of a facet of being a human. It’s just those fucked up thoughts that we have as human beings.
Alyssa Scolari: [00:17:37]
Yeah. Let’s normalize that we all have intrusive thoughts and it doesn’t mean you’re fucked up.
Gina Abbondante: [00:17:43]
I mean, it’s just the way our brain works. Our brain is an amazing machine, but it also does some really bizarre things. So I tell people all the time, like any time that you’re standing on a train station platform. And you have that thought of like, I could just push this person in front of me on the tracks.
That’s an intrusive thought. But most people that don’t have sticky minds or anxiety can just kind of be like, “Oh, that was weird.” And keep it moving. Whereas people that have anxiety and OCD, they get stuck on that thinking. “There’s something wrong with me. Oh my God. I’m having these thoughts. What’s the matter with me?”
So we all have intrusive thoughts. And of course I had had intrusive thoughts my whole life as the rest of us, but it wasn’t until a few years ago when actually my family, my husband and my kids, and I, we went down to Disney and I had had like a really massive panic attack on the way down. And from there I started ruminating on, “Oh my God, what does this mean?”
“Am I going to ruin this trip? I don’t want this.” And just really struggling with the anxiety that, that raised my anxiety and it lowered my threshold for being able to manage the intrusive thoughts. And we were walking in Disney and in our resort. I mean, and I remember having this really big flush of anxiety, thinking about having to take the boat from our resort to the magic kingdom the next day.
And in response to that flush of anxiety, I just had this intrusive thought that said, if this anxiety keeps up this way, you’re going to end up killing yourself. And that was it. I was off to the races. I was, I ruminated the entire trip. Thinking, “Oh my God, I’m a therapist. What does this mean about me?”
“Have I been depressed this entire time? I’m in Florida. I don’t know the mental health system down here. Do I need to fly home? Am I going to ruin this trip for my kids? Like what is the matter with me? “Just I was off to the races.
Alyssa Scolari: [00:19:48]
Yup. That thought train has left the station. It has taken off
Gina Abbondante: [00:19:52]
Yup, absolutely. And it’s a wonder that I don’t exactly know how I got through that trip because it was just like anxiety at a 20, not even a 10, like over the top, you know, but I managed it and it’s interesting looking back, my kids don’t. They never noticed anything was off, which just speaks to the amazing, like actor ability of people with anxiety. Like you’re suffering inside, but outside mostly people have no idea what’s going on.
Alyssa Scolari: [00:20:28]
No idea. Yup. Your kids had no clue. And here you are. And it’s like, boom, onset of OCD. Suicidal. Like I’m gonna kill myself. If this anxiety doesn’t go away. It’s like, Oh God, that’s horrifying.
Gina Abbondante: [00:20:44]
Yeah. And from there I spent the next good probably I would say 10 months, almost a year. Just ruminating endlessly.
And when I tell you, and I tell my clients, this I’m very open with it. I know that feeling. I know that feeling of your anxiety being off the charts, you’re afraid of your own thoughts. You can’t trust yourself, you’re locked inside your own head. I would tell people, I felt like my brain was on fire because it was exactly what it feels like, you know?
Just these thoughts running through and like, “what does this mean about me? And am I dangerous and trying to figure it out?” And then this weird thing happens sometimes where you almost pretend like the thoughts are true and you respond emotionally that way. So it was then I became depressed and, Oh my goodness.
It was just, it was awful.
Alyssa Scolari: [00:21:41]
Absolutely. I mean, I relate to that so much, you know, just the thoughts about the obsessions about like, am I. I have lots of obsessions about like, am I the perpetrator when it comes to being a survivor of sexual abuse? It’s lots of like, well, I’m the perpetrator. Like I did this.
And then I behave as if I am one. Like I closed myself off from the world.
Gina Abbondante: [00:22:10]
Alyssa Scolari: [00:22:11]
All of a sudden my thoughts have become my reality. Yeah. And I’m like, I’m bad. I have to go away. And then I don’t talk to anybody.
Gina Abbondante: [00:22:18]
Right, exactly. It’s so awful. I mean, I tell what I say is that it is the closest that I feel like I have ever come to having a nervous breakdown because it was just so scary on a day-to-day basis, which I think is also very important thing. I think a lot of, even some OCD specialists don’t really touch on is the trauma associated with having an OCD flare up or the onset of it is it is so scary. And the fear that I hear from my own clients and even from myself, is this constant fear of, “Oh my God, is it going to get bad again?”
“Is it going to come back? Can I handle it again”? And I feel like even long after the exposure and response prevention therapy, and once that is over that pervasive feeling of, “Oh my God, is it going to come back again?” That is trauma. That is like the underpinning of the trauma response of having OCD.
