Why Dr. Patrick McGrath Made OCD His Life’s Work

When people with obsessive-compulsive disorder (OCD) tell Dr. Patrick McGrath that they can’t believe he doesn’t have OCD himself, he takes it as the highest compliment. This deep understanding of the disorder, cultivated over 25 years of experience treating OCD, has earned him the trust of countless people seeking therapy at NOCD, where he serves as our Chief Clinical Officer.

In a heartfelt conversation with lived experience OCD advocate Tia Wilson, Dr. McGrath shares the personal experiences that shaped his approach to treating OCD, providing a rare glimpse into his personal and professional journey. Below is an excerpt from their interview, during which Patrick opens up about his early struggles with childhood anxiety, the rejections that ultimately shaped his path to psychology, his decision to make OCD his life’s mission, and the profound loss of his wife to cancer. You can watch the full interview here.

This interview has been edited for length and clarity.

What were your career goals as a kid, and how did they shift as you went through college?

Well, it was interesting. Probably in sophomore year, some of my buddies from high school had gone to a concert and met a couple of people. And I remember meeting those folks mostly over the phone, and just talking to people that I’d never actually met physically. And for a while, people would start calling my house, saying, “I talked to someone who said they talked to you and that you were really helpful talking to them, and I’m wondering if I could talk to you.” And I would say, “Okay.”

And I started to kind of do “sessions” in high school in my sophomore and junior year. People were calling about everything that you would see today, and it’s slightly different without the social media component of it, but people who were sad, or depressed, or going through relationship breakups, or just didn’t feel like they fit in, or had been teased, or something like that, which to me really fit because that had kind of happened to me. I was a nerdy kid, and just kind of didn’t fit in all that great, and it was not very fun. There was even some bullying that happened in grade school.

What was it about treating OCD that was so interesting to you, or that made you want to stick with it?

Exposure and response prevention (ERP) therapy fit my personality, especially the type of therapy that it was, where the therapy is what I’d had to do for myself, which was you have to face your fears. You have to be in the experience and learn how to handle it. It is not about promising you that you’re going to be fine and everything will be okay. It’s about knowing that you have the skills and the ability to handle things.

I know one of your favorite compliments (and one of my favorite compliments I hear about you) is when members say, “You don’t have OCD?” Why does that mean so much to you? Or why do you think that people are able to relate to you and you’re able to relate to the experience of OCD, despite not having it yourself?

I think I figured out the nature of OCD. I describe this a lot, and sometimes I use the example of Lucy holding the football for Charlie Brown. No matter what happens, she’s picking that football up and he’s going flying through the air. And there was an interview with Charles Schultz where he said, “It’s the nature of Lucy to pull up the football every time. Charlie Brown will never kick the football.” And I thought about that, and I thought about what is the nature of OCD?

And I figured out OCD will always do these things. So I can work with people who have OCD and I can describe to them what’s probably gone on in their head and the things they’ve thought before they even tell me. They look at me like, how do you know? My answer’s always the same: because that’s the nature of OCD and that’s what it does. It doesn’t really vary much between people. It’s just the way that it is. I think it’s a theme.

So that is an amazing compliment when people say they can’t believe I don’t have OCD because I think like I have OCD, but it’s because I’ve tried to really bring in the nature of OCD and look at the world through that view. It’s just the view of, “This is how OCD would see the situation.” And if I can bring that into a therapy session and help somebody with that, then they feel like they’re really understood.

When it comes to being in a clinical role, where do you feel like you draw the line with self-disclosure? And why is it that you choose to be so open?

I’m a person, right? I’m not just somebody on the other side of a screen. I’m a human being who has faults, and issues, and sorrows, and tragedies, and joys. …I’m not just some figurehead. I’m real. And if I can find stories or inspirations for people that are helpful to them, I want to share those things with people.

And I don’t ever want to say to someone, “Oh, I get it,” if I’ve never experienced it. I just think that’s disingenuous. So I think I’ve gone through enough things that I can say I get it and genuinely mean it. Now, again, I don’t have OCD. So I’m never going to be able to say to someone with OCD, “Oh, I get what it’s like to live with OCD.”

But again, for me, understanding the nature of OCD, I can at least say to someone, “I get how your brain’s working. I get what’s going through your head. I may not fully ever understand the emotional component to it, but I do know what’s going on in there, and I can help you with that.”

When you’re working with Members and seeing that decrease in symptoms, how does that feel? What emotion are you feeling when you’re watching them have success?

I’m proud of them. I really am. I have a lot of pride in the people I work with who face these things, especially because of the fact that many of their friends or family have no idea the struggle that they’re dealing with, right?

Because as you know, if you think OCD is “Obsessive Christmas Disorder,” or something “we all have a little bit of,” or “Wouldn’t it be great to have a little OCD right now?”…If that’s your way of thinking about OCD, then you are just absolutely out of it in terms of understanding what somebody is suffering with.

I try to bring a lot of pride and motivation into those sessions with people so that they recognize that someone is listening, someone is on their side, someone gets it, and someone is going to keep nudging them forward.

For those people who are in therapy [for OCD], or maybe haven’t started therapy yet but are recognizing they have OCD and starting to learn more, what advice do you have?

To do the hard work. I mean, this is not easy therapy, but it’s rewarding. That’s the good part, right? And so I would contend going back to my first grade experience: It wasn’t easy to stay at school after throwing up all over the place. It was kind of embarrassing, actually. But I think it built in me almost a stamina, or a strength. I learned that I could handle that thing. In building that confidence, I stood up more for myself, I did the work, and I believed that I could do it.

And that’s what I hope for anybody with OCD, that as you go and you start facing life and doing things that you want to do, and not the things that OCD wants you to do, you start to get the life back that you want and you’re not living OCD’s life anymore.

I love that you said “learn that you can handle it.” You’re already capable.

We just get to teach you that you can. You’re already aware.

Watch Dr. McGrath’s full interview on Get to know OCD