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 routines, the impact on relationships, parenting, work, and health — and the quiet suffering that often goes unseen.

We explore both physical contamination fears (germs, illness, food safety, asbestos, chemicals) and moral contamination, where people fear being “tainted” by proximity to someone or something that conflicts with their values. The episode also tackles one of the trickiest clinical questions: how to work with ego-syntonic rules without turning therapy into another rigid rule system.

This is an essential listen for clinicians, clients, and loved ones wanting a clearer, more compassionate understanding of contamination OCD — and how ERP can be done flexibly, ethically, and effectively.

💬 Key themes:

• What contamination OCD really looks like behind closed doors
• Why it’s not about being “clean” or “house-proud”
• The physical toll: pain, skin damage, exhaustion, hunger
• Food avoidance, illness fears, and misdiagnosis with eating disorders
• Moral contamination and value-based fear
• Ego-syntonic vs ego-dystonic rules
• How to assess contamination OCD properly
• Flexibility vs rigidity in treatment
• ERP without reinforcing “right vs wrong” rules
• Helping clients choose values over compulsions

💡 “Contamination OCD holds people hostage.”

🧠 “This isn’t quirky — it’s devastating.”

💬 “There is no ‘right’ amount. Flexibility is the goal.”

🔖 Chapters

00:00 Why we avoided this topic (and why we’re doing it now)

01:00 What contamination OCD actually means

02:30 Moral contamination explained

05:00 The physical and emotional toll

08:00 Illness fears, COVID, and community safety

10:00 When contamination affects parenting and relationships

12:00 Ego-syntonic rules and client-led goals

14:00 Flexibility vs rigid hygiene rules

16:00 ERP and realistic exposure work

19:00 Messing up rituals and tolerating uncertainty

22:00 Assessment questions clinicians should be asking

25:00 Creative exposure ideas

27:30 Final reflections and encouragement

#OCD #ContaminationOCD #ERP #TherapyPodcast #MentalHealthProfessionals #OCDRecovery #ExposureTherapy #BreakingTheRulesPodcast #ClinicianSupport #MentalHealthAwareness

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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 clarity before taking action—and how that waiting quietly reinforces avoidance. The discussion moves beyond symptom management and into the deeper work of distinguishing thoughts vs feelings, building emotional literacy, and helping clients move forward despite anxiety rather than waiting for it to disappear.

This episode is especially valuable for clinicians working with ambivalence, treatment resistance, or clients who feel “stuck” before starting ERP or making meaningful behavioural change.

💬 Key themes:

• Why “ready” is not an emotion—but a choice
• The difference between thoughts, feelings, and bodily sensations
• How emotional reasoning keeps OCD in control
• The trap of waiting for certainty before acting
• Using ACT, motivational interviewing, and values-based action
• Helping clients name fear, dread, shame, and excitement accurately
• Why language matters in therapy—and how it can open or close change
• Moving clients out of intellectual insight and into embodied experience
• Supporting behaviour change without reassurance or avoidance

💡 “Ready is not a feeling—it’s a decision.”

🧠 “Certainty is the fantasy OCD keeps chasing.”

💬 “Of course you’re scared—and you can still act.”

🔖 Chapters

00:00 Introduction and the origin of the idea

03:00 What clients mean when they say “I don’t feel ready”

05:00 Readiness, certainty, and the OCD trap

07:00 Thoughts vs feelings: why we confuse them

09:30 Emotional reasoning and avoidance

11:00 Values-based action and willingness

13:00 Naming emotions vs shutting change down

15:00 Anxiety, excitement, and bodily sensations

17:00 Moving from insight to action

19:00 Why waiting for readiness keeps clients stuck

21:00 Final reflections for clinicians

#OCD #TherapyPodcast #MentalHealthProfessionals #ERP #ACT #BehaviourChange #ValuesBasedLiving #BreakingTheRulesPodcast #ClinicianSupport #AnxietyRecovery

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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 scrupulosity shows up across children, teens, and adults, often hiding beneath “good behaviour,” people-pleasing, over-apologising, and chronic self-monitoring. We also dive into why some clients become stuck in ERP when the underlying issue isn’t OCD at all, but rigidity, control, and ego-syntonic perfectionism associated with OCPD.

This episode is especially valuable for clinicians navigating stuckness, treatment resistance, or confusing presentations—and for anyone who has ever felt trapped by the need to be a “good person.”

💬 Key themes:

• What moral scrupulosity really looks like in OCD
• Why guilt, confessing, and reassurance-seeking are so sticky
• How moral scrupulosity differs from OCPD at a structural level
• Why ERP works for OCD—but often fails for OCPD
• The role of values, culture, religion, and social media pressure
• Common compulsions: confessing, rumination, reassurance, over-apologising
• When rigidity is fear-driven vs personality-based
• How to treat OCPD using schema, ACT, and DBT-informed approaches
• What to do when moral scrupulosity and OCPD co-occur

💡 “OCD hijacks your values and turns them against you.”

🧠 “Good people still have messy thoughts.”

💬 “Rigidity isn’t always anxiety—sometimes it’s identity.”

🔖 Chapters

00:00 Introduction and why this topic matters

02:00 What is moral scrupulosity?

05:30 Why it’s common in kids and teens

08:00 Defining OCPD and why it’s often mislabelled as OCD

11:00 Key differences between OCD and OCPD

14:00 Guilt, confessing, and moral pressure in adolescents

17:00 Social media, cancel culture, and moral anxiety

20:00 Common compulsions in moral scrupulosity

22:00 Psychoeducation vs reassurance

24:00 ERP exposures for moral scrupulosity

27:00 Treating OCPD: flexibility over exposure

30:00 When moral scrupulosity and OCPD overlap

33:00 Differential diagnosis, supervision, and formulation

36:00 Clinical honesty and naming rigidity in the room

#OCD #MoralScrupulosity #OCPD #TherapyPodcast #MentalHealthProfessionals #ERP #Perfectionism #ValuesBasedTherapy #ClinicianSupport #BreakingTheRulesPodcast

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