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25. Making Church a Welcoming Place for People with Mental Health Struggles with Dr. Steve Grcevich of Key Ministry

Written by Carrie Bock on . Posted in Anxiety, OCD, Podcast Episode. No Comments on 25. Making Church a Welcoming Place for People with Mental Health Struggles with Dr. Steve Grcevich of Key Ministry

I had the privilege of interviewing Dr. Steve Grcevich of Key Ministry.  Dr. Steve is helping churches learn how to minister to people with disabilities including mental health. 

He shares about what moved him to begin his mission of connecting churches with families of kids who have physical and mental disabilities. 

  • Different scenarios and social interactions in church that trigger the anxiety in kids and families.
  •  Barriers that make it more difficult for kids and families to be part of the church.
  • How to help kids and families with anxiety and other mental health issues feel welcomed and included in church.
  • Communication strategies and inclusion plan to help people feel more welcome in church.


Links and Resources

Key Ministry
Book: Mental Health and the Church

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Transcript of Episode 25

Hope for Anxiety and OCD episode 25.  Today, I had the privilege of interviewing Dr. Steven Grcevich. I believe that’s how you say his last name. He also told me I could call him Dr. Steve. Dr. Steve is going to tell us about a ministry that God laid on his heart to start that helps churches know how to reach and effectively minister to people with a wide variety of disabilities including mental health. So without further ado, let’s get into the interview. 

Carrie: Tell us a little bit about yourself.

Dr. Steve: Carrie, thanks so much for having me on your podcast. I wear a lot of different hats. So in my tentmaking job, I am a child and adolescent psychiatrist. So I’m with physicians. I went to medical school, actually, I got accepted into medical school when I was 17 years old. It’s a little bit of a Doogie Howser kind of thing through an accelerated program. I have a private practice in suburban Cleveland. I teach at a couple of different medical schools, the child psychiatry fellows. I helped teach evidence-based medicine to medical students. Again, maintain a practice. I do some training for Mental Health Professionals and some of the surrounding counties. And then the other thing that probably takes up about half of my time is that almost 20 years ago, I was involved with starting Key Ministry, which I think we’re going to talk a little bit about today. 

Carrie: So, how did you get to that place of seeing a need for key ministries or a desire to start that?

Dr. Steve: This is probably about 25 years ago. I was on the elder board at my church. This is mid-1990s after the fall of the iron curtain.  We had a whole cohort of families who went over to Russia and Bulgaria and adopted some kids with some really complex emotional behavioral, developmental issues, trauma out of orphanages in Russian Bulgaria after the fall of the iron curtain.

And I’m sitting at an elder board meeting and the person who at the time was our children’s ministry director ended up on our ministry board later on down the road. I came in to do a presentation to talk about some of the struggles that these families were having in terms of staying engaged with church. As you can imagine that these were folks who had been very devoted, highly committed. These are people who are volunteering. They’re serving in leadership roles.

And then kids with other mood disorders kind of in that order. And so not like anything that we would go ahead and submit to a journal or as some sort of formal study. Over the next three months, I just did a survey of families as they were coming through the office for routine follow-ups.

There was one question, “what impact did the challenges that brought you and your child to our practice have on your ability to participate at your church or place of worship?” And I was floored by some of the stories that we started to hear. One in particular that was really memorable was that there was a family that I was seeing where they had a couple of little boys with pretty severe ADHD.

They started describing to me sort of what their experience was like going out, trying to find a church for their family on the west side of Cleveland with these two boys in town. Interestingly enough, they ended up at our church. And we’re giving their testimony at one of the services, talking about the impact that the supports that our children’s ministry was able to offer it had on their family. And the comment that the mom made is the people in the church oftentimes think they can tell when a disability ends and bad parenting begins. And so we oftentimes find that when we have kids with different emotional behavioral issues, and in my practice, I see this a lot, where kids who are anxious oftentimes manifests in anger, moodiness, and irritability.

I’m sitting there, listen to this stuff became obvious that there was an issue. And as God would go about orchestrating things around that time, I had one of the three original research grants for Adderall, which became the most commonly used medicine in kids with ADHD.

I got asked to travel around the country, do a lot of lectures to different medical groups, physician groups. And in the introduction, wherever I went I would say something about the work that our church was starting to do with families who were having some of these kinds of struggles. And the church started getting inundated with requests for help. Basically, Key Ministry came about.

Our current mission statement is that our mission is to help connect churches and families of kids with disabilities, for the purpose of making disciples of Jesus Christ. At the core of that, and sort of our original focus on what we saw as the unmet need was that our focus was on helping churches welcome and include families of kids with quote, unquote hidden disabilities, emotional behavioral, developmental neurologic conditions where the disability wouldn’t be obvious, say in a still photograph of that child. Johnny is just an absolutely wonderful lady. She did great work in terms of helping folks with physical disabilities be part of that. Around that time, the early two-thousands, we began getting like more and more awareness of some of the challenges. For example, families face when they had kids on the autism spectrum as more and more kids got diagnosed.

So, the next wave of this is that churches became very proficient or many of them became proficient. There were good models for serving families where they had kids who quote-unquote special needs. Basically kids with more severe intellectual or developmental disabilities, but by far and away, like if you take a look at the child population in the United States, 75% of kids with disabilities have primary mental health disabilities.

And there’s some fascinating research that came out a couple of years ago. Andrew Whitehead, who was a sociologist at Clemson University, went through about a quarter-million interviews with parents from three waves of the National Children’s Health survey. It’s done every two to three years by the federal government.

This is where they get these statistics that like one in 46 kids has autism, stuff like that. And interestingly enough, one of the questions that they ask as part of this is, “has your family attended a church or a place of worship at any point in the last year?” And what they found was that families who had a kid on the autism spectrum were 84% less likely than other families unimpacted by disabilities to ever set foot in a church. But it was 72% for families where they had a child with depression, 55% for kids with a disruptive behavior disorder, oppositional defiant disorder, conduct disorder, and 45% when we’re talking about kids with anxiety disorders. There’s actually 19% for kids with ADHD. In comparison to that, when they looked at other disabilities, like for example, Tourette’s disorder, kids with intellectual disabilities that didn’t have much of an impact in terms of church attendance at all.

And so when you start talking about sheer numbers and so in the population we serve, children and teens, probably about one in 10 meets criteria for a significant anxiety disorder. The number of kids and families who are impacted by these mental health concerns is far, far larger than the number of families who struggle with what we have traditionally referred to in the church as special needs.

So within the context of what we do in our ministry, there’s a lot of stuff that we do that we put on an annual basis. We couldn’t do it last year because of COVID, but the largest disability ministry conference in the United States.

We have a group that we moderate for 2100 special needs and disability ministry leaders from around the country. So we do all kinds of training consultation, offer all kinds of free support to churches.

My role specifically had been to work on developing a model for churches that are interested in doing mental health inclusion. So we have other folks on our team who will consult and work with, again churches that are looking to serve kids with sort of the traditional intellectual developmental disabilities.

[00:10:44] My piece has been developing a mental health inclusion model that churches can follow if they want to serve this larger population of families. That is probably, and it’s interesting, there’s guy Lamar Hardwick who’s up. Fascinatingly, he’s an African-American pastor of a mixed-race church in Atlanta who was diagnosed with autism in his mid-thirties, wrote this book called Disability in the Church.

And one of the points that Lamar made is that the largest minority group in the United States are individuals and families affected by disability. With all the conversations that are going on in terms of talking about diversity and the need for our churches to become more diverse, one of the places we need to start is by thinking about folks who have this range of conditions. Where many of them, the presence of their mental health condition or the presence of a family with that condition has made it impossible for them to be part of church.

Carrie: Can you talk a little bit more about that as far as what specific things were they encountering that were keeping them from being able to go to church? Like lack of feeling welcome maybe because their child had a disability or just their child being too anxious to be in a group setting. 

Dr. Steve: So what if we take a look at sort of mental health, if we think about sort of mental health collectively as a whole, in the model that we put together, part of what we train churches around is the idea of there being seven barriers. The first one is stigma. In that, for example, there was a study. This is maybe six or seven years old from Lifeway research, where when they interviewed quote-unquote unchurched adults, 55% of them endorsed the notion that people with mental illness aren’t welcome at church. 

Carrie: That is so sad. 

Dr Steve: And interestingly, in some of maybe the more theologically conservative denominations that are more focused on outreach and inclusion, like going back to theological devotee, sixties, seventies, and eighties tend to be the ones that have less insight and less understanding about the nature of mental illness. But no, this stuff is not necessarily a sin problem. There are things that people are born with. And as you know, in your practice, that there are ways in like the lives of individual people who wrestle with this so that there are ways that God uses this stuff in terms of drawing people into closer relationships and deeper relationships. So the churches that are most interested oftentimes in doing outreach and inclusion are the ones that in some instances are the places where maybe mental health concerns tend to be more stigmatized. So that’s the first one. 

The second one is anxiety. And I would argue that that in and of itself. Of all these barriers that’s probably the most common one and the anxiety disorders out of all the different mental health disorders are the ones that are most likely to keep the most people out of church. But we’ll talk about that a little more in detail. 

The third has to do with executive functioning and self-control. Pretty much every mental health condition that you think of ultimately, or to some degree will impact people’s capacity to self-regulate emotions, to modulate impulse control, to be able to plan to exercise self-discipline. And folks with conditions like ADHD would be sort of the prototype of this.

Again, there are many other mental health conditions, significantly impacted. If you’re a family and if you have a kid who has a hard time sitting still, or not shouting out in the middle of a worship service. I had a very memorable case. This was a family that came from out of State to see me.

This may be 15 or 20 years ago where the father was a Southern Baptist pastor in Appalachian, West Virginia, Virginia, somewhere like that, where he came up to see me. And actually, his family doc gave him the money to come on up to our practice where they had adopted a little boy who had pretty severe issues with ADHD and impulse control or aggressiveness.

Shortly after they adopted this five-year-old boy, he punched the son of the guy who was the chair of the elder board. And they fired the father for not having appropriate spiritual control over his family when it was obvious that they adopted this kid who had been through very traumatizing situations.

But when you think about like in the Bible and you think about scripture, like the book of James, self-control is very closely acquainted with sort of godliness and spiritual maturity. Ability to demonstrate that especially for kids becomes like really important. If they’re going to be able to fit into a lot of activities at church.

The fourth is sensory processing. Folks think about this as being an issue with folks on the autism spectrum, but it turns out that folks with pretty much every condition and DSM can experience issues with sensory stimulation. And it’s particularly common, in addition, autism among folks with anxiety disorders and ADHD.

And so that for some people like the bright lights, the very loud music, the very sort of stimulating worship environments. You see in a lot of the contemporary churches, for some folks becomes absolutely overwhelming to the point that it’s aversive. 

The fifth is social communication. We think about churches by nature are intensely social places.

And so if you’re somebody where maybe you feel uncomfortable with self-disclosure with other people or you have a more difficult time picking up on tone of voice, inflection of voice, body language, facial expressions, you’re really going to struggle in terms of like the interpersonal stuff that goes with those being active at church. 

The sixth is social isolation because as you know, think about folks with common mental health conditions, people with depression isolate, oftentimes as a symptom of that depression. Folks with social anxiety oftentimes they’re going to avoid situations where they’re going to come in contact with and meet a lot of people and make a lot of new friends. Families who have kids with mental health issues.

The kids are less likely to be involved with athletic activities are less likely to be involved in extracurricular activities. They are less likely to be in situations where they meet other families who will invite them to church. Not to mention the fact that for a lot of the kinds of families that like your practice serve and that we serve, mental health treatment can be fairly expensive.

And a lot of times, I mean that there are lots of treatment costs that these families are incurring either for themselves, for their children, and either finding babysitters or childcare is too expensive. Or when you have a kid where you just can’t let any 14 year old down the street come over and watch them. It was very hard to become part of the social fabric of your neighborhood or the community. 

And then the seventh one is past experiences of church because I don’t know about you, but about 30 minutes into child psychiatry school, I think I figured out that the apple doesn’t fall far from the tree and that the kids who have these struggles oftentimes have parents who have these struggles.

And so part of the challenges is if the parent had an issue that kept them from being part of church, when they were younger, it’s highly unlikely that any of their children in particular kids who may have a similar mental health condition are going to be part of church. So those would be sort of the big ones that we ask churches to think about. Stigma, anxiety, executive functioning of self-control, sensory processing, social communication, social isolation, and past experiences at church. 

Carrie: One thing I will say about that, that’s interesting is there’s this thing with church, it seems like with leadership and wanting to reach people where you either get one of two situations with a church.

You either walk in the door and it’s almost like everybody attacks you. Like you have the football like it’s “so we’re so excited to see you and, oh, it’s such a great day. Have a good Sunday. Here’s your bulletin.” You know that you either get that response or you kind of sneak in the door and then you sneak out the door and no one talks to you. But then maybe you go home and you go, “No one talked to me at church today” you know, I guess they really don’t care about me.” So how do churches like find this balance and this fine line between reaching people and letting them know that they’re loved and cared for in that environment without overwhelming them? 

Dr. Steve: One of the first things that we try to help churches to do, because the level of understanding, again, from church to church, depending upon what kind of education the pastors have had, the people who are serving on staff at that church can vary so much. One of the places that we’ll start is by helping to kind of educate them about some of the things that they would anticipate being struggles in folks with common mental health issues and to kind of try to put them in their shoes here. I’ll give you an example of a little exercise that we would use as sort of like a little starter, like if we’re going in and if our team we’re doing a big training or if we were training an individual. 

Let’s imagine that Samantha’s family lives down the street from your church. Samantha’s a single mom. She has a nine-year-old son and a seven-year-old daughter. The nine-year-old son got invited to vacation Bible school loves it, wants to go church every week and is begging mom to take the family to church. The nine year old son has ADHD and dyslexia. His seven-year-old sister has a separation anxiety disorder and the mom has social anxiety disorder and agoraphobia.

Think about all of the potential places where something could go wrong and where they might encounter a problem the first time that they would go to attend a church. And so one of the ways I talk about this with families in our practice on the church leaders is that as you know from a lot of the research has been done in terms of neuroimaging. To try and understand what’s different in the brain in folks who struggle with anxiety disorders is that we know that they’re basically hardwired to overestimate or distort the level of risk involved with entering into new or unfamiliar situations.

And so think about what that’s like if you’re visiting a church for the first time. For their family, one of the places that’s going to start is I would bet that mom is going to be looking on that church’s website before she even thinks about putting her kids in the car and going, because the kinds of things she might be worried about would be, “Am I going to stand out?

Will I be dressed differently than everyone else? Will my kids be dressed differently than anyone else?” But there are enough sort of strange stories floating around. It’s interesting, my son-in-law and my daughter in medical school, down in Alabama. And I heard stories from my son-in-law when he first moved down there, it was like looking for a church and, “oh, he was a newcomer.”

And so everybody stood up in the church and came around him to lay hands on him, to welcome him. Yes. So again, if you’re a mom with social anxiety, even the most remote prospect of something like that, or having somebody walking around during prayer time, handing you a microphone, and asking you to introduce yourself, it would be terribly overwhelming.

So you get over that. You figure out how you’re going to dress and you get to church. How many social interactions does mom have to navigate the first time she goes before, she herself, is able to go into the worship center and sit down. So you have the greeter in the parking lot. You probably have like the greeter or the person at the main entrance or the entrance for children. Now because of there for the first time, she has to register both of her kids.

So that there’s like the children’s ministry volunteers who are at like the check-in and the worship center. And of course, they’re going to want to introduce them to the volunteer people who are teaching their Sunday school class. And maybe if the church isn’t too large, probably the guy, the children’s pastor or the student pastors probably going to come over and want to introduce themselves.

So by the way, when the daughter finds out that the expectation is that she will be hanging out with like other girls in the first or second grade Sunday school class, and not with mom on the other end of the building in the worship service, the daughter starts to have a meltdown because of her anxiety at the prospect of being apart from mom.

So by this time, they’re already like five minutes into the worship service, Mom gets to the worship center. And mom with agoraphobia finds there are only middle seats open in the front five rows in the worships. 

And then is there some time during the service where people are expected, like pre-COVID to greet each other and people are shaking hands and hugging on your way out. You have people who are a lot of places have like a welcome center for like new visitors. If you fill out the card, somebody may go ahead and give you a phone call afterwards.

