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167. More Therapy in Less Time: Intensive Outpatient with Madasen McGrath-Wilson

Written by Carrie Bock on . Posted in Counseling, OCD, Podcast Episode.

Join  Carrie as she continues the Themes and Treatment series, offering insight into the different treatment options available for OCD. 

In today’s episode, Carrie welcomes special guest Madasen McGrath-Wilson, an associate marriage and family therapist and associate professional clinical counselor in California, to discuss an intensive treatment option: Intensive Outpatient Therapy (IOP).

Episode Highlights: 

  • How to recognize the signs of OCD and the challenges of receiving a proper diagnosis.
  • The role of Intensive Outpatient Therapy (IOP) in OCD treatment and how it differs from traditional therapy.
  • How faith and evidence-based treatment can work together in the healing process.
  • The benefits of a personalized, one-on-one approach to intensive OCD treatment.
  • Steps to take if you or a loved one are considering an intensive treatment program for OCD.

Episode Summary:

Welcome back to the Christian Faith and OCD podcast! I’m Carrie Bock, a licensed counselor helping Christians navigate OCD with faith and practical tools. 

Today, we’re exploring Intensive Outpatient Therapy (IOP)—a treatment for those needing more support than weekly sessions provide.

I’m joined by Madasen McGrath-Wilson, an Associate Marriage and Family Therapist and Associate Professional Clinical Counselor based in California. Madasen specializes in OCD treatment and has a personal journey of overcoming OCD herself. She shares her experience of silently struggling for years, receiving a diagnosis, and bravely stepping into treatment.

We explore the critical role IOP plays in OCD recovery, especially for individuals dealing with moderate to severe symptoms who need more support than weekly therapy can offer. Unlike inpatient hospitalization, IOP provides more frequent treatment without requiring clients to leave their daily lives.

Madasen and I take a deep dive into how IOP can benefit those who have struggled with traditional therapy and are searching for a more intensive, tailored approach. At the OCD Treatment Center, Madesen’s team offers a unique, personalized program designed to support clients on their journey toward healing—helping them overcome the shame and challenges OCD brings.

If you’re struggling with OCD and feeling stuck, know that there are treatment options available, and you don’t have to walk this path alone.

Tune in now to find out if IOP might be the right step for your healing journey.

Related Links and Resources:

website: theocdtreatmentcenter.com
email: info@theocdtreatmentcenter.com

Explore Related Episode:

Transcript

Carrie: Welcome back to the themes and treatment series of OCD. I think what’s so important for you all to know is that you have options when it comes to your treatment, and so that’s what I’m really big on talking about. Hello and welcome to Christian Faith and OCD with Carrie Bock.

I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing.

When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you with practical tools for developing greater peace. We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith.

I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode. Today we’re talking about a particular option of treatment called intensive outpatient therapy. You may or may not be familiar with that. I am joined by special guest Madasen McGrath Wilson, who is an associate marriage and family therapist and associate professional clinical counselor in the state of California.

She received her master’s degree from Chapman University and has provided therapy to individuals of all ages facing a wide variety of mental health challenges. Madasen’s passion for helping others with OCD was born out of her own personal experience with the condition, and she is in a great place of recovery, which she’s going to talk about later, where OCD rarely affects her daily life.

Her mission is to support others in overcoming OCD and anxiety so that they too can experience that same life change that she experienced. Madasen, so you’re a therapist with a lived experience of OCD, and so I’m curious for you what that process was like of going from, hey, I know I need help, which is, I know, I think for you, like many people, there was a long road from symptom to diagnosis, which that’s like one hurdle.

A lot of people who struggle with OCD face, like, I have all these symptoms, I don’t know what it is, I just feel awful, I’m dealing with all these thoughts, and then once you got to have a diagnosis, what was that hurdle of like, oh, I know I need help, but maybe I’m not quite ready to do this, maybe I just want to avoid it all and not engage, how did you get through that hurdle?

Madasen: Yeah, I think everybody’s process looks different, but for me, just as you were saying, I probably lived with OCD for at least eight years undiagnosed, not knowing what it was. And as I was getting older throughout high school, college, it was progressively getting worse. A lot of intrusive thoughts, a lot of symptoms of OCD that kind of fly under the radar, because it doesn’t meet the stereotypical kind of understanding of what most people think of when they think of OCD.

Lived with it undiagnosed for a while and then once I did finally discover that it was OCD and that there was treatment for it, There was definitely a sense of relief that I experienced, but I would also say I was very resistant to the idea of getting treatment. I did a lot of research on what that would look like.

I read about exposure response prevention therapy. And to me, the idea of just opening up to anyone about the thoughts that I was having was Terrifying enough, let alone the idea of confronting my fears and learning how to tolerate the anxiety and respond differently to it. There was a good, probably two year process of me just kind of being on edge, knowing that I likely was struggling with OCD and hearing that treatment could be very effective, but being very hesitant about making that leap.

And like I said, I think everybody’s is different, but my own process kind of looks like. When I was graduating from college, I just finally had the realization, really at my college graduation, that things were not magically going to get better on their own. I think I had this idea in my mind that with enough time, OCD would Kind of cure itself.

It would fix itself. I thought it would go away on its own. It really hit me as I was finishing college, kind of not knowing what my next steps in life were going to look like feeling kind of at the end of my own rope, having had a really difficult time throughout high school and college because of OCD.

It just struck me that things were not going to magically resolve themselves. And if I wanted to get better, I needed to take the risk of being willing to be vulnerable and being willing to try something new. It kind of felt like my own personal rock bottom. I think everybody’s rock bottom looks different.

But for me, it was just coming to a place where I felt like I didn’t have anything to lose. I realized OCD was not going to go away on its own. I knew I needed help and I recognized I had to be willing to risk and do the hard work. I think for me, it was a process of kind of humility, kind of recognizing and accepting.

If I want things to change, I have to be willing to change. What I was doing was not working. I needed to take a new approach.

Carrie: It is hard for people to accept the OCD diagnosis because it does wax and wane sometimes with stress. And so people will have periods maybe that are a little bit better and they might think, Oh, okay, well, maybe it’s getting better.

Maybe it’s working itself out. I’m pretty sure you’re not alone on that as far as well. Just maybe we’ll just let this ride. Time heals all wounds, that type of situation. Of course. It’s hard enough to sit with the fear yourself, and then you think, oh, now I’ve got to go share this with somebody else. I really don’t want to do that.

But I appreciate you sharing that process because I have, I think, seen some of those same struggles in other individuals that I’ve worked with. I’m just getting to the place of, okay, it’s time. Here we are. It’s time to dig in, and it’s time to do the really hard thing. And you can do hard things when you have the right support.

That’s something I want people to know too. It’s a lot, it’s still going to be challenging, but it’s a better process when you have the right supports in place to be able to get you through those hard places. We’re talking today on the show about intensive outpatient therapy. So there’s different levels of care that people have.

You can go to outpatient therapy, which is typically like once a week, you see somebody in person or you see them online via telehealth. Some people may go every other week if they’re not too severe, or they may start going weekly and then go to every other week, obviously, and then intensive outpatient would be kind of this in between place between I can still kind of get some more intensive treatment while at the same time not having to go to an inpatient hospitalization where I stay there all day or I stay there for a week or something like that.

So it’s kind of this in between level of care. How do you define that? Or how do you look at it in terms of how do we know if we need this level of care or not?

Madasen: I would say intensive outpatient programs specific for OCD can be very helpful for people that are struggling with what we would label as severe symptoms of OCD.

Maybe they’re not homebound, they’re still going about their day to day life, they’re still functioning. But they’re struggling to get the help that they need through just weekly treatment. I know every intensive outpatient program looks different at every facility, but I think for the most part, intensive care is defined by the fact that, like you were saying, you’re not staying at a residential facility, you’re not being hospitalized.

But you are doing treatment on a much more regular basis than you would be if you were just doing weekly treatment. Typically, most programs are going to involve getting treatment for an extended period of time every day or at least most days of the week. And again, I think that can be very helpful for people that are maybe at the higher end of moderate symptoms and also those who are crossing over into more severe or extreme manifestations of OCD.

Carrie: Right. Tell us a little bit about the program at the OCD Treatment Center that you work with and how is that different maybe from other intensive outpatient programs that you’ve heard about or worked with?

Madason: Yeah, well I think first of all it’s very difficult to find an intensive outpatient program that’s specifically geared to OCD.

The program that we have here at the OCD Treatment Center where I work is unique in the sense that it is fully, it’s an OCD program, so that’s all we specialize in, that’s all we work with. I would say the other very unique feature of it is that it’s fully one on one. So the format of the program is, it involves working one on one with the same therapist for three hours a day, Monday through Friday, for three weeks.

And that one treatment, right, the component of being able to meet with the same therapist day in, day out, for three hours each day, I would say is, again, the most unique feature of the program. A lot of intensive outpatient programs tend to be group oriented. There’s a lot of group therapy involved. But with our intensive outpatient program, it is fully one on one because it gives us the ability to really tailor treatment to the individual, meet their specific needs, create a treatment plan that is specifically geared toward their symptoms.

Carrie: Yeah. And I found you specifically because you’re a therapist there that provides an integration between Christianity and these evidence based practices. So that was extremely unique to me, because I think, like you said, it’s very hard to find an OCD, intensive outpatient program, but then it’s definitely hard to find someone who’s willing to integrate Christianity into those pieces as well.

Like, that’s really huge. I think we have to kind of look at when we’re talking about should people do outpatient therapy or intensive outpatient therapy, you talked about the severity. Would you say that maybe you see individuals as well who have tried some ERP before, or they’ve tried specific therapies on an outpatient basis and maybe weren’t able to be successful with that for one reason or another, and this more intensive program has been beneficial to them?

Madasen: Yeah, absolutely. We get a lot of clients who have done OCD treatment before and have felt like treatment didn’t work for them. There can be a variety of reasons for that, but I would say the most common case is we get people who have tried weekly treatment for OCD and just felt like they were not getting the results they were looking for.

And I think it’s very easy for people to then become defeated and start to assume like, Oh, I am the small minority for which treatment doesn’t work. Maybe my case is exceptionally difficult. We get a lot of that coming in to our intensive outpatient programs. And what I find and what I always like to say is I think a lot of times it’s not the treatment that isn’t working.

I think people sometimes are just not getting enough of what they need. It’s a silly analogy to an extent, but I always like to say it would be like if you were sick and you needed to take an antibiotic and your doctor gave you like a tiny little dose. You might not get the results you’re looking for, you might not be feeling better.

It’s not necessarily that the antibiotic you’re taking isn’t working, it’s you’re not getting the dose you need. And so I see that a lot with therapy. When someone’s dealing with more severe symptoms, it’s not that weekly treatment can’t be effective, but you are sometimes putting a band aid on what feels like a bullet hole when you’re just meeting with a therapist for 50 minutes once a week.

I know a lot of people feel like they’re not able to build the momentum that they’re hoping to build and progress in the direction that they’d want to for people who feel kind of stuck in weekly treatment or people who feel like they need a greater sense of accountability, which I think an intensive outpatient program offers the intensive outpatient program format is really beneficial because Each day you’re building more momentum.

You are going to be held accountable, right? Your therapist is going to make sure that you’re implementing what’s being taught each day into your daily life. We’ve just had multiple stories here of people who have tried treatment elsewhere and came in kind of with a poor mindset, feeling like treatment wasn’t going to work for them, being very sick, skeptical of our intensive outpatient program, but on the other side, being very thankful that they gave it a chance because they realized they just needed to find the right fit in terms of a therapist and get that more intensive, highly individualized care.

Carrie: Yeah, I think that that’s a good point that obviously there’s challenges.

When you talk about doing weekly therapy, it’s not bad, but just to say that there’s benefits and challenges and the benefit, theoretically, of weekly therapy is you go, you leave, you practice the skills at home. Like you said, you integrate differently into your environment. If you’re doing exposure therapy, you’re doing some exposures outside of therapy and.

So forth and you come back and you report this went well, this didn’t go well, you adjust things like that, but it also can be challenging if your therapist is sick one week and then you have a sick child and aren’t able to come or you can, like you said, lose momentum in some of those situations or your schedule just gets really crazy with work and you’re having a hard time.

Sticking, being really devoted to that hour. And I know with me, like I’ve done some intensive work with clients and there’s something different that happens when your brain has more time and it knows that this is a dedicated space for treatment versus I have to leave here and then go home and make dinner for the family and put the kids to bed and do all of those things.

Can you talk a little bit maybe about like the compartmentalization and I mean that in a healthy way. We’ve compartmentalized these three weeks for treatment. How have you seen that be a helpful part of people’s process?

Madasen: Yeah, I think it allows people to prioritize treatment in a way that is difficult to do with weekly treatment.

And again, that doesn’t mean that weekly treatment is not a good fit for people. I’ve seen it work for a lot of people and nothing against it at all. But I think the benefit of the compartmentalization of the three weeks is you get to take three weeks and make OCD treatment your primary focus. And of course, everybody’s busy.

We all have other things going on alongside treatment, but for the most part, right, you’re at least designating three hours a day to focus on working with your therapist, implementing what you’re learning and integrating it into your life. I think that that’s a rare component of intensive outpatient therapy.

You’re kind of making the commitment to focus a designated period of time on your treatment and making that commitment to yourself, doing that for yourself, which I’ve seen work very well for people, especially people who have very busy lives. And if they were to do weekly treatment, as you’re saying, they’re kind of, it’s one of the plates that they’re balancing with.

Many other things, and it can be easy for treatment to get lost in that mix. Whereas I think with the intensive care, you’re kind of putting a spotlight on your treatment and that time that you’re devoting to yourself to get the care that you need.

Carrie: Yeah, I think that’s really huge. People also associate intensive outpatient therapy as being very expensive.

They’re like, oh. Wow. And you have people that travel to see you, so they’re paying travel expenses and situations like that. Do you believe that there are instances where this can actually save people money versus being in weekly therapy for a long time?

Madasen: I do. Again, if someone is dealing with more severe symptoms, it’s not that weekly treatment can’t work, but I think a lot of times people aren’t really considering the math of how much time and money weekly treatment is going to take potentially in their lives if they’re to continue with treatment for months or even years.

It does add up. It’s no surprise to anyone that OCD treatment is very expensive. And if you’re pursuing weekly treatment, those weekly session fees do quickly add up. And so the way that I see it is the intensive outpatient program is certainly an investment. It’s an investment financially. It’s an investment of your time.

But in all this, I’ve seen the return on that investment be huge because of the ways in which someone can create change in a condensed three week period. And our entire goal is to equip you with everything you need to essentially be the master of the tools and skills that you would be using. So that you feel like you can support yourself moving forward.

And that doesn’t mean that you might not need some follow up care after the three weeks. A lot of people will then do a few weekly sessions after the three week program, just to maintain their progress and feel like some support as they go back into their daily life and daily routine. But for the most part, the bulk of the work has been done in that three week period.

They have everything that we could possibly give them. We have trained them to be able to implement all of that stuff on their own, kind of build their confidence to be able to manage triggers on their own. As a result, I think it’s easier sometimes for people to, after doing that highly intensive care, Return back to work, and if they were returning back to work and they’re able to be more productive and engage with work in a more healthy way, there’s a return on that investment that they made in the program.

We have a lot of clients who aren’t working because they feel like OCD is interfering with their ability to work or focus at work. I’ve seen the three week program for certain people. Enable them to be able to find a job and get out of unemployment long term. I think the return on the big investment that someone is making with intensive outpatient program care can be huge and it is an investment upfront.

It’s a big investment up front for a lot of people, but I think it ultimately can save people time and money. And for me, I think about my personal experience. I didn’t realize that there was intensive outpatient care available for OCD, so I just thought weekly treatment was my only option. Weekly treatment was very successful for me, but it took me probably a good at least a year and a half to feel like I was in a place where I could discontinue care.

And when I think about intensive outpatient care, I think about How that probably would have suited me better in the sense that I probably would have made progress a lot more quickly and been able to taper down treatment and potentially save time and money that way. So it’s just something to think about and consider because it is a big investment for people.

But I think, like I said, potentially a huge return on that investment if you’re willing to find the care that is. It’s able to be tailored to you specifically and able to provide you with the support that you need.

Carrie: Yeah. I think that this is really great. I think you spoke to one of the reasons that we’re doing this themes and treatment series of OCD is so that people can know that they have options, that they don’t have to just pursue one type of treatment, that they can look at doing some therapeutic intensive, they can look at doing intensive outpatient treatment.

They can look at doing weekly therapy. And putting their whole heart into what am I doing inside a session? And then what am I doing outside a session? Because I think sometimes what you’re doing outside a session in those weekly sessions is just as important as what you’re doing in that 45 to 50 minutes that you’re in session.

That’s pretty huge. I definitely can see a difference in progress if clients are doing their homework versus not doing their homework. Like you said. When they’re there, when they’re right in front of you for a few hours, you have the accountability and you have a little bit more time maybe to get into some things a little bit deeper than you would have in just a 50 minute session.

So that’s a great benefit too, that people feel like, okay, I can really open up about maybe this big fear or this big issue. Sometimes it takes people a little while to get into it, if that makes sense. And then once they’re there and they’re like, oh, okay, well, I have this carved out space. I can get into it a little bit deeper and work through it.

And I think that that’s really beneficial to let people know they have options. And to not give up hope. That’s what we’re all about here on the show, as well as to let people know. Don’t give up hope. Don’t give up on treatment or yourself because the first thing didn’t work. Maybe you found a therapist and you guys just didn’t jive together at all.

You didn’t click. That doesn’t mean you just throw therapy out and say, I’m not going back. We wouldn’t do that with the doctor’s office. We’d find a different doctor and we’d say, okay, let me find somebody else that I feel like has a good bedside manner that I feel comfortable with, or I feel like is more knowledgeable about my condition.

Let me go try that again. I know that’s really hard. I just want to speak to that, that it’s hard if you feel like you’ve had a negative therapeutic experience. It’s tough to get back out there and to make the consultation calls and send the emails and the website forms to try to find the right fit. But I just encourage people to do that.

Take your little break, breathe if you need to, and then say, okay. This is about me. This is not about what happened with this person. I’m going to get back and I’m going to keep going and I’m going to continue to pursue having the abundant life in Christ, what we’re after. How have you seen, like, in this Christian integration that you do, like, the power of, you said, biblical based truth being combined with evidence based practice, and those were your words, that I stole, but I wholeheartedly agree with them because I feel like I try to do similar things.

So tell me about that power.

Madasen: Yeah, absolutely. This is something that I’m probably most passionate about. I really do feel that the evidence based treatment or anxiety and OCD treatment does align with biblical based truths. I love the integration of both. I think the biggest way that I see that alignment is whatever method of OCD treatment you end up pursuing, whether it’s exposure response prevention therapy or ICBT, At some point, that treatment is going to ask you to face your fears and to set aside your safety behaviors or compulsions to actually surrender control in the face of anxiety.

When I’m working with Christian clients, Right. The great thing is that I can remind them that we have someone to surrender that control to. We can learn to surrender our desire to have a sense of safety, a sense of security, give that to God. And for that reason, I see OCD treatment as an exercise of trust and faith.

We can put that faith in God. We can kind of loosen our grip on the steering wheel that we’re gripping so tightly, trying to make sure nothing bad happens or secure our safety in some way. But as Christians, we have somewhere to place that trust. And I find that to be very powerful because facing fears is not easy.

