When you think of Obsessive Compulsive Disorder, you probably imagine compulsive cleaning, but Jana is going to learn about the less talked about effects of the disorder.
Therapist Alegea Kastens shares her personal experience with intrusive thoughts and shocking ideations, and Jana learns about how anyone struggling with OCD can find help and support.
Warning: This episode touches on sensitive topics, such as sexual assault and suicide. Listener discretion is advised.
The following podcast contains very sensitive information regarding intrusive thoughts, sexual assault, and suicide. Listener discretion is advised.
Wind Down with Janet Kramer and I'm Heeart radio podcast.
This week's Thursday episode, We've got a Legra cast In's on. So she's a licensed marriage and family therapist. She has a master's degree in clinical psychology from Pepperdine. She is the founder of the Center of OCD, Anxiety and Eating Disorders. She sees clients out of her New York office as well as via teletherapy. So she specializes in the treatment of obsessive compulsive disorder, anxiety disorders, body focused repetitive behaviors, and eating disorders. And she has a podcast called Books, Looks, and Lobotomies. And she's currently writing a memoir. So let's get her on.
Hello, HOI you did, I'm good? How are you?
I'm good. I'm Jana. This is my husband Alan Leice to me to meet you too. Hello. Hello, So we're excited to have you on to chat all things. I kind of want to just take it back though to the very beginning. When did you well, when did you first realize that you were We're dealing with OCD.
So I was nineteen years old, and well, actually nineteen was when I had my onset of symptoms that just debilitated me. So it was like, in point two seconds everything changed. It felt like a flip switched to my mind and I started having repetitive intrusive thoughts.
All day long.
But I didn't actually get diagnosed for another fifteen months, so I think I was twenty years old when that happened.
What was the thing that was like happening that You're like, oh, this is this is OCD?
So I was having and I don't know how much you know about OCD, but I was having repetitive, unwanted sexual thoughts about kids and animals and family members, and it was the last thing that I wanted to think about, but it just kept popping into my mind all day long. So at first I didn't associate that with OCD because I thought OCD was a disorder of cleanliness and organization. And when I finally googled after fifteen months, like why am I having these terrifying thoughts? OCD came up on the Internet and that kind of changed my whole life.
I had no idea personally, I thought it was something where I heard the clean thing, but also it's like you touch the same spot every single day or is that part of OCD too.
Yeah, I think so. I always gauge things around professional sports, and you hear coaches say all the time when they misplace their cones and they have to walk back and replace them and then walk back and replate, like, Oh, it's just my OCD, But it's not. It's you don't have OCD, you have an attention for detail. There is a big, big difference. And I looked into it a little bit yesterday and it's amazing how it affects people's life. But at what point did it become dangerous for you in your life?
So that's you know, it's a tough question because I was what we call high functioning. I was working in Los Angeles at the time as a publicist, and I think being very high functioning masked a lot of my suffering. But it got to a point where I was in trigger warning I'm going to talk about suicide, where I wanted to kill myself because I didn't want to live with these thoughts anymore. And I had been getting in a lot of car accidents because I couldn't focus, Like I just kept having the scariest thoughts replay over and over and over, and when I wanted to end my life because of this, that is when I really thought like I need to get some kind of help or I will be dead.
I must be really tough. I mean, you know what it's like in period in life where you don't your decision making and trusting your own decision making is as vital. And for that to be, I mean, how much does it affect your decision making and your normal function on a daily basis, because your decision making is everything and life.
Yeah, now I am at a place of recut, so I would say I don't meet diagnostic criteria for OCD. But when I was really sick, it took up every single second of my day, Like there was not a second that I wasn't having a scary thought or doing a mental compulsion like ruminating about why I was having these thoughts, And it became really hard to trust myself.
Like I knew, I knew I.
Was born to be a mom. That's just something that I've always known about myself. I've always loved kids. I worked with kids before the onset of my OCD, and so when this happened and out of the blue, I started having scary sexual thoughts about kids, it made me doubt myself and the kind of person that I was. And I think it's it's a scary experience for a lot of people with OCD because you know who you are, but you have these really odd thoughts in your brain that are trying to tell you that you're something that.
