Counseling – Page 8 – Carrie Bock – By The Well Counseling

Five Signs It May Be Time to Get a New Therapist

Written by Carrie Bock on February 2, 2021. Posted in Counseling.

You’ve waited a long time to get help, finally gotten the nerve to go to therapy, but just aren’t sure about your therapist. Is this really helping? How do you know when it’s time to keep working with your current therapist or walk away? Here are five signs it may be time to get a new therapist:

1. You don’t feel heard.

Sometimes, you may feel like your therapist just isn’t getting it. They try to summarize or reframe what you’re saying, but get it wrong. You may just have a gut feeling that there is no way they can empathize with the story you are telling. Now don’t get me wrong, it would be impossible for me to have gone through everything my clients have gone through. However, it’s important for me to be able to empathize with feelings of sadness, anger, shame, or disappointment they have had in a particular experience. In my own experience of receiving therapy, I’ve been to therapists who were cold or kept steering the conversation to what they wanted to talk about instead of what I was coming in for. It didn’t feel good, and I didn’t go back.

2. Your therapist doesn’t have experience treating the issue you’re bringing in.

If he or she knows in the beginning, the ethical therapist won’t take you on as a client. Unfortunately, many therapists say they treat OCD without specific training or experience working with it. They may treat the OCD thoughts like they treat anxious thoughts, by challenging them or providing reassurance for them. This is problematic. While arguing with the thoughts or attempting to reassure them provides short term relief, it only ends up strengthening the OCD.

In addition, therapeutic issues evolve over time. Destructive behaviors over time may rise to a greater level of concern than when therapy started. What isn’t a problem today may become a problem in three months. I’ve had clients in the past be referred to inpatient or intensive outpatient for substance use issues. Sometimes, clients do not reveal all their issues up front due to shame or lack of awareness that the issue is even a problem.

3. You aren’t able to attend consistently.

Your therapist’s schedule may be so full that he or she cannot see you as regularly as you would like. Maybe your schedule has changed and no longer aligns with your therapist’s availability. You may be fighting to stay for a while because you dread starting over with someone else. However, in order to avoid losing momentum in therapy, you typically need to be seen at least every other week.

Another reason people are not able to attend consistently is financial. If you were paying cash, but then had a change in financial situation, you may have to find a therapist who takes your insurance or is willing to work for a lower fee.

4. You aren’t reaching the goals you and your therapist have set together.

Counseling goals initially tend to be broad such as a client saying, “I want to feel less anxious” or “I want to be happy again like I used to.” To turn these more general goals into action steps, additional questions need to be asked such as: What would you be doing if you were less anxious that you are not doing now? What skills might you need in order to be less anxious? What does happiness look like for you? What is one small step you can take towards happiness today?

If you have completed several sessions of therapy and don’t sense that anything is getting better in terms of your education/awareness regarding your issues, perspective on the issues you brought in, or how you are coping, it may be time to examine why. If you come into your therapy sessions rattling off everything that happened to you that week, you might want to examine if this is the best use of the time with your therapist. Think through what you would like to get out of your sessions or what topics are most important to you. Come with questions from time to time.

I challenge my clients not to see therapy as part of their routine. While they may see me every Tuesday at noon, I don’t ever want that to be just something they do on Tuesdays. I want them to progress beyond where they are today, so they don’t have to continue seeing me each week. If you’re not sure if you’re making progress, ask someone in your life such as a spouse or a best friend if they have noticed any differences in you. Ask your therapist as well. Frequently, my clients have high expectations of themselves and feel like they aren’t making progress when they are.

5. You want more out of the experience than you are getting.

I have a question on my intake asking if people have been to therapy before. The next question has them rate that experience as positive, neutral, or negative. The neutral responses are the most interesting. Clients will say, “My therapist just nodded and validated my feelings. I needed more.” I’m a big proponent that clients should advocate for themselves in therapy if they don’t feel they are getting what they need. If you aren’t happy, let your therapist know what you would like to be different and see if they can accommodate your requests.

Other clients have reported a desire to “go deeper,” but their therapist didn’t ever dig deeper. There may be many different reasons for this. Good therapy is supportive; however, it’s also challenging. Your therapist’s job is to push you towards things you wouldn’t do on your own. If you could have figured out how to manage your problems or issues by yourself, you probably would have done it. Unfortunately, some therapists have not done enough of their own work to go into the deeper waters with you because they have never been there themselves. I’ve probably had hundreds of continuing education hours after graduate school at this point, but the most transformative thing I have done to become a better therapist is to go to therapy myself. Working on my own issues prevents them from coming up in the therapeutic relationship. I am able to show up more present and compassionate for others because I chose to show up present and compassionate for myself first.

What now?

If you found yourself in one or more of the above categories and have been attending for several sessions, try talking to your therapist first. They are there because they want to help you. Talking about your experience with your therapist and the process is important. Give your therapist the opportunity to be on the same page you are on. If it doesn’t work out for some reason, move forward, knowing there is another provider out there for you.

Carrie Bock, LPC-MHSP of By The Well Counseling is a Licensed Professional Counselor who specializes in helping clients with trauma, anxiety and OCD get to a deeper level of healing through EMDR via online counseling across Tennessee and in person intensive therapy sessions. Carrie is the host of the Hope for Anxiety and OCD podcast, which is a welcome place for struggling Christians to reduce shame, increase hope, and develop healthier connections with God and others.

What is EMDR?

Written by Carrie Bock on January 26, 2021. Posted in Anxiety, Counseling, OCD.

When people first hear about Eye Movement Desensitization and Reprocessing (EMDR), they are often skeptical. That’s OK because I was too once. I wasn’t sure how waving my fingers back and forth in front of my clients was going to change how they felt about the past. However, I was desperate. Cognitive behavioral therapy for the treatment of trauma just wasn’t cutting it for the complex client presentations I was seeing. We could talk for hours about how the abuse a client experienced wasn’t their fault. They could give me the right answers, but didn’t feel it. They could change their thoughts, but their bodies were still reactive. Once I started using EMDR and saw first hand how great my clients were feeling, I was hooked.

What is EMDR?

EMDR is an experiential therapy that allows clients to process trauma at a brain level to access healing at a different level than traditional talk therapy. Other approaches to healing from trauma such as Exposure Therapy or Cognitive Processing Therapy (CPT) require the individual to tell the entire story of the trauma repeatedly in order to become desensitized from it. However, with EMDR, telling the story of the trauma is not a requirement. This brings a sense of relief for clients who do not want to retell the entire story, cannot remember the whole story, feel it would be too lengthy to tell, or are bound by security clearances.

The other difference between EMDR and cognitive based therapies is that EMDR addresses body sensations associated with traumatic memories. A rape victim may no longer believe the rape was her fault (changing the thought), but may still carry a sense of shame and distressing body sensations that accompany that emotion. Trauma is often stored in the body can manifest as physical sensations such as chronic digestive issues or panic attacks. I have seen several clients have a reduction in physical symptoms after EMDR therapy.

What is the EMDR process like?

There are eight phases of treatment in EMDR. The initial phases involve screening and preparing the client for being able to reprocess the trauma. The therapist works with the client on building awareness of their present experience emotionally, physically, and mentally. The client also develops skills to tolerate a variety of emotional states and cope with day to day symptoms such as anxiety, nightmares, or intrusive thoughts/memories about the trauma. Clients with an extensive trauma history may take months to prepare for trauma processing. On the other hand, clients who have had previous talk therapy and have coping skills to manage their day to day life may find more value in doing an EMDR intensive.

The next phases are focused on targeting traumatic memories to reprocess the various aspects of the trauma. The client may see pictures, feel intense emotions, and experience body sensations that were happening at the time of the trauma. This process can be difficult and disturbing to the client, which is why not rushing the preparation phase for clients with complex PTSD is crucial. Bilateral stimulation to the brain is utilized through the use of eye movement, tactile stimulation, or alternating audio sounds. The bilateral stimulation is not painful and does not cause the client to go into a hypnotic trance. The client will be present during the reprocessing.

EMDR allows the traumatic material to get unstuck and connect to more positive, adaptive material in the brain. At the end, memories that were highly distressing are no longer distressing to the client. Sometimes the change is very surprising because the client expected to always be bothered by the memory! By healing from these past wounding experiences, clients are able to respond to present situations in new ways. Sam no longer blows up every time there is a conflict at home. Susan is no longer having frequent pain attacks. John still has intrusive thoughts related to OCD, but he is able to dismiss them instead of giving into compulsions.

How do you get trained in EMDR therapy?

If you are interested in learning more about EMDR therapy, you can visit www.emdria.org. This is the website for EMDRIA, the EMDR International Association. Therapists who have been trained in EMDR through a training approved by EMDRIA have completed six days of training and 10 hours of consultation. Training in EMDR therapy is an experiential process. The therapist has to perform EMDR on others and receive it themselves in the client role. Those who have been certified in EMDR have completed an additional 12 hours of advanced training along with an additional 20 hours of consultation with an EMDR consultant. An EMDR consultant has gone through additional hours and has had their consulting supervised by another consultant.

I was initially trained in EMDR in 2013, pursued certification, and became a consultant in 2019. Over the years, I have been able to help clients suffering from PTSD, recent traumatic experiences, anxiety, phobias, panic attacks, OCD, depression, and dissociation to name a few. I have also started providing intensive therapy in EMDR for individuals who are looking to heal faster in a shorter amount of time.

Carrie Bock, LPC-MHSP of By The Well Counseling is a Licensed Professional Counselor who specializes in helping clients with trauma, anxiety and OCD get to a deeper level of healing through EMDR via individual and intensive therapy sessions. Carrie is the host of the Hope for Anxiety and OCD podcast, which is a welcome place for struggling Christians to reduce shame, increase hope, and develop healthier connections with God and others.

How Do You Know If Your Childhood is Affecting Your Adulthood?

Written by Carrie Bock on January 19, 2021. Posted in Counseling.

How do you know if your childhood is negatively affecting your adulthood? You don’t want to be a victim to what happened to you as a child and blame everything on your parents, but you still feel that childhood experiences may be holding you back. If you have worked hard to avoid thinking about the difficult things that have happened to you, you may believe you have put the past behind you. After all, you made it through the past fires and they aren’t burning anymore. You’ve moved out of mom’s house. However, things still aren’t going the way you hoped they would. Here are four indicators that your childhood may be affecting your adulthood.

Your intimate relationships follow a negative pattern you can’t seem to escape.
If you’ve dated several versions of the same guy with a different name who is all wrong for you, you know what I am talking about. You may find yourself responding to others the way mom or dad responded to each other. Typically, people end up in a romantic partnership with someone who treats them very similarly to how they were treated as a child or a partner who is on the opposite end of the continuum. For example, if you were raised by an emotionally neglectful parent, you will most likely have an emotionally absent partner or one who is emotionally dependent on you in an unhealthy way. You will gravitate towards someone who treats you how you believe you deserve to be treated. You may even push away healthy people because you don’t believe you deserve the love they have to give to you. The healthier you are, the healthier people you will attract into your life. The reverse is also true.
You have intense emotional reactions that don’t match the present situations.
If you react to a situation with an emotional level of 8 when the situation calls for a 3, you might be reacting out of trauma. Understand that your brain is constantly linking situations together in order to protect you. When you experience something similar to when the unsafe event happened, the emotions and body sensations connected to that memory flood in faster than you know what hit you. This can happen without a specific picture or memory coming to mind. You may not even be aware of what triggered the emotional reaction or why. If you have experienced trauma, you might say, “I feel crazy.” Often, an immense amount of guilt and shame follows these emotional outbursts. You feel like you should be more in control of your emotional responses and have tried to change, but the same things still keep happening.
You can’t stop thinking about your childhood or you can’t remember it at all.
These are two extremes that can happen as a result of trauma. You may have frequent flashbacks of the difficulties that happened in childhood or frequent nightmares. These are classic symptoms of PTSD. On the other hand, you may have difficulty remembering anything before a certain point in your life such as age 10. Not remembering large periods of your childhood is a symptom of dissociation. Dissociation happens when what you experience in the present is too much for your nervous system to bear, so you have to disconnect from it. This can happen without conscious awareness. If you lose large periods of time in the present where you “zone out,” this can also be a symptom of dissociation.
You don’t feel fully adult.
You can point to many of the adult things you do such as working full time or attending college, and raising children. However, you don’t feel it internally. You regularly encounter situations in which you feel like a child: helpless, lost, and alone. You may know mentally that you can leave your job, but emotionally, you feel stuck. You may know that you can say no or set a boundary, but when you try, your voice is shaky.

The good news is there is hope.
If you believe that your childhood is affecting your adulthood, therapy can help. Learning new ways of coping, relating to others, and processing trauma can get you to a place where the past is truly in the past. When you are no longer haunted by the experiences in your childhood, you can progress forward into a more healthy adulthood.

11. Vulnerability, Grace, and The Power of Church Community with Randy Draughon

Written by Carrie Bock on January 13, 2021. Posted in Counseling, Personal Testimony, Podcast Episode. No Comments on 11. Vulnerability, Grace, and The Power of Church Community with Randy Draughon

What happens when pastors are isolated
How pain can be a good thing
Vulnerability as a gift we give each other
How to build a Christian Community

Verses discussed: Ephesians 1, Tim 1:15, James 5:16

Resources and Links:
Midtown Fellowship, Nashville

More Podcast Episodes

Transcript of Episode 11

Welcome to Hope for Anxiety and OCD, episode 11. Today’s show is on the incredible power of Christian community and how that can impact mental health in a positive way. I wanted to make a very special dedication of this episode on Christian community to BJ Howard. In the process of putting this recording together, I’ve found out that he passed away.

This was someone that was very connected and involved in church, connected to encouraging and mentoring people that were younger than him. He was someone who was able to give me a lot of hope in my life when I needed it the most to keep going and to keep following the Lord and keep trusting his plan for my life.

Thank you so much BJ for your influence. I hope that in some small way this episode and not just this episode, but this podcast is a way to move forward and can carry the torch of the light and the love that you showed to me, to be able to show that to other people.

I got the opportunity on this episode to interview one of the local pastors in Nashville, Randy Draughon. He is the Pastor of Midtown Fellowship, and we were able to get into some great dialogue about being a Christian and living in the Christian community and what that looks like.

Let’s dive right in.

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

Pastor Randy: I’ve been in Nashville for almost 30 years now, married have three kids. I started Midtown Fellowship around 2001. Our passion then was to go into the heart of the city and to start a church for people that had given up on church.

So we were from a very traditional style church and we shed the skin of all that and started a church and a skate park. Most of the folks that were coming to Midtown were musicians or college students. Back then the city had really not gone through any kind of transformation. This was pre-Titans.

Nobody really lived down there unless they had to, which meant that they couldn’t afford to live anywhere else. Downtown was the cheap place to live.

Carrie: Wow, not anymore.

Pastor Randy: It’s true. We’ve seen a lot of change over the years and we partnered with a ministry called Rocket Town and they built a skate park and a big music venue down in the city.

When we got to a point where we needed a bigger space, they opened their doors and they were incredibly generous to us and we needed that because everybody coming to our church was so poor. None of them had any money. We had a philosophy early on never to take an offering because we were shedding the skin of the idea that when you come to church, the church wants so much from you. We’re operating from the philosophy of we just really believe that God has so much to give to you. So God just took care of us.

Carrie: How in the world, like, did you get paid? You didn’t take up an offering. This is incredible.

Pastor Randy: We just prayed and people just gave. I really can’t tell you that we ever spent much time around the budget, trying to figure out how to make it happen. We just were so busy just doing the work of ministry, meeting with a lot of people. We really had a simple philosophy and that was, we really believe that when God impacts one person, the ripple effect of that to their community and their family actually ripples out into the city.

And so we spend a lot of time trying to keep bongo, Java, and business and Fidos and all the coffee shops. You’ll appreciate this, our first offices were on 12 South because it was the cheapest place to get an office. It was just a rolling crime scene over there and obviously, it’s all changed since then.

Carrie: A lot has changed in Nashville. I’m sure over the years that you’ve been there and in terms of like ministry that has shifted somewhat, the population that you’re ministering to, is it more diverse as Nashville becomes more diverse?

Pastor Randy: You can tell me how much you want to get into this. I’m happy to talk about what we’ve done over the years. Midtown, about the first 18 months, was a slow crawl. We had maybe 10 people coming to church and then it began to build and we started to see the Lord really doing some really cool stuff in people’s lives. When we moved to Rocket Town we literally bought a hundred used folding chairs and we called it the purchase of faith.

We believe that the Lord was going to fill these hundred seats and within a year we had close to a thousand people that were coming to services at Rocket Town, and it was insane. We couldn’t get everybody in. In fact, the stage was full of chairs and the floor, and the balcony.

