Breaking the Rules: A Clinician's Guide to Treating OCD

Values, Paradox, and OCD: Finding Flexibility in the Tension


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In this thought-provoking episode of Breaking the Rules, the hosts explore how values and paradox show up in the therapy room—especially when working with clients who experience OCD. Drawing from Acceptance and Commitment Therapy (ACT) principles, they discuss how being “fused” with one’s values can keep clients stuck in rigidity, perfectionism, and fear of imperfection.

The conversation dives into the art of helping clients find flexibility between competing values—like control vs trust, safety vs freedom, and perfectionism vs growth—and how learning to hold both truths can open the door to meaningful change. They also unpack how clinicians can use values-based reflection, curiosity, and compassion to move clients beyond “sitting with uncertainty” toward truly living aligned, balanced lives.


💬 Key themes:

• What it means to be fused with thoughts and values

• Common paradoxes in OCD (purity vs imperfection, safety vs health, control vs trust)

• Using values work to build insight and reduce rigidity

• The connection between values, uncertainty, and acceptance

• Why “sit with uncertainty” isn’t enough without context

• Mapping paradoxes and value clashes in therapy

• How building self-concept helps clients reclaim life beyond OCD


🔖 Chapters

00:00 Introduction: Values and Paradox in OCD

02:00 What It Means to Be Fused with Thoughts and Values

05:00 Why Clients Get Stuck in Rigidity

08:00 Common Paradoxes in OCD

11:00 The Cost of Perfectionism and Fear of Imperfection

14:00 Exploring Value Clashes in Therapy

17:00 Building Insight and Flexibility

20:00 Beyond “Sit with Uncertainty”: Context and Meaning

22:30 Rebuilding Self and Identity Outside OCD


#OCD #TherapyPodcast #AcceptanceAndCommitmentTherapy #MentalHealthMatters #ValuesBasedTherapy #ACT #BreakingTheRulesPodcast #ClinicianSupport #OCDRecovery #TherapyTalk #UncertaintyTolerance

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Breaking the Rules: A Clinician's Guide to Treating OCDBy Dr Celin Gelgec and Dr Victoria Miller

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