And what if you find out that like people who joined the church, one of the things that you’re expected to do is you’re expected to very shortly thereafter become part of a small group with a group of total strangers in which there’s an expectation for folks to disclose fairly personal things. That’s why you tend not to see so many anxious people oftentimes at church.

And so part of what we’re doing when we’re working with churches is that, in contrast, to something like special needs ministry or something that’s a standalone program. This is not a program. This is a mindset. And so that we’re trying to get pastors and folks on staff at churches to understand some of the things that are going to get in the way, because like the best inclusion strategies are going to be things that are going to help everybody.

And in particular, one of the reasons why the ways that we had traditionally done disability ministry didn’t work and don’t work for the folks that we’re talking about is it the last thing that my patients want to do is to be part of something that’s going to single them out as being different.

And in fact, my kids and teens, what they want more than anything else to be treated just like everybody else. So, you can’t put them in a special needs ministry or you can’t expect the folks who we’re working with kids with autism or developmental disabilities to have a good handle on what do you do with the kid with profound social anxiety or the kid on the autism spectrum with 147 IQ who has no social skills and is very awkward in terms of how they interact with other folks.

Carrie: Have you had churches that did certain things to help with kind of getting people through that front door. That’s probably the scariest part is kind of the whole process of entering the worship area for the first time, dropping off your kids, those types of things that you just mentioned. What does that look like in a more anxiety sensitive, I guess. 

Dr. Steve: Okay. So coming back to like what we were talking about before. The more people with anxiety can visualize an experience, especially if they’re going to an unfamiliar place, the easier it may be for them to be able to get over that hurdle. So one of the things that we talk about when we’re working with churches and one of the components of what we have them think about doing is a communication strategy.

One component of that is to take a look at your website. And you want as many pictures, video. You want folks who are exploring the website to be able to have a good picture in their mind of what it is that they’re going to be able to experience. And so this is where this would be especially true is that I have kids in my practice where for example, they’re okay at going to church. And by the way, one of the ways that you figure out who the anxious kids are at church is walking into the worship center of the sanctuary, like when it’s time for the sermon and see who’s still sitting next to their parents. That’s probably like a pretty good bet. I have kids where maybe they can get to church and, you know, they can sit with mom or dad, but the prospect of going to like Sunday school would be overwhelming.

One really memorable kids. So there was in like third grade. This ADHD separation anxiety, some dyslexia kid ended up doing well with some cognitive behavioral therapy ended up in a private school that specializes in working with kids with learning differences. Didn’t hear anything from the family for three years.

Kid is in sixth grade and at the church where the family’s going, he’s not part of Sunday school, but he is going every Sunday with mom and dad. And the biggest event of the year for middle-school ministry was this weekend retreat. And the mom and dad were friends with the middle school pastor who put a great deal of pressure on them to have their child go.

Well, the kid was still struggling with lots of separation anxiety. And when the kid came home one day and considerably larger at this point, when mom informed them that they needed to go to the retreat, the kid became extremely agitated and aggressive. And if mom’s brother had to have just happened to drop by the house, this boy was so upset that she might’ve gotten seriously hurt.

So, the kid has separation anxiety. If we added the details that the middle school retreat is for a full weekend on an island in the middle of Lake Erie that you can only reach by ferry that only runs during the daytime. Can you imagine?

Carrie:  There’s all these barriers.

Dr.Steve: Yeah. So for example when you’re asking people to do something, that’s like a little out of the ordinary.

So with a middle school retreat or a high school retreat, or like churches where people go on mission trips, the same thing applies that an anxious kid would want to know. What am I going to be doing? Where am I going to be eating? Where am I going to be sleeping? Or they’re going to, you know, are they cabins?

Are there going to be bugs around? What’s going to be happening all day long? So that, to the extent that you can go ahead and help folks to visualize that whether they’re serving in a soup kitchen or going on like a weekend or like a week-long retreat to like Appalachia, or whether it’s like two days with other kids from middle school and high school. The more you can envision of what you’re going to be experienced and the more you can prepare folks the better. So, the same thing when you think about this with, in terms of say kids who might be dealing with some degree of anxiety. Making sure that you have maybe other kids around who are greeters, who come from a number of different schools.

So the kids are likely to see familiar faces when they come in the same way. Like for example, I think about some of our kids with anxiety who have difficulty transitioning when they’re going to a new school. Giving them the ability to come and check the church out, maybe in the middle of the week, when there aren’t a lot of people around and either to like meet in person or maybe meet by video their Sunday school teacher so that, here’s where your room is at.

Here’s where you’re going to be going. Here’s what you’ll be doing. The more preparation you can do with someone, for example, who struggles with anxiety, the easier time they’re going to have with it. 

Carrie: These are really good ideas. I think in terms of being able to visualize things I used to have before COVID and I went fully online.

I used to have all kinds of pictures on my website of the office. And I actually paid a professional photographer to come in and take pictures so that people could kind of see the journey from literally like the parking lot to the waiting area, to the hallway where my office was in the suite.

And it was really neat because the photographer actually told me that whenever his wife goes to a new restaurant, she looks up the pictures online just to kind of familiarize herself with the area. And I thought that that was really interesting. So, I think it’s a great idea for churches to use things like pictures or videos, which is a pretty simple solution.

To snap some different pictures and put it on the website to help people feel more welcome or they know what to expect when they’re walking in the door. 

Dr Steve: Yeah, I would add, I mean, there’s some very simple things that churches can do in terms of implementing a communication strategy that are very helpful when you’re dealing with families that are impacted by anxiety, other mental health conditions. In an earlier Lifeway survey, when they asked family members of adults with serious mental illness what they most wanted from their churches was for their pastor to talk about mental health-related topics from the pulpit. It gives everybody else permission to talk about it.

There was a fairly large, interestingly enough, Southern Baptist church here in Northern Ohio that we worked with, who they ended up developing an inclusion plan, where they won the regional award for cultural competence from the National Alliance for Mental illness.

So like some of the things that they did speaking into this is that they did a five-week teaching series on what the Bible has to say about anxiety to address the issue of people feeling more comfortable about self-disclosing. I was there on a Sunday at their worship services because I was training about 75 of their children and student ministry volunteers about how, what they could be doing in terms of interacting, including kids in their ministry.

So I went to a worship service and they ended up renting a video about three minutes long that day with one of the guys who was in their worship band, who talked about his experience with panic attacks and how that impacted his faith for a period of time and how he worked through it. The guy who is a founding pastor of the church did this wonderful. It’s about five minutes long. It was a Facebook video that they produced specifically for folks in the congregation of the church to share with their friends and neighbors who might be struggling. And he started off, “Hi, I’m Rick Duncan. I’m the founding pastor of Kyla Belly Church. And I want you to know that those of you who are struggling with mental health concerns are welcome at our church.

My father was a pastor. He struggled with depression. We know what this is like.” So something as simple as that, that that’s. So de-stigmatizing put in the hands of the people of the church to share it with their friends and neighbors who they know are wrestling with this. I mean, they’ve done a fabulous job. So, in addition, they have, they actually have a licensed therapist

who’s on staff at the church to be able to see folks who have issues. They have a celebrate recovery group. They offered NAMI groups. We are seeing like churches in our area. There are a couple of wonderful ministries that we work with. One is called Fresh Hope and the other one’s called Mental Health Grace Alliance. Where there are now networks like hundreds of churches that are doing Christian-based mental health support groups for teens, college students, and adults with mental health issues and support for their families.

And so, I mean, it’s just wonderful to see the way that like the resources are exploding. And, and I think that it helps that there probably enough folks on staff at churches with personal experience of this firsthand. That they get how it can be an issue for other people.

Carrie: I love that. I love that because what you said about. Some things being said from the pulpit or from the stage, it gives permission for everyone else to talk about it. And if we don’t talk about these things in the church, it just makes us feel like, okay, well we just, we just don’t talk about that here. It’s kinda like parents when they don’t talk to their kids about sex.

It’s just kind of like, well, that’s a taboo subject, I guess that’s off the table. And we don’t realize a lot of times how impactful that is. And especially because too often, we put people in leadership on pedestal pedestals and think they don’t have any problems, but they have problems too just like everyone else.

They have struggle and sin and things that God’s working on in their life. It’s so powerful when we’re able to have authentic vulnerability in the church. And I hate that so many times there’s too many barriers to respite to be able to do that. But it’s life-changing when that happens in a positive and healthy way. Too many of these things that you listed and this, the seven things, really keep us from being able to connect in community with other believers, the way that God has designed us to be in community and to stay connected and to grow closer to God and grow closer to each other.

Tell us about a little bit about your book, the Mental Health and the Church. 

Dr. Steve: Okay. So mental health of the church is basically sort of the detailed version of our inclusion model that we share with churches. The first part of that, we talk about that there are seven specific barriers that oftentimes make it more difficult for families and individuals impacted by mental health illness. 

We also give them seven. We also give them seven specific strategies or ways that they can like, think about how they might think about like responding. And so that, so that some of the things that are like really essential would be like having the church commit.

That they’re going to do an inclusion plan and that there’d be some education of the leaders of the church. The second has to do with the little acronym is teacher. So the first is setting up an inclusion team. The second is looking at sort of the ministry environments or the nature of the physical spaces in which ministry takes place.

So are there ways of making them more sensory-friendly? Are there ways, for example, to design we’re involved with a church where we were like helping them redo their middle school and high school ministry area so that kids who have attention issues would take away more from the teaching and the experiences that they have?

A stands for focusing on activities that are most essential to spiritual growth. So that if you want folks to be in part in a small group, it’s very important to train the leaders of your small groups, in terms of like how you welcome someone who might have issues with anxiety or someone who might be withdrawn because they’re struggling a little at that point in time with the exacerbation of depression.

C has to do with the communication strategy we touched on. H has to do with offering practical helps that in the Lifeway study. 

One of the largest disconnects between what pastors believed about their churches and what family said about their churches was that most pastors believed that their church had a current list of mental health facilities and professionals that they could refer people to. But 70% of families said that that wasn’t the case. One of the things that like the church that I go to does is that before COVID we had large respite events where we would have like 85 kids at the church on a Friday night. And probably the majority of them had a primary mental health issue, where again, the parents were able to get an evening out and then.

Our most popular blog post a couple of years ago was entitled, We had no casseroles. And it was about 60 minutes segment that was done, where they were talking about the struggles that parents in Virginia were having like the teens and young adults getting mental health service. And so the whoever from 60 minutes was interviewing the one mom and she goes, “You know, when our 13-year-old daughter broke her leg in a skiing accident and was in the hospital for a week for surgery every single night, somebody from our church brought us food. Six months later, when she overdosed and was on a psychiatric ward of the local hospital, we had no casseroles.” And so like, why do we, as the church think about like treating those things so differently.

So what are some practical things that we can do to help them? There is education and support, offering like a fresh hope group, offering like a grace group through Mental Health Grace Alliance, having NAMI doing their education and family support groups, making sure that the folks who are in leadership positions in the church get the training they need to understand.

And then our has to do with releasing your people for ministry. For this to work, folks on staff at churches have so much on their plate that they’re overwhelmed that the people need to take ownership of this because God has positioned all of us in terms of where we work, where we go to school in our neighborhoods. We all know people who struggle with.

And I actually think the best inclusion plan is having a trusted friend coming alongside you the first few times that you go to a church. Who can help to navigate the overly exuberant door greeters and some of the other challenges and help their friends and help their loved ones to be able to navigate some of the things that might make them a little more uncomfortable.

Carrie: Yeah, that’s good. That’s really good. I think all of this information is really helpful and I’m glad that you started this ministry and God put it on your heart because I’m sure it’s grown and there continues to be a need for it as more churches are becoming open to how can we include all people.

As we’re winding down towards the end here, at the end of every podcast I like our guests to share a story of hope, which is a time in which you received hope from God or another person. 

Dr. Steve: Well, I think that the thing that brings me the most hope is seeing the way some of the churches that we serve and other like-minded ministry servers are embracing and understanding this cause. That when we started doing this, there, I mean, there’s literally nothing out there that we have a group that we moderate for mental health inclusion, ministry leaders that not as several hundred members. We’re seeing churches implement plans and we’re seeing them welcome more people.

We’re into the hundreds now in terms of churches that are hosting Grace groups and, and, and, and, and hosting fresh hope groups. And when we get invited to like different conferences and have the opportunity to train, there are more people signing up for this mental health stuff than for any of the other things on the program, but these conferences.

And so it’s really encouraging that after a very long time when we see churches get it. I was at a very large church, training over 200 volunteers, one weekend it’s a church people would be familiar with that was very interested in doing this. And so I stayed for worship on Sunday and it was interesting because the lead pastor wasn’t there, but he knew what was going on. At the beginning of the worship service, he starts it off by saying “I’d like to start by praying for anyone who’s with us today who might be struggling with depression.” He didn’t have to do a whole sermon on it, but simply by doing, just simply by saying something like that the folks who were there that day, who may have been wrestling with stuff knew that they would be welcome and knew that it was okay to talk about.

Carrie: That’s good. That is very hopeful. Thank you for coming on and sharing your wisdom. And I’ll put all the links in the show notes to Key Ministries and the book and how people can get in contact with you. 

Dr Steve: Well, yeah, that would be awesome. And you know, I’d like to get together and say, hello. My daughter goes to Belmont University in Nashville, and she’s hoping to become a psychologist.

We have issues with anxiety and depression and things like that. So, I do get a chance to be in your neck of the woods fairly often. Ms. Carrie. 

Carrie: You’re welcome to sit down with me for lunch anytime. We’ll get together. 

Dr Steve: I’ll look forward to it. Thank you. 

_______________________________

My hope really for this episode is for people to share this type of information with their pastor or ministry leaders, small group leaders, children’s ministry leaders.

Your church really may not know that this help and support is available. And so this episode may be an open door for you to start to talk with the people in your congregation about some of your own mental health struggles. So, if it helps to share the episode with them and say, Hey, sometimes this is my experience at church.

I hope that this episode helps you do that as well. So I promised for our 25th episode that I would be giving something away and I am, I am giving a $25 Amazon gift card away to one of our email subscribers. So if you’re saying, “Carrie, how do I get on the email list?” It’s super easy. You go to www.hopeforanxietyandocd.com.

There’ll be a box up at the top where you can put in your name, and your email address, and then you will automatically get a free relaxation download. It’s something that I use with clients that people have found particularly helpful. You have two weeks to become a subscriber to qualify for the Amazon gift card.

And I will be letting the winner know by email and also posting about it on Facebook and Instagram as always. Thank you so much for listening. 

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 Benjamin Bynam. Until next time.  May be comforted by God’s geat love for you.

24. Reducing Anxiety with Secret Keeping Horses, Bailee Teter, LPC-MHSP (temp)

Written by Carrie Bock on . Posted in Anxiety, Counseling, OCD, Podcast Episode. No Comments on 24. Reducing Anxiety with Secret Keeping Horses, Bailee Teter, LPC-MHSP (temp)

Bailee is a local therapist who talks with us about using Equine Assisted Therapy to help with anxiety. We joke about how horses are HIPAA compliant, and I share my story of overcoming my fear of horses.   

  • Bailee’s story about how she became an Equine Assisted Therapist without being a “horse person.” 
  • What is Equine Assisted Therapy?
  • Different models of Equine Assisted Therapy.
  • How does equine therapy help with anxiety and other mental issues?
  • Human-animal emotional connection. God says take care of the animals.
  • Horses read and respond to human emotions like anxiety.
  • Stories about how equine therapy helps people with anxiety

Resources and Links:

Unbridled Changes Website
Bailee Teter
Book: Hope Rising-Stories from the Ranch of Rescued Dreams

Support the show 

More Podcast Episodes

Transcript of Episode 24

Hope for Anxiety and OCD episode 24. Today on the show, Bailee Teter comes on to discuss Equine Assisted Therapy. You even get to hear a little story about how I overcame my own horse phobia that I had developed from a bad horseback riding experience as an adolescent. Without further ado, here is our interview.

Carrie: : Tell us a little bit about yourself. 

Bailee: I’m originally from Texas and moved to Nashville in 2014. I came here to go to Lipscomb to complete my master’s in clinical counseling and ended up meeting my husband here, and so I stayed. We really love where we are and our church community has been such a blessing to us. So we really love it. 

Carrie: That’s awesome. 

Bailee: Fun fact, aside from equine counseling or equine-assisted counseling, I also direct a Christian dance program. So when people ask me what my job is I’m like, “I work with horses and I teach dance classes.”