Alyssa Scolari: [00:23:31]
So what you’re saying is it’s not necessarily that a history of trauma is linked to OCD. It’s more that having OCD can cause trauma.
Gina Abbondante: [00:23:46]
Or both. I think it can happen both ways. Yeah. I think it can happen both ways. I mean, I certainly have seen my fair share of clients that have trauma history and develop OCD because of their trauma history.
I have clients that didn’t have a prior trauma history and developed trauma because of their experience with OCD. I think it can happen both ways.
Alyssa Scolari: [00:24:14]
Yeah. Yeah. I know that when I was little and I had like, I guess more so like the contamination OCD at that point. I didn’t necessarily have a history of trauma.
So, but now as I get older, I have intrusive thoughts of seeing my loved ones dead. Like that is the most upsetting thing in the world. It is truly traumatizing and, you know, going through an episode where I think this had to have been just a couple of nights ago. My OCD, my intrusive thoughts are through the roof. Trigger warning for anybody who’s listening, intrusive thoughts.
So it was just a couple of nights ago because I’m in the process of coming off. I was on Klonopin for a while and I’m in the process of coming off the Klonopin. And the rebound effect of coming off of any kind of benzodiazepine is like anxiety through the roof. So my intrusive thoughts are coming back and I just, the other night I was looking at my family, like my dogs, and I was just seeing everybody dead and the worst kind of dead and the horror that endured from those images.
Right. Nothing happened. I just have that visual. And then the entire weekend I was down for the count hysterically crying, trying to do anything I could to erase the images from my mind like that is at a level…
Gina Abbondante: [00:25:55]
which is a mental compulsion.
Yes. Yes. And that’s the other thing is that a lot of times we think intrusive thoughts have to be thoughts.
Alyssa Scolari: [00:26:06]
They have to be words it’s very often images. It’s pictures. Yes. That a very good thing to point out. Yep.
Gina Abbondante: [00:26:13]
Totally. You know, I see from my own experience, I couldn’t look outside and see a tree and not have an image of myself, like hanging from it, which was terrifying. I couldn’t walk into my kitchen and see a steak knife sitting on the counter and have these intrusive images of me like cutting myself or hurting myself. It’s just relentless. It was absolutely awful. So I think that’s important as well as a lot of people get tripped up on thinking, Oh, these are thoughts. That means it has to be thoughts. Doesn’t have to be, it can also be urges as well.
People get intrusive thoughts can come as intrusive urges, which happens.
Alyssa Scolari: [00:26:59]
Like an urge to do an action?
Yeah. It could be in response to having a physical sensation and then having an urge to, I need to do this compulsion. I need to, or even the feeling of I’m having this fear of, “Oh my gosh, this awful thing is going to happen.”
Gina Abbondante: [00:27:24]
I’m going to do it. I’m going to do it right now.” For instance, when I have clients that are postpartum and they’re changing their baby’s diaper, they might have a fear of, “Oh my God, what if I’m changing my baby’s diaper? And I sexually abused them. What if I do it right now or giving their baby a bath?”
“And they think. Well, I can just push this baby under the water. Okay. What if I do it right now?” It can feel like urges, which is really scary for people as well.
Alyssa Scolari: [00:27:51]
It’s so important to hear you say that, like, and say things like that out loud, because I think that there are thousands, millions of people who have these thoughts. And don’t feel like they can tell a single soul because of the shame.
Gina Abbondante: [00:28:14]
Absolutely. Absolutely shame and guilt is a huge motivating factor in what keeps OCD hanging around for longer as well. Just having shame of thinking there’s something wrong with us that we’re bad, that we’re evil. That were fucked up in some way.
It feeds that anxiety spiral as well of thinking like, “Oh my God, there’s something wrong with me. I can’t tell someone about this because they’re going to want to lock me up or they’re going to want me to go to a mental hospital or they’re going to take my kids away from me or they’re going to whatever.”
Yeah. I think that’s what keeps people that have these thoughts and have these compulsion’s quiet and in secret for so long.
Alyssa Scolari: [00:29:06]
Yes. Especially people who have kids. Oh yeah. Or even, even younger people who live at home with their families who don’t necessarily understand mental health. And I think that in treatment, one of the most healing moments is when the person is able to speak the thought. And have the therapists not blow up and be like, “Oh my God, that’s horrible.”
Gina Abbondante: [00:29:34]
Alyssa Scolari: [00:29:36]
That is, I think probably one of the most healing moments in therapy now when it comes to like the treatment for OCD, obviously, you know, one of the most well-known treatments is like the exposure.
