In this episode, we explore a recent clinical trial of deep brain stimulation (DBS) for the management of severe, treatment refractory obsessive compulsive disorder (OCD). While this study is very small, the authors explore not only which stimulant sites are most effective in OCD, they also studied what stimulation at each site does on a cognitive level and what neural circuits are altered by the stimulation. Along the way, we think about cognitive flexibility (the ability to change the rules that govern decisions) and whether or not enhancing cognitive flexibility is necessary to effectively treat OCD. We also bask in the glory of this example of translational neuroscience and think about what we know about circuits in other psychiatric illnesses.