We really had a dilemma because we realized that the bigger that we were getting the least effective we were at reaching our mission, which was creating a safe place for people that had given up on church, that we were really good at attracting Christians from other churches because we’re a huge artist community. So our bands were killer. Like you can imagine coming to church and looking up in the band area because we wouldn’t put our band on the stage.

We actually moved them off to the side where you couldn’t see them because none of our artists wanted to perform on Sunday morning so it was about the Lord. It wasn’t about them and all of them were professional musicians. So the big dilemma that we had is, do we go to multiple services and see how big we can get this?

I didn’t feel led to do that. So we went to San Diego and we met with a group of people that helped start a Tim Keller’s church up in New York. They were doing something very unique out in California that we brought it back to Nashville. We customized it and then adopted it for ourselves, which was to, instead of going to multiple services, why don’t we take a big chunk of these people and send them back to their slice of Nashville and let them be the church in their community.

Carrie: A lot of churches are doing that now having kind of multi-site campuses.

Pastor Randy: The uniqueness of our model is really based on a couple of ideas. One is then this will interest you as a counselor, is that we really believe that pastors can sometimes be the most dangerous person in the church. They get isolated and isolated men that have power are very dangerous people when they’re isolated emotionally or they’re isolated relationally. There’s some expectation that a whole community of people are putting on them, but they know internally they don’t live up to. That can be a really dangerous scenario for him and If he’s dangerous, then he’s dangerous to the people he’s shepherding too. So we came up with this model of grading campuses. We’re one church, but we have multiple campuses and every campus has its own pastor, but that pastor is in a fellowship with other pastors and we take serious responsibility for one another’s emotional journey, spiritual journey, the whole heart. So we’re kind of a support group for one another.

Carrie: How did you, your church get to that point where you realized we really need to invest in that, not just the spiritual health of our pastors, but the emotional health and the other aspects?

Pastor Randy: Great question about how we got there. The easy answer is I think the Lord just reviewed this so many times through all our failures that he drove us there.

I think maybe the more detailed answer is before coming to Nashville, I’ve worked for some really large churches. I was in youth ministry for 15 years and I got to witness firsthand like national ministries and the men that led them and realized that they were isolated and that the trickle-down effect of that, wasn’t always a pretty story.

When you peek behind the curtain and we began to dream about what would it be like for a pastor to actually open the curtain? And that he ministers out of that place where he’s first in line, as the one who needs grace, He’s kind of the chief repenter and his community that he’s the most vulnerable of anybody.

We realized that the only way that’s going to happen is if we began to mature emotionally and began to mature spiritually at the same time. I’ve seen spiritually mature people that can quote the Bible from the beginning to the end and have these huge prayer lives but they’re not emotionally mature and as a result, a lot of times they’re just hurtful people and they’re not very safe to be around.

Carrie: They don’t know how to have healthy relationships and form healthy connections.

Pastor Randy: Yeah and you know, that’s fair because a lot of times, pastors, men that are called into ministry and women are called into ministry too.

A lot of times they’re intellectuals. They love to study. They love teaching. They love books more than they love people. So a lot of times they’re disconnected from their own heart and therefore they’re disconnected from the people around them because I don’t believe you can be disconnected from yourself and actually connected with other people. I also believe it hinders your connection with the Lord. But if you’re not self-aware enough to know how you need the Lord and where you’re at, I think it’s very difficult to have a meaningful, profound relationship with him.

Carrie: Right. I was thinking about that versus you were talking how

Paul was a big spiritual hero in a lot of ways, but he said himself, like, “I’m the chief of sinners” and such a puzzling verse because you’re like, how can you be the chief of sinners? But he just had that understanding and that awareness of like, “I need all of the grace too.”

I think that’s really cool what you’re talking about to this overlay of like where Christians meant to live in community and so that’s not healthy with pastors being isolated. Also this sense of our relationships with other people and those connections, a lot of times maybe mirroring our connections with God. Would you agree with that?

Pastor Randy: Yeah. Say that again and say it a little differently.

Carrie: Okay. I think that a lot of times we place on God like our ability to connect with him. We place on him things that we’ve received from other relationships in our life, often parents, fathers. And so if our fathers were disconnected or neglectful, then we receive this sense from God that we feel like God’s just kind of distant.

He’s not really there. Sometimes being able to connect healthily with people can help us heal some of that, like Christians. I don’t know the God in you maybe healing that piece of being able to love someone in Christ may help them connect more with God. I don’t know if that’s making sense.

Pastor Randy: That’s so good and you’re really the expert here. I’m just dabbling in your world when I talk about counseling here. We all have trauma in our lives and some of us have pretty severe trauma and it’s trauma that’s either been produced through parents or through relatives. Some of us have trauma that we produced ourselves and that trauma often I’ve seen, it digs these trenches in our lives that it seems like whenever we enter into any situation that triggers that trauma, which could be relational, we tend to go back to that ditch. So if our father was harsh with us, the only way we ever experienced God is as a harsh God. That’s why one of my mentors always tells me if something is hysterical, it’s probably historical that if we don’t understand ourselves enough to know that we have that trauma, then we’re not aware enough to know that I need healing in that trauma so that I can rewrite the script in a fresh healed way. Maybe it’s more than a healed way. Maybe it’s a healthy way.

Carrie: What was that journey for you of your journey of self-evaluation?

Pastor Randy: Well, for me personally, I’ve always sought out older men that would invest themselves in me. I’ve been fortunate I’ve had some amazing men that have the gift of listening and they also have the gift of wisdom. So they let me talk myself out and then they speak wisdom into those places. And if it’s true that our thoughts are really a bad neighborhood and we should never go there by ourselves then the men in my life have gone there with me. They’ve helped me fight the shame stories and we all have shame stories. But probably the most, I would say maybe one of the most impacted things was about six years ago. Our oldest son at 25 died unexpectedly. That story of grief for me and my wife and our family was so traumatic for me that it caused me to start to question everything. In fact, to get a little vulnerable here, I couldn’t let go of the thought that it was my fault and I felt deeply responsible for that. And as I began to unpack, why is that? I began to realize there were a lot of my own issues of codependency that I have not dealt with growing up. I grew up in a home where addiction was a part of our home. And so I just jumped into a whole community of people that had shared experiences like that and began to unpack my own lenses that I’ve put on to how I process my life and how I’ve processed the Lord and how I process other people. So it’s been an amazing journey over the last six years of embracing the joy of grief and the healing power of community and the Lord.

Carrie: I think a lot of times it’s the tragedy points that brings us closer to God and closer to other people, but it can really challenge your theology in the best way and wonder if that happened for you.

Pastor Randy: I think that pain is so misunderstood because I think that many of us live and I don’t want to, maybe I should use an “I” statement here. I lived thinking that if something is painful that means something is wrong, that we didn’t get something right because the right life is not a painful life, but the reality of every relationship is there’s pain. And that’s a part of relational health is realizing that if you’re going to love somebody you’re going to hurt and if you’re going to let somebody love you, it’s going to hurt. That pain is a part of the relationship.

It took a real season to realize that pain doesn’t have the ability to change what is true, but pain does have the ability to change what I believe is true. For me to bring my pain to my community and for me to bring the pain narrative to my community and whether that was through counselors or whether that was through just mentors or friends or people that were fighting for me, letting them fight for me so that my narrative of truth [00:16:12] can come alongside my pain and really call it good, which may sound strange to people that are in pain, that your pain is good, but it can be because the Lord uses that to bring healing in her life.

Carrie: Just as a connecting point to him and to other people.

Pastor Randy: And I mean, that’s what I’m saying, I’m swimming in your waters right now. You’re the pro in this area, but I’m just sharing my own personal experiences. Not necessarily an ocean of therapeutic knowledge.

Carrie: I think it’s really great though, to hear these kinds of messages from pastors, because depending on people’s backgrounds, they may not have had a pastor that has ever been this vulnerable about difficult things in their life like you were talking about the isolation. Maybe there’s the sense that I have to present as the most spiritual person in the room and therefore, somehow that means I present with no problems or no pain. Anyway, I have the Lord. The Lord is good, nothing wrong here.

Pastor Randy: You think about it that if the only time I can preach is when I’ve mastered what I’m preaching and I want to preach with vulnerability. I really don’t have any sermons because who can do that unless you put up a facade and you’re a counselor. What happens when people put on mask and they spend their lives to manage an image and they manage this facade so they can keep their jobs, which is their income.

They can keep people’s respect, which is, they believe my reputation is that if everybody was like me, then we would all be so much like Jesus. It takes a lot of energy and effort to do that so what would it be like for the joy of preaching from a place of, “Hey, I really need this more than any of you need it.”

I’m preaching from a place where I feasted on the Lord this week and I’m just sharing with you what he served up for me. If you have a community that would allow you to do that it’s a beautiful place to be.

Carrie: I love that. I think there’s something really about authenticity that’s attractive to people [00:18:25] and unfortunately, the church has gotten a bad rap for being fake. A lot of times, or Christians have gotten a bad rap for being hypocritical.

Pastor Randy: Because we are, but some of it’s a good rap.

Carrie: Some of it’s true. I used to become frustrated when people would talk about Christians becoming hypocritical and then I realized that Jesus was most frustrated with religious people in the Bible. And so I was like, “Oh, it bothered Jesus too.” There’s a relate-ability there. So if you’re frustrated with the church or people who appear religious, then you know, Jesus understands that.

Pastor Randy: Right and so true. I think that there’s such a gravitational pull to unhealthiness. I mean, you’re a counselor. There are a lot of people that don’t come to see you, people that their whole world of dysfunction and they live in it until they go to their grave.

There’s a huge pull to having a world that you completely control and that it’s not dangerous and you’ve minimized pain by medicating or avoidance or distraction. I think that that pull is so attractive when you realize that vulnerability and openness and willing to admit that your imperfect is so scary.

I love what Bernay Brown talks about is that courage is the ability to let yourself be seen and it really is true. That takes a lot of courage to let your true heart live itself on the outside.

I don’t think that any of us can do that by ourselves. Maybe some can, but I think it takes a community of people that are jumping into that water with us to give us the courage to keep jumping into it.

Carrie: I’ve been processing this verse in James that talks about how you confess your sins to one another and pray for one another that you will be healed. I just find that so powerful because we’re told Jesus is our high priest. So he’s the one that has to absolve us, so to speak of our sin, who we go to for forgiveness. But yet we’re told to confess to other people for this level of healing. That I believe is emotional of just saying, “look, I’m struggling and I need your support and love and prayers.”

Pastor Randy: I’ve never been involved in AA, alcoholics anonymous. I have been involved with adult children of alcoholics ACA, and there’s a fundamental belief in those communities is that when I get vulnerable, when I speak out loud, what I have on the inside of me, there’s something that gets healed in me when I’m sharing that in a community that’s accepting me and go on me too. When I get vulnerable and also I believe it heals something in you, it’s a gift that we give to one another that knits us, not just together, but gives us strength and courage to live our hearts on the outside.

Carrie: Right. Do you believe that kind of going back to isolation? So for people who don’t have these communities, maybe where they feel like they can be safe and vulnerable and open up, whether that’s a church, small group or support group, or something of that nature. Do you feel like that isolation just kind of continues to feed the dysfunction you were talking about?

Pastor Randy: It’s strange that the things that we begin to accept in our lives and even the routines that we began to allow to exist in our lives. And I think that for a lot of people that experience things like we’ve talked about pain, but also like loneliness that they receive loneliness as a curse rather than the emotion of loneliness is actually a blessing and understanding what that blessing, that inviting emotion is actually inviting you to.

They use that loneliness as a means by which they stir in shame into their story and then stepped back from community because they don’t feel like they’re worthy of community and then when you pour resentment on top of that shame and that loneliness, it leads to a real isolated place. But if we understand that loneliness is a gift from the Lord it’s a part of our hearts that’s crying out for, longing and for community and whether I’m lonely for myself or I’m longing a friend or for Jesus. It’s inviting me to something and that’s why we need community because that takes a lot of courage and loneliness to call somebody and go, “I need you, could we go out to dinner or can we go grab coffee?” or “Would you consider meeting with me once every Wednesday morning and let us just encourage each other.” That takes a lot of courage because that person may say “no”.

I think it’s, sometimes it feels easier just to isolate and medicate which is a tragedy. It’s really why we do what we do with our pastors because in ministry, who do you call and say, “I need you” when you’re the pastor of a church, you’re the person everybody calls for, you’re the need meeter. You’re the one that helps everybody else out and the tragedy of that is, imagine a pastor who is very healthy in his need for his community.

I’m not talking about being over needy in the sense of inappropriate but really needing the strength of the community to be spiritually healthy.

Carrie: Don’t most pastors have connections to other pastors though? I’m just thinking about this from the therapeutic lens. If I have a really difficult day or really hard session, I could name for you three or four people that I could call and in a confidential manner and say, “this is what happened to me today” or “this was a really hard session I’m having a hard time dealing with it personally.”

Do you feel like most pastors have that? Or some do and some don’t.

Pastor Randy: My experience is that most pastors don’t have that. My experience is that most pastors would say that they have friends who are pastors, but that their relationship with them is not on the level that you just described, where I can call that guy if I have to four times a week and connect with them, or even once a week. I think I don’t have them in front of me, but you can google search stats on how pastors are doing and it’s not a pretty picture.

Carrie: Just in terms of a lot of people dropping out of ministry or moral failings.

Pastor Randy: Yeah and even surveys about, do men feel fulfilled in their calling? Would they continue to do with what they’re doing if they could get another job?

It’s just ministry doesn’t have to be this miserable place of isolation. It’s miserable in the sense that you’re suffering as you’re caring for sheep, which is a hard, hard job. But you can do it in such a way that if you’re self-aware enough to take care of yourself so that you’re healthy and taking care of other people.

Carrie: That’s really huge. Being able to make sure that your needs are getting met and as Christians, yes, that’s from the Lord, but it’s also from Christian community. I don’t think we can just say, “I go to Jesus and he fills me up.” That’s great but our faith is so communal that we need that interaction and we need the accountability and the people to call out our blind spots, the things that we’re not seeing.

Pastor Randy: Yeah, we were born into a family. I love worship music, but I always chuckle when I hear songs that “All I need is Jesus” and as a pastor, I’m like, “Okay, that’s good” but that’s not what Jesus says. Even God in the garden said to Adam, it’s not good that you’re alone. Adam had God, he’s walking in the garden with God and God said, yeah, you need community. So we’re gonna create community right here. So I need people in my life and it’s how I often see Jesus is the community that God puts around me or the community I help build around me. And that’s the thing I see a lot is that people say, “Man, where do I go and find that community?” You probably aren’t going to go out and find that community, but you can start by you building that community, by finding one other person that you practice vulnerability with and then see who God adds to your number because I don’t think that there’s a whole community of people somewhere out there that are just waiting for us to join them. I think the Lord invites us to go and build that.

Carrie: It’s hard because we live in such an individualistic society or we’re taught possibly from a young age to be very independent and to not have needs and to make sure that we take care of our own business or don’t talk about things outside of the family a lot of times. So it can be a challenge to start engaging in that process. But like you said, if it’s just one person, if you find one safe person that you can be vulnerable with and start to develop that community, I think it will be attractive to the people that need it.

Pastor Randy: How do you help your clients do that?

Carrie: It’s tough. It really is tough. I think it depends on what their background is, faith-wise. Some of my clients, they don’t feel like they can go to people in their church and say, “Hey, I’m struggling with anxiety” or, “Hey, I have OCD.” That would be absolutely terrifying to them because unfortunately, church does not feel like a safe place, or they may have received different messages in the past like the Bible says, be anxious for nothing and you need to go pray about it some more. So there’s all kinds of different Christian communities and their responses to mental health obviously.

It’s so therapeutic for me that we’re having this conversation because I know for me personally, even pastors that I’ve dealt with in the past, I don’t think I could have had this kind of conversation with them.

And it’s always been very passionate for me to figure out how I can support the church as a mental health worker. Sometimes it’s received, sometimes it’s kind of like, “yeah, we want you here in this space” and other times it’s not received very well. So that’s been just an interesting personal journey amongst working with pastors. [00:29:14]

But now I’m in a very supportive place where my pastor is very open about mental health issues, and we’re able to talk about those things and how can I support the church and what does that look like. I’m in a good space with that now. Not all churches are open to counseling or those types of things, or it’s very taboo like “what’s really going on there? Is that really Christian? Is that Godly?”

