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A Conversation With Journalist and Author David Adam About OCD

I spoke with journalist and author David Adam over Zoom about the hurdles to OCD treatment, depictions of the disorder in the media, and how people experiencing it can feel less alone. David Adam is an award-winning freelance journalist and author of the best-selling book about OCD, The Man Who Couldn’t Stop.

I’ve had OCD since I was 7 or 8, but I didn’t get diagnosed until I was 29 and haven’t really talked about it openly until this year, at 35. It seems from your book that that’s common—it typically takes about a decade or more for people to get a diagnosis. What do you think are some barriers to seeking and receiving treatment?

I should say first, I think the US is a decade or so ahead of the UK and much of Europe in being transparent about these things. But generally speaking, there are a series of hurdles.

First of all, the person has to recognize what’s going on. It’s natural to not talk about strange, distressing, disturbing thoughts. That’s partly because we think we must be the only person to have ever had these weird thoughts.

So first you have to recognize what’s going on. Then an added complication is that even if you think you might have OCD, the public perception of it is that it’s a relatively harmless behavioral quirk. Every time you see a Hollywood celebrity say, “Oh I’m so OCD because I like to shower,” that makes you think, ‘This is clearly different from that. What have I got?’ When you do decide you have OCD, it takes a certain amount of courage to say these things out loud.

Then in different parts of the world, it’s relatively difficult to actually see that specialist. You have to find the money, or you have to queue like you do here to see somebody at the NHS; that can take months, if not a couple years. And then if you start to get help, the treatment itself is pretty difficult, if you do behavioral exposure stuff.

So all of those are hurdles you have to jump over to get from feeling rubbish to feeling better. At any of those stages, it’s the easier route to stop and just put up with it.

You touched on this, but why you think OCD is depicted as a quirk or joke in pop culture in a way you typically don’t see for things like depression or addiction?

I think it’s partly because much of OCD is private. My OCD was very portable; I could carry it around and there were no physical, obvious signs. But with people who do have physical, obvious signs, those are what people latch onto as OCD because you can’t see inside someone’s head. What you see is them washing their hands or turning the light switch on and off. I think people relate to that because they think, ‘Oh, I have a weird little behavioral quirk too.’

And everybody does, but with OCD, you’re usually doing the behaviors in response to an obsessive thought that is very distressing. It’s the thoughts that really drive the misery of OCD, and then the behaviors are something we try to do to make ourselves feel better.

I think we’re almost at the stage with OCD we were at with Schizophrenia a decade ago. Around that time, there was this campaign to say, ‘You know what? You shouldn’t use Schizophrenia to mean split personality; it’s actually psychosis.’

I think we haven’t quite reached that moment with OCD. People think they know what OCD is; they’re familiar with the term, and the way they use it is simplistic or not quite right. I don’t think there’s any malice in it. I think it just spreads because it’s an easy concept to grasp, partly because many people can identify with the behavioral side of it.

Yeah, and I think you said something like 90% of people have intrusive thoughts, but 2-3% have OCD. I’m sure it’s complex and there’s not just one reason, but why do you think some people’s intrusive thoughts become obsessions and compulsions, while other people’s don’t?

This is the million-dollar question, and it depends who you ask. If you ask a neuroscientist, they’ll say it’s all down to wiring and the brain; if you ask a behavioral psychologist, they’ll say it’s all down to learned behavior; if you ask a cognitive psychologist, they’ll say it’s all down to patterns of behavior or thought. The honest answer is we don’t know.

The way I think of it is that intrusive thoughts are like seeds that scatter across the population, and in some people they take root; what is it that makes some minds more fertile than others? We have some clues. Certain personality types—people with certain patterns of thinking—seem to be more susceptible. One of those is an inflated sense of responsibility, where people think, ‘It’s my job to look after these things’ when it isn’t. Another is what’s called “thought-action fusion,” which is the belief that to think something can almost be equivalent to doing it.

This is very big in religion. In the bible, one of the ten commandments—alongside thou shalt not kill and steal—is you shouldn’t covet your neighbor’s house or wife. Also in the bible, adultery in the mind is as bad as in the flesh. You shouldn’t want something; you shouldn’t be jealous. These are thoughts—there’s no action involved. To think about something is equivalent to doing it.

Those patterns of thinking [inflated responsibility or thought-action fusion] aren’t mental illnesses, they’re just personality types. But those personality types seem to make it more likely that when you have these thoughts—which everyone does—they’re more likely to take route. We honestly don’t know, but that’s the best guess.

