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Author: Carrie Bock

Carrie Bock is a Licensed Professional Counselor in Smyrna, TN who helps people get to a deeper level of healing without compromising their faith. She specializes in working with Christians struggling with OCD who have also experienced childhood trauma, providing intensive therapy for individuals who want to heal at a faster pace than traditional therapy.

2. Unanswered Prayers for Healing with Pastor Troy Powell

Written by Carrie Bock on . Posted in Anxiety, Counseling, Personal Testimony, Podcast Episode. No Comments on 2. Unanswered Prayers for Healing with Pastor Troy Powell

In episode 2 of Hope for Anxiety and OCD, I had the opportunity to interview my own pastor. We discussed how people with anxiety and OCD wrestle with having these disorders and not receiving healing from God for them. He shares his own experiences of how his prayer life has grown and developed over the last several years. Pastor Troy discusses prayers that were answered and how he handles the ones that weren’t.

  • How Pastor Troy went from falling asleep to engaged during his time with God in the morning
  • Receiving the call to plant a church and the unexpected miracles along the way
  • How praying to God when you are mad or distressed increases intimacy 
  • Doubts and questions during prayer
  • Hope for unanswered prayer

Verses discussed: Phil 4:6, Eph 1:9

Resources and links:

By The Well Counseling
Victory Church, Smyrna, TN “You’re here on purpose because you have a purpose.” 
Victory YouTube channel

More podcast episodes

Transcript of Unanswered Prayers for Healing with Pastor Troy Powell

Welcome to Hope for Anxiety and OCD Episode 2

I am your host Carrie Bock. Today, we’re going to be talking with Pastor Troy Powell, who is the pastor of Victory church. I have really been so blessed to be a part of the Victory family for the last couple of years. This was my first interview on the podcast.

I was super nervous even though I was already interviewing somebody that I knew and knew a lot of the stories that he was going to share. Today, we’re going to be diving into a lot of different issues like how do you develop a prayer life? How do you handle frustrations and disappointment with God when you’re praying?

What in the world do we do with unanswered prayer, especially surrounding healing from anxiety or OCD. So, if you have been praying for God to take your anxiety away and there’s no relief in sight, this episode is absolutely for you. Unfortunately, the audio for this episode is not the greatest. We had a big Tennessee thunderstorm roll in at the time that we were recording this.

You may hear some thunder in the background. I know that our editor has done the best that he can on his end to improve the sound quality. Please don’t judge our show by episode 2 audio. The content was so good that I didn’t want to scratch it.  I really wanted to be able to provide an opportunity for you guys to hear this stuff because it’s just really good.

Pastor Troy’s Journey to Becoming a Pastor

Carrie: Welcome to the podcast.

Pastor Troy: Excited to be here.

Carrie: In church backgrounds, we call our pastors all kinds of different things. Sometimes, people will say like, “Brother Troy”, or typically we call you Pastor Troy, but recently you’ve really embraced this new nickname of PT. I’m curious about how that came about?

Pastor Troy: Pastor Troy has been weird for me in a way. I’m not heavily educated in that theology realm. I’ve got a little bit of theology background and I’ve always just been a servant leader at the church. So when the day came to be called Pastor Troy, that was weird for a while. Plus, I’m from Memphis and there’s a rapper named Pastor Troy. Don’t go buy any of his CD’s. They’re not good. A quick, funny story- there was a Cat’s Music that on the sign out front had like Pastor Troy on it because he had a new album out. The children’s pastors and all the kids were showing in the church, “What are you doing in the Cat’s Music?” and I was like, “Don’t go to Cat’s Music.” I didn’t even know who it was, maybe Jamal or somebody just kind of quickly said, “PT” and that sticks because it’s quicker and it’s easier to say. I love it because it’s both respectful, but at the same time, relatable and kind of chill. So, you can really have a good conversation with somebody.

Carrie: Cool. So tell us a little bit about the journey to becoming a pastor and planting Victory church.

Pastor Troy: I’ll try to do the smallest critical, condensed version of that. I didn’t go to church, didn’t know anything about the Lord till about 17. I sat beside a young man in a math class at school. He started talking to me and we found out that we both liked basketball and so on.

He invited me to his church where they played basketball and long story short, I just fell in love with the environment. The people were super nice. Our kind of tagline at our church is “You’re here on purpose because you have a purpose.” I’ve always known there was a better purpose to life than just give money or become famous or whatever. I could never find that. I worked jobs. I’ve worked them for a day or an hour and quit cause I was like, “What is the purpose of this?” I started going to church for girls, basketball, the food, and all that kind of stuff. The more I stuck around, the more I started to realize, “Hey, there’s something to this.”

Long story short, God grabbed me, held onto me, and then I just said, “Hey, this is what I want to give my life to.” So, I started stacking chairs at the church, that kind of thing, and one by one, the opportunity would open when I’d walk to the door.

Long story of how I got from there to at the time I was the Executive Pastor of our church in Memphis. I just felt this weird, we couldn’t explain that at the time, but it was this urge, this calling in our heart to shepherd people, to pastor people. My two pastors, Matt and Ron Woods would tell us “You’ve got an anointing on your life to be a pastor.” We didn’t know what that meant. We love to counsel our friends. We love to teach the Bible, love to preach the Bible on any Sunday. It was just amazing. We loved pastoring people to our pastor’s vision. We loved shepherding people and we always did it from another pastor.

God Called Pastor Troy To Plant A Church

That was the assignment God had for us, but we just knew that there was a time coming where we would be pastoring our own church. It was just kind of a moment where the church was going in a certain direction. We didn’t really want to go in that direction personally. We knew something was changing for us. We went to our pastor and said, “Hey, this is what’s going on” and our pastor said, “Have you ever considered planting a church?” and we were like, “We didn’t know anything about it.” The more he described it, I said, “That sounds terrible.”

I have to quit my job, raise funds, move my family, get my kids out of school, sell my house, move somewhere potentially that I’ve never been. Then, beg people who don’t know me to give up their life for something. That sounds completely like the hardest thing you could possibly do.

So I said, “No, there’s no way I’m doing it.” And he said, “Well, go with me to a conference,” and I said, “Sure.” So he took me to the conference and the Lord confirmed through a particular preacher that day.

That’s what was happening. She (spouse Darla) had to stay at home because we had small kids. At the altar, at this place, I was crying because I know that God has called us to do this. I didn’t know she was watching the same service online at home in the kitchen and she’s crying at the same time. She’s texting me after it was over and she goes, “We’re doing it” and I was like, “Yes, we are.” 

We knew from that moment forward this will come up. There were a lot of hardships and hurdles to jump but we never lost faith. In fact, we were supposed to do it because of the way that we didn’t want it. We didn’t see it as an opportunity to be the leaders or something. We didn’t see it as the opportunity to get more money or to be finally the person, the boss.  We just saw it as an opportunity to walk where God had us and we knew it. Again, He kind of dragged us at first, but as we fell into that place and said yes, the doors started swinging wide open. There’s no doubt in my heart that this is what God’s called us to do.

Carrie: I like two things about that story that you shared. One is like the sense that you had other people in your life that confirmed God’s vision for your life. I think sometimes it’s easier for other people to see it and we catch that up later like God speaks to us over time and it’s like maybe that is really valid what that person is trying to say. I definitely can relate to times where I told God, “No” and He was like, “nN, you’re really doing this.”

Pastor Troy: I heard a guy say one time that we struggle seeing the anointing or the calling on our lives because we’re the only person we can’t see. Everybody can see us. Everybody can see that you’re gifted. Everybody can see that you’re beautiful. Everybody can see these things, but you don’t see it. As much as that happens with a woman who’s beautiful and is insecure about her beauty, it happens with an individual who is anointed to do the work of God but just doesn’t see it like everybody else sees it. Like you said, it’s valuable when you have somebody in your life, people who are able to tell you, “You are called to do this. You can do it.”

Carrie: That’s good. I think it speaks to the value of the church and being a part of a community because more and more people are fleeing the church in a sense saying, “Hey, I want God but I don’t want anything to do with organized religion”, or “I’ve been burned in the past by churches and so I’m not going to have anything to do with that aspect of my faith.”  I think it’s unfortunate because we miss out on so much when we do that.

Building Relationship Is Vital In Church Planting

Pastor Troy: It is very unfortunate because number one, I just believe that the church is the hope of the world. Number two, I believe it is where you find that fellowship. We try to design Victory this way. We’re not perfect by any means but I always wanted to be a place where right off the bat, you come in the door and you’re welcomed. You belong before you believe. It’s not about your belief system. It’s not about your standards and all that. 

Jesus went fishing like he’ll clean you after He catches you or however it works. You get people in the door and then you build a relationship with them and you get some relationship equity. Then, as you build relationship equity, you’re able to have those conversations about, “Here’s what the Bible says about this. Here’s what the Bible says about that.” Then, of course, you’re preaching the whole time and allowing the Holy Spirit to do that. 

Don’t get me wrong, every Sunday before you start trying to essentially change somebody’s life, maybe the way they’ve been living it for 20 years, you may want some relationship equity first so there is weight behind that where you’re saying, “Hey, maybe you shouldn’t do this. Maybe you shouldn’t do that” because of that relationship. That’s where I think the church has got off a little bit as you walk in the door and they’re telling you what you shouldn’t do, and you’ve already got a blow-up. So, you turn around and leave to where they would build a relationship, love you through the way somebody loved them.

I’ll jump off the subject of this. When I started coming to our church in Memphis, which was called Raleigh Assembly of God, I was so far away from God. People, specifically Ron and Timmy Kennemore, they’ve been at our church multiple times. They’ve been there at every birthday. They were there for the launch. They parented me. They wrapped their arms around me and loved me and I was not lovable, but they did. That to me was a picture of Christ. That’s I believe what the local church can do and can be if people are willing to let it use them that way.

Carrie: That’s awesome. I think relationship is really a key and really important in any change. Sometimes the kindest thing that we can do for people is to speak up and say, “Hey, you’re going down the wrong path” or “You’re on the path of destruction and let me guide you over here and that’s going to lead you to the path of life.”

Taking The Prayer Relationship To A Different Level

One of the reasons I wanted to have you on the podcast was to talk about your prayer life and how it’s grown and developed to where you are now. Can you share a little bit about that story?

Pastor Troy: Certainly, this is one of my favorite stories to talk about simply because I think it’s one that God uses.

So again, I get saved. I’m very young and immature in Christ. I just start serving God and I was serving because I was around, I ended up in circles with more spiritual, mature people. I was a janitor at the church. I was an assistant to different staff members. I just kind of do that whole deal but I’d always struggled with having a consistent prayer life. I would hear people talk about their quiet time or their time with the Lord or when they read, pray, whatever they called it. I wanted it bad but I just couldn’t do it. There was the hurdle of not quite understanding it but as I grew up and as I stayed in the church, that kind of got fixed, but part of it was just, I would try hard and I just couldn’t do it. I’d wake up in the morning and I’d go in the living room and I’d fall asleep trying to do it. I’m not a morning person. I like to get up in the morning, but I don’t wake up and go like, “Oh right.” I don’t drink coffee, so I don’t have any kind of immediate wake-up. I remember when Darla and I really started talking about doing this, planting this church which was probably a year and a half to two years before we actually moved to do it. I just remember saying, “Alright, something’s got to change.” I’ve got to take that prayer relationship to a different level and I know, again, I’d wake up in the morning, I’d go in the living room. I’d sit on the floor, get my Bible out, and then, I’d fall asleep. It was just not working. 

Hearing God’s Answer Audibly

Interestingly enough at the same time, I had gained some weight through the stress of ministry. That’s a whole another podcast. She (Darla) said, “You need to get in the gym.” I’d never been at the gym and so I said, “Fine, I’m going to the gym and lose some weight.” So I go to the gym one night and I’m walking into the gym, and I don’t even know what to do. I don’t know how this machine works.

People are looking at me like I’m weird simply because of God. I turned around and my brother-in-law, Darla’s brother, is walking in the door and I’m like, “I didn’t know you work out here.” and he’s like, “yeah.” And I was like, “Man, is there any chance we could work out together? I don’t know what I’m doing today.” He said, “Sure, but normally I’m here at five o’clock,” and I was like, “That’s no big deal” and I think it was like six-thirty or seven o’clock at night. He goes, “No, no, I’m only here at 5:00 AM.” I was like, “Oh, I thought there was only one five on the clock.”  

I’ve never really heard the Lord audibly, but I can feel it so strong in my spirit that it sounds audibly. God says, “This is what you’ve been asking for,” and so I just said, “You know what, I’m going to do it. You’ll hold me accountable. I know you will and so I’ll come.”

Walking The Track With God

I don’t remember the exact day we started, but I get up at 4:30. I drink the pre-workout that he gave me. It’s kind of caffeine. I get in my car and drive to the gym. We worked out from five to six. Six o’clock, he leaves. We have a couple of the guys with us too. Six o’clock in the morning, I’m standing in the gym that’s almost empty, nothing but senior adults in it. I don’t normally wake up until seven so I’ve got an hour in time that I’m not normally not even up for.

They happened to have one of those tracks above their gym that went all the way around. So, I said, “Well, I’m just going to go walk.” I’m going to put on my headphones and I’m going to try to pray and I walked up there. I put my headphones into Christian music and I just walked and I just started talking to God.

I didn’t have a diagram. I didn’t have a plan. I didn’t have a layout. I don’t even think I actually said a prayer during that first hour, but that hour flew by. I just talk to God as if me and Him were walking that track. There was nobody up there but myself and it was beautiful. It was great.

I felt better about myself. I felt excited to be able to say, “I prayed today,” and so I just started the process and kept it going. I don’t do it on Sunday mornings because normally we’re at church. If we’re on vacation, I won’t work out, but I’d still walk, pray, but I haven’t missed a day in five years.

Carrie: Wow. That’s awesome. 

Listening To The Same Praise Worhip Music List Helps

Pastor Troy: Certainly, it’s matured. It’s grown. It changed my life. What it looks like now is I don’t have to get up as early. Praise God. I will do it if he ever calls me to do that again, but I will get to the gym, I’ll work out. Actually, now I pray first. I’ll get there, I’ll drink my pre-workout while I’m praying.

A couple of keys in case anybody’s listening and wants to model it, I listened to the same praise worship list or music list because I don’t want to be distracted by the song. I don’t want to be surprised. I don’t want the genre of music to change or to go from soft music to loud music or fast music. So, it’s the same. It’s almost like it’s white noise.

