Suicidal OCD vs. Real Suicidal Thoughts: How to Tell the Difference (with Taboo Tracie) | Ep. 454

This episode dives into the crucial differences between suicidal OCD and suicidal ideation—how to spot them, how to respond, and how to support yourself or a loved one with skill, compassion, and evidence-based care.

What you’ll learn in this conversation:

• The clear, practical signs that separate ego-dystonic suicidal OCD from passive and active suicidal ideation.
• A step-by-step game plan for what to do now in each scenario—ERP for SO-OCD, Behavioral Activation for depression, and immediate safety steps for active SI.
• How intrusive commands, urges, and images can feel terrifying—and why “maybe/maybe not” and other non-engagement responses work.
• The big mistakes to avoid (like reflexive reassurance or unnecessary hospitalization) and how to assess risk without feeding OCD.
• Concrete skills you can use today: brief ERP exercises, BA “starter moves,” and supportive scripts for parents/partners.
• Hope and next steps—how people recover and build long-term resilience with science-backed treatment.

Suicidal OCD vs. Suicidal Ideation: How to Tell the Difference—and What to Do Next

Gentle heads-up: This article discusses suicidal thoughts. If you’re in immediate danger, call/text 988 (U.S.) or go to the nearest emergency room.

 

Why this episode matters

Suicidal thoughts can come from two very different places:

• Suicidal OCD (SO-OCD): intrusive, unwanted thoughts/urges/images that clash with your values (ego-dystonic).
• Suicidal ideation (SI): thoughts about not wanting to be here anymore—ranging from passive (“I wish I could pause life”) to active (plan, intent, steps toward action).

Getting this distinction right saves lives and reduces unnecessary fear, shame, and missteps in care.

The quick-glance guide

Suicidal OCD (intrusive)

• Feels ego-dystonic: “I don’t want this” / “This is not me.”
• Language often sounds like commands (“Do it”), vivid images, or intense urges.
• Brings panic, confusion, and compulsions (checking, avoiding, seeking reassurance, hiding objects).
• Goal of treatment: ERP (Exposure & Response Prevention) + no compulsions.

Passive Suicidal Ideation

• Feels like wanting a break from pain: “I don’t want to feel like this,” not “I’m going to act.”
• May coexist with depression (hopelessness, low energy, anhedonia).
• Goal of treatment: Behavioral Activation, depression care, increase supports.

Active Suicidal Ideation (emergency)

• Plan + intent + steps (researching methods, collecting items, saying goodbyes).
• Feels resolute, bottomed-out, not confused.
• Immediate safety first: crisis support, ER, higher level of care if indicated.

 

A practical litmus test (for patients & clinicians)

Ask (and answer honestly):

1. Values check: Do these thoughts match my values?
   • No → Likely SO-OCD.
   • Yes / feels like relief → Assess for SI, especially active signs.
2. Confusion vs. clarity: Am I confused and frightened by the thoughts, or clear and resolved about acting?
   • Confused/frightened → points to SO-OCD.
   • Clear/resolved + planning → Active SI (urgent safety step).
3. Protective factors: Can I list reasons to live or things I still want (people, goals, faith, pets, responsibilities)?
   • Yes → Often not active SI.
   • No / nothing matters → Heightened suicide risk—escalate care.

Clinician tip: “I don’t know” is common in SO-OCD. Don’t assume risk—assess deeply. Avoid reflexive hospitalization for intrusive thoughts alone; it can cause harm and reinforce danger signals.

What to do—step by step

If it’s Active Suicidal Ideation (plan/intent/means)

• Now: Call/text 988 (U.S.), contact your crisis line, go to the ER, or tell a trusted person to help you get there.
• Once safe, build a care plan (therapy, meds evaluation, supports, follow-up).

If it’s Passive SI (no plan or intent)

• Treat the depression and reduce hopelessness:
  • Behavioral Activation (BA): Do the things you’d do if you weren’t depressed—even if you don’t feel like it.
    • Get out of bed (roll → crawl → stand if needed)
    • Light exposure: open curtains, step outside briefly
    • Hygiene: shower, brush teeth
    • Schedule small pleasures (music, sunlight, warm beverage)
    • Move your body (walk around the block)
    • Connect (one text, one call, one invite)
  • Track sleep, meals, movement, connection (the “SMAC” basics).
  • Consider CBT/ACT, medication consult, and increase supports.

If it’s Suicidal OCD

• Use ERP (Exposure & Response Prevention) with Response Prevention (no compulsions):
  • Lower-level exposures: write feared words (“suicide”), draw icons, keep neutral photos of trains/bridges, write brief scripts (with or without humor).
  • In-vivo exposures (when appropriate, stepped): sit near a kitchen knife while not hiding it; stand a safe distance on a train platform; keep “trigger” items in sight.
  • Non-engagement responses:
    • “Maybe, maybe not.”
    • “Thanks, brain.”
    • “Cool story, OCD.”
    • Don’t seek reassurance, check, hide, or avoid.
  • Humor helps (when it fits your style): playful nicknames for the thought, sing it to “Happy Birthday,” or “one-up” the scary script to deflate its power.
• Important: ERP is always safe, legal, values-consistent. We do not do exposures when someone is actively suicidal.

If both are present (SO-OCD + depression/SI)

• Press pause on new exposures if risk rises.
• Keep response prevention (reduce compulsions) + add Behavioral Activation.
• Escalate level of care if active SI is present.
• Return to full ERP when safety and mood stabilize.

 

For parents & partners: how to support wisely

• If it’s SO-OCD:
  • Don’t hide objects, safety-proof, or reassure (“You’d never do that”).
  • Use neutral responses: “Maybe,” “Not sure,” “What does your plan say?”
  • Join an exposure only as coached by the therapist (e.g., calmly present near triggers).
• If it’s depression/SI:
  • Do check in regularly and observe changes (sleep, appetite, isolation).
  • Offer practical help (walk together, make a meal, ride to appointments).
  • Consider attending part of a session to learn supportive responses.

 

Common pitfalls to avoid

• Assuming all suicidal content = suicide risk. Intrusions can be vivid, urgent, and still be OCD. Assess.
• “Erring on the side of safety” without assessment. Unnecessary hospitalization can traumatize and reinforce danger beliefs.
• Pausing treatment entirely when mood dips. Often we keep RP, add BA, and resume ERP when safe.

 

Skills you can try today

For Passive SI (depression):

• Pick 3: shower, sunlight, short walk, one text, one nourishing snack.
• Put one pleasant activity on the calendar every day this week.

