The OCD Stories

Dr Steven Phillipson: Look at you looking at me, and other niche OCD spike themes (#488)

Jun 1, 2025
Dr. Steven Phillipson, a licensed clinical psychologist and Clinical Director at the Center for Cognitive Behavioral Psychotherapy in New York, dives into niche themes of OCD. He discusses obsessive worries about social perceptions, body dysmorphic disorder, and even bizarre fears like fearing your child isn’t yours or being in a simulation. Phillipson emphasizes the complexity of OCD, the importance of accurate diagnoses, and the societal stigma around mental health. His insights offer hope and navigate the intricacies of managing obsessive thoughts.
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INSIGHT

OCD Themes and Core Emotions

  • OCD themes are not realistic but feel emotionally authentic to the brain, leading to desperate behaviors.
  • The core emotions driving OCD include anxiety, guilt, shame, disgust, anger, and depression, which fuel these illusions.
ANECDOTE

Drug History Altering Appearance

  • Some people with OCD obsess that drug use altered their appearance and others can detect it.
  • They overinterpret subtle social cues like blinking as signs others are disturbed by their look, leading to avoidance or reassurance-seeking.
ANECDOTE

Olfactory Obsession Example

  • People with olfactory obsessions believe their body emits a foul odor noticed by others, like bad breath or body smell.
  • One patient thought a fan was turned on to disperse her bad breath, despite no real odor detected.
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