I interviewed a woman and asked her about her experience in terms of mental health in the church. She literally said that pastors have their heads in the sand, like an ostrich. I was shocked by that but I was glad that she was honest and she just said, “that’s been my experience”. And I said, “Why do you think that is? And she said, “Well, because they would have to look at themselves first.” She said because we all at some level have some anxiety or some depression, or like you talked about trauma childhood wounds that maybe haven’t been healed yet and if we don’t do that internal process, how are we going to be able to support someone else that’s on that journey?

Pastor Randy: Yeah. That’s why when I was growing up, I went to a very traditional Southern church I grew up believing that joy was the bully of all the other emotions. That if you’re in pain, “Hey, just rejoice.” This is the day the Lord has made rejoice and be glad. It said joy comes in and beats up everywhere, whether it’s sadness or grief. You’re not a “good Christian” if you’re not rejoicing all the time and just happy, happy, happy, happy.

We get stuck with these crazy messages that mess with our heads which keeps us from navigating our hearts and so my experience, and even here at Midtown, we really celebrate the gift of counseling.

We really believe it’s a gift that the Lord has given to our community to help our people really do an internal journey because a lot of us need master navigators like you to guide us through this jungle called our heart and help us to put language to some of the things that we’re experiencing that our family never taught us how to talk about.

The gap that I often see that makes me sad is the gap between what’s happening in a counseling office to that person’s community. Ideally, I would love just to see a community of people from the church that are journeying with that person as they go to counseling. Out of counseling, that community is supporting them and carrying them, and listening to them. So that counseling with community or helping that person really becomes a full-hearted person. He was really maturing deeply in their life, but often even with very healthy people, what happens in the counseling office stays in the counseling office and what happens in community is often the tip of the iceberg or real surface kind of stuff.

I think that the work has to really be done on our side of this fence that the church needs to realize that AA group that’s meeting in the basement is experiencing vulnerability we need to take that out of the basement and bring it up into the sanctuary, and it’s going to start with the pastor. The only way his community can go on that journey if he’s not gone on that journey is if they go around him and if they go around them, it’s going to hurt him, the church.

Carrie: Wow. That’s so good. I know that I’ve been in group counseling situations and walked away from it and said, “that’s what church is supposed to be like.” This sense of unconditional acceptance for where people are at.

I see you. I see your struggle. I accept you and “Hey, I’m struggling on this journey too” and a lot of times, unfortunately, that isn’t people’s experience in church, but I think that things are shifting and changing. The more that we have these conversations, I hope that this podcast and these types of conversation, I hope it like provokes the church in the best possible way to start looking at this integration of our spiritual life and our mental health and how we can grow together. That those things for many years were believed to be in opposition of each other. “Don’t seek out that secular counseling stuff, that’s not in the Bible” and now we’re realizing that everything that we know about the brain and childhood trauma and all of these things, nothing is against what’s in the Bible in terms of our knowledge of psychology.

When we look at studies about forgiveness, we’re like, “We already knew that as Christians. We already knew that that freed you up” like it’s right there. So it’s just a passion for me to really integrate those two pieces really well.

Pastor Randy: I think It’s really crazy how we as human beings and you probably know more about this than I do, but how we as human beings love to label everything black and white. We love to put things in the categories that we accept and the categories we don’t accept. So there are people that would look at counseling and go, “all counseling is bad and they would give anecdotal stories where Aunt Betsy went crazy after seeing a counselor or whatever. People can say that about the church too. That there are churches that are crazy. They’re just crazy, but that’s not the entire Christian community. So I say that finding a really healthy counselor that really has a good idea of how to guide and care for their people I think is really an essential part of our lives, especially when we’re going through seasons of our lives that we can’t navigate or to understand ourselves even better or joining a support group just to grow emotionally. I would say to people, I would really encourage you to find a group of people in your faith community that can go on that journey with you as well. That it’s a partnership.

I just hate the thought that people go to counseling and they have to leave their faith community when I think that the faith community can actually go with them and support them and care for them and actually grow with them. That’s really a dream of mine.

Carrie: Yeah. I think I have had situations where when people healed from the shame. They were able to go back into their Christian community and talk more openly about their struggles once they were able to work through some of the trauma or the shame pieces, they were able to go back and say, “Hey, these are the things that I struggle with.” And then that opens up other people to say, “Oh, I’ve had some of those struggles too”, or “yes, I’m struggling, what are you doing about that?”

I think just this sense of when people are in therapy if they have support, that therapy process is so much easier than if they don’t have support. If we’re really like straining and stressing to find the sense of who are you connected with [00:36:41] that’s positive and healthy. That just takes a lot longer. Sometimes it ends up being the therapist. The therapist ends up being the positive relationship in their life until they can develop a healthy, positive relationship outside of therapy, but it works so much better if they have even just some kind of support people that they feel like they can call or talk to, or be open with.

So I wanted to ask you if you have any specific encouragement, maybe for people who are struggling with anxiety or OCD,

Pastor Randy: I’m not an expert on either one of those, but I’ve experienced both of those in my life and in the lives of people I care about. I would say that if anything to take the shroud of shame off of those things and to really get aggressive at seeing yourself as someone you’re willing to invest in and not being content with just trying to manage either one of those, but in that state, jump into counseling and find somebody that can help you understand what’s going on inside of you. Help you get some tools to really build and live a healthier you.

I’d also encourage you to find a church that would speak the gospel to you, and really speak the truth of God’s grace in your life. Find a community of people in that church that are willing to go on that faith journey with you that you can be vulnerable with and bring out of counseling into the open.

What’s happening here you might discover that people don’t run and hide from you when you share those vulnerable moments in your own life. You may actually find other people that are going, “me too.” That’s the journey together. You begin to see that what’s happening to you is not as unusual as you might think it is. That normalcy of our own struggles, I think let’s just take a deep breath and remove all the stuff from it that shouldn’t be on it anyway, which is just shame and embarrassment and the kind of things that we don’t want other people to see.

Carrie: That’s so good. I feel like it’s somewhat of a summary of the things that we’ve already been talking about.

Pastor Randy: What I’ve experienced in all the years that we’ve done in Midtown is nobody here has a hard time understanding that their centers, that relates to that’s a message that preaches itself, but you know what? Everybody has a hard time believing is that I’m Holy, but what Jesus did for me is he made me his beloved. That in Ephesians 1, it says that he chose me before the creation of the world and he has lavished grace on me and he did it because that’s his pleasure. That the pleasure of God is to pour on me a new name and love and wisdom and understanding. Sin, I have no need to convince me of that, but my shame is so loud sometimes believing that I am beloved, that my father in heaven is for me and he’s not against me.

Those are the things that I find unbelievable and there are things that are in the way for me to find that unbelievable. Sometimes there are barriers and sometimes there’s trauma and sometimes it’s addiction and sometimes it’s relationships and marriage that are hurting me. I feel belittled by my spouse or my children don’t respect me, or maybe I don’t love my kids

and I feel ashamed about that. All the things that we dare not even whisper in the shadows. And I would say to people, men, you need to pull all those things out and put them in the light of day. And a counselor is a great way to start but a community is a great place to trust. And then maybe you can start to believe the unbelievable story of what Christ came to do for us and what he’s done for us.

Carrie: Yeah. So good. At the end of every podcast, I ask our guests on the show to share a story of hope, which is a time in which you received hope from God or another person.

Pastor Randy: So you sent me this question, what was this like 5 days ago and I thought about it. I could give you such great platitudes right now, Carrie, and talk about hope in Africa or all that kind of stuff and I thought that would be so unfair after this conversation. So I’m going to give you the real story. Okay, so in my garage, like I’m a motorcycle guy. It’s been something I’ve done since I was 15 and I love motorcycles in my garage. I have a couple of motorcycles and one is a project bike that’s been sitting in my garage, unmoved for almost a year and a half.

Sunday afternoon, one of my old friends called me and he said, “Hey, what are you doing this afternoon? Let’s get in your garage and play with that motorcycle.” I said, “okay, come on over.” And he’s one of those guys that we never get together and just talk small, talk like football, sports. He’s very open. He’s very vulnerable. He runs a prison ministry, he’s a musician and he plays to guys on death row. He’s just a very interesting guy. We played with that motorcycle for three hours and after it was done, that motorcycle started and I drove that thing up and down my street to the irritation of my neighbors because it has no muffler on it.

When he left, I realized there are things in our lives that sit dormant and we just avoid them. And I’m with that motorcycle for a year and a half, it’s in my garage and it wasn’t started, and sometimes it just takes a friend that calls and says, “Hey, I’m coming over and we’re going to open your garage.”

I just want to talk about that thing you have in your garage that should be running and it’s not, and it didn’t take a Herculean effort to get it started. It just took a Herculean friend who was willing to come over and when he left it just birthed hope in me that that’s what community is, is someone who’s willing to pick up the phone and say, “Hey, I’m coming over.”

And I would speak to the people in your audience who says, I don’t have a friend like that. And I would say, go be a friend like that. Go and be that friend and you’ll be surprised at how quick those kinds of people will gather around you and then come over to your garage.

Carrie: That’s really good and it only took three hours.

Pastor Randy: I know now they’re all my friends and they crack up that I still like riding motorcycles. Their kids love my motorcycles though. They’re very excited about that.

Carrie: They wave to you as you’re going down the street.

Pastor Randy: They want to get on the motorcycle with me.

Carrie: Very cool. Thank you so much for sharing this wisdom about vulnerability and community and connection with God and others. It’s been really great conversation and I think it’s really going to benefit people.

Pastor Randy: It’s a real joy to be with you, Carrie. Thank you so much.

I really think there are some great takeaways from this interview of just being there for other people, being the kinds of friends, and loving people that we want other people to be towards us. There’s a saying that if you’re able to be a friend, you’re able to make a friend.

I encourage you to find ways to make deeper connections. If you haven’t stopped by yet, I hope that you will visit our website, which is hopeforanxietyandocd.com.

Let me know what you would like to see on the website. I’m trying to compile some resources on there for you that I hope will be helpful.

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.

Is ERP the Only Option for OCD?

Written by Carrie Bock on January 12, 2021. Posted in Counseling, OCD. No Comments on Is ERP the Only Option for OCD?

Individuals who are diagnosed with Obsessive Compulsive Disorder (OCD) are often told that they need to receive Exposure and Response Prevention (ERP) in order to treat their OCD. While ERP has been widely researched and works for some individuals, ERP is not the only treatment option for OCD. Eye Movement Desensitization and Reprocessing (EMDR) can be effective for treating OCD, especially with individuals who have a history of childhood trauma.

8. One Therapist’s Story of Discovering Her Scrupulosity OCD with Rachel Hammons

Written by Carrie Bock on January 7, 2021. Posted in Counseling, OCD, Personal Testimony, Podcast Episode. No Comments on 8. One Therapist’s Story of Discovering Her Scrupulosity OCD with Rachel Hammons

In this episode, Rachel Hammons, a counselor in Nashville, shares her personal experience with scrupulosity OCD and how it affects both faith and mental health. She offers valuable insights on recognizing, understanding, and managing OCD, particularly in the context of moral and religious obsessions.

Episode Highlights:

The signs and symptoms of scrupulosity OCD, a lesser-known subtype of OCD.
How scrupulosity OCD can impact an individual’s relationship with their faith and moral decision-making.
The importance of recognizing the difference between normal doubt and OCD-driven anxiety.
Effective treatment methods, including Exposure and Response Prevention (ERP) therapy.
Practical strategies to break the cycle of compulsions and manage intrusive thoughts.

Episode Summary:

In today’s episode, I’m speaking with Rachel Hammons, a counselor based in Nashville who specializes in helping people with OCD, especially scrupulosity OCD, a subtype that can deeply affect individuals’ relationships with their faith. Rachel shares her personal journey with OCD, explaining how she came to recognize the condition within herself while studying it in her professional career. As someone who works with clients struggling with OCD, Rachel provides invaluable insight into how the condition can manifest, particularly in the realm of moral and religious obsessions.

Rachel opens up about the internal battles she faced, including the overwhelming need for certainty about right and wrong, which often resulted in compulsions such as seeking reassurance or mentally “correcting” thoughts she deemed sinful. She describes how this cycle of obsession and compulsion can make it difficult to differentiate between normal doubt and OCD-driven anxiety.

If you’re struggling with similar issues, whether you’re dealing with OCD or supporting someone who is, Rachel’s insights will resonate deeply. Tune into the full episode for a candid conversation on how to better understand scrupulosity OCD and learn tools that can help break free from its grip.

Links and Resources:

Rachel Hammons
More information on ERP and OCD

Transcript

Today on the show. I am interviewing Rachel Hammons. I did not know Rachel until I started doing some research for this podcast.

I wanted to talk with people who were struggling with anxiety or OCD and were Christian and also listen to podcasts. So I did probably almost 10 interviews with people and Rachel happened to be one of those people. I was able to glean so much valuable information that helped me in knowing what to put in the show. I ended up following up with Rachel a while later and just saying, “Hey, would you be willing to share your story on the podcast?” She graciously said yes.

Rachel Hammons is a counselor in the Nashville Metro area. She specializes in working with people who are struggling with OCD. She also struggles with OCD herself. [00:01:36] She is going to talk with us a little bit more about scrupulosity OCD, how it’s affected her life and how she came to find out that she had it, which is a very interesting story.

Without further ado, here is my interview with Rachel Hammons.

Carrie: So Rachel, tell us a little bit about yourself and the work that you’re doing.

Rachel: I’m in Nashville, Tennessee. I’m licensed in the state of Tennessee. I’ve been working with a lot of individuals with OCD over the past year or so. As I’ve started to do more private practice work, I started off thinking I was going to go more like the trauma route. As I started to learn more about what OCD was I also started to actually see that in myself. I really found a passion for it. So doing my practice work with OCD.

Carrie: So you really didn’t recognize OCD traits within yourself until you were in school, studying OCD?

Rachel: Well, yes and no. I know we’re going to get a little bit into some of my story but I definitely recognized that there were what I would have called more type-A tendencies.

Even though I never really wanted to be a type-A person I always saw myself kind of “I want to go with the flow. Everything’s fine but then I had these really strong needs for structure, black and white thinking things that I would misunderstand, and a really big obsession with making sure that I was doing the absolute best and the absolute right thing.

I just always attributed that to, “I was very type A” or in the more nonchalant way like, “Oh, I’m so OCD.” Even though that phrase is not super helpful, but then after I do more of my professional life and after I graduated even in grad school, we covered OCD but it was more just their obsessions and compulsions, and usually related to like cleaning or going back and checking to make sure you didn’t hit someone with your car.

As I started to do more research and finding my niche with counseling, I’m learning more about what OCD was, especially the subtypes of OCD. This whole subtype called scrupulosity that had to do with moral and religious OCD. As I started to learn more about the symptoms and signs of that, I was like, “Oh my gosh. That’s me.”

Carrie: A lot of people don’t know that that exists. I’m glad that we’re talking about it today. A lot of times people do associate OCD with people that have an organized closet or that clean a bunch or are obsessed with germs. There are these different subtypes. We’re talking about scrupulosity, OCD. How would you kind of define that a little bit?

Rachel: First of all when it comes to OCD, there are several different subtypes that you can experience. There tends to be overlap between lots of them and any one person. I mean, typically you had kind of one or two that’s like those are your struggles, but it can vary over your lifespan. Each of them has kind of unique facets.

OCD in general is going to be comprised of obsessions and then usually followed by compulsion. So if you take that same model and you apply it to what we call scrupulosity, it’s going to be obsessions and then usually followed by compulsions all-around religious and moral issues.

What I think is interesting is you don’t have to be of a religious faith to have scrupulosity. Personally, I am and I would identify myself as a Christian, but there are lots of people who will still experience the obsessions. Again, usually followed by compulsion, but not always around these moral issues.

So in a nutshell, that’s what it is. There are a lot of specific symptoms and things that I’m sure we’re going to get into.

Carrie: How has this affected you personally?

Rachel: I’m actually really excited to share just a little bit about my story because as a counselor I don’t use a lot of self-disclosure, so I’m not sharing my story with all my clients. It’s a piece that I’ve learned about me within the past couple of years, a lot of people don’t know the whole story. So I kind of looked back in preparation for this, just at several different things that I noticed, like from my past, as well as some of the things that I’m still struggling with.

I’ll kind of start with looking back. As I said, there was a lot of black and white thinking. There was a lot of doubt and OCD is sometimes termed like the doubting disease. So I was definitely doubting like, “Is this right? Is this the best thing? Is this true?” I definitely liked some aspects about that, about myself because I like being able to really seek truth, but then OCD twists that, especially with scrupulosity and having it be so much of a mental obsession. It twists what is good and what is truth and what’s most important to you and turns that into this obsession. I know we’re going to get into a little bit later, what does support look like from other people.