Gina Abbondante: [00:29:54]
Yeah. So the gold standard is exposure and response prevention, which.
What that really means is we expose ourselves to the things that create anxiety. That’s the exposure part. And the response prevention part means that we don’t allow ourselves to do the compulsions to neutralize or get away from the anxiety. So what that might look like is, again, if you have someone that maybe has health, anxiety, or health OCD, that they have a belief that they’re going to have a heart attack.
Their compulsion might be that they take their pulse multiple times a day. They’re checking in on their heart. It would be allowing those thoughts.”Oh my God. I might have a heart attack and not allowing them to check their pulse.”
And what that does is it teaches us. It teaches our brain that we can feel afraid and be safe at the same time. So our amygdala, which is that fancy part of our brain that creates the fear response. That’s what makes us feel afraid. And because the feeling is so intense, we then believe we are unsafe. And that’s why we do the compulsion is so that we make ourselves feel safe.
So we’re not quite as afraid by taking away the compulsions because compulsions are what feed the anxiety. When we look at OCD treatment, the intrusive thought part and the anxiety part is not the problem. The problem is the compulsions and the behaviors that we do to get away from feeling anxious.
So a lot of therapists will say, if you can do one part of therapy for OCD, it’s just treat the compulsions. Just move away from doing the compulsions. Every day is an exposure for most people, opening their eyes in the morning is an exposure. So you don’t have to plan too much.
The most important part is. Holding back on doing the compulsions.
Alyssa Scolari: [00:32:08]
It’s so difficult. I don’t know. I just even think back to like last night when I was leaving my office, I have this compulsion right now where I light a candle in my office and I will look at it before I leave to make sure it’s blown out.
I’ll leave. And then not believe that I saw that it was blown out. So then I have to drop my stuff, unlock the door again, go back in, look at it. Then lock up again, go to my car and still, I have to force myself to go to my car because I could just go back 10 times and keep looking at that candle.
Gina Abbondante: [00:32:45]
Right. That’s called unproductive reassurance. So two of the most common compulsions that we see with OCD are actually not physical at all. Well, one of them is kind of physical avoidance. And reassurance seeking. So avoidance is obvious, right? So anything that we’re afraid of, we just don’t do it. So anything that creates anxiety, we don’t do it.
If we don’t do it, that makes the anxiety drop way down. Oh, done. You know, we’re fine. We don’t do that again. Yep. Reassurance is very sneaky, especially in the days of the internet, because Googling is probably number one of the reassurance seeking compulsions anytime we put into Google, “why do I feel, or why is this happening?”
Or we never, totally never, it never goes anywhere good Because there’s nothing on the internet going to be able to say you’re totally fine. It’s just OCD.
Alyssa Scolari: [00:33:51]
Yep. There’s not one website out there. Maybe you should make one that pops up.
Gina Abbondante: [00:33:56]
Oh my God, that’d be great. I’d be a millionaire. And we’ll probably not people wouldn’t like it.
They would look for there another answer to that. But it’s really like that reassurance seeking. We look at reassurance seeking in two ways, productive reassurance, which means you can go to the internet. Like if you’re learning how to build a bird house or something, you look for your instructions on the internet, you get a plan, you execute your plan.
That’s productive reassurance. Unproductive reassurance is kind of like what happens when people check, which is: “Okay I’ve gone. I’ve see that I blew it out. I walk away, but I don’t remember.” I’m not sure I can’t handle that uncertainty. I’m going to go back and check again and again and again and again, but because it was never about really checking.
It was just about getting away from that sensation of anxiety and uncertainty that was driving it.
Alyssa Scolari: [00:34:52]
Yeah. Now I’m wondering as I’m hearing you talk, I’m wondering, how did this work for your treatment, with the thoughts of committing suicide? How does treatment work with that? Because you can’t necessarily do, like, I don’t know how does treatment work with that.
Gina Abbondante: [00:35:14]
Yeah. So it was really hard. It got to the point where I would. Let’s talk about unproductive reassurance. I would Google TV shows before I watched them to make sure that there was no themes of suicide in them. I couldn’t even like listen to the radio because like, if Nirvana came on the radio, it would spin me the fuck out.
So, it started with things like that, where I would purposely listen to songs that had themes of suicide or a band member had committed suicide. And I had to listen to them and let the anxiety come and go and not engage in mostly it was avoidance for me. So I had to not avoid, just sit, let the anxiety calm, let the anxiety go.
