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Breaking the Rules: A Clinician's Guide to Treating OCD: Daily Summaries Delivered
by Dr Celin Gelgec and Dr Victoria Miller
Breaking the Rules is a show for mental health professionals designed to help you build confidence in treating Obsessive Compulsive Disorder (OCD). Effective treatment of OCD requires commitment, creativity and the recognition that things can sometimes get a little … messy. And on the show, you’ll hear from a range of leading professionals and learn everything there is to know about OCD and other related mental health concerns. This podcast is brought to you by Melbourne Wellbeing Group, a psychology practice based in Melbourne with a special focus on treating OCD. Hosted on Acast. See acast.com/privacy for more information.
Latest Episodes
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- Yesterday19 min
Counter Conditioning: The OCD Tool Your Therapist Might Not Have Told You About
ERP is the gold standard for treating OCD. But what happens when disgust — not fear — is running the show?In this episode, Celin and Tori unpack counter conditioning: a behavioural technique that pairs OCD triggers with something pleasant or neutral to help clients actually access exposure work. It sounds counterintuitive. That’s kind of the point.They cover:What counter conditioning actually is (and why Quentin Tarantino is a perfect example)Why disgust doesn’t respond to exposure the same way fear doesHow to use it without accidentally creating a new compulsionThe “floaty” principle — softening ERP without losing the exposurePractical tools: smells, tastes, humour, National Geographic baby animalsWhy doing ERP with your client — not to them — changes everythingWhether you’re a clinician looking to expand your toolkit or someone who’s found traditional ERP overwhelming, this episode offers a genuinely fresh perspective on what accessible, creative OCD treatment can look like.Follow us on Instagram @melbournewellbeinggroupListen on Apple Podcasts, Spotify, and YouTube. Hosted on Acast. See acast.com/privacy for more information.
- Sep 21, 202633 min
I Think My Child Might Have OCD: What Do I Do?
This one's for the parents.In this episode of Breaking the Rules, Dr Celin Gelgec and Dr Tori Miller tackle one of the most common questions they hear from families - I think my child might have OCD. Where do I even start?The episode begins with Celin sharing a moment from a school tour with her three-year-old daughter — catching herself wondering whether her daughter's leaf-counting was a compulsion, before laughing and pulling herself back. It's a perfect illustration of what happens when you know too much. And also of the core question this episode explores: how do you tell the difference between normal childhood behaviour and something worth paying attention to?They walk through the watch, wait, wonder principle — why not rushing in to diagnose, label, or rescue is often the most helpful thing a parent can do. They explore what normal development looks like at different ages, why the 7–12 age group is when OCD most commonly first emerges, and what the telltale signs are that something has shifted from typical childhood anxiety to something more persistent.They also get practical — what to do if you're worried, who to talk to, and which resources are worth your time.Warm, funny, honest, and genuinely useful. Whether you're a parent with questions, a clinician who works with families, or someone who grew up with OCD and is finally making sense of it — this one's for you.In this episode, you'll learn:Why context and developmental age are everything when it comes to reading your child's behaviourThe watch, wait, wonder principle — and why not rushing in is actually the most helpful thing you can doWhat typical development looks like at different ages — and why so much of what looks like OCD is actually completely normalWhy the 7–12 age group is when OCD most commonly begins — and what developmental factors contribute to thatThe difference between typical childhood anxiety and reassurance-seeking vs OCD-specific patternsThe telltale signs that something has shifted — frequency, intensity, impact on functioning, and family lifeThe one sign that's most specific to OCD: when one reassurance is never enough, and it needs to be said in just the right wayPractical next steps — GP, maternal child health, psychologist, and the community resources worth knowing aboutWhy your job as a parent is not to stop what's happening — it's to help them with what's happeningResources mentioned:Anxiety Recovery Centre of VictoriaInternational OCD Foundation — iocdf.orgNatasha Daniels — YouTube and parenting communityEli Lebowitz — resources for familiesNew episodes of Breaking the Rules drop fortnightly. Follow or subscribe so you don't miss one.www.melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
- Sep 7, 202631 min
OCD or Anxiety? It's Not a Black and White Question
OCD or Anxiety? It's Not a Black and White Question The question has been coming up in supervision a lot lately. Is this OCD — or is it GAD? Specific phobia? Health anxiety? Social phobia?It sounds like a simple diagnostic question. It isn't.In this episode of Breaking the Rules, Dr Celin Gelgec and Dr Tori Miller dig into one of the most common and most confusing clinical challenges in the OCD space — differentiating OCD from anxiety disorders that present in similar ways. They explore why OCD and anxiety so frequently co-occur, how anxiety disorders can morph into OCD over time, and why we're increasingly seeing subclinical OCD presentations in the clinic — and why that's actually a good thing.They also talk about what to do when you genuinely can't tell. Why the DSM is a guide, not a definitive answer. And why the most important thing you can do is take your client along with you through the process — because a diagnosis that happens to someone, rather than with them, rarely lands the way it needs to.Celin also shares a story about a client who'd worked through most of her trigger list — and