The OCD Whisperer Podcast with Kristina Orlova

105. Is There a Difference Between Automatic and Intentional Thoughts in OCD? with Michelle Massi

Jan 9, 2024

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Our minds are fascinating realms capable of producing a myriad of thoughts, some fleeting and inconsequential, while others persistently tug at the edges of our consciousness. For individuals grappling with Obsessive-Compulsive Disorder (OCD), this mental landscape can be particularly challenging to navigate. One crucial aspect of understanding OCD lies in differentiating between automatic and intentional thoughts, unraveling the intricate dance of the mind, and shedding light on the often misunderstood concept of thought-action fusion.

In today’s episode of The OCD Whisperer Podcast, we sit down with Michelle Massi, a licensed marriage and family therapist with over 15 years of experience treating Obsessive-Compulsive Disorder (OCD). Michelle has a private practice in Los Angeles and has worked at the UCLA OCD Intensive Treatment Program and the UCLA Childhood OCD Anxiety and Tic Disorders Program

During our conversation, we discussed the difference between automatic and intentional thoughts, particularly with intrusive thoughts experienced by individuals with OCD. Michelle explains the concept of thought-action fusion and emphasizes that having a thought does not define a person's character. She also discusses the role of guilt and shame in OCD, encouraging individuals to have self-compassion and recognize that everyone has negative thoughts or biases. The conversation also touches on exposure and response prevention therapy.

In This Episode

[03:27] Automatic and intentional thoughts
[03:36] Thought-action fusion
[07:31] Overly paying attention to negative thoughts
[08:06] Automatic and intentional thoughts (revisited)
[09:42] Labeling thoughts
[13:38] Certainty and uncertainty
[15:44] Imaginal exposure scripts
[16:28] Pushing clients beyond normal limits
[19:49] Alternative approaches to imaginal exposures
[23:14] Guilt and shame from judgment
[24:40] Recognizing intrusive thoughts
[27:30] Self-compassion and inner conversation

Notable Quotes

[09:15] "If I have the thought, like, what if this bad thing happens, I have 100% control over whether or not I'm going to do anything with that thought." - Michelle
[13:39] "I don't need to solve a problem that doesn't exist yet. I haven't yet stabbed somebody, so I don't need to worry about whether or not I'm going to." - Michelle
[22:02] "I don't need to sit there going, 'Oh my God, I didn't die. It's like, I don't know if I did or not. And right now I'm doing the dishes, so I'm going to focus on doing the dishes. I don't need to have this argument." - Michelle
[29:42] “You’re not alone. You can get help, find support, and find a community to connect with.”

Our Guest

Michelle Massi is a seasoned mental health professional with over 15 years of expertise in treating Obsessive-Compulsive Disorder (OCD) and anxiety disorders. As the former Associate Clinical Director at the UCLA OCD Adult Intensive Treatment Program, she navigated the complexities of comprehensive care. Michelle's commitment to advancing the field is evident through her role as an International OCD Foundation (IOCDF) BTTI faculty member and a consistent presenter at the IOCDF Conference from 2009 to 2023. With a focus on education and collaboration, she extends her impact by offering training and consultation to clinicians, clergy members, and family members, contributing to the broader mental health community.

Resources & Links

Kristina Orlova, LMFT

Michelle Massi

**Disclaimer**

Please note, while our host is a licensed marriage and family therapist specializing in OCD and anxiety disorders in the state of California, this podcast is for educational purposes only and should not be considered a substitute for therapy.

Stay tuned for bi-weekly episodes filled with valuable insights and tips for managing OCD and anxiety. And remember, keep going in the meantime. See you in the next episode!