Specifically, right now with the church and the environment I grew up in when you see a very studious, responsible kid that’s reading their scripture, that’s asking questions a lot of times, the initial thought is, “Oh wow. This kid is really on fire for God.”

There was a huge mental health component to that where I was like wrecked with anxiety over making sure I got the right answer. Some of the things that I look back on and some of them I kind of laugh about. The first one I’ll just tell you is I think the most obvious obsession and compulsion that I ever experienced. When we were younger, my mom had specific TV shows that we were allowed to watch and that we weren’t allowed to watch. There was never any really comparison like this one’s really bad or this one’s really good. It was just like, “these are the ones you can’t watch.” So one of those that I wasn’t allowed to watch was SpongeBob, but for some reason, in my head, SpongeBob became like the epitome of evil. My mind was just like SpongeBob is bad.

So initially you can start to see that black and white thinking, but where that would come up for me is at the time a lot of people had those SpongeBob flush toys in their car or the dice that you would hang from your rearview mirror. I remember specifically walking past cars as we’d get out to go to the grocery store and seeing those [00:08:43] and I had to say “I hate you” a certain number of times to SpongeBob to get rid of the evil. I thought it wasn’t necessarily super distressing unless there was a lot of SpongeBob or like SpongeBob was on at the doctor’s office. I felt so guilty and this evil was next to me. I had to keep saying, “I hate you. I hate you. I hate you.” Sometimes out loud, sometimes in my head.

Carrie: Sometimes I think people don’t realize that the compulsions can be internal. Their child may be struggling with something and they say, “I don’t think they’re really struggling with that” but they don’t realize what’s going on necessarily in that child’s head at those times.

Rachel: That’s I think is one of the reasons that OCD in general, but particularly scrupulosity tends to go really under noticed or underdiagnosed because what you see is this kid that’s working really hard to follow God or to follow even their schoolwork or obey their parents, but what you don’t see is the internal distress that kid is going through. Especially in my case, if you don’t know that that internal distress isn’t necessarily normal or doesn’t have to be that way, you just assume that that’s like what you’re supposed to be doing or that you’re more on fire for God than other people are. Not like in a judgment way, like I’m holier than now, but just in a way of like I’m really, really trying hard to know who God is and what he expects of me.

Carrie: It was just the water you swam in basically. You didn’t necessarily know anything different.

Rachel: Right. One of the ones that developed as I got a little bit older and one that I think is still fairly difficult for me is, I don’t know if you remember the verse it’s like the classic worry verse where it says, “Do not worry about anything, but in everything by prayer and supplication, present your request to the Lord.” [00:10:48] I think this is an example of where OCD twists what is really good, and makes it very confusing. As I read that, I always read it as a command like my biggest fear just as a heads up was sinning. So my obsessions revolved around making sure that I didn’t cross whatever this random black and white line was, and making sure that I didn’t sin.

Other people with their scrupulosity can have things like “this is going to send me to hell, that’s my biggest fear,” “I have blasphemy.” Mine was specifically “did I sin or not?”

When I would read that verse, it was comforting in the sense that I knew God didn’t want me to worry, but I read it as don’t worry and this is the command. If you’re worrying, you’re sinning. The thing that I always struggled with was I couldn’t control my worry. I knew especially as I got older I can’t control my emotions. I can control what I do with my emotions, but my thoughts and my emotions are going to come into my head and yet still in the church, they talk about like, “if you’re worrying, give that over to God and then your worries go away.”

Carrie: “Take every thought captive and make it obedient to Christ”, which I imagine is super challenging.

Rachel: Right. So I was trying to find and I am still trying to find this balance of God comforting me by saying, “Hey, you don’t have to worry because I’m here or is God saying “don’t worry.” I think that’s one of the ones where OCD is still like, “I don’t know. It might be a command.” And so if it’s a command, you better make sure you’re not worrying at the same time. I’m also like, “That doesn’t make any sense because I can’t control my worry. I’m doing my best.” So there’s still this struggle or I guess this fight of “am I sinning or not.”

Even though you know in your head what you feel is probably accurate, OCD still brings in that doubt and that tiny bit of doubt or that tiny bit of uncertainty is where the individual OCD tends to struggle the most because OCD says, “it’s better to be safe than to take that risk” and that risk is really big. So in my head, I’m like if I take that risk of don’t worry being kind or gentle or like you are okay instead of a command, then what if I start to just let myself worry and then I’m sinning. So it’s better just to not worry, which doesn’t exactly work.

Carrie: Right. I think another thing that’s important to point out is the compulsions provide some temporary relief, which makes it super hard not to engage in them. So it’s like, there’s this temporary relief but then the kind of feeding that cycle just ends up increasing the whole picture and making it worse. It’s hard because you want that momentary peace, I guess.

Rachel: Exactly. Which is what you see. I think the contamination aspect of OCD is where you see it most clearly. If I’m afraid that I’m contaminated by germs then my compulsion is to wash my hands. Washing my hands initially makes me feel like I’m clean from the germs, but then the OCD brings in doubt. That probably contaminated me so I have to wash my hands then and that probably contaminated me. So I have to wash my hands then. You see this cycle start to develop and actually changes in your brain start to develop where your fire alarm sense of anxiety is heightened.

If you look at the physiology of what’s going on in the brain in individuals with OCD and anxiety, that amygdala, that emotion center of the brain is actually hyperactive and it’s more active, more sensitive to things going wrong in our environment.

The way that I like to describe it is like it’s a broken fire alarm. [00:15:05] If my fire alarm is really great if there’s an actual fire, but if I’m cooking some steak and some steam gets up to the fire alarm and it goes off, that’s really annoying. So OCD is basically turning that fire alarm into something that is much more sensitive than it needs to be. Then as you follow that pathway of these obsessions and compulsions that pathway gets stronger and stronger and that fire alarm continues to be heightened and heightened.

If you apply that to scrupulosity individuals with OCD, their brains are going to get more and more sensitive to this potential, like times that I might be sinning or fears that I did something that angered God. If you aren’t able to resist those compulsion’s or practice ERP in a way that is helpful, not overwhelming, but helpful, those portions and that connection between the two is just going to get stronger and stronger.

ERP basically just says we’re going to restructure that so that the pathway isn’t as strong, but that ultimately means you’re not doing the compulsion, which is what calms you in the first place.

Carrie: Right. ERP stands for exposure and response prevention. So how does that work?

Rachel: ERP in general, like you said is exposure and response prevention. Basically, there’s two aspects to it. There’s the exposure piece. The part of exposing myself systematically in a way that’s not overwhelming to my system, but systematically exposing myself to what I’m afraid of in my case, potentially sinning.

The response-prevention is basically asking you to stop doing the compulsion. So you expose yourself to the thing you’re afraid of. You also take away the safety net of the compulsions and you do those simultaneously again in a systematic way so that eventually you learn one anxiety isn’t dangerous.

Anxiety is going to go up and it’s eventually going to come back down or at least I’m going to be able to tolerate the distress of the anxiety and that whatever my OCD said was actually so fearful is probably not as fearful as OCD made it up to be in my head. That being said, I think there’s one really important piece when it comes to scrupulosity, for example, contamination OCD. If I’m really afraid of mud getting on me and I think mud is contaminated in any environment, touching mud is going to be something that brings up anxiety.

When you talk about scrupulosity, you’re not only dealing with these obsessions and compulsions, but you’re dealing with something that’s so central to what this person believes is right and wrong. You’re dealing with this core value. If I asked somebody to do something that’s against their core value, which is not what ERP promotes, but if you misunderstand it and I asked them to do what I might think is a sin, I’m essentially creating this moral injury. That’s not treating the OCD, but instead eliciting this potential sense of shame and going down this I just have to do what’s wrong.

ERP instead promotes sitting with that uncertainty piece. So the obsessions where I’m really concerned, “is this a sin?” “Is it not?” “I’m not sure where’s the line”. We’re kind of coming up to that line and playing around with it a little bit, to sit with that uncertainty to recognize there’s probably not a line at all, but again, in a way that’s not violating this person’s sense of right and wrong. I feel like that was a little confusing.

Carrie: It is. For example, if you’re having a fear and uncertainty about sinning, does that look like going a couple miles over the speed limit? Does it look like sitting with the sense of, “what is this right or wrong” or just sitting with that anxiety for a little bit and not trying to avoid it?

Rachel: Yes and no. Everyone experiences their scrupulosity or their OCD a little bit differently. For some people, if they also have the core fear of not sinning, that OCD tends to fixate on certain aspects of not sinning. So there may be certain aspects in your life that you’re totally okay with uncertainty, but then OCD is going to take certain ones and be like, “this is the one you’re going to focus on.”

I think where you can start to differentiate, is this OCD, or is this a legit thing I need to kind of explore.

Stepping back just a little bit, one thing I like to talk about with my clients is this difference between information seeking and reassurance seeking, meaning when I’m looking at if I sin or not, am I going through that scenario in a way that’s not anxiety-provoking like I’m just thinking, “Okay, is this a sin? I’m not sure. I think I need to do some more research. I think I want to reread that passage in the Bible. I think I just want to understand” and that’s not an anxiety-driven cycle. That’s just like, “I want to understand and I want to grow closer to God in the way that I’m acting” and that’s good.

When it becomes reassurance-seeking, it’s usually this anxiety-fueled like, “I’ve got to see if I did it wrong. I’m not sure I might’ve. Let me read the passage. Let me read the passage again. Let me double-check.” Holding those two is one way you can assess if it’s OCD or just an issue that needs to do a little bit more research on, [00:21:07] or is it a little bit of both.

Carrie: So often they have a tendency to seek reassurance from the people that are closest to them. That could look like a parent or a spouse or with some of these types of things that may be even a pastor or a church leader. I think that’s why I’m so excited that we’re doing this to open up that conversation.

[00:21:27] There maybe somebody listening to this who’s been providing a lot of reassurance and not realizing that that person may have OCD.

Rachel: Right. So like you said if that looks like you going to a pastor to check like, “Hey, is this a sin? Did I mess up?” or going to your parents, “Hey, was this wrong? Is this okay?” Those are good questions, but OCD is going to bring in not only are you asking that question the one time, but it’s going to bring up this doubt and this doubt it tends to also be followed along with, for me personally, like “where is that exact line between this is right and this is wrong? By asking that question over and over again, maybe I’ll get a certain total response. Maybe I’ll get a certain phrase and response and that lets me know everything is okay. Whereas when I’m information seeking, I’m not looking for a specific response, I’m just wanting to learn more.

Carrie: I think it’s good to normalize. There is a normal level of doubt within group identity. “Am I saved?” I hope we all ask that of ourselves once or twice in our lives. Is there evidence in my life? Is this situation right or wrong? Are they moral things? Does God love me or not? Those types of things are normal doubts, but then what you’re talking about is something that’s repetitive and it’s very anxiety-provoking and ongoing.

Rachel: Right. In some ways I wish that there was like a list of this is what scrupulosity is and this is exactly how you treat it. Like you were saying earlier some people are obsessing over like, “Did I go a couple of miles over the speed limit?” Scrupulosity shows up and OCD shows up very differently for different people. The way that you treat it while ERP tends to be fairly foundational for every person, that’s going to look a little bit different. For me, when I challenged myself with recognizing the signs that come up, it’s usually like am I analyzing for doubt? Is there a lot of doubt going on? How long have I been thinking about whether or not I’m sinning? Because usually If you sin, you’re able to look back and probably within five minutes, you’re able to assess like, “Yeah, that wasn’t good” or “that wasn’t right.”

I find going back and forth and back and forth. I’m starting to obsess. [00:24:06] I’m like, “Am I thinking about this really, really black and white? Am I looking for the line between what was right and what was wrong” How anxious am I? Am I anxious to find the answer right now?”

One thing I talk about with my clients a lot is when our anxiety goes up, our judgment or our ability to make rational decisions naturally comes back down. So if I’m feeling really, really anxious, it’s going to be really hard to think about rationally and systematically what I need to do about that anxiety. So if I’m really, really anxious about finding the answer to whether or not I sin it’s going to be really hard to even systematically look at. So instead, I need to maybe take a break and let that anxiety naturally come down. If I’m still worried about it after the fact, maybe I can come back and revisit it, but if it kind of went away, that was probably an indication that it was OCD.

Carrie: I think that’s a good first step obviously with making any behavior change. We have to recognize what we’re dealing with. [00:25:14]

I’m sure you’ve seen this in your practice and I’ve seen it in my practice as well. It’s very common for people to believe that they have generalized anxiety disorder or they may have been to other counselors who have diagnosed them with an anxiety disorder. As we start to dig and ask more questions like, “Hey, do you seek out reassurance from other people in your life?” Or “Do you tend to get stuck on these certain things?” Some of the people recognize, like, “Oh wait, this is not anxiety. This is OCD.” At some level that can be overwhelming, but at some level, it can be freeing.

Rachel: When I read through some of the signs and symptoms of what scrupulosity, what OCD was, there was so much relief in that. Just knowing that you’re not crazy. You’re not totally out there. You’re not dealing with something in isolation. It’s normal in the sense that it’s OCD normal and there’s treatment for it. I don’t have to consistently live with this overwhelming anxiety over whether I’m doing the absolute best thing or the absolute right thing. [00:26:37] That’s going to involve some anxiety in the process.

Going back to what you said, I think what’s really tricky sometimes in the counseling world is assessing, is this anxiety or is it OCD? And while the two have a lot of similarities, obviously each case is different, but with anxiety, you can provide coping skills. Something that’s going to help bring my anxiety back down. “I’m really anxious.” “I’m going to practice deep breathing.” “I’m going to practice grounding skills.” If I do that with OCD, I’m actually not exposing myself to the fear. That’s probably not realistic.

I’m never actually sitting with the uncertainty because I’m just trying to reduce the anxiety cost from the uncertainty. So you kind of get caught again in a loop of, you can almost ride the line between either you’re doing your compulsion to bring the anxiety down, or you’re doing your new coping skill to bring the anxiety down. Then you never actually face and fight and deal with the anxiety that isn’t even necessarily over something realistic. Meaning my anxiety over is this right? Is this wrong? Where’s the line? Am I sitting right now? If I don’t sit with that uncertainty of, I don’t know, I’m not sure I might’ve sinned. Instead, if I try to beat that with coping skills and try to calm that anxiety down, that anxiety is just going to get stirred up the next day, because that’s what OCD does. It brings in that doubt. It brings in that “what if.”

While there are a lot of similarities and while coping skills are even helpful with OCD at times, to know that difference is really important and really crucial because your treatment is going to be a little bit different.

Carrie: Absolutely. With the ERP, there’s an exposure hierarchy, and you’re not going to expose somebody to their worst fear in the beginning. You’re kind of building up to some of those things because I think some people may be listening to this and going like, “Oh gosh, that feels too big to sit with that anxiety.”

Obviously, if there are counselors who are trained in this, who know how to walk you step-by-step through that process to get there. It’s also working sometimes in tandem with other people or providing guidance to the clients of how their parents, spouses, or whoever might be able to respond to them in a helpful way.

[00:29:13] Sometimes that means holding off on the reassurance seeking that’s part of the response prevention.

Rachel: Right. I think that a lot of times we think If I just calm this person down if I reassure them if I tell them everything’s okay. Naturally, that’s what we want to do, to comfort somebody, but in reality, there’s a level of uncomfortableness that is so crucial to sitting with to be able to recognize that my OCD was way over exaggerating this fear. There are times where my fear is really legitimate and I’m still obsessing over it in a way that’s taking over my life. So again, sitting with a certain level of uncomfortableness is huge in learning how to treat and sit with OCD.

I guess I’ll use a contamination example cause I think it’s a little simpler. If my biggest fear is sitting in the room with the dog, like maybe I had a bad experience, I’m not going to ask my client to go sit in the room with the dog and play with it for an hour. Instead, I might have them sit, look at a picture of a dog and practice that over and over again. I might have them listen to a dog barking and practice that over and over again because exposures don’t have to be this huge and overwhelming. Not to say that the anxiety itself is dangerous because even if you do get overwhelmed by an exposure, that’s okay.

The anxiety isn’t dangerous. It’s just flooding your system like that. It’s probably not going to be super helpful. So finding systematic ways to work up to getting the life that you want to get is really what you’re going for. If you have a scale of zero to seven, seven is like the fullest anxiety I can have. Zero is fine. You want to find with exposure that starts around a level three or four. So something hard but manageable.

If I was to give you one more example, like in my own life, one of the things that I dealt with a lot as a kid, and it kind of died down for a while and it’s recently come back over the past probably year. I have this phrase or this compulsive phrase that I have to say and it’s, “God, please help me to do the right thing” and that falls in line with a lot of my “I don’t want to sin, I need to do the best right thing, the absolute right thing.”