You are not.
So it really attacked my whole identity and at a time in my life where I think, nineteen twenty years old, you're already kind of trying to find yourself, and that really impaired a lot of different areas of my life.
I have two kind of questions around it. At the first, So were you nervous to speak about the things that you were dealing with because I could sense some or I could imagine people hear that and they're like, oh, stay away from my kids, or something like a thousand Yeah.
Oh, I was terrified.
I didn't even want to google it because I didn't want like, I didn't want to google why am I having these scary thoughts about kids? Because I didn't want the Internet to say you're a pedophile because I knew that I wasn't.
I was not getting enjoyment out of these thoughts.
OCD is very egodystonic, Like I knew that this wasn't me, and then I was really afraid to tell a doctor because I didn't want them to tell me you must be a pedophile, because I knew so deeply that I wasn't. And that's a fear a lot of people with OCD have, whether it's postpartum obsessions about one's baby harm obsessions, like they worry that they're going to go see a therapist who doesn't understand OCD and then says you're a killer, or you're going to drown your baby, or you're a pedophile, and that's actually the last thing that the person is.
So now that you've gotten, you know through through the work of all this, like what was the do you know why it comes up? And then how was the like the healing to get through it?
I really wish I had that answer, And I'm writing a memoir right now, and like that is the question that I probably won't ever have an answer to. We don't know what causes OCD right now. It's often people think it's a mix of genetics, biology, environment, So if you have trauma growing up, that might contribute to it. And I was anorexic at the time, so I think that me being anarexic struggling with an eating disorder and not eating enough probably contributed to my brain not functioning as well as it should have. But I don't think I'll ever know what caused this, and that is kind of scary if I think about it, because I guess I never know if I'm going to have that like relapse of symptoms again in that way.
So how did you get through it?
Then?
What were the If someone else is listening to this, they're like, oh my gosh, same and I've been to or ified to admit it. So thank you, you know, for sharing for those that can, because you're going to be helping people obviously through sharing everything you share. So what was the first thing you did and how what were the steps following?
So I saw a therapist who understood OCD, which was really helpful. And there's a specific evidence based treatment for OCD. It's not like general talk therapy that you might do. It's cognitive behavioral therapy with an emphasis on exposure and response prevention. So I started seeing a therapist who understood OCD, and then I also started taking medication, which I'm not saying that other people have to, but that was also a really big tool in my healing journey, like quieted the thoughts down, I didn't feel as anxious, and it enabled me to do the therapy work.
I'm just curious what medicine.
I'm on, Prozac, prozach okay, yes, yes.
Just curious if I had anything, because I used to take lexapro. So I was just wondering, like which ones stimulate certain different SSRIs or whatever.
It depends on the person.
Which is another shitty Like I had to go through four medications and three different doctors to find a doctor and a med that actually worked for me, And that can be really scary for people who want that fix quickly, to feel like a guinea pig.
Yeah, it just it just amazes me because there's a perception of what an outside perception of what OCD is like, to give an example, like, and it's a poor perspective really, Like to give an example, I used to play soccer and there was a period where I was walking the team out and I was a captain, right and I was, I had so many superstitions, so been interesting to see what the links are between superstitions and OCD. Because there's one time we were just walking the team out. I was going in the field and like, my shoes are facing the wrong way in the locker room, and I left my teammates and walked back like eighty yards so that I could put my shoes back the right way, just so that I thought, because I thought that would ruin my performance. So it'd be amazing. I'd be amazed to see the links between what people think are superstitions and think are OCD when it's not. It's just a it's just a stupid superstition based on which is essentially what it is, based on what you think how it's going to affect your day and affect your performance. And when I read I didn't take a deep dive, but I read about OCD, and I'm like, wow, it's so far from what you think it is it really is and what and what the public perceivers is o c D. And it actually really amazed me, Like even like I seen I saw one of your posts yesterday. It was about you having intrusive thoughts on a plane yes, related to me because Janna is not a good flyer.