It’s a big ask to have someone confront their fears and set aside their compulsions because their compulsions are what is making them feel safe, even though it is perpetuating the entire problem. It’s a big ask for people, but I think when you have somewhere that you can place that faith and that trust, it makes a huge difference.

And so I really love that combination of evidence based treatment and the power of Christ. I think there’s nothing greater than that for people that are requesting a faith based approach to treatment. I think that not only does it help enable them to successfully overcome their OCD, but it can also be an opportunity for them to grow in their faith and their relationship with God.

And I just love being able to witness that.

Carrie: Yeah, I think that’s really incredible and recognizing that as you work through these. treatments, getting to a place where you can do things that you weren’t able to do before, whether that’s inside your faith, like going to church, Oh, I was getting too triggered and I wasn’t able to go to church or I had such a big struggle with reading my Bible because every time I would come across certain words or I couldn’t read certain stories, when they’re able to work through those things and get to the other side and say, okay, Now I’m actually able to serve in the church because I’m not afraid of children anymore.

I’m able to connect with the things that are really important to me. Like that’s completely life changing. So beautiful to watch people go through that process.

Madasen: A hundred percent it is. And I think it’s just such a powerful reminder just to point clients in the direction of relying upon God’s strength rather than their own strength, because I think part of the problem of OCD is oftentimes we are relying upon our own control.

We have a little bit of a control issue or wanting to be in control. When we can learn to, again, release some of that control unto God and rely more upon his strength and believe that he’s going to help fight this battle on our behalf. And we just have to trust and set aside our own safety behaviors and compulsions.

Yeah, it can be very transformational, and I love to just walk alongside people with that journey that they’re on.

Carrie: Awesome. Well, this has been great. I have one last question. Because you have lived experience, I had someone ask me recently, what does recovery look like? They said, does this mean it doesn’t show up anymore?

Does it mean that it pops up at different points? For you, how would you answer that? What does recovery look like?

Madasen: Yeah, such a great question. I don’t remember where I saw it, who wrote this quote. I cannot take credit for it. I saw some OCD therapists post online recently a quote that really resonated with me.

Something along the lines of recovery from OCD does not look like no longer experiencing the presence of OCD, but rather learning to not fear its presence. So I think what I take away from that is OCD is still there to some extent, granted it’s, if you’ve done the work, if you are no longer engaging compulsions, it’s usually much more in the background, it usually pops up for people a lot less frequently, that’s certainly my experience, I feel like it’s night and day from where I used to be and It’ll pop up here and there, but it’s nothing in comparison to how in my face and loud it was originally.

Its presence still is there to some extent. It lingers. It has the ability to kind of pop back in, pop up. But I think the biggest difference is that we don’t fear it to the same extent anymore. We’re not living in fear of it. We’re not feeling as though we’re walking on eggshells anticipating the next trigger.

There’s an acceptance of, yeah, it could rear its head. There’s some times where I’m gonna get triggered. But there’s a confidence in your ability to move through that and a confidence in the tools that you have to be able to manage it. As a result, there’s just less of an emotional reactivity that someone experiences when their OCD shows up.

And so I think it’s the fear component that’s the biggest difference. The fear begins to subside and ultimately OCD’s presence gets a whole lot smaller. Which is great, but I think it’s the fact that we’re no longer being terrorized by it and living in fear of it. That’s the biggest change. And there’s so much freedom and that to feel like the thing that was once your biggest fear, right?

The thing that was terrorizing you the most to watch it go from being all encompassing to being background noise and something that you no longer flinch at when it rears its head is really the change that I experienced myself and that I see for a lot of my clients. And that’s how I know someone is really in recovery and on the right path.

Carrie: Yeah, I think that’s a great answer. I love how you said in the background, too. That’s something that I, an analogy I usually use is it’s in the background, not in the foreground, but it’s also good for people to hear. Hey, it’s possible you’re living proof of that every day, and now you’re helping people get to that place of freedom as well.

So thank you for coming and sharing today.

Madasen: Oh, yeah, absolutely. Thank you for having me.

Carrie: As some of you already know, I’ve been providing intensive therapy for the last few years now where people come to see me. between one and three days. And it’s a great opportunity to really kickstart your recovery process, to get some foundational skills built in or to process through some trauma that you’ve had from your past that you know is really contributing to your obsessional story.

If you want more information on that, you can definitely check out my website at kerrybach. com. To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings, and receive information on exclusive sales, become an email insider today. All you have to do is go to carriebock.com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us. Until next time, may you be comforted by God’s great love for you. Christian Faith and OCD is a production of By The Well Counseling. Opinions given by our guests are their own and do not necessarily reflect the views of myself or By The Well Counseling.

This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

166. When OCD Interferes with Eating. Could it be ARFID? with Brittany Braswell, RDN

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

In this episode, Carrie sits down with Brittany Braswell, a registered dietitian and host of Faith Filled Food Freedom podcast, to discuss a specific type of restricted eating that can be seen with OCD: Avoidant Restrictive Food Intake Disorder (ARFID). 

Episode Highlights:

  • The connection between OCD and disordered eating behaviors.
  • What ARFID is and how it differs from other eating disorders.
  • How OCD behaviors can worsen disordered eating patterns
  • How fear, sensory sensitivities, and past experiences can contribute to restricted eating.
  • The impact of disordered eating on physical, mental, and spiritual well-being.
  • Practical strategies for overcoming food-related anxiety and finding food freedom.

Episode Summary:

In this episode of Christian Faith and OCD, I’m joined by Brittany Braswell, a registered dietitian and podcast host of Faith Filled Food Freedom. Brittany shares her expertise on a lesser-known eating disorder that’s closely tied to OCD—ARFID (Avoidant Restrictive Food Intake Disorder). 

We dive into the challenges people with ARFID face, from sensory sensitivities to fears about eating certain foods. Brittany explains how this disorder, often misunderstood as just “picky eating,” can cause serious nutritional imbalances and impact both physical and mental health. This conversation is also helpful for anyone dealing with eating-related struggles linked to OCD, even if they don’t have a formal eating disorder diagnosis.

ARFID is more than just a fear of gaining weight. It’s driven by sensory issues, trauma, and irrational fears, such as choking or getting sick from food. Brittany and I talk about how these fears can escalate and affect a person’s relationship with food, leading to restrictive eating habits that can be emotionally and physically damaging. We also explore how ARFID often overlaps with OCD, especially when anxiety about food or body image becomes overwhelming.

If you or someone you love struggles with food-related anxiety or OCD, you’ll find valuable takeaways that can help break the cycle of fear and restriction.

This conversation is full of practical tips and biblical wisdom for anyone dealing with food issues, body image concerns, or eating compulsions.

Related Links and Resources:

www.brittanybraswellrd.com

More Episodes to Listen to:

Transcript

Carrie: Hello OCD Warriors, I am very excited to share today’s episode with you. We have an interview with Brittany Braswell, registered dietitian, podcast host of Faith Filled Food I brought Brittany Braswell on the show to talk about a very specific type of restricted eating that can be seen with OCD called ARFID.

However, even if you don’t have ARFID, but you have any type of eating struggles, Related to OCD. I know that there are several nuggets that you’re going to get out of this episode. So let’s dive in

Hello, and welcome to Christian faith and OCD with Carrie Bock. I’m a christ follower wife and mother Licensed professional counselor who helps christians struggling with OCD get to a deeper level of healing I couldn’t find resources for my clients with OCD.

God called me to bring this podcast to you With practical tools for developing greater peace, we’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you.

So let’s dive right into today’s episode. Welcome, Brittany. Tell us a little bit about yourself.

Brittany: Thank you so much for having me, Carrie. I am a registered dietitian by Education and Trade, and I serve in my private practice with Christian women who struggle with disordered eating and negative body image.

So, we’re doing a lot of coaching around Fear foods, food freedom, body image, lots of unhealthy or disordered or intrusive thoughts around food and body. It’s kind of the gamut of it. I love it. It’s a really cool way for me to really take my love for the Lord and really use that to help the women that I work with really escape this place of fear and bondage around food and their body to get them hopefully to a place of freedom where their relationship to the Lord grows in the process.

Carrie: And I know that we’ve talked about there’s an overlap between OCD and individuals who have disordered eating, not all the time, but sometimes I was thinking of some clients, even then I was working with recently that have some hangups around food or have some ideas around food, like you said, that aren’t healthy or that are obsessive, maybe they’re obsessed with the kinds of foods that they’re eating or the amounts of foods that they’re eating people who weigh themselves all the time.

They’re weighing themselves just constantly, or like you said, in terms of body image, sometimes with OCD, they can be constantly checking themselves in the mirror. Yes. Yes. I see that a lot. Do I look fatter? And eating disorders are not my specialty, but I know that I wanted to have you on the show to see if we could talk a little bit about ARFID.

And I know you said that’s something you’ve worked with before, but you run the gamut and work with a much wider variety of eating challenges. Can you tell us maybe a little bit more broadly some of the things that you see?

Brittany: For a lot of the women and some men that I work with, not everyone has a diagnosed eating disorder.

If eating disorder freaks you out, just lay it to the side for a minute. And we’re really just focusing on behaviors that are going to negatively impact essentially your physical and mental health. These are going to be things like restrictive behaviors, meaning you are typically choosing to withhold food.

This is not, may I have lack of access. This is willful restriction. Right. There’s also a lot of different types of binging behaviors. And so. This is not always followed by purging, but that does happen as well. So binging would just be generally eating a larger amount of food in a shorter period of time than would typically be average or comfortable.

That’s kind of the high level view of that. And then lots of clients maybe struggle with purging in some way that can show up not just as making yourself sick, which a lot of people struggle with, but this might also be less recognized. But like, if you feel like, Hey, I just have to exercise, or if you notice you have a compulsion when it comes to movement or exercise.

That can be a form purging that can be really hard on your body, especially if you’re not adequately nourishing yourself. And there are lots of behaviors in between. I know we’re going to dive into RFID a little bit. There are lots of forms of restriction with that. I also love it because it’s a little bit more unique when it comes to the body image piece of things.

If you kind of just think about disordered eating on a spectrum from anything from very highly restrictive to I have no fullness cues or awareness around fullness levels and maybe there’s a lot of binging, kind of see the gamut, everything in between.

Carrie: Okay. What is ARFID? How would you define that? ARFID

Brittany: is an acronym and it stands for Avoidant Restrictive Food Intake Disorder.

The simple way to think about it is, it’s like picky eating on steroids. So often, it shows up initially, for a lot of people, we see it pretty often in kids, and young adults, or teenagers, but it can develop later, or it can get more severe later too, and OCD behaviors can, I hate to say compliment it, but they can kind of overlap.

At the same time, so kind of some of the differences in ARFID versus what most people kind of think about as a stereotypical eating disorder is you’re still going to have that lack of meeting adequate nutritional needs, usually with ARFID, because there’s a lot of restriction, but it’s not typically tied to, Hey, I’m afraid I’m going to gain weight, or I’m afraid my body’s going to change.

There could be a lot of different reasons for it. A lot of times it is sensory, meaning, hey, I’m afraid that, hey, if I eat this thing, I might coke, or if I eat this particular type of food, it might make me really sick, even though maybe I ate it not that long ago, maybe it’s going to make me sick now, or, hey, I’m really afraid this particular type of food because so and so told me it was bad, and so maybe it starts off as a fear food.

Then I’ve had clients that they won’t have an issue with food, but because they get so nervous about it, it’s like their body physically responds and it doesn’t settle well on their stomach. So then they think, Hey, I can’t tolerate it. Lots of times with ARFID, we see there’s not a lack of availability of food, but there is a lot of restriction, not just because of again, like body weight, body image, just a lot of.

Sensory issues and fears typically that contribute to, hey, I’m only going to eat this small handful of items, which you can kind of tell probably from that, you’re typically going to be pretty malnourished from a nutritional standpoint. Not malnourished in the sense of you may be eating enough, but you’re very likely missing out on a lot of key nutrients.

It can still affect your body physically and definitely your mental health as well.

Carrie: I wonder if this can start for people sometimes if they have had stomach issues, either related to anxiety or related to some type of illness, and then they’re afraid to eat certain things because it didn’t make them sick when they were ill, say with IBS or something else.

They’re afraid of having a negative reaction.

Brittany: Yes, I’ve seen that and I’ve seen it too from even just the acute, like, Hey, I ate the food at a restaurant once and I got food poisoning or it just didn’t sit well on my stomach. And so now I feel like I can’t ever have it again. So it can show up in lots of different ways getting started.

Carrie: How would people know that this is something that they’re struggling with? If, say, they only eat a certain number of foods or certain types of foods? How does that show up?

Brittany: I would say the amount that you eat or the particular foods you choose are going to vary person to person, but it is typically a much smaller variety of foods that you are comfortable consuming and that you are willing to consume.

And that’s different because as we work through a lot of the ARFID symptoms, sometimes there’s foods that, hey, I’m willing to eat that, I don’t love it, but I’m working on tolerance with it. I would say the three kind of big areas, you can kind of say, hey, do I have any red flies in this area? When it comes to prototypically, how does ARFID sort of present itself or show up is number one.

Do you have any textural type of sensitivities or selective sensitivity? So an example of this might be, Hey, I really don’t like foods that are smooth and creamy. It’s not just a preference, it’s, Hey, I have a particular response to this, or this particular food makes me like gag or get nervous, or I once choked on something that was crunchy and so I can’t eat crunchy foods now.

Being able to just think through like, are there any textures or even visually, I’ve, I’ve worked with some clients who visually, they really like everything to look the same. As an example of that, like, let’s say that’s going to really limit you on produce because it’s not every single strawberry. It’s going to look the same across the board, right?

Or apples. So apple juice might be more tolerable than fresh apples. So think about sensory kind of things. The second kind of area you could sort of self assess is, am I afraid something is going to happen when I eat this? It’s like a physical aversion. I’m afraid I’m going to choke or afraid I’m going to get sick or I’m afraid something terrible is going to happen.

We can bring in irrational fears and trauma into that too. It’s really easy for a trauma food Which is usually a food that you associate with a specific trauma event. It can be easy for those to turn into food aversions as well. The broader you go with it too, like let’s say, Say you were at Taco Bell and you have a particular trauma history or event that you associate with Taco Bell, then instead of just saying, okay, well, I’m not going to eat tacos anymore, okay, well, I can’t eat Mexican food, so now you’ve just taken lots of ingredients, right, and you’ve said, oh, I can’t have this this way.

So the more broad it shows up, typically the more restrictive you’re going to be. So that’s kind of the second area. So we’ve got sort of sensory issues or selectivity, fear of these aversive or negative consequences. And then sometimes in general, you get like this lack of interest in food or eating. It doesn’t even really sound good.

I think I only like these things. Unfortunately, that’s where sometimes physicians, especially parents and family, will just go, Oh, well, they’re just a really picky eater. You just do it. Just eat the thing. So sometimes there’s a lot of stress related to that, and it can actually push people further away even from wanting to or being willing to try new foods.

So that lack of interest shows up sometimes as well. So you can do a kind of a quick little assessment in each of those areas and just go like, Self check wise, are there anything? Any behaviors or thoughts or fears in any of these categories, maybe that present a red flag?

Carrie: Yeah, there’s a couple of things that I was thinking as you were talking about that.

One is that we have something in ICBT that we call living the fear that with OCD. So when you have something like, if you have a doubt, is this going to make me choke? Or am I going to get sick from this? Then all of a sudden, I mean, your throat may actually constrict a little bit. Which happens with anxiety.

A lot of people don’t realize that or your stomach may start to churn or you may start to feel discomfort there because of your anxiety response. It’s like telling your body how to respond. And I can imagine that if you’re very sensitive to your body and the noises it’s making. That can make this very challenging in terms of treatment.

Brittany: There’s a lot of different things that can absolutely come in play with that, where, again, we see a lot of the disordered eating and the OCD.

Carrie: The other thought I had about, is this something that can be similar to orthorexia, where you Only want to eat, quote, healthy foods, whatever you deem those to be,

Brittany: they can go hand in hand, but I would say typically the mindset behind each one is usually different because when it comes to orthorexia, oftentimes for someone who’s really full blown into orthorexia, and if you’re not familiar with this term, it’s essentially kind of this obsession with clean or healthy eating.

Oftentimes those struggling with orthorexia, the reason they’re choosing certain foods is because of a Either a desire or even a fear, they either have a desire to be a certain level of health and they think I can control my health if I eat this way, or I’m terrified that I’m going to be sick or I’m going to develop this illness if I don’t eat a certain way.

Or if I eat certain types of foods that are, the words I hear a lot are like, these are junk or these are unhealthy. We try when I’m working with clients to really get rid of a lot of the moralizing language around food. Yeah. Really pushes us into an unhealthy relationship with food most of the time. So yes, there can absolutely be some overlap, but I would say oftentimes people can fall into orthorexia and not even realize it because it frequently starts as, Hey, I just had this desire to eat more nourishing foods and to improve my physical health.

And then it can turn very quickly into a fear based again, kind of compulsion or desires that can absolutely be some overlap with OCD. It may just be a matter of working with someone to really get to the root and go, what initially contributed to the desire or the behavior showing up to see maybe which way it tends to lean a little bit more.

Carrie: That makes sense. Kind of getting behind the thought process that’s leading to the behaviors. Yeah. I’m wondering, as far as with the body sensation component of ARFID that we were talking about, Are there people who are uncomfortable with maybe even normal body sensations, like your stomach telling you that it’s full?

Maybe I have some strange fears. That is not a good thing.

Brittany: Yes, I don’t know how much you see that overlap when it comes to OCD, but I see that on a very regular basis with a lot of the clients that I have worked with, students that have been in my communities, is, Brittany, I don’t like the feeling of being full.

Either physically it feels uncomfortable. Or been told, if I feel full, then I ate too much. And so then there’s all this shame on, I broke this rule or I should have stopped at a certain point. Sometimes it comes more from the eating disorder side on, I’m afraid I’m going to gain weight. But oftentimes it comes back to this rule on, if I feel full, something’s wrong.

I did something wrong. I shouldn’t feel this way. And so one of the things that we can do with that, that I think is really helpful. And you can find them for free online or Carrie, I can give you a link. I’ve got one that I put together. I’m just looking at essentially like a hunger and fullness scale. We so often think about hunger and fullness is like, I’m hungry or I’m full, but it’s just like your bladder.

You can’t just say like, I do need to go to the bathroom or I don’t. You don’t all of a sudden, contrary to what my four year old will tell you on a road trip, like I didn’t have to pee until now and now I have to go. The same thing works with our hunger. It’s not just like, Hey, we’re totally fine. And then all of a sudden we’re famished.

Just like the same thing, like our bladder gradually fills over time, our hunger is going to gradually intensify. And same with our fullnesses, we’re going to gradually get more full. Even if you just like take a sheet of paper and draw a line left to right, horizontally, put zero on the left. 10 on the right and a 5 in the middle and go, okay, if 5 is totally neutral, not experiencing any mental or physical signs of hunger or fullness that are overtly noticeable.

And then 10 is like, I feel like I just ate Thanksgiving dinner twice over. 0 or 1 being like, I’m about to start crying because I’m so painfully hungry. There’s going to be a gradual step up or down all throughout the day. Even if starting from that point. Being able to say, again, got to do this without making them into rules on how can I only eat when I’m at this number and I have to stop when I’m at this number, but it can really help increase the awareness around, okay, if five is neutral, what does a three feel like for me, for me, if I give a personal example, that might be, okay, my stomach is kind of growling, I probably need to eat in the next 30 minutes, or I’m going to start getting a little hangry, I’m going to start being short tempered, Those kind of things.