It drowns out the people that are around me. I now have a prayer request on my phone, different prayer requests that I marked cause I’m gonna show you something in a minute that I brought for this. That’d be pretty cool. 

Carrie: That’s awesome.

Checkbox To Highlight Answered And Unanswered Prayers

Pastor Troy: I’ve now actually got an app on my phone where I can read the Bible now during that time as well, and take notes on what I’m reading. So in that whole hour, I start off thinking about God. I’ll go into my prayer requests. I’ll read my daily reading for that day. Of course, depending on what’s happening in my life, it kind of changes. 

One thing I wanted to show you this, I don’t know if you’ll be able to see this at all, but this is the book I had when I first started doing my prayer. These are some of the prayer requests that I had written down. They can be very specific. I wish I could share this one day. I actually have my beard because I wanted to grow a beard so bad. 

During this season, we had to sell our house. We had people moving with us. One of our guys lost his job. They said they were going to allow him to work, move to Nashville but work from Memphis. They fired him. We had to raise $175,000. Our water heater went out.

I had all these people. We had people who were asking to move with us. So, I had all these prayer requests and I just could not get that verse out of my mind, “Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God and the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” So I would pray over these things. The reason why they’re highlighted is that He answered the prayer. 

My phone has a little checkbox that you get but what that does for me is it allowed me to go back and see all that God was doing. One of them that’s not highlighted on here because I had moved out of this book is church location. I moved on to a different book.

Carrie: That’s awesome. 

Pastor Troy: It’s been life-changing for me. First of all, understand this about me, Carrie, I don’t like surprises. I like to set stuff up. I like my house. I want to clean the dishes, put the dishes in the cabinet and let them set there cleanly and I’d rather use a paper plate, never get them dirty. Like, I’m weird. I like stuff to be stable and so not only did I pick the number one career for my life to become unstable, but now I have to deal with everybody else’s lack of stability, right? If their mother becomes sick, if their job furloughs them, I’m now involved in that. 

Experiencing God While Working Out Put Things Into Perspective

I have a lot of anxiety or I have potential for a lot of anxiety and this has been life-changing for me because every morning I go get my perspective right. I sit, I bring whatever it is I’m dealing with and then I give Him the actual day [00:19:00] and I can spend some time reading my Bible and worship if that day calls for it. When I go work out, I listen to podcasts and sermons while I’m working out. So it’s like a two-hour experience with God and by the time I leave, I am so jazzed for the day with a different perspective. 

God Cares About Everything, Even Little Things Like A Hair Tie

Carrie: That’s awesome. I like that you prayed about your beard because I think there are some things that we really think, “Oh, that’s too small or it’s too insignificant” or “I can’t really bring that to the Lord.”

There was a story one time where I was on my way to the gym and I was like, “Oh, I forgot a hair tie” and I was like if I go through this workout class I’m just going to go crazy cause my hair is going to be flying everywhere and some really gonna bother me. I got there to the gym and I opened up the locker and there were two hair ties in there and I was like, “I know this is the Lord.” I know there were two because you had been preaching [00:20:00] about how God wants to do more in your life. I was like, “See, there it is, it’s right there.”  

I love little things like that. God’s concerned about the details of our life. Yes, He’s concerned about our job and our health and our family and things like that but he’s also concerned about little stuff that most people would find insignificant or say, “You don’t really need to bother God with that.” I guess, so to speak. He’s not bothered by any of it. 

Pastor Troy: Not at all. I have two kids, a 10-year-old and a five-year-old. The five-year-old is still really little and she still has a raspy voice. If that little girl asks me for anything, if she says daddy, “I can’t find my hair tie.” I will flip this house upside down to find it for her and on a second, I’d say. “We’ll just get another one” or “Hey honey, your hair’s fine down” but she wants it and your love for her drives you to find it. There’s a verse, I don’t remember the reference, but it talks about how a dad will not give [00:21:00] their son. I think it’s like a rock if they asked for a fish. So how much more would God not do that to us? If that’s the way I feel about Kacey Rae, how much more does God feel that way about me?

If I can get to that level of intimacy where not only am I asking Him for healing and provision, but I’m asking Him to give me a hair tie, that’s the level of intimacy that most people never get to.

God Does’nt Get Offended When We Are Mad At Him

Carrie: That’s awesome. So what do we do when we do pray about some of the big things? I look at things that have happened in my life. I lost my foster children. I lost my marriage and I remember specifically when I lost my foster children, I just said, “You know, God, I will live a thousand years and I will never understand why you allowed that to happen in my life.”

Do you feel like it’s okay for us to go to God with [00:22:00] things like doubt or questioning? If you could talk about that for a little bit. 

Pastor Troy: Yes. First of all, I think that’s always the hardest part about having a consistent prayer life because if you have a consistent prayer life, you are eventually going to ask God for something that He doesn’t give. It’s just going to happen like“go ahead and mark it on.” I could find stuff in this book and some of the stuff are highlighted, but it’s not highlighted because He gave me the prayer. It’s highlighted because I didn’t get it. I just knew that was the answer.

Obviously, If I had the supernatural answer for why God does those things, I’d write a best-selling book, but I do want to say this to the direction you were going, during that time that I have in prayer, there’s often a time that I call the lamenting time. You go through the Bible, you see David do it. [00:23:00] You see Joseph, you see different men and women of God where there’s a season where they cry out and they’re angry at God and sometimes it lasts for only a short time. I think David when his son with Bathsheba dies, he cries out, he tears his clothes, and then you’ve done that and I’d get up and move on.

Here’s what I’ve learned from that, number one, God doesn’t shake or get offended or shiver when I get mad at him. I don’t get scared when my daughters get mad at me because I don’t let them do something they want to do. I understand the process. So as long as I’m communicating with them. I tell my kids all the time, “You don’t have to agree with me, let’s talk about it”. 

A lot of times with God, I think what it is God’s saying, “That’s fine. Go ahead get it off your chest. Cry, yell a little bit, scream” like, “God I can’t take it.” 

I think what He tries to teach us is that principle, I haven’t learned it quite to a level of excellence [00:24:00] yet, but the ability to cry, lament but once you’re done get up and move on. 

Once there’s a moment that you have done that and you have had a perspective shift or you have had confidence now that for whatever reason God didn’t give it to you but God is on the throne, let’s move on. I think you and I both could name many, many moments in Memphis where now that I look back, I’m thankful God didn’t answer that prayer.

Carrie: Yeah, absolutely. 

Lamenting To God Will Draw Us Closer To Him

Pastor Troy: There are still things that I will go to my grave probably wondering, “God, why didn’t you give that to me” “Why didn’t you make it easier?” That whole idea of God’s looking at the puzzle from the top and we’re looking at it piece by piece. I believe and I would love to assure anybody that in your prayer time with the Lord, do not hesitate to just let Him know how you feel. Do not hesitate. If you’re unhappy with something, tell him. If it didn’t go the way you want it to, [00:25:00] go get mad, scream, yell. I think He just draws us closer. I think He just continues to console us and lets us lament to Him so that we can get through that season and into a season of healing.

Carrie: There’s a certain emotional connection that comes about when you welcomed the emotion into the room. So like for example, in counseling, sometimes people have a hard time crying in front of me initially, but then when they do that, it’s a connecting point. I think the same is true of God. If we try to hide our feelings from Him or come to Him in some kind of pious religious way, then we’re missing that deeper layer of intimacy to say, “I’m hurting right now,” or “I’m mad at you” or “All of these emotions are here.” We just miss out on that connection. 

Being Vulnerable with God Will Deepen Our Intimacy With Him

Pastor Troy: My wife and I don’t have a lot of fights, but we like to call them “intense conversations.” [00:26:00] Everyone we’ve ever had, if I look back on it, because of that conversation, we grew in our level of intimacy. When you’re angry, you’ll say things that you really feel. You may not say them in the best of ways, but you’re no longer beating around the bush. You’re no longer sugarcoating it. You are just, “You know what, here it is” and when those moments happen again, you can’t just turn around and walk out of the house and not talk about it. When handled correctly, I think that recovery from a fight or recovery from a disagreement, or whatever misunderstanding brings a new level of intimacy. I think it’s the same way with God. When we have that time, that intense conversation with God, we see once we get through it, there’s a higher level of intimacy.

Carrie: I agree. I think that’s great. It really goes back to prayer, being more about a relationship with God, [00:27:00] rather than this is something that I do because I’m obligated to do it or I pray in a certain way because that’s what I was taught at church.

I know for me for a long time, I wasn’t really honest in my prayer life, not at the gut level, honest place and I think that difficulty with being vulnerable with God and being vulnerable with other people really scented my spiritual growth in a way. When I went through difficult things and tragedy, my prayers got a lot more gut-level honest to where I could be real. That drew me closer to the Lord in the end even though I wasn’t happy with the process of having to go through those things.

Pastor Troy: I think you hit it on the head. I think that the number one foundation has to be laid out is that prayer life has to be way more about having relationship with God and less about a religious process or even a means to an end. It’s not I’m doing [00:28:00] it so that I can get A, B or C. A lot of days where I don’t even pray a prayer request. I just talk through what I’m going through. I just talk through what I’m thinking and my insecurities and all those kinds of things and I feel better. I didn’t even ask for anything. God may answer one of those prayer requests that day because obviously, I’ve prayed about it before, but it’s about having that daily meeting.

The Bible talks about being at a level with God where you are revealed the mysteries of God. I really think that the more we can get close to God in an intimate level where we get to a place where our prayer time is more about just hanging out with him than it is about a means to an end, when you keep it regular.

God always knows where to find me and my wife will talk about this, anytime she’s praying about something that she wants God to move in my heart, she’ll pray in the morning when I’m at the gym because she knows I’m in [00:29:00] conversation with God. God wants to do anything. If God wants to speak something to me, He knows where to find me.

I said this at church recently, when all of the COVID-19 stuff hit and we weren’t allowed to go to the gym, I walked and ran outside around my neighborhood and prayed. I remember praying about COVID-19, praying for our church, praying for people who had lost jobs and so on and so on. I remember saying to the Lord, “I’m so glad this isn’t the first time you’re hearing from me. I’m so glad that because the world’s upside down and all of a sudden I’m talking to you. I’m glad that for five years, I’ve been talking to you when it was a Saturday when all we had to do was lay around the house and play games when it was the best of best days, I was praying to you that morning.”

I’m glad that that’s the routine I’ve put in place, which in result has created an intimate level of relationship which I think has unlocked some of God’s mysteries. 

When God Doesn’t Answer Your Prayers…

Carrie: That’s good. A little bit about this in terms of unanswered prayer. I just wanted to address maybe for people that are listening [00:30:00] out there who would say, “I’ve prayed for healing for my anxiety” or maybe they’re having debilitating panic attacks on a regular basis. Maybe they’re struggling with OCD which can impact people’s connection, ability to pray, relationship with God. So for somebody who said, “I’ve been praying for God to take these things away and I’ve been praying for healing and I haven’t received it and I’m just so discouraged by that”. What would you say to encourage them? 

Pastor Troy: That’s a great question. Obviously, every situation is going to be different, right? Because of that particular situation, how long have they been in it? Throughout the Bible, you’re seeing so many people healed and delivered. I think we automatically fall in that vein that we think prayer should bring healing and deliverance right.

About Bob, we may not forget about what he went through. The person I immediately think about that I think would allow me to bring some encouragement in this area. [00:31:00] is Paul. When Paul says “I’ve got this thorn in my side, and I’ve been praying for God to take it away once, twice, three times and God has not removed it.”

I think that’s such a funny situation because Paul is such an incredible man of God who has given his life to the kingdom of God, asking for this little thing to be delivered and God doesn’t do it. I heard a preacher say one time, the reason that they don’t identify the thorn is so that you and I could apply whatever our thorniest into that, as if it was a blank. The part that I don’t hear preached about enough is when Paul’s talking about the thorn. He says a couple of lines in there that reveals that what it’s doing is keeping him in humility, but also bringing him to the feet of Jesus. 

The best way I can explain this is with this illustration: four years ago, five years ago, [00:32:00] I had this extremely bad situation with kidney stones. I think they said it was like 13 kidney stones in both kidneys. I had a brand new baby. Kacy Rae was just born. My wife is dealing with a newborn baby by herself and I’m on medication painkillers, whatever it was, just enough to let me go to work. Six o’clock I was right back into pain so I would come home. 

Darla would have the heating pad on the couch. I would sit on the couch and do nothing. She would handle a five-year-old and a newborn by herself. I would just sit on the couch looking at the TV.  By seven o’clock, I was so miserable. All I want to do is go to bed. So I go to bed. I’d lay in the bed. I could hear her screaming at our kids, dealing with our kids’ crying. 

[00:33:00] At two or three in the morning, I just go in the living room and watch Boy Meets World. It was miserable and this went on for like four months straight. It was just terrible. I prayed. Every second of every day and I pray like this, “God, you could snap your fingers and it would just stop right now, so why aren’t you?” 

I could write down you a list, 10, maybe 20 things that God taught me through that experience. Had it not happened, I wouldn’t be the same. I wouldn’t be the same physically as far as fitness. I wouldn’t be the same in my marriage. I wouldn’t be the same in my intimacy with God. I would not be the same father. 

I’ve preached a sermon before about taking my kids for granted and when they wanted to hang out and do something, I was like,” Oh, I’m too busy. Every time they said my name, I dropped what I was doing and went and spent time with them. So I say that if somebody is going like, “I need some hope and all these because God’s not taking it away from me,” instead of praying, “God, take it away from me” shift that. Still, pray by all means as Paul didn’t stop praying. Start praying, “God, what are you trying to teach me in this? What is the perspective you want me to see?” What are some things in that intimacy with Him? Again, like we were talking about earlier, you’re not going to Him with a means to an end. Now, it’s not we’re going out and talking to you so you will deliver me so that once I’m delivered from it, I’ll just move on because we all have that tendency that once our problems are fixed, we forget.

It’s a lot easier to stay on the other side because obviously, God did end up healing me. It could’ve been a lot quicker, but he did end up doing it. Don’t get me wrong, I’m not trying to belittle the situation because it’s just so much easier talking about it when you’ve been delivered from it. If I was going to give an encouragement, it would take some time to set up a [00:35:00] situation where you have an hour a day of prayer and for 15 minutes, pray that God would deliver you, even then for 45 minutes, pray that God would help you see why He hasn’t. 

