Obsessive-compulsive disorder (OCD) can feel so dark. It can make a person feel lonely, afraid, isolated, ashamed, guilty, and just plain bad! Therapist Krista Reed breaks through some of that darkness with her vibrant and colorful personality as well as the refreshing perspective that therapy is still effective even when there’s an element of fun included. Thank you, Krista, for sharing your story with us!
You belong to a group of very special people: OCD therapists who also have OCD! How did you decide you wanted to treat the disorder you’d been struggling with?
Originally when I graduated in 2007, I wanted to focus on infant mental health. I was very passionate about working with young children and was working on an infant mental health endorsement and becoming a registered play therapist when OCD took hold of my career. I began having fears of molesting my young clients, who several of them were in therapy for sexual abuse. I went to someone in my city who reported on his website that he specialized in OCD. The session was hands down one of the most humiliating experiences in my life. I shared with him the fear of molesting my young clients and he then proceeded to do a risk assessment on me and then reassured me that I was “harmless” and “nothing was wrong.” I recall leaving his office feeling terrified that he would report me, I would lose my license to practice, my husband would leave me, and I would be abandoned by everyone. I lived for years struggling with my OCD and having little to no trust in therapists, even though I was one, and I believed that this was just going to be my life. Eventually, I heard about exposure and response prevention (EPR) therapy. Unfortunately, I could not find anyone locally who treated it. Also, it was hard to find a therapist who I already did not know. In 2016, I learned about ERP and while learning how to utilize this intervention to clients, I began learning how to do exposures myself. The more I got into ERP, also incorporating mindfulness, I noticed that I was in fact getting better. I just feel in love with this work and knew that this was something that I wanted to do throughout my career.
In addition to treating OCD you also treat body-focused repetitive behaviors (BFRBs) and body dysmorphic disorder (BDD). We both know there are a ton of misconceptions about what OCD is—are there any misconceptions about BFRBs or BDD you’d like to clear up?
Body-focused repetitive behaviors and body dysmorphic disorder are both not obsessive-compulsive disorder. Very frequently, a client will step into my office with an OCD diagnosis when they may only pull their hair (trichotillomania) or spend countless hours in front of the mirror camouflaging their “perceived flawed” area (this is a common compulsion with BDD). These disorders may fall under the “Obsessive Compulsive and Other Related Disorders” chapter in the DSM [Diagnostic and Statistical Manual for Mental Disorders], yet they are different. Both BFRBs and BDD have different treatments than OCD. Just as it can be harmful for a clinician to falsely advertise that they treat OCD, it can also be harmful and shameful for a clinician to attempt to treat BFRBs and BDD without the proper education.
You treat OCD with cognitive behavioral therapy (CBT), specifically ERP, but you sometimes supplement that treatment with play and art therapy as well as yoga and mindfulness. How can these techniques all work together to help your clients with OCD?
I am just a big kid who loves to play and be silly! OCD caused me to believe the fear that people would judge me or dislike me because I am playful and silly. I have learned that this is true with so many OCD sufferers. Although exposures can be scary, disgusting, and stressful, I enjoy finding ways that not only incorporate the individual’s values into them, but also finding something that might also be somewhat fun. Yes, that might sound like a contradiction, but hear me out. Adults can make mud pies, run around barefoot outside, lick the cake batter off a mixer, do cartwheels in public, and even play on a playground with their children or relatives. When creativity, artistically or physically, is used, the possibilities are endless for how exposures can be done. I also love to incorporate food. Doing mindful eating with “unsafe” foods can be extremely cathartic and healing for people struggling not only with OCD, but also ARFID [avoidant/restrictive food intake disorder] and emetophobia.
One of my all-time favorite exposures was singing Christmas carols, in public, in the middle of summer. My client had an absolute blast and even went around throughout the week and went to neighbors’ homes to go caroling!
I have OCD, but I also have fears I don’t consider OCD symptoms, like a fear of heights. Would my fear of heights be treated similarly to my OCD symptoms, with gradual exposures?
Absolutely! With OCD the thought that brings distress can occur even when someone is away from the feared/disgusting stimuli whereas with a phobia, the distress primarily occurs when exposed directly with the feared/disgusted stimuli. For example, your fear of heights might not bother you unless you are in an elevated situation. As with OCD, working alongside a professional who is trained to work with phobias is advised, as if an individual is exposed to the fear too soon, they might feel “flooded” and discontinue treatment.