And so you can start recognizing a little bit of hunger or mild hunger, moderate hunger. How does that change? And that can be just a helpful way to, instead of having that black and white mentality on I’m hungry or I’m not hungry, or I’m full or I’m not full going, How hungry am I? Or how full am I? And that can just kind of bring a little bit more awareness physically to where we are.

And then mentally, what thoughts tend to, it’s really interesting to start gaining awareness once you know physically where you are. What types of thoughts align with the different levels of hunger, of course, that you have, and that’s a great way to start increasing your awareness, your body awareness, or what I start teaching eventually is body trust and body wisdom so that you can trust your body again to be able to make decisions that help you feel nourished and you don’t feel so out of control around maybe certain foods or so fearful around others.

That’s the hungerfulness skills, a great place to start the awareness in that area.

Carrie: I think this is all really valuable, even if people don’t have ARFID, just to kind of be aware of, because there’s so much information, we have just an overload of information about health and what we should and shouldn’t eat, and like you said, It’s very easy when you’re dealing with OCD to be in a black and white thinking state.

Like, this is good food, this is bad food. I’m sure that you see that quite a bit. Tell us a little bit about how ARFID is treated.

Brittany: There are a lot of different ways. When it comes to our fed, and I think it’s so important here, if y’all don’t hear anything else, I say, I hope you will take this away that it is really multifaceted approach and that it’s so helpful to have somebody in the nutrition profession, but somebody in the therapeutic function as well, because it really is, it’s such a battle of.

Body and mind, because there’s a lot of exposure therapy. There’s a huge amount of exposure therapy with ARFID, meaning I’ve got to give myself the opportunity to eat these foods. But getting started, if that sounds like terrifying, like, Oh my gosh, you’re about to make me eat all these foods that I say I don’t like.

Oftentimes, it starts just with other sensory introductions to it, going, What does this food actually look like? Haven’t actually had this food on my plate in years. Or, the last time I had it, I choked and so I feel like I can’t have it again. Sometimes it doesn’t mean, hey, your first exposure, you need to eat a handful of grapes.

Maybe it’s I need to just wash some grapes and put them on my plate and just be okay with them. Or maybe I need to put them on my plate with some other foods and know that, Hey, if this food over here touches this food, we might have to challenge some rules there. Right. And so being able to just start with that and then looking at, okay, maybe from there we go to touch, we go, what does this food actually feel like?

The last time I had this, the crunch scared me. So what if I just crunch it with my fingers so I can see how easily it gives. What does it smell like? Does it really make me gag? Or maybe this particular food wasn’t prepared the same as this one. And so sometimes just having that initial sensory exposure for a little while can be really, really helpful.

I go back and forth on this a little bit, considering that I work with so many women who would classify themselves as, hey, I’m very type A and. They maybe tend to have a lot of rules or they get overly, they like to food journal a little too much, but sometimes food journaling can be really helpful when you’re doing these exposure activities to notice, again, with the awareness piece on, not just did I like it or didn’t like it.

That’s a really dangerous question to ask with foods because it’s really easy to go black and white and to write it off going, Nope, didn’t like it, but to be able to say, Hey, I could tolerate temperature of this. The warm chicken nugget from Chick fil A was much better than the room temperature one. Or I didn’t like the warm because it changed the texture.

I liked it better when it was ribbed up. And so being able to ask yourself more specific questions on what aspects of this did I like or did I not like? What aspects of it were tolerable? What would I be willing to challenge again? Being able to kind of get away from those yes or no answers can make them more subjective or more Open ended can be a really helpful place to start when it comes to those exposures.

Carrie: Let’s say somebody has been struggling with disordered eating for a while, and they’re concerned, or they have a loved one that’s concerned about, how do I know if this requires a higher level of care, like hospitalization, or some type of intensive outpatient, where would you say that line is?

Brittany: That’s a good question.

A lot of people like to say, go ahead and jump to, like, get your labs checked. I think more information is often helpful, maybe not in every situation. So some of the things I would say to watch for, number one, has the number of foods or the amount of foods that you’re consuming, like total volume consumed, as well as variety.

Have either one of those significantly changed, especially have either one decreased, it is not helpful typically to look at the scale first, because the scale may or may not change a whole lot as what you eat changes or as the volume changes. However, if you do start noticing clothing is feeling different or when I did go to the doctor, I had lost a fairly significant amount of weight in a short amount of time when that is unintentional, especially if it’s intentional, you need to come to me and have, we need to have another conversation.

But if it’s unintentional, it’s a good red flag to go out. Like I wasn’t trying to do this and what could have contributed to that. So unintentional weight loss. A reduction in the amount of food or the variety of food that you’re consuming. If you go, these don’t happen a lot. It’s not super common to just go get your labs taken on a regular basis, but even just having like a normal CBC kind of panel and just saying, Hey, can I get my basic labs checked so they can look at things like your electrolytes and your protein status, things like that, to make sure.

We’ve got to be medically stable when you’re not eating enough, your body temperature tends to drop, your blood pressure level changes. There’s a lot of signs that your body will give you, but I say that with the caveat that labs can’t tell the whole story either. So these are just all pieces of things that we want to look at.

And then I would say kind of maybe the last category that I would touch on here is. Hey, do I need help or do I need a higher level of care even? It’s really looking at a lot of have your fears around what you are consuming increased. People around you, are they able to lovingly point that out? Are you able to hear them?

And if you’ve been getting very defensive on, hey, no, no, I’m okay. It’s fine. But people are still, hey, it seems like you’re not eating. You ate this food last week, but this week you’re not. Being willing to hear that can be really hard. You have people around you that love you and support you and you start noticing them asking more questions about that.

It’s a really good red flag on maybe I need to get some extra support.

Carrie: Yeah, I think those are all great, great things to mention. Tell us a little bit about the Joy Filled Eater and How you work with clients, how people can find you.

Brittany: So the Joyfield Eater Lab is the group coaching program that I run for Christian women who are really just ready to break free from negative body image and disordered eating.

And this is the group where we kind of have a rolling enrollment. So you come in and for six months you get weekly coaching calls. We meet twice a month to do kind of Q and A and we talk through the course content and the models you get access to. And then twice a week, if you’re one of those people who’s like, I want to do it, but sometimes I don’t make time to do it.

Twice a month, we have co working calls. And so we all hop on and we work their content together. We implement, we have clients that will sometimes do their fear food challenge, like on a call. Um, and so it just gives you that extra little bit of support or accountability to say, Hey, here’s what I’m going to work on for the next 30 minutes.

And then. We all turn off our cameras or mute our mics and we do the work and then we hop back on and you get to say, Hey, here’s what I finished. So we do that. And it’s a lot of fun. It gives you an opportunity, not only to get the educational side of things and the coaching, but to also develop some community because anytime you have anything that you struggle with, especially when it’s that physical mental combination, it’s hard sometimes to talk about and to find people who really get it.

So it’s a fun place to be able to build community with like minded women who. Understand what you’re going through and we keep confetti on my desk. So we throw confetti to celebrate, to celebrate the wins every week on our calls. So if you need a confetti moment, y’all come, come join us at the Joyful Leader Lab.

Carrie: Hey, that’s awesome. We all need more confetti moments in our life. I talk a lot about celebrating the small successes, and if you were able to eat something that you were terrified of eating, then that is awesome. It’s really great. It is awesome. Progress. Well, thanks so much for coming on the show. Um, it’s been a great conversation.

I hope that you enjoyed today’s interview, and just know I am always looking for guest suggestions or people to interview. If you would like to come on the show and tell your personal story of OCD, I am hoping to record some of those this spring to air them over the summer, if I can get enough people who are willing to do that.

You can reach us with any of those guest suggestions at kerrybach. com slash podcast. If you used to get emails from us and have found that you are no longer receiving those, I really want to ask you to check your spam folder. I won’t bore you with the technical reasons, but we had some issues earlier this year, and now less and less people are actually opening and reading the emails.

So if you’ve been missing out thinking I wasn’t sending them, I am still sending them every week. Just double check your spam if you’re not receiving them. To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings, and receive information on exclusive sales, become an email insider today.

All you have to do is go to carriebock.com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us. Until next time, may you be comforted by God’s great love for you.

Christian Faith and OCD is a production of By The Well Counseling. Opinions given by our guests are their own and do not necessarily reflect the views of myself or By The Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

165. Is He Really The One for Me? Relationship OCD 

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

In this episode, Carrie talks about Relationship OCD and how it distorts normal relationship doubts into obsessive thoughts. She shares valuable insights and practical tools for overcoming ROCD while maintaining faith in God’s plan for your relationships.

Episode Highlights:

  • How Relationship OCD (ROCD) impacts relationships and leads to constant doubt and reassurance-seeking behaviors.
  • The connection between past experiences, childhood, and past relationships in fueling ROCD obsessions.
  • How trauma-informed therapy and OCD-specific strategies can help address underlying issues in Relationship OCD for deeper healing.
  • How ICBT (Inference Based  Cognitive Behavioral Therapy) can be an effective approach to challenge and reframe the irrational thoughts that drive Relationship OCD.

Episode Summary:

Today, we’re diving into a topic that many of you struggle with: Relationship OCD. I know this because we’ve addressed it before in episodes 88 and 131, where Samara Lane and Pierre shared their personal experiences with relationship OCD. These episodes have been incredibly popular, and for good reason. Relationship OCD can be especially challenging to navigate because, in normal relationships, there are naturally occurring uncertainties.

You may have had a conversation that seemed fine at first, only to later realize that the other person was upset by something you said. These moments of doubt are normal, but when OCD takes over, it causes you to obsess about these interactions, seeking constant reassurance or replaying them in your mind. But even after you get that reassurance, OCD convinces you that it’s still not enough. It’s a never-ending cycle.

If you’re struggling with Relationship OCD, it’s important to recognize that it’s not just about social anxiety or insecurity; it’s about the compulsive need for certainty. It’s easy to fall into the trap of googling relationship advice or asking others for validation. However, this only fuels the OCD cycle. Instead, I encourage you to reflect on your past experiences and how they might be influencing your current fears and doubts. Sometimes, past trauma or unhealthy relationships can set the stage for OCD to take over. Understanding where these feelings are coming from is the first step toward healing.

I also highly recommend seeking a trauma-informed therapist who is familiar with OCD. Stay with me through this episode, as we explore practical steps for moving past the doubt and embracing the freedom that comes with trusting in yourself and in God’s guidance. You are not alone, and with the right tools, you can move forward in your relationships with confidence and peace.

If you’re struggling with Relationship OCD or any aspect of OCD, I encourage you to listen to the full episode and explore the practical steps I discuss to help you break free. Visit carriebock.com for more resources to support your healing journey. 

Explore Related Episode:

Transcript

 Hello and welcome to Christian Faith and OCD  with Carrie Bock. I’m a Christ follower. wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you with practical tools for developing greater peace.

We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right in to today’s episode. 

Today we are covering Relationship OCD. I know this is a topic that many of you struggle with. How do I know that? It’s because way back in episode 88, we did an episode on relationship OCD and anxiety with Samara Lane, where she shared some of her own personal story of relationship OCD and how that impacted her when she was dating and engaged to her now husband.

That episode has been incredibly popular. We also had an episode back in 131 of another personal story of relationship obsessions where Pierre talked with us about how he would ask every visiting pastor whether or not it was okay to get married again because he had had a divorce in his past. Just know if you’re curious about specific topics like this one, you can always search our episodes on the website at  carriebock.com. There is a tab called podcast breakdown with a great search feature on it that will lead you to those episodes. Relationship OCD can be really tough to work through because in the natural state of affairs there are a lot of uncertainties in our relationships. There may be times where you felt like a particular conversation or interaction went well only to find out that you came back and that that person was actually upset about something that you said and now there’s a riff that you didn’t know that was there.

Conversely, we can also probably have all had the experience of we have a social interaction and we think, oh, I was totally awkward, that was really weird, people didn’t like me, whatever the case was that we told ourselves about this relationship or social interaction and we were completely wrong, that wasn’t how people saw it at all, it was fine, everything was good to go.

I can think of a few different interactions that I’ve had with clients even and I have to at times tame my direct nature when it comes to therapy because I can feel very passionate about something and I do really care about the people that I work with and sometimes that comes out a little sideways or I come off too strong and there definitely have been situations where that’s I’ve come back and apologized to people or checked in and said, Hey, I know that we had this intense conversation last time where basically I was getting on to you about how you haven’t done your homework or how this is a serious issue in your life that you need to take care of, whatever the situation was.

And sometimes people were like, No, I really appreciate that. That was exactly how I needed you to be in that moment. That was what I really needed to hear, even though it was probably hard for me to hear. And in the course of many years, I am sure there probably have been some people that I’ve scared off from being too direct.

I’ll just say not every therapist is a good fit for every person, because sometimes personalities just don’t gel very well. And someone can be really, really skilled, but if you don’t feel that sense of connection with them, then you may not be able to progress forward. And that’s why we talk about the therapeutic relationship being so crucial.

Unfortunately, in the case of OCD, oftentimes what I see is that people have a great relationship with their therapist. The therapist is lacking the skills to be able to help them effectively. With relationship OCD, if that’s the only theme that’s going on, you’re probably not going to recognize it as OCD right away, or you may be in denial that this is actually an OCD issue.

You may just be thinking, no, I have social anxiety, or I feel insecure in my relationships, or I just really need to know this one thing. I need to know if I’m supposed to marry this person or not. And if I get the answer to that question, then everything will be better. The problem is that if it’s OCD, we know that everything won’t just be magically better once you answer that one question.

Even if you get some relative certainty about it, OCD will then come in with some other doubt. Let’s talk about typical obsessions and compulsions. You may obsess about past social interactions, how they went. You may have the compulsion to replay certain social interactions in your mind. You may start to question or doubt what was actually said in the interaction as you’re playing it back.

There may be concerns about whether or not you have offended someone. Of course, these types of situations can lead to a lot of reassurance seeking. So you may be asking that person, Hey, did you get offended in our conversation? Are we okay? Is our relationship alright? Things like that. You may be thinking to yourself, Well, Carrie, you just told us that you went back and checked in about some of your relationship interactions and whether or not the relationship was okay after those interactions.

Does that mean that it’s always OCD? No, absolutely not. The problem with OCD is that even after you get that reassurance, you’re still going to be questioning it, or you’re still going to be doubting whether or not your relationship is okay, even if someone just told you, yes, things are fine. The very thing that you’re trying to prevent, though, a rift in the relationship, can actually be caused by seeking reassurance too much.

If you’re struggling with relationship OCD, you also might read a lot of articles online. You might be googling information on relationships, or how do I know if I’ve offended someone? I would say relationships with your significant other probably get most impacted. So if you’re dating, it will be, how do I know if I should marry this person or not?

You might be googling that or asking a lot of different people, how do I know if this person really loves me? There are so many different things relationship wise that you can get stuck on and understand that ruminating is a big compulsion in this area as well. You don’t want to just be sitting there thinking about this over and over.

Or providing some type of self reassurance. This can take a massive amount of time for you that you’re not wanting to spend only on this. Might be important, but it might not be the only important thing in your life. OCD causes you to laser focus on one thing when you’re in that OCD bubble, and it really closes out the other things that are important to you.

Of all the themes of OCD, I really believe that relationship OCD is probably most connected to earlier experiences in life. Oftentimes, as we get into the story surrounding the relationship OCD, It either goes back to something in childhood or it goes back to a past relationship that could have been a relationship that was abusive, either verbally, physically, mentally, or it could have just been unhealthy in different ways, maybe not full blown abuse, but you know, it wasn’t a good situation.

And also, people may reflect back and recognize that they weren’t in the best place in their relationship with God while they were in that unhealthy relationship. That may cause you to be more concerned about your next relationship. Well, I want to make sure that this one I do the right way because that other relationship was unhealthy or toxic, and I don’t want to go down that road again.

That’s a good desire to have. However, OCD takes over and then you’re spending a ton of time on this instead of just slowing down and waiting out the process. It takes time to get to know someone, obviously, and to see them in different settings and environments. As you’re going along a dating relationship, for example, it’s going to take you time to know whether or not this is a godly person.

Whether or not this is somebody that you would want to marry, but that can be a really big obsession that you get stuck on. You might even have obsessions about getting divorced before you even get married. I think this one is pretty common as well. Once again, this is something that can be traced back to family of origin experiences.

Maybe your parents argued all the time, had a contested divorce. Maybe they didn’t get divorced, but they were miserable and it wasn’t a relationship that you would ever want to emulate in the future. What if you don’t have a picture of what a healthy relationship or marriage looks like because you haven’t seen it?

Maybe you haven’t seen it in your family, or you haven’t seen it with other friends. This is one area where I believe that the church can be incredibly healing potentially is to have these pillars or individuals who have been married a long time that can pour into the younger generation or the generation maybe that feels broken coming out of a divorce, coming out of a negative relationship situation.

Or maybe who stayed single for a long time, like, there should be other people that we can look to, even if our own families were unhealthy, to be able to say, hey, I know that this couple has something that I would want to emulate, like, these two people are following the Lord and they really do love each other, I see them love sacrificially.

If you don’t have that, I would really encourage you to pray that God will show you who those mentors can be in your life. Everyone has some type of relationship baggage, whether that’s from a broken friendship, broken romantic relationship, broken family of origin relationships. And we all have a place in our heart that needs healing from these broken relationships.

So the first step is really breaking it down and identifying how did this story get built up to where I’m obsessing about relationships? Am I struggling with fear of abandonment? Am I struggling with a fear of conflict because I haven’t seen healthy conflict in a relationship? There are some couples that don’t fight and that’s not healthy to never have an argument or never fight because it usually means that someone, one or both parties, is stuffing their feelings or holding things in to a point that things never get addressed until there’s all of a sudden this big wall of resentment.

It’s important to have a healthy level of assertiveness in your relationship where you’re able to share wants and needs that may not have been modeled for you, or you may have felt like it just didn’t matter what I needed growing up, I wasn’t going to receive it, and then that translates over into your relationships.

I would really encourage you to sit down with a journal or a piece of paper sometime if you’re struggling with relationship OCD, and map some of these relationship issues out that you believe that you’re struggling with. If you have a hard time identifying them, you may have a close friend, family member, Someone that you’re in a romantic relationship who can help you see some of those things that are hard to see on your own.

I talked way back in episode 10 about my anxiety dating my husband currently. I definitely had a fear of abandonment because I had been abandoned by my first husband and I knew how that felt and did not want to go through that again. I knew that consciously, but that was also manifesting in my body in a very physiological level, trying to keep me safe from getting too close to anyone or from opening myself up and making myself vulnerable.

That’s a huge and important piece in relationships, to be able to be vulnerable. So if that’s something that you’re struggling with, I really would encourage you to find those pieces that are blocking you from being able to do that. If you have Relationship OCD and are seeking therapy, I would really encourage you to seek someone who is trauma informed as well as OCD informed.

If your past is affecting your present, you’ve got to deal with it in order to have a better future. I have a variety of options for helping people that you can find on my website. I have Christian’s Learning ICBT, which will walk you through the ICBT process to apply to your situation. I have multi day intensives if you’re struggling with trauma and OCD.

together that can be super helpful for you. All of that is on karybach. com. Let’s talk about a few things that you can do if you’re struggling with relationship OCD. The first step that we’ve already talked about is really to build awareness of how this came to be and how you came to be stuck on these specific issues.

