When Anxiety, OCD, Phobias, Stress & Eating Disorders Make Life Feel Small: A NJ Specialist Therapist Speaks Out On Real Health Radio Podcast
By Dana Colthart, LCSW | Clinical Director, Clear Light Therapy | Englewood, NJ
Earlier this month, I sat down for a conversation that felt genuinely meaningful to me, not just professionally, but personally. I was a guest on Real Health Radio, episode 356, hosted by Chris Sandel of Seven Health. For nearly an hour and a half, we talked about OCD, anxiety, eating disorders, and what it actually looks and feels like when someone is stuck in a cycle they cannot get out of on their own.
You can listen to the full episode here: Real Health Radio, Episode 356 — Anxiety, OCD, and Eating Disorders with Dana Colthart and on Spotify.
I want to use this blog post to pull out some of the most important threads from that conversation because the people I most want to reach are probably not the kind of people who stumble on a podcast by chance. They're the people in Ridgewood, Tenafly, Rumson, or Colts Neck who are quietly googling things at midnight, wondering if what they're experiencing has a name. Wondering if anyone actually understands it. Wondering if it can get better.
The answer is yes. Let me tell you why.
What We Actually Talked About for 90 Minutes (And Why That Matters)
One thing I've noticed in my years as a therapist and as the clinical director of Clear Light Therapy is that most people who reach out to me have been struggling for a long time before they make that call. They've read things online. They've wondered if they're "too anxious" or "too weird" or "too broken" for therapy to help. They've tried to manage it themselves, through avoidance, through rituals, through sheer willpower and found that none of it worked for very long.
What Chris and I talked about on that podcast is exactly why that happens and what actually does work.
The conversation covered:
How OCD and anxiety disorders create self-reinforcing cycles and why most people's instinctive responses to their symptoms make things worse over time
The difference between intrusive thoughts and the compulsions and rituals (including mental ones like reassurance-seeking and rumination) that follow them
How Exposure and Response Prevention (ERP) works, why it's considered the gold standard for OCD treatment, and what it actually looks like in a therapy room
How Acceptance and Commitment Therapy (ACT) helps people build psychological flexibility, not just tolerance, so they can pursue the life they actually want even in the presence of uncomfortable feelings
The surprising overlap between OCD, anxiety, and eating disorders, and how these conditions often share the same underlying emotional architecture
What it means to help teens and adults not just understand their symptoms, but genuinely move toward a life that feels meaningful
I don't do a lot of podcast interviews. I said yes to this one because I believe in what Chris is doing at Seven Health, and because I wanted to speak directly to people who are suffering quietly and haven't yet found the right support.
Life Feeling Small Is Not a Character Flaw, It's a Symptom
Here's what I see more than almost anything else in my work: people whose lives have gradually gotten smaller because of anxiety, OCD, or fear.
Maybe you used to go places, try things, take risks. And then slowly, without fully realizing it, you started avoiding. The highway. The party. The doctor's office. The restaurant with unfamiliar food. The social situation where you might say the wrong thing. The thought that scared you, so you pushed it away and then couldn't stop thinking about it.
Avoidance is incredibly effective — in the short term. It makes the anxiety go away. The problem is that it also confirms to your brain that the thing you avoided was genuinely dangerous. So the anxiety grows. And the avoidance grows with it. And your world gets smaller and smaller until even things that used to feel ordinary now feel impossible.
This is not weakness. This is not a personal failing. This is how anxiety and OCD work and it is exactly what evidence-based treatment is designed to address.
At Clear Light Therapy, the clients we work with are often high-functioning in many ways. They're professionals, parents, students. They hold it together at work and fall apart at home. They look fine from the outside and feel terrified on the inside. They've carried this for years, sometimes decades, and they're exhausted.
If that sounds like you, I want you to know: you are not alone, this has a name, and there is a way through.
OCD Is Not What Most People Think It Is
One of the things I was most passionate about discussing in the podcast is how misunderstood OCD remains, even among people who think they know what it is. OCD is not about being neat or organized. It is not a quirky personality trait. It is not something you can logic your way out of.
OCD is a cycle. It starts with an intrusive thought, something unwanted, disturbing, or deeply contrary to your values that pops into your mind without your permission. This is followed by intense anxiety and distress. And then comes the compulsion: a behavior or mental action designed to neutralize the anxiety. Washing, checking, seeking reassurance, praying, mental reviewing, avoiding triggers, confessing, whatever form it takes, the compulsion provides temporary relief. And then the cycle begins again, usually stronger than before.
What makes OCD so insidious is that the compulsions feel logical. Of course you'd want to check the stove again. Of course you'd want to confess that thought to your partner. Of course you'd want to avoid the situation that triggered the spiral. But every time you respond to an intrusive thought with a compulsion, you are teaching your brain that the thought was a real threat and that only the compulsion can protect you.
ERP, Exposure and Response Prevention, works by interrupting that cycle. We gradually, systematically approach the feared situation or thought while resisting the compulsion. This is not as simple as "just don't do the ritual." Done properly, ERP is a carefully designed, compassionate, evidence-based process that teaches your nervous system that the threat is not real, and that you can tolerate discomfort without the compulsion.