God’s Gift In Unanswered Prayers

Carrie: I try to remind myself, sometimes God’s always working. God’s doing something here, even if I don’t see what it is or I don’t know where this is going. Even in our culture of American and what’s happening right now between COVID-19, between race relations, God’s doing something in our nation. 

If we are tapped in and we are tuned in and saying, “God, what are you doing in my life? What are you doing in my community? What are you doing in the nation and the world?” Then I think we’re going to be a lot better prepared to handle situations as they arise. They’re out of our control.

Pastor Troy: A hundred percent. It’s about stewardship, right? So you mentioned COVID-19, [00:36:00]  I think God has got so many things that He’s going to do by the time all this is over both through the racial dividing and through COVID. 

I’m going to use the COVID-19, for example, when it first hit, we went a couple of months, we couldn’t even leave our houses. The kids weren’t going to school. Not that any of that really changed, but it was really extreme. So number one, we had dinner meetings every night. We were meeting people every night, so we were never eating at home. That forced us that we can’t go to restaurants, so we’re cooking at home.

My back porch was just a bunch of junk piled up. Somebody had given me a free grill. I never even turned it on. So Darla and I took some time and we bought a swing and we cleaned it up and we cleaned the grill up and we got some plants and put out a table and long story short, four months later, every night, we have dinner with the kids. We’ll put them in bed and then we go sit on that porch and we just swing and we talk.

So my point is that God gives us these, whether we’re considering it a gift. So again, back to [00:37:00] Paul, he talks about the stone, he says, “God gave me that.” 

Nobody’s going to consider COVID-19 a gift right now but if you allow the spirit of God to give you a little bit of perspective shift, again, not that any of those things are good, people being sick, people dying, small business, that’s all bad, and we need to do all we can to help. We’re a mess, whatever it might be, but there’s another side of it that says, “All right, God” I’m going to also look the other way and say, “What can change in a positive way as a result of this? What can I learn that makes me a better person.” Moving forward from what people would have considered a terrible situation. 

Carrie: Right. There’s a gift in there at some point. I want to end our podcast time together. This has been really awesome. Some of the things that you’ve shared and topics that we’ve gotten into. 

Pator Troy’s Story of Hope

I like to ask every guest, what is a moment of hope maybe that stands out for you, a time where you received hope [00:38:00] from God or someone else in a period of maybe a discouragement or time where you had a hard time moving forward?

Pastor Troy: There’s so many. I think of two big wins right off the bat though. I’ll try to say real briefly, the first one, which you’ve probably heard me talk about before, we had to raise $175,000 to launch our church and my dad’s blue-collar, “If you want money, you work for it.” That was really difficult for me to ask people and God actually kept providing so we were about $65,000 away from our goal and we decide that we’re gonna launch the church nine months earlier than we originally planned. We’re going to launch in September. We moved to January. So we kind of started panicking. We didn’t want to have to borrow money even though there are great organizations out there that will let you do that.

We wanted to launch debt-free and so we just didn’t know what we’re going to do. We have missed some deadlines for some of those applications and I remember just praying like, “God, I need something.” [00:39:00] Long story short, a pastor friend of mine whose church is kind of a parenting church of ours, called us up there for a video and totally pretended like it was one thing. Darla and I arrived and they handed us a check for $65,000. It’s moments like that, that it can only be God. 

The second one, since I had this book, I was going to show you or read it to you cause I don’t have it memorized. So we were supposed to launch the church or plant the church. We felt that calling from that conference.

I’m trying to decide the name of the church and I’m getting kind of uneasy because we don’t know where we’re going. I’m starting to get to that point of like, “God did you really call us?” because all the people that I know are like, “Oh, God called us here.” Most people got called back to where they were born. At some point and God called them back to it. We were leaving where both Darla and I were born. So there was no like, “Oh, we’re supposed to go [00:40:00] here.” I was just kind of getting to that point of doubt. I needed some hope.

I had to go to a conference that I didn’t want to go to. It’s normally a boring conference for me but my pastor made me go. So I said, “well, that’s fine.”

I’ll go but I’ll sit in the back and play candy crush and get through it. So we’re getting ready for the first night and the guy who’s speaking is like 80 years old.

So I’m like, “This is not going to be entertaining for me.” My pastor says, “come here” and he takes me to the front row beside him, and then before it starts, he gets a phone call and leaves. He leaves me on the front row by myself. So I can’t play candy crush because everybody’s gonna see. So I did what I had to do. I listened and I took notes. He preached this entire sermon and I forget the title of it, but he preached it. He just read the verse when he started off, Hebrews 11:8 and he reads this [00:41:00] “By faith Abraham obeyed when he was called to go out to a place that he was to receive as an inheritance, obeyed and went, even though he did not know where he was going.”

I just remember floodgates just because you can’t write a better script than that. You know what I mean? Like God knows that’s what I’m struggling with. It takes you to this place I don’t want to be and He makes me listen and that guy steps up, and that’s the first words he said.

It’s just a couple of, probably hundreds of moments that I could share with you where God has given me the little nuggets of hope to just keep me moving in the path that He’s got to move me on. 

Carrie: Awesome. Well, thank you so much. I look forward to when we can see each other in person and all hug each other and all that good stuff at church, it’ll be a good day. We’ll probably all be okay. 

Pastor Troy: That’s so true.

______________________________________________________________

[00:42:00] I really hope that this episode blessed you as much as it did me and I am so thankful to be connected to a pastor who cares about and is in support of mental health. 

You can reach me for show opinions and suggestions at our website hopeforanxietyandocd.com. 

Hope for anxiety and OCD is a production of By The Well Counseling in Smyrna, Tennessee. Our original music is by Brandon Mangrum and audio editing was completed by Benjamin Bynam.

Until next time. May you be comforted by God’s great love.

3. Ruling Out Physical Contributions to Anxiety with Melanie Lowe, NP

Written by Carrie Bock on . Posted in Anxiety, Personal Testimony, Podcast Episode. No Comments on 3. Ruling Out Physical Contributions to Anxiety with Melanie Lowe, NP

In episode 3 of Hope for Anxiety and OCD, I interviewed Melanie Lowe, NP to discuss how undiagnosed physical conditions can contribute to anxiety. Melanie also helps Christians understand why there is no shame in taking medications for mental health issues.

  • Various health conditions that can contribute to or increase anxiety
    • sleep apnea, thyroid malfunction, or vitamin deficiencies
  • Why it’s important to have a Primary Care Physician 
  • Taking medications for mental health as a Christian 

Resources and links:

By The Well Counseling
Cornerstone Primary Care
Study on exercise and antidepressants

More podcast episodes

Transcript of Episode 3

Hope for Anxiety and OCD Episode 3. 

Today on the show, I am interviewing Melanie Lowe who is a nurse practitioner at Cornerstone Primary Health Care in Hendersonville, Tennessee. I was really excited to be able to speak with a medical professional on the show to talk about some physical issues that may be causing or contributing to anxiety. A lot of people don’t know that when you’re experiencing anxiety, a first stop to the primary care physician to get some testing and blood work is really in order. Melanie and I are also going to talk about being a Christian and taking medication for mental health. Let’s get to the show. 

Getting To Know More About Melanie Lowe

Carrie: Can you tell us a little bit about yourself and how you got involved in the medical field and kind of the decision, the process to start your own medical clinic?

Melanie: Sure. My name is Melanie Lowe, and I graduated from Auburn University. That’s where I did my undergraduate in 1994. I practiced nursing in an Open Heart Surgery Center for three years and then decided to go back and get my master’s in nursing, but that was in nursing education. 

My ultimate goal was to teach in the nursing programs there in Auburn, which I did for three years. That was a great experience because as a nurse, we just love to be educators as well. So, after that period of time, we started a family. My husband and I have two children. I took eight years off from school to raise the kids and then once they got into school, then I said okay, it’s time for me to go back and get back into the nursing field, which I did. So I went to work. We moved from Indianapolis to Hendersonville, Tennessee, and I went to work for Vanderbilt in the cardiovascular unit there. And then I decided after two years that I was ready to go back and get my nurse practitioner degree, which I got in 2008. That’s the progression as I got to be a nurse practitioner and that is my ultimate, ultimate goal and love. I just love it.

Different Titles In The Medical Field

Carrie: Maybe you can help some of our listeners because I know we hear different titles in different fields. What is the difference between being a doctor and being a nurse practitioner?

Melanie: Doctors, of course, have different degrees: primary care provider, internal med, physician. They go through a course in undergraduate medical school. Some of them do different extended studies if they want to be an endocrinologist or specialist in cardiology, things of that nature. We have mid-levels, which are nurse practitioners and physician’s assistants. They do similar jobs. They work alongside doctors a lot of times in various clinics, but nurse practitioners and PAs can also go out on their own like I have and open up their own medical clinic in the State of Tennessee. We have to have a supervising physician. So you will see that sometimes when we write certain medications, narcotics, we have to have a supervising physician sign off on that. They have to be in our practice at least once a month just to sign, not to actually see patients but need to be overseeing us at least once every 30 days. Mid-levels can prescribe just like physicians. They can order imaging. They can make a referral. When it comes to medical care, we can all do the same thing. It’s just that nurse practitioners have less schooling than physicians.

Benefits of Seeing A Nurse Practitioner

Carrie: Do you feel like there are benefits at times to seeing a nurse practitioner over a doctor?

Melanie: Well, as most people probably know, generally, most nurse practitioners will spend more time with their patients. I think that’s one of the big differentiating things between mid-levels and a provider, that’s a physician. What you’ll find though is that in a corporate clinic, there’s a schedule that dictates how much time you can spend with each patient.

If you go out on your own and start your own clinic, you can decide how much time you want to spend with each patient, depending on how in-depth you want to go. For us being a Christian-based clinic, we have the opportunity to talk about emotional, spiritual, physical, all of the aspects versus it just being like you’re in here to get your medications refilled. 

We’re moving on to the next station, so we have a lot of flexibility with our schedule and how long we want to spend with our patients. That’s one of the biggest things. The tagline actually for my clinic is the full extent of medical care with the heart of a nurse, and I think that kind of encompasses everything so we can do the whole medical ground. With the heart of a nurse, let them understand that we want to sit down and get to know their families and their children and things that are going on in their life. That gives us hope, a little portion of the heart of a nurse.

How Melanie Started A Christ-Centered Clinic

Carrie: I think that’s really huge because health is so interrelated. Our physical health and our emotional health and our spiritual health are very interrelated and a lot of times, unfortunately, seeking help or treatment, we’re only isolated on one aspect of those when we really need an all-encompassing approach.

Melanie: Right. That’s why where the vision came with my husband and I. We decided in 2010 to start a clinic. We didn’t know what that clinic was exactly going to look like but we did know that we wanted to be Christ-centred healthcare, and therefore, that’s the name Cornerstone. We wanted Christ to be the cornerstone of the practice. The biggest thing for us was to do the physical, emotional, and spiritual health with that, and because that makes up each individual. You’re right, if you take out one portion of that, then usually if you’re great physically, then maybe emotionally or spiritually, you’re not doing so well and that affects us physically. Each one of those is so interrelated. 

I think that’s one of the biggest reasons that patients when they see a Christ-centered or Christian-centered clinic they’re more apt to come in, feel open to share their faith, discuss what’s bothering them, or maybe a struggle that they’re having, so that’s where we have found our biggest benefit we think to most patients.

We have lots of stuff around like we have lots of artwork that’s Christian. We have scriptures that are on the walls and I think one of the biggest things for us is we have a prayer board out on the wall. When patients come out, we have little cards that say prayers or blessings. If they have prayer requests, we don’t put anything, identifying who they are, but we put those on there, and we put them on our wall. As they come in, and we hear that their health issues have been resolved, or they got to buy the house that they didn’t think they were gonna get, then we move it over to the blessing side so that people can see how we’ve transitioned and how prayers are being answered. 

Other people are coming in because they just want to sit down and have you pray with them because they’ve gotten some bad news and maybe they have cancer. They’ve got some kind of diagnosis, and they will literally stop in and just ask if they can go to a room and pray. They’re not here for an appointment and so it kind of gives you that welcoming and inviting part. You’re right, that’s how this is all together physically, emotionally, and spiritually.

Melanie’s Chosen Ministry

Carrie: Those are very unique practice concepts. I don’t think that I’ve ever heard of anybody that’s practicing medically in that way. So, that’s pretty unique.

Melanie: We have found that it’s a lot more accepting than most people would. I initially feel that we have believers that come in who are Christian. We have people of other faiths. We have non-believers, but if they’re struggling with something and you ask if you can pray with them, I have yet in 10 years had anybody tell me that they didn’t want me to pray with them. Amazingly, they’re very accepting of that. We don’t push it on them but we just say, “Hey, is that something that you would allow us to do with you?” They are very open. It’s our ministry. This is kind of a ministry. Each person has a ministry field and this is what it is for me. I can actually have my ministry field and my work all in one.

Why having a primary care physician is important?

Carrie: So one of the things that I see in my practice, I will always ask people, when they initially come in, “do you have a primary care physician?” And unfortunately, we’re living in this day and age where many younger people don’t really see the value in primary care. They don’t see the value in going to the doctor for just a general wellness checkup and so they’ll tell me things like “if I get sick, I just go to that little place in the drugstore and they take care of it.” Why do you feel that it’s important for people to have a primary care physician that they go to?

Melanie: That’s a great question. We have a lot of people that do the same thing, especially the younger people who maybe don’t have any chronic illnesses like you’re talking about. We’re thankful that the urgent cares are open on the weekends and after hours, but what we would hope is that someone would call their health care home. We want to be the home of the person so that they can go somewhere else if we’re not available. 

Ultimately, the importance of primary care would be to begin to build a relationship with the patients and then if there are changes that come along the way, whether it’s maybe something that you see, and then something physically you see or in the lab, you can watch trends, and you can start seeing those changes, but that’s overtime. It’s not something that you would normally know if you went in to get a sinus infection and then the next time you had a urinary tract infection. Well, nobody’s really keeping up with all the other aspects of your life. So that relationship would be one of the biggest things.  

The second thing would be trust. If you go to see somebody on a regular basis, you build that trust with them, and then they’re more apt to open up and tell you maybe some internal struggles that they’re having, or “hey, this is kind of embarrassing” or “I don’t really want to tell you about it,” but then they will feel that they trust you enough and know that it’s in confidence that they will tell you things that they won’t get a chance to tell somebody that’s in an urgent care. Something that is brought up with screenings, we see a lot of people who don’t get theirs once a year.  