For SO-OCD:

• Write a 10-line script beginning with “My brain says…” and end with a shrug line like “Maybe, maybe not.”
• Keep one small previously avoided item visible for 10–20 minutes while doing nothing to “make it safe.”
• Practice a neutral line 5 times: “Thanks, brain. I’m not solving this.”

 

When to escalate care—no second guessing

• You have plan + intent or have started gathering/ researching means.
• You feel nothing matters and protective reasons to live feel absent.
• Your therapist recommends a higher level of care based on risk.

U.S.: Call/text 988 or chat via 988lifeline.org. If outside the U.S., contact your local crisis service.

 

Final word of hope

People recover from both SO-OCD and depression. ERP changes how your brain responds to intrusive threats; Behavioral Activation rebuilds momentum and meaning. With the right assessment, skills, and supports, you can move from fear and confusion to clarity and care.

The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans, and if they currently take your insurance, head over to https://learn.nocd.com/youranxietytoolkit

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Transcription: Suicidal OCD vs. Real Suicidal Thoughts: How to Tell the Difference (with Taboo Tracie)

Kimberley: Suicidal thoughts are among the most terrifying and taboo experiences a person can have. For some, they stem from a deep emotional pain and the desire to end their suffering, and for others their intrusive, unwanted. Deeply ego, dystonic hallmarks of o of suicidal OCD, how can you tell the difference and how can you respond with compassion, skill, and care when it’s happening? Today I’m joined by the incredibly brave and insightful Tracy Abraham, also known as Taboo. Tracy, an advocate and survivor who has lived experience with both suicidal IDA. With both suicidal OCD and real suicidal ideation. Together we are peeling back the stigma and breaking down the critical differences because some lives truly depend on it. Welcome to your anxiety toolkit. I’m your host, Kimberly Quinlan. This podcast is for all things anxiety, OCD, bfr, bs, a space to give you mindfulness based skills and science backed resources that you can bring into your recovery journey. So let’s get started. Thank you Tracy, for being here.

 

Tracie: Thank you for having me. This is like my most favorite stuff to talk about, so I’m really glad that we’re talking about it.

 

Kimberley: Yeah. So I first wanna just like say this is a, to a touchy topic. Um, you’re 

 

Tracie: Yeah.

 

Kimberley: you know, it’s a, it’s a. It’s a really difficult topic for even me to even address because is so much suffering around this topic, and I wanna do it with care. I know people wanna do it with care, and people are really, really suffering.

 

So just for us together, like what, what can we maybe, what can we set as an intention, you and I, for our listeners to help them navigate this episode as we go into it? 

 

Tracie: That’s a great question. I think I probably the most important thing is understanding. The nuance and differences between when things are something that you need to pay attention to and, and take action on towards safety versus understanding that it’s part of depression versus understanding. It’s part of OCD.

 

So really parsing out those things. And then the overarching goal is to not let OCD get you stuck trying to figure it out because yeah. It’s pretty cut and dry when you know the difference. It.

 

Kimberley: It is refreshing for me to hear you say it is pretty cut and dry because I think people with OCD or clinicians who are treating people with depression, um, it’s, it’s scary, right? And, and we want It.

 

to be cut and dry and often feels like it’s not so, so let’s, let’s go straight to like. Understanding. So can you describe for me and give, and we can chat back and forth on like what is the experience of someone with suicidal OCD or suicidal obsessions?

 

Nice. 

 

Tracie: Sure. So suicidal OCD and suicidal obsessions, which is one of my ride or die themes since I was 10 years old. Um. Is really this intrusive thought process. These maybe even intrusive urges, intrusive images, um, that are telling you that you want to harm yourself or end your life, um, or that maybe you’re that way, um, or maybe you’re going to do that.

 

And, um, it can come up in so many, so many different ways. And I like to mention urges and feelings because a lot of people say, yeah, but. You know, sure I have intrusive thoughts, but I really felt like I was gonna do something. And so really highlighting that it can show up in all the different ways, and that it’s not always going to show up as maybe I’m going to do this.

 

Sometimes it also shows up like, you’re going to do this. You want to do this, this is how you’re going to do this. You can’t stop yourself. So I think those are important highlights.

 

Kimberley: And I love that you bring that up because that’s actually a lot of the questions that I have received from students or clients or even strangers on social media is they’ll say, I hear that OCD is a condition where they have intrusive thoughts. What if thoughts? mine don’t sound like that. Mine sound like a command.

 

Like you have to do this or you want to do this, and that can take them. guard because they’re think, you know, I think that there is some. unplanned reassurance that an intrusive thought is an intrusive thought. And when it shows up as a command or it shows up as an urge. And I think we all understand that urge, um, feeling.

 

You know, I, I do, I, I remember. I remember, and I use this as an a simpler example, is I remember holding my daughter on a balcony and having the urge that I was going to throw her, like I felt this energy in my arms. Now, I would never throw my child, but it did feel like my, my arms wanted to do something.

 

And so that urge can be equally as concerning and perplexing. 

 

Tracie: Absolutely. No, absolutely. I had this come up a couple of weeks ago. I’ll just give you a really good example of, uh, an urge with suicidal OCD. Um, my. Well, actually my daughter was in Australia for three months visiting her boyfriend, and my husband was in California visiting his family. So I was home alone.

 

It was just me and the cat and the chickens. So of course all my harm OCD, my suicidal OCD went to, well, you’re home alone and they’re going to find you dead ’cause that, you know, there’s no one else except the animals that I can harm. Um, and I have had really. Had this under control for a long time. It still, it comes up every day, but in terms of having it well managed and not distressing, um, and I was eating breakfast one morning and all of a sudden my body just went into this extreme urge.

 

I was like, you’re gonna run into the street and run in front of a car and you’re not gonna be able to stop yourself. And I was like, oh. I haven’t had an intrusive urge in a while, and it felt like you said like this, I could feel the energy in my body. It was like, you’re just gonna run out the door. Um, and so what I did was I, I faced my fear actually.

 

Um, I was like, yeah, I know what this is about. And so I went and put on some running shoes. I was still in my pajamas and I ran toward the street. Um, and obviously I stopped before I went into the street with the cars because I already know that this was, this is just one of my intrusions. And then I ran back in and finished my coffee, um, and called it a day.

 

Um, but that’s what living with suicidal and cd, that’s very well controlled looks like. But it felt like for a second it was like, wait, this feels super real. Like are you gonna do it? And I was like, you know how this goes. You know what to do.