So whenever I feel a little bit anxious even if I think I might’ve sinned or even if I just am feeling anxious because I have to get up early the next morning, I’ll say, “God, please help me to do the right thing.”

For some reason, that phrase helps bring that anxiety down, even though it becomes really compulsive. The phrase itself starts to make me anxious because I’m like, “Oh my gosh, I keep saying it over and over again” and I don’t need to.

If I was to look at my own hierarchy, I know that if I was not to say that phrase it would make me anxious, but it wouldn’t make me overwhelmed. It would work because it comes up honestly, a lot but eventually I know that anxiety will ultimately kind of dissipate, but right now my brain is still kind of stuck in that loop of “this is just naturally, this is automatic.” So if that gives you just any example of where you might start on your hierarchy, that’s probably where I’d start on the line.

Carrie: Great. Good to know. So how can support systems, spouses, churches help someone who’s struggling with OCD?

Rachel: First of all, I think I’d recommend counseling, but secondly, being able to recognize that the kid who is really perfectionistic on the surface, really diligent, really seeking hard to make sure they understand the right thing. Just checking in like, “Hey, what’s it like for you as you’re trying to understand more about scripture?” Even just asking like, “Is there ever an anxiety that you experienced?” So knowing that the kids who are much more like perfectionistic have a hard time with, I guess, hard time accepting uncertainty, noticing gray areas. All of those could potentially be signs. They may not be an issue for that kid and that’s fine too. Then you start to dig a little bit deeper under the surface and you recognize, “Oh, that kid is actually really struggling with anxiety.” It might just be good to kind of like, “Hey, have you ever thought about what it would be like if you didn’t have anxiety?” “Is that a possibility like a world that you want to live in?”

I think the easiest people to inform or that I think would be really great to know a little bit more about OCD would be the people in the church, the leaders in the church because if they can recognize what is going on I think we’re going to be able to identify scrupulosity a lot easier.

I think that you see a lot of it again. I said earlier, underdiagnosed going on in the church and then parents too, especially if your kids are seeking reassurance all the time, that can be a really big indication. Even in schools, like noticing, “Hey, this kid is really struggling when they make a mistake on their test.”

So any place that those people are in all the time if you can recognize those signs and then just kind of give a quick check-in and then knowing the resources, knowing somebody who is in the counseling world who does treat OCD, who does know ERP is going to be like your best bet.

Carrie: Right. So really just supporting that person and that, “Hey, it’s okay to get counseling.” Sometimes we need help that’s professional to help us work through some of these things.

Rachel: Right. There are also several books that you can look into that’s more of like a self-help book, it’s by Dawn Huebner. It’s something like when your brain gets stuck. That’s more of a kid’s guide to working through OCD and so if the signs are really minimal or even if your kid is on the younger side, and you’re just starting to see some of these signs, like exploring what that looks like, it could be a really great resource. At least a good first step to see if that’s all the support that they need.

Carrie: At the end of every podcast, I usually ask guests to share a story of hope, which is the time that they received hope from God or another person.

Rachel: I think that there’s a lot of little moments of hope for me. Looking back on my story like I mentioned earlier, the biggest piece of hope for me was learning the fact that I had OCD. That was eye-opening and huge. I also know that one of the biggest pieces of hope too that I had is if you’re a Christian or if you’re a religious faith reflecting on who you think God is, or even doing some research on not necessarily this specific event, this specific sin, this specific fear, but who is God?

I can learn more about the character of God, and I know that times that I’ve learned more about the character of God the way that Jesus treated people, that’s going to look vastly different than the way that my thoughts tend to speak to me. So when I reflect on who God is, or at least even if that’s a question cause sometimes I’m like, “I don’t know who God is” like, I don’t know how He responds.

Just reflect on something that you know about God. I know that God is love. So if God is love, He loves me and He wants the best for me. So at least I know that I have that support. I have that hope that God just any parents are loving their kids, God wants the best for His kids. God wants the best for me. So at least in that, I know that I have someone on my side that’s walking through OCD or walking through my struggles with me. I think that’s kind of what I tend to reflect on especially when I’m really stuck in the obsessions and I really don’t see an end to this particular one, reflecting back on what you know, grounding yourself in what you know to be true.

Carrie: Right. I think that may be hard for some people to sit with and wrestle with because there’s a sense of, “I do love God. I am trying to serve him with my life and be a good Christian all of those things and yet I’m wrestling with this on a day-to-day basis.”

I’m just kind of curious what you would say to someone with that thought process.

Rachel: One of the biggest struggles for me is making sure that I was doing the right thing. Even in that compulsive phrase that I talked about, like, “God help me to do the right thing.” I’m consistently trying to understand this situation, this particular anxiety. What I tell a lot of clients, honestly, at the beginning of some of our sessions is OCD is really confusing, scrupulosity is really confusing, especially scrupulosity because it’s so foundational to our thoughts and I want to do the right thing so badly.

[00:39:12] So it can get really easy to think about and to get lost in all of the things that I don’t yet have, or that I don’t yet know, or I don’t yet know how to fight. So one, I like to paint a picture of how ERP works, counseling works.

There’s hope. There’s a lot of hope with OCD at the same time remembering the things that you do know. Like I mentioned a little bit earlier, reflecting on, even if it’s not like God’s character still what are some of the things that are your strongholds? What are you anchored in? Maybe I can anchor into the fact that I know I’m saved. Maybe I can anchor into the fact again that I know God is. At least I can take that of the very phrase from the Bible and know exactly what this says, God is love. I can ground myself in that. I can ground myself in even knowing the people around me that I have as my support systems. I can ground myself in knowing that at least I have the letter from God, the scripture in my head.

So going back to at least what you know while you don’t know everything, you know, some things, and it’s gotten you this far. So can we start there and know that there’s hope to build on from there.

Carrie: I think that’s relevant to so many people, not just people who are experiencing OCD, but anxiety, or even just a traumatic experience or a hard season in your life. I know that there have been times where I’ve gone through difficult things and exactly what you said, “Okay. What do I know?” I don’t understand this situation in my life at all. I don’t know why God allowed it here, but I do believe that God loves me. I do believe he has a plan somehow in the midst of all this mess like that, He’s gonna take this and make something good out of it and that really helped me get through that until that was resolved.

Rachel: Yeah. There’s one moment, I guess, that I like to reflect on and this, I guess has a little bit less to do with OCD, but more of just one of the most profound moments that I felt like I had with the Lord. I remember it was when I was in high school, maybe early college. I was preparing for leading a Bible study that night and The Lord had really laid this passage on my heart. I don’t remember what the passage was, but I remember just wanting to know really badly what it meant. I was really confused because there’s a lot of different religions that interpret that passage differently and so I was like, “I’m going to learn what this passage means that I’m going to figure it out and we’re going to talk about it in Bible study.”

So I was like spending probably a couple of hours reading this passage, reading research on the passage, trying to understand. Even then, I guess you can see some of the OCD of like, I have to miss out and I have to figure out the right and wrong answer between it. And I got so, so frustrated because I couldn’t figure out the answer and I wanted to have it for the Bible study. I went outside and I was about to start doing even more research to understand it. I just kind of felt like the Lord say, “Hey, wait, wait, wait, can we pause here?” I remember looking up at the trees cause I was on a back deck that was a screened-in porch and I just felt like the Lord was saying, “Hey, Rachel, look at the trees around you” and I was like, “Okay, so I’m looking and I’m seeing them blow in the wind” and the Lord was like, “Do you see them blowing in the wind back and forth like that?” I was like, “yes.” I was kind of blown away that I was having this conversation with God. The Lord was like, “Do you know, like how I did that? I was like, “No, I don’t know how you made the trees move” and he’s like, “Do you know all of the intricacies of exactly what type of wind and what exactly, what type of molecules and atoms and particles that went into me being able to move those trees back and forth?” And I was like, “no” and he was like, “but you know that I was the one behind it” and I was like, “Oh, yeah.”

So for some reason, hearing that the Lord even though I didn’t understand how the trees were moving, I knew that the Lord was behind it. I know that God is good. I know that He knows the answer, even though I don’t. I kind of took that and I felt like the Lord brought me back to that passage that I didn’t understand.

God was like, “Today may not be the day that you’re going to understand that, but you know that I know the answer and you know that you’re trying to know the answer and that’s okay. Because you know that I know the answer and you are following me. You can just keep following me and eventually, we’re going to get somewhere then we may never know the answer to this specific one, but you at least know that I know, and if you can trust me, you can follow me to the end.”

So that’s I guess kind of my message of hope too for OCD, in general, is if you’re religious or not, like, who are you following? Where are you walking? Where do you want to be in your future?

If you’re religious and you know that God is good and that you’re following Him, at least, you know, that you’re following somebody who knows what they’re doing. That helped me a lot.

Carrie: Awesome. Thank you so much for being brave and bold and sharing your story and what you’ve been through. I hope that really helps and encourages someone else today.

Rachel: Thank you for the opportunity. Just to be able to share some of my story is really exciting for me.

_____________________________________________________________.

I am so thankful for Rachel being willing to be so vulnerable with us and talk about her symptoms and how OCD has affected her. This is actually the second person on the show that has talked about exposure and response prevention. I’m a little bit frustrated with myself only because I’ve been wanting to talk about EMDR and how it can be helpful for OCD.

I know that I’m going to have some episodes in the future on EMDR and how EMDR can be helpful for OCD. Even though it is not a therapeutic approach that most people think of when they think of OCD treatment, I plan on doing a solo episode in the future regarding why I have chosen to utilize EMDR prior to using any type of exposure-response prevention methods with clients.

If you find that interesting, stay tuned in for later. I just want to throw that out there that exposure and response prevention is oftentimes the recommended therapy for OCD, but it’s not the only thing that works. So I’ll dive more into that in a future podcast. Just wanted to throw that out there.

[00:46:19] Until next time let’s continue this conversation on Facebook or Instagram, or you can always reach me at hopeforanxietyandocd.com

6 Factors to Consider Before Searching for a Counselor

Written by Carrie Bock on December 31, 2020. Posted in Anxiety, Blog, Counseling, OCD.

Note of clarification: In this article, I am using the terms counselor and therapist interchangeably to refer to a provider who is trained and licensed by the state to practice. I am not referring to someone who may engage in counseling or counseling techniques who has not been formally trained to practice professionally.

If you want to find a doctor, there are several ways you could approach this. You could ask a friend, check the insurance website, the doctor’s website, or read reviews. Finding a therapist comes with unique challenges. I have listed the important factors to consider when finding a therapist below. Understanding this information helps you know what information to cover in the initial phone call or email when reaching out to a therapist.

Hope for Anxiety and OCD Podcast – Not sure about Therapy?

9. Not Sure About Therapy? Try it on! with Erica Kesse, LPC-MHSP

Written by Carrie Bock on December 30, 2020. Posted in Anxiety, Counseling, Personal Testimony, Podcast Episode. No Comments on 9. Not Sure About Therapy? Try it on! with Erica Kesse, LPC-MHSP

Why finding the right therapist is more like dating than choosing a doctor—and how personality, approach, and connection matter more than we often realize.
What “Try on Therapy” actually is and how it’s changing the game for people who are curious but hesitant about starting therapy.
How stigma, especially in faith communities, holds people back from getting the support they need—and what we can do about it.
How racial identity and cultural experiences impact both seeking therapy and providing it, particularly in Black communities and churches.
Why therapists themselves need care, connection, and professional community, especially those working in high-stress helping roles.
How to advocate for yourself in therapy, from setting goals to speaking up when something doesn’t feel right—because you’re the expert on you.

Episode Summary:

In this episode, I had the privilege of sitting down with my friend and fellow entrepreneur, Erica Kessee, founder of Your Goal Concierge and the creator behind Thrive on Therapy. Erica introduced us to the powerful idea of “trying on therapy”—a creative and approachable way to help people explore what therapy might feel like before diving into a long-term commitment. It’s an innovative concept that breaks down stigma and makes mental health care more accessible and less intimidating.

Our conversation also explored an important truth: not all therapists are the same. We discussed the wide range of counselor personalities, therapeutic approaches, and how vital it is to find a therapist whose style and presence truly fit your needs. Erica and I both believe that choosing the right therapist isn’t just about convenience—it’s about connection.

We also didn’t shy away from the harder topics. Erica shared her deeply personal experiences as a Black Christian woman navigating the intersections of mental health, faith, and race. Her stories about being overlooked until someone white validated her work—and the silence around mental health in many church communities—were moving and eye-opening.

From our lighthearted office memories to serious reflections on spiritual identity and systemic challenges, this episode covers so much. Whether you’re in the helping professions, seeking therapy yourself, or curious about how faith and culture impact mental health, there’s something in this conversation for you.

🎧 Want to hear more? Tune in to the full episode.
Her insights may challenge you, inspire you, and expand the way you think about healing, faith, and emotional support.

Links and Resources:
Erica Kesse, Your Goal Concierge
Try on Therapy
Mental Health Marketing Conference

Transcript

Today, we are talking to Erica Kessee who is a good friend of mine and fellow entrepreneur. She is going to share with us something that she created called Thrive on Therapy. I’ll let her tell you more about that.

One thing that I want you to pick up, hopefully from this conversation is an understanding that there are many different types of counselors and many different personalities of counselors.

There are many different counseling approaches that those counselors utilize and this can really help you if you’re processing, searching for a counselor, or what you might need from a counselor. And of course, I couldn’t have Erica on the show and not ask her about her experience with racial issues and mental health in the black church, but I was not prepared for what she was going to say.

So let’s go ahead and dive into this episode with Erica.

Carrie: Miss Erica, you and I used to share an office space together, right?

Erica: It was a blessing because another colleague told me about you and that you had an office. I was so excited because I was able to be in a space and start my practice in my own office and it was ready for me to hang my shingle.

Carrie: Yeah and we have to let people understand that this office space was very small and you somehow found a way to make it super cute and homey and you had someone help you decorate. It was adorable, very adorable.

Erica: I was very proud of my space, loved my little space, my little couch. When you will listen to a decorator, they work wonders. So it’s just like, “you paid me.” So cozy and sweet.

Carrie: One of my favorite Erica stories that I have to tell is that we have a lot of things in common. We have really a passion for people getting really good help and treatment and reducing stigma. We have no problem talking about difficult issues, but our temperaments are a little bit different in terms that I’m kind of quiet and somber and calm and Erica is exciting, exuberant, and full of energy and life. That was very interesting. There would be times where I just go down to your end of the hall and just kind of gently turn up the sound machine. Do you remember that?

Erica: Yes. When I was working in community mental health and in other places when there’s other people around, it’s always been noted that I am having a great time in my session and I am laughing, enjoying the time that I spent with the people who are in the room with me and it is outside of the room and so it made the sound machine to be brought up a little higher.

Carrie: I think that’s an interesting thing cause we’re going to get into this a little bit later about different therapists having different personalities and different fits. There’s just kind of a little intro of one example of that, but tell us a little bit about yourself and how you got to where you are today professionally.

Erica: I am Erica Kessee, a CEO and founder of Your Goal Concierge. I also have a service within Your Goal Concierge called Thrive on Therapy. Your Goal Concierge Mission is to provide services, support, enhancement, and encouragement to those who are in helping professions. Counselors, coaches, nurses, frontline people who had to go out of the house even in the middle of quarantine. Those are people that I serve and people who are trying to create businesses, try on therapy as a service specifically because I have a master’s in clinical mental health counseling and civic leadership.

I wanted to make sure that individuals, both the public had the right fit for their therapy and that therapists had opportunities for networking opportunities to show their craft and opportunities to offer services to others and show what they’re good at and to make sure that individuals are with them. Every counselor coach knows this person is like the perfect client for me because they have a lot of the same story that you have.

You understand how to work with them and get them to the next level. It is an immersive learning experience for individuals. So individuals who have the temporary license, which that’s what I have, or a master’s in clinical mental health counseling can provide this immersive learning experience to people so they can at least get a taste of therapy because there’s a lot of stigma associated with getting mental health services.

Carrie: Right. I remember you came by my office one day and you were so excited and you were like, “Carrie, you try on clothes?” And I was like, “at the store” and I was like, “yeah”. She was like, “what if you could try on therapy?” And I was like, “What in the world are you talking about? This is a little out there, Erica. I don’t know about all this.”

Tell us about how that originated because you did actually create this for the mental health marketing conference originally, right?