Annual Screening Is Necessary

Annual screening and those screenings are so important because you can catch things really early, and so that you can take care of them and treat them before they become a more serious and more difficult-to-treat problem. Screenings are super important whether it’s wellness exams for just your overall annual physical, whether it’s a pap smear or mammograms. We try to do all of the screenings to keep people up to date on those. If you’re going and you’re not having that continuity of care, nobody’s keeping up to when your last mammogram was or when your last physical exam. It’s super important to have that relationship so that that can be developed along the way, and then there are ultimately better outcomes for the patient when you do that.

Ruling Out Anxiety and Other Health Conditions

Carrie: That absolutely makes sense to me that someone can see your whole health history across time and start to notice patterns maybe before you do or before a one-stop-shop would. Sometimes people come in, and they may feel intense physical symptoms, and you may rule out medical causes and it looks like it’s anxiety. Can you talk with me a little bit about that process? How do you know or differentiate if this person who’s maybe presenting with difficulty breathing or rapid heart rate? How do you know if that’s anxiety or not?

Melanie: Most people who struggle with anxiety know that some of the common symptoms would be things like a headache, or rapid heart rate like you mentioned, palpitations, difficulty sleeping, their mind is racing. They might have a lot of GI issues, diarrhea. Amazingly, that anxiety can cause symptoms and multiple body systems. Other things to rule out can be done through blood work, EKGs. You have to figure out if it is the anxiety that’s causing the physical symptoms, or if [it’s] something physically making them have anxious feelings. 

For us, if you rule out efficiencies such as vitamins like B12, B6, and iron, those deficiencies can cause people to have anxious feelings. If they have a hormone imbalance and that hormone could be the thyroid. Hyperthyroidism where your thyroid is in your neck, and it controls a lot of different parts of your body but one of those is how rapid your heart can go. If you have hyperthyroidism, you are in overdrive and so you have a lot of thyroids which increases your heart rate. If somebody comes in and they’re having no symptoms, and you do a simple blood test, you can find out if that’s the cause. You treat their hyperthyroidism, and then their anxious feelings all go away. Anemia is another one. If someone is either losing blood or maybe not making enough blood, so the red blood cell counts are low. They’ll have a rapid heart rate, they’re short of breath, which is very similar to what people experience with anxiety. If you rule that out as a cause and find out why they are anemic, give them some iron, build their stores back up. Amazingly, they can get rid of some of those symptoms. 

Some people actually have underlying heart issues where their heart will race or they’ll have skipped beats. That can be from electrolyte imbalances, like magnesium and sodium, and potassium or it could be an underlying heart issue. Again, once you take care of that, it will help with the anxiousness.

A lot of people drink too much caffeine. They’ll have caffeine in the morning, and then they’ll have some monster drinks. All of those caffeine or any other drug or alcohol abuse that they might have can cause withdrawal even from similar symptoms. 

Trust and building that relationship with a patient will let you ask questions like, “Do you struggle with taking too much pain medication?” or “Do you struggle with some of these things?” Obviously, you wouldn’t have that opportunity in urgent care.

Sleep deprivation, if somebody has sleep apnea, for instance, they don’t even know it, and they’re not sleeping well at all over time. When they’re sleep-deprived, anxious feelings, inability to think clearly, all of those occur. Simple things can rule out the physical and then you can determine if the anxiety is really the underlying cause, or if it’s something else.

The Relationship Between Anxiety and Sleep Apnea

Carrie: I’m glad that you brought up sleep and sleep apnea because I have had several clients that went through the sleep study process [and] found out they had sleep apnea. As they started to wear the mask at night and get that treatment, their mental health has improved dramatically, not to say that all of their anxiety or depression has gone away, but they feel so much better physically, which helps them feel better emotionally. A lot of times that goes undiagnosed for a while, right?

Melanie: It does and not everybody falls into the typical category of what you would expect somebody with sleep apnea to have. A lot of times they always say if your neck is greater than 17 inches, like if a man’s dress shirt is above that, then you might be apt to have sleep apnea. A lot of people wake up and they are just as sleepy when they wake up in the morning as they were before they went to bed. That can give some people some idea. Those who have partners or married, they’re the ones who can say “I witnessed them stop breathing, and they’re having issues.” 

Sleep deprivation and sleep apnea can lead to things like those we talked about other hormones. That can be lower testosterone, specifically, and estrogen. So if somebody has sleep apnea and they have the symptoms of low testosterone, they can feel anxiety, depression, things of that nature. If you take care of their sleep apnea, amazingly, a lot of other things fall into normal, and then they can rule out what’s left.

How Important Is Sleep To The Body and Mind?

Carrie: I’m curious about what you think about this issue related to sleep is that we also are living in a society where people seem to think that sleep is optional like I can sleep six hours a night, and then down an energy drink in the morning, and then have maybe a cup of coffee in the afternoon, and I’m good to go, everything’s fine. What are we really missing out on medically and physically when we’re missing sleep?

Melanie: When you have very short spurts of sleep, or you’re using things such as caffeine to keep you awake, and then some people will use alcohol to get them to sleep, those things start to mess with your circadian rhythm. Your sleep cycle gets off completely. What happens with that is when people are using caffeine or other things, once that sleep cycle gets off, you have to go through a withdrawal period of those in order to get things to cycle back into normal. 

You’ll see some people who may need five or six hours of sleep, other people do not function well without seven or eight, if not more, so when you wake up in the morning, you can’t think clearly. You feel like you can’t even recall a name. You can’t think of what you did yesterday and all of those are symptoms of not having enough sleep in a long time. 

Sleep is really important. That’s the time your body has a chance to restore itself, heal up and reprocess, and put memories in place. It’s amazing what your brain does during that time of sleep, and it needs to have it adequately each night for you to feel that way.

Carrie: There’s definitely a connection between trauma and sleep disruption. That inability of the brain to process that information at night can really cause more problems during the day is something that I’ve seen from the mental health side.

More Patients Are Coming Out About Mental Health Conditions

Carrie: So do you see quite a few patients in your practice that present with anxiety? Is that something that you see on a regular basis?

Melanie: Yeah, we see it every day. I think one thing that surprises people is that probably 60 to 70% of patients that see us on a daily basis are coming in with some type of anxiety, depression, a combination of that. It is just amazing how many people and how prevalent it is, and even our young people. I think there’s a lot of pressure for young people to get into colleges. I think it’s starting out a lot younger now. I treat 12 and above, so I don’t see a lot of really young patients. In adolescence, it’s just that they’re all competing to get into a certain college, and they’re trying to study for certain tests. There’s so much competition, and that I think is part of that source. We’ve seen that starting in young people and then we have everything from it could just be life circumstances. It could be that during this COVID. 

We have noticed a remarkable number of people who are having the mental health aspect of it now not as much physical. We have not treated anybody so far with COVID but during this pandemic, we are seeing it escalate. People who have never been on medications before or starting them or those who are already on something, we’re having to increase it just to help them cope through this, but it is more prevalent. I think now it’s exciting that the stigma is not there anymore. We openly talk about mental health issues with patients every day, because it’s not that stereotype where we feel like we can’t tell anybody what’s going on. So we do try to make that something that we bring up in conversation, “Do you struggle with anxiety?” or “Do you struggle with depression?” and that opens the doors for people to discuss that with us. It’s a daily thing for us.

Presenting Different Treament Options To Patients With Mental Health Conditions

Carrie: I think that’s a great thing because a lot of times the medical professionals can be a gatekeeper to people seeking out counseling or mental health treatment because like you said, they do have a relationship with you, but maybe they’re concerned about going to a counselor and you can talk with them about it, that it could really benefit them and work alongside the medication that they’re taking to help them see even more improvements.

Melanie: Right. I think a lot of people end up either they get themselves shamed into not taking medication. They get shamed by friends or family, or even within themselves. They feel nervous about taking medications because they’ve been told “you need to pray harder and your faith is not strong enough.”

I think that’s very difficult for the patients when they come in here because they already are dealing with the guilt of having to come and ask for help. We try to make it as easy as possible and just present all of the options that they have and let them choose what’s best. Just making the decision to go on medication or to get counseling, admitting that they have an issue with anxiety is a huge thing for them but once they make that and commit to it, it’s amazing how much benefit they get from all of these, whether it’s medication counseling, it doesn’t matter. There’s a huge benefit with all of those together. Some people are open to moving past that and getting that help, which is what we love to see. We love to help them.

Explaining Medications To Patients

Carrie: Right. Because this is an argument I hear, a lot of people will say, “I’m concerned about getting on medication because I don’t want to become addicted or dependent on something” or “I don’t want to have to be on this medication for the rest of my life.” What do you say to someone with that type of argument?

Melanie: That’s one of the things that we discuss with patients when we start those medications because what we found is when patients start them, it doesn’t necessarily have to be lifelong. We tell them it all depends. It could be their life experiences. They could genetically be predisposed to have some of these mental health issues because of family genetics, life experiences, and so they may need to be on something long-term. They may have realized that they’ve been struggling with this since they went to kindergarten and so they are probably looking a little more long-term. 

The majority of the people that we started on may just be situational. It may just be that they have just lost a loved one or were recently divorced, and so they’ll take medication for six months to a year and try to see how they are doing through counseling, journaling, and all the lifestyle modifications and then come off of them. 

I think the other thing too is a lot of people still have that thought that the medications are going to somehow change their personality, that they’re gonna withdraw from people or people are gonna know that they’re on something. Amazingly, the medications are so mild that they just take away the symptoms. It actually gets rid of all the cloudiness or the things that maybe were suppressing their personality. It actually removes all that. That’s the old so-and-so that I knew before. They started to see those personality traits that they had, but they hadn’t seen those in a long time. So it’s not necessarily lifelong. Some people need to spend two or three years but a lot of times we can just use them to help them transition through some circumstances and then come off the medication.

Carrie: I actually did that in my own life. When I went through a divorce, I got on antidepressants for six months. I was in counseling during that period as well and I followed up and talked with my counselor and talked to my doctor about coming off the medication, and they were both in agreement that it was time and then I was feeling more hopeful and better and functioning better in my life. That was a huge help for me for those six months to have that because it made it so that I could continue to work and could continue to function and be a responsible adult.

Melanie: It is amazing like you said, there are so many different types of medications now that we aren’t just stuck with a certain class. So we as primary care providers, will start somebody on something and take care of them. If it ever escalates and needs further combinations of medications that we in primary care are not as comfortable in prescribing, that’s when we’ll send them to a psychiatrist or someone else who can put together medications that we do not feel comfortable putting together. The majority of the people, we can treat in primary care, just like with any other disease process.

That’s one of the things I would say, a lot of people feel that mental health medications aren’t as important. I think that’s why they try to tell people not to get started on because think about diabetes, that’s a chemical imbalance. Think about hyperthyroidism or hypothyroidism, it’s a hormone issue and chemical imbalance and we would not look at those people and say “just keep praying.” We wouldn’t tell them and shame them into not getting help. We would never tell them that, “Hey, if you pray hard enough, your blood sugar is going to go down from 500 to 200.” 

We would treat them and I think we need to understand that and most people are on board with this and use this as another chemical imbalance. That’s why I feel like the stigma is gone and we just need to talk about this openly because so many people struggle with it. There are options. It would be different if we had nothing to offer, but there are too many things that we can do to help them.

Carrie: Right. I agree. I like that you brought up that there are different classes and different types of medication that people can be on because they may start on a particular medication and it just doesn’t work as well for them. People’s body chemistries are a little bit different and they may have to try a different medication or increase or adjust the dosage in some way in order to feel better.

Melanie: That’s exactly right. A lot of the times we get that information from counselors, like maybe a patient goes to see a counselor first and they’re the ones that say, “you know what, I think that this person would really do well with starting a medication” and that’s I think confirmation to the patient as well that they have two different people like you said, you got your counselor, and then you’re with primary care and now together, you’re gonna see them in your office. You can tell if you can think clearly, and you can see some improvement and benefits from the medication, or we can say from our end “okay, you’ve had a lot of weight gain, it looks like you are still really struggling, and you’re crying a lot”, and so together as a team, and this is, again, one of those team approaches where we just all need to work together. If there’s a side effect, speak about it. Tell us because there’s a lot of options, and we can change it up and make it work best for both.

Healthy Lifestyle Can Help Improve Mental Health

Carrie: Right. Awesome. Let’s talk a little bit about how lifestyle changes can impact us in a positive way, our physical health, and our mental health.

Melanie: That’s a great one. Because a lot of times people may not have given as much thought to maybe their diet and exercise and we asked them about that a lot. A lot of people don’t realize how that can actually impact mental health as much. If you think about diet, when they used to say,  “what goes in is what comes out,” but to be honest with you, there’s so many foods and so many different diet plans and stuff that people were on. Not all of them are best when it comes to nutrition. I would say, definitely read through and find out which diet plan is best for you whether it’s just losing weight, or is it just eating more healthy anti-inflammatory foods, meaning things like reducing your gluten, reducing your dairy, and reducing your sugar that is probably the three biggest things and those are the best tasting things usually. 

It’s hard to get people to realize that but if you just reduce those gluten, sugar, and dairy in your diet, amazingly, people feel more energetic. Their joint aches and pains, everything that can be inflamed, it amazingly helps that and so that is one huge dietary thing. If I can impress on anybody, it is to try to use that kind of diet. Don’t go strictly keto, and don’t go strictly whatever. I’m just saying, just do a balanced diet with a reduction in those three things. 

I think people would feel better overall, along with exercise. It’s hard. People are struggling with time. They can’t find enough time between family and work and other outside responsibilities, taking kids to their different activities.  I think part of that would be to find 15 or 30 minutes. It doesn’t take a lot. You can actually find videos that do 10 minutes of high impact in the morning or in the evening. I think each one of us could find 10, 15, 30 minutes a day but the goal is somewhere around 150 minutes a week. So if you can pick out 45 minutes, three to four days a week, or just 30 minutes, five days a week, and find out what you love. Just get up and move. It doesn’t matter. Just do something like gardening, mowing the grass lawns, that sort of stuff, walking the track and then along with this, as well as getting out there and having support. Get out with your friends and do something that you enjoy and get that accountability because it’s so much easier to do stuff with other people. Plus you can talk to them and solve all your problems while you’re walking and you’re doing your healthy stuff as well. Those are just some of the things that in addition to medications and counseling and things that would be helpful for mental health.

Carrie: Absolutely. Before the pandemic started, I was very involved in group fitness and that was just a lot of fun to get together with some other ladies and do a dance workout or a boxing workout and it’s just fun and it’s helpful. It keeps you going to have somebody else there with you exercising. I think it keeps you committed to it. 