Carrie:  Those were two pretty unique interests. 

Bailee: Yeah. They’re not anything I would have ever planned for myself. If somebody would have told me like in 2016, in the future, you’ll be directing a dance program and doing equine-assisted counseling, I would have been really stressed out about how to make it happen and really confused because I’ve danced my whole life but I did not grow up with horses. And so before I started working as an equine assisted counselor, I didn’t really have much background with horses. So that’s been a really cool story in and of itself. 

Carrie: Tell us how you got on that track because when people go to graduate school for counseling. Obviously, there’s a lot of different places that they can take that. And so how did you get into the equine-assisted route?

Bailee: Well, I didn’t go to school for equine. I actually have a really big heart for using creativity to help people heal and help people grow. Someday, a long-term dream of mine is to have my own organization that helps people connect to God through creative outlets. And through that comes healing. And so in the counseling program, I did my specialization in play therapy.

We did toys and sand tray and creative arts and music and all of these things were my electives in the counseling program. After school, I worked for a community mental health organization for a year and a half. I was really burned out. It was hard for me to be in an office. It was hard for me to be sitting still.

I felt really isolated. I didn’t feel like I had a lot of support just where I was. I was contracted into a school. And so I was at the school, but not part of the school. I learned a lot. I worked with a lot of different ages of kids and teens, and a lot of different things about case management too, but it was not the place for me.

I am not an office person, which you can see that now by the jobs that I have. So I had contact with a professor from Lipscomb and he knew for probably about six months that I was just really unhappy and I was searching and I was praying a lot like, “Lord, what are my options? Where do I go from here?”

I don’t even know if I like counseling. I just did this degree and now I’m confused and really burned out. And after about six months, one day, he was just like, “You know what? You need to go meet my friend. She’s interested in art and she does something with horses.” I was like, “okay.” So I went out to Unbridle Changes is where we are in Goodlettsville.

And I observed two sessions, two days of sessions. And she, at the end, Don, who’s the other therapist out there was like, “well, if your professor trusts you. I’m really good friends with him. I trust you. You want to join us?” That was that.

Carrie: That’s amazing networking right there. I love it when that works out.

Bailee: Yeah. And I feel like I’m not a good networker. So that was all God. 

Carrie: Yeah. I know for me, like when I’ve been in certain environments, whether it’s counseling or other things. Maybe you’re not this intuitive, but was there a feeling or a sense like when you went to Unbridled Changes, you’re like “Oh almost like I can breathe. This is where my soul is meant to be.”

Bailee: Yeah. Definitely. Every time I drive over the hill, when you get there, we’re at the end of a hill, we’re not long off of long hollow pike, but every time I drive over that hill and you just see, we think there’s about 50 acres of fields and horses. it’s just like I’m here. It’s a peaceful place. All of the staff members are believers. And so there’s just this connection. We all have that fundamental similarity. Even though we’ll see clients that are not necessarily Christian and we respect where they’re coming from and their stories, but just having that as the core. There’s peace for sure on the property and the horses add a big part to that for sure.

Carrie: That’s awesome. So tell us for, those who don’t know, which is probably a lot of our listeners haven’t had interactions with equine-assisted therapy. What does that look like? 

Bailee: Part of the story where I got involved too. I did not have to be a horse person to do this type of therapy. There’s different models. I am trained in EAGALA, which is Equine Assisted Growth and Learning Association. There are a few different models. I think one is called Path where they do therapeutic riding or the people ride the horses. And there’s some just different versions out there, but through EAGALA you have an equine specialist and you have a mental health person. And I am the mental health certified person. I did my training with another girl who is an equine specialist.  And to do that she had to have over 6,000 hours of working with horses and the horse background and all. Knowing their personalities and their behavior. We worked together and all of our sessions and clients keep their feet on the ground.

And very rarely do we teach them any kind of horsemanship. Sometimes in our program or for me, we’ll step outside of the EAGALA model and teach us a little bit of horsemanship so the kids or the adults will feel a bit more comfortable. But usually, we keep our feet on the ground and let the horses have free rein to interact with the clients, whoever they want to.

There’s actually some research that has come out, I think probably in the last 10 years. The most recent article I saw was 2017. There’s some preliminary research about something called coupling where horse heart rates and human heart rates will start to mirror each other when they’re in close proximity.

And so there was one research that had three different scenarios in this situation where the horse’s heart rate was closest to the human was when the horse had free reign in this situation. They weren’t being restrained. They weren’t behind the bar. They had free rein and they could choose to come and interact with the person.

So that’s kind of how a lot of our situations go. We’ll bring a horse into the arena. We’ll have a client create something out of props or toys. Kind of a very common one early on, it shows me what it feels like to be you. So they’ll build something out of toys or props or different things. And then we’ll kind of watch the horse.

And a lot of times that horse will approach like as they’re building and show curiosity and show like their sensitivity to what’s going on with the person. The reason horses are so effective is because they’re naturally prey animals in the wild. So like a dog, if it gets scared or if it gets hurt, it’ll fight back.

A horse usually won’t. It’ll run. They are so sensitive to their environment. They’re so sensitive to whatever is going on that when they look at a human they expect the human to kind of be quote unquote, “the predator.” And so they’re sensitive to what’s going on with people. And so if you come in showing a lot of anxiety, you’re carrying a lot of anxiety.

Even if another person could look at you and not tell, the horse can tell, and the horse will respond to you differently whether you’ve got anxiety, depression, trauma, they can pick up on some of those things. 

Carrie: That creeps me out a little bit. So if you go in there and you’re anxious, the horse runs from you, or is the horse kind of like a little more empathetic than that?

Bailee: I would say it depends on the horse. It wouldn’t necessarily run. Usually what we’ve noticed is it will kind of put its head up or it’ll be on alert a little bit. But in coordination with the counseling, we’ll say, “can you go help that horse be calm?” And so as the person is trying to help the horse calm down, they essentially calm themselves down as well.

And just that connection with the horse to the human. It’s like an externalization of whatever’s going on inside your heart. The horse will kind of act on it. Some of them are just really empathetic and can tell, especially the ones we’ve used a long time for therapy though, they’ll be gentle. 

Carrie: I’m sure there’s a selection process that goes into which horses would be good therapeutic leave versus not that’s already been done by the organization.

Bailee: Yes. EAGALA’s model is that any kind of horse could be used for therapy. The horses that we use most of them are all-natural Tennessee walking horses because the farm is also like a breeding farm. We have 25 to 30 horses, but also the equine specialist, that’s kind of their job to be able to know horse personality. Which ones are sensitive to the weather. Which ones are sensitive to kids versus adults. We choose which one we think would work best. 

Carrie: Do people usually work with the same horse over time, or do they work with different horses? Kind of, depending on what their needs are?

Bailee: That depends on the person too, and the situation. I have one client, she is really, really connected with a specific horse. Every time she comes, she at least has a little bit of time to spend with that horse. She just feels really comforted by this horse, really safe with this horse. So even if we have her doing something, and it didn’t feel do we have her doing something in the arena, she’ll always at least get a few minutes with this one particular horse.

And a few weeks ago she came and that horse, I actually got a little nervous cause the horse was just like laying on the ground. And I was like, “oh no, was the horse okay?” But it was just kind of a calm day. And usually if you approach a horse that’s laying down, it’ll get up.  Kind of that prey instinct as well.

But this woman was having kind of a rough week. She was feeling overwhelmed. She was feeling like there was a lot going on, but she’s so connected to this horse. She walked over there. The horse looked at her and then laid its head back down. And so she crouched down next to the horse and it was heading it and stroking it. And when she came back she was like, “oh, I feel so much better. I feel so much calmer here.”

Carrie: Wow. That’s awesome. I think what’s interesting too because I’ve looked into other kinds of therapy that use animals like animal-assisted therapy with dogs or things of that nature. And sometimes people talk to their animals and I have cats and I talk to my cat.

Sometimes I like to think we have little conversations. But there’s something about this sense of being in the presence of an animal. And now that I’m doing more telehealth therapy, there’s something about people having their animals in session too. [00:13:08] That’s really powerful. That certain level of comfort or draw that they can get from that. And I wonder if that’s a part of this equation too. A lot of times people who have challenges in their relationships, they feel like they can connect to animals more easily than the other people around them.

Bailee: Yeah. I can definitely see that. Because animals don’t judge us and they hold secrets very well. We’ve told clients multiple times if you feel like you can’t tell us something, you can go tell the horse cause they keep secrets really well. I definitely think there’s something to that relationship between human and animals. I mean, God created it that way. Even in the beginning, he said, take care of the animals. There’s a special connection there. 

Carrie: Your horses are fully HIPAA compliant. 

Baillee: Yes, definitely. They don’t tell the secrets. They keep them. 

Carrie: What are some of the issues that you see people coming in with? Obviously this is a show focused on anxiety and OCD, so feel free to speak to that, but I’m sure there are a variety of issues that people seek equine-assisted therapy for.

Bailee: Anxiety is a big one for sure. Just the nature of being outside in creation without the constant barrage of information and technology and in a new environment. I think the environment in itself helps reduce anxiety and then along with the horses. So we do get quite a bit of anxiety, trauma, depression.

I’ve been there for about two years. In the past two years, we’ve had kids that come with sensory issues that are also just looking for ways to cope with a lot of that and getting to touch the horses and feel the ground and smell the smells. That is just really beneficial for them.

Relationship things, family conflict, adjustment, a big variety, anything you would see a regular therapist for equine would work for as well. 

Carrie: I’ve always thought for myself that I should, at some point or another, pursue equine therapy because I don’t have a positive relationship with horses.

And I thought maybe I should try to improve my horse relationships at some level. I was scared. Absolutely somewhat terrified of horses for many years. Not that I had to be around them. It didn’t cause problems in my life enough to go to therapy over it, but I had a traumatic horseback riding experience when I was 16 years old and basically was just kind of thrown on a horse.

And it was like, “Hey, pull the reins this way to go right, pull this way to go left, pull back and say whoa if you need to stop.” And that was pretty much my horse instruction. There was no, let’s walk around the corral a little bit or anything of that nature. And the horse took off just running because there was a break in between us and the next trail horse.

And they were kind of trained to fill in the gaps. So that’s what the horse was doing. Just filling in the gap. And I was so nervous. I was of course very anxious and screaming because that was the only thing I was taught. And I’m bouncing on the horse and I get off of there and I was like, “I don’t like this. I’m never riding a horse again. This was an awful experience, blah, blah, blah.” And so I wish tried to push myself a little bit to do things because I feel like I’m always asking my clients to be brave and to try new things and to step outside of their comfort zone.  

About a couple of years ago, I was taking a day off and I decided to go to Land Between the Lakes. Have you ever been to Land Between the Lakes? It is a big area to fall. So for those who don’t know is this just this big like park area on the border of Kentucky and Tennessee. And they have all kinds of things. They have a place where you can drive through and see buffalo. And that was super cool. And they have a planetarium and tons of hiking trails.

I saw that they had this little sign that said horseback riding, and I had absolutely no plans to go horseback riding, but I thought, here’s your opportunity to get over your fear horses. And you should just go in here. Don’t give yourself time to talk out of it. Just get over there and, and talk to the people.

So I explained to them, I said, “Look, this was my experience. I had a very traumatic horse experience but I’d like to go horseback riding.” And they said, “This horse is so old. It will not run. It’s not even going to down upon you.” It just walks through the woods. It’s very relaxing. And I was the only person, I guess because it was a weekday and I was the only person on the trail ride with the trail guide. And so I worked through. I made friends with the horse before I got on and I worked through my fear of horses. So now I guess I don’t need to go.

I’ve always had a curiosity or an interest in it. And I think a lot of people don’t really realize that this is an opportunity for them. I would say, especially if someone has been through a lot of talk therapy where they have a hard time maybe articulating or opening up about things. Do you feel like pursuing these more creative approaches to therapy like a good avenue or a good route to try?

Bailee: Yeah, absolutely. I remember in grad school, I don’t even remember exactly which project it was. It was in research class and as a dancer, I’ve always been interested in the way that creativity impacts our brains and our emotional wellbeing. And I feel like we are more like God when we are creating than any other time. And so I did some research on just research articles and looking up things. And there were some studies, I think they came out of somewhere in Europe that said our brains connection when we are doing experiential therapy is so different than when we do talk therapy. Especially because we have learned how to build up barriers and convince ourselves how to answer and respond to things in very structured and safe ways when we use our words. But when we use art, when we use toys, when you do sand tray, when we’re moving, even being active, like with the horses, experientially, our bodies are processing things. Our minds are processing things that bypass the language part of our brain.

And so I definitely think that any kind of experiential therapy is helpful when people kind of get to a stuck place in therapy, or if they just want to try something different. I think that equine therapy is really helpful in combination with talk therapy. I kind of do a mix of both in my sessions, and I know that we’ve had therapists bring their clients out to the farm to do one or two off sessions with us just to gather more information or to gain more awareness for the client.

Carrie: That’s an interesting route too. I hadn’t really thought of that. So, if someone is looking for equine-assisted therapy, what do they need to look for? What kind of training would you recommend that they searched for?

Bailee: I think I mentioned earlier, I know of at least two different types of equine-assisted therapy. One is EAGALA, which is what I’m trained in. The other one is Path. They’re both therapeutic. Path is therapeutic riding, so you get on the horse. You’re engaging the horse a little bit, probably what you did when you went to land between the lakes, building that bond, that relationship with the horse.

There’s a really cool book that I read a couple of years ago. I think it’s called Hope Rising. And it’s just stories about kids somewhere in the Northwest who came out of a traumatic situation and they were paired with a horse who came out of a traumatic situation. And they learned and they became friends with each other and they grew and it was horsemanship.

So that was a very unique thing in that situation. There’s a lot of benefit to therapeutic horsemanship I think, like learning how to walk a horse, how to ride a horse, how to train a horse. But what I do is not horsemanship. Like I said earlier, we let the horses just be free and interact on their own accord.

So I think you would want to determine what you’re looking for in equine-assisted therapy. Primarily, if you’re looking for counseling, you want to make sure that you have a credentialed counselor. Somebody that knows what they’re doing and what they’re talking about. I would say somebody that aligns with your beliefs.

If you want a Christian therapist, you can find Christian equine therapists. You can find people that are marriage specific. There’s a variety around Nashville. There’s really quite a few. But then make sure that the people that you’re working with are also credentialed or trained with a specific program because you wouldn’t want to just show up to somebody’s house and they brush their horse and they call it therapy.

And it’s not really therapy. So you want to just check their background, their resources. And I would say too, making sure that the horses are treated ethically. Because if you’ve got a location, that’s got one or two horses and they’re seeing 20 clients a week, that’s not going to be good for the horse’s wellbeing.

They get burned out too. They give a lot in a session. We have quite a few that they have been so involved deeply in sessions that when we are finished with them, we have to tell the other therapists. “This horse needs a break. They’re done for the day.” So having like a variety of horses or just a plan in place for the horses get burned out. That’s part of the equine specialist job is to look out for the wellbeing of the horses. 

Carrie: That’s awesome. That’s really neat. It’s cool that they have that emotional connection and they get worn out as well. And then they need a rest. 

Bailee: They sure do. We’ve had some really, really cool sessions of just the horses feeling so much of what’s going on inside these people. I’m thinking of one specific incident.

We had a kid whose family was going through a lot of changes, a lot of chaos. There was some addiction involved and the kid kept telling me, “I’m fine. I’m fine.” And we were just like, “There’s no way you’re fine” like to that language, setting up that barrier. And we brought in the specific course, and typically we don’t tell clients the horse’s names because we don’t want them to have preconceived notions, we let them pick names themselves.

But I’ll tell you the horse’s name to make this story easier to understand. We brought in John Henry. It’s because if you have a best friend it’s named something and then we tell you that that horse has your best friend’s name it might change the way you view the horse.

And we want them to be as blank of a canvas as they can be, at least in the beginning, so that we can put our own expectations and our own projections onto the horse and deal with it that way. We’ve had people call a horse, that horse has called math. That one is English. That one is social studies. It worked out that way because they’re struggling in one of those subjects.

So there’s so many different ways that you can do it. This specific incident, this kid kept telling us he was fine and his mom was like, “I’m just not sure he’s fine like there’s so much going on.” And we brought John Henry into the arena and something happened, but John Henry started running circles. Running in circles, he started bucking, throwing his head around, just huffing and puffing and snorting. And this is a big horse, when he stands up on his hind legs he is tall. After he kind of calmed down and we looked at that kid and then we said, “well, what do you think about that?”And he was like, he had his arms crossed and he kind of had his brow frown and he was like, “Nothing. I don’t feel anything.”