Erika: Yes. Exactly. So for the mental health marketing conference, I started going to the conference while I was at Lipscomb. I went to get my master’s in clinical, both masters from Lipscomb University. There was an opportunity as a student to go to the mental health marketing hub. I got there and I looked around and I saw all the marketers and I thought, where are the clinicians? They don’t have a seat at this table when they’re supposed to be marketing for mental health services. Only the clinicians know how to market to the people they’re trying to bring in the doors. And so I spoke to the founder, which was an Austin parent about incorporating more clinicians. I did speak the next year and it was that third year that we spoke about having clinicians at the table. Then the third year was, hey, we’re going to actually pilot trial therapy and let these marketers experience therapy because they had never experienced therapy. They have no idea how they are going to be marketing something they’ve never experienced.

Everybody else gets something free. If somebody is in the market, they get a product for free. So they can say, I buy into this product. Like a sample, that’s what trial data is. It’s a sample of therapy and the sample is actually not watered down or anything, but we call it an immersive learning experience because we don’t want to say it’s therapy. It’s just a crucial relationship. So you don’t want to say that you’re entering into that relationship until you’re truly entering into a relationship with a person that’s going to be taking you to the level you need to go to according to your treatment plan. So we offered it and at that time we asked Carrie, even though I went over there to her office, I was actually trying to get her to come to be a trial therapist.

I’m always a connector. I’m always thinking about opportunities to reel people in and Carrie was one of the child therapists that year. I can’t remember the numbers. I do have an annual report. If anybody is interested in it, you can reach out to me for it. I have the numbers in there. With every person that we did have, every person that I met was there also exhibiting. I did have a conversion of a person that stayed with me from that conference that very first time.

Every single year we’ve done trial therapy there and they asked us to come back every year, try on therapy in there because there are marketers, people who’ve never experienced it. There it’s just valuable and this makes sense to me.

Carrie: Now you’ve expanded to other places and it’s not just for the conference and it’s not just for marketers, what other locations have you been to where you’ve utilized this?

Erica: Because of the specificity of the middle half marketing conference so we went to the Sexual Assault Center here in Nashville, Tennessee. They were talking about a particular thing that could trigger individuals. There was a therapist there who could be available for anyone that was triggered but then we also provided sessions at the end of the conference.

I closed two people from that. When I say closed, they converted into clients. I went to the sexual assault center twice. After the second time doing the mental health marketing conference, I met a lady with HCA health corporations in America, and they had a hiring event at top golf, which is a place where people can do golf and shoot there.

Carrie: They’re trying to hit a target right, the golf ball into a target. I’ve never done it before, but it doesn’t look like much.

Erica: It’s a cool place. So we went there and we provided group therapy. We had therapists there, they wanted a group, they wanted to hit as many people as possible and so we did three 30 minute group sessions on self-care. The topic of self-care was amazing. I had a wonderful time. They’re going to invite us back next year. As soon as someone tries it, even like it’s so fun in trial therapy, usually, you convert them to a client. When a corporation tries this trial therapy then they usually want me to come back every year to continue to do it for the individuals that they’re serving.

Carrie: it’s been a great success for you. I think it’s opened a lot of people’s minds to what therapy is. Maybe people have ideas that it’s something mystical or they’re really uncomfortable about it like it’s this big mystery like, “what in the world do you do in there?”

Erica: That’s part of our marketing. What happens behind those closed doors. A part of the marketing is also learning the product of therapy. The product of therapy is sitting with that therapist. The therapist is the product. You need to have a relationship with that person and get the right fit with that person. So I recommend you not just meet someone and say, “Okay, I’m going to go through therapy with that person.”

I feel like you should shop around, there’s a sample here and a sample there of how they flow, how it feels in the session, what things they say, and the methods that they will like to show you. Mainly, I would have to say how it feels, because if you’re doing some transference or anything else, which is when you feel some feelings about this person and you’ve never met them, but they bring up things in you that are not so good, then you don’t need it. Then you don’t need that therapist. You need to get somebody else.

Carrie: You mean if they remind you of your mother who you got a strained relationship with it may not be the best fit.

Erica: Not a good fit.

Carrie: Talk about that a little bit, because I think a lot of times people approach finding a therapist like they would a doctor like, “Okay, well maybe who’s in my insurance network or who’s the person that’s within the 10-mile radius of me and looking for a therapist really needs to be a very different process than that.

Erica: Oh my goodness Carrie I just had a bright idea and maybe we should collaborate on that. Oh, I’m sorry. This is how I am, but yes it shouldn’t be a different process and you’re right.

Let’s talk through that process now. It can’t be that way. That’s why when your insurance gives you a list, they give you a list. The list is pretty big.

You need to go through and call through. First of all, if they don’t call, if they don’t call you back or they call you back, like three months later, then you know, it’s not a good fit. There’s some issue that’s there that you don’t mean to keep pursuing but also the whole insurance rate also, the radius is maybe a problem as well. It’s like you have to decide that this is life or death.

A lot of times people don’t see our mental health, our brains, and our emotional health as a life and death situation, but it is because most of the time when people come to us, it’s a conflict that’s happened. That’s just during a crisis. So sometimes holding onto this crisis for years and then finally it just boils over and they’re finally reaching out. You can’t decide that it’s going to have to be with the person within a radius or the first person that you get to answer the phone.

Carrie: I think the process of finding a therapist is really important and I can only share from my own personal experience of finding a therapist. There was one period of my life where I really wanted to see a female therapist. I thought that person is going to be someone who I would feel more comfortable with. I don’t feel comfortable with talking with a male right now, but then after I went through some other things. I was really looking to get back into the dating world after my divorce and I just said, “I want to talk to a male about this because I feel like I need that perspective.”

I need that opposite sex perspective of some things that I’m dealing with or some questions that I have and that was just so helpful. So even sometimes that male or female distinction, sometimes people feel more comfortable with a younger therapist. Sometimes people feel more comfortable with an older therapist and don’t feel bad because maybe it sounds kind of superficial like, “Oh, I’m ruling that person out because they’re too old or they’re too young, but it’s who you’re going to be able to connect with personally. Other people are going to be able to connect with that other therapist personally. So it’s okay.

Erica: It is. I’m so happy you’re affirming and confirming that it is okay to have your preferences. Just like right now because I’ll have to say black awareness and racial awareness that’s happening, I’ve gotten more people contact me who are black or people of color because they need counseling, but also because they are reaching out to someone that looks like them. And so it’s important to decide to pick who you want. Even somebody that looks like you may not be a good fit either. You need the right temperament.

I know I need an action-oriented counselor. I don’t want one to just sit there with me because I will take over the session just like right now. Carrie knows what she’s up to. So like, I need someone that’s going to say, “This is your homework. This is what you need to do.” Give me some parameters. I need some CBT DBT. Well, let me explain those things, cognitive behavioral therapy, dialectical behavioral therapy. So I need these things for myself. I know that.

Carrie: Sure. Those types of interventions are helpful for you.

Erica: So that’s something to think about too when you’re trying on therapy is the structure. What is the structure that works best for you? Especially in a trial therapy session, you can always ask a therapist about internal family systems or psychoanalytic therapy or EMDR or like I specialize in plant expressive arts therapy. So talk through what that looks like.

So it’s, it’s good to kind of build your many, a listing of things that maybe sounds like something you want to try. You can talk through that. For example, when you’re talking about male and female thing. One of the people who came and did the mental health marketing conference was an exhibitor there, so she wasn’t a marketer. She worked in one of the nonprofits. She wanted to test out or try out a male. So she was able to check out one of the males there. I try to have it at the conference, like blubber city, diversity, and males. They’re scarce.

They really are. I had actually a black male. She was able to meet with him and she was the one that converted to see me because she got a taste of him. It didn’t fit and be with me and we did great work. So she did get that out of her system. She understands a male, isn’t a good fit for her.

So then she decided to try something else, which was great.

Carrie: I think it’s important to you that once you talk with a therapist, whether that’s over the phone or once you meet with them in person, they may be diving into certain topics because of their training and their worldview and how they were trained as a therapist.

Specific different types of therapy, just like Erica was talking about earlier that that person may be kind of guiding you down a path that you might not want to go to. So they may be an insight-based therapist. And you may say, I need an action step or vice versa. Maybe you’re not ready for an action step and you’re just going to therapy because you’re trying to learn about yourself. Maybe I’m very upfront that I’m very interested in people’s past and trauma and difficult experiences that they’ve had because that’s the lens that I work from, but not everybody is like that. Some people will say, I don’t want to hear about your childhood.

I just want to know what’s going on right now. And so it’s important to know those distinctions in terms of finding a fit. If you find someone that’s going in one direction, it’s okay for you to say, you know, I think I’d really like to go a different direction, or I thought we were going to talk about this instead, or this is important to me right now.

You have that power as the client.

Erica: Yes, Carrie. I’m very expressive. So yes, it is definitely about the relationship that you have with the person that you’re working with. You have to take ownership of your session. I’ll have to say this in a medical field too a lot of people are not taking ownership of all of their doctor’s appointments as well.

But with counselors, you’d say, “Hey, I want to work on this because they’re supposed to be building your treatment plan according to what you need and what you think your goal is. That’s one reason why my organization is called Your Coal Concierge. I’m your goal concierge. I’m going to help you with your goal.

It’s just important to have that relationship and speak up for yourself. There’s no power differential between you and your therapist. They are an expert in what they’re expert in. So they do understand that because they got the master’s degree, but you’re the expert on you and they’re there to help you work through and deal with and support you and where you’re going.

Carrie: I love this conversation but I also want to move on because I know there’s some other things I want to ask you about.

What is your spiritual background and how would you describe your spiritual identity today?

Erica: Okay. I have to talk about the past a little bit in order to get to today and I won’t be long-winded.

I grew up in Missionary Baptist Church then went to Full Gospel. That’s where I learned about my relationship with God. I didn’t learn much about it before, but once asked about the relationship with God it’s like my eyes were open to the possibilities of this beautiful connection.

That’s father. That’s just for me and for other people too. The relationship that I have is just for me and God. I could ask for whatever I want and it just blows my mind. I also believe that God lives inside of me and I’m still grateful too because I’m also I’m Christian too. So I believe in Jesus.

I need a savior as well, but you can tell that it’s like, people go through things and they may have got a family that taught them to do things a certain way and they just go along with it, I decided to do my way. According to me, thinking through and deciding that this best works best for me to, to be Christian and believe in Jesus.

And then I am also very spiritual because I really take a whole to that part of God living inside of me. So if God lives inside of me, then I got a source to everything.

Carrie: I’m curious what your experience has been in black Christian community surrounding mental health treatment.

Erica: I had a group that I was trying to promote that never really happened because people are not ready to have this conversation.

People are not. It’s not just black churches too. I went to some Church of Christ to do some things and try to do some things. I’ve noticed that it really doesn’t want to deal with things. It’s like an ostrich with his head in the sink. It does not want to deal with the real things that’s happening.

Carrie: Let’s pretend this is not going on. Let’s pretend people are not struggling with these big issues like anxiety and OCD.

Erica: They don’t want to talk about them. I would think that you could find evidence in the Bible where there was somebody who was displaying the symptoms of anxiety and how they persevered or OCD and how they persevered.

One of my things that I always talk about is single motherhood. They don’t want to deal with that either.

Carrie: It’s very prevalent.

Erica: Yes, I did my master’s thesis on that. They didn’t want to deal with it. I never got support within the church to help do a group for single mothers.

Anyway, black church entered the price, white churches. The reason why I’m saying this is because those are the ones that I know of. I don’t know. Churches, and that’s my experience with them and it’s my personal experience. I just know that that’s one reason why I have another endeavor called trials spirituality, which if you go to Your Goal Concierge. That is my website, yourgoalconcierge.com. There’s a link that says trial spirituality. In there, it talks about small groups that people have at their homes. Actually, churches used to do this, but they have small groups at their homes about specific issues, scriptures that go along with for example, anxiety, that’s fine. So in the Bible to study who has anxiety and how they persevered through it and that group talks about it. So that’s definitely something that I am very passionate about. Let’s talk about the real things.

Carrie: We’ll put all of the information on the websites, in the show notes too, so people can click on the links.

Why do you think this is? Why do you think that people have their heads buried in the sand? Because we look at the lifetime prevalence of things like anxiety and depression and it’s high. This is not just affecting unbelievers. This is affecting believers as well. So what do you think is going on with church leadership that it’s having the ostrich mentality?

Erica: I think it’s too hard. It’s too hard of a topic and they don’t want their own stuff to come out like there’s needs to be some kind of transparency that happened in their own life. They probably have had it. Everybody has some anxiety. Everybody has a little bit of it. So that means you have to address your own stuff, This is like with counseling. That’s one reason why I decided to do my master’s in clinical mental health counseling because I needed to evaluate myself before I can even sit in the room with somebody else and I’m not sure they’re willing to evaluate themselves, but then they don’t address. There’s a lock.

Carrie: Right. Talk with me a little bit about your experience regarding racism, black issues related to counseling because I know you and I have had some conversations surrounding this. There may be some white therapists that don’t want to look at their own experiences or their own potential biases that may have a hard time seeing someone of another race or cultural group and vice versa too.

Erica: So being a black woman, it really is a conversation going on right now and I was just telling a friend of mine who is a white woman about it. It’s an everyday thing. They were talking about the protest that was happening and I said, “there’s no reason for me to get out in the streets and protest.” It’s a protest that I get up every day and not to come to the weight of the world that I feel as a black woman. Knowing that the people around me who are close to me could easily be killed at any point, just because of my skin. People don’t even think this way. Zora Neale Hurston kind of summed it up. She’s one of my role models is that my race, my race is only a part of who I am like brown coloring on top. Like it’s so much of me that doesn’t have anything to do with my race, but it’s just one of the parts, just like I am, you know, I love to giggle.

This is same day. It’s just one of the big. So everybody puts so much merit on it and seeing the differences in us when there’s so many similarities that my experience with racism is every day. Like I hear it. I feel it. I see it all the time and I can tell you many stories.

Because of who I am. I love to have, I love creating, I have an idea and launching things, but I’ve had many circumstances where people did not want to see the merit in what I was saying and what I was doing until somebody white was interested in it. I was capitalized on in some type of way by someone who was white on a regular basis.

That’s a normal thing. There’s always circumstances where someone wants to capitalize on what I have, which I mean, as a black person, I’m never going to have as much as they know. I’m working on trying to create my own dynasty, but like, there is just historical wealth that people who are white have that I will never be able to match.

Right. Because I’m working towards that, I started from the bottom, everything that there’s always someone who tries to align with me to try to capitalize on me, even my supervisor that I had.

Carrie: So like for example, people wanting you to do work for free or expecting that from you and so forth.

Erica: Yes work for free. That’s normal. I’m the kind of person where I get in and I jump full speed ahead into organizations and to opportunities and so I just give away so much information and I’m not paid the way that I see my counterpart being paid or the information is taken. I’m not appreciated for what I was, what I gave.

At all. Yeah. So that occurs. That’s the part that hurts me sometimes. I’ve spent some time with God on that and what God has for me, it’s for me, and whatever I gave away was what needed to be given away.

Carrie: And do you think that people could benefit sometimes from going to a therapist of a different race?

Erica: Of course. I know I’ve been to several people who were not my race and I got something out of each one of them like beautiful stories. Whenever I was in a room with someone, I had a white male one time through my EAP program when I worked at Vanderbilt and I only met with him one time because he was like to the point-blank. He affirmed me and I was on my way. I didn’t need to go back. I was good. I just needed someone to affirm me and affirm things that I did know, because when he talked about the exhaustion that you have in between two programs, getting my bachelor’s and getting my master’s and that loll in between there, I was not trying to give myself a rest.

I was ready to go to the next thing. And he was telling me, no, this is the time to rest. It’s all right. Your life is not going to crumble. Those kinds of things. So it was great. They were a white male, but also, you know, I’ve had, I had, uh, I had a black, older woman who I needed because she was helpful and there was transference that I felt with her that I wanted and I needed because I needed a mother in my life.

I needed it and I got it from her. It was a beautiful relationship. It was very psychoanalytic. So that was the part that I was missing like she didn’t give me much of that, but I found that somewhere else. So I think that every relationship that we have in our lives and not just counselors is something that you need in your life.

You call into your life to happen for you. So just look around and you’ll find the right people for you.

Carrie: I think we have so much to learn from each other. People that are similar to us and people that are different than us, people that look different than us. People that think different than us and people that have different backgrounds. And if we just keep our mind open to what we have to receive from that person like you were saying I think it’s a great thing.

Unfortunately, a lot of times we get so close-fisted to our position or stance on something that we are not willing to look at what’s the other side and why does this person feel so strongly about this? Why does this person who’s out in the street protesting? Why do they feel so strongly about that? Why is this person at home who feels very passionate about these issues, but they’re not protesting and so forth? Kind of like you talked a little bit. How about, is there anything, I guess that you would want to say just as an encouragement to Christian Black women?

