99. OCD and Inferential Confusion: When Reality and Imagination Collide with Carl Robbins

Do you ever find yourself double-checking if you locked the front door? Or perhaps you've felt the need to wash your hands repeatedly, even though you know they're already clean? These common experiences might seem like minor quirks, but for individuals with Obsessive-Compulsive Disorder (OCD), they can become all-consuming battles against inferential confusion.

In today’s episode of The OCD Whisperer Podcast, we are thrilled to be joined by Carl Robbins. During our conversation, we discuss the concept of inferential confusion in OCD, where individuals confuse their imagined possibilities with reality. Carl explains the difference between normal uncertainty and obsessional doubt in OCD, and emphasizes that OCD is always in the imagination and disconnected from relevant information in the present moment. The conversation also touches on the controversy between choosing Exposure Response Prevention (ERP) or Inference Based Cognitive-Behavioral Therapy (ICBT) for treating OCD.

In This Episode

• [01:15] The concept of inferential confusion in OCD
• [03:47] Differentiating normal uncertainty and obsessional doubt
• [08:23] How obsessional doubt manifests in checking compulsions
• [09:20] The difference between doubting processes in OCD and normal uncertainty in everyday situations.
• [10:27] How obsessional doubt arises in OCD and the role of inferential confusion in creating selective reasoning errors.
• [12:55] Choosing between ERP and ICBT
• [19:21] The concept of inferential confusion in OCD and how it relates to finding effective treatment approaches.
• [20:12] Different models and choices in OCD treatment.

Notable Quotes

• [07:06] "Obsessional doubt is based 100% on my imagination, and once you cross over into the imagination, there are endless possibilities.” - Carl
• [15:33] “I think often people will say ERP has been around longer than ICBT... and that if it doesn't work or, you know, very often people will get a response, but they won't go into remission..” - Carl
• [19:58] “What's so important is to understand that nobody's wrong. These are models. These are theories that are applied to our understanding of OCD and how to treat it.”

Our Guest

Carl Robbins is the Director of Training and Senior Clinician at the Anxiety and Stress Disorders Institute of Maryland. With over 35 years of experience treating OCD and related disorders, Carl has been a mentee of Dr. Sally Winston and has attended multiple trainings through the IOCDF, ADAA and ABCT. He has also presented at the IOCDF and ADAA conferences on OCD and recently underwent individual training with Dr. Fred Aardema, the co-developer of Inference-based CBT for OCD. Carl is passionate about promoting the dissemination of ICBT in the US through various platforms, including consultation, teaching, lectures, social media, and podcasts.

Resources & Links

Kristina Orlova, LMFT

• https://www.instagram.com/ocdwhisperer/
• https://www.youtube.com/c/OCDWhispererChannel
• https://www.korresults.com/
• https://www.onlineocdacademy.com

Carl Robbins

• https://www.linkedin.com/in/carl-robbins-3839039/
• https://www.anxietyandstress.com/

Mentioned

• https://icbt.online/

**Disclaimer**

Please note, while our host is a licensed marriage and family therapist specializing in OCD and anxiety disorders in the state of California, this podcast is for educational purposes only and should not be considered a substitute for therapy.

Stay tuned for bi-weekly episodes filled with valuable insights and tips for managing OCD and anxiety. And remember, keep going in the meantime. See you in the next episode!