I'm like, and I'm constantly thinking, is it Does that mean I'm OCD? Then? Because but I have like thoughts all the time. I'm like about the plane going down, and then what's going to happen? And then like am I gonna have to do this? And I have like thirty different steps of what I'm doing on the plane?
Yeah, so my question what are those intrusives? So if you're in the exit role of a flight, yeah, what goes through your head and makes it so dangerous for you?
So like now I can laugh about it because I'm in a place of recovery. And by the way, like anybody can have an intrusive thought, For the person with OCD, it's repetitive, it tends to stick, and the person is performing mental, mental, and or physical compulsions that take up an hour of their day. So if you have a random intrusive thought, that doesn't automatically mean that you have OCD. For me, I was able to just say, like, that's a ridiculous thought and get on with it. But ten years ago that would have consumed my entire flight, Like I probably would have wanted to get up and move to a different row, because I would have been so afraid that I could just snap and open up the door midflight.
And then what so, okay, so you say that, and then what are the other actions that you say go along with it for the next hour.
So mental compulsions are big, and a lot of people don't understand that. They think if someone has OCD, I'll see them redoing something or sanitizing. For me, all of my compulsions were mental. So they might sit there ruminating about whether or not they actually want to open the door. They might mentally review the past to see if there are any instances that confirm that they could be a killer, or they could reassure themselves internally. They could neutralize their thoughts constantly repeating I'm not going to do that, I'm not going to do that.
So a lot of mental compulsions for people.
I'm wondering now is like my anxiety actually OCD.
Well, there's a complete deference on how anxiety affects. You'll see, like I was reading, but.
I obsess of things like mentally in my brain.
Anxiety is your perception of yourself.
That is fear too of like unknown.
Tell us the difference for sure between anxiety and OCD. With OCD, there tends to be what we call obsessional doubt or pathological doubt. So the person is doubting what they know. Like I know that I'm not a pedophile, but I keep having these thoughts about that. I know that I'm not a killer, but these thoughts keep popping into my mind. So there's a lot of doubt that is not super rational. And there's also a lot of anxiety. With generalized anxiety, someone might be experiencing an excessive amount of anxiety about an everyday life experience like taking an exam, getting onto an airplane, but it's not necessarily that irrational.
What if if that makes sense?
And what's tough is people with anxiety can perform mental compulsions. You can ruminate all day long and have anxiety and not OCD.
That's fascinating.
So then how what's then the difference with that? So, like, let's say I ruminate all day like, oh my gosh, I'm so because I have like this weird like medical anxiety thing. I'm like, oh my god, I'm gonna go to the hospital and I'm gonna be sick in this That and the other all day ruminating about it, where then would it make it OCD.
So a lot of the times it comes down to the doubt. So like, for instance, what if I have cancer. If that's someone's obsession and they have health OCD, there isn't anything in the here and now that would substantiate that doubt.
If it is.
More of anxiety about a health situation that's actually happening, that would be a bit different, because with OCD, we want to resolve the doubt to the best of our ability, to get the person to understand you're not a pedophile, you don't have cancer, you're not a killer. Whereas if it's something future based with anxiety, like what if our plane crashes, that's not really something that we can resolve. There is some uncertainty to tolerate there. So they are pretty similar.
Really, it can be resolved, yes, absolutely, oh yeah, Whereas sometimes with anxiety, when it's future oriented, there just isn't an answer.
Okay, that makes sense, So then I'm just anxious human? What has been? Because how old? Can I ask? How old are you?
I'm twenty nine?
Okay, oh you love that, twenty nine?
Do I look old? Scared?
No?
No, no, because you're still young, you know what I mean, Like it's I feel like I'm but thank you the same trust. So you've been essentially quote living with this for you know, as you know, ten ten years. What has been the biggest besides therapy in the medicine, like, the biggest tool for you that has helped you on this.
Path acceptance and acceptance of the thoughts that I'm having.
Not that the thoughts are true. I think that that word.
Scares people with OCD, but I really had to get to a place of this is my brain. It will think the wildest thoughts possible, and I just have to let those exist because the more that I fight with them, the more I experience those thoughts. So acceptance, I would say, is the number one tool out of anything that I've done that changed my recovery journey.