What type of things from your past are feeding into this story that we need to be so obsessed about this and so super careful. That we don’t somehow mess up this relationship or these relationships that are in our lives. Definitely walk away from reassurance seeking, googling, reddit, all of those things that we’ve talked about in the past.

It’s only going to reinforce that obsessive compulsive loop for you and you’re going to continue to go around in that cycle. Being able to recognize when you’re starting to ruminate on something is super important so that you can detach from that and start thinking about something different, go do something else that’s important to you.

We talk a lot in ICBT about relying on sensory information. And that can be hard in relationship OCD, right, because we are going to have what we call sensory gaps where you may not exactly know what that person is thinking. Does this person really love me? I may not know that yet. I may not have been in the relationship long enough to have a sense of that.

Now, if I have been in a relationship with somebody for quite some time, and there’s been all of this evidence that they do really love me, or they have made sacrifices for me, then I can go back and look at that, and that can potentially be sense data. What OCD does is that it doubts the senses that are clear and already here.

And so being able to identify that is helpful. Like, oh, I actually do have some sensory evidence that this person has made sacrifices for me, that they do really care about me, that they’re not perfect. And I think that’s a big piece of relationship OCD, recognizing that. All relationships are going to have issues, and all relationships are going to have imperfections.

You’re not going to find the perfect spouse. You’re not going to find the perfect friendship, and knowing that that’s okay. And, that if you are in a healthy relationship, that it can survive conflict. It’s actually not the amount of conflict that is the issue, it’s what we do with that conflict. How we move forward, how we make repairs.

When repairs need to be made, that’s another thing that we didn’t talk about earlier, is that you can have all kinds of ideas about relationships, like conflict is bad, that may not be true at all, but you might need to work on realigning, especially if you’re beating yourself up over mistakes maybe that you feel like you’re making in the relationship.

So just to recap a little bit, how has my story led me to this point, building the awareness over what pieces are OCD, the ruminating, the reassurance seeking, what type of rules have I set up for relationships, how is this Relationship OCD, is it getting blended with other forms of OCD, are they coming in, so it may start out as like a perfectionism OCD that’s bleeding over into the relationship OCD, and I’m getting super hyper fixated on any time I make a mistake or hurt the other person’s feelings.

Or any time that we get into conflict, I’m getting hyperfixated on any time that my need is not met, and then questioning the validity of the whole relationship by one or two instances. And that’s the biggest thing that I would tell you about relationships, is that it takes time to notice relational patterns.

So do we have enough external sensory information to make a judgment about this relationship, or don’t we? If you don’t have enough information about the relationship, you’re going to have to hang in there and wait, and resist the temptation to make snap judgments. If you have actually vetted this person, if other people are coming to you and saying, Wow, this is a really great guy.

You definitely should marry him. He’s exactly the man that you’ve been praying for. And you’re still doubting that? It sounds like OCD is causing you to doubt the sensory information that you already have. You may not doubt that the other person loves you, but you may then start to doubt if you love the other person.

And for that, you need to really get in touch with your internal sense data. How do you know that you love someone else? Are you doubting that you love anyone else in your life? Are you doubting that you love your mother? How do you know that you love your mother? When you’re good tuning into and identifying, trusting that internal sense data, that really helps you be able to move forward in some of these areas.

I know relationship OCD can be sticky and tricky, it’s a little less straightforward than some things that feel really tangible. The important thing is for you to know that there is absolutely hope for you and help is available. You can find me at kerrybach. com. Thank you so much for hanging out with me today, and until next time, may you be comforted by God’s great love for you.

To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings and receive information on exclusive sales. Become an email insider today. All you have to do is go to  kiribach. com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us.

Until next time, may you be comforted by God’s great love for you. Christian Faith and OCD is a production of By The Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area. 

164. What if I stab someone or kill myself? Harm OCD 

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

In this episode, Carrie explores the struggles of Harm OCD, including fears of harming others and self-harm, and how these intrusive thoughts are tied to OCD. She shares practical ways to separate thoughts from actions, showing you how to confront these fears and find a deeper sense of peace.

Episode Highlights:

  • What Harm OCD is and how it manifests as thoughts about harming others, even loved ones.
  • How these intrusive thoughts, while deeply unsettling, do not equate to a desire or intent to act on them.
  • How shame and stigma can trap Christians, leaving them feeling isolated and fearful about their faith.
  • The difference between Suicidal OCD and actual suicidal ideation, and why understanding this distinction is crucial for treatment.
  • The importance of separating thoughts from actions and understanding that negative thoughts don’t define who you are as a Christian.

Episode Summary:

Today, we’re diving deep into harm OCD—a theme that can bring up fears of harming yourself or others. It’s common to struggle with these thoughts, but it’s important to know that having them doesn’t mean you will act on them.

If you missed episodes on contamination, health, or scrupulosity, I recommend going back to listen. Even if those themes don’t match yours, the ICBT techniques we discuss can be incredibly helpful for all forms of OCD. For example, practicing skills on a different theme can ease anxiety and offer more objectivity when learning to heal.

In harm OCD, people may have terrifying thoughts about hurting others, like, “What if I lose control and harm my loved ones?” These thoughts often come as “what if” questions or vivid images, which can be really disturbing, especially when they arise while interacting with loved ones. But remember: these intrusive thoughts don’t reflect your true desires.

The key here is to understand that having a thought doesn’t mean you’ll act on it. Just because a thought comes into your mind doesn’t mean you desire to follow through with it. God calls us to bring these thoughts and emotions to Him, trusting Him to align our true desires with His will. He transforms our hearts, helping us act out of love and obedience.

Tune in to the full episode for more insights on overcoming harm OCD with faith and practical tools.

If you’re ready to tackle harm OCD and deepen your healing through ICBT, I’d love to help you on this journey. Visit my website at carriebock.com. You don’t have to fight this battle alone.

Explore Related Episode:

149. Writing an Alternative Story to OCD’s Default Narrative with ICBT

Transcript

Welcome to the themes and treatment series of OCD. Today we’re talking about harm OCD. Maybe you fear harming yourself. Maybe you fear harming another person. We’re going to tackle both of those today. 

Hello and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you with practical tools for developing greater peace.

We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right in to today’s episode. 

We’ve already covered contamination, health, scrupulosity. Go back and listen to some of those episodes. Maybe even if you don’t have those themes, it might be helpful for you to hear some of the other ICBT information that’s woven throughout those episodes. It might be beneficial to your particular theme.

Sometimes we will have people practice the skills of ICBT on a different theme than what they actually struggle with. It reduces the overall anxiety in the treatment process, and it allows people to have more objectivity as they’re going through and learning. In harm OCD specifically, people can have thoughts about stabbing another person, and this may come in the form of like, what if I lost control and just hurt my loved one?

Or, what if I mentally snap and drown all my children in the bathtub because I heard a news story about it? And these obsessions may come in verbal what if questioning. Or they may come in more of a pictorial format. And obviously that can be very frightening if you’re dealing with these images and thoughts that are popping into your head at various times when you’re interacting with loved ones.

And one thing we know is that there’s not a direct correlation between having these thoughts and the types of information that you’re consuming on TV, movies. You might not be watching any type of violent content. You’re not listening to crime podcasts. You’re not trying to dwell on these types of stories.

You’re not reading dark horror novels, but somehow these thoughts are still in there, and they’re stuck. As with all themes of OCD, there probably is some element of shame. How in the world am I having all of these thoughts that I don’t want and I don’t want to act on? And what does that mean? Because I’m a Christian and I know that I’m supposed to think about things that are good and lovely and excellent, worthy of praise.

How do I get this stuff out of my mind? So there may be different things that you do to try to neutralize those thoughts, either in a mental compulsion way, like thinking about something different, you might repeatedly confess those thoughts, might try to think of, uh, positive thought, you might end up doing some type of research on the internet about people who have lost control or snapped or done things that people thought they would never do.

Another compulsion is avoidance, avoidance of knives, avoidance of being in the kitchen. You may even avoid being around certain people, even though you love them, but you’re afraid somehow of harming them. That avoidance, unfortunately, though, just reinforces and strengthens this idea that you’re unsafe in some way or that you can’t be around these people because you’re going to hurt them.

And that’s not what we’re wanting, right? You may have intense suicidal OCD. Of course, this is really scary to tell anyone about because you think if I tell someone I’m having these thoughts about harming myself or killing myself, that automatically means that I’m going to be locked up in a mental hospital and it’s going to be a terrible, horrible, awful experience.

What’s the difference between someone who is truly suicidal and someone who has suicidal OCD? Typically, suicidal individuals are ambivalent. There may be a part of them that wants to die or kill themselves and then a part of them that doesn’t. If someone is struggling with suicide, those thoughts tend to come and they may come on very strongly.

But if given enough time, they will dissipate and die back down. This is why we talk so much about suicide prevention, about talking people through that ambivalence process and helping them find reasons for living and staying alive. Someone who is dealing with suicidal OCD would adamantly say that they do not want to die or do not want to kill themselves, but they’re afraid.

They have an intense fear that they’re going to do something to hurt themselves. Also, the thoughts may not dissipate. They may continue to come back as this person engages in the compulsions. Also, there may be just lack of any reasons that they can identify for why they’re having these thoughts. When someone is Dealing with genuine suicidal ideation, they will have a sense of hopelessness.

They may have a sense of feeling like they’re a burden. This is not what someone with OCD would say. Obviously, there may be some overlap and gray areas here, and if you genuinely are concerned about harming yourself or you have a loved one that you’re concerned is going to kill themselves, then obviously you need to have intervention professionally for someone to be able to go assess and figure out what’s going on and what the plan needs to be.

It is important to note that many people have these thoughts at various points in their life and don’t act on them. What I would want people who are struggling with harm OCD to know is that thinking about something is not the same as acting on it, or feeling an intense emotion does not mean that you’re going to act on that.

So, for example, you can be intensely angry at someone or have intrusive thoughts about harming them, but never act on those things. Just because you have a thought doesn’t mean that you have a desire or an intent to follow through with that thought. Let’s look at a couple of real life examples. One of these I actually used in Christians learning ICBT.

I think as Christians we get so scared sometimes of our thoughts and emotions if we feel like They’re somehow not in line with what God would want us to think and feel. And I really see these as an opportunity for us to bring these things to the Lord so that He can align our true desires and intentions towards Him, and we can act out of those true godly desires and intentions that He wants us to have.

That’s a work of Holy Spirit transformation that happens in our life. It’s not just something that spontaneously happens. It’s part of our submission to his will and desires. Let’s say that someone deeply hurts me, and I can think of people in my life who have deeply hurt me. I might have a thought like, oh, I just want to get revenge on this person, or I want them to suffer the way that I’ve suffered, and I have an intense emotion of anger.

But at the same time, I know that I’m desiring to please God, and I know that in order to do that, I need to forgive this person and be able to let the offense go. So I take my thought process and my emotion and even like my urge to get revenge, I bring that over to God and pray through it. I pray for that person.

I pray for God to change my heart. God works in my life and I. Submit my desires and my will to him so that I can be in alignment with obedience with what God wants me to do. And God changes my heart so that I’m able to forgive that person, even though it started out really rough with that thought and intense emotion, it ended in a positive action space.

My point is that in OCD, things get really blended. Thoughts and actions get blended. We call that thought action fusion. You may see thoughts and urges as the same thing as desires and intent, and those are two different things. So it’s really important to pull those pieces apart for yourself, that you can have thoughts, emotions, like urges.

that don’t end in a particular action that OCD is telling you and convincing you is going to happen. There are plenty of times where we might not want to get out of bed in the morning, or we might not want to do a particular task, like exercise. We know that it’s good for us, and so we hang on for the goal in the long term, and we don’t act according to that particular feeling or that particular thought that we’re having in the moment.

And if you recognize this in an everyday process, that helps you be able to apply it to OCD and find the confusion there. I think there’s a lot of confusion in the church on this issue related to trying to control our minds and what we’re thinking and trying to control our emotional state. And if we are truly abiding in Christ, we do not need to work that hard.

Hear me out on this. It’s God that’s doing the work within us. We don’t have to try and control or squash every quote bad thought that we think comes into our mind. You’re going to have negative thoughts at times, you’re going to have difficult emotions, come up, submit those to the Lord, seek his truth, respond in healthy biblical action.

Another key is to not make so much meaning about what a particular thought says about who you are as a Christian or says about your spiritual condition. If you are struggling with harm OCD, know that God knows you’re struggling with these thoughts. I pray that he shows you what your true desires and intentions are underneath all of that mental chatter that OCD is trying to engage you in.

And if you can learn to not Engage with those thoughts to not get sucked into that OCD story. They’re going to die down, and they’re going to become irrelevant for you. The very thing that you might be trying so hard to control, if you’re able to step back and let go, that’s the process that’s going to allow those thoughts to die down, not trying to jump in and fix them, or solve them, or eliminate them, or do something about them.

I realize that is easier said than done. If you are struggling with harm OCD, know that help and treatment are available. You do not have to go through imaginal script writing if you don’t want to. I am in Tennessee and would certainly love to talk with you further about this. You can reach me on my website at karibach.

com. OCD warriors, until next time, may you be comforted by God’s great love for you. To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings, and receive information on exclusive sales, become an email insider today. All you have to do is go to kiribach. com and scroll towards the bottom of the page.

You’ll find a spot to put in your email and receive a free download in your inbox from us. Until next time, may you be comforted by God’s great love for you. Christian Faith and OCD is a production of By The Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area. 

163. Overcoming Shameful Sexual Themes (HOCD/POCD)

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

In today’s episode, Carrie talks about some of the hardest OCD themes to discuss, like HOCD and POCD, and how they can bring shame and confusion. She shares insights on how OCD can distort your thoughts and how separating those thoughts from who you really are is key to healing.

Episode Highlights:

  • How OCD targets sensitive themes, like sexual thoughts, and creates shame and confusion.
  • The difference between your true desires and the obsessive thoughts OCD throws at you.
  • How your body can react in ways that confuse you, but it doesn’t mean you want those things.
  • How ICBT helps you break free from the OCD cycle and find peace.

Episode Summary:

Welcome to Christian Faith and OCD. Today we’re talking about two really tough OCD themes: Homosexual OCD (HOCD) and Pedophilia OCD (POCD). These are often hard to talk about, especially for Christians, but I want you to know you’re not alone, and there’s hope for healing.

OCD often targets the things we care about most, and for some, that’s sexual thoughts that feel very distressing. These thoughts are ego-dystonic, meaning they go against who you really are. Whether it’s doubts about attraction to the same sex or inappropriate thoughts about children, OCD can convince you that these thoughts reflect your true desires. But they don’t.

The key to healing is learning to separate these intrusive thoughts from your true self. When these thoughts pop up, it’s important not to engage in self-testing or compulsive behaviors. Remember, your body’s natural responses aren’t an indication of your true desires. These thoughts are just a part of OCD, not who you are.

You can learn to trust your true desires and let go of the shame and doubt OCD brings. POCD and HOCD don’t define you, and they don’t disqualify you from being a loving parent or partner. God loves you unconditionally and understands your struggles.

If you’re ready to begin your healing journey, I invite you to join Christians Learning ICBT and explore more resources on my website at www.carriebock.com . You’re not alone—there is always hope for overcoming these struggles.

Explore Related Episode:

132. Sexual Obsession or Lust? Scrupulosity Wants to Know with Steve and Carrie

Transcript

We are smack dab in the middle of a themes and treatment series for OCD, and today is all about those themes that you don’t want to tell anyone, that you don’t want to talk about out loud, especially as a Christian. We’re talking about sexual themes. homosexual OCD, pedophilia OCD, which we may refer to in this episode as H OCD and P OCD, just because it makes it a little bit easier.

Hello and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you.

With practical tools for developing greater peace, we’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you.

So let’s dive right into today’s episode. Every once in a while when I’m talking with a potential new client, someone will ask me a question similar to, Is there any theme that you haven’t dealt with at this point? And I will be sure to list the various themes that I’ve worked with, including pedophilia OCD, because this is one that people don’t want to share right away.

It can be really embarrassing. They feel like they have a lot of stigma or shame surrounding it. And so I hope that this episode can help dispel some of that shame or stigma that you might be feeling if you’re dealing with a sexual OCD theme. We know that OCD hijacks things that you care about and gets really fixated on them.

If you really care about children or you have a desire to have children in the future, often pedophilia OCD can come on for women who are like desiring children in those childbearing years, or it can happen as women are pregnant. I’ve seen both of those situations. Of course, this theme is obviously not just limited to women. And the biggest thing here is being able to separate having these thoughts from yourself, who you are as a person, and from your true, actual desires and intentions. That’s so huge. What we see with POCD specifically is that it’s a distrust of internal sense data. You’re distrusting what you actually want, intend, and desire. The same is true for homosexual OCD. OCD doesn’t care that you might be married and fully attracted to your husband. It doesn’t care if you’ve only dated members of the opposite sex. It does not care if you have no intentions of following through any homosexual thoughts that you might have.

It is going to try to convince you that you have some secret inner desire for someone of the same sex, and this causes a high level of distress internally for you, a lot of anxiety. That’s why we call these thoughts ego dystonic, meaning They go against who you actually are as a person. We also know that OCD is highly selective.

There are many things that you probably really do trust your internal desires on. I was just working on some updated slides for our Christians Learning ICBT training, and I thought, wouldn’t it be fun to play a little bit of Would You Rather? Now, in the traditional sense, would you rather picks two different crazy things?

Usually you’d want neither of them, but somehow you have to choose. And it’s just a fun little game that people play, but let’s not play the wild and crazy version and just think about, would you rather have, like, if someone said you won an all expenses paid vacation and you can either go to the beach or the mountains. Which one would you choose? And how do you know that? There’s something inside of you that has a pull in one direction or another. If I told you, would you rather have a piece of pie or chocolate cake? My husband would choose the pie all day long, and I would choose the chocolate cake all day long. It’s an internal preference that we have.

Do you prefer summer or winter? Outside of the OCD, you’re in a logical reasoning process where you can take the sensory information externally and internally and put it together to know what you truly want and desire. What gets really confusing in sexual OCD themes is something called arousal non concordance.

Feel free to look it up, but it’s essentially where your body responds sexually to a situation that you don’t want it to respond sexually to, such as potentially when you’re looking at a child or when you’re looking at homosexual porn. Self testing some of these things is a compulsion. People get into a pattern with these themes of saying, okay, well, let me test this out and see if I really am homosexual, then I’ll get turned on by homosexual porn.

You may get aroused by a variety of different things, and that does not prove that you actually want or desire that sexual material. Sometimes just, Thinking about sex may cause you to have a physiological response, especially if you’re in a period of heightened anxiety. So you think about that. If you’re anxious because of the OCD, you’re already in a more aroused state.

I don’t mean sexually, I mean from a nervous system, blood flow response. Your heart may be beating a little bit faster. You’re maybe breathing a little bit more shallowly. It’s complicated because our bodies don’t always respond in the way that we want it to. There tends to be a lot of internal self checking as a compulsion that happens with these types of themes.

A lot of rumination, a lot of research, a lot of Google searches, and remember every time you engage in any of those compulsions, it just feeds back that obsessional loop to say, Oh, this is something that we need to act on. This is something we need to do something about. You might have other intrusive sexual images that come into your mind from past experiences with porn.