And we’re like, but you reacted like your body reacted. We can see that you reacted and so that was a place where we were able to start getting some of those. We specifically noticed this happened, or he reacted this way even though his words didn’t want to tell us something was going on in his heart. And eventually it came to that. The way that horse was acting, represented how he felt inside.

Carrie:  Wow. That’s so neat. That’s really cool. Yeah. It’s almost like the horse gave him a language that he didn’t have, 

Bailee: Yeah. That’s definitely a big part of it, for sure. 

Carrie: Are there any other stories or things that you wanted to share about how you’ve seen equine-assisted therapy be helpful for people with anxiety?

Bailee: I had a couple that kind of came to mind when I thought of this question. Another John Henry story is he’s a really good therapy horse. He’s actually had some traumatic experiences, so he is very in tune with people. I think they say that horses will either go to the extreme where they’re really not interested in people, not interested in anything, or they will become really gentle and really sensitive. He’s a really sensitive horse.

So one of my very first sessions was actually with the kid who was experiencing a lot of anxiety and irritability, but he was non-verbal. And so his parents brought him. They were just hoping that something more hands-on and something more natural would be helpful for him. And so my equine specialist at the time, she gets John Henry because we know he’s a pretty good horse, like with kids. And she had him on a rope because she was a little nervous about how the kid would respond. So usually we let them go free, but she kind of had him. She was sort of controlling the situation and we were trying to get the kid, “Hey, come pet the horse.”

The horse can see that like no response from him at all. He completely ignored us, sat down on the ground, and started building piles of dirt. And we were like, “okay, this is not going how we expected it to go.” And John Henry is pulling at the rope and acting kind of irritable, kind of crazy.

There was like a few cats around and they were just like meowing like there was just a lot of chaos in the situation. And I told my equine specialist, I said, how about just let him off the rope and see what happens. She was like, well, are you sure? I’m like, yeah, let’s just let them off. And so she let him off and he made a beeline for the kid kind of quick.

And then he slowed down until he got to a really gentle last step right up behind the kid and put his mouth down to the kid’s head. And when he touched a kid on the head the little kid turned around and looked right at John Henry. And that was the first interaction of anything in his environment

we had seen him do besides the dirt. So for the rest of the session, that kid would play in the dirt a little bit and then turn around and look at the horse. And if he moved, John Henry would move and he would stay right there with him. And at one point the kid became really fascinated with this horse, his feet, which most horse professionals be like, “Don’t get near the feet. Don’t get near the feet.”

So my equine specialist got a little nervous, but then she noticed that horse wasn’t moving a single muscle. He was so aware that this kid was by his feet. He was so aware of what was going on with the kid that he was totally still. Just after that, the kids started opening up more, started interacting with us more. We got more eye contact. His parents said he realized he was less anxious at home. So that was a really sweet one just because it’s kind of unique in that he wasn’t verbal. He couldn’t do talk therapy.

And so using the horses and using the environment was really cool. And then I had another.. These are a little shorter. That first one was a little long. So I know, remember one, this client, she was in her mid twenties. She came from a really chaotic home environment, had a lot of trauma, anxiety, and depression including some suicidal ideation and she had tried talk therapy. She really didn’t connect with her therapist. It was not a good situation. So she came out to see us. And so we invited her to spend a few minutes outside with the horses.

Just a lot of times we’ll say, go make friends with the horses or go, just figure out what it means to be still with horses. Depending on what the people bring we’ll give them a prompt and send them out into the field with horses. And this time we just said, “What does it mean for you for your heart to be at rest? “What does it mean for that anxiety to come down and that depression to release?” And she stayed out there for, I don’t know, 10 to 15 minutes. She came back and her face looked completely different. And she had spent a lot of time with a specific horse. And I was like, “so what did you learn?” She was like, “Well, you know, I realized I don’t have to work so hard. I don’t have to fight all the time. These horses, I enjoy their company just because they’re here and they enjoy mine just because I’m here. I have value because I exist.” And that was just like such a light bulb moment for her and just totally shifted her perspective of herself and of her value in the world.

And then another one was a woman who is about 40 and she had walked through a season with miscarriage and just had a lot going on grief, anxiety in relation to like what would happen in the future. Just a lot of baggage that comes with that as well. And so we gave her the prompt to just go see where she feels like she can actually connect, which horse she feels connected to. And she ended up really spending a lot of time with one of my favorites and her name is Gypsy. The woman came back and she was telling us about why she felt like she connected with Gypsy. And she just felt so much calmer when she was with her like the horse could really understand her. And she spent some time talking to the horse. We don’t know what she said but you know, Gypsy HIPAA compliant, she keeps her secrets that she was just out there for a while. And she was telling us all these things and telling us about her season of the miscarriage.

And I was actually able to share in that moment that Gypsy had also had a miscarriage. And it’s that, like the client, she just started crying and she was like, “I just knew. I knew there was something she understands me.” So after that, each time she came back, she would just feel really connected to Gypsy and did a lot of work with that horse.

Carrie:  That’s so cool. Towards the end of every podcast, I like to ask the guests to share a story of hope, which is a time that you received hope from God or another person. 

Bailee: We could talk about this all day. 

Carrie: It’s a good topic. 

Bailee: It really is. And especially for the time that we’re in right now, we feel like hope is elusive to some people.

For me, I feel like it has been such an anchor. And I hope it’s definitely in the Lord, but in the dance program, I teach, I get to write a spiritual curriculum each year. And I felt like this year, the Lord put on my heart the theme to be the promises of God and just took that scripture from Hebrews 6 where God makes a promise to Abraham and he’s like, “I will bless you and I’ll give you many descendants.”

And it says that God had nothing bigger to swear by. So he made an oath on his own name and it says, when God makes a promise, he cannot break it. He cannot lie. And because of that, it gives us strength because we can trust that he is who he says he is. That hope is an anchor for our soul. I picture that as like putting my heart on something that’s stable rather than on like the world around me. I felt like that was so important for me in this past year because it’s the story of everything in 2020. Everything has shown to be shakable. The world has been completely shaken. Everything has been ripped out from underneath us.

Things have changed. People have died. There’s so much I want my students to know. I want my students to know that God is so firm. And that’s where I’ve really found my hope. When he says he will bring all things under his rule and he will renew heaven and earth.

He’s not joking. He’s not playing games. His word is secured. I’ve seen God do many things, transform lives, speak identity, serve on a prayer team at my church too, and just seeing him work in that. As I was thinking about this, I thought of just this cool concept. I had my first garden this past year.

And it was a total experiment. I was like, I don’t know if this is going to work. I don’t think I have enough sunshine, but here we go. And it was abundant. I had so many cucumbers that I didn’t even eat them. It was amazing. And so I’m planning for my next year. And last week I was doing some garden prep. So, do you know what one of the best fertilizers for a garden is? 

Carrie: Is it horse manure?

Bailee: It is. It is because they eat so well. All the grass. So last a couple of weekends ago, I got it from a place in town in Nashville, and I went over and got buckets full of manure. Buckets full of manure to transport in my car.

I don’t have a truck. And I came and I was like spreading it out all over my garden and just in preparation for this next season. And then it was just, God was just teaching me more through this. I work with horses all the time and we get the good parts of them. We see the way that they interact, we see their hearts, we see their compassion, but the manure is kind of gross. The poop is gross. The clients don’t like to walk around like, “Oh, it’s horse poop.” And I’m like, “well, it’s part of having a horse.” There’s some gross parts. And then planting my garden, what I wanted was those gross parts because that’s what eventually will break down and out of that becomes beautiful things.

And so just like the Lord takes our broken stuff and he brings redemption and beauty out of broken things is just the way the garden works. Come this fall or come this spring and summer out of that horsemen, there will be grown seeds of nourishment and beauty and that’s just been really hopeful for me.

If nothing, I feel like God is a God of redemption. He brings beauty out of brokenness. So just thinking like using horseman manure to bring beauty and a garden, that’s just given me some hope recently. 

Carrie: I love that. That’s really what the show’s all about is giving people hope and seeing that God can take the hard parts of our story and the painful things and make something beautiful out of it. Thank you for coming on and sharing all that. This has been Inspirational but also so informative. There were so many just different little nuggets that you got to share with us. 

Bailee: Thank you for having me. It’s so fun to get to talk about it. I love what I do, and I know a lot of people don’t really understand it. So it’s fun to get to explain a little bit more in detail. 

Carrie: Awesome. 

____________________

I love having these types of interviews on the show because we’re all about increasing hope here. And if you’ve found that one particular type of counseling didn’t work for you, or you feel like I don’t know that I could do the whole talking thing, or that’s not a good fit for my child, this might be something to look into as an option. 

We have some exciting interviews coming up on the podcast, as well as a very special mother’s day edition. Next week, I will be discussing a giveaway in honor of our 25th episode. So make sure that you stay tuned for that as well. I’m also asking you to save the date of May 15th. We are going to have our very first webinar on reducing shame. So what I’m hoping to do through these webinars is have a little bit more of a time for me to present some information, as well as have follow-up questions and answers. Or if you have questions about shame that you would like me to address during the webinar, I certainly can do that.

Please feel free to send those questions through our website contact form wwwdothopeforanxietyandocd.com. And we will see you on the webinar at 10:00 AM central time on May 15th. As always, thank you so much for listening. 

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 completed by Benjamin Bynam. Until next time it may be comforted by God’s great love for you.

23. Acupuncture and Anxiety With Encircle Acupuncture

Written by Carrie Bock on . Posted in Anxiety, OCD, Podcast Episode. No Comments on 23. Acupuncture and Anxiety With Encircle Acupuncture

Today, I had the privilege of having not one, but two guests on the show! Alexa Hulsey and Trey Brackman, both licensed acupuncturists came on to talk to us all about acupuncture and how it can be helpful for anxiety among other things.  

  • What is acupuncture and how does it work?
  • What happens during an acupuncture session?
  • Modalities acupuncturist use for patients who feel anxious about acupuncture needles.
  • Some theories about how acupuncture helps with anxiety 
  • Acupuncture and spiritual connection

Links and Resources:

Alexa Hulsey, L.Ac, Founder of Encircle Acupuncture
Trey Brackman, L.Ac

Encircle acupuncture
Community Acupuncture 

Support the show 

More Podcast Episodes

Transcript of Episode 23

Hope For Anxiety and OCD, episode 23. Today on the show we are talking all about acupuncture. I was able to interview Alexa Hulsey and Trey Brackman from in circle acupuncture. They are both a licensed acupuncturist and they talk to us about what an acupuncture session looks like and how acupuncture can benefit anxiety.

So let’s dive right in.

Alexa: My name is Alexa Hulsey. I’m a licensed acupuncturist. I have been practicing since 2005. And I am the owner of Encircle Acupuncture here in Nashville. We have two locations in Nashville. I like to say that I became an acupuncturist because I wanted to help people. And then I became a community acupuncturist because I wanted to help a lot of people. Community acupuncture is set up in a way to make acupuncture affordable and accessible to really anyone who needs it because we offer our services in an affordable way. 

Carrie: Awesome and Trey?

Trey:  How did I get into acupuncture. That’s almost 30 years ago. I got my first acupuncture treatment right out of high school and decided that that’s what I wanted to do after my own experience. I’ve been practicing now for 18 years in a community-based setting. And I did private room acupuncture for a long time and was really hard for me because I couldn’t do it with enough people and it wasn’t affordable enough for them to get it enough to be beneficial to them. And when I found Alexa, nine years ago, I actually went into one of her clinics to get acupuncture and I was like, this is what I want to do and how I want to do it. I’ve been with Alexa full-time for nine years this year. 

Carrie: So tell us a little bit about the difference between what you just said there about maybe a private acupuncture versus a community acupuncture clinic.

Trey: So private room acupuncture is one person in one room, typically on a massage table and community acupuncture, we have a big room and pre-COVID, 21 or two chairs in east Nashville. And in Bellevue, 13, 14 chairs recliners, and you’ll have a patient every 10 minutes and in a community acupuncture setting. Typically in private room, you’ll have a patient every 30 or 45 minutes. So you can treat a lot more people in a day than you can do in community acupuncture than you can in private room. 

Carie: Awesome. 

Alexa: Community acupuncture really gets back to the root of how acupuncture has been traditionally practiced for thousands of years in China and in other Asian countries. Acupuncture was typically done in groups. In some areas, an acupuncturist would travel to a village and just treat people in somebody’s house. And so our set-up, it kind of feels like a living room. Everybody’s in a comfortable chair and it makes it so that we can see more people and that way we can charge less.

Carrie: Awesome. I really liked that concept in terms of receiving care and receiving health in a community setting. Whereas a lot of times in America, our healthcare is so individualized and isolated at times too, because of that. That’s really neat. A lot of the listeners probably have never had an acupuncture session so we just want to talk with them a little bit about what does that even look like? 

Alexa: Sure. I’ll walk you through what a typical acupuncture session is like. We start like pretty much any medical appointment with you, filling out some paperwork, we’ll ask about your medical history and then we’ll do a brief intake with a new patient.

The goal of our intake is really to just figure out why are you here? What can we help you with? What’s really bothering you. And we try to really focus in on a patient’s chief complaint and what is going to be the thing that we really want to focus on. What patients will find often is that if we focus on one or two things for their first few treatments, then all of these other things that they might not have even mentioned to us also start to feel better because everything is connected. So it’s kind of fun when that happens. We really focus on a patient’s chief complaint.

We will recommend a treatment plan based on what they’re seeking help for and what our experience is in treating that condition. A treatment plan varies, but generally people need a course of treatment and not just one acupuncture treatment. So it’s like taking vitamins. You can’t just take one vitamin, you got to take a lot. So you’ll need a course of treatment. Usually, sometimes we have people come in once a week. Sometimes we want them to come in every day if their pain is so severe that they can barely walk. So we talk about a treatment plan.

And then we’ll have a patient, they’ll be in a recliner in our clinic we use points on the extremities. Patients will just roll up their sleeves and pant legs. They don’t have to change clothes or anything like that. And we will needle a few points on the head, arms, and legs. Usually, we’ll use somewhere between 10 and 20 needles during a treatment. Once the needles are in, we cover up the patient with a blanket and walk away. And then that’s when the real magic happens is when a patient is resting with the needles in. We typically let them rest for about an hour and then we’ll take the needles out and, and the treatment is done. So really most of the acupuncture treatment is the patient lying there, relaxing, doing nothing.

Carrie: That sounds like a good time to me, just relaxing and doing nothing. I have had acupuncture and I did find it to be super relaxing. And that’s one of the reasons that I wanted to have you both on the show because we’re talking a lot about anxiety. 

It’s interesting. The point that you brought up there, Alexa, about how when you work on one issue, you don’t always realize the domino effect that’s going to happen If you’re working with someone in terms of pain and then all of a sudden their pain is relieved. They notice they start sleeping better and then they notice it’s like a ripple that happens and that’s really neat. Or then maybe they come up with some other things like therapy, they come up with some other things that they want to work on once one thing is relieved. It’s like, “well, maybe can you help me with this too?”

Alexa:  Yeah, that definitely has, 

Trey: I would say 90% of the time. Yeah.

Carrie:  Yeah. In terms of anxiety and pain and other physical issues, sometimes when you have physical issues the anxiety surrounding dealing with those issues can be so great and almost worse than the actual medical problem that you’re having right now.

I know that happened to me a couple of years ago, I was dealing with some digestive issues and someone said, “Well, maybe you’re just stressed about it.” And I said, or “maybe you’re just stressed in general and that’s causing these digestive issues. And I said, “I don’t think you understand my stress is from the digestive issues” because I can’t figure out what’s going on and how to fix it. This is not a psychosomatic complaint. 

Alexa: Anxiety and depression are huge components especially of pain conditions. Dealing with pain for a long time that does become depressing. You start to think my life is never going to be the same again.

You become anxious about what the future holds.  And then those anxiety and depressive feelings can compound the pain that you’re feeling and taking a pain medication can help the pain, but it’s not going to do anything for your depression and anxiety. Whereas what we do with acupuncture is a much more holistic approach.

Carrie: Can you explain a little bit of from maybe what’s been studied about how does this actually work? 