For me well, and with you being very open to on your podcast, I make up that it's probably difficult to having people that come to you and like say things that might be again hurtful, but also you're speaking your truth too. So in that we've obviously helped a lot of people. What's the biggest thing that you've heard from people that reach out to you.
I get messages almost every day that I've saved someone's life, which really I I mean I sometimes they can't even comprehend it, but it's usually that like, I've never heard someone openly talk about this. I didn't know that what I was experiencing was OCD because of all the misconceptions.
So probably those two things.
And I think having someone like I never know how to talk about this, but when you when you think about someone having scary sexual thoughts about kids, you probably think about like the eighty five year old grandpa in the basement. But when it's someone like me, who's like, you know, was a twenty five year old, twenty one year old whatever experiencing it, I think it makes people feel better like this can happen to anyone. You know, You're not like a creepy, gross, weird person. It's just a mental health condition.
For the anorexia. Do you mind if we touch on that for a second.
Oh?
Absolutely?
Yeah.
Was that just a way of controlling? Was that a part of the OCD you think was having that control? Was it was it inexia or bolimia?
It was anarexia.
It's arexias? So did you not eat because of a message you heard or was it control or what was it?
That's another thing I don't think I'll ever have the complete answer to.
But it was me.
It started with me wanting to lose weight, and that's something that I had been told my entire life, that I should lose weight, and so I started a diet my freshman year of college, and then a couple of months later. The only way I can describe it is like I just fell into an eating disorder and I couldn't think about anything else other than food and body, and it was it felt similar to OCD because there were obsessions and there were convulsions, but it was to.
Me a lot easier than the OCD that came.
Next, Right, And like you said, like I feel like or I'm sure there was nutrients possibly missing in the.
Brain, right, Oh for sure.
Yeah that might have triggered certain things.
Yeah, not eating can really impair a person's cognitive functioning, and so I work with OCD and eating disorders. Those are two of my specialties. And if someone comes in and they're really malnourished, that is like the first thing that we have to address, because it's hard to do that cognitive treatment work if your brain is just not functioning.
It's interesting because my daughter's in she's in third grade, and she has I don't know where she's heard it because we don't say fat or skinny in this house. We always just say like healthy, and you know, we work out a lot. But I've never been like, oh I'm fat or anything about skinny. And so she the other day she was like, Mommy, am I fat? Or am I skinny? And I'm just like, I was like, honey, you are healthy, you are beautiful. But I'm like, am I even saying the right words. I'm like, I don't know because I'm like, obviously I wouldn't say like, yeah, you're skinny. I mean, she's she's a slender girl. But I'm like, I you know, it's like all of a sudden, third grade is opening the door to all these bigger conversations which something happened their day. I have to talk to you about allan. But we know she heard something at school, and so there's things I'm like, oh my gosh, It's like I remember what it was like for me, you know, being a kid and then going into middle school and just having the comparing your bodies to other girls, and even it's worse now because it's social media. So it's just like and then I've been looking at her lunch box too and being like, honey, and I noticed that she didn't eat all of her food and she had like a lot left, and so I kind of looked at her and then I'm like should I even be questioning her on this right now? But also like she barely touched her lunch, so and it was after the skinny conversation, so I was like, hey, baby, I was like, I noticed you didn't eat your lunch, like is every were you okay? She's like, oh, I just had a lot of the nuts, and I was like okay. But then it like cocked in my head, is like, oh my gosh, is she like thinking about not eating because she wants to be skinny? And so then I just like spiraled on that.
But any advice, So, I think when kids come to us and they say, am I skinny?
Am I fat?
What's really important is to look at those words as descriptors and to try to help them see that. So there's nothing wrong with being fat. If a person is fat, there's nothing bad about that. Some people have more fat on their bodies. Some people have less fat on their bodies, So talking about those words in that way instead of saying like you are skinny, which obviously you didn't do. And even the word healthy can be super loaded. I think a lot of the times people think that being thin means being healthy, but you can also be fat and be healthy.
You can be thin and you can be unhealthy.