That’s something that I’ve seen many times, and it’s not just, like, I was seeking out pornography, it could have been something that you stumbled upon or were exposed to as a child or adolescent that got all of this internal stuff really triggered or fired up in some way. There can be immense amount of shame surrounding that, or if pornography addiction was a part of your past, there can be some shame around that as well.

Sometimes people will do certain internal compulsions, like say a certain prayer, try to shake their head a certain way to get rid of the thought. Try to think something positive, like a positive neutralization to the thought. Just know that all of those things are compulsions if that’s something that you’re going through internally.

We’re really trying to not do those things in response to those obsessions. And I know that that can be extremely difficult for you. If clients come to me and they’re using language like the bad thoughts, I really encourage them to reframe that. This is OCD, so we need to call it what it is. I know some people feel like, because of maybe past sexual history, or exposure to pornography, or just Something else in their past, they may feel like somehow they have caused this OCD to happen to them.

I don’t find that thought to be true or particularly helpful in these situations. What we do want to figure out is what’s the reasoning process, what’s the story, what are the reasons for the obsessional doubt, what’s the fuel? Something has gotten really stuck, and when we can figure out what OCD’s reasoning process is surrounding this, We can find cracks and holes in that reasoning process, finding the selectivity of that doubt, doubting the internal sense data, the desires.

And then you can feed your brain an alternative story, getting in touch with who you really are as a person and what you really want. I’ll just throw this out here that POCD does not disqualify you from being able to be a great mom or a great dad. Don’t allow OCD to tell you that these thoughts mean that you’re never going to be able to get married or find someone who will understand these obsessions that you’ve had.

You do not have to be disqualified from living the life that God has called you to live. He completely understands how your brain is working at this moment in time, and he loves you regardless, unconditionally. These themes are highly treatable with ICBT, though it is so important for you to know that there is hope out there.

As hard as it is to talk about these things, I really encourage you to find a therapist that you can trust. who can walk you through this process. And if you want to join us for the next round of Christians Learning ICBT, I hope that you’ll sign up for our waiting list at cariboc. com slash training. To receive weekly encouragement, find out about our monthly meet the podcast host zoom meetings, and receive information on exclusive sales, become an email insider today.

All you have to do is go to carriebock.com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us. Until next time, may you be comforted by God’s great love for you. Christian Faith and OCD is a production of By the Well Counseling.

This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

162. Hope for Scrupulosity with Dr. Constance Salhany

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

Welcome back to Christian Faith and OCD! 

This week, Carrie continues the Themes and Treatment series with a deep dive into scrupulosity. Joining her for this powerful conversation is Dr. Constance Salhany, clinical psychologist and founder of Cognitive Therapy of Staten Island, They explore how ICBT offers a powerful, self-theme-based approach to treating scrupulosity, helping individuals break free from cycles of fear and guilt.

Episode Highlights:

  • What scrupulosity is and how it manifests in religious and moral concerns.
  • The difference between scrupulosity, religious OCD, and spiritual OCD.
  • How ICBT (Inference-Based Cognitive Behavioral Therapy) approaches scrupulosity.
  • The role of self-themes in OCD and how they shape obsessional doubts.
  • How understanding one’s identity as a child of God helps in overcoming scrupulosity.
  • Why trusting in a personal relationship with God is key to healing from scrupulosity.

Episode Summary:

Have you ever found yourself constantly worrying about whether you’ve sinned, confessed properly, or followed every religious practice to the letter? If so, you may be struggling with scrupulosity.

In Episode 162 of Christian Faith and OCD, I had a conversation with Dr. Connie Salhany, about what scrupulosity is, how it develops, and most importantly, how to find freedom from it.

One of the most challenging aspects of scrupulosity is how it extends beyond just religious concerns. I’ve seen this quite a bit with my clients—what starts as one type of OCD can quickly spill over into the moral/religious realm. Someone might initially struggle with obsessing over everyday decisions, wondering if they’re offending God without realizing it and then wonder if their salvation is in jeopardy. 

Scrupulosity isn’t just about religious concerns—it’s deeply tied to OCD. 

As Dr. Connie shared, many people with OCD experience obsessional doubts that spiral into scrupulosity. It can even overlap with other OCD subtypes.

For years, Exposure and Response Prevention (ERP) has been the gold standard for OCD treatment. But, Inference-Based Cognitive Behavioral Therapy (ICBT) has been gaining attention, especially for scrupulosity.

ICBT focuses on identifying the “self-theme” behind a person’s obsessional doubts. It helps reframe these fears by distinguishing between obsessional doubts and reality.

Dr. Connie shared how true healing comes from trusting not in a set of rules, but in someone—in a loving God who knows our hearts.

“The most important thing in treating scrupulosity is helping people know, that they know, that they know—trusting not in a something, but in a Someone.” – Dr. Connie 

If you struggle with scrupulosity, remember: You are not alone. God’s grace is greater than your doubts. There is hope and help available.

For a deeper dive into this conversation, listen to the full episode. 

Have you experienced scrupulosity in your faith journey? Send me a message—I’d love to hear your story and encourage you along the way!

Related Links and Resources:

cognitivetherapysi.com

Explore Related Episode:

133. Looking for an Alternative to ERP? Find out if ICBT is Right for You

Transcript

Carrie: Welcome back to our themes and treatment series on the podcast, where today we’re talking about all things scrupulosity. I feel very honored and privileged to have Dr. Connie Salhaini on the show, joining me to talk about this important topic. Dr. Salhaini is the founder and clinical director of Cognitive Therapy of Staten Island and the founder of Catholic Mental Health Professionals.

As someone who originally trained in CBT and exposure and response prevention, I think she provides some really unique insight ICBT. Inference based cognitive behavioral therapy has shifted and changed her practice over time, specifically in working with clients who are dealing with scrupulosity.

Hello and welcome to Christian Faith and OCD with Kiri Bach. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. I couldn’t find resources for my clients with OCD. God called me to bring this podcast to you with practical tools for developing greater peace.

We’re here to bust through the shame and stigma surrounding, struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode.

Tell us a little bit about

Dr. Connie: yourself. Sure. I’m a clinical psychologist from New York, and I have a husband and children and grandchildren and a dog. And I’ve been doing this work since the stone ages. I’ll say it’s since the mid 1980s when I was a student. So it’s a long, long time. Has this been your only career that you’ve had?

Well, when I was a college student, I worked in Burger King and lots of other places, but this has been my one and only profession.

Carrie: I just know a lot of people in the counseling field have had other careers or things and shifted gears, but I’m similar. I have not been in the field as long as you have, but this has been my only career.

That’s awesome. Your kids are grown now and you have some grandkids.

Dr. Connie: Yep. Great life, yeah. So many blessings.

Carrie: How did you get involved in the process of becoming a clinical psychologist? Did you start out working with OCD, or was that something that you just started seeing a lot more of? How did you get into the OCD work?

I knew

Dr. Connie: that I wanted to treat anxiety disorders. I knew that I wanted to do the best I could, so I researched. And at that time, CBT for anxiety disorders. I just got my hands on everything that I could. I landed an internship at a non profit patient advocacy organization called Freedom From Fear. At that time, they still do a clinic.

And so I worked in the clinic and it was A super exciting time back in the mid 1980s. Now I’m talking before Prozac, folks were using exposure, but not like with ERP that we know today. So we were using it and they had a satellite at the place that I was working, which was a research through Columbia University, College of Physicians and Surgeons and the Psychiatric Institute.

It was just such a blessing to be there at the time when they’re doing all of this groundbreaking research because the people who were coming in with OCD weren’t getting better with the tricyclic antidepressants and with some of the treatments that were done at the time. And there was like a buzz of excitement.

I had this great mentor and she was wonderful. And she was, oh my goodness, head over heels in terms of all of the research and everything, and it was really contagious. And then from there, I mean, I just kept learning. I always wanted to try to learn as much as I could for my patients. And so I learned Becky and CBT and I learned some ERP and I took classes with whoever I could take classes with, follow up with whoever I could to learn anything that I could to help people.

It was really a passion.

Carrie: You were starting to see like, Oh, what we use for anxiety. We can’t necessarily use the same strategies or the same approaches for OCD. Exactly.

Dr. Connie: Yeah, it was really, really exciting time to be there.

Carrie: And then you got trained in exposure and response prevention that was considered.

the treatment for OCD as far as the psychotherapy standpoint.

Dr. Connie: And as well as a variety of other treatments that I learned for other anxiety. Well, at that time, they were anxiety disorders, now OCDs by itself. So I learned everything that I could. And now, what’s really interesting is that two and a half years ago, I became aware of ICBT, inference based CBT.

And that spark that I was telling you about, Yeah. And it was like this contagion, this fever, it took over and I wanted to, again, to learn everything I could about ERP. And then ICBT became my thing. It threw myself in and I started to see amazing things happening.

Carrie: You’re one of the people in the ICBT community that is really kind of known for treating scrupulosity.

Certainly, there’s a lot of clinicians who treat it, but that’s one of your specialty areas within ICBT. That’s what we’re really trying to explore today is what is scrupulosity? Like, how would you define that just for the lay person?

Dr. Connie: That’s really a great question. Scrupulosity, like if we look at Where it dates back to, I think it’s always been here, but we can see maybe 15th century Roman Catholic Church and this notion that folks who have worries about sin, about committing some grave sin, a need for atonement.

Yes. And it’s kind of like. We could say like seeing sin where there isn’t sin, or it actually comes from like a little pebble, a scruple. The idea is that this little sharp pebble, right, would be like sharp or hurting and think about like a sensitive conscience and the person being exposed to this pebble and the pain.

Just thinking about the term scrupulosity, you know, depends on the literature, it depends on what you’re reading. So sometimes scrupulosity looks like a subset. of OCD. Okay. We could be religious scrupulosity or moral scrupulosity for people who aren’t religious but they’re just worried about violating some kind of moral code or value that they have.

Also you’ll see religious OCD, and that’s more about Practices, it could be practices in whatever the faith tradition is, messing up those practices.

Carrie: Like I’ve got to pray a certain way, or I’ve got to pray with sincerity. I have to, like for Catholics, I have to confess constantly.

Dr. Connie: Did I do a fast correctly?

Did I observe certain feast days correctly? We can go on and on. But the idea is that this is grave. This is terrible. This is something that’s going to result in damnation and all of that. And the thing with, um, scrupulosity, we can also see spiritual scrupulosity, again, in people who don’t belong to any faith tradition, but they may have doubts about energy forces, or it almost looks existential at times.

So this overlaps. I think of scrupulosity as OCD and you can see so many ways that scrupulosity can be involved with other forms of OCD. Like for example, pedophilia OCD, someone could have that, right? Oh no, no. What if I’m attracted to children? Oh no. What if I’m going to harm children? Oh no, then God will never forgive me.

Then I’ll be damned forever. It’s interesting because you could even see it in somebody who has symmetry. OCD, just still OCD. I don’t line these things up correctly, these religious objects or whatever. And is this going to be offensive to God? Does God think I’m disrespecting? So it’s quite interesting.

Carrie: That was one of the things I wanted to ask you about. Cause I’ve seen that quite a bit in my clients where you start out with OCD and then everything, it could be even they’re feeling like they’re going to be careless and accidentally hit somebody, hit a pedestrian. What really is then they keep going with that obsessional doubt and say, Oh, well, if I hit a pedestrian, then that would be just terrible because then I would be offending God and be on my fault, all of these different things, even some things that aren’t really moral issues that are just decisions that we make in life, someone might make that a moral issue, become really, really obsessed about it and have God connections to it.

I mean, I think, do you see this a lot with like relationship OCD? Yeah. Am I marrying the person that God has for me, that type of thing.

Dr. Connie: Yes, or vocations, the same thing. No, so we could see it. It seems like there’s anything that’s important to the person. And one of the things that ICBT does so well is it identifies the self theme under it.

And that’s the person who’s afraid of becoming this person that they’re not. Like a person who could be negligent or a person who could be bad. And then we need to define what that means to that specific person. But that theme is like the big story underneath all of these different obsessional doubts.

And I’m a cognitive behavior therapist for years and years and I never saw it explained in this way. And I think that’s why I took a liking to ICBT because we can see how all of this different themes fit. Or interconnected.

Carrie: Yeah. I love that vulnerable self peace and then also looking at the real self.

Who are you really according to your beliefs and in terms of, I think that helps Christians a lot to be able to say like, okay, if I really see myself as a child of God, I mean, that makes a huge difference in how I live out my life.

Dr. Connie: Mary, you are so right about that. I think that is the most important thing about scrupulosity and the treatment of scrupulosity is when people can come to know that they know that they know, like really trust.

You know, that they’re trusting, not in a something, but in a someone, in the relationship that they have with God. And that makes all the difference. Lots of folks know it, but because of the fear, it’s intense. The suffering is awful. When they come to know that, it changes everything.

Carrie: It really does. And I find that a lot of people will seek help from a pastor or a counselor.

A mentor, someone in their church before they seek mental health help because they think this is a spiritual issue. Well, I’m somehow doubting God or what if I’ve committed this sin? What if I have not asked for forgiveness? What if this means I’m going to hell and those types of things? So it looks at mass as a spiritual issue, even though it’s not a spiritual issue.

This is a OCD affects people’s brains. And so I think it’s really important for people to understand that, that this is not a, a deficit in their spirituality. Absolutely. Yeah, the people that I meet really, they want to connect with God in a positive way. That’s really like their true desire underneath.

And all of this OCD gets in the way of them having that really Authentic, genuine connection that they want to have.

Dr. Connie: I agree completely. And I think that’s what draws me to the treatment of scrupulosity. It’s the people, they have such beautiful hearts and real great desires. Just want to please God. They just want to live a good life.

They are really beautiful and they’re so tortured by a story that has nothing at all. And in treatment, if we can restore them to that, it’s amazing. There’s nothing better. This is like a joy if we can help folks to get there. So I love this work for that reason.

Carrie: Exposure and response prevention for scrupulosity relies on a lot of imaginal scripts. Did you have some discomfort surrounding that when you would try to utilize it with clients? Can you tell us more about that?

Dr. Connie: Sure. First off, we know that ERP works great treatment. For myself, in my treatment of folks with scrupulosity, I always shied away.

From imaginal scripts with script, I would do it with other things and I would also do exposures, let’s say, a more, I guess, in depth way with other things. I have no problem sticking my hands in the garbage, touching my face, touching my hair. Modeling that no problem, no problem at all. But I remember even in training, I was like, please don’t give me a script case.

Please don’t give me a script case because I felt so uncomfortable with that. There’s a lot of reasons why I didn’t want to add to someone’s distress, but I also didn’t want to confuse the person in terms of what their faith practice was and what was an exercise in treatment. So then I relied a lot on ACT.

Group. I did a lot, a lot of act work. I’d still do response prevention, but I wouldn’t do, yeah, like those hard, those exposure exposures. Exposures like, oh gee, that a person could be possessed by the devil or wanting to sell their soul. I wasn’t doing, it wasn’t coming from me. It violated something within me.

Again, I leaned on that a lot.

Carrie: Acceptance and Commitment Therapy.

Dr. Connie: Correct. Acceptance and Commitment Therapy. But even then, it wasn’t the best fit. I can see it now. Yeah. I’m not saying that Acceptance and Commitment Therapy doesn’t work. I’m not saying that, or that ERP doesn’t work. But for me, this is a better fit.

And I think it’s also a better fit for a lot of the people I see. Some other folks would never do those exposures. Or how about convincing clergy to allow that. Oh my goodness. That was part of what we used to do. Yeah, let’s talk to your priest. Let’s talk to your minister. Let’s explain to them what we’re going to be doing. That was a hard

Carrie: Sure, that makes a lot of sense. I think really what you’re talking about is we have to, as therapists, have to be aligned with a particular treatment because our clients are going to feel it if we’re not fully aligned or we’re not fully bought into it. And that affects, obviously, our ability to provide the services.

And I think what you said is true is like when we find something that feels like a really good therapeutic fit for our people, then the people that come to us, it kind of just fits with them as well. It’s like this nice, natural flow. How has ICBT been helpful for your clients with scrupulosity?

Dr. Connie: One of the things that I think ICBT does is it restores. The trust in themselves, in who they really are, and also it helps them grow spiritually. So when we’re removing those obsessive doubts, and some people have told me they don’t believe those obsessive doubts anymore, and I love it. I say to people, why not? And they say, well, it doesn’t make any sense. Yeah, I love that when we can do that with someone and they’re free to then practice their faith in the way that they want to, their relationship can become so much more close.

It’s difficult work and it requires the willingness of the person to do this work, but I have seen that kind of success. I think it also, ICBT doesn’t blur the lines. As much as for me, the therapeutic exercises and the spiritual practice ICBT is value free. So anyone can come with their value systems intact and there is a respect for that and so that you don’t have to go there at all with ICBT.

And I think that another thing that happens, you mentioned the real self, and this is so important, restores what people they know, but they’re doubting their true intentions, their true desires. And who they really are. It provides this other story. The doubt has this whole set of reasons behind it. We clear that up and then we look at obsessional narrative and come up together with an alternative narrative, which in my experience often is about how they are the beloved child of God.

And it just changes everything. And then after that, then we can get into situations with reality sensing and get them back into doing things in a non OCD way. It’s just so different.

Carrie: Yeah, I loved what you talked about with the true desires and intentions because that’s something that gets really doubted heavily in some of those things that we talked about before, like the pedophilia OCD and then leading into the scrupulosity OCD.

I think there are so many Christians that because they haven’t necessarily just worked on OCD in general, it’s, oh, well, I have all these horrible thoughts, whether they’re violent thoughts or thoughts about harming children or thoughts about blaspheming God. Then they’re making some type of spiritual meaning surrounding that.

Well, because I have these awful thoughts, that must mean then therefore that I’m not a good Christian or I’m not close to God or I’m not going to heaven, whatever type of meaning they’re making out of it. And so really just being able to peel back and provide some just general education about OCD, you’re not choosing to have these thoughts.

You’re not wanting to have these thoughts. This is a process that’s happening in your brain, and we can retrain your brain and retrain your ability to reason with these types of thought processes differently and really targeting that obsession that you’re having and kind of debunking the argument that it’s making.

It has led people to be kind of aligning what you were saying with their head and their heart. Well, I know that God’s loving, but I feel this fear towards God, or I feel, I notice when I have these obsessions come along that I’m really super scared, but I know that God is loving. I know that I am practicing my faith.

I know that I’m doing the right things, but it’s not aligning. And so really going through this process of teaching people the modules of ICBT is super helpful. And also, I think just really letting people know that they have options for their treatment is so huge. You as the client have the options that somebody feels like ERP is really the way that they want to go and they feel aligned with that, that they can certainly pursue that.

And if they want to do ICBT, that they can pursue that. And I think that that’s really huge for the OCD community and something that we’re trying to continue to educate people on and let them know.

Dr. Connie: Absolutely. It’s so important what you said about the reasoning process with. ICBT, it’s kind of validating for people that these thoughts don’t just intrude upon them, that there’s a reasoning process behind it.

Once they can see that, and once they can clear that up, then they can realize that those horrible feelings that they’re having, the fear, the guilt, the false guilt, as well as that, is coming from the story. Yeah, that’s where it’s from. They change the narrative and everything changes. So how does it work?

Go back to the obsessional doubt and we’re upstream as we say. Right.

Carrie: Well, for sharing all of this information. Our listeners will find it really helpful and we’ll put links for them to find you in case they’re in New York or want to pursue seeing you.

Dr. Connie: Oh, that’s wonderful. Thank you. Thank you so much.