Yeah, it’s a lot of responsibility to give yourself, that if I just do this—for me, it’s often that someone won’t die. And then I think for me a lot of it comes down to control. Trying to control my circumstances so I don’t feel fear, but the OCD ends up breeding more fear. Have you seen that in yourself or the people you’ve interviewed? Is it kind of a coping mechanism or a way of self-soothing gone awry?

It’s hard to say, because it shows itself in such different ways. I met someone who had obsessive thoughts that when they closed their eyes, their whole world would change. They’d open their eyes and be in a different place around different people. It’s hard to see how that would be useful, but in other cases things like washing your hands to protect against germs, to a point, does help you. I think the kind of mental surveillance we have is almost instinctive—it’s beyond our cognitive reach—so it clearly did have value evolutionarily.

In your experience and in the research you’ve done, what are some of the effective treatments for OCD?

There isn’t a treatment that fixes everybody, but all the evidence suggests that if you give enough people a combination of relatively high doses of antidepressants and cognitive behavioral therapy targeted towards the obsessions and compulsions*, you’ll get decent results. It doesn’t help everybody, but it helps most people feel a bit better. With some people it does far more than that, and unfortunately in some cases it doesn’t seem to work at all.

Is there anything that gives you hope for people experiencing OCD?

I think it’s a question of access—if we could get more people access to the treatments that work for most people, that would be the best way to lift the burden of OCD. In the UK, it’s very difficult for someone to see a dedicated CBT counselor, because there aren’t many of them and they’re overworked. In some parts of the country or world, there aren’t any at all. It’s kind of the boring answer to most medical issues—that public health measures are the way to do it.

But to give people hope: every time I do an interview or go on the radio, there’s always someone who emails me to say, ‘Oh my god, I’ve never heard anyone talk about this, it described my situation and I feel like I can get help now.’ So just being aware that there will be people out there who are reading this and seeing their own experiences for the first time. And as much as it’s hard to get treatment—if you can get the right one, you can feel better, you really can.

And like you said, talking about it is important because people might think they’re the only one experiencing this and should basically suffer in silence. Or they may not realize they have OCD, which prevents them from even trying to seek help.

Exactly, and you can feel a connection to people again. I think OCD can make you feel like you’re alone and a bit of a freak. You can feel that connection, because there are millions of us who feel the same.

*I also have found some help/relief in mindfulness techniques

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As we continue to grow Amatus Health, the need to stay competitive and differentiate ourselves in unique ways is crucial. Building creative approaches to reach more people will take our company to new heights. This is why I am pleased to announce that we are officially rebranding. Our new national name, TruHealing Addiction & Mental Health Treatment, will eventually replace Amatus Recovery Centers.

You may be asking, “Why are we doing this?” This new name will give us national uniformity and help brand ourselves as a whole, which will be done in phases. You will still see our existing facility names co-branded with TruHealing for the time being.

Healing is what we do. Everyone who comes through our doors is in a moment of profound struggle in their lives. We support them through a life-changing process of healing and recovery, and they leave our facilities changed. This new name is a representation of that process. As mentioned above, it also allows us to have a national brand, which will make us a recognizable name in the addiction and mental health field.

In summation, these changes present an excellent opportunity for our organization to develop our mission, vision, and purpose. I look forward to prosperous growth as we head in a new and positive direction.

Sincerely,

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Mark Gold
CEO
Amatus Health

Dr. Adam Cusner, PhD is an organizational psychologist by training and has brought his decade-plus experience to the healthcare field serving as the Executive Vice President of Operations for a 22-facility portfolio of skilled nursing facilities, assisted living and independent living centers across Ohio and Arizona, with an annual revenue over $250MM. While serving in this position, Dr. Cusner brought accelerated growth to these facilities, while increasing employee retention and workflow optimization. Dr. Cusner has a proven track record in the healthcare industry of providing successful leadership through his financial acumen, strategic planning, interpersonal skills, along with his ability to build strong, effective teams.

 

Dr. Cusner’s credentials include a Philosophy Doctorate in Organizational Psychology (PhD) from Cleveland State University, a Master of Arts in Psychology (MA) from Boston College with an emphasis on Psychology of Work, a Bachelor of Science in Psychology (BS) from Boston University with an emphasis in Organizational Behavior in Business and is a board-certified Nursing Home Administrator (LNHA). He has published and presented research articles in the field of organizational psychology at national healthcare conferences. Dr. Cusner is completing a book on organizational psychology in the healthcare field, which is expected to be published late early summer 2022. He is also a member of the American Psychological Association (APA), has served as the APA’s Division 17 communications chair, is a member of the Society for Industrial Organizational Psychologists (SIOP), and was selected as a professional reviewer for national conference research presentations.