then asked if she had to do the rest. What Celin said, and why, is one of the most honest things we've put in an episode about what it actually means to be done.In this episode, you'll learn:Why OCD was only separated from the anxiety disorders in DSM-5 (2013) — and what that tells us about how much they overlapThe anxiety disorders most commonly confused with OCD: GAD, health anxiety, specific phobia, and social phobiaWhy untreated or poorly treated anxiety disorders can morph into OCD over time — and what to watch forWhy subclinical OCD is showing up more often — and why that's worth treating earlyThe key diagnostic features that separate OCD from GAD in practiceHow scrupulosity OCD gets missed as social phobia — and why it mattersWhy you don't need to know the answer straight away — and how to take your client through the processWhat discharge from OCD treatment actually looks like — and who gets to decideNew episodes of Breaking the Rules drop fortnightly. Follow or subscribe so you don't miss one.www.melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
- Aug 24, 202632 min
Getting Creative with OCD Therapy: When to Go Beyond ERP
ERP is the gold standard for OCD. But what happens when it's not enough on its own?In this episode of Breaking the Rules, Dr Celin Gelgec and Dr Tori Miller explore one of the most important — and least talked about — questions in OCD treatment: when and how to bring in other therapeutic modalities, and how to do it without abandoning the principles that make ERP work.Tori shares what traditional manualized ERP actually looked like in the early days of her career — rate your SUDS, watch the clock, wait for the anxiety to come down — and how the field has shifted since the inhibitory learning model changed the way we think about exposure. Celin reflects on her experience of always working in an integrated way, and why the principles of ACT have always felt like ERP to her — because they are.They also get honest about the moments when ERP becomes a battle. When the exposure menu turns into a war. When a client has every reason in the world not to engage — and what to do instead.Whether you're a clinician looking to expand your toolkit or someone living with OCD who's wondered why their therapist keeps talking about values and mindfulness -this episode will change how you think about what treatment can look like.In this episode, you'll learn:What traditional manualized ERP actually looked like — and how it's evolvedWhy the inhibitory learning model changed everything about how we approach exposureHow ACT principles map directly onto ERP — and why urge surfing is response preventionThe question to ask before bringing in any new modality: is this ERP-friendly?What to do when a client refuses to engage with the exposure hierarchyHow schema therapy, DBT, and imagery rescripting can be woven into OCD work without softening exposureWhy ERP has a 20% dropout rate — and what that tells us about why integration mattersWhen to hold the line and when to shift gears — and how to know the differenceWhy getting your client's life back is always the goal, even when it doesn't look like ERPNew episodes of Breaking the Rules drop fortnightly. Follow or subscribe so you don't miss one.www.melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
- Aug 10, 202641 min
Assessing OCD: The Complete Guide for Clinicians
Four years in, and we're going back to basics.In this episode of Breaking the Rules, Celin and Tori walk through the full OCD assessment process from the ground up - because with new listeners joining and so much focus on treatment in recent episodes, it felt like the right time to start at the beginning.How do you actually assess for OCD? What does a comprehensive clinical interview look like? When do you bring in psychometrics? And what happens when the OCD isn't responding to ERP the way it should?Celine and Tori cover the full assessment process — from taking a developmental history to using the Y-BOCS, working through the DSM-5 criteria, and navigating differential diagnosis. They also discuss PANDAS and PANS: the rare but important condition where OCD is triggered by an infection, why ERP alone won't work, and how asking one simple question about recent illness can completely change a treatment pathway.Whether you're a clinician new to the OCD space, refreshing the fundamentals, or someone who's wondered how OCD gets diagnosed — this one's for you.In this episode, you'll learn:Why a full developmental history is non-negotiable — even with adult clientsThe two age of onset clusters for OCD and why they matterHow to use the Y-BOCS as an interview tool rather than a take-home questionnaireWhy scoring the Y-BOCS isn't enough — and what you still need to checkJonathan Grayson's Freedom from OCD scale as an alternative for clinicians new to the spaceThe DSM-5 criteria for OCD explained in plain languageHow to differentiate OCD from anxiety disorders, autism, OCPD, and other co-occurring conditionsWhat the insight specifier really means — and why good insight doesn't mean mild OCDWhat PANDAS and PANS are, how to spot them, and why they require medical treatment firstHow a thorough assessment sets you up seamlessly for ERPAlso featuring: a baby learning to roll over in the background.www.melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
- Jul 27, 202628 min
The OCD Trap Even Therapists Fall Into