I know that it’s, you’re a double minority in a sense, because, you know, there’s somewhat male privilege in our society, whether we want to admit that or not men are often paid more for the same positions than women. You’re also a racial minority and a lot of times what I’ve seen in my practice is that African-American women just kind of put up with a lot of things that they don’t necessarily need to put up with.

And sometimes they need somebody to speak into that space and say, “Hey, you can set a boundary there or you don’t have to do that, or you’re doing too much, you know, let go get some help.” I don’t know, maybe I’m stealing your thunder.

Erica: I remember, I love it that you had a board in the lobby of the suite that I worked at.

I worked out of the suite and it was, she took care of the lobby and everything, and there was a chalkboard and coffee table.

One thing I put on there was I have done enough. That’s something that I was speaking to myself, but black women and all the people that seem to be my clients, individuals that are type A people who are running and running and running to get things accomplished that they feel that they need to get accomplished in life, but they don’t give themselves rest and stuff.

Well, and so they have to decide something. They have to decide that they’ve done enough. I’ve done enough. You know, the thing is, people are going around saying, you know, I am enough, but for these people and those are my clients, the ones that made that message. I have done enough. I want to give them rest. Let’s be strategic about the next step you take.

Let’s not just go right into something else. Let’s decide that this is the next thing for me. And so I find that with black women It’s a crushing feeling of all the things that I have to do. I have to lecture with my male friend or my partner, my children. Oh, we’re doing virtual school right now with my boss.

My mind, I also feel the burden of the whole black community. Recently, we just had another blackmail murder. It just weighs down on us and it makes us want to run to do something to fix it, but I’ve done enough. I’ve done enough.

And one thing, another affirmation I would love to give is that I just recently started and it felt so good was I am at peace with the progress in my life. That made me just do a deep breath because I am. If I could just be at peace at the progress. Because you have done, I mean, just take like you get suspect amnesia and you think that you didn’t do a lot, but if you sit and think about all of these you haven’t.

You can sit and think about what you’re grateful for it makes you sit down and be strategic about the next thing that you’re going to do.

Carrie: Because progress is more important than perfection. Love that.

All right. So at the end of every podcast, because this is called hope for anxiety and OCD, I like to ask all the guests to share a story of hope, which is a time that you received hope from God or another person in your life.

Erica: Okay. I received hope when I had a very traumatic scenario happened. I had a fear of losing a child or my child dying. That was my fear and then it happened and it broke me down and it helped me see all the people around me who were capitalizing on me taking on the responsibility of so much.

I went through a depression and I reached out to a therapist and my hope came from my daughter, looking at me. She was the one that walked me to the car in the middle of my ectopic pregnancy and put me in the car, put the seatbelt around me and said, my daughter who is seven, she put me in the car put the seat belt around me and said, “Mama it’s going to be okay.”

And I knew that came from an inner part of her like that wasn’t a seven-year-old clock. That was God telling me that this is for a reason. All of this is for a reason. You’re going to be okay and in the middle of it, I’ve received that hope. Even though I was in pain there was a piece that I had because ultimately the version of who I am now is so much greater than I ever been. I would never be at a point that I can say, I’m at peace.” I’m not with my progress or even give myself the self-care and the self-love if I had not shared all those people around me and taking all of my energy and taking all of my love and not putting in anything. So that’s my story of hope.

Carrie: Thank you for sharing that. It is really those hard times that we go through that are transformative for us the most. And we can look back and go, “Oh, wow. That was a really hard situation but if I hadn’t gone through that, I wouldn’t have reaped to this benefit over here and I can be thankful for that.”

And you never know who you’re going to meet, who may be walking through similar circumstances that you can encourage as well. And side note, Erica’s daughter is really cool too. She’s fun. She’s a fun human being.

Thank you so much for being on the show and for talking about trying therapy and how we can find a good therapeutic fit.

Thank you for talking to me about hard sayings, about racial issues, and letting me ask you those questions as well. I think that’s awesome.

Erica: Thank you so much. It was such an honor. Thank you so much for reaching out to me to be on here. We’ll love to come back and you want me to talk about something else or whatever.

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Everyone. I had no idea that Erica was going to speak so strongly about her experience related to mental health in the black church and remember this is just one person’s experience that we’re interviewing. It’s on my wishlist bulletin board for guests, I would love to talk with a black pastor who feels like that they really get and support mental health.

So if that’s you and you are listening or you know of a pastor, or this is your pastor and you say, “Carrie, you absolutely need to talk with them.” Please, please get them in touch with me. You can always reach us on hopeforanxietyandocd.com. Thank you so much for listening to the show. If you feel like our content is valuable, I really hope that you will tell a friend and say, “Hey, I found this podcast and I think you might be interested. Why don’t you give it a listen?” I’m sure you know somebody that needs a little hope.

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.

Bring Your Own Tissues: My Experience with Online (Telehealth) Counseling

Written by Carrie Bock on December 16, 2020. Posted in Blog, Counseling, Personal Testimony.

I wrote this about a year before COVID-19 hit. Telehealth (online) counseling was still in the shadows and people were skeptical of it. In 2020, telehealth is more the norm than in person sessions. I felt this was worth sharing as the words are still as true today as they were in 2019.

My therapist lives about three hours away, but I don’t get in a car to see him. I turn on my computer. I’ve been seeing him via telehealth, and it’s been one of the biggest blessings of this year.

7. How PCIT Can Help Your Anxious Child with Anika Mullen, LPC-MHSP

Written by Carrie Bock on December 9, 2020. Posted in Anxiety, Counseling, Podcast Episode. No Comments on 7. How PCIT Can Help Your Anxious Child with Anika Mullen, LPC-MHSP

In this episode, Anika Mullen, a Licensed Professional Counselor specializing in Parent-Child Interaction Therapy (PCIT), shares her expertise on how this evidence-based therapy helps parents manage challenging behaviors and foster emotional growth in children.

Episode Highlights:

What is Parent Child Interaction Therapy?
How PCIT is helpful for children with behavioral problems
How receiving PCIT virtually through online counseling benefits families
Are the tantrums my young child is having a normal part of development?
PCIT Calm adaptation for anxious children
Reinforcing brave behaviors over accommodating anxiety

Episode Summary:

I’m excited to speak with Anika Mullen, a Licensed Professional Counselor who specializes in Parent-Child Interaction Therapy (PCIT). Anika shares how this evidence-based therapy can help parents manage challenging behaviors like tantrums and defiance while also fostering emotional growth and reducing anxiety in children. We discuss how PCIT works for children ages 2 ½ to 7, its origins, and how it empowers parents to support their child’s development and set clear, consistent limits.

What makes PCIT unique is its combination of attachment theory, play therapy, and behavior therapy. Anika explains how these approaches work together to strengthen the parent-child bond and improve behavior. She also highlights the real-time coaching parents receive during sessions, which helps them confidently apply new skills in their everyday environment. Additionally, we dive into PCAT-CALM, an adaptation of PCIT for children with anxiety, which helps kids face their fears in manageable ways while providing parents with effective tools.

If you’re feeling overwhelmed by your child’s behavior or emotional struggles, this episode is packed with practical advice. Tune into the full episode to discover how PCIT can help you build a stronger, more cooperative relationship with your child and support their emotional development.

Resources and links:
Anika Mullen, LPC-MHSP
Parent Child Interaction Therapy

Transcript

For today’s episode, I got to interview one of my friends in the counseling profession. Anika Mullen. It’s kind of like Monica but without the M. It’s what she told me when I first met her. Anika was so sweet because when we went to record this show. We had been talking and got through almost the entire interview. We were towards the end and I realized nothing got recorded. I was absolutely mortified.

I say all this to let you know that I’m completely human and Anika was so gracious. She said, “Carrie it’s okay. Just hit record. Let’s do it again” and so we got a little bit of practice before our actual recording and I think it turned out really well.

Today on the show, we are talking about PCIT which stands for parent-child interaction therapy. This is a therapy that Anika is specialized in and has received training in. She’s going to talk about the origins of this therapy as well as its use for children who have tantrums or behavioral issues. We’re also going to get into how can this help parents support their child who has anxiety.

Let’s dive right into this interview with Licensed Professional Counselor, Anika Mullen.

Anika’s Story of Becoming a Therapist

Carrie: Anika, you and I have known each other for a few years but I don’t know that I’ve ever heard the story about how you decided to become a therapist.

Anika: Yeah, we haven’t talked about that yet. In college, I volunteered with an organization that helps human trafficking survivors. I decided that if I wanted to work with trauma survivors in the future I wanted to get the education and do the work I needed to provide the best treatment we have to offer to address therapy. I decided to get a graduate degree in clinical mental health counseling.

When I was in clinical mental health counseling, I attended a training call with an organization in California that works with sex trafficking survivors. In that call, they were talking about how some of the sex trafficking survivors that they were working with and helping got EMDR therapy, eye movement, desensitization, and reprocessing EMDR. If they had PTSD before therapy, after going through the EMDR therapy process afterwards, they no longer met the criteria for post-traumatic stress disorder. I found that just absolutely incredible that for that level of repeated trauma we have something that is helpful. That really inspired me to get training in EMDR after I graduated and actually prompted me to get to know you because EMDR is one of your areas of expertise.

What is PCIT? What Types of Clients Would Pcit Work Best with?

Carrie: Great and now you’ve taken a little bit of a shift. You were working with children of a variety of ages and some that had experienced trauma. Some that had anxiety. Some that had behavior problems. Now you’ve shifted into your own practice of providing PCIT. So what ages is PCIT indicated for?

Anika: PCIT has been thoroughly researched as an effective treatment for ages two and a half through seven. There is new research now coming out about PCIT for toddler ages. So like 15 to 24 months, and who may be struggling with attachment or regulation and development and even language skills. They are showing that PCIT is effective for that age. There’s also some research being done about an older child adaptation. We don’t currently have randomized controlled trials for older children yet.

How PCIT Was Developed

Carrie. Can you tell us a little bit about the background of PCIT and how it got started?

Anika: Absolutely. Dr. Sheila Iberg started developing it in the 1970s. She was at that time drawing on different types of therapy that had positives. She really wanted to take the powerful, positive aspects of these different types of therapy and so she combined the attachment theory in play therapy which really has a calming effect on children and can be very therapeutic, healing with behavior therapy. It can really help turn around challenging behaviors and increase the behaviors that we want to see.

Drawing on aspects of play therapy and behavior therapy, she also drew on the work of Constance Hanf who is a psychologist that developed a type of therapy that instead of the therapist doing the work, the therapist did was coach the parent in being the therapeutic agent of change. So the PCIT that she developed, she decided to draw on attachment and play therapy as well as behavior therapy to create a combination that really draws on the best of both. Also, she was drawing on the research of Diana Baumrind who was looking at different styles of parenting and what styles tend to have the best outcomes. What was identified in that research was authoritative parent team, which is not authoritarian but authoritative parenting has a combination of warmth and nurturing as well as clear communication and from effective limit setting.

By drawing on behavior therapy that has a lot to do with behavior change and limits and seeing behaviors we want while also drawing on play therapy, she was able to create a system of therapy that increases the nurturing and the connection in the warmth while also increasing predictable calm limit setting. That kind of combination is really for children that might have developmental challenges or, or ADHD or histories of trauma, just certain personalities that can be more challenging to parent.

The authoritative style, when parents can be equipped with those skills, it can really just reduce stress for everyone and increase positive interactions and really help promote healthy, emotional regulation and development.

Carrie: That sounds like she can really combine the best of three different worlds.

Fostering Warmth Between Parent And Child

Anika: She did. Drawing on the work of Constance Hanf, she was able to teach parents those skills through lectures. She would join the parents with an earpiece in their ears, watching through a video camera or one-way mirror and coach them live.

It wasn’t just giving parents all this knowledge and homework and sending it home and saying, “Here you go, this is what you should do.” It was like, “I’m here with you. I’m coaching you every step of the way you can get these skills. We’re going to practice this one. Alright, let’s work on this one today.” And then a lot of encouragement and praise until the parents have the confidence that they have the skills to manage the more challenging elements of parenting.

Carrie: Because how many times have you, or I’ve been taught something with someone else and we think, “Oh, I got this. I’m good” and then we leave that environment and go to do it on our own and we go, “Oh no. What was it they said right there?”

Anika: The close working relationship where I’m really encouraging the parents and prompting them with little reminders when needed on the skills and celebrating those successes, it helps them turn around with that same optimism and warmth to help their child. It’s very supportive on the therapist to parents side as well as the parents to child’s side. That warmth is really established as the first part of therapy, the play therapy, warm, nurturing aspect. That’s something parents receive from me as well.

Equipping Parents With Information And Skills

In the second part of therapy is where I really equip parents with the skills to address the more challenging behaviors that something that their child is experiencing.

Carrie: There are several different types of therapies for children as you just named. Some are less directive than others, for example, non-directive play therapy. The child will come into a room full of toys always with the play therapist and the play therapist may reflect what the child is interacting with in the relationship to them and the toys, whereas PCIT is a lot more of a structured approach.

Anika: It is structured in that there are different stages of therapy. In the first stage of therapy, we actually teach parents professional play therapy skills. We teach them reflection. We teach them other play therapy skills. What that does is it really sets the foundation needed when we get to the limit-setting stage that is more structured like behavior therapy.

Carrie: Right. I know that you’re also a parent yourself. Could you tell us a little bit about how learning about this therapy impacted you as a parent?

Anika: It really, having seen how transformative those parent play therapy sessions are with kids. It made me want to offer my child the same thing. I see building kids’ confidence, building kids’ social skills, and just increasing the likelihood that the child wants to please the parent and cooperate and be a team.

Seeing the positive impact that five minutes a day of play therapy with their kid had on so many kids’ lives, I want my kid to have that too. So what we call special time as part of our everyday life now it’s just something that my kid can count on. It tends to be calming and then just a really therapeutic time to connect. I’ve also found it just really built my confidence in how to address non-compliant behavior. Often for a lot of families, getting out the door in the morning, getting to the school bus on time is a highly stressful time and it can easily lead to what I call the escalation cycle where one person raises their voice, the kid doesn’t comply and gets irritated and reactive and then it escalates more and more as the bus is coming and we’re still not ready to get out the door.

PCIT has really equipped me with the skills to increase cooperation in a positive way, and also to firmly set limits when they need to be set because limits actually help kids feel safe. They actually reduce anxiety. Sometimes kids listening to limits can save their lives. Limits are a very important part of parenting and PCIT really helps parents in tangible ways to see that balance of worth and nurturing and clear, calm limit setting.

PCIT Improves Child’s Minding and Listening

Carrie: I know you work with parents who by the time they get to you, they may feel they’re at the end of their rope. They may feel so overwhelmed by their child’s emotional outburst or by their avoidance of behaviors because they’re angry. They won’t sleep in their own room for example and parents may say, “I don’t understand what happened because I did the same things with my second child that I did with my first child and it’s just not working. Can you speak to that a little bit?

Anika: I work with a lot of parents who’ve been getting a lot of mixed advice from a lot of different people. It may be a parent or a grandparent or a religious leader or a friend or everybody’s just giving them advice about how to respond to a child’s behavior. I find it really helpful that I have this ability to draw on over 40 years of research of professionals who’ve worked with really challenging children about what really helps turn dynamics around and replace that escalation cycle with respect and cooperation and what we call in PCIT, minding and listening. So following directions and heating the rules and having these tools, I can encourage parents like, “Yes. I hear that this other approach hasn’t worked but I’ve seen PCIT work for a lot of families. Let’s just give it a try.”

I really see my role as encouraging those parents and being the new wind in their sails and giving them tools that they haven’t had before, or haven’t applied in this way.

PCIT Via Telehealth

Carrie: You and I had a conversation early in 2020 about online therapy and the benefits of it and how to really encourage people to engage in online therapy because so many people have been hesitant. Then we had a pandemic and all of a sudden, pretty much all therapists were online. We’ve really seen the way that people are receiving services be transformed in the midst of which I think is a good thing that’s coming out of a very hard situation in our country and world. And you made a decision actually to go be an online therapist before the pandemic. Can you talk to us a little bit about that decision?

Anika: One of the things I love about PCIT is it helps catch things early on before they become more ingrained habits and patterns of behavior. So turning around aggressive behavior with PCIT and a preschooler or early elementary age child it’s 12 to 20 weeks so three to four or five months at the most. Research says that the impact of PCIT even six years later is still there. Since it’s such a powerful intervention, I wanted to find a way that would make it more accessible to more families.