 

Dr. Cusner is an advocate for his employees and is drawn to the tie between culture and quality. His extensive strategic and operational skills have delivered a high degree of success across all department levels. Dr. Cusner facilitated the establishment of an in-house financial team to provide billing and collections, accounts payable, vendor management, along with financial reporting. This provided $1.5MM annualized savings. Further, he developed department efficiencies for: Medical Staff recruitment, service-line growth, quality and safety, corporate accountability of budgetary expectations balanced with direct reporting to investor groups.

 

Dr. Cusner coordinated the financial turnaround of a 300 bed CCRC (skilled nursing, assisted living and an independent living center) in Arizona, which has been epitomized as the most financially challenging state to manage CCRC facilities. Dr. Cusner also strengthened the business growth of the Ohio facilities by 12%. He was recognized by the Governor for demonstrating a “care-conscious approach” during COVID, when Dr. Cusner carefully consolidated facility residents to accommodate staff and improve clinical care. Dr. Cusner demonstrates a results-driven culture by delivering a high-quality level of care and employee engagement.

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Yaffa Atias is the Director of Special Projects at Amatus Health. Atias is a leadership professional with a decade of experience in healthcare. She holds a BA in interdisciplinary studies from Thomas Edison State College, and a Master’s in Healthcare Management with a concentration in project management from Stevenson University. She completed her graduate capstone at Mosaic Community Services, now an affiliate of Sheppard Pratt.

 

In her role at Amatus, Atias leads and manages interdisciplinary team projects, creates solutions for any operational gaps, and continually strives for quality improvement in all processes. Atias led the organization’s COVID-19 preparedness strategy, resulting in all facilities remaining operational, and in 600 employees being retained as staff without resigning out of fear. In her role so far, she implemented licensure for three new states.

 

Atias believes Amatus Health and TruHealing stand out because every employee, from corporate to center staff, has a real passion for helping people. Atias shares this passion, “My natural compass always tugged me to behavioral health. I’ve always been fascinated by the human psyche. I have also been intimately privy to those suffering from mental illness and substance use. I later understood that my experiences weren’t unique, and quickly realized how pressing the need really is to effectively prevent and address. Moreover, how life-changing proper intervention truly is.”

 

Atias was born in Los Angeles, California and grew up in Israel and Maryland.

Melissa McCarthy is the Vice President of Business Development at Amatus Health. With a decade of experience in the behavioral healthcare and addiction treatment industry, McCarthy is passionate about recovery. She has her finger on the pulse of marketing trends, with the end goal of helping businesses grow so they can serve more people in need.

 

McCarthy has worked at large enterprise recovery centers across the country spearheading business development teams. She has a wide range of experience, including transforming a third-party digital marketing and client acquisition services company into a full-continuum behavioral healthcare provider, managing several successful rebrands, and growing annual revenue fivefold.

 

As VP of Business Development, McCarthy leads a team of over 20 business development professionals nationwide. She manages client acquisition, coordinates in-service trainings with various referents and hospitals, and presents at conferences on addiction and mental health disorder treatment.

 

“Sadly, many individuals die waiting for access to life-saving behavioral healthcare services,” says McCarthy. “I am in relentless pursuit of better—better access, better care delivery and better outcomes. I consider it a privilege to work in an environment where miracles unfold daily.”

 

McCarthy lives in Maryland with her daughter.

Hometown: Saugus, MA

 

Passions & interests: The greatest passion of mine is being able to dig into the work with men in early recovery. There is nothing better than witnessing and being a part of the change. My journey in long-term recovery has taught me to value the little things in life that I am now able to do. I love to do anything that allows me to be present with my wife, family, and friends. My wife and I enjoy traveling, trying new foods, and taking long motorcycle rides with our friends. If I am not on the road working or with my wife, I am studying or playing softball.

 

The best part of my job is being able to show up for my team and clients; they all mean the world to me. I get to brainstorm and strategize with tons of different personalities. A lot of the team does not know, but I love learning from them. If I am not learning something about our industry or workplace, I am certainly learning how to effectively collaborate with different types of individuals.

 

Together, we can change the narrative and be a part of the solution to better treat those trapped in the problem.