Trey: Well, there have been a lot of modern-day studies that through MRIs and thermal imaging, that show that it reduces inflammation, improves blood flow, can stimulate hormone releases, balance your hormones, but how the body actually knows to do that when we take the needles and put them in these specific points, there is no definitive answer as to how the body knows to do that when we’re doing acupuncture, but it works. It’s been working for thousands of years and just in the 18 years I’ve practiced, just observing people come in and get better and reduce their pain or help their anxiety or their OCD or their arthritis in their knees, whatever it is, how it’s doing that, I’m not sure anyone has really discovered the real true one answer to that. 

Carrie: I’d love a good mystery and intrigue, but I’m also very intuitive. So I’m kind of in that camp of like, well, if it works let’s use it. You know, I don’t need you to always explain everything to me on a scientific study level.

Testimonials are very valuable. Do you think that this is a little bit of an offshoot of a question, but things like acupuncture and chiropractic and holistic wellness, a lot of times aren’t valued or paid for by insurance companies. Do you think that we’ll get to a point where we shift from a disease model to a health model at all? Do you think that we’re making any strides towards that?

Alexa:  I do think that we’re making some strides. Acupuncture is being used by the military and is being paid for by the military. There is talk of acupuncture being used by medicare to treat acupuncture specifically for treating lower back pain is going to be covered by medicare one of these days. Trey probably has been hearing the same line too, since he went to acupuncture school. I’ve since I enrolled in acupuncture school, I’ve heard insurance reimbursement for acupuncture universally is just around the corner. It still hasn’t happened. 

So our work around has been just, well, let’s not even worry about insurance. Just charge a price that everyone can afford. Our prices are less than a copay and now we don’t even have to worry about insurance. We don’t have to fill out insurance forms and that gives people a lot more flexibility because insurance will usually limit, some insurance does pay for acupuncture.

We will usually limit the number of treatments a person can get or what it can be used for. The way that we approach it is, let’s just let the patient decide what they need and just make it available to them. 

Carrie: And the community based acupuncture model, I just wanted to point that out that that’s not just in the Nashville area that people can actually go online and find community-based acupuncture in their area.

Trey: Yeah, worldwide. 

Carrie: Oh, worldwide. That’s awesome. 

Alexa: Worldwide, absolutely. There are clinics everywhere. If you do an internet search for community acupuncture, type in the name of your city. Not every town has a community acupuncture clinic, unfortunately, but it becomes more and more prevalent. 

Carrie: Whenever you guys want to come to Rutherford county, you’re welcome. It’s open invitation. 

What about if people are anxious surrounding needles, if people say, “I don’t really know if I can do that acupuncture thing, because she just said she was going to stick a lot of needles in me.”

Trey: We actually see that quite a bit and my personal approach to that is I’ll use four needles on somebody who’s typically a little bit anxious.

You can do a really good treatment with just four needles, especially for someone who has anxiety surrounding needles. And that first one or two treatments for them is about them getting used to the idea and feeling acupuncture needles go in and realizing that it doesn’t hurt. I have several patients that are still needle-phobic, but they come anyway because it really helps them, but they just put in their earbuds, turn on their meditation or whatever, their music, and they close their eyes and they just don’t watch and then they’re fine. Usually, I start very slow with them and just do four, maybe four, sometimes six needles, and go from there. 

Carrie: It could be a really good exposure for some people that have that specific phobia, it might help them have a more positive experience. But also the needle size that you’re talking about is a lot smaller than a typical needle.

Trey: Yeah. Two of your hairs together. They’re like 36 gauge. They’re tiny. 

Carrie: Yeah. So maybe that helps relieve some people’s anxiety here thinking about trying acupuncture. It’s not as bad.

Alexa: It’s truly not as bad as you think. A lot of patients report that they don’t even feel the needles. Which if you’ve never had it, it seems impossible, how can I not feel the needle going in me, but it is because they are so, so thin and fine. We did this more before the pandemic, but if someone wanted to bring in a friend or a family member who was anxious about the acupuncture, we would invite them to come in, just like say, “Hey, come sit next to your friend and watch what happens and just relax. See what it’s like.” It’s more difficult to do that now during the pandemic obviously because we have a lot more restraints on how many people we can have, but our model does allow for friends and family to come in together. So if somebody wants to try it and they want to bring a friend for moral support and the two of you get treatment at the same time, we can do that.

Trey: And we’ve had lots of children over the years and teenagers who have come in to get it and their parents will come and sit with them and hold their hand while they get their first few needles. We’ve done that as well for four kids. 

Carrie: Yeah, I think that’s really helpful for people to know that this is a good option for children and adolescents too. A lot of times people are looking for more natural remedies because they don’t necessarily want to put their child or teenager on medication right away, and this might be a good alternative option for them to look into. 

Alexa: Definitely. 

Carrie: Anything else that you wanted to say in terms of how you’ve seen acupuncture be helpful for anxiety?

Alexa: I think we could probably both speak to a lot of cases where we’ve seen acupuncture be helpful for anxiety. I would say that, that is probably the number two thing that brings people into our clinic. The first being pain. We do treat a lot of pain and the second is probably anxiety. We see so many people with anxiety. People don’t always have great results with some of the pharmaceutical options that are out there to treat anxiety.

They might have side effects, or they just don’t want to be taking that and they’re needing solutions. I don’t know how much we want to get into sort of the theory of how it helps anxiety. 

Trey mentioned that there’ve been some studies showing that acupuncture reduces inflammation, increases circulation. The way that we look at it is that acupuncture is going to basically remove blockages in your body. So we look at the body as a system of energetic flow and we call that energy Qi in Chinese medicine. Qi reaches every part of your body and it’s really what makes us alive. Qi gets blocked easily by lots of different factors.

And so we’re really using the needles just to remove those blockages and restore balance, and then the body does. The work on its own that it needs to do to be into a balanced and harmonious state with something like anxiety, a lot of times we’re working on the heart system and that doesn’t necessarily mean that someone with anxiety has heart disease, their blood pressure might be fine.

Their blood flow might be fine, but there’s an imbalance there in that system. The heart is the center of the emotions in traditional Chinese medicine and it gets out of balance easily when there’s a lot of external stressors. And so a lot of times we’re working on restoring balance to that system.

The heart system also is related to sleep. So people with anxiety often experience a lot of problems with sleep. So we can work on those things in tanem. Sleep is one of those things that we’ll often get better without someone expecting when they’re coming in for acupuncture. And then they’ll come back, like you said, after a few treatments and say, “oh, I’m sleeping better. And I wasn’t expecting that.”

Carrie:  That makes a lot of sense to me in terms of what you were saying about the heart because a lot of people who experience anxiety have a more rapid heart rate and their stress system is getting over-activated in times where it doesn’t need to be activated. It’s also connected to pain because the pain pathway in our brain also runs through that limbic system controlling the fight, flight or freeze response. It’s interesting how all of those things are interconnected and then when we’re out of balance, as you said, and something gets stuck, if you can release that it’s like the body already knows what to do to heal itself, which is very similar to a type of therapy I do called EMDR, which works at the brain level. And it’s kind of from the same premise like your body and your brain already know what to do to reach that point of healing. It’s just a matter of getting you unstuck. So that’s really neat. 

Alexa: Yes, absolutely. 

Trey: I always referred to it as getting out of your own way and letting your body do what it already knows how to do.

Carrie: That’s good. Let’s talk about maybe people who are coming from a Christian faith perspective. I did a previous show on mindfulness, which was super fun and we talked about origins of mindfulness and how that can integrate with Christian faith. I think when things come out of Eastern origin, some Christians are like, “Oh, that’s not Christian.[00:20:46] That’s more rooted in Buddhism and we have to watch out for that. It could be a spiritual practice that goes against our faith.” Would you mind speaking to that concern a little bit?

Alexa: Sure, absolutely. Our approach, first of all with acupuncture and traditional Chinese medicine, spirituality is a huge part of health. And so it’s important that a person feels that their whatever practices they’re doing are aligned with their spirituality because that’s going to promote healing. Traditional Chinese medicine comes from a tradition of Daoism. It’s really rooted in Daoism and Daosim isn’t a religion, it’s a philosophy.

And it’s a way of looking at the world and the body and health based on observation of nature. So we take those observations of nature and then apply them to the body. So for example, we talk about the pathways of chief low in the body. We relate those to bodies of water, and some points are described as being like springs or like rivers or like wells because those points behave the way that those bodies of water would, it would behave in nature.

So Daoism can really be in alignment with any religious beliefs. And for that reason, a person of any religious faith can get acupuncture, can be treated by an acupuncturist, and still rest assured that the treatment is going to support their spirituality. It’s going to support their religion. It’s not going to be in conflict with anything that they believe.

Carrie: Do you find that some people have spiritual experiences, like when they’re receiving acupuncture like having a sense of spiritual connectedness? 

Trey: Yes, and that was one of the things I was actually just going to touch on in all the years I’ve practiced. I’ve worked on a lot of people who have come in and are Christian and a great many of them over the years have told me one of the things that they love about coming to acupuncture is that it allows them time to pray and when they get their needles because it clears out all the rest of the chatter that goes on in our heads. They turn their phone off. They take their smartwatch off and they truly just rest and it allows them to really actually be clearer about what they’re praying for, or who they’re praying for. And I have seen and heard that a lot over the years that it just clears out the clutter of the brain and it allows them just to focus on that one thing and in that way. 

Carrie: That’s awesome because I think I have had that experience in terms of receiving acupuncture. I don’t remember why, but I remember that I ended up crying one of my first few sessions and it was just this, I can’t really explain it other than there was a sense of spiritual connectedness to God in that moment through prayer. And just that sense of being able to just be and just rest and be present is really powerful. Something that we don’t do enough in our society is just allow ourselves to be and to rest and to give our bodies space and openness to heal or to connect with something outside ourselves. 

Alexa: It’s so powerful and it’s so healing when you can get into that state where you’re feeling connected to the divine and you’re feeling really in alignment with your own spirituality. It’s a huge part of healing and also when people are going through a difficult time with their health, they really rely on their faith to get them through that.

I love what Trey was saying about people using that time to pray because faith is what gets many of our patients through their most difficult challenges.

Trey: And when there’s a lot of people in the clinic when the clinic is full and everybody’s in there, and they have their needles in and they’re all in their space, you can feel the hum of the energy in the room where all the people in here are doing the exact same thing.

They’re there, they’re resting, they’re healing. They’re letting go of their stress, their anxiety and you can feel that hum when there’s two, three, four, five, six, seven, 10, or 12 people in the room, all doing the same thing. If you’re paying attention, you can feel that hum of all of them trying to heal and whatever level they’re trying to get it to.

Carrie: Does that feel like a lot of energy or does that feel like a release of energy? I’m just curious.

Trey:  It depends on the people. Sometimes it’s really heavy and strong and it’s like you’re parting it to get to the people and sometimes it’s light and airy. It depends, I think on who’s in the clinic and why they’re here and what they’re praying about or meditating about or focusing on while they’re here. So the feel of it actually changes. 

Carrie: That’s very interesting. 

Alexa: And it’s cool because in that way, each patient in there is contributing to the healing of the other patients as well. You’re creating this collective healing space. So we’re all helping each other, which is not a typical approach in healthcare.

Like you said, it’s usually very individualized, very isolated, but our approach is we all have something to offer. We can all give and receive in the process of healing. So it’s beautiful to be able to be a part of that. And Carrie, you mentioned about having an emotional release and that is not unusual at all for someone to have an emotional release during a treatment or after treatment crying. Sometimes people laugh.

And I noticed that especially with patients who are dealing with anxiety because anxiety can be so much work to manage just in your daily life. Just trying to navigate situations that people without anxiety wouldn’t find difficult when you have anxiety. It is difficult whether it’s going to the grocery store or having a conversation with a coworker.

So it’s so much harder to do some of those things that when you finally do get the chance to rest and relax, you don’t realize how much emotion you’ve been holding on to and then that release feels great and it’s an important part of healing. 

Carrie: That makes a lot of sense to me because it does take a lot of energy when you have anxiety, too, whether it’s to get through the day or sometimes that energy is used to suppress other painful emotions and that makes sense to me. 

So we’re kind of winding down to the end of our interview, but I do want to say that I’m going to put some links in the show notes for those who are local to look up Encircle Acupuncture and for those who are not local to look up community acupuncture near them so that people can join in on this experience.

Since the show is called Hope for Anxiety and OCD, I like to ask our guests to share a story of hope at a time that you received hope from God or another person.

Alexa:  I’ll go first. I feel so lucky because I get to hear stories of hope pretty much on a daily basis from our patients. It is very inspiring to be around. One patient in particular, who has really inspired me as a patient who a couple of years ago received a very scary cancer diagnosis. She had been coming to the clinic for a long time, just for various ailments, and then she received this diagnosis and it was so scary but she was determined to do what she had to do and she followed her doctor’s advice to the letter.

She did all of her chemo. She does all of her radiation. She did all of that. She put a lot of trust in what her doctor was recommending and at the same time, she also said, “I’ve got to do more. This is the fight of my life and so I have to be all in.” She did more research and homework than I’ve seen most patients do.

And she really became an expert on healing her cancer and she did, she beat it, and she’s more than a year cancer-free now. Even some of her nurses have made comments to her, like, “wow, you are really doing so much to heal.” And her response has kind of been like, “well, you know, I have to.” She’s a very spiritual person and really relied on her faith to get her through

the scariest time in her life. And I still see her every week and she’s doing great. She’s just to me, an example of courage in the face of something really scary and using that as an opportunity to learn. She’s come out of this even healthier than she was before. She’s a huge inspiration.

Carrie: That’s awesome. 

Trey: I have several. I could probably filter through but mine is oddly more personal, which is normally not what I would share. Nine years ago, Alexa and I hashed out an agreement on a little over nine years ago, hashed out an agreement on a napkin actually. And I lost the job that I had and I called Alexa that same Friday at like noon.

She called me back at two o’clock and I started the following week and it really has allowed me to do something I was ready to walk away from because it wasn’t fulfilling for me. And that totally changed in the nine years I’ve worked for you. We’ve treated hundreds of thousands of people, and it’s brought a lot of joy to me personally, and by extension to my wife and kids.

Carrie: That’s awesome. 

Alexa: And Trey I just love that we’ve been working together for so long, but I think everybody can relate to that feeling of just being in a place where it’s just not right and you want to change and it’s scary to make a change, but you can do it. It can transform into something that you love. [00:32:00] So that’s an inspiration to me too, I’m glad you shared that. 

Carrie: That’s awesome. Thank you so much for being on the show and for sharing with us, your wisdom and your experience with acupuncture and kind of letting all the newbies know what it’s like, and hopefully, it’ll encourage people to try it out sometime.

Alexa: I hope it does. Thank you for having us. 

Carrie: You’re welcome.

_______________________

I know I talked on this episode a little bit about my own experience with acupuncture. I wanted to do that because initially going into it. I was really nervous like is this going to be something that’s not in alignment with my Christian faith? And I did a lot of research, read everything on the website, as well as some other information on the internet about acupuncture and how it works and what the process was. And I said you know what, I don’t see anything for me personally that goes against the Bible or goes against the major tenants of Christian faith. I believe that acupuncture is one of the tools that God has given us to help heal our bodies and lead us towards a place of greater health.

And for you, it may or may not be for you and that’s okay. Hopefully, I won’t get any hateful emails on this issue. If I do, I’ll just ignore them and pay attention to the people that are enjoying the show. 

Speaking of people who are enjoying the show, did you know that we have people who are listening all over the place, including Mt. Juliet, Tennessee? Which is not too far from here. All the way to West Lake Stevens, Washington, and Paradise, Nevada. I know that we have some people who are listening in Europe, Africa, and Australia as well. So, where are you listening from? Let us know by messaging me on Instagram or Facebook, I would love to hear from you. And if you aren’t following us there, please do.

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.

18. ERP is Not the Only Option for OCD

Written by Carrie Bock on . Posted in Counseling, OCD, Podcast Episode. 7 Comments on 18. ERP is Not the Only Option for OCD

Today I am flying solo to discuss my own experience of learning about Exposure and Response Prevention Prevention and why I ultimately went back to using EMDR to treat OCD. 