I've seen ERP change lives. Completely and profoundly. That's not marketing language, it's what I've watched happen in my therapy room with real people who came to me at the end of their rope.
Why Bergen County and Monmouth County Families Need a Specialist (Not Just Any Therapist)
Here's something I don't say to be harsh about other clinicians: OCD and anxiety disorders require specialized training to treat effectively. A well-meaning therapist who isn't trained in ERP can actually make OCD worse by providing the reassurance that functions as a compulsion, by spending time on talk therapy that inadvertently becomes rumination, or by focusing on insight without addressing the behavioral cycle.
I am an OCD specialist. My team at Clear Light Therapy is trained in ERP and ACT. We treat OCD, anxiety disorders, phobias, and eating disorders using evidence-based approaches that have been tested in research and proven effective. I am a Certified Eating Disorder Specialist (CEDS), and every member of our team brings rigorous clinical training to this work.
We serve Bergen County communities including Ridgewood, Tenafly, Englewood, Teaneck, Wyckoff, Mahwah, Fair Lawn, and Fort Lee, as well as Monmouth County communities including Rumson, Red Bank, Middletown, Colts Neck, and Holmdel. We offer both in-person sessions at our Englewood office and telehealth therapy for clients throughout New Jersey.
We are an out-of-network provider, which means we do not accept insurance directly. We work with clients who have PPO or out-of-network benefits and can provide superbills for reimbursement. Many of our clients find that their insurance covers a significant portion of our fees. Our clients value the quality of specialized, boutique care, and the confidence of knowing they are working with a clinician who truly specializes in what they're dealing with, not a generalist who handles everything.
What ACT Added to the Picture (And Why It Matters Alongside ERP)
In the podcast, we spent meaningful time on Acceptance and Commitment Therapy, ACT, and I want to expand on that here, because I think it's one of the most underappreciated tools in this kind of work.
ERP helps people stop doing the things that maintain anxiety and OCD. ACT helps people understand what they actually want their lives to look like and move toward that, even when it's uncomfortable.
A lot of the people I work with have been so consumed by managing their anxiety that they've lost touch with what they actually value. What they care about. What kind of person they want to be. What relationships, experiences, and activities actually matter to them.
ACT doesn't try to eliminate anxiety or make uncomfortable thoughts go away. Instead, it helps people develop a different relationship with their inner experience, one where they can notice a difficult thought or feeling, acknowledge it without being hijacked by it, and still take meaningful action in their life.
When ERP and ACT work together, what you get is this: someone who is no longer controlled by their anxiety, and who is actively building a life they care about. That's the goal. Not just symptom reduction, real, grounded, values-aligned living.
Phobias and the Shrinking World
I also want to speak directly to something we touched on in the podcast that doesn't get enough attention: phobias.
Specific phobias of flying, driving, vomiting, needles, dogs, storms, choking, heights, or any number of other things, can quietly devastate someone's quality of life. People learn to work around them. They turn down the vacation. They avoid the doctor. They plan their whole day around not encountering the thing that terrifies them.
And because avoidance works, temporarily, they convince themselves they're managing just fine.They're not managing. They're shrinking.
At Clear Light Therapy, we treat phobias with the same evidence-based rigor we bring to OCD and generalized anxiety. Exposure-based treatment for phobias has an exceptionally high success rate. People who have been terrified of something for twenty years can, with proper treatment, reclaim that part of their life. It is not easy. But it is possible, and we will be with you every step of the way.
A Note to the People Who Are Still on the Fence
I know how it feels to wonder whether reaching out is worth it. Maybe you've tried therapy before and it didn't help. Maybe you're not sure your situation is "bad enough" to deserve support. Maybe you're worried about the cost, or the time, or what it would mean to admit you need help.
I hear that. And I want to say something clearly: the people I work with are not in crisis. They are not at rock bottom. They are smart, capable, high-achieving people who have been living with something painful for too long and who, underneath the anxiety, genuinely want their life back.
You don't have to be falling apart to deserve specialized support. You just have to be willing to try something different than what you've been doing.
If the conversation Chris and I had on Real Health Radio resonated with you — if something clicked, or if you recognized yourself in something we described — I'd invite you to reach out. We offer a complimentary 15-minute consultation. No pressure. Just a conversation.
Listen to the Full Episode
You can find episode 356 of Real Health Radio, "Anxiety, OCD, and Eating Disorders with Dana Colthart", at the following links:
Ready to Take the First Step?
Clear Light Therapy is a boutique group practice based in Englewood, New Jersey, specializing in OCD, anxiety disorders, phobias, and eating disorders. We offer in-person therapy in Bergen County and telehealth therapy throughout New Jersey. We are out-of-network and do not bill insurance directly.
To get started:
Visit danacolthart.com
Fill out our contact form, I personally respond within 24 hours via text or email
Or call us at (609) 384-4874
You deserve relief. You deserve a life that doesn't feel small. Let's find out what's possible.
Dana Colthart, LCSW, is the clinical director of Clear Light Therapy in Englewood, NJ. She is a Certified Eating Disorder Specialist (CEDS) and an OCD and anxiety specialist trained in Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and integrative mind-body approaches. She serves teens, adults, and families in Bergen County, Monmouth County, and throughout New Jersey.