And thank you for the work that you do. It’s so important to have somebody like you doing these podcasts, especially faith based work.

Carrie: I just want to share with all of you what God has been working with me on in my life. As I Have been studying the scriptures and coming across very specific scriptures that maybe I have shared with certain clients dealing with scrupulosity or scriptures that I felt, Hey, wow, this could really unlock something for someone with OCD.

I’m starting to take notes on those things, write down questions, and I’m not sure what this is going to turn into, if this is going to come out in podcast form or it’s going to come out in written form, but. I know that when I have it all collected and gathered together, I will be sharing it with you. I definitely have a passion for helping Christians with OCD to have a really healthy understanding of theology because oftentimes wires have gotten crossed along the way from Things that we’ve been told or things that we learned from imperfect parents, church situations that maybe weren’t the best or the healthiest, and sometimes those things can get us really stuck and keep us from being able to move forward in a healthy way in our relationship with God and God.

I don’t want anybody to be held back by any of those things. Until next time on the podcast, may you be comforted by God’s great love for you. To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings and receive information on exclusive sales, become an email insider today.

All you have to do is go to karybach. com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us. Until next time, may you be comforted by God’s great love for you. Were you blessed by today’s episode? If so, I’d really appreciate it if you would go over to your iTunes account or Apple Podcasts app on your computer if you’re an Android person.

in and leave us a review. This really helps other Christians who are struggling with OCD be able to find our show. Christian Faith and OCD is a production of By the Well Counseling. Opinions given by our guests are their own and do not necessarily reflect the views of myself or By the Well Counseling.

This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

161. What if I Go Crazy? Health Obsessions

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

Welcome back to the Themes of OCD series! Today, Carrie is diving into health-related OCD, covering both physical and mental health obsessions. She explores how OCD latches onto body sensations and turns them into sources of anxiety.

Episode Highlights:

  • How OCD amplifies normal body sensations into obsessive fears.
  • The role of reassurance-seeking, especially through Google and online forums.
  • Why searching for health-related information can fuel the OCD cycle.
  • Practical strategies to break free from compulsions and find peace.
  • The importance of mindfulness and reframing intrusive thoughts.

Episode Summary:

Welcome back to Christian Faith and OCD! Today, we’re diving into health-related OCD—both physical and mental health obsessions.

Did you know some people develop an intense fear of schizophrenia or postpartum psychosis? Others fixate on illnesses like cancer, autoimmune diseases, or even long COVID. 

You might find yourself hyper-focused on every body sensation—wondering if that headache means a brain tumor, or if a moment of sadness signals clinical depression. Maybe you’ve even fallen down the Google rabbit hole, searching for early signs of serious illnesses or scouring forums for reassurance. Sound familiar? You’re not alone.

OCD often tricks us into thinking that seeking reassurance (especially online) is helpful, but in reality, it reinforces the cycle of fear and compulsions. That’s why one of the most powerful steps you can take is to gradually step away from Google searches and constant symptom-checking.

In this episode, I’ll walk you through practical strategies to break free from the health anxiety spiral—learning how to observe sensations without assigning catastrophic meaning to them. We’ll also explore how mindfulness can help you sit with uncertainty, rather than feeling the need to “figure it all out” immediately.

If you’re struggling with OCD and health fears, know that healing is possible. Let’s talk about how to move forward in faith, rather than fear.

Explore Related Episode:

118. How Do I know if this Thought is an OCD Obsession? with Carrie Bock, LPC-MHSP

Transcript

Welcome back to our Themes of OCD series. Today we are covering all things health related, physical health, but also mental health obsessions.

Hello and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you with practical tools for developing greater peace. We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith.

I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode. You may not know that some people have obsessions about developing schizophrenia. or some type of psychosis. And for whatever reason, this seems to be common in the prenatal postpartum period.

There are a lot of women nowadays that are afraid of developing postpartum psychosis. They’ve heard things on the news or read stories on the internet. Let’s talk about the variety of health obsessions that you may be struggling with. You might have a concern about having some type of long term illness such as cancer, such as an autoimmune illness, an autoimmune disorder.

You may have concerns about long COVID. What we find is that these obsessions usually capitalize a lot on body sensations. You will have some type of body sensation and then OCD comes in and tries to make some immediate meaning out of that body sensation. I’m having a headache. I’ve had a headache yesterday.

What does that mean? Could I have a brain tumor? And that’s a tough one, right? Because you can have a headache for about a hundred different reasons. You might have heart palpitations and think that you’re having a heart attack. What this looks like on the mental health side is that you may have a down day or maybe going through an experience that genuinely makes you sad.

OCD rushes in and says, Are you depressed? Do you think you might have to go to the mental hospital? Are you developing bipolar disorder right now? You were just up yesterday and now you’re down. The OCD has a tendency to take these normal, everyday experiences such as having a headache, feeling heart palpitations, Having a down or sad day and then exploiting it and expanding it into making meaning about something that there’s no actual sense data evidence for.

OCD may cause you to think that you’re actually hearing sounds, or maybe I think I see something out of the corner of my eye, and then I’m making some type of meaning. Did I just hallucinate right now? With the compulsions for this theme, there’s a lot of internal checking that people do. People will check on their feelings internally.

They may check on their body sensations internally. A lot of reassurance seeking from friends, family, but especially reassurance seeking from the internet. There are so many forums out there like Reddit that people will look up their symptoms on, googling everything to do with the first signs of schizophrenia, or how do you know you’re going crazy, or postpartum psychosis, what is it like to live with schizophrenia, how bad does it get?

I mean, you can just imagine the amount of information that we have now at our fingertips. That people did not have 50 years ago. If you struggle with this, there’s two things that I’m going to encourage you to do. The big one is get off Google, if you can. Get off searching for things related to your health or your mental health.

Clients will argue with me sometimes that it helps them a little bit. But then other times they read things that cause them to be more distressed. It doesn’t matter if you read something and it causes you relief or you read something and it causes you distress. Either way, you’re perpetuating that obsessive compulsive cycle.

Because every time you do the compulsion, you reinforce the fact that you need to pay attention to that obsession. This is really key to understand when it comes to reassurance seeking. Because I think people think that when they get that temporary relief, that’s a positive. It’s actually not. It’s a negative.

We’re just strengthening the whole process all over again. So we want to do our best to remove yourself from Google and Reddit and those types of websites. Now, if you can’t right away, that’s okay. Can you set a timer for two minutes and tell yourself, I’m going to wait two minutes before I get on Google?

Or can you set a timer for five minutes and say, I’m going to not get on here until it’s five minutes has gone up. Now, sometimes you may find that the urge passes in that five minutes. It may not, but if it does, let’s take the victories where we can get them when it comes to OCD. Okay. The other thing I really stress to my clients is not all sensations are symptoms.

Let’s repeat that again. Not all sensations are symptoms. Bodies are incredibly noisy. They don’t always act according to plan. They do strange things. And here’s the other thing you have to understand, that your body and your brain are in constant communication through your nervous system. This is happening super fast.

My grandmother had this book I remember a long time ago that said, Your body believes everything you tell it, and the premise behind the book was basically like, you shouldn’t say things like, my arm is killing me, or I feel like I got hit by a truck. Your brain hears and your body responds accordingly.

So here’s a test. I want you to bring up a memory, could be recent, it could be a little bit farther back, but a time where you knew that you genuinely felt happy or joyful. Could have been a graduation, a wedding, a birth of a child. See if you can picture that really vividly in your mind. And get really in tune with how you felt emotionally there.

And as you start to do that, even for a moment, you’re gonna notice that your body has a response. Hopefully bringing up positive sensations for you. Or you may feel areas of your body just go more limp or relax a little bit. It depends on your comfort with relaxation and whether or not your body cooperates with that process. However, the key thing to notice is that the reverse is also true. So if we get really fixated on a symptom and we start to notice it really deeply and really fully, That this can cause that symptom to increase all the more or to be louder. So if we’re focused on that headache, saying, Oh, I have this headache.

It’s awful. And now we add some anxiety on top of that. Well, what if there’s a deeper issue? What if I’m going to have a brain aneurysm? What if I’m going to have to go to the hospital for this later? What if it’s going to be the worst migraine of my life? Some of you have dealt with some of those. And that you can get really, really worked up in what we call the secondary suffering piece.

As you get really worked up in your mind about that sensation, that sensation becomes worse because now we’ve dumped stress on top of it. Being mindful is super, super healthy, I think for all of OCD, but especially if you’re dealing with health concerns. Being able to be like a third party noticer of what’s happening without feeling like you have to get sucked into an obsessional story surrounding this body sensation.

So what does that look like? It means practicing. Just noticing the flat facts of the situation. I have a headache. It doesn’t feel good. I don’t need to make any meaning out of it right now. Now, obviously, if I have the worst headache, that I’ve ever had in my life, and it also comes with other symptoms. So usually, that’s why we say not all sensations are symptoms.

Typically, if you’re having some type of medical emergency, you’re going to have other symptoms like a stiff neck, fever, you might have tingling or numbness in parts of your body. There could be all kinds of different things that could happen as our body’s way of letting us know that we need further attention and evaluation. And that’s where we can enlist your medical professionals that you see, not in a way of reassurance seeking, but in a way to help you, okay, this is something I struggle with, I struggle with having these headaches on a regular basis, for example. How do I know if I have a headache that needs further attention or evaluation?

Maybe your doctor says if you’re having this many, maybe they say if it’s at this level of pain, maybe they say if it comes with some of these other symptoms. And that’s a really great litmus test for yourself to know is this a health OCD concern or is this a medical emergency because we don’t want to flip all the way to the other side and say, well, I’m just ignoring all that because it’s just probably my OCD.

We want to find this middle ground, which I know is really challenging because it’s easier to be in all that black and white thinking. And you think about when you do go to your doctor’s office with a symptom, what are they going to know? They’re going to want to know things like how bad it is. What’s your pain level on the 0 to 10 scale?

They’re going to want to know, when did this start? Was there some kind of origin to it? How long has it been going on? These are all types of things that you can notice for yourself and maybe jot down a note or two, not in a compulsive way, not in a I’m searching for these symptoms, but just like, Oh, that came up again.

Let me jot it down day and time, maybe. You can look at concerns about your mental health in a similar light, hopefully, if you’re dealing with some of these obsessions that you’re able to talk with a therapist about them, where we can look at normalizing emotional experiences that you might be having.

You may have been through a major grief and loss incident and you’re afraid of becoming super depressed or non functional. Maybe you’ve had a specific trauma and you just feel like you’re walking through a fog or you don’t really feel fully connected to yourself. Those are things that can be worked on in therapy to get you to a better place.

In the cases with health concerns, either physical health or mental health, you might have concerns about being disconnected from your loved ones or not being able to care for them, such as in the space of being a new mom. This is that feared self piece that we talk about in ICBT, and we want to look at what, quote, evidence OCD is using to reinforce the need for these types of compulsions. All OCD themes can be highly distressing, and I want you to know that the high level of anxiety that comes with OCD is not indicative of whether or not your obsessions are going to come true. OCD draws you in with a story and gets all of these internal fears churned up inside of you is a way to say, Hey, pay attention to this.

It’s important. I’m not going to let you let it go. You’ve got to somehow find resolution and no amount of research after research, no amount of articles is ever going to lead you to resolving that obsessional doubt. And that’s how we know. that this is OCD. We all have periods of everyday doubt with our health where maybe they say, Hey, I’m not really sure, but something’s come up abnormal on a scan or in your blood work.

We need to do a little bit more testing or a little bit more digging. They may look at doing a biopsy or a follow up scan. And during the time that you’re waiting on those things, you’re naturally going to have anxiety. But those everyday doubts get resolved when we find out the test results or find out the treatment process and plan.

What OCD does is it comes in and may even doubt results that you have received from the doctor. Maybe somebody has told you you don’t have cancer. And you’re doubting, well, did the right specimen get to the right person at the lab? Did they miss something? Was somehow the report done wrong? What if I still do have cancer?

You’re not trusting the sense data at that point. If this is a theme that you’re struggling with, that you are kept up at night wondering if you are going to die, or If you’re going to have to go to the mental hospital, I really encourage you to reach out for help and support. I am in Tennessee and you can reach me online at carriebock.com or find a therapist in your area that can help you. Know that wherever your health journey has taken you, I certainly have a husband who is experiencing a medical disability right now. So I say firsthand that God loves you, that he has a great plan for your life, and is completely in control. You can trust him with your future.

To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings, and receive information on exclusive sales, become an email insider today. All you have to do is go to kiribach. com and scroll towards the bottom of the page. You’ll find a spot to put in your email and receive a free download in your inbox from us.

Christian Faith and OCD is a production of By the Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

160. You Can’t Touch It!: Contamination OCD

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

Welcome to the Themes and Treatments for OCD series! 

In this segment, Carrie breaks down contamination OCD and shows why it’s not simply about fearing germs. 

Learn how ICBT can offer you a way out of the compulsive behaviors and bring true relief from contamination obsessions.

Episode Highlights:

  • The complexities of contamination OCD and how it goes beyond a simple fear of germs.
  • How contamination OCD can manifest through fears about illness, bodily fluids, or even specific diseases.
  • The importance of understanding your personal story behind OCD to help break the cycle.
  • The power of ICBT (Inference-Based Cognitive Behavioral Therapy) in addressing compulsions and obsessional doubts.

Episode Summary: 

Welcome to the first segment of Themes and Treatments for OCD series! 

Today, we’re diving into contamination OCD, one of the most common yet often misunderstood themes. You’ve probably seen it in movies—people constantly sanitizing or avoiding germs—but it’s much more complex than just a fear of getting sick.

Contamination OCD can show up in many forms, such as fears about germs, diseases, bodily fluids, food spoilage, or even allergies. It can also involve the intense worry that you’ll pass contamination onto someone else. The compulsions—like excessive hand washing, cleaning, or avoiding specific places or foods—can become ritualistic and deeply ingrained over time.

What makes contamination OCD tricky is the emotional reasoning behind these compulsions. Sometimes it feels like there’s a “right” way to clean or protect yourself, and if it’s not done exactly right, you just don’t feel safe. That’s where ICBT (Inference-Based Cognitive Behavioral Therapy) comes in. Unlike traditional approaches, ICBT helps uncover the reasons behind your obsessions and compulsions, digging into the personal stories that fuel your fears, not just the behaviors.

Changing old habits isn’t easy, especially when it feels like these routines are keeping you safe. But with time and practice, it gets easier. Whether traditional ERP has worked for you or not, ICBT could be a great alternative. Learn more about it at icbt.online or check out past podcast episodes for more insights. If you’re looking for a Christian perspective, join the waitlist at carriebock.com/training. You’re not alone—there’s always hope!

Tune in to the full episode for more on managing contamination OCD with ICBT and overcoming it!

Explore Related Episode:

138. The Connection Between Trauma and OCD

Accordion Heading

This is the first segment in our Themes and Treatments for OCD series. When I was coming up with podcast ideas for this year, I thought we really should break down the different themes and maybe do a podcast episode on each theme. So today we are talking about contamination OCD. This is probably the most well known OCD theme.

It’s the one that gets portrayed in all the movies and TV shows. It’s the monk type person. You know, I can’t touch something or I need a sanitizing wipe. I need my hand sanitizer with me all the time, and now I’ve gotta wash my hands. Even though it’s portrayed a lot, I feel like most people don’t fully understand it.

They just see it kind of as a, oh, you have a fear of germs, you’re a germaphobe, and you don’t wanna get sick, so you don’t wanna touch anything. It’s more complicated than that, and there’s a wide variety even within the contamination OCD theme. So, you can have obsessions about germs, getting sick, and that may be you, or it may be someone else.

Maybe you’re afraid that your child is going to get sick, or your spouse is going to get sick, that you are going to somehow pass that on to someone else. Sometimes that can be more distressing than actually being sick yourself. You can have fears surrounding catching certain diseases, like HIV, or hepatitis.

Maybe you’re concerned about being contaminated by certain bodily fluids such as urine, feces, blood, or semen. This may lead to concerns about becoming pregnant or you causing someone else to be pregnant. There may be concerns surrounding food, specifically food spoiling, going bad, concerns that certain foods you’ll all of a sudden become allergic to or won’t be able to eat, and these concerns specifically don’t have anything to do with concerns about weight or body image.

Common compulsions for the contamination theme include hand washing, Excessive hygiene where you’re just in the shower for two hours, cleaning, avoiding, that could be avoiding using public restrooms, avoiding. Eating certain foods, avoiding going to certain restaurants you believe are contaminated, may involve using gloves or lots of sanitizer, and the challenge is that with contamination OCD that the routines tend to be very ritualistic.

So I have a certain way that I get ready in the morning or I have a certain way that I need to take the trash out or a certain way that I need to respond after I pump gas. The other challenge with hand washing and other compulsions is that there can be a little bit of just so mixed in, like I can’t really stop because it has to feel a certain way.

I have to feel clean. So what’s interesting about even something like hand washing, if you were to look at a traditional behavioral exposure and response prevention approach, they would say Do something and then don’t wash your hands or you’re only allowed to wash your hands if they visibly look dirty You’re about to eat.

You’ve just used the bathroom like in those settings you could wash your hands one time the cool thing that I love about inference based cognitive behavioral therapy or hereby referred to as ICBT So we actually care about the story and the reasons of how did you come to believe that washing your hands is the solution?

What obsessional doubt are we trying to resolve by doing this? It’s very different for different people. So you may say, well, I’m washing my hands this way because I used to work in a hospital and I saw someone who contracted MRSA, and I know how bad that can be. Or you may say, I wash my hands so much because I’m a single mother and there’s no one else to take care of my children if I go down and get sick.

You might say, I wash my hands so much because how can I be really sure that they’re clean? I don’t see dirt on them, right? But there may be germs because germs are invisible and how would I know when they’re all off my hands? By really uncovering the reasonings behind your obsessional doubt, which ICB tells us that there are reasons that OCD uses to support these doubts.

Sometimes they make more sense to you than others. There are facts mixed in inside the inferential confusion process. It is a fact that we should wash our hands in certain situations to prevent illnesses from spreading. We also all lived through COVID, which was a very scary time, where we were told repeatedly to wash our hands, make sure you’re washing them for 20 seconds.

There was a lot of fear, a lot of uncertainty, and for some people, that has carried over. That fear has never gone away. The long term goal in ICBT would be to look at the arguments that OCD is making, the story that it’s drawing you into, and convincing you that these compulsions are absolutely necessary in your life in order for you to maintain a sense of safety.

Once we know more about that story and understand it a little bit better, then we can start to find cracks in OCDs. reasoning process. Not to argue back with it. I think that’s a big misnomer about ICBT is people say you’re arguing with the OCD. No, we’re finding cracks in the OCD reasoning process. We’re identifying inferential confusion so that we can retrain the brain to notice these obsessions as irrelevant To our present sense data, the goal is to be able to trust your senses that your hands are clean or trust your internal sense that you’re not a dirty, awful person.

I want my clients to be able to have a certain sense of confidence that they would be able to handle situations if they did get sick or if their loved ones did get sick. And they may have gone through some things in the past where somebody was sick or they were sick and they felt like they couldn’t handle it or they didn’t handle it very well.

There may have been some medical trauma in the family history. These are the types of things that a very traditional behavioral approach, I feel like, doesn’t take into consideration. Being trauma informed is very important when it comes to OCD. So I would encourage you, if you’re dealing with contamination, look at what is contributing to that story in your mind.