  • The reason ERP is so widely recommended for OCD treatment
  • The problem with psychological studies: People are complex 
  • Problems I saw firsthand with ERP
  • Benefits of using EMDR to treat OCD

Exposure and response prevention for obsessive-compulsive disorder: A review and new directions:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343408/

Studies on EMDR and OCD: https://www.emdria.org/public-resources/emdr-therapy-and-ocd/

One Therapist’s Story of Discovering Her Scrupulosity OCD with Rachel Hammons
Panic Attacks, OCD, and God: A Personal Story with Mitzi VanCleve

Support the show 

See more:

The Power Of EMDR For Anxiety

More Podcast Episodes

Transcript

Welcome to Hope for Anxiety and OCD, episode 18. On today’s show, it’s a solo episode. So you just get me and I want to continue this conversation that I started with Sarah about EMDR as a treatment option for OCD. I’m really excited to share this with you because I feel like when people start talking about OCD, that the very next thing they start talking about is exposure and response prevention (ERP)

I’m not saying that there’s anything wrong with exposure and response prevention, or as we’re going to call it ERP for this episode. What I am saying is that there are more options than just ERP for treating OCD. ERP has helped a lot of people. And so if it’s helped you then more power to you, that’s awesome.

 I’m so thankful and glad but if you feel like you’ve struggled with ERP or you feel like you want to learn about a potential different option then this show is for you. 

The reason that ERP is so most often recommended for OCD is because this treatment option has been researched more than others treatment options. And let me tell you about psychological studies and how those typically work. When someone is studying a condition such as OCD, they’re typically trying to only study OCD. And a lot of times we’ll rule out people who have what we would call dual diagnosis. They have more than one diagnosis on record. [00:02:10] I had a hospital reach out via email several years ago saying, “Hey, we saw that you see people with OCD and we are trying to do this research study. Would you let people know?” And I emailed them right back. And I said, “well, would my clients be ruled out if they also had PTSD.” And they said, “yes, they absolutely would be rolled out.”

At that point, I realized that whatever they were studying ceased to be relevant to the actual clients that I see in my practice. I often see people who are not only dealing with OCD, but they also have a history of childhood trauma. The other thing I want to bring up about psychological studies is that there’s a lot that we don’t know. Psychology is a relatively young science. While we’ve learned many things over the years about how the brain works and how different methods of therapies work and how some therapies are better for certain diagnosis, there’s still a lot that we don’t know. And the types of people that we see in counseling, they don’t fit. Just say standard one size fits all profile. Something that often happens. Whenever I go to a new training, you will learn about something like, “Oh, we have this really great method,” and they’ll show you the success stories. They may even show you video of it working well with a client that they worked with with permission. Obviously, we don’t just videotape people. We ask for their permission for learning and education purposes. But they may have these great examples. And then inevitably you will take that back and you’ll say, “Hey, can I try this new technique with you that I learned?” And it may work on the first person that you try it with and you may try it with a few other people. [00:04:18] And inevitably it doesn’t matter what the psychological technique is, you will run into someone that it just doesn’t work for that you have to revamp or adapt it differently or use something else entirely. And that’s one of the reasons that I want to expose you listeners on the show to a wide variety of mental health treatment options for anxiety and OCD because I don’t think that there is a one size fits all. And a lot of times when people look at counseling. They lump it as one big thing.  I tried counseling and then, you know, that didn’t really work for me but there are many different types of counseling and I hope this show is kind of helping you and exposing you to some of that.

So let’s talk about my background with ERP that I wanted to share with you. I had an experience where I went to a two-day training on exposure and response prevention. The reason that I sought out that training in the first place was because I was seeing a lot of clients with anxiety that was really starting to become a niche of my practice. [00:05:40] So seeing people with trauma and people with anxiety, And I started to see that when certain clients would have peak levels of stress, they would start to engage in some OCD compulsions. And it made me realize that if I was going to see people with anxiety, I was really going to have to understand more about OCD, how it’s approached and try to figure out how to help these people who were experiencing OCD symptoms in peak stress points.

So I went to this training. It was very professional training, excellent information on OCD, excellent information on exposure and response prevention, how to start utilizing it in your practice. It certainly didn’t make me an expert on it or anything, but it was enough to get me started, to start working with some people that, had a diagnosis of OCD, not just had a few symptoms here or there. That point. I started seeing some people who were coming out of inpatient treatment, where they had received treatment for OCD and they needed some follow-up with their ERP. There were some patterns that I was starting to notice and particular patterns that I wasn’t comfortable with. One pattern I noticed with these individuals was that they seem to be carrying a lot of shame. It was either shame related to past trauma, self-esteem issues or even just having the OCD diagnosis in general and having to deal with that on a day-to-day basis. So that was a level of concern for me because I don’t want people to be stuck in shame. I had to ask myself, is it a win if people stop engaging in compulsion? if they’re still carrying around a baggage of shame. That just didn’t seem to jive with me or, or feel good in my practice. I also worried about whether or not ERP could be contributing to some of that shame because part of the process of ERP at times is to track certain behaviors, such as times where you engaged in a compulsion and times where you didn’t. I noticed these clients also had an untreated trauma history as well, which since I was a trauma therapist, that concerned me.

The main issue I had with ERP though seem to be what I call a glorified whack-a-mole process. Really targeting symptoms instead of getting to the root of the issue. This seemed horribly inefficient because one you would target one theme or one compulsive behavior then another obsessional theme with another compulsion would pop up right behind it.

What I’ve learned from trauma therapy is that you can treat symptoms all day long, but if you don’t treat the issue underneath that’s driving the behavioral symptoms, you’re not going to get very far. It’s going to be a lot harder. It’s going to be a struggle like swimming upstream. 

I had one experience where a very skilled and trained ERP therapist told me that she banned prayer for a client that was dealing with scrupulosity. That bothered me as well because I’m not going to ban a behavior that’s crucial and critical to someone’s faith practice. The idea of exposure and response prevention, which we’ve talked a little bit about in previous episodes is that, ultimately your goal is to have a client be able to sit with the obsession without acting on the compulsion. Doing this inside of session with the therapist, as well as outside of the session for practice, for homework.  And the ideas to be able to sit with that until the anxiety level drops. That can be really challenging and very distressing for clients. If they’re able to get through it, then there is a certain level of success and accomplishment that they feel. But sometimes the difficulty level of ERP contributes to the dropout rate. 

One study that I read that I will put in the show notes for you is that ERP has a 20 to 30% dropout rate and ERP has a 50% success rate in terms of symptom remission. So here we have a lot of people promoting ERP as a treatment option for OCD, and there’s a 50% success rate.

I want you to just think about that for a minute. There’s few things that we would recommend that had a 50% success rate. If you’re dealing with obsessions and compulsions that are wrecking your life, 50% sounds like a pretty good gamble of something to bet on that it may work for you. The problem that I have is hearing from other professionals that this is an automatic go-to treatment and this is what’s been studied and you really shouldn’t look into anything else. Sometimes other treatment options are discouraged and I have a problem with that because I think that we all should remain humble as professionals and recognize that different people need different things or different approaches.

I want to tell you a little bit about what I’ve been able to do with EMDR therapy with clients who have OCD. Ultimately, I decided to go back to what I knew and to adapt EMDR for the treatment of OCD. One of the things that I like about it is that it helps reduce the body level internal distress that people experience. A lot of times what I’ve seen is that individuals with OCD are able to go in their head. They’re able to solve problems. They’re able to kind of mentally escape from emotions and difficult distressing physical sensations. So by utilizing EMDR we’re able to work at a body level on reducing that physiological distress that people experience.

In the initial preparation phases, I’m working with people on things like mindfulness, distress tolerance skills to be able to sit with difficult emotional experiences. And often as they’re able to do that, they start to feel a little bit better. We definitely target the shame piece with education about OCD. Sometimes, that’s the first EMDR target is dealing with that shame versus trying to deal with the OCD. What I’ve found is that if people can release the shame first, then that helps them be able to engage in the next part of therapy, dealing with the obsessions and compulsions. EMDR starts with what’s going on in the present and then looks at what past memories may be contributing to the present experience because it approaches things that way. You’re really able to get down to the root of what’s going on instead of just working on various symptoms. 

Sometimes the root has to do with control, either dealing with things that are outside of one’s control or feeling this need to be in control or be perfect in some way. Sometimes it has to do with vulnerability. There can be all kinds of different things underneath that layer. 

So this is a process. There’s a process of dealing with the shame piece and developing self-compassion. There’s a process in learning some skills to manage day-to-day when the OCD arises. And then there’s this deeper layer of really getting to the root of what experiences contributed to this development in the first place. And what I’ve found is when you’re able to do those things with that process, people feel a lot better about themselves and they may still have some OCD symptoms, but it’s more like, “okay, I’m noticing that that’s there and it’s in the background and I’m a lot better able to ignore it than when I started therapy.” And that’s huge. That’s absolutely huge for people. 

Anytime that you can get to a place where you’re managing the obsessions and compulsions and noticing that they’re there but not getting roped into them, that’s an absolute huge win. And however you get there, whether you use ERP or whether you use some people are using ACT, Acceptance and commitment therapy for OCD, or whether you’re using EMDR or another method, just know that there are different options for you. You don’t have to be locked into one treatment option because of your diagnosis, regardless of what that diagnosis is. I’m going to include some information for you in the show notes about exposure and response prevention and the article that I read regarding that, which was a review of the research and then some studies on EMDR and OCD. And you can look for yourself and evaluate. It’s often helpful to incorporate more than one therapeutic technique together.

I believe this is where people, especially who have complex presentations, are able to see the best results. So you certainly could incorporate EMDR with ERP. I’ve done that for clients before, especially more so in phobia situations where they needed kind of like a gradual way to ease into getting over a certain fear.

Today’s story of hope starts with me crying in a parking lot in Target because I couldn’t build a website in 2017. I was in the process of building my business By The Well Counseling, trying to get everything off the ground. There’s a lot that goes into starting a business and I was running on fumes. I was working full time, seeing clients. And then in the evenings, I would be working on stuff to start the business. One of the things I believed I needed to get going was a website. Someone had recommended a certain site for me to build my own website. And I could not figure it out on my own, hence the crying in the Target parking lot. Everything had just reached a boiling point. I was overwhelmed and in tears and just thought I cannot do this anymore. Fast forward, Now I’ve built several websites. I had a former blog website that I’m not using anymore that I built. I built a completely brand new website for my counseling practice on a different platform about a year ago and I partially built the Hope for Anxiety and OCD website. I did get some help from a professional on that one to make it look more snazzy. But what I learned that I thought I couldn’t do, which was build a website, I could actually do. I just didn’t know it yet. So maybe there’s something in your life right now that you feel like, “I can’t do it. There’s no way,” but you may be looking back a few years later and say, “Wow! That very thing that I thought I couldn’t do, I can do it now.”

That’s my story. Do you want to share your story of hope with me? I would love to hear it. You can contact me through our website 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 was completed by Benjamin Bynam. 

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

Do I have Anxiety or OCD?

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

Understanding the difference between anxiety and OCD can be challenging. After all, both disorders affect the mind and body. Those with anxiety or OCD can experience physical, mental, emotional, and spiritual distress. Let’s start by looking at the symptoms of each disorder.

Common Symptoms of Generalized Anxiety:

  • body tension
  • increased heart rate 
  • frequent worry
  • difficulty concentrating
  • feeling edgy 
  • difficulty sleeping

At a basic level, anxiety occurs when your internal fear response kicks in when it’s not needed. Our fear response is a good thing, given to us by God to keep us safe. The problem is that our brains and bodies are imperfect. Thus, the fear response can get turned on in response to something that is not actually going to hurt us. As an example, let’s say that you have generalized anxiety and get nervous when put in new situations. Your brain has made a connection somewhere along the way that new situations are potentially dangerous and must be avoided or engaged in with extreme caution.

Today, you are meeting your new male coworker. You may have worrisome thoughts. What if he’s mean or rude? What if he doesn’t like me? I’m always so awkward in these types of situations. What should I say? Your body starts to get hot and a little sweaty. You notice your heart has started beating a little faster. You take a few deep breaths, wipe your sweaty palms, and tell yourself everything is probably going to be fine with the coworker. You’re still a little edgy, but have calmed yourself down enough to meet him. Meeting a new coworker is not a life or death situation, but your body may be so worked up that it feels like it is.

Understanding OCD:

OCD involves the presence of both obsessions and compulsions. An obsession is an intrusive thought that feels real, doesn’t respond to logical reasoning, and often creates internal doubt. While obsessions are a thought process, they are accompanied by distressing emotions and body sensations that are similar to what a person with anxiety experiences. This is the part that is confusing and often leaves the OCD undiagnosed for years. Compulsions are a behavior that someone feels compelled to engage in as a way to satisfy the obsession. Like scratching an itch, there is temporary relief, but in the long term, engaging in a compulsion strengthens the obsession, starting the whole obsession/compulsion cycle over again. Obsessions and compulsions can vary widely, but I have listed some common examples here:    

Examples of common obsessions: 

  • Offense: I must have hit someone with my car while driving. I offended my coworker. I have sinned or offended God. 
  • Cleanliness: I have touched something that caused me to be contaminated. I’m dirty. This surface is dirty. I’m going to throw up.
  • Harm: You may picture yourself harming yourself or someone else. You may be concerned about harming yourself, spouse/loved one, or child.
  • Relationships: Am I destined to be with my boyfriend/girlfriend? Maybe I married the wrong person. 
  • Just so: Something doesn’t feel right, so I have to keep focusing on this aspect until it feels “just so.” 

Examples of common compulsions: 

  • Checking: Checking the appliances multiple times before you leave the house or turning your car around to see if you hit someone
  • Counting: completing actions according to a certain number such as flipping the light switch 3 times, avoiding certain numbers
  • Repeating: re-doing schoolwork because you didn’t like your handwriting, repeating certain words in prayer or repeating a prayer a certain number of times
  • Reassurance seeking: Asking your boyfriend multiple times if everything is OK between the two of you, asking your boss if you have done the right thing, asking for permission to do something you don’t need to ask permission for, asking someone questions a different way until they give you a desired response. 

Let’s circle back to the example of meeting the new coworker, looking at it from an OCD lens. You have obsessive thoughts you can’t seem to get out of your mind about potentially harming the coworker. You picture yourself spilling coffee on him or accidentally tripping him. You put your coffee cup back on your desk. Your body starts to get hot and a little sweaty. Your heart has started beating a little faster, but you’re too consumed with your thought process to notice. Please don’t let me be awkward, you pray internally. It doesn’t feel right, so you say it two more times. Please don’t let me be awkward. Please don’t let me be awkward. You feel a small sense of relief, but then wonder if you should find the boss to get more information about the coworker in order to make sure you don’t offend him or harm him in some way.   

The importance of determining if you have anxiety or OCD:

Why does it matter anyway? The key to effective treatment is proper diagnosis. If you see a therapist who practices Cognitive Behavioral Therapy for anxiety, they may teach you to challenge the anxious thoughts like you are in a court of law, looking at contradictory evidence.  This would only seek to strengthen OCD, causing more distress. You may see a kind therapist who misses the OCD and provides reassurance that everything is going to be OK. You see the therapist every week, feeling a little better, but after six months of therapy, you’re not any better than when you started. You still have tremendous struggles outside of session. OCD treatment involves increasing one’s ability to tolerate distress. This can be done through several different therapies: Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention (ERP), or Eye Movement Desensitization and Reprocessing (EMDR).

In my experience, EMDR is a great treatment for both anxiety and OCD. Unlike other forms of talk therapy, EMDR works at a brain and body level to help reduce uncomfortable body sensations. Clients defeat the avoidance that anxiety and OCD bring by learning mindfulness and distress tolerance skills. Present behavior is traced back to past learned experiences. After processing, clients may notice some obsessive thoughts, but they are now in the background instead of the foreground. Clients are able to experience the obsession without engaging in the compulsion. If you are in TN and interested in EMDR therapy, click here. 

What is EMDR?

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 in person and online counseling across Tennessee and EMDR 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.

Panic Attacks, OCD, and God: A Personal Story with Mitzi VanCleve

13. Panic Attacks, OCD, and God: A Personal Story with Mitzi VanCleve

Written by Carrie Bock on . Posted in OCD, Personal Testimony, Podcast Episode. No Comments on 13. Panic Attacks, OCD, and God: A Personal Story with Mitzi VanCleve

Author Mitzi VanCleve shares her own personal story of experiencing anxiety, panic attacks, and OCD and ultimately, how God has used these things for good in her own life.

