Hello and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you. With practical tools for developing greater peace, we’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you.
So let’s dive right into today’s episode.
Oftentimes people will say. If you have OCD that you need to do either exposure and response prevention, also known as ERP, and that’s how we’ll refer to it in this episode, or inference based cognitive behavioral therapy or ICBT, which is how we’ll refer to that one. And one thing I know from working with thousands of clients at this point is that people are very complex and we’re dealing with more than one thing at a time. Often I will hear different counseling professionals talking about combining different treatments, but that information isn’t typically shared with the masses.
So I wanted to talk with you about that today in a way that you can understand it. So why combine ICBT and EMDR? Why do we need two different therapies? Well, you may not need both, so let’s just throw that out there. There are some people who are dealing with more milder forms of OCD or OCD just seems to really shoot up when they’re under stress and then it kind of dies back down to a more manageable level. Each person is different and you may just really benefit from just the OCD treatment. Maybe that’s all that you have going on in your life and you’re not having a lot of other challenges. When people come into therapy, I’m really looking at what are the strengths here?
What kinds of supports do they have? Do they feel really solid in one or two aspects of their life? Maybe they feel like the family stuff is going really well, but maybe work is a huge stressor or challenge. Maybe they feel vice versa. Like, Hey, I’m confident at work. I kind of know what I’m doing there.
But then when I come into these more intimate relationships, I’m really struggling. Maybe they’re feeling like they’re in a good place spiritually with their relationship with God, and that’s a big strength. But then they’re also having these other type struggles in their life with OCD, like contamination, for example.
So every person’s situation is different, and I think when you go into therapy. You want to find someone that’s really gonna help you customize your treatment plan and your goals to get the most maximum benefit that you’re gonna have with that time together. And I think a lot of times we as therapists maybe have this in our head where we’re going and oftentimes struggle to really verbalize it out.
That’s something that I know as a therapist, I’ve challenged myself to say, Hey. You need to share what’s going on in your head as far as the pathway to treatment. And so if your therapist doesn’t share that with you, or I’ve often heard people say, Hey, I went to go do EMDR, but they didn’t really do the EMDR with me yet.
Well, they were probably taking some history and they were probably doing some type of preparation. Or determining what type of preparation needed to be done before you could jump into reprocessing, because EMDR is an eight phase treatment approach, and those initial phases are about preparation. Super important.
If you skip those, you will be in trouble. I promise. So that’s just a side note to know that, hey, you can always ask about your treatment process at any point in time and say, Hey, I know we’re doing this, but how is that leading up towards my goals or what I originally came in with? We’re not gonna be offended by that.
We want you to understand this process. If you know my background and my story, I really started from a trauma therapy approach and then added ICBT into that. Now, how I’ve utilized these therapies has changed over time. I. Experience of working with people. What I’ll tell you about EMDR and that stands for eye movement desensitization and Reprocessing.
It’s actually, I tell people the worst named therapy because you don’t necessarily need eye movements. The founder said that if she hadn’t already named the therapy and it wasn’t already out there, she would’ve just called it reprocessing therapy. Essentially, what you’re doing, for those of you who aren’t familiar with EMDR, is that it’s helping you reprocess specific memories.
These memories could be things that are causing acute PTSD symptoms. So if you see EMDR, for example, on someone who’s been through like a car accident, they might be having nightmares about the car accident, flashbacks, memory intrusions. They might just have these intense body sensations whenever they go to ride in a car or drive.
We would do the preparation phases with the client to help them be able to shift from a. Heightened state to a more relaxed state when people have had prior forms of therapy, this doesn’t usually take too long unless they have not had any type of somatic therapy or connection with their body.
Sometimes people do not have a connection to their emotional experience or what is happening in their body. If that is the case, you’re gonna need to do a lot of preparation work prior to being able to reprocess memories. When you get into the reprocessing phases of treatment, your therapist is asking you a set of specific questions that helps you kind of get back into that memory.
You may have physical feelings of what it was like to be in that memory, emotional experiences of what it was like. You may be seeing pictures of what happened at the time. Or have negative beliefs about self, like I’m bad or it was my fault. And all of these different pieces are connected to the memory and you’re using either eye movements or there’s other machines that will like called a tapper machine that’ll vibrate in one hand or the other.
Sometimes we have people online do self-tapping. There’s different ways to accomplish the bilateral stimulation. All that means is that you are getting stimulation on one side of your body and then the other side, sometimes in EMDR literature, it’s called dual attention stimulation. The reason for that is because you are supposed to be kind of have one foot in the memory and one foot in the present.
We don’t want people to be completely connected to the memory because then they’re dissociating if they’re not present with us, and we don’t want you to be fully present. Because if you are fully present, then you’re not able to access the parts of your nervous system that you need to access. So essentially, we are letting your brain and your body do all the work.
And that’s the Christian integration piece. We believe as Christians, God created the brain. God created pathways to healing. And I believe when we’re using something like EMDR, we’re just tapping into what God’s already created and has given us the wisdom and allowed us. To be able to tap into that. The idea is that if you get a cut on your finger, for example, and it’s just a, like a normal paper cut, something that you might encounter in every day.
