The Hardcore Self-Help Podcast with Duff the Psych

A New Approach to OCD: Internal Family Systems w/ Melissa Mose

Nov 10, 2025
Guest
Melissa Mose
Melissa Mose, LMFT, a 30-year clinician who specializes in OCD and blends IFS with ERP. She explains how sudden-onset OCD changed her path. The conversation covers what OCD really looks like, how IFS maps inner parts, why combining IFS and ERP can help, and Melissa's Self-led ERP model and training work.
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ANECDOTE

Sudden Onset Childhood OCD Changed Her Career

  • Melissa Mose's daughter developed sudden-onset OCD at age eight after a bout of strep, later considered PANDAS/PANS.
  • The child became preoccupied with food contamination (e.g., 'did I swallow plastic?') and improved quickly after intensive outpatient ERP.
INSIGHT

How The Obsession Compulsion Loop Works

  • OCD is a negative-reinforcement loop where obsessions raise distress and compulsions relieve it, teaching the brain that rituals work.
  • Compulsions can be physical, mental, reassurance-seeking, or avoidance, and the temporary relief strengthens future ritual use.
ADVICE

Do ERP In Small Steps And Prevent Rituals

  • Use Exposure and Response Prevention (ERP): expose to the anxiety trigger and prevent rituals so the nervous system habituates.
  • Start very small, scaffold exposures, and build capacity so clients can learn anxiety settles without rituals.
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