  • Obsessions Mitzi experienced even as a young child
  • Experiences of mental health stigma from Christians 
  • Learning about panic attacks from a magazine article
  • Mitzi’s experience with scrupulosity OCD
  • Acting as if
  • How she used used imaginal exposure to help treat her OCD
  • How she made the decision to take mental health medication as a Christian 
  • Wrestling with God about having OCD
  • How church leaders can support individuals experiencing OCD

Verses discussed: Psalm 13, 2 Cor 1:4-5, 2 Cor 12

Resources and links:
Strivings Within- The OCD Christian
In Your Dreams 
OCD Online
Grace Abounding to the Chief of Sinners
ERP (Exposure and Response Prevention) 
ACT (Acceptance and Commitment Therapy)

By The Well Counseling

More Podcast Episodes

Welcome to Hope for Anxiety and OCD Episode 13. Today, I’m sharing an interview with author Mitzi VanCleve. She shares her own personal journey of diagnosis, treatment and interactions with the church in regards to dealing with panic attacks, anxiety and OCD. I’ve found her story to be incredibly hopeful in terms of how we can grow closer to God through struggles in our lives. So let’s dive in. 

Transcript Of Episode 13

Carrie: When did you start to have symptoms of OCD? 

Mitzi: Well, that really started even as far back as when I was a toddler. I know that sounds surprising. The only thing I can say about that is in my childhood right up until I was quite old, I never understood a lot of what I was experiencing was actually OCD. The first thing that I can go back and look at is really long-held obsessional fears and themes. The very first one was it was sort of unusual as OCD things are. It was a fear of being flushed down the toilet and the sphere was so intense that I would not use the big toilet until I was five years old and I was forced to go to kindergarten.

Even as a small child, three years old, four years old, I could sit there and watch a toilet being flushed, look at the hole in the bath and the toilet and say, “well, I can’t fit through there,” but it didn’t make any difference. My brain had just decided this was the thing to be afraid of and from there, once I got past that one, there was health obsessions. I remember, a really long period of time where I heard about the idea of swallowing your tongue and that just drove me nuts. I worried about it, wondered how that can happen. I ask my parents about it. I would forget about it while I was playing then when I go to bed at night it would come back and that’s when I would really struggle like the times when I didn’t have anything to do. So there was a lot of weird themes and health obsessions. 

By the age of 10 is when I first developed some obsessions related to self-harm. That just started with hearing about a form of not self-harm, but just a form of harm that could happen to a person. I don’t want to really go into the details. Sometimes it’s a little bit hard to explain specifically obsessions in details because it can get a little graphic and upsetting that people who don’t have OCD don’t really understand.

Why would you think that? And so this morphed from my fear of this thing happening to me to actually doing it to myself, like losing control and harming myself. That just went on and on and on for the longest time. There was something in me that knew these things weren’t at all logical and so they scared me so much.

I wouldn’t really tell my parents. I would exhibit symptoms of anxiety. I would have nausea. I would get up in the night shaking and feeling like I needed to vomit and things like that. I was afraid to, especially about the harming thing, I was afraid to verbalize that as a kid, but that’s where it started.

It became more debilitating after the birth of my children. After the birth of my second child, I developed panic disorder. Not knowing what that was I always struggled with social anxiety and just your basic kinds of anxiety disorders as a kid, but I didn’t know such a thing existed.

I never heard about OCD, anxiety disorders, panic disorder. Those words were foreign to me. I only heard about crazy people. There’s a thing where there’s a stigma and even as a child, the stigma was there. That idea that I might be crazy was terrifying to me and so when the panic attacks started, that felt like I was going crazy.

My first one was not nocturnal. I was falling asleep and I woke up with a panic attack and that happened to me a lot. It still does sometimes. I just know what it is now. That combined with that old harming obsession, the panic attack, the feeling of I’m losing my mind. I’m losing control. The derealization, that deep personal personalization that you feel at that moment makes you feel like you aren’t going to be able to control yourself. That combined with the harming themes. After the birth of my children, the harming thing switched from me, hurting me, going crazy, and possibly hurting one of my children in a really awful way and that was just so debilitating. I can’t even begin to describe how awful it was.

Carrie: The hard thing about OCD thing is that the themes do shift. As you get older or go through different developmental stages in life. It seems like once you have a handle on one theme, sometimes another theme will then pop up.

Mitzi:  Oh, yes, it’s very true about OCD. That’s why it’s important to understand how the disorder operates, how to get on top of a theme before it gets on top of you.

And then it grows too big and large. It gets kind of stuck in your head. I do try to tell people that there’s physical symptoms with this too when you’re going through this. For me, some of the things I experienced during that really bad season, which was a very long season of unharmosity was an inability to eat.

I struggled to get calories down. I’m five foot eight. I dropped to 114 pounds. People thought I was anorexic. It had nothing to do with anorexia. I just was nauseous. The anxiety was so bad. I couldn’t sleep. And of course, if you have an anxiety disorder and you’re not eating and you’re not sleeping, that makes things even worse because that level of physical stress on your body is going to make a disorder worse. So that was what it was like and how it was like for me before I knew it was wrong. 

Carrie: I’m curious about what your parents thought. Did your parents just think like, “Oh, she’s really nervous a lot, or she’s kind of an anxious child” or they had no idea everything that was going on in your head?

They didn’t. There were some people in my family, distant relatives who had struggles which caused them to even not want to leave their house and things like that. My mom would talk about that and she would say, “You know, you’re going to end up like that” but she didn’t really know what was going on.

 I know my mom, there were like reassurances, which is a usual reaction for a parent to do that. A lot of times it manifested just as me being sickly. When I was struggling with certain health obsessions, I would get very, just like I described

sick to my stomach and I would lose weight. And so they were taking me to the doctor and try to figure out what was wrong but it was being approached like it was a physical issue. A lot of this just due to the fact that I didn’t verbalize a lot of the OCD themes, but even if I had, I’m not sure there would have been enough knowledge back then for my parents to know what was going on because that was in the 60’s when I was growing up. I think the information and knowledge and understanding about what OCD is and how it operates has come a long way since then.

Carrie: Right and hopefully also our physicians and pediatricians are also able to recognize a little bit better when they’re seeing some symptoms that potentially could be anxiety in a child, which often presents more as physical ailments.

Mitzi: I will share that when I got really, really bad with the harming OCD and the panic attacks, they were just relentless. I lost count. I have no idea how many I would have in a day or in the evening. At that point, I did open up to my mom. I began to know, “okay, this obviously is something to do with a mental health issue.” And so all I can think of was I probably need to see a psychiatrist and so I needed to share that with him, somebody. I had talked to my husband very little about it, just a little bit and I opened up with my mom. Growing up as a Christian and in a lot of Christians, there was that stigma [00:10:30] especially back then that Christians don’t have mental health issues. And so as I was sharing with her, I thought it might be a good idea for me to see a psychiatrist. She was really upset about it and she talked about faith and then she said something that was really hard, “that’s just for weak people.”

It was hard because it put the brakes on my pursuing that at the time, and I did pursue it still, but I didn’t get a diagnosis. The person I saw didn’t have any clue and he was relating things to stress and it, again, faith and, and it just I got nowhere. 

Carrie: Okay. So you did see a psychiatrist, but they weren’t able to help you with that?

Mitzi: No, he just and of course, some of the scary obsessional themes, I didn’t verbalize them. I talked about anxiety and I talked about the panic attacks. I didn’t hit that word though. Just this is what’s happening and tried to describe it. So it wasn’t a good experience and it didn’t help me, sadly.

Carrie: Yeah, that’s unfortunate when people do reach out for help and then they find somebody that isn’t familiar maybe with OCD, or doesn’t quite know how to help them navigate through that process. 

So what was that process of getting the help that you needed? 

Mitzie: The first help that I got was really for the panic disorder and that was interesting.

I, I believe that during the time of my praying through this and asking God for help and just feeling so desperate that God came through. At that time I was still struggling. I was pregnant again, that tells you how long I was still struggling tremendously and I had become pregnant again.

I was about four months pregnant. I was at my aunt and uncle’s cottage, my husband and my brothers, my family, and my aunts and uncles they were watching a TV show which I did not need to watch at that time. It was called “Alien” which you’ve heard of. It’s the perfect show if you’re struggling. I was trying to avoid watching it.

So I picked up a reader’s digest magazine and the words on the front of the magazine where they show the stories, one of them said panic disorder. It said it might not be what you think it is. Just the word panic struck a chord with me. I opened up this magazine and started reading the story of this woman who had panic disorder and it was me. I was reading about myself and they listed all the symptoms of a panic attack and I had all of them. I finally had an answer for that. And so at the time, I was pregnant and I really couldn’t implement meds and things like that. I just started working on things like breathing techniques.

After I delivered, I started doing really intensive aerobic exercise. I was jogging four and five miles a day, and I gradually getting healthier which eventually took me into a period where the disorder waned. It wasn’t as bad as it had been, but that’s when I learned just about panic disorder. I didn’t have any idea about OCD and so that kind of wax and wane on and off throughout the rest of my life up until the age of 50.

Carrie: So I think your story is very similar to other people’s in terms of a lot of times there’s a big gap between when people start to have symptoms and when they even find out this is actually OCD they’re experiencing because they feel ashamed of the symptoms. They feel ashamed of the thoughts, or they feel like, “okay, this sounds really crazy and nobody’s going to understand it or believe it, or they’re going to lock me up somewhere if I tell someone that I’m having these thoughts especially related to harm.”

Mitzi: Yes. What you say about they’re gonna lock me up somewhere was a genuine fear of mine because I couldn’t understand why I was having the thoughts to start with. For me to share that with somebody, they’re going to be like, “You really are dangerous.” Sometimes I would think maybe that would be good because then my kids will be safe. That’s how awful it is. You feel like your brain is telling you this is something that you should be afraid of this thought. I say it’s almost like you have a phobic response to the thoughts that you’re having and you’re having to live with them in your head.

If it’s a spider or something, you can just run away from it. Once it’s a thought in your head, it’s there. All that you’re doing to try to get rid of it makes it worse. Of course it did with me because I didn’t know it was OCD and I didn’t know what to do about it. It was at the age of fifty.

Carrie: So at the age of 50, what happened?

Mitzi: I had already been struggling. I was going back through a flare of anxiety and panic attacks because there’d been a lot of stress in our life. I’m not going to go into all the details, there were a lot of changes, big life changes. One on disability moves, just lots of changes, lots of uncertainty.

And so I didn’t notice it for a while, but it was kind of too late by the time I did start to say, Oh no, you know, I’m going back through this again. I was having panic attacks. I was starting to have obsessions about my health again, related to stuff that normally I would just brush off. 

That’s how OCD is It’s always looking for a target, something to be upset about. During that time, I was praying again, reading my Bible, doing all the things I normally do as a Christian to try to receive information from God about what I can do about this. How can I help myself, but also just gain comfort. And I got a lot of comfort from the songs, even back when I was in my twenties, because I saw in there things that described how I was feeling. 

My son also gave me some sermons on tape and he said, “These are really good, Mom.” We always share things like this. So I put one of those sermons in. It was actually on it on a CD. I was doing dishes, I was trying to stay very busy and distracted. This particular pastor was talking about our struggles with sin. As Christians and I understood. It wasn’t new to me that as Christians, we will still be fighting sin our whole life. It’s not something that we’re cured of. It’s something we’re aware of. We’re made aware of when we become a Christian and we have a desire to please our Savior. So we work continually towards pleasing him through obedience. He finally says this one statement, which I don’t even know why he said it in the middle of the sermon. He says, “If you call yourself a Christian but you’re still all the time struggling and sinning as strongly with sin, you really might want to think, are you really a Christian? In the past I would have been like, “yeah, of course.” This time my brain just latched onto that. It was like, wait a minute. What if he’s right? What if all this time, all these years, I thought I was a Christian I’m not. And what if the reason I struggle with this thing, whatever it is is because of that. It just was like a dam broke open and the intrusive thoughts related to that, just pour it out just one after another.

I just began this war with it. It was a mental 24/7, every minute I was awake, I couldn’t sleep and that was the new OCD thing, but I didn’t know it was OCD.

Carrie: No one’s ever had that before. It was a new theme. 

Mitzi: Yeah. Until I was engaging with my compulsion. So by then, at this point in my life, of course, we had the internet and I was doing what’s called research, lots of Googling, researching around the topic of,  “Am I still saved?,” doubting your salvation. I was reading all these articles about how we can know we are Christians and I would read them. It didn’t help. It didn’t make it go away.Suddenly one day I stumbled across a Christian forum that said doubting salvation and then it said, OCD. I was like, ”what?” That’s what I’m going through. Out of curiosity, I opened it and I started reading the posts from the people in this group

and it was amazing. It was just like the Reader’s Digest thing. I was reading my story. They were telling exactly what I had been going through. I was stunned and as I read more and more in this forum, and then I started going further out about OCD, what it is, how it manifests, what causes it. I had it and I had it since I was a kid and I never knew, and that opened up the door for me to finally have a way to manage this beast called OCD.

From there I began learning and learning more about ERP, about medications, about therapies like ACT. All the ways that this thing that I called “it”, this ugly “it,” for all these years, it had a name. I get tearful sometimes talking about it because God did answer my prayer.

He just didn’t answer in the way I was wanting. The way I was wanting was just take this thing away, whatever it is. He was pointing me to, “This is what it is, and this is what you can do.” It was just astonishing to me that I could live my whole life, basically until I was 50 years old and never have been able to get help.

There were so many long seasons of just debilitating, crippling suffering, and it was hard for me to believe, but just the relief, so overwhelming. 

Carrie: We talked about that in an earlier episode with someone about how diagnosis itself can be a relief when you get a proper diagnosis. And then you can say, “okay, now that we know what we’re dealing with, what can we do about it?” “What’s our next step forward?

Mitzi: Exactly. Even after you get a diagnosis because OCD is OCD, it’s going to make you doubt but as you begin to bravely risk working with things like Exposure Response Prevention (ERP) therapy for me, it was brave when I was told, I probably needed to try some medications, but that was hard for me. Some of that was pride. Some of it was just because I have never taken anything like that before. What will it do to me? All the fears and that was a big struggle, but it’s so worth it because the alternative is staying stuck and doing the same thing over and over and not getting better and feeling worse. 

I was determined just like with a panic disorder, I was like, “What can I do about this?” And I found out these things are effective. It was hard. It’s not like you began ERP and the next day, I’m all better. It’s a process. The longer you’ve been struggling with the theme, I think it’s a longer process. Your brain’s got this practice cycle of intrusive thought, anxiety response, compulsion, more intrusive thoughts, more anxiety, more compulsions. It’s a habit that needs to be undone and that takes time. 

Carrie: Right. Did you get into therapy at that point? 

Mitzi: I started going to a therapist and I think this is the hardest thing about OCD is being able to find a competent therapist. My therapist was good for dealing with basic anxiety disorders, like panic disorder, generalized anxiety, social anxiety, but when it came to OCD, she was asking me to apply basic cognitive behavioral therapy like you would for depression which would be to challenge the thoughts, to counter the thoughts into right logical reassurances.

Carrie: Which is exactly what you don’t want to do with OCD.

Mitzi: I started doing that and I got worse and I was like you know what, but there was one thing she offered up that was great and I still say it today, it’s act as if, and that’s part of the choice

part of OCD. OCD thoughts may be telling me this and telling me that, but I’m going to act as if these things aren’t true. And in the realm of Christianity and scrupulosity, even though my brain was telling me, “I think you might becoming an atheist.” I could say I’m going to act as if I’m a Christ follower. I’m going to do all the things that a Christ follower does even if my emotions will not validate that choice. That is my choice. So that aspect helped, the other was worse. So I pretty much learned on my own, I did visit some really good websites like ocdonline.com. Dr. Philippson. A lot of his work was just phenomenal to help me understand.

I learned about imaginal scripting, imaginal exposures, and I wrote them and did them and recorded them. I was able to learn that on my own, but a lot of people really do need a competent therapist because it takes a lot of grit and determination and courage to do ERP. I just think having a competent psychologist who’s trained to do these things and understands the disorder is something, unfortunately there just aren’t that many and a lot of it has to do with network, with insurance too, which was one of my biggest hurdles. I could not afford the counselors and the therapists that I needed to see. I had to go to the ones in network and even later on when I was going through a bumpy time with my OCD, after I knew what it was, I was just going through a really bumpy time.