I know that there have been studies done where they’ve actually compared people who were on antidepressants and people who exercise and people who did both. A lot of times the people that fared the best did both. But the people that had the exercise, sometimes they did as well as the people that were on antidepressants, so that’s pretty incredible too.

Melanie’s Story of Hope

As we’re getting to the end, I think this has been very helpful information that you’ve shared with us. I like to ask every guest to share a story of hope, which is maybe a time that you received hope from God or another person. 

Melanie: Mine probably doesn’t come from a specific person. I would just say that God has given each one of us certain gifts and talents that we’re supposed to use to bring others to Him and to further His kingdom and to glorify Him. I think if we find something that we’re passionate about and that we love, and we keep God first and focus on the perspective of putting Him as a priority. He will be steadfast and He will be the one that gets us through and makes us feel fulfilled. 

Back in 2010 just opening up this clinic, it was stepping out on a limb and it was stepping out on faith. There were times when there wasn’t a single patient when we first opened. There may be one patient in an eight-hour day. There could be two. There were times when there were financial difficulties, “when are we going to stay open?” or “are we just going to sell out to a corporate or just slow down?” 

There are lots of things along the way but continuously, God will put people in place or the patient would come in. It’s like “let me pray for you” and it was amazing how it became almost like a community. It was over and over. God was just like, “just be steadfast, continue on this path, even though you can’t see what’s going on, and then rely on me.” 

Now during this pandemic, here we are moved out of our old place where we rented. We built a building and during this COVID, when everybody else is furloughing people, we’re hiring and growing and the Lord says like, “just be patient, just continue and be patient.” 

I think that would be just the sign of hope for anybody that’s trying to think of something that they’re passionate about but they’re afraid to maybe step out. 

I would say just step out in faith, and just continue to pray about it. If it feels like it’s not gonna work out, just continue to be in prayer, and have others pray for you and amazingly, it’ll work out or you’ll find out what you need to do next. 

Carrie: God has a way definitely of coming through right when we need Him and that’s awesome. It’s an encouraging testimony. I appreciate you sharing all of this helpful information and taking your time to be on the show. I hope that this podcast really encourages people that if they don’t have a positive relationship with a primary care provider, they can have that and that they can find somebody that they can connect with and trust and have as their health home.

Melanie: Thank you so much and like I said, I agree with you. I just want people to reach out and ask for help and not go through this alone. 

Carrie: Absolutely. I enjoyed this interview.

I hope you found the information helpful. When we look at a symptom that our body is experiencing such as anxiety, it’s important to evaluate what is the message of the symptoms we’re experiencing. What is the meaning to it? Sometimes this may mean that we’re having physical issues such as a malfunctioning thyroid. It could mean that our body is responding in response to past trauma that we haven’t processed. Anxiety could be the result of constantly living in the future and worrying instead of learning and focusing on being in the moment of what’s actually here right now. 

Anxiety being such a broad symptom, I just really encourage you to look at what is that symptom or what is your body in a way trying to communicate to you.

You may need some medical help or some counseling help to help you figure some of that out and tease it out and that’s okay too. There shouldn’t be absolutely any shame in getting what you need. It doesn’t matter if that need is physical or emotional. 

I hope that this episode prompts you to think about how you can take better care of yourself too. 

Until we meet again. You can find us on Facebook and Instagram, or always at hopeforanxietyandocd.com. 

Hope for anxiety and OCD is a production of By the Well Counseling in Smyrna, Tennessee. Our original music is by Brandon Mangrum, and audio editing is completed by Benjamin Bynam.

4. Importance of Proper Diagnosis with Jessica Huddleston, LPC-MHSP

Written by Carrie Bock on . Posted in Anxiety, Counseling, OCD, Personal Testimony, Podcast Episode. No Comments on 4. Importance of Proper Diagnosis with Jessica Huddleston, LPC-MHSP

In Episode 4 of Hope for Anxiety and OCD, I interviewed my friend and colleague Jessica Huddleston to discuss the importance of determining whether or not someone is suffering from anxiety or OCD. Many people with OCD are in therapy for years receiving reassurance-seeking, but not getting better. Jessica also discusses a common treatment for OCD.

  • Personal story of how her daughter has been impacted by OCD
  • Importance of differentiating between anxiety and OCD
  • Exposure and Response Prevention (ERP) 
  • Creating exposures for social anxiety
  • Power of a proper diagnosis to reduce shame and increase hope

Resources and links:


Sabin Behavioral Health in Smyrna, TN
More information about ERP and OCD

More Podcast Episodes

Transcript Of Episode 4

Hope for Anxiety and OCD Episode 4

Today on the show, we are going to be talking to my good friend, Ms. Jessica Huddleston. She is a Licensed Professional Counselor and Certified Psychological Assistant at Sabin Behavioral Health in Smyrna, Tennessee. She’s going to talk a little bit about her own experience of having a child with OCD, as well as talk about professionally the importance of diagnosis.

Let’s dive right in. So just to start out, one of the things that I’m doing on this show is talking to different people with different viewpoints. Instead of just going and interviewing all Christians, because I think it’s important at times for people to seek the help that they need and that may be outside the church, or it may be outside the traditional Christian community setting.

How Jessica View Spirituality

Carrie: [00:01:17] I’m curious for you, what is your kind of viewpoint on spirituality? 

Jessica: I believe that everybody has some kind of spiritual power and it’s important for them to embrace it with whatever denomination or belief system that’s important to them, but it’s really just holding their own values and their own morals. That is the bigger picture for me and my goal as a clinician is to understand that person’s values. So if that means that I need to be educated on it, so be it. I believe everybody is a bit different, but being in the setting that I’m in, as well as being a counselor and my background being in clinical, I feel like it’s important for me to not be biased and hold my personal opinions separately from whatever the clients are.

Carrie: [00:02:09] Right. Do you find it challenging at times to work with people that have a different viewpoint than you do? 

Jessica: No, most of the time. The goal is for me to understand what their belief systems are and sometimes that takes me getting educated. Sometimes it takes the individual teaching me. Sometimes it’s me going and reading things and figuring out and just having an understanding. I’m very open to asking questions, like, “What does this mean if I don’t understand” or “Why is this important?” Things like that. Having a common understanding is more important than anything that I particularly believe. 

Jessica’s Experience Dealing With Her Children Who Have Anxiey and OCD

Carrie: I know that one of the reasons I wanted to have you on the show was to talk a little bit about your own experience in your family with OCD or anxiety. [00:02:58] Can you talk a little about that? 

Jessica: My son is 19 and he has difficulty with anxiety. One of my daughters has OCD and we recognized it early on. She wasn’t even two yet. We were noticing some odd behaviors where she was collecting things and trying to hold things close to her and when she was able to talk, she told us that she collected everything because she was afraid we wouldn’t come back to the house. So every time we left, she wanted to have everything ready so she could take it with her, and that included garbage like a candy wrapper or whatever.

She would just collect everything and we’ve spent a long time, [00:03:43] she’s 12 now, I spent a long time working on a lot of those issues and she’s doing a lot better, but it does come out with her schoolwork, her wanting to be very perfectionistic and afraid of making mistakes. Her teachers have been really supportive, intentionally asking her questions that she doesn’t know the answer to [00:04:04], and then they just praise her for trying, which has been a huge help. Luckily, she goes to a really supportive school. 

I do know that one of the things that I’ve run into professionally is a lot of parents feel stuck because the schools don’t really understand their child’s difficulty with OCD. I worked really diligently to educate the parents so they can convey that information to the school because a lot of times kids will come across as just being non-compliant. It may, especially if they use avoidance as their tactic with things. I think that’s really important to me to help parents have the vocabulary and the tools to be able to get their children what they need. 

Avoidance In OCD Does’nt Work

Carrie: Right. I’m sure that the advocacy process has been ongoing because every year there’s a new teacher and more educating that has to be done.

Jessica: [00:04:57] Some parents feel compelled to pull their kids out of school or homeschool or now with everything going on, with virtual schooling, that totally makes sense. But when the parents want to take their kids out of school, I have a serious conversation with them about why and what the benefits are and what the drawbacks are. I don’t think a lot of times parents realize that they might be helping their child for the moment and hurting them in the long run especially with avoidance. 

It might be reinforcing their avoidance unintentionally. I mean, the parents are doing it because they want their kids to be avoidant. They’re doing it because their kid is struggling in school, is complaining, and all of that stuff. It seems like a straightforward solution, but sometimes kids need to learn how to get through that struggle.

How Jessica Recognized OCD in Her Child?

[00:05:45] I really recognize that with my daughter early on, because on top of her having OCD, she had selective mutism and that was difficult. It wasn’t at home though. It was only at school. She would talk. We didn’t know for the first year. She would talk at home non-stop about everything.

[00:06:08] She tells us everything that somebody did wrong at school. Got out of line, all this stuff, but at school she never said a word. It wasn’t until she got her finger stuck in a table at school and all the kids had gone inside and they realized they were missing one. They went back out and she was silently crying and they called me and they’re like, ”well, this happened.”

[00:06:29] I’m like, “Oh, accidents happen.” “Kids stick their fingers in tables.” “She’s not seriously hurt.” “It’s fine.” They’re like, “Yeah, we just didn’t know. She sat out there for about five minutes because she was so quiet.” I’m like, “Wait, what do you mean she was quiet?” They’re like, “Yeah, she never talks at school” and I’m like, “what?” That’s when I realized. She was at that point in kindergarten. She’d gone there for pre-K for two years and apparently, the most she ever talked was a whisper, and nobody ever mentioned that. 

It’s really strange but once we figured it out. Once we realized what was going on, we just started having her talk to strangers, talk to anybody and everybody and she got out of that habit pretty quick. 

Carrie: So she was comfortable with talking to family members and that didn’t make her anxious, but when it was outside family members, she was really nervous to communicate to them. 

Jessica: She would talk if somebody was close to her. If she felt like she had permission or if she felt safe, she would do it. She talked to her teacher when we went to the parent-teacher conference. So I didn’t know it was happening until they’re like, “Yeah, but I thought you knew because she was always that way.” They thought it was just something that was an abnormality of her, and I was like, “I guess it is.” [00:07:51] It’s just not one that she presents everywhere, which is one of the things that clued us in very quickly to her selective mutism. 

Carrie: I wonder if it was really hard for you at times to push your daughter towards things that you knew were going to be good for her while seeing how much distress she was in.

Using Positive Talk And Helping The Child Face The Things They Are Afraid Of

Jessica: [00:08:10] Absolutely, nobody wants to see their child in pain but when you know that it’s the same thing as getting them to ride a bike or talk to a friend for the first time. You know it’s hard for them, but you know it’s good for them. 

We use a lot of positive self-talk and trying to build that without it also becoming a compulsion, is a bit of a trick, That’s one of the things that we figured out of just reminding, “you’ve done this before,” “you’ve done things like this” “you can do this.” I would only say it once and then she would be expected to do. One of the other things that I say that annoys her profusely is “you’re fine” “you can do this.” The more that we challenge her, the easier it gets, the less resistance I get. 

What I’ve seen clinically is that parents that struggle to push their kids in the beginning, they get a lot more resistance. They have a lot more trouble with it, but afterwards, once they get in a habit of pushing the kids to expand their horizons, they get better and it gets easier the more they do it. 

Carrie: And the more that you start to face the things that you’re afraid of, the more internal confidence that you develop, and that carries you to the next exposure, so to speak.

Jessica: Right and giving them the confidence to recognize that they just need to lean into the anxiety instead of backing away from it.

Jessica’s Scope Of Work

Carrie: [00:09:41] You are a Licensed Professional Counselor and also a Certified Psychological Assistant. I wanted to ask you, tell us a little bit about your work environment and the kind of things that you do there. 

Jessica: Well, I have a lot of roles. I have a wonderful plaque in my office that says I’m the “Vice President of Miscellaneous Stuff.” [00:10:08] Here at Sabin Behavioral Health, I am the operations director, but I also do a lot of intake interviews with the other two psychologists that we have. We also do neuro-psych testing. So we’re often screening individuals for memory-related or cognitive-related changes or neurocognitive dysfunction as well as just looking at general psychiatric-related difficulties and determining what course of action needs to be taken if they need to have a psychological evaluation or a neuropsychological evaluation. or if they are in the process or in need of therapy. Those kinds of things. 

We see individuals from as young as four and as old as in the nineties. We have had somebody that was ninety-five, but we don’t get that very often, but it does happen.

[00:10:57] We kind of run into a gamut of different difficulties. We treat everything that runs in the DSM except for probably antisocial personality disorder because most people don’t see those in the private setting. Outside of that, we pretty much deal with almost anything. I have had exposure, response prevention training multiple times and so I treat individuals that have OCD, spectrum disorders, some including body dysmorphia, trichotillomania, hair-pulling, and skin picking as well as OCD. 

Me and Dr. Hanson and one of the psychologists here will treat individuals with obsessive-compulsive personality disorder, which is different than OCD. It’s a bit challenging but it can be very rewarding once you get people to understand how their behavior is affecting their life. 

I mostly deal with adolescents and adults, but I do see kids. So just not very many. I love doing the hierarchy. I think it’s very rewarding and reinforcing not only for me but for the individual to work on their anxiety and kind of getting them to push through it.

What is ERP and How Does It Work?

Carrie: [00:12:13] Right. Can you tell people a little bit about what a hierarchy is? 

Jessica: Part of exposure-response prevention (ERP) is you sit down with the individual and go through a list of everything that bothers them. I am always amazed even though I know it’s going to happen, but every single time I’m amazed with all the depends. [00:12:30] Well, what does it depend on? Getting all of those things out. There are varying opinions on where you start. Personally, I’m not extreme, I don’t just throw people in and do exposures. Usually, the first four sessions are working on rapport building and building trust so we can get to a place where they know that I’m not trying to hurt them.

[00:12:55] There are some other people who do exposure response prevention (ERP) that do very traditional exposure response prevention that you know, from day one, “okay, this bothers you, we’re going to work on it.” I’ve found that in this setting, it’s not as advantageous just because people that are coming here are having gone through other therapies that didn’t work for OCD. People that go to centers that just treat OCD usually already know they have OCD and they’ve tried other things and they didn’t work. So it’s easier for you to just say, “Okay, this is what we’re going to do and we’re jumping right into it.” [00:13:28] But in this setting, I found that easing people into it is a little bit better because often, even if they have OCD, they usually have some other issues that are interfering with their life. And so I take a little bit of time to show them how changing can be beneficial and we work on some of those easier issues like communication and with the younger kids, emotional recognition. Just recognizing what you’re feeling and labeling it. 