When Therapists Spiral Too: What OCD Taught Us About OurselvesCan therapists get caught in the same OCD traps as their clients?Absolutely.In this honest and vulnerable episode of Breaking the Rules, Dr Tori Miller and Dr Dr Celin Gelgec pull back the curtain on a real moment where a late-night social media post sent Celine into an OCD-style spiral of doubt, reassurance seeking and perfectionism. What started as curiosity quickly became hours of researching, second-guessing herself and questioning everything she thought she knew.Using this experience, they explore one of the most important concepts in OCD treatment: transference and countertransference. They discuss how therapists can unknowingly absorb a client's uncertainty, feel the urge to rescue, reassure or change course, and why recognising these reactions is essential for effective treatment.This episode is a powerful reminder that clinicians are human too. The goal isn't to eliminate uncertainty or become the perfect therapist—it's to notice what's happening, stay grounded, and continue modelling the very skills we ask our clients to practise every day.Whether you're an OCD clinician, a mental health professional, or someone living with OCD, this conversation offers valuable insight into perfectionism, uncertainty, and why learning to tolerate not knowing is at the heart of recovery.In this episode you'll learn:How therapists can become caught in the same uncertainty loops as their clients.What transference and countertransference look like in OCD treatment.Why noticing your own urges to rescue, reassure or "fix" can make you a better clinician.Learn more about Melbourne Wellbeing Group:https://melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
- Jul 13, 202635 min
Sex & OCD: The Theme No One Wants to Talk About
Sex & OCD: The Theme No One Wants to Talk AboutSex is one of the most misunderstood and least talked about themes in OCD - but it's also one of the most common.In this episode of Breaking the Rules, Dr Tori Miller and Dr Celin Gelgec explore how OCD can latch onto sex, relationships, identity and intimacy, creating overwhelming shame, fear and uncertainty for people of all ages.From sexual orientation OCD, relationship OCD and contamination fears around intimacy, to intrusive thoughts about loved ones, children or animals, they explain why these thoughts say nothing about who you are—and everything about how OCD operates.This episode is also a practical conversation for clinicians. Dr Tori and Dr Celine discuss how to ask the difficult questions, build enough trust for clients to disclose taboo themes, and create a therapy space where shame no longer has to be carried alone. They also explore how trauma can intersect with sexual-themed OCD, why careful assessment matters, and how Exposure and Response Prevention (ERP) can be adapted to support recovery.Whether you're living with OCD, supporting someone who is, or working as a mental health professional, this episode offers reassurance, practical guidance and a powerful reminder: intrusive thoughts are not intentions, and you are not defined by the content of your mind.In this episode you'll learn:Why sexual-themed OCD is far more common than most people realise.How shame keeps people trapped in silence and delays treatment.How clinicians can confidently assess and treat taboo OCD themes using evidence-based approaches.Learn more about Melbourne Wellbeing Group:https://melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
- Jun 29, 202632 min
When OCD Looks Like An Eating Disorder with Dr Alissa Knight: Part 2
OCD, Eating Disorders & ARFID: Where Do You Start? | Dr Alissa Knight (Part 2)In Part 2 of our conversation with eating disorder specialist with Dr Alissa Knight, we dive deeper into one of the most complex areas of mental health treatment: the overlap between OCD, eating disorders, autism, trauma, and ARFID.How do clinicians untangle symptoms when OCD and eating disorders are working together? What happens when OCD disguises itself as an eating disorder, or when an eating disorder hides behind OCD? And how do you know where to begin treatment when both conditions are causing significant distress?Dr Alissa shares her unique, person-centred approach to formulation, treatment planning, and building trust with clients who have often been misunderstood, misdiagnosed, or passed between services. She also provides practical insights into working with ARFID, including how Exposure and Response Prevention (ERP) can be adapted to help people gradually overcome intense fears around food.This episode is packed with clinical wisdom for psychologists, therapists, students, families, and anyone interested in understanding the deeper relationship between OCD and eating disorders.In this episode, you'll learn:• Why OCD and eating disorders so commonly occur together• How OCD can unintentionally protect and reinforce eating disorder behaviours• The difference between OCD-driven food restriction and eating disorder pathology• How to determine which condition to treat first• Why collaboration and client buy-in are essential for successful treatment• The role of trauma, autism and nervous system dysregulation in eating disorders• Practical ways to adapt ERP for ARFID treatment• Why rapport is often more important than any therapy model• The biggest mistakes clinicians make when working with eating disorders• How to help clients feel safe, understood and empowered in treatmentDr Alissa also shares a powerful reminder for clinicians: your greatest therapeutic tool isn't a treatment manual, it's your ability to connect with another human being.Whether you're treating OCD, ARFID, anorexia nervosa, or working with complex presentations, this episode offers a refreshing perspective on what effective and compassionate care can look like.To learn more about Dr Alissa Knight follow this linkwww.melbournewellbeinggroup.com.au Hosted on Acast. See acast.com/privacy for more information.
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About Breaking the Rules: A Clinician's Guide to Treating OCD
Breaking the Rules is a show for mental health professionals designed to help you build confidence in treating Obsessive Compulsive Disorder (OCD). Effective treatment of OCD requires commitment, creativity and the recognition that things can sometimes get a little … messy. And on the show, you’ll hear from a range of leading professionals and learn everything there is to know about OCD and other related mental health concerns. This podcast is brought to you by Melbourne Wellbeing Group, a psychology practice based in Melbourne with a special focus on treating OCD. Hosted on Acast. See acast.com/privacy for more information.
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