The Upside of OCD w/ Michael Alcee

September 19, 2024·55 min·5 clips

Michael Alcee argues that OCD involves a unique temperament with extraordinary empathy and a fertile imagination.

Clinical psychologist Michael Alcee discusses his book "The Upside of OCD: Flip the Script to Reclaim Your Life" with host Scott Barry Kaufman. Alcee practices an integrative therapeutic approach combining existential, humanistic, psychodynamic, and Jungian elements. He challenges the standard medical model of OCD, which defines the disorder as intrusive obsessions paired with anxiety-reducing compulsions. Alcee proposes that people with OCD possess a distinct temperament characterized by heightened empathic sensitivity, with German research showing they score higher on empathy than both healthy controls and those with other anxiety disorders. He argues they also exhibit existential sensitivity and fertile imaginations that can spiral into "what if" scenarios. Alcee reveals that Charles Darwin struggled with OCD, obsessing that his children would die and seeking middle-of-the-night reassurance from friends about potential offenses. The psychologist describes people with OCD as having "hearts ten sizes too big" but lacking self-compassion, often treating themselves as mass murderers despite being scrupulously moral. When Kaufman shares his own OCD checking behaviors at airports, Alcee traces them to feelings of lost control during transitions rather than treating them as meaningless symptoms. Alcee recounts his COVID-era obsession about a potential dental cavity triggering family deaths, which he resolved by recognizing his underlying grief and fear rather than just tolerating uncertainty. He critiques exposure-response prevention (ERP) therapy for focusing solely on content while ignoring the emotional and existential context of symptoms. Alcee advocates combining behavioral techniques with exploration of feelings and meaning, arguing that OCD often conceals important emotional information about loss, change, and mortality. The conversation references creative individuals with OCD including Nikola Tesla (counting in threes), musician Jack Antonoff, and singer Camila Cabello. Alcee notes OCD has high comorbidity with other conditions, potentially because neuroticism threads through all mental disorders. He frames people with OCD as "existentialists from the start" who wrestle with being versus non-being without proper philosophical vocabulary or mentorship. The discussion maintains a conversational, exploratory tone blending clinical insight with literary and philosophical references from Leonard Cohen to Carl Jung. Both participants self-identify as humanistic psychologists and openly discuss their own OCD experiences. The conversation appeals to clinicians seeking alternatives to pure behavioral approaches, people with OCD looking for more affirming frameworks, and those interested in personality, creativity, and existential psychology.

As heard by us

A humane case for OCD as struggle, temperament, and meaning-making.

The episode treats OCD as more than a list of symptoms. Michael presents it as a temperament shaped by heightened existential sensitivity, a richer imagination, and a drive to make meaning.

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Why you'd press play

If you want a less flattening OCD conversation, start here.

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