And kind of teach my brain. No, this is okay. It’s still safe to do this. And then it sort of built from there. I did a lot of, for me, it was a lot of imaginal scripts. So I would write out scripts of what my worst case scenario was in my head of, okay. Worst case scenario is this anxiety continues on. I become nonfunctional.
I can’t leave the house. I can’t take care of my kids. My husband is resentful and angry with me. I can’t work anymore. I fall into a deep depression and because I fall into a deep depression, I ultimately become suicidal and feel like this world is hopeless and this life is not livable. And I follow through on my thoughts and I would have to write that and then read it over and over and over and over again, because the anxiety would do the same. The anxiety would come up, it would spike. And I would have to practice not allowing myself to compulse meaning I couldn’t avoid, I wouldn’t allow myself to ruminate. So it was just sort of like a bit of a different approach because there’s not a whole lot of like physical things that you can do when you have a fear of suicide.
Alyssa Scolari: [00:37:30]
Right. And that was what I was asking, but I guess it’s kind of getting almost creative with the type of exposure because it’s a different type of OCD than just like, “okay, you have to touch this door handle and then sit with it.” But regardless, it sounds like what you’re pointing out is that nobody can stay in a chronic state of anxiety forever. Right? So the goal is repetition until your body regulates.
Gina Abbondante: [00:37:58]
Exactly. Yeah. So the rule is any emotion, even the good ones or the ones we judge as good, only lasts in our body for 90 seconds. Anxiety follows the similar suit. It has a very definitive pattern.
It starts, it rises, it peaks, it falls off and it goes away and that happens in 90 seconds. If we can ride that out without feeding the anxiety. So how do we feed the anxiety? We feed it with those what if thoughts. We feed it with more intrusive thoughts. We feed it with ruminating over whether or not these things are going to happen.
If we don’t feed it and we just let it be, it will cut off and we teach that part of our brain: “Oh, wait, I didn’t have to do X, Y or Z thing. The anxiety left on its own. Hmm. Okay.” The funny thing is though, as I very well know this, we can learn fear and a fear response in two seconds, but it takes way more like wildly more time to unlearn a fear in our brain.
Alyssa Scolari: [00:39:14]
Isn’t that a bitch?
Gina Abbondante: [00:39:17]
It really is.
Alyssa Scolari: [00:39:18]
I know. It’s like, what the fuck, man? Yeah. It can take a split second for that fear to start up, but to be able to get it to go away is work upon work upon work. But the point is is that you can recover from OCD.
Gina Abbondante: [00:39:40]
Oh, absolutely. Absolutely. I will give this caveat though.
So people come to me and they say, what does recovery from OCD look like? And people don’t usually like my answer when I tell them this, because a lot of times people want the answer of, yup, you’re going to wake up. You’re going to do all this and you’re going to have no anxiety anymore. And you’re never going to have another intrusive thought either.
You’re going to be healed. It’s going to be sunshine and rainbows and puppies, and you’re going to be great. And that’s not how it works. What recovery from anxiety disorders and OCD looks like is you learn how to be anxious better. You learn how to become nonreactive to the anxiety. You learn how to become nonreactive to the intrusive thoughts that come, you learn how to be anxious better.
Alyssa Scolari: [00:40:39]
And I would imagine that there’s also like ebb and flow to it where like, there are certain things that trigger it. Like when there are really stressful moments of your life, it may be much harder, but as time goes on, just like you said, you learn to be. Anxious better.
Gina Abbondante: [00:40:59]
Yeah. And yeah, there’s totally going to be times of stress and there’s gonna be things that trigger it and you might have a pop-up intrusive thought.
That’s like, totally you weren’t expecting. And it does spike anxiety, but we use our skills. We know what to do. We do the same thing every single time. So that we don’t really have to think about it too much. Even just yesterday. I was going to pick up my daughter from school. I was a few minutes early, so I parked in the parking lot across the street.
Cause my daughter’s school is weird. You can’t go in until it’s time for pickup. And there was a teenager, but I’m guessing it was like late teensish in the parking lot. Alone playing loud music and immediately my intrusive thoughts went to, “Oh my God. What if he’s a school shooter?” Cause that’s a huge thing of mine in my harm OCD world.
And I wasn’t expecting it. And I noticed it, it caught my awareness and I did the same things I do every time. Okay. We know what to do. You sit here, you let that anxiety calm. You let that anxiety go. You are not going to ruminate over this. Ruminating is a huge compulsion of mine, but I’m not going to ruminate over this.
I am going to act as if everything is okay, let my thoughts come and go and do what you need to do. So it is, it’s a practice. It’s a thing that we have to make those behavior and lifestyle changes and stick with them.