But then your body knows exactly what it needs to do. It knows what cells need to activate, what cells need to multiply to be able to close that wound. It becomes a problem though, if you get an infection. I. Or if you have a large wound that might need stitches, your body isn’t able to bring that skin back together and be able to fully go through the healing process.
Thank God for modern medicine that we are able to utilize things like bandages and stitches and. Now they have the glue. Sometimes they don’t even have to use the stitches. Essentially, EMDR provides that opportunity for those wounds that our brain wasn’t able to process and fully heal on our own. Some of that is done in REM sleep, that like deeper level of sleep where you actually do move your eyes back and forth.
You may have seen this with, if you’ve ever had a dog that you’ve watched go to sleep, and then sometimes they’ll move their eyes back and forth as well. I bring up PTSD because 25% of people who meet criteria for an OCD diagnosis also meet criteria for A-P-T-S-D diagnosis. So really looking at those individuals who are duly diagnosed, we wanna make sure that we’re addressing both issues, that we’re addressing the PTSD, and we’re also addressing the OCD, but EMDR is not just for people with PTSD, and I think that is a big misnomer.
EMDR is also for individuals who feel stuck in some area of their life. They may come in and say, Hey, every relationship follows a similar pattern, or, I can’t seem to ever be vulnerable and open up in relationships. I’ve had a level of church hurt. It’s not a fear for my life type of situation, but it’s got me stuck in my relationship with God and I need to be able to move through.
The church hurt situation in order to come back to a healthy relationship with Jesus. Maybe you freeze physically and emotionally. Every time there’s conflict in which you need to address something or need to lovingly confront someone, maybe your body just gets frozen. What I hear from people is they know all the right answers.
Maybe you’ve read the book on conflict resolution. Maybe you’ve read some Brene Brown books about being vulnerable, but you just can’t seem to implement these things in your life. Part of the EMDR training process is that you work on practicing with each other, and I remember processing this toxic work experience and it was very, very strange for me because.
I was not nauseous. I wouldn’t say that that’s the right way to explain it, but almost like I felt this physical sensation like I was throwing up or something was coming out of my body and I had to actually open my mouth during the processing. Very strange. I had no idea at the time what was going on.
But like everybody said, I was just kind of trusting the process and going with it. For some reason, it just didn’t click in my brain, or I didn’t make this association that after I had had the toxic work environment situation happen, I. I actually threw up. It was either from the stress of everything had nothing to do with what I ate.
I knew it was completely stress induced, and I don’t remember if it was that night that I threw up or the next day that I threw up, but there was that connection to that memory and my body was essentially working that out because trauma is not just stored in our brain, it’s stored in our body. I’ve worked with a lot of clients who have fears surrounding throwing up where we have actually processed times where they’ve thrown up maybe times where they’ve witnessed someone else in their family throwing up, and that can be really helpful for.
Amid phobia diagnosis or for individuals who maybe have some contamination concerns, maybe they’ve had a really bad experience where they got super, super sick, and understand that, I’m not saying that that’s going to cure your OCD, but I am saying that it can calm down your nervous system. Which is experiencing a lot of anxiety due to the OCD.
So typically, if someone is coming to see me for an MDR intensive, there’s two different pathways that we go down. Some people will come in and say, Hey, I know that I wanna target these three memories. I know that they’re really holding me back. I can’t get them off my mind. It just seems stuck. They’re overwhelming to me.
And I’ll say, okay, we’ll look at that together. And I’ll obviously look at the whole picture to assess and make sure they’re gonna be able to do that. And then the other people that I have come to see me are not sure maybe what the specific memories are that have affected them. And that’s okay because there’s a whole process to being able to assess and get back to some of those memories, and they may be things that you find insignificant when they come up, or maybe you say, oh, I haven’t thought about that in a long time.
If that’s what your brain and body is telling us that’s holding on to the trauma or the negative core belief that you’re believing about yourself, then that’s what we can target. EMDR is a past, present, and future therapy. We’re starting with the present, what’s getting triggered up in the present and then floating that back to the past.
Where did that originate? Where did that come from? And then looking forward to how do you wanna handle those situations in the future? It’s a very powerful therapy and works really well when it’s done well. Do you have to understand if you’re looking for an EMDR therapist, you wanna ask a lot of questions.
How often they’re using EMDR. Some people get trained in it and really don’t use it that often. You wanna find out about their level of training and experience. You can be EMDR trained after you’ve gone through two weekends of training. There’s EMDR certification, which is a higher level of training, and then the last level is EMDR consultant, so that’s what I am, have done lots and lots of hours and lots and lots of trainings and have to, as a result of the certification and consultant status, you have to have ongoing continuing education in EMDR as well.
To summarize, EMDR works at a brain body nervous system level to help you get to a place where you feel what you believe and know to be true. It’s often that we believe and know certain things about ourselves in our relationship with God and who we are. We know those at a cognitive level, but we don’t feel them.