How do you or other people or objects become contaminated? How does that contamination spread from one person to another person? When you do that, you may be able to recognize that some of this defies common sense data. That’s another aspect that ICB talks about, is trusting in the senses, and one of those is not just your five senses, that you can see that something is clean, you can smell something is clean, you can know that you’ve taken the steps to clean something, but really trusting common sense data.

and internal sense data as well. What does it mean about you as a person if you are contaminated or get sick? This might help you identify what you would call the feared possible self or the vulnerable self. It’s not really you, but it’s who OCD says that you are. I’m excited one of my colleagues is going to come on and talk about this concept in more detail in a future episode, how this interplays with Christian faith, which is really exciting.

I know it can be super challenging and scary. to do something differently than OCD has told you that it always has to be done. For example, if you have a certain ritualistic compulsive routine after you use the bathroom and now you are trying to make changes to that, or eliminate aspects of that, just know that that’s going to be very challenging, especially in the beginning, but the more that you are able to gain a little bit of ground, the easier and easier that it’ll be.

The most important thing that I would want anyone to know is that there is hope regardless of the OCD theme that you are dealing with. Maybe you’ve been highly advised to do exposure and response prevention if you have contamination OCD. If that has worked well for you, awesome. We’re all for it. Love that.

If you felt like ERP just wasn’t for you, or you’re interested, I would encourage you to look into ICBT. There’s a good amount of information at icbt. online. You can also search the podcast for previous episodes on ICBT that we’ve done. And if you happen to be interested in learning all of this from a Christian perspective, you can join the waitlist by going to carriebock.com/training. I’ll add this part in after I talked about being concerned about HIV. You may have concerns about being in touch with bleach, other chemicals, some type of chemical or radioactive waste.

159. Parenting a Child with OCD? SPACE coaching with Katie Wetsell

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

In this episode, Carrie welcomes Katie Wetsell, a parent coach and mother of four, to discuss how parents can support their children who are navigating the challenges of OCD.

Episode Highlights:

  • What it’s like discovering your child has OCD and the challenges parents face in supporting them.
  • The key principles of the SPACE (Supportive Parenting for Anxious Childhood Emotions) approach to supporting children with OCD.
  • How parents can gain confidence and tools to support their children, even if they aren’t currently in therapy.
  • The role of faith in providing strength and comfort for both parents and children navigating OCD.

Episode Summary:

I’ve been part of the inference-based cognitive-behavioral therapy community for a while now, and that’s how I came across a concept called SPACE. I wanted to bring this to the podcast because it’s something so helpful for parents out there supporting their kids—especially those struggling with OCD. 

Joining me today is Katie Wetsell, a parent coach and mom who knows firsthand what it’s like to support a child with OCD. Katie’s journey began when her son was diagnosed with OCD during the pandemic, and this experience not only reshaped her family but also inspired her to become a parent coach. Now, Katie helps parents all over by offering practical tools and emotional support.

Katie breaks down the SPACE protocol, showing us how parents can find the right balance between empathy and confidence in supporting their children. By focusing on small, manageable goals, the SPACE protocol helps parents avoid enabling OCD compulsions while also tending to their child’s emotional needs.

Katie shares valuable insights on how parents can create a nurturing, supportive environment at home without feeling overwhelmed. 

Tune in to learn how you can implement these strategies to help your child thrive and step into your role as a confident, compassionate guide, supporting them through their struggles with OCD, anxiety, or other emotional challenges.

Related Links and Resources:

parentingwithhope.org

Explore Related Episode:

86. How to Catch Your Teens Anxiety Before it Gets Out of Control with Gina Nelson, LCSW, CDW

Transcript

Faith: Hello…

Carrie: That is my almost three year old debut on the podcast. She was in my recording space and wanted to know what’s that? And so I was showing her a few things on how the microphone works. It’s kind of cool to have my daughter on because today’s episode is for the parents out there. I know that we have a lot of people who listen to the show who are parents or a loved one of someone who has OCD. And it’s really great that you’re listening to the podcast in order to try to understand them better. As you know, I’ve been involved in the inference based cognitive behavioral therapy community for a little while now. And it was through that community that I found out about something called space for parents and I wanted to put this on the podcast for all of you parents who are struggling out there wondering, how do I best support my child or adolescent, maybe even young adult that’s living with me, who is struggling with OCD, what can I do to help them and kind of point them in the right direction?

The thing that I love about this treatment is that it doesn’t matter whether or not your child or adolescent is in therapy. There are still positive things that you can do as a parent to help nurture and support them towards a growth process. Stay tuned because I absolutely love how our guest Katie Wetzel really integrates this treatment with our faith.

Hello, and welcome to Christian Faith and OCD with Keri Bach. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you.

With practical tools for developing greater peace, we’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode.

Carrie: Katie, tell us a little bit about yourself and how you got into parent coaching.

Katie: I am first and foremost, a mom of four kids, so I am parenting a lot and actually benefited from a parent coach. Gosh, about 10 years ago and really helped us through a difficult season, particularly with my son, who ended up years later being diagnosed with OCD. He had a really rough time around six. We reached out for a parent coach and were really helped and then trade was a pediatric nurse Practitioner and was working as a nursing professor. Okay, then the pandemic hit and I had four kids virtual schooling. My youngest was starting kindergarten.

My oldest was starting high school. I was like, I can’t go back. My husband was a pharmacist, so he needed to be there full time. Anyway, then I basically retired from nursing. I still do a little bit, but. Then decided to get certified as a parent coach. And mainly because those last few years of nursing, I found like I was really gravitated towards parents and more passionate about parents and more able to see that I’ve always loved kids, but kids love their parents. And if I can love their parents, well, I can also love that kid well.

Carrie: I love that.

Katie: And so parent coaching was a natural next step for me to further dig in and support parents who are navigating hard things with their kids.

Carrie: Yeah. This is a side note, but I love stories about career shifts because I think a lot of times people think that they’re stuck and that they can’t do something else or that their skills aren’t going to translate somewhere else.

So that’s sounds like it’s worked out really well for you. So you talked about having your own son who struggles with OCD or was diagnosed at a younger age. Was that a shock for you? Was that overwhelming like all of a sudden I need this new set of skills because I’m having things that I haven’t seen with my other children before.

Katie: My older son had like general anxiety Definitely was like, okay when around 10 or so I was like, oh, this is not what I’m used to This is something different, but he never would go to therapy or anything So I’d learned a lot about how to help him through anxiety And then my second son, around six this time, he was really struggling, got diagnosed with Tourette’s syndrome.

And looking at Tourette’s, a lot of things, common comorbidities are ADHD and OCD. With his tics, I was always kind of curious, wait, is that a compulsion or is it a tic? It’s kind of confusing. So it was in the back of my mind and I had been watching like YouTube videos and learning Again, first anxiety because my older son, but then OCD with this question with my other child and it was when the pandemic hit, I knew he was doing some things in numbers.

Like he was like tapping and I was like, are you just tapping? Or is there a certain number? And he was like, oh, it’s a certain number. And our neurologist just called it OCD like behaviors. But didn’t actually do an evaluation and then in the pandemic, I said, Hey, buddy, seems like you’re not taking as much just kind of checking in.

Like, I noticed the Tourette seemed to be better. And he goes, yeah, but I’m counting a lot. What do you mean counting a lot? And so he was counting a lot in his head. And then we kind of asked more about it. Is it like just sometimes or all the time? Because he’s great at math, so I thought he’s just playing with numbers. And he’s like, yes, all the time. Wow. And so then we actually got an evaluation. Found out there was more going on. There were intrusive thoughts and things that we didn’t know because it was also internal.

Carrie: Yeah, I think that’s important for parents to hear who may have discovered they have a child struggling with OCD is that I think it can go on for a little while.

Before it actually externalizes and that your kids may be having certain obsessions that they’re afraid to tell you because they’re scary or they’re uncomfortable and they don’t want to tell their parents. And then I think also you have the opposite end of the spectrum where you may have children who have some confession compulsions and feel like they have to tell their parents everything.

So it really runs the symptoms kind of can run the gamut and I remember asking prior guests who had struggled with OCD when he was a child, I was like, how much of this did your parents actually know that you were obsessing about tucking in your stuffed animals a certain way when you were six years old?

And I think a lot of that just went unknown or I don’t want anybody to feel guilty if they miss something.

Katie: Oh, I was asking, I was going to specialists and it just took a while and I know that from being a nurse practitioner, sometimes it takes a while for it to ripen, to tell what it is, to be able to be clear what exactly are we dealing with but it’s still hard.

Carrie: Tell us about SPACE and that’s an acronym So, what does that stand for?

Katie: Actually, I found out about it while I was parent coaching and watching all the videos Came across it and it’s space is supportive parenting for anxious childhood emotions And it’s parenting protocol that has been researched and studied for kids with anxiety disorders, including OCD.

And when I found out about it, I was like, well, these concepts are what I’m coaching through Connected Families. So Connected Families is the Christian organization that I was getting certified through as a parent coach. But this specific protocol that it fit right in with the concepts and the messages.

That we were helping parents with through connected families, but this was more specific for anxiety and OCD with more robust tools for that specific struggle, it was a lot of things that I had come to find were true as a nurse supporting other people’s kids, but also things I had to develop as a parent again, like I said, with my oldest, who would not go to therapy things I had to learn how to support him.

And then my son with OCD, when he was doing telehealth, because it was, like I said, the pandemic, and so I was always popping into his telehealth visits, being like, Hey, this happened the other day, and I handled it like this. Is that okay? Like, I was kind of stealing a little bit of time for how do I parent him the rest of the time?

I love the work he’s doing with the therapist, but like, what do I do? How do I support him? And so coming across this space protocol really just kind of solidified and gave me confidence.

Carrie: I think that’s really key because obviously when you have a child that has OCD or anxiety, it does affect the whole family.

It’s not just affecting that child. So it’s affecting sibling relationships. A lot of times it’s affecting parent child relationships. And so I do think it’s very important for parents to get help and support for them. They may be dealing with their own anxiety or their own OCD sometimes in certain cases.

And, or, like we talked about before, they may just not have the tools. It’s like, okay, well the things that worked with my other children. Now are not working with this child with these specific needs and that is so crucial. It does take some humility as a parent to be able to say, okay, I feel like I’m a good parent, but I also need some more tools in my toolbox and I need some extra support because this child is exhibiting a different set of behaviors or symptoms than my other children.

I think it does.

Katie: Absolutely. Or myself, I’m like, gosh, I’ve never felt woken up in the morning and felt like something bad was going to happen. I never had to count things to go through a doorway. I’ve never had to do this. This is something I’ve had to face. How do I help a kid who’s struggling with something I’ve never encountered to that degree?

But I’ve also had parents who, like you said, were struggling with their own anxiety. Having that orientation of understanding and confidence in a solid plan, and even a sounding board with the coach to look through the plan with them and be like, ah, you’re doing it, gave those parents confidence to you.

Carrie: That’s good. I would imagine, and you can correct me if I’m wrong, because I know very little about this. I would imagine there’s some level of teaching parents how to empathize and attune to their children in these situations.

Katie: Yeah, so when we start the space protocol, the space program, whatever you call it, we start with just understanding baseline concepts of what is happening with anxiety, what’s going on in the kid.

What does that look like in a parent child relationship? How does that feel for you as a parent and how you engage with it? We start there with those things and then very like simple definition of support. We talk about acceptance and confidence. We work on statements. So what are the things you usually say to your kids?

What are the things you usually think? What is your mindset when you’re encountering your child’s struggle? And looking for ways we can move from the parent who’s really accepting, sometimes might be lacking confidence and so they’re overprotective, they’re protecting their kids from things that aren’t actually threats, but they have so much compassion, they’re attuned to their child’s struggle, but they’re lacking confidence.

So we help that parent take that great empathy and attunement and add some confidence to it. Another parent may be on the other side. They’re confident their kid is okay. They can do this, but they’re not very empathetic about the struggle their child is having. And so that parent can tend to be demanding.

And although they have so much confidence in their kid, they’re kind of adding anxiety because they’re skipping over that entonement and empathy. And so we’re going to try to bring both parents together. Or help the parent who waffles between protection, overprotection and demanding, get more balanced with that, both that attunement, that understanding what my child’s going through, but also confidence in their ability to overcome.

Carrie: Those two things I think are really key because I wanted to definitely bring up accommodations. This is a big thing. That parents who have a child with OCD struggle with, like, how much do I accommodate? How often do I accommodate? Sometimes they don’t even realize because kids are really sneaky about getting what they need.

Especially OCD, kids can be super sneaky about how they seek reassurance. They can be super sneaky about how they get parents to do things.

Katie: One way it’ll start another one, yeah.

Carrie: Sometimes parents may be not even in awareness of how much they’re accommodating until they have that outside viewpoint to say, Oh wow, do you realize you’ve changed your entire routine to coming in the house because you have a child who’s struggling with contamination and now this is a big deal?

How do you help those parents just in terms of accommodation, what space is approach to that?

Katie: We’ve kind of built some awareness of the mindset that’s driving our reaction to our kids. Then we build in some more consciousness around what are accommodations. So accommodations. Are things that we do because our child is anxious and how we assist them to avoid or handle that anxiety.

This is not when there’s actual danger. So that is protectiveness. If your child is anxious about I’ll give an example of we had a local school shooting and my daughter was really anxious afterwards and asked me about if I locked the doors. Me locking the doors is protecting my child, so it’s okay for me to lock the doors for us to feel safe, but she would ask me about the locks multiple, multiple times.

That’s where I’m like, okay, the more I answer, the more she’s dependent on me to feel safe, instead of the knowledge that the door is locked to feel safe. She needs me to answer every, like, more than once. So accommodation is like, my child wasn’t anxious, telling her we lock the doors every night should be the end of it.

Carrie: Right. Right?

Katie: But because my child is anxious, I might answer multiple times, thinking that I want to be a good mom and make my child feel better. So it comes from a really good place, or I may be, again, confident, like, you’re fine, quit asking. Right? Which is dismissive. But to go back to like, okay, I want to help my child, but if I help them too much, if I accommodate too much, then they get dependent on me and they say, oh, I need to ask three or four times to feel confident.

Versus learning to feel confident with that one time in their memory, the knowledge and wisdom they have from getting that answer. That’s just one example. I get a lot of times parents will be like, if they do anything to help their child, then they feel like they’re accommodating. I’m going to say it’s like, no, some children are young and vulnerable.

Their brains are not as developed. Their bodies are not as developed. They need our help as parents. Kids are wired to seek reassurance and safety from their parents.

Carrie: Yeah.

Katie: That’s what we do a lot of, like, how are you helping but not over helping?

Carrie: Yeah. And I know I’ve worked with a lot of adults who were constantly reassured as children.

Then that behavior carries into adulthood and they may not feel like they can make any decisions on their own without running it by their parent. They may not feel like they can be competent parents without constantly seeking reassurance from their spouse or from their own parents. I think it’s important if you have the opportunity to step in and develop these skills while they’re still young to say, Hey, I know it’s super hard and I know you may feel super anxious, but you can do it.

I mean, essentially that’s what I’m hearing from you is like, Oh,

Katie: supportive statement right there.

Carrie: Yeah. OCD is telling you, you can’t touch that door handle right now. And it feels super overwhelming or super scary. And like, I’m here to help you know that I’m here for you and you can do it.

Katie: Absolutely. So acknowledging that’s definitely something we had to do with my son with OCD, like, I understand it’s really loud in your voice right now, but what else do you know?

What else do you see? Like, talk back to it. One of the things I remember one time doing this places where accommodations did show up for us was around food.

Carrie: Okay.

Katie: I had a son who was a typical picky eater. I was a picky eater as a kid. I got that. But with my son who had OCD, it was clearly something different.

I remember one time he started a new theme where he was like, well, that’s a dinner food and it’s lunchtime. And I immediately was like, nope. Sounds like your OCD is getting really loud right now and trying to make some new rules to make things hard. We’re going to have this food. This is what’s for lunch.

Let’s talk back. And so some of that awareness helped him, but also me not just like, okay, well, we’ll eat something different. Not me following OCD’s rules.

Carrie: I think it is a helpful to have that balance the like you’ve been talking about of the empathy and the confidence and support and I imagine to the parents just being in tune with their own emotional experience as you’re going through this process, because there It can be very frustrating, especially for parents who feel like they’ve been dealing with this for a long time, or let’s say in the case of maybe an a little bit older child or an adolescent that just completely bucks therapy and says, I’m not doing this at all.

I don’t want to participate. This is just the way I’m going to be. And what I’m hearing from you is that space really helps in those situations support the parents to know that they can still make progress in the connection with their child, even if their child’s unwilling to participate in therapy.

Katie: Yeah, that was so exciting from the research on this program is that it was shown to be just as effective as cognitive behavioral therapy. That’s awesome. This is something parents can utilize whether or not their child is in therapy. So if your kid is, then that’s wonderful. But if they’re not, you can still make progress and.

I will say this is one thing my background as a nurse really taught me, as much as it’s helpful to have a professional work with your child directly, which I think is great, especially adolescents. But, man, kids want care from their parents the most.

Carrie: Absolutely.

Katie: Working with parents is, it’s not to say that you’re the problem, it’s to say that you can be a part of the solution.

Carrie: Yes.

Katie: It’s to say that, hey, you can also help your child and that can be difficult. So talking about your own emotions to let them not rescue them from the discomfort of their anxiety. But to allow space, use that word again, space in the traditional sense instead of the acronym, but allow space for you to confidently hold space for them to move through the discomfort and find out that they’re okay and find out that they were capable.

That’s hard to do. And so that’s the benefit of working with a therapist or coach to have someone else help you as you hold that difficult space for you and your child to move through that wave and get to the other side and see that you were again safe and capable.

Carrie: I started out my career working with children and families.

I do very, very little to none of that work right now, but occasionally we’ll take on some adolescents. But what I saw was there were the parents that kind of wanted to essentially just be like, Okay, here’s your therapist, go fix my child. And the things that we would tell parents would be like, I’m with your child one hour a week, and you are with your child all of these other hours during the week.

And so if we don’t teach you as well some of these therapeutic skills or the things that we’re trying to implement in the home or develop healthy routines and rhythms that will make them feel safe and healthy, then it doesn’t really matter what we’re doing one hour a week. That’s just a drop in the bucket.

I think that’s important for parents to know and hear because they think, well, I’m, in your case, you may see some parents that throw up their hands and say, well, I don’t know what to do. I’m not the professional. They just need to go see the therapist and then just fix them and they’ll, we’ll all be fine and the family will be better.

It’s like, no, that’s not exactly how things work. You’ve got to surround your kid and really learn and grow and develop. I think. If you’re open and willing to that process. I know being a parent has been one of the most challenging things for me because as my daughter grows and develops and she’s getting close to being three.

And so now I can understand why people use the term three nature. I mean, she can argue like a good 13 year old sometimes. And I’m like, Who are you? Like, where is my sweet child? As they grow and develop and change, like, these new behaviors happen and come out. And so, obviously, that’s amplified whenever you have a child that is dealing with mental health issues like OCD.

Katie: And I will say again, my son got his diagnosis during the pandemic, virtual schooling for kids and dealing with everything else that was happening. And I know it can feel overwhelming for the parent to get help for themselves, right? Like, I don’t have time for me if you can just help my kid and maybe that needs to be what you do is you get help your child in therapy before you look at space, but I think if you can find.

The room to work through these things. It will save you time and energy in the long run. What we do is we identify as we work through the concepts. What are accommodations? Where are they happening? Then we pick one target in the space protocol. We’re not trying to change your whole life at once.