 

Kimberley: You recently posted on social media. You were at a train station in, in, excuse me. Um, you had recently posted on, you were at a train station and. You sort of was just standing there and then in the video you go, well, and you shrugged and you said, I guess not this time. 

 

Tracie: Yeah.

 

Kimberley: I thought was a really interesting approach or a beautiful approach using what we always talk about here on your anxiety toolkit, which is sort of like, a shrug it off or a That’s cool bro.

 

Kind of nonchalant response. Um, do you wanna share what. That experience was like, and maybe give like a real life example of how OCD impacted you in that situation. 

 

Tracie: Sure. So, um, so my friend was coming up to visit me because I was alone at home. And, um, so she was coming through the train station and I was like, all right, gonna go visit her. I knew in advance every time I go to this stinking train station that I get suicidal OCD, whether I’m getting on the train or I’m picking someone up because it’s, it seems odd.

 

Maybe all train stations are this way. I don’t know. I don’t take a lot of trains, but there’s no guardrails or warning signs. There’s sort of a different color strip. Where you could just, if you’re standing there, the train, like, and you’re really like, you put your arm out, the train would hit your arm, but there’s not really, there’s like a little stein like, back up, don’t really be here, kind of thing.

 

You’re like, eh, you know, little warning. Um, and so of course I go up there and it’s like, Hey, you’re gonna just actually throw yourself onto the, onto the tracks. And then it was like this whole conversation starts going on in my head and I’m not ruminating. This is just happening without me. Oh, well you can’t throw yourself too early.

 

’cause then somebody will come take you off the tracks and then before the train comes, you have to wait till the train is really close so it doesn’t have time to hit the brakes. So I was like, oh yeah, you’re right. That makes the most sense. You do definitely have to wait till the train’s close enough that there’s no time this job.

 

So it definitely runs you over. So. I was like, went into my ERP mode and I was like, all right, this is happening. And I felt my body. So I was like, what if you stand in the little area where I’m pretty sure you’re not supposed to stand ’cause it’s too close, but also the train doesn’t hit you. Um, and I was like, okay, I’m gonna do that.

 

So I felt my anxiety go up a bit. I like medium amount. And I went and stood there and the train still wasn’t coming yet. And it was like, what if the wind blows and pushes you in? What if this happens? What if you get vertigo? What if you just, I don’t even know why, but you just fall over. What if the train creates a wind that pushes you over?

 

What if somebody comes close to you and you get startled? What if you cough too hard? I mean, the, the most ridiculous things are coming up. And I was like, yeah, that’s all possible. That’s exactly why I’m gonna stand here, because I’m hoping that hap I hope I cough so hard, I fall on the tracks. Yeah, that’s gonna happen.

 

Um, and so that’s exactly what I did and I thought, well, let me share this exposure with other people. Who are trying to maybe do lower level exposures to their suicidal SCD to see if I can get through a really high level exposure. You can certainly do something less than this, if not the same thing. Um, and so that’s exactly what I did, sort of held that up there.

 

The train was coming and of course the closer the train gets, the more my anxiety’s going up. Like, you’re gonna jump. And I got the intrusive urge. See, you’re just gonna flip yourself over. And I just waited. And again, it. It went by me and I was like, eh, maybe next time. Um, because so far I’ve done this exposure about four times, and I haven’t thrown myself in the tracks yet, but maybe another day.

 

Kimberley: Yeah.

 

I think it’s so great that you, and thank you. I know it’s, it’s, it’s, um, vulnerable stuff, but it’s so great that you can. Explain that minute by minute. ’cause I think that really does give a deep understanding of what it’s like for someone with suicidal obsessions or OCD in general. Like, it, it just is so dang creative and dramatic and, and it can find its way into the every little corner of the potential problem and the potential consequences like that is just so typical of OCD.

 

And so thank you for sharing that. Um. For contrast now, I mean, we can talk about treatment in a little bit, but for contrast, what is, what is the experience of someone who has real, um, ideation? Um, what does that look like for folks who are experiencing it? 

 

Tracie: Yeah, well, I think su so suicidal ideation or passive suicidal ideation, you know, for people that don’t know, it’s thinking about. Not wanting to be here anymore, thinking about not wanting to be alive, but maybe you’re not quite at the part where you’re like, and for sure I don’t wanna be alive and for sure I’m gonna do something about it.

 

So it’s sort of the precursor or just a different space. So what I like to think of it as, and this is how I always describe it to people, and when I’m training therapists or talking to my own clients. I say, you know, humans don’t get a pause button. If we had a remote control where we could just hit pause, fast, forward, stop.

 

I feel like sometimes passive id, suicidal ideation is that we’re asking for a break. Can I just catch a break? And most of us can’t take breaks from our life. There’s no just can I go sit in a, you know, on an island alone and not think about my problems? Nobody can do that, that I know. Maybe somebody. Um, and so the thought that I don’t wanna be here anymore, a lot of times goes with that.

 

So it’s depressing. You’re very stressed out and you’re just like, I, I wanna break. So that’s what I think about passive suicidal ideation. I have that on and off. Um, I don’t know, at least a couple times a month, sometimes several months in a row where I’m just like, yeah. It would just feel so much easier if I wasn’t here anymore.

 

I wouldn’t have to do the following hard things. I wouldn’t have to get through this tough situation I’m in. Um, so that’s, that’s what that’s about. And, and, and it doesn’t mean, you know, maybe you’ve thought of ways that you wanna do it, and I feel like that’s sort of sometimes, especially for clinicians and sometimes also for people suffering, go, oh no, but I thought of a way and isn’t that a problem?

 

Then I always say, doesn’t everybody have a way? I mean, maybe I’m completely lost, but I feel like everybody who’s ever thought of this thought of a way, I have a way I’m not using it, but I have a way that doesn’t make it more dangerous. It just means that I’ve thought it out.

 

Kimberley: Yep. And so when, when do we then go into active suicidal ideation? What would that look like? 

 

Tracie: You know? That’s going to look like, first of all, that you recognize that you have given up. You recognize that this is too much for you, and you recognize that you would like to start making steps toward researching and moving toward that plan or a plan. Maybe you’re looking online for ways to do it.

 

Maybe you’re looking around your house. Maybe you started collecting pills or looking up dangerous combinations or, uh. You know, giving your stuff away, um, saying goodbye to people. Like really you’re actually in active planning to go toward ending your life, not wondering if you’re going toward it, not wondering if maybe that’s what this is about.

