Obsessive compulsive disorder - OCD treatment and therapy from NOCD

For years, no one listened to my OCD struggle – I’m making sure no one feels the same way

9 min read
Jessica Migala
By Jessica Migala

Tracie Zinman-Ibrahim, LMFT, CST, wasn’t the first in her family to become a therapist—and she wasn’t the first to struggle with obsessive-compulsive disorder (OCD), either. But despite her family’s experience and professional expertise, it wasn’t until she’d suffered for decades that she finally conquered OCD.

As Tracie looks back on her childhood, she sees that her OCD symptoms started when she was around age four or five. She was constantly counting—ceiling tiles, telephone poles—and following strict rituals. It was exhausting and distressing, especially for a young child: “These behaviors started really young, but no one noticed or mentioned anything to me that it could be OCD. And I didn’t know any different. It felt just like a ‘me’ thing,” she says. 

It was similar for other members of her family, too. Her grandma had contamination OCD, with intense fears of contracting an illness—especially around bathrooms, floors, and food. But it was never taken seriously. 

Though Tracie’s mom was a therapist herself, the family’s OCD symptoms were generally brushed aside. “No one in my family ever got treated for OCD. It was more often minimized and treated casually: Ha ha, isn’t it annoying that grandma washes her veggies 12 times? or Oh my gosh, that’s so OCD! We were aware of it as family, but not in the way we should have been. Not in a way that helped anything change,” she says. 

The day OCD took over

At age 11, things took a decided turn for the worse. Tracie was grieving a tough living situation at home. Her parents had gotten divorced and she was dealing with the challenges of having a step-parent. She was depressed. One night, the sadness was so intense, she couldn’t stop crying. Her parents were confused about what was going on, and neither one of them wanted her at their home when she was in such an emotional state.

Tracie had been seeing a therapist, and so when her dad called to ask what he should do, her therapist suggested he bring Tracie into a psychiatric hospital for an evaluation. There, she was asked one single question that would completely change the course of her life: “Have you ever had thoughts of hurting yourself or someone else?” 

“Something in my brain clicked. I never had thought of hurting myself; never considered if that was an option. Thoughts about dying, though? My head started spinning all of these ideas,” she remembers. Tracie told the staff that yes, she had. 

After that, Tracie was immediately admitted to the child and adolescent unit at the psychiatric hospital. “I was terrified. I didn’t know what was going on. I spent the next few days crying constantly and thinking about harming myself—I couldn’t get it out of my head after the staff asked me that question,” she says. In group therapy, other kids would talk about how they’d cause self-harm by scratching or cutting. And that’s how Tracie learned how to hurt herself. 

Thoughts of self-harm continued to consume her mind. At the time, she had no idea what was going on. Looking back though, Tracie is confident that it was the start of her suicidal OCD, a subtype of OCD focused on distressing and unwanted thoughts or impulses about ending your life. In reality, people with suicidal OCD want to protect their life, not end it.

Between the ages of 11 to 18, Tracie spent most of those seven years hospitalized or in residential care. At one point, she was sent to a state hospital where she was placed in seclusion. When the staff would ask if she still had thoughts about hurting herself, she’d tell them that it was all she could think about. During that time, she also suffered from homicidal OCD, a symptom of harm OCD, where she had intrusive thoughts about hurting her father. 

During her long hospitalizations, Tracie didn’t understand what was going on. She was well aware of her OCD, but struggled with her identity as someone who, she had been convinced, was suicidal and homicidal. The truth is, she wasn’t either of those things—it was her OCD talking. 

As a young teenager while at home on a short break away from the psychiatric hospital, Tracie did what few teens do in their spare time: she read through her mother’s copy of the Diagnostic and Statistical Manual (DSM). And reading through the description of OCD, she saw her own experiences, clear as day. 

And so starting at age 15, Tracie began telling the staff at her psychiatric hospitals that she had OCD. Her psychiatrists—the very people who were supposed to be taking care of her mental health—never even considered that she had the disorder and didn’t listen to her. 

“I saw dozens of therapists and psychiatrists, and I still didn’t have an OCD diagnosis. They ignored it completely. After I would tell them I had OCD, I don’t know if they even wrote it down,” she says. Though she, as a teen, had read about the condition in the most authoritative, widely recognized source, “not one person was aware that there were different types of OCD. No one was learning about it.”

As an adult, Tracie was trying to pick up her life and sought mental health treatment to process the events of her childhood. And still, her therapists weren’t interested in hearing about her OCD, and tried to focus instead on her rough childhood. The problem is that with OCD, “talk therapy” approaches like these do not work—and unsurprisingly, Tracie wasn’t making progress. 

Finding treatment that actually works: ERP therapy

No one should suffer, overlooked and unheard—the way Tracie did for years—so she knew she had to make a difference. She went on to become a licensed marriage and family therapist. Eventually, she began to see people who had OCD—and at first, she used traditional cognitive behavioral therapy, which is what was taught to her during grad school. “I noticed that it wasn’t working for any of my clients. I considered that maybe I was just a bad therapist,” Tracie says. 