One of the fun things to do with some of the younger kids and sometimes with adults is we label their OCD. We give it a fun name. So when we talk about it like it’s a person external from them, that has two benefits, one is it speeds up communication because you’re like, “Oh, you know, that’s just my OCD again” or like “I see my OCD is interfering with this conversation or whatever.” It’s fun to come up with ridiculous names for them. 

[00:14:31] The other benefit is helping them understand that it is an external issue. It’s not who they are as a person. And it helps me internalize that difficulty and also recognize how it interferes with their life, but it’s not them doing it to themselves. It gives them a safe place to talk about some of their intrusive thoughts because they can be very embarrassing. They can be very damaging to their family. 

I’ve had a client before that was afraid of accidentally assaulting his sister, so he avoided her and they didn’t understand because they were younger. He had no desire to do those things, but he just had an intrusive thought about, “What if I did that?” And so he was mortified for saying that out loud. We gave him a space to talk about it and understand how intrusive thoughts aren’t things that we want. We all have intrusive thoughts. Some people say it’s the sticky brain but for people with OCD, those thoughts have a tendency to resonate a little longer and they give them more value than you.

[00:15:36] We would just have a thought and be like, “Oh, that’s weird, whatever.” For people with OCD, they have a tendency to think about it, engage with it more, and then it leads to more anxiety. Then they developed behavior or some kind of a compulsive ritual to minimize, reduce, negate, whatever that intrusive thought.

[00:15:59] I really do believe that not only engaging those intrusive thoughts but also kind of playing them out like, “Okay, what would that look like if you did that?” “What would happen?” And kind of going through those steps, doing some in vivo exposures can be really helpful in the beginning.

[00:16:19] So they see that you’re not trying to hurt them. It’s just you’re trying to get them to understand that fear is controlling them. 

Dealing with Clients With Different Level Of Insights

Carrie: Right. I think it’s important to point out that people who have OCD tend to be relatively intelligent, at least the ones that I’ve worked with. They’re aware enough to know that these thoughts are irrational and don’t make sense to them. [00:16:42] So then there tends to be some shame about getting stuck on this particular thought that I know makes no sense. 

Jessica: Well, there are varying levels of insight. People seek out therapy most often especially adults who have better insight and they come in saying things like, “I feel crazy” “I feel like I’m losing my mind” “I feel like I’m out of control.” They recognize that something is off and they don’t know what it is, but they know something’s off.

I’ve worked with people that have poor insight. It’s a bit more challenging because getting them to recognize that they have this thought doesn’t mean that will actually happen, can be very difficult, but over time I found bringing in family members and collateral support in those situations is very effective. When you start to get them to realize that what they think will happen, isn’t going to happen, they get better insight. They get faster at progressing through the treatment.

[00:17:37] I always tell people that treatment for OCD is teaching a counterfactual. It’s teaching you that something you believe isn’t true. And so that’s really hard to teach somebody that what they think is going to happen isn’t going to happen without putting them in that situation. [00:17:58] That’s why we do a lot of activities, a lot of exposure. I won’t ask them to do anything that I wouldn’t be willing to do myself. It doesn’t matter if it’s gross. It’s not going to hurt me, but if there is something like I haven’t come across anything that I’m just like, “nope, I’m not going to do that” but like all sorts of dealing with different bodily fluids or things that look like bodily fluids and eating things off of toilet seats, done it all. I’ve even had a client that, well, it doesn’t count because it wasn’t wet, we licked it, stuck it on the toilet seat, and then ate a gummy bear. [00:18:36] I didn’t die. I didn’t get sick. It feels weird, absolutely.

Carrie: So you did that exposure with them? You ate the gummy bear off the toilet?

Jessica: Yeah. I’m not going to ask them to do something and I’m like, ‘’Oh no, that’s disgusting, I won’t do it.”

[00:18:53] I’ve even played with animal poop. It’s gross. Been there, done that. I was like, “Okay, it smells bad.” We sat with it and talked with it and I’m like, “Okay, now we’re going to wash our hands.” That was part of that exposure.

I’ve had clients sometimes who’ve social anxiety, or if clients have OCD and have social anxiety, we use the exposure treatment as well for that. [00:19:22] My favorite thing is we make an extremely difficult coffee list and we walk over to Dunkin donuts. And they have to order it. I order it really, really fast and then they have to order it. 

The people at Dunkin donuts are extremely supportive. They like, “see it’s come in.” They’ve caught on. I’ve never told them what’s going on, but they’ve caught on to what’s going on. So they’re very supportive ever and they’re just being patient with this. And we go through all activities and take a lot of deep breaths and do that depending on their age. I will encourage them to take deep breaths. When they’re older, I won’t prompt them to do any self-regulation activities, but some of the younger kids, if you don’t do that, they’ll just give up. [00:20:06] So it is a preventative, “don’t give up,” “just take a deep breath” “you’ve got this”. 

Carrie: I think what you’re talking about really goes to having to have a great relationship with your therapist like you said, so people know that I’m not trying to do something to hurt you. [00:20:25] This is actually going to help you in the long run. What’s painful in the short term will be helpful in the long run, but also this element of being able to be authentic, not asking clients to do anything that you wouldn’t do. And it encourages people to stay engaged in the process because quite frankly, it’s hard sometimes, and it’s very hard and ERP has a pretty high dropout rate.

Jessica: [00:20:55] Especially with younger clients. I tell the parents because I feel like, for the parents, it’s just as hard. So I will tell them early on that we’ll do a hard week and then a soft week and then a hard week to get the kids going because if they think that it’s always going to be hard, they start avoiding therapy. [00:21:14] And that was early on. So like some of the fun sessions, the soft sessions as I call them are working on emotional recognition. We’ll spend the whole hour processing the previous exposure, things like that, just to show them how well they did and kind of gas them up and get them ready for the next one because I feel like without that they think I’m just evil and I’m mean, and they don’t want to come around.

[00:21:38] I think in certain settings, somebody could do traditional exposure response prevention where it’s gung-ho from hit the ground, running and go, but I don’t know that many people are tolerant of that. I’ve had some clients that come in and they’re like, “This is what I want to do.” and I’m like, “all right, let’s go” “we can do it.”

[00:21:56] That’s generally not what I’ve found, especially with younger children because a lot of times you’re also having to console and prevent the parents from using accommodations because they don’t mean to, but they do. And so you have to help them recognize that this exposure is just as much for them to get used to it as it is for the kid.

Differences Between Licenses and Certifications In Psychology

Carrie: [00:22:18] So just to clarify for everyone that’s listening, as far as titles and things like that because it’s very easy to get confused when you’re looking at counselors, psychologists, psychiatrists, and there are so many labels out there. So you work with psychologists? And psychologists are responsible for testing.

Jessica: [00:22:42] Well, not just testing but the American Psychological Association has carved out there that psychologists are the only ones allowed to do testing in most settings. The way that it’s actually set up is the certified psychological assistant does the testing and the psychologist actually is the one that interviews them, writes the reports, and does the feedback.

We’re a little different here plus I have both of the licenses. I am allowed to do diagnosis because I am a licensed professional counselor with the mental health service provider designation. My situation is a little bit different, but I will tell you that Tennessee and California are the only ones that really have certified psychological assistance. [00:23:22] Most other States have what is here as a senior psych examiner. So other settings, if somebody is outside of Tennessee, they might see a counselor that can also do testing. That’s just not the case here. I will tell you most people when they go and get their education, they specialize, and so even outside of Tennessee, most people do one or the other. It’s very, very rare that they do both.

Carrie: People tend to do testing or counseling, is that what you’re saying?

Jessica: On the master’s level, yes. Psychologists, however, depending on how they get their degree on what they focus on. You can get a clinical psychology degree or you can get a counseling psychology degree. You can get a forensic one. There are lots of specialties but it’s up to them to ensure that they get the training and requirements to be able to perform those services. Ultimately just being a psychologist in Tennessee, it gives them the access permission to do psychological evaluations and to do counseling.

[00:24:21] It’s also important for people to understand that the difference between a psychologist and a psychiatrist because I feel like that’s where a lot of people misunderstand. In Tennessee and in most other States. Psychologists cannot write prescriptions. They are a PhD, not an MD and for a psychiatrist. They can prescribe medication and they can do brief counseling services, but very few psychiatrists have the time to do that because there is a shortage of psychiatrists. The last psychiatrist that I knew that actually sat down into counseling retired. So most of them maybe we’ll do psycho-education with patients, but they don’t actually do any of that counseling services, like exposure, response prevention. Usually, that’s left to the counselors or to a psychologist.

Importance of Proper Diagnosis

Carrie:[00:25:12] What do you think is the benefit of proper diagnosis? Because I think sometimes people are very hesitant to get a label, but if you’re labeled with or diagnosed with anxiety and you actually have OCD, that can be detrimental to you. 

Jessica: I’ve seen counselors that had good intent trying to help a client. [00:25:36] They were unintentionally becoming an enabler for their OCD by accidentally giving them reassurance when they’re reassurance seeking or telling them that it’s understandable that they have irrational fears and things like that, which inadvertently reinforces the irrational beliefs. And it exacerbates the problem and it gets worse. [00:25:59] They will, in that situation often get addicted to their counselor, not addicted in the sense of an addiction, but as a person that accommodates them. They will seek that person out to reassure them. That can be very devastating when a counselor changes or things like that, and the fact that they’re not going to get better. It’s just shifting their compulsive behaviors.

[00:26:21] It’s not changed. It’s not getting to the root of it. I often refer to OCD as a personality disorder. It’s one of those things that comes up and goes away when they’re not stressed out. It doesn’t really go away. It just gets better. It’s easier to tolerate. It kind of ebbs and flows with their stress level.

[00:26:39]  When somebody gets really stressed, they will get very entrenched in some of their compulsive behaviors. If one of those compulsive behaviors is seeking reassurance on a regular basis, they can be very hard on counselors. With emails, phone calls, appointments in between, and it’s not their fault. It’s because that person makes them feel good for a second and so they want to feel relief for a second. The problem with the compulsions is they relieve the anxiety. They just kind of take the edge off, but it also does is increase the global level of the person’s anxiety. [00:27:18] So each time they do it, it just takes a little bit of the edge off, but the anxiety continues to grow and so it kind of defeats the purpose. That’s why it’s beneficial to get at the root of the intrusive thought and really address that than it is to address the compulsions. You just prevent them from doing the compulsions.

Why Proper Diagnosis Is Important In The Treatment of OCD?

Carrie:[00:27:36]  When you’re doing the exposures, do you find that you have people who seek out psychological testing who have been in counseling aren’t getting better and are trying to figure out why?

Jessica: Actually more frequently, we see counselors sending people to us saying, “I’ve done everything I’m supposed to do” “something is wrong here, something isn’t adding up.” And they’ll send them to us and clarify the diagnosis and send them back. That’s very helpful for a lot of counselors. They’re trained in making diagnoses, but some of them may be new. Diagnosis are so intertwined and it’s possible that somebody has OCD and generalized anxiety. [00:28:17] The likelihood of that is low, but it’s possible. 

Sometimes counselors will take diagnosis that where somebody was hospitalized or a diagnosis from a doctor, things like that. And they’re kind of following off of this assumption that that’s accurate information, but they don’t realize that in those other settings, somebody only saw it for a snapshot usually when they’re not in a good place. So it’s not very accurate and so doing psychological testing can be beneficial for even somebody that’s just starting out in counseling. The reason it can be beneficial is it helps speed up the therapy process in that you don’t fall into landmines. You don’t fall into, “Oh, why weren’t we talking about this the whole time.”

[00:29:00] It already starts coming out in the evaluation. So even if the client struggles to recognize some of the difficulties that they have, we can’t just by making a full diagnosis, we can still alert to ”there is an issue in this area” so then it can be addressed in counseling.

Carrie: I know that in my experience, providing a proper diagnosis has been very relieving and helpful for clients who have been labeling themselves with other things such as “I’m crazy”, or “there’s something really awfully wrong with me.” [00:29:37] And when you’re able to say, “okay, well these symptoms lineup with this diagnosis” and it actually makes sense. Not only that, but there’s hope because this is something that’s treatable. We can help you with this. We can help you have a better life. 

Jessica: It’s also making something that’s very vague, very distinct, and it gives them a path that they can work on. It helps them see that there is a light at the end of the tunnel. I believe that by doing psychological evaluations, I really build buy-in with clients. You get more effort into changing their behavior. If they know what you see and the way that you see it, they know what we think in that situation. [00:30:17] They get to look at it in black and white, just the way we do and so we’re working on the same thing. It’s not like that old bully for the psychologist or most people think of old Freudian psychoanalysts sitting back behind you on a couch and just taking notes about you and all that stuff. What we’re doing is I want it to be dynamic. I want it to be an interactive process. I’m here to help you. I’m not here to tell you what to do. I’m here to guide you what I think might be beneficial. I could be wrong. You need to tell me so we can discuss it.  And so it’s an exchange rather than a dictation.

Carrie: [00:30:55] That’s good. I like that a lot. I would say that collaboration is really helpful for the things that we just talked about. We want people to come back. We want them to be involved and engaged and so we want this to be working for them. If something’s not working, it’s helpful for people to let us know that so we can shift gears a little bit.

Jessica: And move the needle. I always say therapy isn’t about getting you to the end really fast. It’s about moving the needle every time. We just want to move it a little bit more and a little bit more. 

One of the other things that testing does that makes it very helpful is that every client, at some point plateaus. They’ll start to plateau. [00:31:35] Even though they’ve got more work to do, having the psychological evaluation, you can go back and show them how far they’ve gone, how much they’ve grown. So this is where you were in this stage, “look how far you’ve come.” That gives them a little bit of that inertia to keep going. The push from the inertia. I think that is one of the things that’s really beneficial for doing the evaluation. I do know that it can be time-consuming because it takes time to get the authorization from the insurance company and those kinds of things, but I think the information that comes out of it is very relevant clinically.  [00:32:08] It gives you a kind of an approach. It gives you information on modalities that are more beneficial for that person instead of just kind of going in blindly and taking six weeks to figure that out.  We can use that time to do the evaluation and kind of move things forward. 