PCIT offices historically needed those two-room spaces. They often were in a city or in a university setting. So people farther away from cities and universities didn’t have access to it and now more therapists are getting trained in it. Recently, they became licensed in Nevada and in Alaska because Nevada only had one PCIT therapist in the whole state and Alaska had no PCIT therapist. So by going online and by being telehealth, I was offering an equally effective treatment that was just way more accessible. You didn’t have to fight traffic to get there. You didn’t have to be close to a PCIT therapist. It just helps make it easier to fit into family’s lives and at times less costly too cause I’m not fronting the cost of having a double office as well.

Carrie: Right. One of the things that’s great about utilizing PCIT online is that the parents are able to practice these skills with their children in their own home. I think that’s a beautiful thing.

Anika: Absolutely. They’re finding that the behavior changes are easier. Instead of a child coming to an office and learning these new ways to interact and the parent applying the skills in the office, we’re coaching families in real-life settings at home. And so it’s easier for those new skills and new behavior patterns to stick because they’re in the environment that they’re part of every day.

How PCIT Can Help With Anxiety In Children

Carrie: Right. I know you told me that PCIT also has an adaptation specifically for anxiety. Can you talk a little bit about that?

Anika: Sometimes kids with anxiety also have externalizing behaviors. We call it outbursts and defiance when given a command because they’re anxious about whatever the situation is. There are also kids who are just anxious but are actually pretty compliant and eager to please. With kids that were both anxious and had defiant behaviors, the therapist and researchers were finding that PCIT was very calming and it helped reduce their anxiety.

They did an adaptation of PCIT, which we call PCAT-CALM. This adaptation is focused specifically on kids that are experiencing anxiety but don’t necessarily have behavior problems. Again it uses the same approach of having the parent be the agent of change. The parent being the ones doing the play therapy with the therapist coaching in their ear and supporting them along the way. It teaches parents ways to increase the child’s sense of calm and security. Also, how to help the child when the child is encountering situations that once the child is afraid of. For example, if a child is afraid to go to a new place or talk to new people, or is afraid to go to sleep in their own bed or afraid to sleep without all the lights on, it teaches very simple steps parents can take to help support the brave behaviors.

Oftentimes kids will seek out parents for a lot of reassurance and nurturing when they’re anxious and parents are in a tough spot because you want to help a distressed child. You’re caught between rock and a hard place like you don’t want to encourage avoiding the thing that’s safe and that it’s okay for them to practice being brave with. If your child is in distress, your natural urge is to support them and help them through that. Unfortunately, what happens is with anxious children they’ll seek reassurance and get that nurturing that helps them calm down in the moment, but the next time they’re anxious their habits going to be, “I’m going to need more reassurance.” So it kind of fuels the cycle of avoiding and getting reassurance instead.

With PCIT we train parents how to have a lot of that nurturing and that warmth during the play therapy and calm, strategic ways to increase brain behaviors when the child’s facing something that is safe but that they’re afraid of.

Carrie: I love that because so many parents who have anxious children also struggle with anxiety themselves. This model seems to help build their confidence as a parent and being able to help their child with anxiety, which I imagine may in turn, help them with their own anxiety too.

Anika: I find parents want to do the best for their kids. [00:18:20] So when they know clearly this is what they can do and it’s going to help their child learn to be brave even when feeling some levels of stress, it helps the parents be brave when they’re feeling the stress of their own child being anxious. I find my role as supporting the parents in being brave with these new parenting techniques and steps and then the parents are able to turn around and provide that similar support to their child.

Carrie: Great. Maybe there’s someone listening today who is feeling a little overwhelmed like, “I don’t know if I could take in all this new information and really learn it. It sounds kind of hard.” What would you say to them?

Anika: I would say that parents that reach out are often under a lot of stress already and it’s like, “how can I do one more thing? Life’s already stressful enough to juggle.” What I’d say is that the process is designed in a really step-by-step manner and not going to teach you things and then just send you home to do it all on your own and figure it out on your own. I’m not going to be upset if you’ve had a hard week and it’s been hard to use the skills.

What To Expect In A PCIT Session?

The beauty about this PCIT is that I get to be there with you in your home via the video camera with an earpiece in your ear like a Bluetooth earpiece or even a headphone. I get to support and encourage you as you’re practicing these skills that get to praise your little successes.

I get to join in the process with you and really be a supportive, safe place for you to develop these therapy skills that are going to help your child so much and it’s not all at once. There’s two stages to the therapy. Usually, there’s the first meeting where I get to know you. I get to hear about your concerns, the struggles that your child’s been having. The next one, I get to observe the child and in different kinds of settings and interactions. After that I meet with just the parents, I teach them some of the skills that we’re going to be practicing in the first stage. We role-play them. We answer questions about them and then learn them. I join you in practicing them.

So again, in your home, your child being your normal child and I get to coach you in the moment, how to apply the skills. Then when we get to the second stage of therapy, after that, play therapy foundation’s been laid. That’s so critical. They’ve actually done research where they tried to do the predictable limit setting part of treatment first and then do the play therapy afterward. It’s not as effective that play therapy, that nurturing warm business central foundation for addressing the challenging behaviors.

So when we get to the second part of therapy, we don’t even move on until the first skills come easily. You don’t even have to think about the first set of skills so much when you get to the second part. Once they’re fluid, it’s fluid and come easily. We move to the second part and again, I’m right there with you and coaching you. I praise you for the efforts and the successes, and it’s just really built step-by-step so that it’s not overwhelming. So it feels really doable and manageable.

It’s Okay To Seek Professional Help For You Child

Carrie: One of the things that we’re all about on this podcast is reducing shame. There may be a parent out there that feels overwhelmed and feels like, “Oh my gosh, I’m feeling my child and now I’m at a level where I need professional help.” What would you say to that parent?

Anika: First of all, I really respect the parents that reach out and kind of bust through that shame barrier because the parents that I work with, like I said, they often have another child that they’re parenting worked fine for. They’ve often tried things that so many people have said to try with the child and it’s just not working and it’s okay. It doesn’t mean that you failed that you’re reaching out at such a crucial time. It shows me that you really love your child and that you’re ready to do what it takes to help turn this situation around, which I find wise and insightful, and courageous.

Carrie: Absolutely. We know that it’s a lot easier to intervene early than it is to wait until later and that’s really true of any mental health difficulty. If you’ve been struggling for a long time that doesn’t mean you shouldn’t get help. Any time that we can say, “Hey, I’ve hit a speed bump in the road of life and I can’t seem to I’ve tried my non-professional avenues and I can’t seem to work through that.” Maybe it’s time to look into professional counseling.

Anika: The fact that you’re even considering it takes courage. I know that there can be different messages in different communities about seeking mental health care, being a problem. I find that often after graduating from PCIT, parents are just really proud of being such a key part of the process like they weren’t the problem. By having these professional therapy skills, they’ve really been such a big part of the solution like I’m not training people how to be the average parents. I’m training you with these expert skills to intervene with anxiety and with behavior problems. I find that it really builds parents’ happiness and they can sometimes also be insightful in their own circles then as well and somebody that other people look up to.

When To Seek Professional Help for Your Child’s Behavior?

Carrie: I love that. So I know that in our society, sometimes we really normalize behavioral challenges at certain ages. We say things like, “Oh, you know, they’re just going through the terrible twos or the terrible threes and it’s normal for young children to throw tantrums sometimes.” How do we know if it’s a normal behavior or if it’s something where maybe we should seek professional help for?

Anika: Excellent question. It is normal for young children learning about limits and regulating their behavior. For example, up to two and a half, those temper tantrums are a normal part of development. Where we start to get concerned is if after two and a half, they’re not going down in frequency or they may be going up in frequency, duration, and intensity. If there’s concerns at preschool and daycares about aggressive and defiant behaviors is kind of like a red flag. There is a sign that help could be really beneficial at this point is if you see what’s called the coercion cycle. I tend to like actually the term, the escalation cycle where a parent sets a limit, or it gives a command for a child to do something and the child then says, “No, I’m not going to” or “You can’t make me go.”

It starts to escalate. Then the parent escalates with the threat and then the kid gets more angry and then it sometimes ends up in some type of aggressive interaction, or the parent giving in just cause this is so exhausting and I’m not going to deal with it right now. So if that kind of escalation is becoming a normal part of everyday life, that’s a really great sign that PCIT could be a really good tool to come in and turn that dynamic around before it becomes more ingrained.

Carrie: Kids don’t want to be in that cycle and parents don’t want to be in that cycle. So both people end up losing because I think the child, even though they may get what they want in the short term, they’re not getting what they need in the long-term.

Anika: It doesn’t feel good to anybody, but it’s a cycle that is really easy to get caught up in especially if there’s really high levels of stress or if there’s just certain child personality, characteristics, or even developmental delays or challenging conditions like ADHD that just lead to a lot of impulsivity and hyperactivity whether there’s like an underlying biological issue that made their child more challenging to parent or not. It really gives the parents the tools to turn things around and to really be proud of their children’s cooperation and minding and listening.

For anxiety, you’re asking about how to know if you should seek out help. Some childhood fears are normal and they don’t necessarily interfere with a child’s life. They’re not impacting their ability to make friends. They’re not impacting their ability to be dropped off at daycare. Oftentimes, one of the most common early childhood anxiety disorders that I see is when a child’s afraid of separating from a parent, that can be really stressful for both the child and parent because the parent needs to get to work and the child needs to let go of their leg and be dropped off at daycare. So if the child’s anxiety is impacting their ability to sleep or they’re having lots of tummy aches and headaches, and just not being able to do what you and the child need to do throughout the day, that would be a sign that it’d be a good time to reach out for some professional support.

Carrie: I think that’s great advice. There’s a difference between a child saying, “Hey, I’m afraid of the dark” but then they’re still willing to go sleep in their bed versus a child that says, “I’m so afraid of the dark” that they refuse to sleep without a light on or refuse to sleep in their own bed.

Anika: Absolutely. I haven’t talked so much about the PCIT but it is also very gradual. We’re not going to ask the child to face their biggest fear on day one. We’re going to increase their level of security, increase their self-confidence, and then we’re going to slowly start engaging in situations that previously caused anxiety and teach them to be proud of themselves for being brave. It’s really a sense of accomplishment that the child has at the end. It’s not like a big terrifying experience.

Carrie: You and I both know from working with a variety of people that gradual behavior changes are often the best and that we’re going to see more lasting impact that way.

Valuing Clients Faith As Part of Their Identity

Carrie: This information that you’ve shared about PCIT I know is going to be super helpful for our listeners. I wanted to just briefly ask you a little bit about just so people can understand where you’re coming from like how you identify spiritually?

Anika: Some of my values are just in valuing humanity and our connectedness. I’m a firm believer in loving our neighbor and really speaking up for the cause of the oppressed and caring about those who are less fortunate than us. Times where I feel the most spiritual or connected are when I’m outdoors on a hike and I see like the sun filtering through a canopy of beautiful old trees. I really feel the most alive and connected outdoors and surrounded by the beauty of nature all around.

Carrie: I see a variety of Christians in my practice, but we may be coming from different denominational backgrounds or express our Christianity or live that out in different ways. I really want people to know that there are times where they can seek professional help from someone that may be outside of their faith and that person will still be respectful of their faith boundaries based on professional ethics and so forth.

I really value people’s faith as part of their identity. I’ve worked with a lot of different people and in my family, there’s a range of faith and beliefs myself. It’s all across the spectrum. I see people whose faith and his Christianity is such a source of strength, resilience, and community and connection, and inspiration to do what is right and just, and defending for the cause of the oppressed and just such an inspiration.

I’ve also worked with people who have found religion to be a source of trauma and pain, and they have not had healthy experiences in their churches, their communities. Really I want to be able to work effectively no matter who walks in my door. I care about the health and wellbeing of their child and the tools that I have are very applicable to diverse cultures and to diverse faiths.

I’m not going to change someone’s faith when they walk in the door, I’m going to say like, “Okay. So what do you believe? What values are important to you?” And then, “How does PCIT work with those values and work within your worldview?”

Discipline Instead of Punishment

Carrie: Right. I think the basic components don’t go against biblical principles. Essentially, you’re working with investing and having healthy, positive relationships with your children, having discipline, and limits is definitely a biblical principle.

Anika: I do think that the word discipline actually comes from the word disciple and so the goal of discipline is to teach. It’s not to punish. That’s really one of the things that we help families to do in PCIT. Oftentimes the escalation cycle can lead to a lot of punishment, but it doesn’t stop the escalation cycle from happening the next day.

Oftentimes punishment can seem like it works in the moment, but for certain personalities and certain children, it can actually increase the frequency of the escalation cycle. Whereas discipline is an important part of the Christian faith. We teach clear limit setting, following through. It helps your children to respect what you say, and to mind and listen to the limits that are set. I’ve seen Christian families really benefit from the PCIT process.

Carrie: I like that because I think it also supports this value of communication with your children where you’re not disciplining out of anger, and you’re not allowing yourself to be ruled by that anger, which I believe is also biblical.

Anika: It also really values love and not provoking your children to anger. I think it really can fit well within a Christian worldview.

Carrie: Awesome. That’s one thing that I want all our listeners to hear is that even though there are a variety of therapeutic techniques out there, and many of them are not in opposition to what we actually believe. And so we don’t need to be afraid when we’re seeking help for ourselves or our children that somehow we’re going to be given advice to be turned away from Christianity or we’re going to be misled or misdirected in some way, shape, or form. If that does happen, then that person is probably not acting in a truly ethical manner.

Anika: As therapists, we’re trained to be able to provide helpful skills that have been found to be effective for other people struggling with the same situations, but to be able to share them with people who maybe from different backgrounds than we are, it would be unethical of me to try and enforce my beliefs or my spirituality on the family that I were to be working with.

Carrie: I appreciate us being able to dialogue about that piece because it drops some of the mystery of what actually happens in counseling a little bit in a professional sense so maybe reduces some stigma and shame there as well.

Anika: Absolutely. I also welcome families to let me know if there are elements of their faith or their belief system that they want to incorporate in our work together.

Anika’s Story of Hope

Carrie: That’s good. That’s really good. So one of the things that since this podcast is called Hope for Anxiety and OCD, I love to ask our guests at the end of every podcast to share a story of hope. This is a time in which you received hope from God or another person.

Anika: One of the most challenging times of my life was when I was pregnant with my child and I had a condition. It started five weeks before my child was born and my body broke out in hives and blisters from my rib cage all the way down to my toes. It was very hard to sleep. It just felt like I was constantly burning especially my fingers and toes because there’s so many nerve endings there. It was just very hard to cope with. It’s a pretty rare condition. For the majority of the women that have it, it fades away after the baby’s born. In my case, I was one of the very few that it continued after my child was born for about five more weeks. After my child was born, it did not go away. I no longer had an end date like a bunch of that point.

All I have to do is make it until the baby is born and all I have to do is make sure he’s born. It was still there and I had an infant to feed and take care of. I guess the point where I couldn’t even sleep I would be getting through the nights with ice packs on my fingers and my toes and taking three or four hot-cold showers to reduce the level of burning sensation that I was experiencing.

I think it would have been really easy to become hopeless at that time. Just I was not getting enough sleep. It’s already a stressful time of life and also it’s a very idealized time. You should enjoy every moment of it. They’re only going to be little once. It could’ve been really easy to go down the, “why me, why did this happen to me route.”

One thing that gave me hope and really helps me through that time was remembering family members who had walked with a child through open-heart surgery and eventually the death of their child. Just their courage and strength walking through that time gave me hope that I could get through whatever I was experiencing.

It just really helps put it in perspective and remind me that people have gone through such difficult things and have come out of it as such beautiful, wonderful people that there is another side to this, and I can get through this however long it’s going to last.

Carrie: Thank you for being so vulnerable and sharing that story. I know that’s going to impact somebody and encourage them in a positive way today as well as listening to this.

Thank you so much for being on the show. I just appreciate your friendship really and truly over the years. I think that we share a lot of the same values therapeutically and just from a human [00:36:49] connection standpoint of just wanting to love on people and provide really high quality, good counseling services to them. We’ve gotten the opportunity to just see people be empowered and set free from things that they thought they would never be released from. That’s just what keeps us going every day when it gets hard. Thank you for all that you do.

Anika: I really appreciate your friendship as well. Really seeing the transformation that happens in families and seeing the changes, that’s what keeps me going. It’s what inspires me to keep doing what I do.

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That was my first time hearing about Anika’s story of hope and I was really blown away by that. And also just blown away by her courage and willingness to share that.

If you’re a parent, I hope that in some way you were encouraged by this episode. If you know a parent that would benefit from hearing it, please let them know about our show. About this episode, you can always find us online anytime 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.

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