Alyssa Scolari: [00:42:33]
Very difficult one, but one that can be done nonetheless,
Gina Abbondante: [00:42:39]
The way I look at it is it’s awful. And I would not wish this on my worst enemy, but there are worse things.
Alyssa Scolari: [00:42:47]
Yes, but also the discomfort of recovery of going through that process, I still think is easier than staying in a world where OCD runs your life.
Gina Abbondante: [00:43:03]
Oh yeah. Oh yeah, for sure. Cause it really is. It’s all encompassing. If you think of like Howard Hughes, who was like the epitome of someone with OCD, he devolved into a world where he couldn’t leave his house because he took 17 showers a day and he just devolved into a world of his own madness. And that’s totally possible with having OCD, you know?
Alyssa Scolari: [00:43:32]
Yep. When it’s unchecked, that’s what it can become. Did you decide, did OCD become a huge passion of yours after you had that moment in Disney?
Or were you already very passionate about OCD prior to even knowing that you had it.
Gina Abbondante: [00:43:52]
Sort of a little of both? So, because I had always specialized in anxiety disorders. So it had always been on my radar as a passion. Like, you know, it’s really interesting that I see so much of this because anxiety around OCD as an anxiety disorder. I have yet to meet anybody walking on this planet that has any other anxiety disorder and doesn’t have a compulsion.
So that’s where it kind of, the overlap comes in. So, I had been doing ERP and exposure therapy with clients for years, because I would see so much of it in just the regular population of clients.
And then it was interesting. You would think that by knowing what to do that when you start to experience yourself, you know what to do and you don’t .The short answer is you don’t. That’s a very different thing to be able to do it for someone else, but when it comes to you and ourselves, I was in the weeds.
So that sort of renewed my passion for it, for knowing, for getting to that place of like, Oh, wow. Yeah. Like I knew what panic attacks were before, but now I know what this is like, and Oh, this is a whole different thing.
Alyssa Scolari: [00:45:23]
Whole different ball game. Oh my gosh. So now. Your group practice. Are you accepting new patients right now?
Gina Abbondante: [00:45:33]
We are. So we have as myself and I have another therapist who also specializes in OCD. We all have our little are things that we are interested in or our population, so to speak, but we are accepting new clients. We have some clinicians that specialize in adolescents, which is huge because there’s so many adolescents and kids that need therapists and just not enough therapists to go around.
Alyssa Scolari: [00:46:02]
Yes. Not enough adolescent therapists out there. That’s for sure. Sure. That’s for sure. And it’s Change of Mind Counseling, is that correct?
Gina Abbondante: [00:46:13]
Yes. It’s Change of Mind Counseling.
Alyssa Scolari: [00:46:16]
So I will definitely pop that into the show notes for anybody who is listening today, who is interested. Obviously from the conversation you can tell Gina knows her shit. I learned a lot today, a lot about OCD.
So thank you for coming on the show and for being vulnerable, because I think it’s really hard. You know, and I know we were talking a little bit about this, like prior to recording, but I think it’s really hard to be vulnerable as a therapist because there’s just this, I don’t know, idea that therapists are…
Gina Abbondante: [00:46:56]
That we have our shit together. Yeah, that we together, which is like furthest from the truth. I mean, listen, we didn’t get into this field because we’re like these epitome of perfect mental health. We got into it because we’re in struggled with our own shit.
Alyssa Scolari: [00:47:15]
Right, right. I’m not the portrait of a mental health over here. Yeah. No, there’s this idea that we just like are not affected and that we have all the answers to life and it’s like, we don’t and we struggle.
And I think it takes a lot to just break down that barrier and just say “Hey, no, I’m a human too.” And part of you going through this and you being in recovery is part of what makes you, I think, such a good therapist.
Gina Abbondante: [00:47:50]
Yeah. I mean, I think, I think it’s important. I think it’s the relatable aspect.
I think people want to hear. They want to hear their story. They want to hear other people have been through a similar experience to them and they’re not alone. And. I try to normalize that as much as possible. And I’m very open with my clients about that. I have OCD that I’m in recovery from it, you know, some days are better than others.
And I think that’s really important because I think we have to normalize the struggle. That it’s normal to have days that are good and some days are bad and that’s okay. It doesn’t mean that it’s going to be all good or all bad, or what that means something about you and your coverage journey.
And I think that’s super, super important.
Alyssa Scolari: [00:48:44]
Yeah. I think it’s one of the most powerful parts of the therapeutic relationship is like the ability to just kind of like be a human, for sure. So thank you so much for coming on today.
Gina Abbondante: [00:48:56]
Yeah, well thank you for having me. It was great.
Alyssa Scolari: [00:49:01]
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