Your Instagram posts are so fun and inspiring! Where do you get your ideas? Do you have a background in acting or dance? There’s so much creativity at play.
(Blush) Well, thank you! I grew up loving art, music, theater, and simply am blessed with being incredibly right-brained. I went to Kansas State University with a performance scholarship as I wanted to be on Broadway and then eventually movies. I still have a passion for musical theater and try to see as many musicals as possible.
As far as where do I get my ideas, well, I suppose you can thank my OCD for that one! I hid my disorder for years and I found ways using my creativity to mask it. Honestly, I just got fed up masking my authentic self that now I embrace it. I have learned to put myself out there, be colorful, and be seen. OCD never wanted me to be seen and now I am enjoying my life not being OCD’s understudy.
You recently launched a series of 90-second videos called Taboo Tuesdays, which you will post every Tuesday of 2023. Why did you think it was important to focus on taboo obsessions?
I have been treating OCD for nearly six years and constantly see people struggle to enter treatment for the fear of being judged by the one person whose job it is to not judge them. I want to educate anyone who is willing to listen about what “real OCD” is and that taboo obsessions are not only common, they are treatable. I am fed up with comments about OCD sufferers being dangerous, or pedophiles, or simply it is all about “being clean.” The more information we put out there, not just with my “Taboo Tuesdays” but your blog, OCD advocates, podcasts, etc., the closer we are getting to erasing the stigma of this disorder.
What is the ICT OCD Alliance, and why did you found it?
2020 sucked. Obviously. It was one of the most challenging years I have ever had as a clinician. More and more individuals were seeking therapy services than ever. Being one of the few OCD specialists in my area, I was struggling to get people into the office timely. I only knew one other clinician in the state who treated OCD. She and I were both overwhelmed and wanted to support one another. She heard of another clinician who treated OCD and then I found two more! It felt like a dream come true! We started meeting toward the end of 2020 providing support, education, training and OCD resources, and referrals to one another. Then in 2021, I bought the rights to the name “ICT OCD Alliance.” ICT being Wichita, Kansas, and the word “alliance” because we all advocate for the same cause—getting people who have OCD-related disorders the help they deserve without struggling to find therapists through Google and false advertising. Each therapist who is a part of the alliance has been treating OCD for a minimum of one year using evidenced-based treatments. We are simply a group of clinicians, each with their own practice, who support one another and provide grassroots advocacy for our community. We meet twice a month, once for consultations and the other for advocacy and plans of the community (presentations, trainings, podcasts, etc.) Our goal comes down to my own therapy experience: I never want anyone with OCD to ever feel harmed by their clinician. I want every single person with OCD to find someone who can treat them and guide them toward recovery. This past year our group even provided presentations at the Denver IOCDF conference.
If you could share just one piece of advice with someone who has OCD, what would it be?
Actually I would like to share a poem versus advice. Ironically I just wrote this poem today. The poem is a letter to my younger self.
To Who I Was,
Who I Am
You were little, young, and fragile
Thoughts filled your head; Damnation
You felt alone, weak, and helpless
You were just a child; Desperation
Words never escaped your tongue
The thoughts echo; Alienation
Little girl crying on the swing
To Hell you would go; Devastation
Weird, awkward, and frightened
Frozen in fears; Stagnation
Grey, Black, and Hidden
Transparent rainbow; Imitation
A mixture of future’s chaos
Swarming the mind; Insubordination;
Quiet the tomorrow tornadoes
Breathing restriction; Suffocation
Life’s beauty untouchable
Stuck with Moments; Dissociation
Your hope was never fully buried
Stubborn young girl; Determination
You’re no longer little, young, or fragile.
Thoughts still fill your head; Toleration
You no longer stand alone weak and helpless.
Embracing inner child; Unification
Your memories now occupy rooms
The thoughts muted; Innovation
Little girl flying on the swing
Mindfully present; Transformation
Brave, graceful, and eccentric
Facing the fears; Celebration
Blue, Green, and exposed
Fluorescent rainbow; Imagination
Blending of time’s surprises
Encompass the mind; Collaboration
Waking today’s atmospheric wave
Openly breathing; Intoxication
Enveloping life’s beauty
Unstuck in moments; Participation
Your hope will never be fully buried
Stubborn young girl; Liberation