 

It’s, and, and as somebody who, who has had that type of suicidal act of suicidal ideation and, um. And I’ve had a couple of obviously failed suicide attempts. Um, it doesn’t feel, didn’t feel anything like my suicidal OCD. This felt like the true bottom, hopeless. I’m done. I don’t have the energy to go on and I’m gonna do something about this.

 

Kimberley: Thank you for sharing that and so. You’ve beautifully outlined the difference between these three. So there’s suicidal, um, OCD, there’s passive ideation, which you’ve talked about it being like, I’m, it’s not that you want to, you know, die by suicide. It’s more of just like, this.

 

is too hard. And I wish there was an easy way to just eject. Um, you know, what’s so difficult and then that more active suicidal ideation, which is the plan, the intent, um, the moving towards that plan. action involved. is it possible for folks to swing between these three areas? Um, and if that was the case, what, what would you suggest they do? 

 

Tracie: Yeah, um, definitely ’cause I’m somebody who definitely has switched between the three over time. I have a depressive, persistent depressive disorder on top of my OCD. Um, and I would say yes, first of all, yes, you can be on any given day in any of those places, and if you have suicidal OCD, it’s probably gonna latch on anytime that you happen to be depressed.

 

That’s just one of the triggers tends to be for people with suicidality, now I’m depressed. Now it’s more likely that I’m gonna have this thing happen, which is. True. Um, so I think it’s about staying in contact with, if you’re in treatment, letting your therapist know if you’re at that hopeless place or you believe you’re really close to it, or, um, you really feel like I, I don’t wanna be here anymore.

 

Um, and making sure that they know that and that they get you somewhere to be safe if you’re not in treatment. Recognizing that for yourself so that you do go to a crisis center. You call, you know, your local crisis number, go to the emergency room, you get evaluated so that you can be kept safe while people help you, uh, kind of regulate back to a, a place where maybe it’s just passive now and maybe we can get our life back on track.

 

Um, but I would say it’s, you know, to me it really kind of goes more along with, with the depression. Are you doing something about it? Um, are you not doing something about it? Because I know a lot of studies show like, you know, untreated OCD can increase depression, but also depression can get better as you get your OCD treated and vice versa.

 

You can do better treatment, uh, for your OCD when you’re less depressed. And 

 

Kimberley: Yes. 

 

Tracie: these things are really connected, so you can see how they all play with each other over time. ’cause maybe you’re doing better this month and so everything’s better. And then maybe the next month something really hard happens.

 

So it’s really knowing the difference. Like I know the difference, like if I really was wanting to jump in front of a train, I wouldn’t go to the train station and stand that close to the tracks. For instance, I would know. That I intended to do that, and I wouldn’t go to the train station. I would go get myself some help.

 

Kimberley: Right. And so what I think you’re saying, and you can correct me if I’m misreading this, but if you’re having real, um, active suicidal ideation, we don’t do exposures for that. We actually go get help.

 

Tracie: That’s it.

 

Kimberley: Um, if you’re having. Intrusive thoughts, intrusive urges, intrusive, uh, commands. Um, then you would move more towards what we talk about here a lot on your anxiety toolkit, which is using exposure and response prevention. Um, you would engage then on those skills. 

 

Tracie: That is correct. Exactly. If I, if I had been thinking at breakfast, if I was crying and just thinking about how I wanted to end my life and I was gonna run in front of a truck. I wouldn’t have put on running shoes and run toward the street. I did that because I knew that that did not agree with what my values were in that moment.

 

Kimberley: Yeah. And you that, so that’s a beautiful little nuance piece here is you’re obviously an expert in this area. You, you, you know, you’ve had a lot of experience. You obviously are very good. How would someone who’s new to this start to know the difference? Because like we’ve said, commands can feel intrusive, commands can feel like active. Suicidal ideation. So can you talk us through like how might somebody identify what is OCD versus what is a real danger to their wellness? 

 

Tracie: Yes. I love that question, and I talk to therapists about this probably every week because it’s dear to my heart as somebody who had suicidal OCD that was misdiagnosed. It wasn’t assessed properly. It wasn’t treated properly. Um, and I think. One of the biggest errors, it’s gonna sound nuts, but I’m gonna call it an error.

 

The people will say, I want a error on the side of safety and put this person in the hospital and erroring on the side of safety when you actually, it’s, you just don’t know how to do this. Assessment properly can cause clinical harm, so causing one kind of harm instead of a different kind of harm is not better.

 

You know, as somebody that spent 29 hospitalizations with suicidal and homicidal OCD sitting in seclusion where people are telling me I’m a harm to myself when I’m not, that’s what created me to become suicidal in real life. So I like to point that out because that’s probably the number one thing I hear is, but yeah, but I wanna be careful.

 

You wanna be careful. You have to do an excellent assessment. You’d need to ask a million questions if that’s how long it takes you to figure it out. So 

 

Kimberley: a clinician. 

 

Tracie: as a clinician, so when somebody says, oh my gosh, I just, you know, I, I can’t stop thinking about harming myself. I’m thinking that I’m going to whatever.

 

I’m gonna, you know, stab myself. I’m hiding all the knives and sharp things. Well, somebody who wants to do that, I wonder why you’re hiding them all. Are you hiding them because you’re afraid of doing it or you’re hiding them because you want to do it and now you’re scared and you’re gonna go to a hospital?

 

Explain this to me. You know, I’m having thoughts about it. Okay. And, well, I have images about it. Okay. But I feel like doing it. Okay. So tell me, what are your reasons for living? Sometimes it’s those protective factors as we call them. Why? Why wouldn’t you do it? Oh, I wanna see my kids grow up. I wanna do this, I wanna do that.

 

I have all these things. I wanna travel. That doesn’t sound like somebody that’s actively suicidal to me, it sounds like suicidal. When you are not inspired by things anymore, you’re not looking forward to the future. Um, I think about that very first hospitalization at age 10. The question was. Have you had thoughts about harming yourself or ending your life?

 

Yes. Done. Book closed. We’re done. You’re going to the hospital. The follow-up questions could have been, do you have, have you ever thought of a way to do that? Yes. Okay, so now it’s getting a little nervous. Okay. Do you intend to do those things? No. It scares the heck out of me. Oh, okay. Done. Hands washed.

 

They could have just put me into some OCD treatment and we would’ve called it an afternoon, but they were erring on the side of safety, um, as they call it, and did 10 years of clinical harm instead. So I think really it’s asking questions, but also recognizing how somebody, even just their presentation, I think about the difference between when I had untreated.