Jessica’s Story of Hope

Carrie: Since this podcast is called Hope for Anxiety and OCD, I like to ask the guests at the end of our show to share a story of hope, which is the time where you’ve received hope from God or another person.

Jessica: [00:32:41] Well, I feel like I get hope every time somebody is successfully improving. I had a client that came in. He’s a middle-aged man. He was convinced he was narcissistic. He was convinced he was a narcissist and so in talking to him, it was really that he had OCD. He was just very entrenched in his compulsive behaviors, and so he would force them on other people. He thought that he must’ve been narcissistic to do that.

He successfully terminated treatment. We got to the end. He was doing great and the last therapy session I’m like, “You still feel like a narcissist?” He got so much better about being able to talk about what was bothering him.It improved his marriage, it improved his work relationships. He had even gotten fired from a few jobs because of how his behavior was so ingrained. That gave me a lot of hope. It gave me hope, not only for my own child but hope for my other clients that things can get better. You just have to keep working at it.

[00:33:48] It’s a process. It’s about the journey, not the sprint. You got gotta stay on it on the long haul. It’s about making sure that you’re moving the needle. It’s not about making anything happen quickly because if it happens quick, it doesn’t stick. I really believe that and that’s what gives me hope for clients. That it’s about using behavioral techniques and efforts to help them understand their cognitions to change their behavior, which is the epitome of cognitive behavioral therapy. 

Carrie It’s always so exciting when people are at a healthy level of coping where they feel they’re in a good place to stop therapy. [00:34:30] That’s just a really exciting time. It’s like, “let’s celebrate and let’s talk about how far you’ve come” and “call me if you need anything.” That’s awesome. 

Jessica: I go as far as giving them a certificate and telling them it’s revocable at any time, so they can come back whenever they need to. “Here’s your literal certificate” “You’ve done all the hard work.” “You earned it, you earned your degree because it is hard.” And if somebody trivializes that and doesn’t take it as serious, you have a tendency to get people that drop out of counseling before, but just because they think things were better, better doesn’t mean great, it just means better. 

[00:35:03] We want to get things where they’re moving in the right direction and you’re not likely to have any kind of relapse of it because OCD is insidious. It’s anxiety in general. They’re both very ingrained in our world and they’re required for function of life. So if we just remove anxiety, that wouldn’t be good for people either. We have to get to where they’re back at a more normal, responsive range and that’s important. It’s kind of hard to do, but  sometimes things can hit people really hard and out of the blue. The world gets turned upside down and some of those old behaviors can have spontaneous recovery of those old behaviors, and so teaching them the tools on how to deal with it. Sometimes they can manage it on their own. Sometimes they come back to therapy, but knowing that we’re here is what’s important for me. They know that they can come back at any time. We can talk about it when we figure out what needs to happen.

I have had a client come back after three or four years and it was due to, they lost their wife and so it was grief and we’re like, “Okay, this is grief” “We can work through this, absolutely.” They were afraid that it was going to cause their OCD to come back, but it was really just working through the grief. At least they also felt very comforted knowing that they had somewhere to go in that moment instead of having to start from the beginning because the idea of that was overwhelming.

Carrie: [00:36:33] Well, thank you so much for being on the show and sharing with us your wisdom about a variety of topics. I think it was great. 

Jesicca: You’re welcome.

______________________________________________________________

I just want to say that if you’ve been in therapy for a pretty good chunk of time and you haven’t been able to see improvements, it’s really an opportunity for you and your therapist to sit down and evaluate why that is because there may be several different reasons that you’re not getting better. It may be a situation where you’re having a hard time integrating what you’re learning and practicing it at home. It may be a situation where, what you’re trying to receive from your therapist, they might not have as much training on, or it may be that their approach might not be working for you.

Jessica’s talking about moving the needle, if you’re in therapy and you don’t feel like your needle is moving, it’s really important for you to evaluate why. Definitely, get the help that you need and if you’re stumped and your therapist is stumped, then psychological testing may be the next best step for you.

I hope that sharing this information will really help someone get what they need. If you really like the show and you find the content valuable, will you do me a huge favor? Will you go on your favorite podcast platform and review us. I would appreciate that so much. Reviews really give a personal firsthand account of what people can expect from our show.

Hope for anxiety and OCD is a production of by the world counseling in Smyrna, Tennessee. Our original music is by Brandon Mangrum and audio editing is completed by Benjamin Bynam.

Until next time. May you be comforted by God’s great love for you.

5. Can God Use Your Anxiety for Good? Rhett Smith, LMFT

Written by Carrie Bock on . Posted in Anxiety, Counseling, Personal Testimony, Podcast Episode. No Comments on 5. Can God Use Your Anxiety for Good? Rhett Smith, LMFT

Anxiety is often seen as a negative, something we ask God to take away from us. In episode 4 of Hope for Anxiety and OCD, Author Rhett Smith discusses how God can use anxiety for good in our lives.

  • Rhett’s story of transitioning from pastoring to therapy
  • How anxiety can be used for good
  • Rhett’s view on pastors going to therapy
  • How pastors and ministry leaders can support those in the congregation with anxiety

Resources and links:
Verses discussed: Philippians 4:6, 2:20, 2:28

By The Well Counseling
Rhett Smith
The Anxious Christian:
Restoration Therapy
MMPI assessment
CS Lewis quote: “Friendship is born at that moment when one person says to another: What! You too? I thought I was the only one.” 

The Science Behind Engaging with Music for Anxiety Relief with Tim Ringgold
Ruling Out Physical Contributions to Anxiety with Melanie Lowe, NP

Transcript Of Episode 5

Welcome to Hope for Anxiety and OCD Episode 5.

Today’s episode, you are going to get to hear my interview with Rhett Smith. It was an amazing privilege to be able to interview him. He is a former pastor, licensed marriage and family therapist, ministry leader, speaker, podcaster, and also the author of the book, The Anxious Christian, Can God Use Your Anxiety For Good?

Rhett has some really great things to share with us about the use of a famous verse for anxiety, Philippians 4:6 regarding how sometimes we use this verse and sometimes we don’t. 

So diving in today, here is my interview with Rhett Smith.

Carrie: For those that don’t know you, tell us a little bit about yourself.

Rhett: I am in private practice in Plano, Texas, which is kind of a suburb of Dallas. I’ve been in private practice for probably about 10 to 12 years. I primarily work with couples and families. I do a lot of individual work too, but I’m trained and licensed as a marriage and family therapist.

[00:01:36] I spend about half of my week, about two days a week seeing people in my office and then over the last year and a half, I got more into executive coaching and went back to school at SMU to do some more training. I am currently working with some vice-presidents and stuff and some different organizations here in the Dallas area. I’m doing some executive coaching and helping them perform at a higher level. On the side when I have time, I enjoy doing stuff like this, like podcasting and do a little bit of writing and a little bit of speaking. I would say though those are primarily what takes up my time.

I’m married to my wife, Heather and I have a 13-year-old daughter who starts eighth grade tomorrow and a ten-year-old son who starts fourth grade tomorrow online. We’re trying to be flexible and anticipate, whatever happens, happens. 

Carrie: I also saw on your website that you were a runner. 

Rhett: I do like to run. I’ve always run my entire life just a little bit here and there. I was in track in high school, but short distance.

The short story is that my brother said, “Hey, you wanna run a marathon for this organization to raise money?” And I said, “Okay” and so I ran my first marathon in 2006. Prior to that run, no more than maybe three miles at a time, I started getting into running and the distance has got longer. I did a 50k and then I did a 50 miler.

[00:03:12] In February, I just completed my first 100k, which is about 62 miles. These are all now primarily trails. I do it mainly because it’s a way for me to kinda have my own therapy, to get out, and to have some solitude and silence. It’s just a way to take care of myself and exercise since I sit in a chair a lot during the week. For me, it’s just a huge outlet and I really enjoy it. 

Carrie: Yeah. I can definitely attest to that. Exercise helps with mental health.

Rhett: For sure it does. 

From A Full time Pastor to A Therapist, Providing Mental Health Support to Pastors and Business Leaders

Carrie: So you had talked about doing some executive coaching. Do you have a background in business then too? Were you involved in business before therapy?

Rhett: No. Before therapy, I was a pastor, full-time. I had gone to seminary out of college. I actually planned to do this in college. I wanted to be a psychologist and I took a church history class in my senior year and it changed my life. I decided to go to seminary. I went to Fuller Theological Seminary there in California. I started off at the extension campus in Arizona and I was working at my Alma mater, which at the time, was a small Southern Baptist School called Grand Canyon University. I was working there and going to school and then I moved to California. I was required to do a church internship as a part of that. I landed at a church called Bel-Air Presbyterian Church and I was working in the college ministry on the campuses of USC and UCLA. Just by weird kind of circumstances, they ended up putting my name in the hat. They’re on the search for a new college pastor. 

I didn’t really want to be in ministry. I just went to seminary to do a PhD. I wanted to teach and I ended up getting the job. I was the college pastor there in Los Angeles for about seven to eight years. I have no business background but it was in the ministry and the way that I got into therapy was just working with college students day in and day out. 

I realized that what I love was not the preaching and the speaking, but was the one-on-one and helping people through difficult times.

I just felt ill-equipped to handle some of the more difficult situations. So I decided to go back to Fuller Seminary when I was pastoring. I did my marriage and family therapy program there. I think the combined experience of working with pastors and leaders and doing therapy just helped in such a way that all of a sudden, I had business leaders and organizations asked me to come to speak to their leaders about mental health, how to deal with difficult relationships, or what our boundaries are like in the workplace. I found myself in the business world with no really quote-unquote business experience except building my own practice.

I really enjoyed that aspect of work too. Working with business leaders to help them figure out how to perform at higher levels and how to actually take care of themselves. To be honest, even though it’s not a therapy, most of them are like, “Hey, I don’t mind if you do a little therapy.” So I’m in this weird place kind of spending time between church work, kind of corporate world, and in my own private practice. I just kind of learned a lot along the way. 

Carrie: What’s really interesting though, I would imagine is that there’s a lot of overlap and relationship principles. You can apply those anywhere. You can apply those in your marriage. You can apply them at work. You can apply them in your corporation. So there’s probably a lot of overlap in that wisdom. 

Rhett: Yeah. I would think in my experience, any of the training that we’ve done, especially when relationships and family systems and stuff is that it’s really easy to apply to organizational systems. I may have to change the language a little bit in terms of how we communicate and the tools that I might use, but what I’ve come to learn recently is that there’s really nothing new under the sun. Everyone is saying the same thing. It’s just that we’re all coming from different angles. I’ve enjoyed stepping into that world and I feel kind of green and new at it, but I’ve learned a lot. 

Equipping Pastors To Deal with Mental Health Related Issues

Carrie: That’s awesome. Can you tell us a little bit about the training that you’re doing with pastors on mental health issues? 

Rhett: One of my mentors is Terry Hargrave. He’s at Fuller Theological Seminary and he founded a model called restoration therapy. I got into that by doing some marriage intensives back in 2010 to 2014. Up at a ranch here in Texas, we would bring couples in and do these marriage intensives. The model that we used was his model, which eventually he kind of built into a bigger framework and started training therapists.

I was trained early on in his model and I’ve been really close to him. Over the course of the last several years, he and his wife, Sharon who’s on staff at the Boone Center for Marriage and Family at Pepperdine University, got together with some other leaders from Azusa Pacific and Fuller Seminary. They decided that we need to equip and train pastors. Pastors are overwhelmed and busy. They deal with all kinds of issues. They’re the frontline that people bring all kinds of issues to them, so they put together a team of about seven to nine people with experience in different issues related to mental health.

We’ve recently had some of our work published through Barna as part of a relationship kind of mental health piece. I’ll be doing that again in a few weeks and I’m looking forward to that. 

Carrie: That’s awesome. I think pastors oftentimes are ill-equipped to deal with mental health issues and so providing that training is really crucial because they are on the front lines and people are coming to them with problems.

Rhett: Yeah. It’s a lot to ask a pastor to, who at the most maybe was required or given one class on counseling and seminary and then everyone comes to them for everything.

There’s this huge gap I think. There’s a lot of opportunities to come alongside pastors and to be a resource for them and help them in any way that we can. Being a former pastor myself, I feel like that’s really important. 

Integrating Faith With Pyschological Tools

Carrie: Do you find that some are hesitant to refer out because they aren’t sure if people are going to be getting sound biblical advice or feedback on their issues?

Rhett: Yes for sure. You talked about going to Denver Seminary and I went to Fuller Seminary and a lot of my friends are going to Dallas Seminary. So depending on the education, people and pastors are concerned about what kind of therapy it is going to be. Is it going to be biblical therapy? Is it going to be some type of Nouthetic therapy, which is basically the only counseling you provide is that you open the Bible and point to specific verses or it might be like new age therapy. 

I guess what I tell pastors is my job as a therapist is to bring the best psychological tools and to integrate my faith into that process. That’s how I was trained. What I find is if I have a good relationship with the pastor, then they feel safe and trustworthy. Also, we’ll create a list of different therapists in the area that I think are really great at what they do. We’ll give those to pastors as well.

I think that is a huge fear for pastors and I understand that, but I think it’s changed over the years. I don’t see that fear nearly as much as I used to. I think churches have done a good job of vetting who they think is best for their congregation. I always tell people, if you’re looking for a therapist and you don’t know, just go to your church. They usually have a list of therapists that they highly recommend.

Misapplied Bible Verses About Anxiety

Carrie: You wrote a book about anxiety called, “The Anxious Christian”, which I wanted us to dive into a little bit, but before we do that, I wanted to talk a little bit about this verse, Philippians 4:6, “Be anxious for nothing…” 

There are a lot of Christians struggling with anxiety and they tell me that they feel shame around this, first because they’ve tried so hard not to be anxious through prayer. They’ve tried to bring everything to God. They’ve tried to ask Him to take their anxiety away.

Are there times you feel where we as Christians misapply this verse or are taken out of context? 

Rhett: Yes. I think that’s the verse that got me really interested in writing more about this topic because like you, I have people coming to my office and they needed help. They had reached out to someone, maybe a ministry leader or a friend, and that verse I think was meant in good intention, but it was received in a way that made them feel ashamed like their faith wasn’t good enough. They ended up in a counseling office with someone they didn’t know but that was the only safe place.