I thought I could sure use someone right now and my therapist had passed and I called around and I would ask, or I would write. I know I communicated through email. I would say, “what do you know about ERP and ACT as far as treating OCD?” And they would say,” I don’t know what that is but I can help you with your OCD.” I’d be like, “Probably not.”  So that’s a hard thing. That’s a really hard thing.

Carrie: It is hard because really, therapists would have to pursue training after their degree to specialize in OCD. And a lot of people don’t do that unless they have some type of personal connection or in my situation, I was working with a lot of people who just thought they had anxiety and then I was starting to see more OCD as I was starting to hear more about what they were actually worried about and struggling with. So that’s kind of how I got branched off into it, but I think a lot of therapists have not received further training on it.

I want to get in with you on the spiritual aspects, really of struggling with OCD. I know a lot of people who are struggling out there probably are praying prayers just like you pray, “God, this is awful. I feel terrible. I’m all tore up inside. Will you please just like touch my body and touch my mind and take this all away.” How did you work through some of that wrestling with God?

Mitzi: When I didn’t know I had OCD, I did a lot of that and it was a wrestling time. I thought during that time, maybe this was due to pass. Maybe there was something I needed to confess. So I would pour over everything I could think of and current things and confess for the OCD and the anxiety I would go through. I knew these verses, every verse related to worry, anxiety, all of those things. 

I had most of that memorized. Anyway, I did understand what those things meant. What I didn’t understand was the difference. The Bible talks a lot about anxiety and worry, but if you look at those passages of scripture, you will see these are situational.

Worries and concerns, they’re about real-life trials and afflictions. It isn’t this always there’s a free-floating sense of dread and physical symptoms and everything of anxiety that can even be there when you aren’t even worried about anything. It’s like panic attacks, for instance. So that was confusing to me, but there was also a feeling because God wasn’t taking it away just miraculously. Maybe he’d abandoned me. 

There’s a particular Psalm, Psalm 13, I think it says “How long, Oh Lord, will you forget me forever? How long will you keep hiding your face? Please answer me.” 

Just the desperation there of the feeling when we’re going through painful suffering and trials of “where’s God in all of this?” It took a while for me to understand growth through affliction and that came gradually. There’s several aspects of this. There’s my own, not understanding the difference between commonplace, worry that everyone experiences, and a disorder like anxiety or a real mental health issue.

That was the biggest hurdle for me to get over was to learn. So when I learned that I had OCD and I learned I have panic disorder, I was able to shift over into, “well, maybe this is how God’s answering my prayer.” I was able to see just like if  because I do have hypertension, the answer to that, God gave me wasn’t you just miraculously heal my hypertension, it was for me to go on medication, treat my hypertension. And so that helped me to understand that these are very real disorders and to learn about how they develop, why they develop, how they’re genetic. I see that in my family that’s definitely genetic and that it’s not a sin to treat a disorder and affliction and seek professional help for it.

That was something I had to work through, but when you try to talk about it to other Christians, actually, if you don’t know what’s going on, but you know it’s a mental health issue. You may not know, like we’ve talked about how you can have OCD and not know it. So you might be going to a pastor or Christian friend, and you might talk a little bit about your anxiety disorder.

They come at you with what I call “mini-sermons.” They start telling they start quoting you all the verses about anxiety as if you’d never heard them before. It was especially when they know you’re Christian. They know you study the Bible. They know that you followed Christ to the best of your ability.

It’s very condescending because they water it down too. “You just don’t know how to not worry because you don’t trust God.” This is a faith issue. If you had more faith, it’s even gone so far, and this is the one that drives me the most nuts is if you have a mental health issue or anxiety disorder, people will say things to you like you have a theme? That sort of thing. That’s bad. This is awful especially for a person with scrupulosity, religious OCD themes. I mean, that’s horrifying. It just makes it 10 times worse. There’s this lack of knowledge out there when it comes to understanding these disorders.

I really think anxiety disorders are probably the least understood because of Bible verses about worry being equated with an anxiety disorder and they’re not at all the same. And if you’re a sufferer you definitely know the difference, but people who don’t have experience or a loved one who they know and see going through this, they just automatically assume, unfortunately, that this is what it is.

Carrie: Right. It’s hard for pastors and ministry leaders to understand. They don’t necessarily have that type of training or clinical background. And sometimes they’re dipping toes in the water that they need to kind of stay out of and just say, “Definitely we will support you and love you and pray for you but we also want you to get professional help because that’s important and God can use those things in your life. God can use therapy and medication.” These negative experiences that you had with maybe pastors or other people in the church who were well-meaning, let’s say, and trying to help you, did that cause you to want to go public with your story and write a book?

Mizi: Yeah. Yes, it really did. It wasn’t just that though but that was a big part of it. What you just said about they really don’t have the training or the ability to recognize these disorders. Scrupulosity, for instance. If a person is struggling with doubts about their salvation and maybe this pastor has known this person for most of their life and they’re suddenly in their office and they’re going through all these thoughts with them, then the pastor gives them the reassurance from scripture and they’re like, “okay” and then they come back again.

They start saying the same thing over again and even the pastor there’s a level of frustration that can develop and they’re not equipped and they aren’t knowledgeable about OCD and how it manifests itself in a person who’s suffering. So I found that it was really important to share my story about living with anxiety disorders as a Christian and a Christ-follower, but in particular about OCD because it’s so misunderstood. And in particular about scrupulosity OCD because when you go that direction, people are even more inclined to think it’s a spiritual issue even the sufferers themselves really struggle.

They can even know they have OCD and they accepted about all the other kinds of themes and obsessions that they struggle with. For some reason, when it switches over to their relationship to Christ then it’s a spiritual issue. So the book explains why it’s not, and that OCD is OCD no matter what the theme, the treatment approach is the same. If there are things you don’t understand, which is very possible about your walk with God that you can learn through the Bible true, valid, real questions in OCD that can even happen because we’re all at different places in our walk with Christ. [00:37:05] You can still learn that thing, but you don’t have to learn it 50 times. That’s when you know, what’s OCD. It’s like if the answers don’t suffice, if the anxiety isn’t satiated, and laid to rest with answers that are logical reasoned arguments, it’s OCD. Especially if you have OCD, you can pretty much be sure. And so I wanted to lay that all out my own journey because I felt that there’s probably a lot of people with this struggle. If a Christian, a believer, a follower of Christ has OCD, there’s a good chance that it’s going to go that direction and they’re in their life at some point, because OCD always goes after what’s most precious to you.

And for the Christian, their walk with Christ is the most precious thing of their entire existence. So it’s going to go there and I wanted people to understand they weren’t alone, but I also knew there were a lot of people like me who got all the way to 50 or 25 or 30, 40, whatever and didn’t even know that that’s what it was. I thought by sharing my story they could discover that the way I did and, and get directed towards the help they needed and that was important to me. The other aspect of it is the growth in it through that. Before I go there, I did want to add to what you said about ways that the church can support people with these issues, these different kinds of anxiety, all mental health issues as far as that goes. 

I think the number one thing they do is listen and then validate the experience as a real affliction not merely a spiritual issue that can be fixed by more prayer, more Bible study, more faith but to literally be willing to support people and say, “Hey, this is a real medical or mental health issue for which you can get help. We want to encourage you towards going to your doctor and starting that process. We want to encourage you that if they say you should see the specialist to go ahead and do that.

We want to encourage you that if they suggest medication might be helpful to you, by all means, please, please do that because it’s so harmful to say things, like it’s a lack of faith and taking medication, means that you aren’t trusting in God and all the things that you can.

And it’s so harmful and I don’t even know how to describe what I’m trying to say. It puts up such a roadblock.

Carrie: It just makes the problem worse. 

Mitzi: Yeah and it hurts people. It’s important for churches to be able to be compassionate, pray for the person with a mental health issue, and the same exact way you pray for anybody who has any other type of health issue. Treat them the same, validate instead of turning it into a spiritual issue. I wanted to say that this is what the church needs to do. 

Carrie: Yeah. I think that that’s so important and so helpful because we have this ability to rally around people who have just had a baby in the church. We’re really good at that. We can bring you a casserole and we’re really good at rallying around somebody that’s going through cancer or has lost a loved one but then when it comes to something that’s invisible, like an anxiety disorder or OCD, almost like people don’t know what to do with that.

Mitzi: Yes. They either don’t know what to do with it or they’ve kind of bought into the stigma and I’ve tried to kind of sort that out. I don’t know all the reasons people don’t believe in the validity of mental health issues but I suspect that part of the reason might be just a fear of my total health issues because of when I was really young and I was first starting to experience these mental health issues to the point where they were debilitating, all I could think of was I’m going to get locked up in asylum. So there’s these visions and pictures that people have of what it’s like or what people are who are crazy, that sort of thing.

So there’s fear around stigma of what it is to struggle with any kind of mental health issue and it said because there’s so much help out there. There’s so many people in the churches that are sitting in the pews who have mental health issues and you won’t even do that. 

Carrie: Absolutely, that’s huge. So as we’re getting towards the end here at the end of every show, I like to ask the guests to share a story of hope since this is called Hope for Anxiety and OCD. So this is the time that you’ve received hope from God or another person. 

Mitzi: Okay, there’s lots of stories I could tell. There’s been so many things and I get notes from people all the time about how the book has led to them for the first time discovering this is what’s wrong and finally getting the help they needed. So that’s how God’s used my experience where you comfort one another with the same comfort you yourself have received from God, which has been very humbling to me. For me, I don’t even remember how I knew to read this book, but I picked up a book by a person called John Bunyan that he wrote in 1666 and it’s called “Grace Abounding to the Chief of Sinners.” Mr. Bunyan’s story resonated with mine in ways I could not have believed. As I read this book about his experiences, really what he had was OCD scrupulosity. When you read this book, it is just absolutely eye-opening and the struggles that back and forth.

That’s how it debilitated him, how it crippled him, how he would be trying to even preach later on a sermon and the intrusive thoughts would just be blaring in his head and he was so terrified they were going to come out of his mouth right while he was preaching and it just crippled him. He tells this whole thing and it’s so interesting to read because it’s like that’s what it was like for me. At the end of his account, in this book, he says, he admits that this thing was an affliction that God had allowed in his life. It was an affliction. The very next thing he says is God, I’ll use his language, “God Duff order it for my good” and then he gives this list of all the ways God had used this to grow him and his faith. Even his account of how he learned to just accept the uncertainty of the thoughts and to press on in his choice to venture all for the sake of Jesus Christ was ACT basically.

This is amazing. I’m thinking God knew that I was going to read that book. He wrote it in 1666. God knew when I read that book, John Bunyan’s story was going to encourage me and it would show me something. It would show me that this affliction has a purpose. The last chapter of my book, I share the purpose in my own life.

That chapter is called Purposeful Affliction. One of the biggest ways I’ve changed in how I talk about my anxiety disorders and in my OCD in particular, as I used to kind of go along and say, “well, I have OCD, but God can still use me in spite of it.” That’s kind of how I worded it. Now I say, I have OCD and God is able to use me because of it. That’s because of the ways He’s grown me through this experience of affliction. That’s not uncommon. God, Paul talked about it, talked about a storm in the flesh. God said to me, my grace is sufficient for you. My strength is perfected in your weakness.

Paul ends up saying, I’m going to glory in this affliction because of this because when I’m weak, I’m depending on God’s strength and not my own. God uses these things in ways, perseverance, and empathy. The things that I learned through my OCD in particular, in my OCD scrupulosity is just amazing but reading that book that was just literally a godsend. And you think about it, they didn’t even know what OCD was back then, but God laid it on John Bunyan’s heart to write about it and so 1666, 150 years old. Here we are and I’m like reading this book and I’m like, “this is amazing.”

It just shows that OCD has been around for a really long time. It’s not a new thing. It’s just that we now understand you know what it is and there’s help and there’s hope, and everyone who is struggling with this, I just want them to have the chance to understand what it is and how to get help especially for my brothers and sisters in Christ. 

Carrie: Right. Your story and what you’re doing and just being vocal and open about being a very strong Christian who has also had a struggle in an affliction, I think it’s so hopeful to other people. Hopefully, who will hear this podcast, but what we’re talking about with church leaders that such my passion and desire is that people would just get however they get it, whether they’re getting it through listening to a podcast or reading your blog or talking to somebody with a personal struggle. I just want people to be able to sit with people in pain and say, “We’re here for you.”

Mitzi:  Yes. It’s so huge. It is so important and it’s important to understand that it’s painful. Like you called it invisible and it is. I would still get up every day, go through the motions like a robot. Sometimes I would fix my hair. I would put on my makeup. It was difficult to go out when I was really, really sick, but I still did it. I would sit in church and be tortured because of my OCD, but I would sit there and sometimes I’d want to run out, but you can’t see it. It is really debilitating.

The only way you could see it on me was I would get really skinny. I would get quieter. I would withdraw. I probably didn’t smile and laugh much. Those kinds of things but it’s very painful. For me definitely has been the thing that caused the most pain in my life and the most long-lasting because it can just hang on and hang on. I went through one whole pregnancy with it and then in between, and then another whole pregnancy. I still had the same thing going on. That’s how long it can hang up. 

Carrie: If people want to dive in and read your whole story, will you tell us the name of the book? I will put a link to it in the show notes as well. 

Mitzi: Sure. The name of the book is “Strivings Within-The OCD Christian” and you can find it on Amazon. If you just write that in and even my name, you can look at my name, it’s VAnCleve. That’s the main book I have out there. I do have another book.  We’ve talked about as far as OCD today necessarily, but it’s a direction, another direction up and going, and it’s a fictional book with a little bit of my experience mixed in as a teen. That was about what it was like to have social anxiety and it’s written in a fictional form and that one’s called, “That’s in Your Dreams. That’s the name of that one. That’s all also on Amazon, but it’s kind of a nice book for teens who struggle with that type of anxiety, social anxiety. It might be relatable to them in a story form. It’s just a story about a girl trying to go to high school and trying to fit in, be normal and the social anxiety is always shoving her back down. And so I want to try to work on those kinds of things too for teens, but I haven’t been very dedicated with that.

Carrie: Thank you so much for coming on and sharing your story.

Mitzi: Thank you, Carrie. I appreciate the opportunity, anytime. I can share not because of what it does for me, but what I hope it might do for someone else who’s looking for answers, looking for hope, looking for someone who can relate to what they’re going through. And also like you said, for the church and for pastors and people in leadership positions to understand better what these disorders are, what they’re like, and how they can help. So thank you. 

Carrie: Ever since I did this interview with Mitzi, I have been really pondering this idea of growth through affliction in our lives. I hope that you chew on that one for a little bit too because there are so many different things that God uses that are hard to go through and yet they grow us closer to him. They grow us closer to other people and they shape our character in ways that we might never have received had we not gone through those difficulties.

I hope that this podcast has encouraged you. If it has, will you do me a big favor and tell a friend. There’s probably someone in your circle of influence who needs messages that will help them reduce shame and increase hope and that’s what we’re all about on the show. Thank you so much for taking the time to listen today. 

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

What is EMDR?

Written by Carrie Bock on . 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.

Is ERP the Only Option for OCD?

Written by Carrie Bock on . 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.     

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Hope for Anxiety and OCD Podcast – One Therapist's Story of Discovering Her Scrupulosity OCD with Rachel Hammons

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

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

  • What is Scrupulosity OCD?
  • How Rachel discovered she had been struggling with it
  • How to determine if this is a normal level of spiritual concern or could be OCD
  • Exposure and Response Prevention
  • Learning how to sit with discomfort and ambiguity  
  • Getting to know the character of God and filtering information through that lens

 Verses discussed: Phil 4:6, 2 Cor 10:5 

Resources and links:
Rachel Hammons
More information on ERP and OCD

By The Well Counseling

More Podcast Episodes

Transcript of Episode 8

Hope for Anxiety and OCD Episode 8

Hello, if you are new to the show, we are all about reducing shame, increasing hope, and developing healthier connections with God and others. 

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

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.

Should I Take Medication for my Anxiety or OCD?

Written by Carrie Bock on . Posted in Anxiety, OCD. No Comments on Should I Take Medication for my Anxiety or OCD?

Maybe this is a question you’ve asked yourself. Perhaps you have concerns about side effects, becoming dependent on medication, or wonder if this option is for you. My response to this question is always the same: It’s a personal decision. Each person has to decide what is best for their body depending on their own symptoms. Some of my clients are able to tolerate medication with little side effects while others try several different medications and react negatively to all of them. Some want to try counseling first before starting medication. I respect and honor each individual’s decision.  

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