 

Suicidal OCD. These thoughts were terrifying to me when I was truly suicidal. Those thoughts were welcome. These were welcome thoughts. These were, yes, absolutely these, this is not distressing. It was, I was distressed about life and that’s why I wanted to do this. And that’s clear line different. I’m gonna do this.

 

Let me go figure out the best way to do it. Not I’m distressed by all the thoughts coming to me about ways to do it. What if I do this? Oh no. What if this means something versus I’m done.

 

Kimberley: Yeah, I know for me clinically, I remember when I was y younger and greener in my work. Um, I had a client who had suicidal obsessions and you know, as a new clinician you’re kind of like kind of reading off a script almost, you know, you know what it’s 

 

Tracie: Yeah.

 

Kimberley: kind of horrifying to think back. But I was asking her those sort of very good clinical questions and her answer kept being, I don’t know, don’t know. I, I, I don’t know, like, you know, and, and I think that is also an a, a. A little gap that a lot of clinicians are like, well, if you don’t know, we will err, err on the side of like, so what are your thoughts on if someone’s experiencing that? Well, like, I’m not sure I, I, I think it’s o cd, but I, I don’t wanna do it, but I, I feel like I do.

 

And, and they’re sort of like teeter tottering back and forward. What, what can you share about that? 

 

Tracie: Yes. I think that happens a lot. I actually, one of the things I say is don’t expect the person to know whether the difference, this is your job, if they are coming at you with confusion. That sounds like OCD to me 

 

Kimberley: Hmm. 

 

Tracie: You’re not confused when you’re suicidal. You’re like, this is a terrible life. I’m done.

 

I don’t wanna be here anymore. What’s the point? That sounds very different than I don’t know, which is how I used to answer all the questions when they would ask me on a weekly basis. Are you still thinking about it? Yes. Um, do have you thought of some ways? Yes. Do you wanna do this? I don’t know. 

 

Kimberley: Right, 

 

Tracie: I just keep thinking about it, so probably.

 

Kimberley: right, 

 

Tracie: seems like it. Why would I be thinking about it constantly if I didn’t wanna do it? Confusing, you know, confusion isn’t the same thing as being suicidal and being done with your life.

 

Kimberley: Yeah. And it’s so nuanced, isn’t it? And I think it does just take, um, the, I know as a clinician. I think the first thing I, what I would say here, and I maybe should have, I apologize, I should have said this at the beginning of the episode for folks, is, is it’s okay to falter on this conversation? You don’t have to say it perfectly.

 

You may need to ask the question. As a clinician, I know I’ve had to ask the same question in a couple of different ways because it is an uncomfortable conversation. You’re not going to clinically present it. Like with all the, the right words. So I think it’s a messy conversation and we have to be okay with it being really messy.

 

And maybe you’re, I don’t know, Tracy, if you’ve got it down pat, but I have to really let it be messy and we both are gentle and slow it down. Um, it isn’t a just a yes or a no. It might be asking more questions. 

 

Tracie: Exactly. No, because everybody sitting in front of you is also a different individual human, so there’s not one way to go about it. Everybody presents differently. Maybe you have a history with this person, so you know their history. Maybe you, they’re brand new and you don’t know a lot about them, so you’re still trying to figure it out.

 

Um, but no, absolutely. How you ask, you know, again, it just, it just asking so many questions. I’ve certainly had to ask and ask, and ask and ask, and then usually when I’m sort of like, okay, let me go with this. Do you have any reasons to live as well? 

 

Kimberley: Yeah. 

 

Tracie: I’ll shift into, give me your protective factors. Why do you wanna be on earth?

 

What would stop you from hurting yourself right now? And when there’s this nice list of things that make sense, or at least some really valid things, um, I’m like, okay, well that, so would those things would you say keep you from doing it? And they’re like, yeah. Like, oh yeah, I think we’ve arrived at a conclusion then.

 

Kimberley: Yeah. Yeah, it’s, it’s exactly it. Another area I just wanna touch on really quickly, ’cause it’s at the top of my mind, is I’ve had clients who have been consistently having suicidal obsessions, but go in and out of depression. And as a clinician, I also often keep a check with myself of, don’t just assume it’s always suicidal ideation either.

 

I mean, sorry, let me say that again. Um, editors, can you please cut that out? Don’t just assume it’s suicidal. OCD. Too often if someone says, oh, I’ve been having an increase in suicidal thoughts. There have been a couple times where I went to say like, oh, that’s, you know, we just practice your ERP, or I had to pause and be like, no. an assessment. It, it’s not compulsive to do that with a client. It’s not create, it’s not doing co compulsions in session like you’re allowed to, um, help them to arrive at how they might respond. So I just wanted to bring that up as well, just because I’ve fallen into that trap of sometimes we can go the other way and just assume it’s all suicidal.

 

OCD. 

 

Tracie: Yes, it’s absolutely true and. And even further is make sure that every time someone says that they have suicidal obsessions, that you’re not doing a full suicidal risk assessment because then that feeds into, oh no, maybe you’re suicidal and I don’t know what I’m doing. A suicidal risk assessment every session.

 

It’s like knowing the difference between weight. Now you’re, you’re act, oh, you’re having more depression. 

 

Kimberley: yes. 

 

Tracie: That’s going to tweak something in my head. I’m gonna ask some questions. Maybe you just look more depressed. But you’re not saying you’re more depressed and I’m noticing the depression 

 

Kimberley: Yeah. 

 

Tracie: really going, has anything changed?

 

Do you think about this? Have you started thinking about it differently? Have you started having different considerations when it comes to that being suicidal or, or having these, does it feel different?

 

Kimberley: I love that. So let’s work now backwards. So. I think we’re clear. If you’re having active suicidal ideation, go to safety. Tell somebody, let them know if you’re having passive suicidal ideation. What is the science backed. for that. When you’re having depression, you’re kind of giving up.

 

You’re hopeless, you’re helpless, you feel worthless. What might be some really helpful skills or strategies someone can use if they’re experiencing that, disregarding, whether they have OCD or not. 

 

Tracie: Yeah, just purely. Just you’re having passive suicidal ideation, which can be part of depression. Um, yeah, I get that separate from my OCD quite frequently. And I use behavioral activation, uh, therapy, which is basically, I love to just juice it as as easy as possible. All the things that you would normally do if you weren’t depressed, that feel really hard and you don’t wanna do them, do them anyway.

 

Kimberley: Yes. 

 

Tracie: that’s like the whole therapy in a nutshell. It’s pretty easy. Um. Sounds easy, but it feels really hard. 

