We’re incredibly proud of the therapists in the NOCD network. While all of them are trained in delivering evidence-based treatment for obsessive-compulsive disorder (OCD), many have overcome OCD themselves. We want you to get to know some of the NOCD clinicians who have dedicated their lives to helping people end the struggle. This article’s author, Lisa de Guzman, LCSW, has also shared her OCD Journey and shares content about OCD at @the.abc.therapist on Instagram.
Our lives are intricately woven with the threads of our cultural upbringing. While often vibrant and empowering, this rich tapestry can sometimes entangle us, delaying our journey to wellness and self-fulfillment. As a therapist, I’ve come to appreciate this complex interplay, especially as my own cultural roots profoundly influenced my battle with mental health disorders, including obsessive-compulsive disorder (OCD).
Growing up in a household of Chinese immigrants, I was immersed in a culture with rigid expectations, particularly regarding respect toward adults and authority figures. This cultural backdrop starkly contrasted with an incident at age seven—a tantrum that, in retrospect, I can identify as my first encounter with OCD-induced anxiety.
I remember spending hours meticulously folding blankets, which brought me a peculiar sense of order and satisfaction. But when my father, with the best intentions, unfolded the blankets and placed them over me to ensure I was warm enough, I threw a fit, my arms and legs flailing wildly. Tellingly, however, I waited until he left the room, a testament to how deeply ingrained those cultural expectations were.
This need for precision stealthily crept into other facets of my life. Whether arranging my backpack or aligning food labels in our kitchen, these rituals became my secret struggle, causing frequent distress and taking up hours of my time. Bound by the cultural expectations I mentioned, I didn’t know how to seek help, and my suffering was a silent companion, its weight known only to me.
Dealing with this thing alone had unfortunate effects. In elementary school, I was so in my head with obsessions and compulsions that I found it difficult to concentrate. My teacher’s solution was to take me out of mainstream class and put me in English as a second language lesson for a few hours each week. I was born and raised in the U.S. and knew I didn’t belong there. I knew she’d put me in that ESL class based on my appearance and my quiet stillness. Believe me when I tell you that for a little girl with perfectionism OCD, falling short of expectations both the Chinese and American culture held for me felt disheartening and dismal.
A missed opportunity to receive help
It wasn’t until graduate school that I started putting some of the pieces of a mental health puzzle together. While studying to be a social worker in graduate school, I stumbled upon descriptions of OCD that dovetailed my experience, which now included obsessions around contamination, perfectionism, and harm. Yet, when I broached the subject with my therapist, she acknowledged that I had OCD tendencies but didn’t believe that I met the diagnostic threshold of OCD.
The years that followed saw diagnoses of adjustment disorder and major depression. Still, a significant piece of the puzzle—my untreated OCD and emerging post-traumatic stress disorder (PTSD)—remained unknown and unaddressed.
Back then, over two decades ago, mental health treatment was a different landscape, less evidence-based, more psychodynamic theory, and, for me, not particularly helpful. These therapies helped to identify fears and emotional processing but missed the critical components of skill building and active coping.
I began taking selective serotonin reuptake inhibitors (SSRIs) for my depression just a few years ago, and they’ve made a really big difference to my quality of life. I certainly could have benefited from taking them at an earlier stage in my life, but I was raised with the idea that Chinese medicine was the answer to any ailment and Western medicine was considered for life-threatening emergencies. As a result, I was resolute in my resistance to them.
This cocktail of known and unknown disorders took a profound toll. Days blurred as I withdrew from the world. My mental state deteriorated, and I found that I was unable to perform normal daily tasks like brushing my teeth or showering. My mental health problems were perhaps best evidenced by the fact that it took me seven years to graduate college. When I finally completed my course of undergraduate study, I went into practice as a therapist but later took on leadership roles in housing and homelessness. It wasn’t until my late thirties and my return to the world of therapy that my OCD and later PTSD were finally formally diagnosed.
Discovering the gold standard treatment for OCD
That’s when I discovered exposure and response prevention therapy (ERP). Applying this evidence-based technique to myself, I uncovered its transformative power in managing my OCD symptoms. While I don’t wish to undo my past—after all, it has sculpted me into the therapist and person I am today—I can’t help but ponder how different my journey might have been with earlier ERP intervention.
Returning to a career in therapy wasn’t just a professional choice for me; it was a natural extension of my journey through the tangled web of mental health. My early struggles with OCD, depression, and PTSD have given me a profound empathy for those grappling with similar issues. As someone who has walked a mile in those shoes, I bring more than just clinical expertise to my practice—I bring a piece of my soul.
Every day, I use my ERP toolkit, not just as a clinician but as someone who continues to apply these principles to my own life. The non-engagement responses, disengagement skills, uncertainty statements, and mindfulness that I teach are not just techniques from a textbook; they’re part of the fabric of my daily existence. They’ve been my companions on a long road to wellness, and now they are the tools I share with others of lived experience.
Integrating my journey with my practice
Looking back, I realize my mission has always been to serve others, particularly those on society’s margins. As a social worker, that commitment was evident, but it’s in my role as a therapist where my values fully align with the ethos of the organization I work with. It’s not just about giving care—it’s about sharing a mission, a sense of purpose, and an understanding of the human condition.
When my clients come to me, they’re often in a place of extreme vulnerability. My job is to meet them there with compassion and authenticity. They must see me not just as a therapist but as someone who truly gets it. At NOCD, our training ensures that we’re competent in evidence-based practices. But for me, the combination of this education and my personal experiences allows me to connect with NOCD members on a deeper level. For those who might stumble upon this article and identify with any part of my story, I say: You’re not alone. Your curiosity has led you here for a reason. If you’re seeking support for your wellness journey, take that next step. Reach out to our Care Team and embark on a very often life-changing journey.
Fear is often the most significant barrier to starting ERP or any therapy. It can be daunting, but I encourage you to be brave. You deserve a life beyond the confines of OCD or any other condition, robbing you of your potential. If you suspect you’re dealing with multiple conditions, don’t let the question of which to tackle first paralyze you. Connect with a NOCD therapist who can help you navigate these symptoms, prioritize your treatment, and tailor a protocol to your unique situation.
To anyone from a background where mental health is stigmatized or reaching out for help is not the norm, be brave in your truth. It’s your right to seek a better life, and there’s hope on the other side.