[00:13:17] In some ways, I feel that’s a tragedy that they had to go somewhere where they didn’t even know anyone to talk through this. I do think it’s misapplied. We can talk about this at length, but in short, the flow of that whole book is there’s a lot going on. The word there in Philippians 4:6 that Paul uses for anxiety, which says, “Do not be anxious” is the same word he uses for anxiety in Philippians 2:20. He talks about the anxiety that his ministry leader, Epaphroditus had. He says Epaphroditus has anxiety for the people there because he cares about them. Paul uses that same word.

In Philippians 2:28, Paul talks about basically the lessening of his own anxiety. He uses a different word there for depression. They’re also in Philippians 2 and so you get this really interesting passage where Epaphroditus has anxiety. Paul talks about the lessening of his anxiety. You get to Philippians 2, it’s about Christ coming down in suffering on our behalf. 

Paul is someone who’s been through a lot of difficult times. I think in the flow of everything he says, “don’t be anxious”, but if you are, in Philippians 4: 7-8, he says, “do these things.”

I think in the context, they actually acknowledged that there’s anxiety present in their lives, that we can go to God and we cannot be anxious, but if we are, there are some things that we can do. I just think the whole flow has to be applied when we talk to people about it, rather than just say, “don’t be anxious.” That does a disservice to people. 

Carrie: Yeah. I love the other verses in that section that talk about “The Lord is near” and you think about like your kids when they were little, just you being there, sometimes is that calming presence for them. It’s like, “I’m here. I’m with you, you don’t need to be afraid.”

Rhett: Yeah. In 4:7-8, he basically talks about whatever is beautiful and Holy and loving, he says, “Meditate on these things.” 

Paul knows thousands of years before we have the science to know it, that the things that we think about, change our beliefs. The things that we are to believe, change our actions. I think Paul has a lot of grace for people and the whole flow of the text needs to be taken into consideration. 

We need to handle people in a very loving way who come to us with anxiety or depression or some other mental health issue.

Rhett’s Journey Of Anxiety And His Book, The Anxious Christian

Carrie: You make this argument in your book that a lot of Christians I think are focused on, “God, please just take this away, please.” “Can I get rid of it, please?” “I don’t want to deal with anxiety anymore. Just release me from it.” 

You make the point that God can use your anxiety for good. How have you seen that played out in your own life? Or can you talk about that a little bit more? 

Rhett: I think I first thought about that idea because I grew up in a family where my mom had breast cancer when I was six and she passed away when I was 11. I talk about that in my book. That was the day that I began to stutter and I still stutter sometimes but it’s pretty rare. 

That was the day also that anxiety was kind of introduced into my life. What I noticed over time was that the really beautiful things that happened in my life were the things that I was able to work through my anxiety. Anxiety propelled me to work towards those things.

A couple of examples I use in the book is when I was a junior in college. I was asked to speak at our chapel for the Easter morning sunrise service. I’ve been praying about that, that God gave me an opportunity to speak somewhere just because I knew I needed to face my fears. I got a call to speak and I declined it. I remember getting off the phone saying, “I prayed about that.” I called them back up and said, “I’ll do it.” This is in 1996, almost 10 years after she (mother) had passed away. I remember getting up and speaking in front of an audience really for one of the first times and I stuttered my way through it. 

I knew like something was about to change for me. This happened later on when I took the job at Bel-air. I remember saying to God, “Okay, I’ll take this job, but you have to show up for me and you have to speak for me.” What I started to notice is the things in my life that are really important. God somehow used that anxiety to propel me towards things because the anxiety was uncomfortable. [00:18:16] So it forced me to look for solutions. It forced me to look for ways to change and ways to grow. 

Sitting With Anxiety As A Conversation Partner

Anxiety doesn’t leave you feeling comfortable if that makes sense. It was almost like the anxiety was God’s way of saying, “Get up and get moving. I’m not going to let you sit here. I’m not gonna let you just struggle in this” and so I just started to listen to my anxiety and pay attention to it. 

If I’m working with people right now, I had them imagine like anxiety is a conversation partner.  What is anxiety saying to you? How can you grow? I’ll use this metaphor: We all drive cars and our car has dash lights that tell us what’s going on underneath the hood and we paid attention to those things. Our car will run smooth and we’ll get to our destination. If we ignore those flashing lights, we’ll end up stranded, right? Or broken down. We just know physically and physiology and from the science that depression, anxiety are often just internal cues of something going on saying, “Hey, pay attention to me, pay attention to me.”

Reframing Anxiety And Following God’s Leading

[00:19:16] I encourage people that when they’re anxious or feeling depressed, ask yourself how you can listen to those things cause they might be a way of God guiding you and leading you. Do not see it as something’s wrong with you, but maybe there’s an opportunity for growth in here. 

I know there’s lots of nuance around that. [00:19:36] I’m not saying God just gives us anxiety to grow us, but how do we reframe it as something wrong with us and more as maybe an opportunity to come alongside and to move in the direction God is guiding us. 

Carrie: Right. I think for me, I resonate with the sense of, sometimes God calls you to do big things and I think it’s normal to be anxious in that process. For me, it caused me to lean more on God and rely on Him during that time. It’s also almost been in some ways a confirmation. I know I need to do this. I feel a spiritual piece of this is where God is leading me. I’m anxious about it because it’s bigger than me. It’s not something that I can do on my own. I need God to intervene. 

Rhett: Yeah. I love that. I think there’s lots of good stories in the Bible where they may not use the word anxiety specifically in the text, but somebody is overwhelmed with the tasks that God has given them. Moses or Gideon or Peter, Paul, Mary, all of the people that they have to depend on God to get them through that situation. 

I love that idea that it’s almost confirmation that if it’s too big, maybe you were on track. 

How Churches and Pastors Can Support Mental Health

Carrie: How do you think pastors can really support Christians in their congregation who are struggling with some of these issues? How can they come alongside them and say, “You know, I’m here for you.” 

Rhett: That’s a great question. I think it starts from the top down. It’s a ministry, it’s a pastor, or a ministry leader, or someone who leads the Bible study within the church or as a volunteer leader. I think the message actually has to come top-down. It needs to be something like, “we want you to know that it’s okay If you struggle with mental health issues, anxiety, depression.” 

Number one, it’s okay. There’s not a stigma around it. I think that almost has to be verbally spoken and number two, we are going to look for ways to make it safe for you to find a community to talk about these issues within the organization. 

Number three, we’re going to partner, pair up with other organizations or leaders within the mental health field if you feel we can’t support you, or even if we can, we’re going to bring other leaders in to help, guide us, or to give us some expertise in areas that we don’t have. You can get into a lot of details after that, but I think it starts with just the idea of a pastor getting up and saying, “it’s okay if you struggle and it’s okay if you’re anxious or depressed. This is a safe place to be in that moment and we’ll walk you through that.” I think if you do that, the other stuff will come in terms of how we execute mental health within the church and how we come alongside people. 

Carrie: I think that’s huge. Just normalizing the struggles and saying like “that’s okay” because how many people, in the trajectory of their life, there’s a huge percentage of people who at some point or another are going to experience either anxiety or depression.

Rhett: Yeah and there’s a quote attributed to C.S Lewis and I can’t remember which writing it is but something like, “Two of the most beautiful words in the English language is “me too.” It’s like to know that “you’re not alone.” That other people suffer from this and I think if you say that out loud to people, a lot of beautiful opportunities will open up then in terms of how you can discern to come alongside each person in their own unique way. 

Shame Around Mental Health In The Church

Carrie: One of the things that I ran across when I was doing this podcast was I had a couple of people telling me they were struggling with anxiety. It’s hard for me to talk about it in the church because people see me as a spiritual leader or as a pillar of faith. For me, when I start opening up about anxiety, they’re like, “no, not you.” So it almost gets this response of denial. I think that’s just a good thing to put out there for other Christians who may be in the congregation to say that when somebody is trying to tell you about their struggles, believe them and really hear them.

Rhett: Yeah. Statistics can be all over the place. When we’re talking about anxiety, for example, on average, about 18 percent of the American population, 18 and over is diagnosed with an anxiety disorder. That’s someone who’s diagnosed. I saw the latest stats this year that said 33% and so it’s probably pretty high right now. Those are people who’ve actually gotten the help that they’re diagnosed with. They’ve seen the counselor, they’ve seen a doctor, they’ve seen a psychiatrist. 

If I’m a pastor and I’m preaching, let’s say to a congregation of a hundred people. I could safely assume that 20 to 33 people in that audience have been diagnosed with an anxiety disorder that says nothing about the other 70 people who probably have some level of anxiety or have experienced anxiety, but there’s shame around it or who haven’t gotten help or don’t even know they’re anxious because they’ve lived in that feeling for so long. That’s a huge amount of the people that you’re ministering to each week and that’s significant. That’s why I think the issue has to be addressed. I think it’s safe for pastors or it’s important for pastors to say from the top, down even if they haven’t shown anxiety, that it’s okay if you are.

Pastors Need Counseling Too

Carrie: [00:25:31] Having been a pastor yourself, do you feel it’s beneficial for pastors to receive counseling? Just to have an objective viewpoint, or be able to talk about the stressors that come with ministry.

Rhett: Yeah. I actually grew up in a pastor’s home too, my entire life. I credit my dad with that because there was never a stigma. I knew that he had seen counselors and stuff as well.

I think this is kind of a strong language, but I would say it’s a must. If you’re going to be in ministry, you need to have a counselor that you work with regularly. I was going through the ordination process and the PCUSA, I’m not ordained but my initial steps were I was required to have the MMPI Assessment on me cause they want to flesh out if people are stable and stuff and I had to see a counselor. I had already seen a counselor prior to that and then when I decided to do my MFT training in California, every hour, you see a therapist. They’ll give you three hours towards your state licensure. So I did hundred-plus sessions with a therapist there and then I continued that for a couple of years after I was working on my license. I have a therapist I work with here. 

I probably see right now 20 to 25 different pastors within my practice. The pastors I see usually come from congregations where they’ve made that something as important.

As pastors, we want you to go get help, or we want you as a congregation to get help, but there are people who kind of come one-off from other churches. What I find is communities that have made it safe and told their pastors, “this is important.” I see pastors doing that.

I don’t know. I’m biased, but I think pastors should have a therapist they work with regularly. I think it’s dangerous not to. I think counselors should have counselors that they work with regularly. I mean, it’s important when you’re helping people that you have a place to get help and to have space to talk about things.

Carrie: There’s something about just clearing out your own junk that makes you more available to other people. I really believe that. 

Rhett: Yeah. If you’re doing this work all day with people and doing pastoral counseling and doing the work that you do as a pastor or a counselor or health field, your bandwidth over time gets pretty frayed. You have less to give others. I see that in my own marriage and my own parenting and my friendships, I just have less to give over time. I’ve had to figure out ways to take care of myself and to get the help that I need so that I can be in these relationships with people. 

I think pastors, there’s a heavy burden on them and so I just think they need an outlet, to have that safe, confidential outlet to wrestle through issues. 

Carrie: I think what you’re kind of talking about a little bit is there’s this potential for burnout and that’s not just from ministry leaders, that’s other people as well. Moms can get really burnt out on what they’re doing and that can cause a lot of either the result of ongoing stress and anxiety until things just kind of crash.

Rhett: Yeah. I think burnouts can happen in any field. Lay or professional field, you may have noticed in your practice, the word burnout is being used more. Currently, I think with my clients, in the workshops that I’ve been doing, as COVID has dragged on and uncertainty is dragged on people have felt burnout.

You mentioned moms stay at home, parents are burned out, having to teach and to do other things that they were doing, parents are working from home. Burnout I think it’s not something you can usually anticipate. You can sense it coming on, but from what I gathered from the research and experience, all of a sudden, it just kind of hits you and then you can’t function.

I think we’re in an interesting time right now that’s why people are reaching out to mental health people, counselors, and therapists, getting help is probably pretty critical. 

Rhett’s Story of Hope

Carrie: I think we pretty much covered the stuff. So, at the end of every podcast, I like to ask our guests to share a story of hope, which is a time in which you received hope from God or another person.

Rhett: I knew that the question was coming in. It’s a really good question. I have to think about it for a while cause I feel fortunate that there’s a lot of people around me who’ve given me hope or who’ve encouraged me but the thing that came to mind was my daughter who I’d mentioned earlier is 13. She’s in theater at her school. Last year when she was in a theater production, I was watching and she had a couple of different parts where she spoke and I was watching her speak and she did it with confidence. That really hit me at the core. I think also because I pictured myself at her age and I was in a school play that you had to be in and I remember staring my way through that and living in fear and anxiety. 

Seeing her being so competent, I think gave me a sense of hope that God changes and redeems situations. He transformed people’s lives. Even though I struggled with anxiety and stuttering and things were really difficult for me, He was able to help me work and to grow that it somehow changed my daughter’s life in such a way that she didn’t have to deal with those same struggles.

Though my daughter is not me. I felt like in some way it was a mirror God saying, “things are going to be okay.” It just gave me a sense of hope. I saw my younger version of myself in her and that’s been something I’ve thought a lot about, I think over the last probably five or six months since she had that play, that’s something I’ve been really encouraged by that through difficult times, things are gonna be okay. We’re going to be okay. We’re going to get through these times and God will redeem the situations and He’ll fix the broken pieces. That for me is huge.

Carrie: I think it’s really powerful seeing your child have something maybe that you didn’t have at that point in your life. That’s awesome. I’m so glad that you have that gift. 

Rhett: As a therapist, I’ve just become aware that I’m going to mess my kids up. There’s no perfect parenting. The things that you don’t even intentionally do, kids just interpret in certain ways. So it’s given me a lot of hope to know that we do the best that we can and, and it’s not perfect. God’s going to work and it’s cool to see our kids inspire us. We didn’t thrive in ways that we thought we messed up. 

I think that’s why I enjoy working with people in counseling. I’m able to see people’s lives changed and transformed, and sometimes it’s really slow and other times it’s overnight. That’s what keeps me engaged.

Carrie: I really appreciate you giving us the most valuable gift of your time today and talking about these issues with anxiety and church leaders. It’s just been incredible to just get your wisdom on these issues. 

Rhett: Thank you so much. I appreciate you having me on. It’s been fun. I enjoy doing this stuff. Awesome.

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I really enjoyed that interview and I hope that you did too and were able to get something good out of it. If you want to continue the conversation with us, please hop on over to Instagram and Facebook. You can follow along with the show there and hopefully receive some microdoses of encouragement for your day.

Hope for Anxiety and OCD is a production of By The Well Counseling in Smyrna, Tennessee. Our original music is by Brandon Mangrum and audio editing is completed by Benjamin Bynam. 

Until next time.  May you be comforted by God’s great love for you.