After searching the internet on a whim—what’s the best way to treat OCD—she saw her answer: a specialized form of therapy known as exposure and response prevention (ERP). ERP has been backed by decades of clinical research. She learned that ERP is fundamentally different from the other forms of therapy that failed to help her in the past, and she was determined to learn everything she could. This was her best shot at putting an end to the suffering she’d endured since she was a child.

Using her expertise as a therapist, Tracie began applying what she’d learned to her own life, actively engaging in new responses to her obsessive thoughts and fears, rather than falling back on compulsions. She started small: at first, she just touched money—something she had avoided for years due to a fear of contamination. But this simple first step made a life-changing difference. It showed Tracie that instead of being ruled by fear, she was capable of choosing what she would and would not do, and what she would and would not believe, rather than always allowing OCD to choose for her. 

For the first time in her life, Tracie found hope that she could truly beat OCD. And she didn’t stop there. Instead, she sought out the specialized training she needed to apply what she’d learned and help others who shared similar struggles. “Eventually, I started using ERP with my clients, and I finally saw them start to get a lot better,” says Tracie. 

This lesson—a lesson of empowerment and purpose—changed the course of Tracie’s life. Today, OCD is still present in her life—her suicidal and harm OCD triggers rear their heads on occasion. But she is able to completely manage her symptoms through ERP. “I get triggered all the time, but people wouldn’t necessarily know. I have OCD, I accept it, and I can now sit in the middle of uncertainty about anything,” she says. 

Now, Tracie is thriving—and she’s helping countless others thrive, as well.

Breaking the same barriers that held her back

Tracie knew she wasn’t the only person whose life had been turned upside-down by the lack of accessible, specialized treatment for OCD—the root of the problem was a mental healthcare system that simply didn’t give therapists the knowledge and training they needed. 

Research shows that physicians and mental health practitioners routinely misdiagnose OCD, according to a review in the Journal of Affective Disorders in 2021. That’s because even highly experienced therapists may know nothing about OCD treatment beyond what they learned in graduate school or during a weekend workshop. But to treat such a severe, chronic condition, much more intensive and specialized training is needed. A pervasive problem, says Tracie, is that many therapists believe—often in good faith—that they are treatment specialists for OCD, when they’ve really only scratched the surface. Too often, they aren’t trained in using ERP, they don’t fully understand how people’s obsessions contradict the values that are most dear to them, and they’re not equipped to provide individualized care to people of all ages, identities, cultures, and lived experiences. 

Tracie recognized that what therapists need is in-depth, specialized, expert-led training in treating OCD—not just the condition, but the OCD community as a whole. Her dedication brought her to NOCD, where she joined the mission to invest deeply in each and every therapist and create a truly world-class network of OCD specialists.  

NOCD properly, extensively trains each and every therapist in our network […] This is something that’s lacking with other therapists and therapy platforms that treat people with OCD.

Tracie Zinman-Ibrahim, LMFT, CST

As Chief Compliance Officer, Tracie’s work starts with NOCD’s rigorous interview process, ensuring that only the most empathetic, qualified, and capable clinicians are able to join the NOCD Therapy network. Selected therapists then go through 3 months of rigorous training, including education on ERP therapy, common co-occurring conditions, cultural competency, and actual mock sessions. At the end of the process, Tracie’s team administers comprehensive evaluations to assess the mastery each therapist has developed through their training—this way, no one who comes to NOCD for help will encounter the ineffective treatment that kept Tracie stuck for years.

Even after therapists complete the full training program, Tracie and other clinical leaders provide ongoing consultation and support. By overseeing NOCD Therapy members’ treatment outcomes, her team can identify when their therapists may need extra support. 

Every step of the way, Tracie and her team ensure that NOCD is setting therapy members up for life-changing results: “NOCD properly, extensively trains each and every therapist in our network to specialize in the gold-standard treatment for OCD, which is ERP. This is something that’s lacking with other therapists and therapy platforms that treat people with OCD,” she says. 

Creating the change the OCD community needs, one therapist at a time

Tracie’s ultimate goal? To put an end to the misunderstanding, lack of access, and improper training and education that have plagued the OCD community for so long. Although real challenges remain—OCD is still highly stigmatized and misunderstood, keeping people from seeking the help they need—NOCD is making lasting recovery more available than ever before. 

If you think you may be struggling with OCD, experts like Tracie truly understand what you’re going through, have learned how to conquer OCD themselves, and are there to guide you through every step of your recovery journey: “I’ve built ERP into my lifestyle. This is where my passion comes from. I lean into it, I bring levity to it with humor and laughter. It helps me to help others.”

NOCD Therapists specialize in treating OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

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