So I think helping your kids see that no matter what, like, these are descriptors and they're not good or bad, they just are. Some people have long hair, some people have short hair, some people have round bellies, some people have flat bellies, and all of that.
Is okay, yeah, that way a better conversation.
But it sounds like she's really internalized something from school. So I think having that conversation might be helpful.
Okay, thank you, I appreciate that.
I talked to me about groin. I started to watch a yesterday.
I'm obsessed.
Okay, an Scottish accent too.
Anyway, So, oh my god, I just went to Scotland last week for the first time and it was amazing.
So wait, catch all of us up that had no idea, I mean, the listeners.
Please all did you enjoy scott Scotland.
Oh my gosh, I want to move there, but I have an American stafford charitary so pitbull, and I don't think that she'll be allowed.
That would be your own reason for not moving.
Yeah, because they'll take her away.
Mmm? Is it a pit bull?
I mean technically, but aren't all bull terriers?
You know?
Can you go back to the gruns?
It's called groin ahead.
This is the funniest I have ever been asked this.
Listen. I might be smiling and laughing, but I get that it might be. It's obviously a.
Sure.
So I started to watch. I started to watch a video with you and one of it, I think it was maybe someone you'd on your podcast or a show, and you and you guys started to talk about groino and then my flight took off and I couldn't I couldn't hear the rest of it, so I stayed intrigued. So I thought, I need to ask you what and elaborate on what it actually is.
Okay, this is a life saving question, It really is.
So basically, this can happen for anyone, not even just people with ocd Our bodies don't always respond to what we're actually aroused by So what tends to happen for people with sexual intrusive thoughts is they feel something in their gronal area because they're having a sexual thought that is not automatically indicative of desire. So there's something called arousal non concordance where you're having a physical response but it's not at all concordant with what you like up here, and so people with OCD talk about it as like a gronal response. I'm having a coronal response to this thought that is so disgusting to me. And Emily Nagowski, I'm not sure if you've heard of her, she wrote, Come as you Are. She's a fabulous sex educator. She gave an example her husband in high school was thinking about a donut and then got an.
Erection thinking about a donut.
Yes, he didn't want to put the donut, but when you're thinking about like a whole and you're fifteen years old, like your brain registers that as sexual somehow, and so he had an erection thinking about that, and that's kind of what that is.
Like you could have a sexual thought about your mother and it disgust you.
But because it's sexual in nature, your body responds, or I also want to give a trigger warning.
I'm going to talk about sexual assault.
People who are raped sometimes orgasm, not because they're enjoying it whatsoever, but because their body is responding to something sexual. So a grinal response is you are having some kind of response and you think it's evidence that your obsession is true and it is not.
So is that what happened to gym from American pie?
I haven't seen that, you know, an American pile. I was just twenty nine.
Penis and a pie. An apple pie just goes what a pull?
Wow?
More questions?
Yeah, these are great questions from you.
Yeah, I just really need I needed to clear it up what it actually was. It was intriguing, but it's one of those questions where I didn't know whether it was going to be because it kind of seems funny, but it's not as serious clearly, So then don't how you approach it? So I'd just be okay, growing tell me more.
I'm glad you asked, because that is something that keeps people stuck in like I might be this bad person when it's like no, you're just having a bodily response to something, just like we can feel anxious about something that isn't actually real. Same with our bodies, we can feel like a bodily sexual response to something that we do not desire.
Crazy.
You're great. Yeah, I appreciate you coming on and so you got your when when's your memoir coming out.
Spring of twenty twenty six, So I'm still writing, I'm on deadline.
That's amazing.
Thank well you.
I appreciate you being authentic. I appreciate you sharing your story. You were helping people and that is the win at the end of the day, and everyone else, you know, can just look the other way if they don't want to listen, is what I always say.
So yeah, I love that. I think you're educating people on something that they think they know about it, but the one of a clue what it?
I literally just not OCD was just cleaning obsessively. Yes, so this is very enlightening. And everyone listened to books, Looks and the Bottom. Yes, podcast new episodes every Wednesday. Thank you so much, girl. I really appreciate you.
So nice to meet you.
Bye.