Therapist Maggie Perry presented at the 2020 OCD Gamechangers, and it’s easy to see why: With her creation of Huddle.care, an innovative online therapy program, she is helping change the way individuals with OCD and anxiety get treatment. Feelings of isolation and shame don’t stand a chance against support from a therapist and peers who get it. Thank you for being here, Maggie!
How long have you treated OCD? What led you to focus on OCD and anxiety?
I’ve been treating anxiety and OCD full-time for seven years. I trained at the Anxiety and Stress Disorders Institute of Maryland for my doctoral internship and post-doctoral fellowship. Since then, I owned an in-person private practice in San Francisco for two years and have been running Huddle for three years. I’ve been excited about anxiety disorders and OCD since my training because (1) they are treatable through cognitive and behavioral methods, (2) sufferers can make quick progress, and (3) some treatment interventions are hilarious. Put another way, I’m highly motivated by helping people get better and I find the process of psychotherapy for anxiety and OCD interesting, fun, and meaningful.
Tell us about Huddle.care. Why did you create it?
Huddle.care is a group therapy program that meets by video chat. It includes education, community time for progress and accountability, small group therapy, and individual sessions. I created it because I love group therapy. I believe that group therapy is the best way to overcome shame. Group therapy is not popular because it is difficult to schedule. I created a model that overcame some of the challenges of scheduling by putting it online and allowing people to come at any time.
Most of my readers are familiar with standard treatment for OCD, seeing a therapist one-on-one, in person. What makes Huddle.care different, and why is it so effective?
Huddle.care uses the evidence-based methods you’d expect in individual therapy, plus the support, validation, and normalization of hearing other people going through the same thing. It is effective because the support of other people reduces shame and increases motivation and hope above and beyond what individual therapy offers.
Having an anxiety disorder can already make a person feel isolated—add a pandemic to the mix and it can start to feel unbearable. You’re offering free online support groups during this uncertain time. What would you tell someone who’s curious about joining one?
I’m offering both free peer support groups and a free month of the Huddle program to provide extra support during the pandemic. The peer support groups are great if you would like to meet other people and discuss your experience with loneliness and isolation during the pandemic. Peer support groups differ from group therapy because there is no leader and you won’t learn cognitive behavioral skills to support your mental health. In the Huddle program, the groups are semi-structured and the topics are decided by the group when everyone arrives. The licensed therapist who is leading the group sets an agenda and decides what cognitive and behavioral mechanisms work best for the topics that the group has decided upon in that group. Everyone gets an equal amount of time to contribute to the group.
Several people with OCD have said they’re actually not anxious about COVID-19, and there are different theories about why. I don’t feel extra anxiety about it, and I’ve wondered if it’s because I feel validated—unlike the doubt my obsessions cause, I know this is real. Or maybe I’m prepared for the uncertainty because I’ve had to develop those skills over the years. Have you had clients say they’re not particularly worried about the virus?
Yes, I think all three scenarios are occurring: some people feel validated that fears that have previously seemed irrational now seem rational, some people already have the skills to relate well to the uncertainty, and some people have had an increase of anxiety because of all of the uncertainties related to the pandemic. Like always, it’s best not to judge what you feel afraid of and why, but rather focus on how to relate effectively to the thoughts, feelings, and sensations that scare you. If you suddenly feel less anxiety because this problem is real, I suspect that your OCD in everyday life is typically maintained by shame about your content. If you don’t have anxiety because you already know how to relate to uncertainty, then your treatment is going great! Keep it up.
When it comes to OCD, what is the difference between reassurance and support?
OCD always come back. You can tell the difference between compulsive reassurance-seeking and support because of how it functions. If you need support, you will feel calm, connected, and supported when you receive it. If you are compulsively attempting to get reassurance, you will get brief relief and then have the urge to get reassurance again. The content of the support or reassurance isn’t as important as how the behavior is functioning. Usually the person who is giving the reassurance can tell that the person asking seems unable to be reassured. The reassurance-seeking person will feel a little better, but then worse after seeking reassurance. Both people should reflect on how they feel to decide whether to offer support or to refrain from reassurance. The best question that both people can ask when a question pops up is, “Would I ask this question if I didn’t feel anxious?” If the answer is “Yes, I would still ask” try delaying for at least 30 minutes, but preferably one day, to see if you would still ask. Any problem that actually needs solving is also a problem tomorrow. If you need support, you’ll also need support tomorrow. For today, see if you can manage your own experience.
If I were to join Huddle.care, how often would I get to see Thompson? Does he have office hours?
Thompson works the same hours I do, although he often sleeps on the job. You will often see him sleeping on the couch behind me. He likes to wag his tail when I laugh and he’s proud of his contributions to your mental health.
If you could share just one piece of advice with someone who has OCD, what would it be?
Avoidance creates, maintains, and intensifies your OCD. Find your avoidances and do the opposite.