The Role of Resilience in the Treatment of OCD, Anxiety, and Depression: A Client Example

Elizabeth Spencer

When my client Mary first came to see me, her resilience and stress tolerance were low. She sought treatment for OCD, perfectionism, and the resulting procrastination. As an adult, these conditions threatened her autonomy and independence. Like many of my clients, the role of resilience in treating her OCD, anxiety, and depression was profound.

Life was not easy for Mary.

For several years, I worked with her. This included a period when she was so disabled by OCD and depression that she was admitted to a day treatment program. She remained in that program for a month before she was stable enough to begin weekly work with me.

She was determined to live independently from her parents and made the jump when she was 29. Even though she had been in the same job for a year before moving into her own apartment, she found that getting herself up and out in the morning was a tougher challenge than expected.

When she missed one day of work, she couldn’t think of what to say to her boss. That one day turned into an entire week of work missed because of anxiety.

Mary overcame that obstacle like she had all the barriers before that – by recognizing how anxiety bossed her around.

Anxiety set the topic. Anxiety is mean and picked every topic Mary cared about most. Mary learned that is just the way anxiety works.

Eventually, she learned to talk back to her anxiety and graduated to monthly booster sessions. Living well with anxiety is a lifelong struggle for her and many of my clients. They need support for much longer periods while they continue to build the resilience necessary to overcome the daily challenges of OCD and anxiety.

In 2016, we unwittingly scheduled our monthly booster session the week after the Clinton-Trump election. And Mary had been a longtime Clinton supporter.

Going into the session, I was a bit nervous to see how she was doing. Smaller things than this had overwhelmed her. In my practice in the Washington, DC area, people with less severe anxiety had been struggling that week.

Mary arrived on time, was neatly dressed, and began our session as usual by setting up an agenda.

She said she wanted to talk about three topics: the election results, a new obsessive thought about her parents that was bothering her, and an upcoming interview for a promotion at work.

Even now, I feel the emotion of that moment sweep me again.

This brave, resilient woman had been saddened and shaken by the loss of her political candidate. Still, she was moving on in her life. I am so enormously proud of her.

She said, “I have been through hard things in my life. I have learned to say to myself, ‘I don’t like how that worked out, but I am interested to see what happens next.'”


We spent a brief 10 minutes reflecting on her sadness about the election. She gave herself credit for successfully managing that sadness without descending into anxiety.

Then, we moved to the other important topics on her agenda.

I have seen this many times in my practice.

People who do the work of CBT as they struggle with OCD, anxiety, or depression reap the reward when more challenging times arrive.

CBT helps them build the resilience needed to weather what’s ahead—no matter how uncertain it is.

When I talk with my colleagues and the providers in our Anxiety Training Community, I hear much of the same. The role of resilience in the treatment of OCD and anxiety is an important part of the work.

CBT works. The results are long-lasting. It can help our clients face situations very different from the ones they had practiced in our offices.

Life is uncertain.

It’s wonderful to know that with CBT we can give our clients a strategy (and resilience) that can help them cope and even thrive in our ever-changing world.

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