 

Kimberley: Yeah. 

 

Tracie: Um, so I do that for myself. So if I wake up, sometimes I’m just having like a really stressful situation, um, at home or just in my life. Just being a human is hard sometimes. Um, and I’ll wake up and I’m just like, I don’t, I’m gonna call out work today.

 

I’m gonna cancel all my clients today. I just, I’m gonna sleep. I feel like crying. I don’t wanna do anything. I’m not gonna shower. And then I’m like, just kidding. What would you say to somebody else suffering like this? And I’m like, uh, you have to go to work anyway. You have to shower anyway. Go brush your teeth.

 

I’m like, woo. You know? And even if I have to, and this is real, like sometimes just pulling myself out of bed could be really rough when I’m in that I will roll out of bed and fall on the floor as an interim to getting out of bed. I will crawl a little bit if I have to. I’ll like pick myself up and I’ll be like, Hey, one thing, just do the first thing you normally do.

 

So 

 

Kimberley: Yes. 

 

Tracie: having sunshine, like I sleep with blackout curtains, so it’s pretty much a depression room until you open them and sunshine comes in. So I’m like open, I don’t wanna open it too bad, you know, I have to open it. I have to see the sun and I have to take a shower and, and then I always tell people it’s not because you may will necessarily feel better right away when you’re doing these things.

 

That over time you do this over and over and over and there’s some chemical alterations that are gonna happen in your brain that help cut through that depression and that passive suicidal ideation. Go do the enjoyable things even if you don’t enjoy them.

 

Kimberley: yeah, yeah. That’s what I say. Schedule pleasure. Um, even if they don’t feel pleasurable, schedule the things that used to make you feel some. Even at 1% degree of pleasure. I I love that. Excellent. Okay. And then now let’s sort of pivot to folks with suicidal OCD. we are going to use exposure and response prevention. Is there any nuanced or, um, subtle adjustments you make to an ERP plan for folks with suicidal ideation? Uh, excuse me, suicidal ICD.

 

Tracie: Um, I do not, so I’m just one of those people. Well, I guess I’ll say a couple things. One is ERP in general, I only use it 60 plus years of scientific based therapy. Works for everybody. Been using it for 20 years with clients. Been stayed well myself, using it for 20 years. I happen to be medication resistant, so I only have ERP on board to keep me this well.

 

Um, so, okay, now I just forgot your question. I’m like, we’ll edit this and then remember your question.

 

Kimberley: No, it was, do we, um, so editors help us, um, edit this out, please. Um, the question.

 

was, um, do we make any adjustments to the ERP agenda or, or strategy? 

 

Tracie: That’s right. So all ERP out the door is always safe and legal and ethical, and it doesn’t go against anybody’s morals or values. There’s nothing dangerous about it. And so because of that, that goes across all themes I’m treating. I don’t make any adjustments. Um, and because people are like, I know, but isn’t it scary that you know, they’re afraid that maybe they’re going to, you know, do something with a sharp object?

 

Shouldn’t we put them away? The answer is no, because that would make it worse. That would make you fear that you’ll do something that you’re not gonna do, which is the same as fear. If I don’t wash my hands, I’m going to get whatever. Germs or illness, it’s not different. So, um, no, actually we go toward it, but we don’t ask anyone to do anything that’s unsafe, so it wouldn’t make sense.

 

Like, I, I mean, I can show you if you want, but I keep a very large knife, um, next to my computer station at all times because I have suicidal OCD and I have this intrusive thought at all. I’ll show you. It’s a, it’s a, it’s, it’s a. I, this is my suicide slash murder knife, um, because I have suicidal and homicidal, uh, ideation.

 

No, I’m just kidding. Um, I actually have the OCD and, um, so this has been there forever actually. I, it doesn’t bother me at all. Um, and the reason 

 

Kimberley: next to you all the time, 

 

Tracie: all the time, this is always, it’s, it’s actually next to my mouse pad at my computer at all times. Um. And the reason I have such a large knife is because I, I have had solid for probably the last year, the intrusive thoughts and images and urges that I was going to take a knife that’s large enough to go in my throat one way out the other way, and that I would always do it while I’m on a Zoom call, by the way, either with a client or running a support group where I then also traumatize other people and they all learn.

 

That. Just kidding. If you have something sharp next to you, something bad will happen. And so I used this specifically because it, it fit, it’s large enough to fit the bill for what it’s saying, and I keep it handy. And there’s nothing dangerous about that. Now, of course, we’re gonna work up a hierarchy. I’m not gonna just meet somebody and say, put a large knife next to yourself at all times.

 

We, we have to start an ERP low. Think about what if you were. You know, buttering your toast with a butter knife and your daughter walked by, um, would you also butter your daughter? Um, you know, whatever. And

 

Kimberley: I saw the most awesome reel this morning of a mom who had gotten, taken her baby’s baby’s booty off like a little sock and butted the to little toes and put it between two croissants and pretended to eat it. And she would, she’d post it about how this would be an exposure for some people, and it just 

 

Tracie: Oh my gosh. Exactly. See, but somebody who had harm o CD with their baby, that might be an excellent, excellent exposure, especially if they have cannibalism, OCD. I mean, I feel like that one’s good for like five themes all at once.

 

Kimberley: Sorry, I didn’t mean to cut you off, but it just cracked me up so much. 

 

Tracie: Yeah, no, I mean, so, so no, I don’t make any adjustments. Um, I’m somebody who does very high level exposures for myself, but also, not everybody has to do really high level exposures. Sometimes you just, it’s altering treatment to be appropriate for the person who’s right in front of you, and I think that’s what’s important.

 

Sometimes I have people that are like, listen. We’ve gone all the way up my hierarchy of exposures and I’m still a little bothered. I’m like, you wanna go next level with me? And they’re like, sure. It’s like, all right. Train station platform. You know, that’s when we start getting into the, like, larger things.

 

Um, so I, I almost consider them to be preventative. Not that you can prevent OCD preventative in that I’m not waiting for my themes to come haunt me because I’m always haunting them.

 

Kimberley: Yes. I call it the insurance policy on your OCD if you’re willing to go to the top level, that’s your insurance policy on your treatment. Um, it’s not that it will pre prevent it from coming, but it’s, it’s a really good way to like put a long term like guarantee on the, the changing of your brain. 

 

Tracie: Yet.

 

Kimberley: So before we move on, I, I’ve got a another few questions about exposures for suicidal OCD. Um, do you also implement scripts imaginal? What role does that play in the treatment of suicidal OCD? 