Carrie: That’s good. That’s good.

Katie: You’re going to pick one target that thing. Hey, if, if one thing could be different, if one thing could be better, what would that one thing be? And so that one brings relief to everybody, but then it also helps you not only learned, but also practice the skills. For the next thing that’s on the list, I might work with someone on that next target or a lot of people go on their own and maybe a year later there’s one they’re stumped on and they check back with me, but we’re not changing your whole life at once. We’re going to focus and that is much more doable, especially if you’re feeling overwhelmed.

Carrie: How many sessions do parents usually participate in? Is there a range?

Katie: I typically do six sessions.

Carrie: Okay,

Katie: Now again, I’m a parent coach and so I will ask for a bit more homework in between the sessions and that typically works well.

Now everybody’s a little bit different. Some people can make progress on that first target in less than 6 sessions. And so we may just use those last few to like, again, pick a new target or. Whatever they need, I’m going to give them the full benefit and other people might need a little bit more, but six and to be a pretty good average, it just depends on prior knowledge and experience and how much is going on.

Carrie: Before we wrap up, I wanted to ask you about the faith integration piece for you. How you see this therapy, what’s that connection between this therapy and your Christian faith?

Katie: Yeah, so one of the first concepts we talk about is how children are wired to seek an adult for safety.

Carrie: That’s good.

Katie: Like, if your three year old is scared, they’re not gonna go confront what they’re scared of or hop in the car and drive away.

Right. Right. They’re going to cling to you. They’re going to go to mom first. And as adults, it may look a little bit different, but in some ways it doesn’t. As Christians, we, I go to my heavenly father when I’m scared. Yeah. Right? When I’m afraid, when things are uncomfortable or uncertain, I can find refuge.

So that’s safety I need in the Lord. And I can find strength to encounter that thing that felt threatening with his strength, with help and hope. And a lot of times that is my experience as a parent. I am either wanting my kids to be my safety, I want them to change so I feel safe, and they’re a child, like, it’s not supposed to go that direction.

So that’s where I see I step into my faith, and then sharing that with my kids, and inviting them to follow me to do likewise. Even if mom’s not there, God is always there. When you grow up, God is always there. I need to first be in that refuge and strength myself, but then showing my kids, teaching them how to go to the Lord and we can go to the Lord together, that even as adults we have the church to help us.

I find those truths are more robust in my faith versus me just being able to do it all by myself. As a Christian, we don’t have to do anything alone. We have God and His Holy Spirit and all that He provides for us. That to me is so much more hopeful than just doing it all by yourself. God can grow us in our ability, but we’re not alone and we’re not without help.

That faith helps me find the acceptance and the confidence. You know, that’s the whole gospel is that we are accepted because of what Jesus did. Even though things are hard, I can still belong and be known by God, and I can have confidence in his help and his hope.

Carrie: That’s awesome. As you were talking, I was thinking about Jesus’s love for us.

That is very empathetic. Jesus cried with people, you know, that were hurting. He had a deep level of compassion for the poor. And at the same time, he had boundaries. So there’s this balance. And I think we really struggle as human beings to be fully loving and also have boundaries. And boundaries in themselves can be very loving, especially in parenting, because boundaries protect us and so forth.

So finding that, and it’s something that I think I ask the Lord in my relationships, like, okay, is this a time where I was supposed to let this offense go and radically love this person and show grace? Or is this an opportunity for me to set a boundary, which is also very loving? Like, how do I handle and navigate these situations?

That’s what kind of came to my mind as, as you were talking about this particular treatment.

Katie: I think one of the favorite things as a coach is watching people grow in their confidence to be led by God, to ask God for wisdom and receive it. And so they’ll tell me wins where we’ve worked on concepts and targets, but sometimes they’ll tell me about, I just felt conviction that I needed to hold this boundary and it was uncomfortable, but I did.

Great. I wasn’t there. I didn’t tell you to do that, but God was there. or ideas they came up with. I can help and I can support. I can teach and I can celebrate wins with you. But like God is with you. That is the confidence that I hope parents really walk away from that they can see evidence of their growth of how God provided for them to understand and support their child, but also confidence that God is with them and will continue to answer their cry for wisdom.

Carrie: Yes.

Katie: And for redemption of this hard moment. And that’s what some, so my kids who have anxiety are teenagers now, and it’s amazing the wisdom they’ve gained by working through these hard things. During the pandemic, when everybody else was struggling with anxiety, my son, who had gotten diagnosed, the treatment was, it was like his year of bravery is what we called it.

He rode his bicycle for the first time. That’s one that sticks in my mind. He was like 11 before he rode a bike because he was anxious, not because he couldn’t. I mean, he did have some coordination issues and things. But at that point, it was more anxiety. There were just these little evidences of him overcoming and just the wisdom he gained.

Now he’s an advocate too. And so that’s why I share openly about his experience is because he’s confident about how OCD has given him wisdom and insights and his ability to not be defined by it and to overcome it. Even though it’s still lingering there, you

Carrie: know, it’s amazing. Yeah, that’s great.

Katie: I want to say that too. They share about my kids. They give me permission, but I love that. They have given me that permission out of confidence and them overcoming these struggles.

Carrie: Well, thank you so much for sharing. How can people find you?

Katie: I have a website. It’s parentwithhope.org. Parents can find me there and you can book online.

I put the podcast that I’m on on there so you can listen to me talk about other things too. And then you can even schedule a free consult call and just, yeah, let’s see if we’re a good match for SPACE or other coaching.

Great. I was just searching for providers in Tennessee who provided this therapy and you were the only one that I could tell that was definitely Christian.

So that was encouraging to me. And that’s how we got connected was through your website. I will put the link in there for people and that way they can get in touch with you. Wonderful. I’m so glad that we had Katie Wetzel on the show today to talk about space. And I want to speak to you as from one parent to another today to say that if you’re really struggling as a parent, if you feel like you’re having a hard time regulating in your relationship with your children, Maybe you have past trauma, you have been trying so hard to break those generational curses so that your children don’t have to grow up the way that you grew up.

I would love to help you process through that and walk you through that journey. If you’re in Tennessee, I have intensive therapy sessions and I’m really trying to grow that part of my practice. This year, I also do therapeutic retreats for people who are out of the state who want to come for a few days and really dive deeper into trauma work or OCD work, if that’s a part of your story.

Maybe your child is struggling, but you’re also struggling with trauma and OCD. I would love for you to come and have this transformative experience so that you can be the parent that God has called you to be and that I know you want to be inside. For more information, you can visit my website at carriebock.com, and you can contact me via the contact page. To receive weekly encouragement, find out about our monthly Meet the Podcast host Zoom meetings, and receive information on exclusive sales, become an email insider today. All you have to do is go to carriebock.com and scroll towards the bottom of the page.

You’ll find a spot to put in your email and receive a free download in your inbox from us.

We’re going to be talking about the importance of mental health and how it can help you This is a podcast that is for informational purposes only and should not be a substitute This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

158. Is This Thought a Sin? 

Written by Carrie Bock on . Posted in OCD, Podcast Episode.

In this episode, Carrie dives deep into the overwhelming fear that often accompanies OCD, particularly when it feels like your thoughts might be wrong, sinful, or even harmful to others.

Episode Highlights:

  • How to discern true desires vs. OCD-driven thoughts
  • Why intrusive thoughts don’t equate to sin
  • How intrusive thoughts are not intentional and do not reflect your true desires or intentions.
  • The difference between thought suppression and thought replacement, and why they do not effectively work for OCD.
  • How the Holy Spirit can reveal your true desires and guide you in decision-making, especially in challenging times.

Episode Summary:

If you’re struggling with OCD and wondering if your intrusive thoughts are a sign of sin, you’re not alone. Many Christians feel torn, thinking they might be unintentionally harming others or dishonoring God with their thoughts. The truth is, these thoughts are often out of your control, and they don’t reflect your true desires or intentions.

As a Christian counselor, I’ve helped many clients face the same concerns. They wrestle with disturbing thoughts about violence, sexual behaviors, or blasphemy, feeling guilty because these thoughts contradict their values. But here’s the truth: intrusive thoughts are not sins.

In today’s episode of Christian Faith and OCD, I dive into the critical question: “Is this thought a sin?” I explore how God sees your heart and intentions, and why suppressing these thoughts or replacing them with scripture can reinforce the OCD cycle. Instead, we’ll uncover healthier ways to approach intrusive thoughts, grounded in faith and powerful tools like Inference-based Cognitive Behavioral Therapy (ICBT).

When struggling with OCD, the best thing you can do is trust the Holy Spirit to guide you through it. Let go of shame, and find peace in knowing that your true heart and intentions matter most to God.

Listen to the full episode now and start breaking free from mental compulsions.

Explore Related Episode:

118. How Do I know if this Thought is an OCD Obsession? with Carrie Bock, LPC-MHSP

Transcript

Oftentimes I find that my Christian clients are concerned that they’re doing something with the wrong intentions or the wrong motives, that they’re intentionally trying to harm people in some way or hurt people’s feelings or take advantage of them. When that’s not actually what their true internal desire is.

And how do we know what our true intents and desires are? Sometimes it may be pretty clear to us. But sometimes it may not be, and we may be questioning, am I doing something for the right motives? 

Hello, and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing. When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you. With practical tools for developing greater peace. We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith. I’m here to help you let go of the past and future to walk in the present abundant life God has for you.

So let’s dive right into today’s episode.  I wanted to take an episode and try to answer a question I think that so many of you are facing with. Is this thought that I’m experiencing a sin? Oftentimes we know that Christians who are struggling with OCD will often seek out help for their obsessions from a pastor or a small group leader.

Some type of spiritual mentor or advisor first before seeking professional help because they see these thoughts as a spiritual problem. Maybe you’ve been in church a while and you’ve heard verses like Philippians 4, 8. Whatever is true, whatever is noble, right, pure, lovely, whatever is admirable. Think about these things.

That’s a rough paraphrase. So you’re thinking, how do I do that? When I have these awful thoughts that pop into my head about sexually abusing children, violent thoughts, harming others, harming myself, blasphemous thoughts, maybe you’re struggling with homosexual thoughts that you would say, I would never act on that thought.

Regardless of the type of thought that you may be struggling with, one thing I know that I want you to know is that God already understands this issue even more than you do. God knows your heart and your mind, and He knows your true intentions and desires. When Philippians 4. 8, it’s telling us to be intentional about our thoughts.

Obsessions are not things that you are intentionally thinking about. They pop into your mind when you don’t want them to, and they’re what we call egotistonic thoughts, meaning They’re not in line with who you see yourself as and the things that you value. If we view a thought as bad, especially coming from a church teaching concept, a lot of times we will try one of two things.

We will try either thought suppression.  Or, we will try thought replacement. Neither of these actually work, but let’s look at them individually. Thought suppression is when we say, Oh, can’t think about that. Don’t think about that. Don’t want to think about that. Push that down. Push that down. Almost like you’re trying to shove a beach ball underneath the water, and then it just pops back up when you don’t want it to.

There’s a concept called thought thought fusion that captures this pretty well. It’s where When we’re thinking about, what if I have that thought? I recognize that may be very metacognitive for some of you and not quite make sense. How this shows up in practicality for people typically is, let’s say I have intrusions about hitting a pedestrian with my car.

Is that I may get in my car and then go, Oh no, what if I’m driving to work? And what if I have that thought? And then because now we’ve opened up that door or I may say something like, Oh, I’m about to drive to work and I don’t want to have that thought. And I want to try to suppress that thought and put it down.

Instead of acknowledging, like, these are thoughts that sometimes I struggle with when I’m driving in the car and getting to this place of acceptance, that’s an issue for you in your life. Just being able to acknowledge that something is there, as hard as that is, and as much as you don’t want it, That can really be the first step towards healing.

Psychology will tell you that thought suppression doesn’t work. They’ve actually done studies on this where they’ve asked people, Hey, don’t think of a white bear, I believe was the study, and then they come back and they ask people, how often did you think about the white bear, versus having a control group where they were just told, think about whatever you’re going to think about, and then they came back and asked them, how much did you think about a white bear?

Well, I didn’t think about that at all, because no one had kind of planted that in there, right? So we know that thought suppression does not work in us being able to not think about certain things. You probably know from personal experience that doesn’t work as well. Don’t feel bad if you’ve tried that, though, because many people do as a way to control their thoughts.

The next thing that we try to do to control our thoughts is thought replacement. Now this is a favorite for the church, and I actually call it kind of a Christianized CBT approach, Cognitive Behavioral Therapy. What the church does is it says, okay, if you’re having a certain thought, like a sexual thought, I want you to go find a verse that talks about your body’s a temple of the Holy Spirit, or I want you to find a verse on flee from sexual immorality.

The verse about temptation, and every time that particular thought comes up, that you repeat that verse. The problem is that in OCD, this becomes a compulsion. It may provide some temporary relief, but that compulsion is actually reinforcing the obsessive compulsive cycle, so you just get caught in that loop over and over again.

You feel slightly better, But then the thought comes back and so then you feel like you’ve got to do something about the thought. Another way this shows up oftentimes for Christians is either compulsive praying, I’m praying that God will get rid of that thought or take it away, or I’m rebuking that thought in the name of Jesus.

So I’ve seen both of those come up for people quite a bit depending on their spiritual backgrounds. Okay, Carrie, so I have these unwanted thoughts, and suppressing them isn’t working, and replacing them isn’t working, praying them away isn’t working. What in the world do I do? We’re going to get to that a little later.

Because you actually showed up for, is this thought a sin or not? And let me tell you, when it is not a time to determine whether or not a thought is a sin, it’s not a good time to determine that when you are in this OCD bubble, is what we call it, where you’ve gotten sucked into an OCD story, and now you’re looping in obsessions and compulsions, and you’re having a really hard time.

Thinking clearly and seeing your way out of that. That’s not a good time to evaluate your thought process or evaluate the content of your heart. James 1 14 15 says, But each person is tempted when he is lured and enticed by his own desire. Then desire, when it has conceived, gives birth to sin, and sin, when it is fully grown, brings forth death.

So let’s look at this process of sinning. First there’s a desire, then there’s a sin, and then if we don’t deal with our sin, it brings spiritual death. One of the things that I really like about inference based cognitive behavioral therapy, or ICBT, Is that it really encourages people to tune into what we call internal sense data, which is your true intentions and desires.

So if I asked you today, do you have a desire to travel across the country? Some of you might say, yes, that’s so exciting, I really want to do that. And then others of you are going to feel something inside like, no, I really just like being at home and I want to be in my cozy pajamas and watch a movie on TV, sipping my hot chocolate.

I’m good. I don’t really like to travel or I don’t want to go too far. OCD is going to cause you to question what you actually desire spiritually. Oftentimes, I find that my Christian clients are concerned that they’re doing something with the wrong intentions or the wrong motives, that they’re intentionally trying to Harm people in some way or hurt people’s feelings or take advantage of them when that’s not actually what their true internal desire is.

And how do we know what our true intents and desires are? Sometimes it may be pretty clear to us, but sometimes it may not be. And we may be questioning, am I doing something for the right motives? I will give you an example from my own life, way back in  2015, for those of you who aren’t familiar with my story.

My first husband left, he did not want any part of the marital home, and I had to make a decision about whether or not to try and stay in the house, or try to sell it. I was really praying through this process, and obviously it’s a big decision to make when you’re already emotionally a mess. But I was concerned that I was trying to hold on to this house for reasons of greed or monetary gain.

And through the process of prayer and being in touch with the Holy Spirit, it took a process of several days and weighing out all of the options. God really showed me that the reason I wanted to stay in my house was because I felt safe there. And it was in a good neighborhood, and so perhaps, I’m not sure, and I know God would have taken care of me either way, had I sold the house, I think that I might have ended up living in an apartment complex or somewhere else where I didn’t feel as safe as being able to stay in my home.

This led to me pursuing getting roommates in order to be able to pay the mortgage and stay there, but my point of the whole story of telling you that is that as you pray about decisions or as you are concerned about eradicating certain sins from your life, the Holy Spirit is able to reveal to you the desires of your heart and the things that are not in line with God’s will for you.

We can really trust and rest that the Holy Spirit is there to keep us on course and on track. Doesn’t mean that we aren’t ever going to get off track. We do have sin in our lives that’s going to come up. It’s the Holy Spirit’s job to search our heart and to convict us of that sin. When we look at the progression in James 1.

14 and 15, We see that sin is not an instantaneous situation. We look at situations, for example, where someone decides to have an affair on their spouse, and we think, oh wow, that was sudden, that just seemed to come out of nowhere. Well, from the process of these verses, that’s not the case at all. We come to a point of decision, but even before we come to that point of decision, there’s a desire.

So there’s a heart condition first, and then a behavior. That leads me to believe that intrusive thoughts in themselves do not have enough time to give birth to sin. If we say, oh, I’m having this thought, and I don’t want to have this thought, it’s just popping into my mind. All kinds of people have intrusive thoughts.

The problem is that when Christians have these thoughts that go so against their values, They then try to make some type of meaning about it, that somehow my desires are evil because I’m having these types of thoughts pop into my head, or I’m not a good Christian, or I don’t love God because I’m struggling with intrusive thoughts.

That’s not the case. OCD is a mental health condition that affects your brain. It’s not a spiritual problem. I talk with so many people who have trouble grasping this, but it really helps reduce shame. And it really helps you seek the proper type of treatment so that you’re not continuing to suppress thoughts and replace thoughts.

Here’s a verse that some of my clients get really stuck on. I wanted to talk with you about it a little bit. Matthew 5, 28. But I say to you that everyone who looks at a woman with lustful intent has already committed to lust. adultery with her in his heart. Specifically for people who struggle with sexual intrusions, this can be a very challenging verse because they feel like, well, I must be committing adultery because I’m having these sexual intrusions in my brain.

If you look at the entire context of this passage, Jesus is calling out the Pharisees in the Sermon on the Mount. He’s saying, look, you guys are doing all these outward, quote, religious type activities. You’re tithing, not just you’re tithing your money, but now you’re tithing, like, your spices. But your hearts are corrupt.

You don’t care about people. You’re not loving the poor. You’re looking down and judging other people. Doesn’t matter how good you look on the outside if the inside is corrupt. If you interpret Matthew 5. 28 into that larger context. It goes back to what we were just talking about earlier, about intentions, the heart, trusting the Holy Spirit for conviction.

This verse is not about us working to control our internal experience that’s happening. We submit ourselves to the Holy Spirit who works within us, both to will and to work for His good pleasure. Philippians 2. 13. There’s probably much that could be said on this topic, but I want you to know that if you are struggling with these types of intrusive thoughts, You’ve tried suppressing them, you’ve tried replacing them with scripture, you’ve tried praying them away.

I want you to know that there is help and hope. I would love to tell you more about inference based cognitive behavioral therapy and how that might be helpful for you, especially if you’re dealing with a lot of mental compulsions. It helps you to learn how the obsession is irrelevant. All the tricks and cheats of OCD, the thinking errors that are involved, the over reliance on possibility, and really targets you recognizing the irrelevance of the obsession so that you can move forward and not buy into the OCD lies and story.

Stay tuned as over the next couple months we’re going to be talking about the individual themes of OCD, how they show up. I’ll be flying solo again on some of the episodes, but I also have some guests that I’m trying to arrange and bring along that I’m really excited about. Until next time, may you be comforted by God’s great love for you.

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Christian Faith and OCD is a production of By the Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.