Allison was born in Columbus, Ohio and was raised in South Florida. She graduated from the University of Florida’s College of Journalism and Communications. After college, Allison started working at the largest talent agency in the world, William Morris Endeavor. There, she learned marketing from top leaders specializing in global PR and endorsement campaigns, in both the Latin and English markets.

 

Through strategic public relations and creative campaign concepts, Allison has secured more than 200 national broadcast and print media placements for behavioral healthcare organizations. She brings over 15 years of marketing and PR experience, with a strong background in leading communications strategy for addiction treatment and behavioral healthcare facilities. In her role as VP of Communications, she oversees branding, public relations, social media, marketing, events, and content creation.

 

In her spare time, she loves cooking, boating, yoga, and traveling. She and her husband Bryan reside in Boca Raton, Florida.

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Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.

 

Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.

 

“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Avi Burstein is VP of Clinical Services at Amatus Health. He manages all therapeutic programming at all facilities nationwide.

 

Avi is originally from New York, and graduated from Ferkauf Graduate School of Psychology. He brings over 13 years of experience in the Behavioral Healthcare Industry, in both the public and private sectors. He is passionate about therapeutic communities and the fellowship they foster between patients. Through his work in LGBTQIA, urban, rural, and religiously observant populations, Avi recognizes that each patient is unique. Therefore, he strives to ensure clinical approaches, staffing, administration, and education meet the expectation of each community Amatus Health serves.

 

“Our work must also include ending the societal stigma surrounding such conditions by building safe and supportive networks that include clients’ families whenever possible,” Avi said. “By valuing change and owning imperfections, we can strive to be better providers and walk through the door of recovery with our clients.”

Marty Markovits is the Chief Information Officer at TruHealing. He oversees the people, processes, and technologies of the whole organization to ensure the business is running smoothly.

 

Markovits grew up in Brooklyn, NY (which he calls “the greatest city on Earth”) and graduated with a degree in Clinical Psychology from Queens College.

 

Markovits is a veteran in Information Technology within the healthcare field. He ensures that IT processes are simple, cost-effective, and secure. His expertise spans the entire healthcare domain, from billing and claims, to clinical, to Human Resources. He says, “My passion is to provide fully automated and operationally meaningful Business Intelligence analytics, with absolute data integrity.”

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Hometown: Savannah, GA

 

Passions & Interests: I spend my time outside of work with my wife and children and am actively involved in various community needs and causes.

 

The best part of my job is knowing that we are creating a safe, healthy, nonjudgmental environment where people can come and better their lives. There is nothing more satisfying than helping others learn to live again and piece their lives back together as they become strong, productive members of society.

Together, we can bring families back together and promote healing and well-being.

MARK GOLD, CEO OF AMATUS HEALTH BIOGRAPHY

With over 16 years of proven executive leadership and driving company growth, Mark Gold’s momentum for success isn’t slowing down anytime soon. He serves as the CEO of Amatus Health, one of the fastest-growing, behavioral healthcare organizations in the country.

Possessing an excellent handling of clinical compliance and high performance standards, Mark established 14 CARF/JCT accredited addiction and mental health treatment centers and three ancillary healthcare businesses. Mark’s natural leadership skills as well as his creative thought process to generate new revenue strategies make him one of the most sought-after professionals in healthcare. Mark has a track record of leading organizations to outstanding ROI on overall portfolio performance. In addition, his expertise includes workforce planning, growth revenue, high client and investor satisfaction.

Aside from daily business oversight, Mark invests in his staff and helps build their professional development. His commitment to his colleagues and employees toward advancement and inclusiveness helps them achieve goals, builds connections, and provides a competitive advantage in the healthcare field.

Corporate and Charitable Leadership

Mark has been instrumental in building healthy communities and providing access and quality healthcare to underserved populations. His service in the community is a testament to his passion and selfless dedication to the cause of eradicating addictive disorders and stigma.

He launched several prevention and education programs and created the first-ever “Social Justice” scholarship fund of over $750,000.00 to help communities of color into inpatient drug treatment. Mark says, “The best part of my role is the knowledge that what we do impacts countless lives, with far-reaching effects,” he said. “It is incredibly rewarding to be part of a team that guides individuals onto a safe and accessible path to healing and recovery.”

He is a board member of Ahavas Chaim, a non-profit that offers at-risk teenagers crisis intervention and mental health support. He is also a committee member of the organizations Bonei Olam and Chai Lifeline Mid-Atlantic.

Personal and Educational Background

Mark studied Talmudic Law at Yeshiva’s Mir Yerushalayim in Israel. In Mark’s free time, he loves snowboarding, boating, and spending time with his wife and children.