 

Tracie: Yeah, I, you know, I find everybody’s a little bit different, so I try different things. So like on a lower level, we might just be writing down a triggering word like suicide or. End my life or draw a picture of a knife, um, or writing a script about it or writing a goodbye letter or writing. And then I ended my life and then making a funny ending actually like, and then my kids had a party with all the money they saved ’cause they didn’t have to buy me Christmas gifts.

 

Um, that’s a big one I like to do. It adds in a little cognitive diffusion or humor. 

 

Kimberley: Yes, 

 

Tracie: Techniques that sort of make it sound silly. I’m a very, very big on humor because nothing about OCD is funny. It never feels funny, it doesn’t feel humorous. I tend to keep humor in all of my stuff. Very few people actually, that I work with don’t like it Sometimes.

 

Sometimes like, listen, I don’t wanna laugh about this. And I’m like, fine, we’ll take it seriously. Um, write a script and make it serious and don’t have a funny ending. Um, you know.

 

Kimberley: I do think that the, the building humor into it is key though, right? Because if you do, not to say that people who wanna keep it serious is that’s not that they’re doing anything wrong, but we treat it like it’s serious, we’re still training our brain to take it serious. And I feel like if we’re willing to, uh, sing it to the Happy Birthday song, which is one of my favorite.

 

Things or to I play a game called One Up Like You. I’ll say what I think is scary. You make it worse. I’ll make it worse. Even still, you make it worse. We are one up each other. I do believe, especially for these like scare, like topics that are highly misunderstood, bringing humor in is almost crucial.

 

Would you agree?

 

Tracie: I would a hundred percent agree. I use humor constantly. I wish I still had it here because it’s funny. I made myself a suicide bowl the other day, which they’re like, what is a suicide bowl? I took a lovely glass, like, I don’t know, maybe it’s like a fruit bowl or a salad bowl. 

 

Kimberley: or 

 

Tracie: Yeah. Like some very beautiful, it’s like from your kitchen, like something you would serve in.

 

Um, and because my OCD was just the suicidal CD was like, maybe you’re gonna take pills, maybe you’re gonna stab yourself. Maybe you’re going to, so I went around the house and I got a couple different knives. I got a bunch of pills. I put a little bit of, uh, mouse poisoning in there. I just, I found it several I items and I put ’em in and I put in a beautiful bowl, um, and I put it on my desk.

 

Um, and so that was just, you know, you know, and I was like, I like variety. 

 

Kimberley: Yeah, 

 

Tracie: just something funny to say about, so. Yeah. And I was like, you know what? I like to keep my options open. Um, and so it was, it’s an exposure. But also it’s funny, like it’s kind of funny to have a delightful bowl. Like why does it have to be in a beautiful glass bowl with like bubbled edges?

 

Well, because it’s silly. That’s why, 

 

Kimberley: Yeah. 

 

Tracie: um, I want it to be beautiful.

 

Kimberley: I love that you do that. I, I do the, I, I, I have found that my in, in my experience, um, and, you know, 15 years of experience, the folks who are willing to take light and be creative in your exposures, tend to do better. Um, let’s. talk about what happens or what would You do? How might we, um, modify treatment if someone is having active suicidal ideation and having suicidal OCD, um, maybe they’re having active suicidal ideation because they’re so depressed about how terrifying their OCD is. Maybe they have a coexisting condition or they have multiple different obsession subtypes and it’s just. much for them. How might we modify treatment for those folks?

 

Tracie: You know, I like that question and a lot of people will ask me like, do you just stop ERP? Like what do you do? So what I’ll do, and there’s not like a hundred percent perfect answer. Everybody should always do this exact same thing. This is just what I do. I say we’re gonna stop exposures right now. We’re gonna focus on response prevention, so we’re gonna still focus on not compulsing, but I’m not gonna add the distress of the of exposures to you right now.

 

But we’re also not gonna ignore this because I don’t want your OCD to get worse. So I’m still gonna ask you to use non-engagement responses and response prevention messages and do the things that keep you from compulsing. We’re gonna do a lot of behavioral activation, but if you’re actively suicidal right now, in this moment, I’m also going to actually probably put you inpatient to help you be safe if you’re at that level where you’re actively suicidal.

 

I’m not gonna keep you on an outpatient basis probably, unless you’re like two notches this direction of that. Soon as you’re at that, I’m gonna help you get somewhere that you can get that get, make sure you’re safe, and then come back out. If you’re sort of right before that, and you’re not quite there yet, I, I’m, I’m gonna do some behavioral activation, is gonna be my main focus.

 

We’re going to work on building hope and we’re gonna work on making sure you’re not compulsing.

 

Kimberley: Yeah, Thank you for that. Thank you for that. Often parents will ask me, um, let’s say I have a young adult or a teen who have both. and of course parents are anxious too because no one wants to see their child in that situation. The parents wanna keep checking on their child, right? And, and making sure they’re okay. How might we help the parents or the loved ones, the partners, um. Support the person, um, if they’re having both or one of these, you know, conditions.

 

Tracie: Yeah, I mean, if somebody, if strictly has suicidal OCD, um. If you’re not gonna keep checking on them, you’re not gonna ask them how they are. If they ask you to hide something, you’re not going to. If they say, do you think that this means that I’m going to do something? You answer, maybe, I don’t know. Could be, Hmm, not really sure about that.

 

Maybe you should talk to your therapist. Um, I have two outta my three kids have OCD, so I get to practice this as a parent sometimes. Um, yeah, I don’t know. Sounds like it could be amazing or terrible. And 

 

Kimberley: Yeah. 

 

Tracie: they’re like, ah. Um, however, when people are actually depressed, maybe they really are suicidal or passively suicidal.

 

Um, doing regular checks, just sort of paying attention to have their eating patterns changed? Have their sleeping patterns changed? Are they isolating more Kids tend to isolate in their room partners too. I dunno what it is about bedrooms, I guess. ’cause you could just lay there. Um. 

 

Kimberley: Yeah. 

 

Tracie: Maybe somebody isolates in their living room if you don’t have a bunch of kids running around.

 

Um, but, um, Nick’s noticing those behaviors and then checking in with somebody. Is there something that I could do, you know, is, has anything changed? You know, can I get you, can I help? Can I join? Maybe if you’re in therapy, can I, would you be okay if I joined even part of one of your therapy sessions so I can learn more about this or help them understand what’s going on?