They don’t feel true to us, and I think that’s the biggest gift that I’ve received as part of going through this process, is really being able to feel loved, to feel valued, to embrace who God has created me to be. Now let’s talk a little bit about ICBT. I’ll shorten this because we spend a lot of time on it, on the show.
I Ccbt is much more cognitive where you’re looking at the obsessional reasoning process, the tricks and cheats of OCD, like living the fear out of context facts, all these reasoning processes that OCD is using to kind of solidify what we call the obsessional doubt, that there’s reasons for the obsessional doubt.
There’s an obsessional story, an alternative story. We’re talking about things like the feared self who OCD says you’re gonna become and the real self, but it doesn’t really address that nervous system component like I was talking about before. It’s very logical, it’s very cognitive, but doesn’t really get into like nervous system regulation.
So how do I combine EMDR and ICBT? I will usually collaborate with the client depending on what they’re bringing in, and also might give some direction if I have a strong feeling one way or the other. The beautiful thing is that it’s fluid that we can start with either, that we can flow in and out of one into another.
Like I said, I’ll get the clients input on it. Sometimes they will come in, like I said before, and have specific memories that are troublesome to them and so we, that they believe is contributing to their OCD. Even so they may also identify, yes, I have these memories, but the OCD is really troublesome and so I need some skills, tools.
How do I deal with it when it’s coming up? So we’ll do some obviously basic OCD education surrounding that. I’ll usually start with ICBT, and then as we get into modules three and four where we start talking about the obsessional story and we start talking about the feared self, then it’s usually clear at that point.
There’s personal experience in that obsessional story that comes up. There’s personal experience that’s tied to that feared possible self. And usually it’s pretty clear if there’s some evident trauma that comes out in one of those modules, I’ll say, Hey, is it okay if we take some sessions and try to really process through some of these pieces after we process the trauma?
Then we can head back into pick up at module five and move forward that direction. There also may be some challenges that people have getting in touch with their real self. And as we explore that, some of those negative beliefs that they might be holding onto about themselves, there might be some things that we can target there and identify.
Okay, so how did you come to have that negative belief about yourself that seems really stuck and seems really pervasive throughout all areas of your life. As we explore that some things might come up that we can process. The bottom line is that to go back to where we started with, people are complex.
You’re a complex individual. It does happen, but very rarely do I get people that just have OCD going on. There’s usually other types of like identity work that they’re trying to accomplish, or they have relationship challenges. Maybe they’re having trouble dealing with stress in their life. You want to find someone who’s going to help you look at the whole picture, look at yourself holistically, and kind of help you make some determinations of what you might need.
One of the things that I love about the ICBT community is that I’ve found a lot more therapists in there who are trauma informed or who are used to working with highly sensitive clients. We’ve had a episode on the highly sensitive person that I would encourage you to go back and listen to if you think that might apply to you.
What we know about highly sensitive people is that certain things are going to register on their radar as traumatic, more than people who aren’t highly sensitive. And in light of that OCD treatment needs to be informed and adjusted to meet the needs of those highly sensitive people. I love that ICBT is able to do that without causing a high level of anxiety.
Even if people have struggles with talking about their own theme with ICBT, you can utilize other stories where you can practice the skills in an off theme manner is what we would call it. So we would find an OCD theme that you don’t struggle with and walk you through some of the skills with that theme.
This is particularly helpful if people have a lot of anxiety surrounding their OCD theme to the point where they have struggles even talking or communicating about it, which of course can cause struggles in therapy. Who by combining these two OCD treatments. I’m able to deliver therapy to people in a way that’s understanding of their trauma, that’s respectful of their nervous system.
That’s not overwhelming to them. Not to say that it’s gonna be completely comfortable or not at all uncomfortable, that’s not what I’m saying. I just find it to be a good fit and a good connection between the two therapies and all in the interest of people receiving the healing that they need. That is what’s most important, and it is most important that you don’t give up on yourself, that you keep going through this process and keep allowing God to refine you through it.
I love that there’s nothing inherently Christian about either of these therapies that I’ve talked to you about, but they can integrate really well with our faith that as you trust God to provide you the wisdom and trust God to connect you with the right types of people that are able to help you along on this journey.
And what I’ve seen over the years of therapy is that if we can get some of this gunk, weirded out of our lives, whether that’s just past trauma that’s stuck in our body or brain or faulty ways of thinking that we can identify and point to as, Hey, that’s OCD. I don’t have to listen to that. Then it allows you and frees you up to have a healthier relationship with God, to have a healthier relationship with others.
And that’s what we wanna do. We wanna love God with everything that we have and love other people out of that love that we have received by God. Thank you so much for listening and allowing me to share this with you today. Until next time, may you be comforted by God’s great love for you Christian Faith and OCD is a production of By the Well Counseling.
This podcast is for informational purposes only, and should not be a substitute for seeking mental health treatment in your area.