 

Um, and that goes for the OCD or the. Just depression. I’m a big fan of having family members. Loved ones come into a session and ask, I recently did a session with parents who were like, well, you know, they, she’s always asking me, you know, do you, mom, can you like, you know, I, I need you to hang on to all my belts.

 

I don’t wanna hang myself and I need you to hang on. Oh, mom, get rid of all this stuff. And I was like, no, I think you should just pull it all out. 

 

Kimberley: Yeah. Yeah. 

 

Tracie: Just pull it all out. That’s what I would do. You know, and mom and I actually, we had. A loose belt each of us in session that we wore. Uh, and the kid didn’t want to, that was okay.

 

Um, and we’re like, we’re gonna wear the belts around us like it’s a necklace belt. Do you like it? Do you like it? Do you wanna wear one as well? So also sort of being, showing people, whether it’s a partner or your child, um, participating can be helpful. We do that as ERP therapists sometimes. Um, you know, I’m like, listen.

 

You’re, you wanna hold the knife? I’ll also hold the knife. How about that? You know, you’ll do that. I’ll do that with you.

 

Kimberley: Amazing. Amazing. You are amazing. I, I, this has been so wonderful and I think really on point in helping people find a very compassionate, rational, effective way to differentiate. Between these three really difficult experiences. Is there anything left that we haven’t said? I mean, that, you know, of course there’s a million, we could go on for hours talking about this, but is there is something, some point that you feel like we really need to cover here to really hit this home for folks?

 

Tracie: I mean, I, I would say, uh, from different angles, right? If you’re a clinician or you’re a provider who treats these things and you’re not comfortable in knowing the difference, make sure that you con consult with people who do. 

 

Kimberley: Mm-hmm. 

 

Tracie: out to somebody who does, don’t try to do something that you don’t feel competent in without good oversight, because that’s when things go wrong.

 

Um, we don’t like mistreated any disorders. Um, if you are somebody who’s suffering from a condition and you’re being treated and you feel like things are getting worse and not better. It’s also okay to tell your provider that it’s also okay to switch. I feel like sometimes people get really attached, but I really like so and so.

 

I’ve been seeing them for a long time. Well, that to, okay, but like are you getting better is my question? Ask yourself if you’re getting better and if you’re not getting better, seek evidence-based treatment. Even sometimes people will say like, this is evidence-based treatment, or, I am doing something that’s helpful.

 

If you don’t feel helped, go find help elsewhere. You know, fig, so that you can get that treatment that you deserve. Um, and know that there’s always hope, because it doesn’t matter what your history is, it doesn’t matter, you know, like people are like, oh, it’s a miracle you’re here. I’m like, it’s not a miracle actually.

 

I’m just here. I’m the person and I have this history and, and don’t be afraid of people’s history, I guess would be the other big thing. I get that a lot. I’m kind of afraid this person has done this being in the past. It’s been like this and this, and now they’re saying this, and I’m like, oh, you just described me.

 

Do you wanna put me in a hospital today? No. Okay. So don’t be afraid of a presentation. Um, if you have your own anxieties, like get consultation for it, 

 

Kimberley: Yeah. 

 

Tracie: out so that you can get better at it if you care to get better at at, at this particular thing. And if you’re not comfortable, just don’t do it.

 

Kimberley: Yep. Amazing. I love that you talked about that too. Um, right. That, that we have to, as clinicians, we have to check ourselves, 

 

Tracie: Yeah.

 

Kimberley: and our own anxiety that shows up. So that’s really, really wonderful. And I think too, I, I would add for folks who have been, let’s say, mistreated or misdiagnosed, um. Just continue to look for OCD trained clinicians. A lot of folks have been, you know, admitted to a hospital incorrectly. But if, you know, again, just make sure you’re doing a thorough give, ask the questions before you see them. Um, you know, have you had OCD training? Do you know what ERP is? So that you know that these are people that will be able to handle you and your condition. 

 

Tracie: Yes, exactly. Exactly. And every therapist is not for everyone. Like I’m not for everyone. There are people who are looking for somebody that’s like extremely fluffy and soft and. And I just tend to be like, are you suffering? Yes. Do you wanna get better? Yes, I’m very solution focused. Let’s get on it. ’cause you have to get better now let’s do it.

 

You know? And so sometimes some you are with somebody who’s trained, but it just doesn’t feel like a good fit. And that’s okay too. It’s okay to go find somebody who feels like a better fit for you.

 

Kimberley: Yeah. Yeah. Beautiful. where can people hear about you more, learn from you.

 

more, get in touch with you. You are literally dynamite in this area, so tell us everything. 

 

Tracie: Thank you. Well, um, I’m actually very minimally on social media just because I feel it drives me nuts. So I’m only on Instagram, um, at Taboo. Tracy Tracy’s, T-R-A-C-I-E. Because I’m unique like that. Um, and yeah, it’s all about OCD advocacy, taboo themes, some of my exposures, a lot of stuff about treatment. So,

 

Kimberley: Yeah. It’s a really, really good Instagram. I love, it’s there, there are no other Instagrams like 

 

Tracie: oh.

 

Kimberley: Yours, yours is raw and, and to the point. It’s exactly, you. It’s so good. I just find it’s, I tell all my staff to follow you. It’s so good. 

 

Tracie: Think you That’s so sweet. I mean, I’m on LinkedIn case was like, and what, what are her credentials on? Where has she been doing the last 30 years? You could go to LinkedIn and find that out. It’s a little less exciting. Um, I have no exposures on LinkedIn. It turns out just my credentials. 

 

Kimberley: And where can people work with you? 

 

Tracie: Um, well, I have a couple of different areas.

 

I am, I work at no cd, um, which you can go to no cd.com. Um, and I also have my own private practice, specialized psychological services. I’m not always taking new people in either area. Sometimes I’m full, believe it or not. Um, but always happy to reach out and we can talk about it.

 

Kimberley: Amazing. Thank you. I truly am honored. This was a beautiful conversation. I feel like you covered a lot in a very short period of time, so you should be very proud. 

 

Tracie: Thank you. I’m so glad just to be here and have somebody who can talk about these things in an intelligible way to spread real information. I mean, this is, this is like what? Like, this is what I live for. Actually, I live for a bunch of things. Uh, but this is one of the major things that drive, this is my passion inside.

 

This is what gets me out of bed when I’m depressed. You’ll get up and show people how to do this, and I’m like, oh, that’s true. You care about it. And so thanks,

 

Kimberley: it’s true. You do. It’s a very inspirational, truly. 

 

Tracie: thank you for having the space to do it in.

 

Kimberley: Yeah. Thank you.