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

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

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

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

By The Well Counseling

More Podcast Episodes

Transcript of Episode 8

Hope for Anxiety and OCD Episode 8

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carrie: How has this affected you personally? 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

_____________________________________________________________.

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

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

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

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

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

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

10. Carrie’s Story of Anxiety in Dating with Now Husband Steve

Steve and I recorded this show about a month before our wedding. We talk about my anxiety during the dating process and his involvement in helping me work through it. 

  • Anxiety about putting myself out there to date and how that brought me back to therapy 
  • Challenges of Christian dating after a divorce 
  • Accepting the anxiety and difficulty trusting as part of the process of getting closer
  • Advice to singles in the church

By The Well Counseling

More Podcast Episodes

Hello and welcome to Hope for Anxiety and OCD where we are all about reducing shame, increasing hope, and developing healthy relationships with God and others. I am very excited to share this episode with you. Episode 10, because I have my now amazing husband, Steve Bock on the show, and we are going to be talking about how anxious I was during our dating process.

I hope that this story encourages other people maybe who are scared to get out into the dating world, or if you have a partner or a husband, wife who is struggling with anxiety, this episode may help you a little as well as far as how to support them. So without further ado, we’ll dive into the show. So Steve, welcome to the podcast.

Steve: I’m excited to be here. 

Carrie: Steve is normally a kind of behind-the-scenes guy and has done a little bit of public speaking, but tends to serve in the background. So I’m very excited that he is stepping out of his comfort zone a little bit and has agreed to be on the podcast. 

Steve: Yeah, it’s good to be here. Nervous though. 

Carrie: That’s okay cause we’re talking about anxiety, so it’s all good. Your anxiety is welcome.

We are about a month away from getting married. 

Steve: Yey! It is good. 

Anxious About Dating

Carrie: We’re going to talk a little bit about our story and how we came to be a couple. My story actually started a little bit in the beginning of 2019 where I realized that I wanted to get back into dating, but every time I had tried in the past I would get these awful stomach aches.

I was very anxious about putting myself out there in any way, shape, or form. I had done online dating. I had done meetup groups where I had dated here and there with guys and I realized that I wanted to be married and that if I was going to do that, I was going to have to figure out how to work through this high level of anxiety that I had after my divorce about dating again. And so I ended up going to therapy over it and I told my therapist, I want to date but every time I go to do it, it’s just this awful anxiety comes over me. I can’t sleep. I have stomach aches and I just can’t do it. I can’t follow through.

It was really funny because I saw this man online. One of the reasons I went to go see a man was because I wanted a more of a male perspective on dating. I actually was cleaning out my file cabinet and I filled in the paperwork sometime in the fall of 2019 where I had sent this paperwork to him saying, “You know, I want a date, but I just can’t.”

And here’s why when I read that it was so therapeutic for me because I realized like, “Wow. I don’t feel this way anymore.” I was so excited to go to therapy and tell my therapist about finding that paperwork and saying, “Hey, I think I’m actually ready to date.” I think it’s time for me to put myself out there and I made the decision that I was going to try dating apps again. I got on a dating app and I had went on a few dates with a couple of different guys, but I just was a little bored and didn’t feel like I was making a good connection with the guys that I was meeting. This little heart kept popping up on Facebook every day when I would go in and it would say, “Try Facebook dating.”

I was like, “I don’t know about that. I’m not sure” but I thought, well, “shoot.” I’m not having any luck on this other app that I’m using so I might as well give it a try. 

So what was your pre-us meeting story? 

Steve: My pre-Carrie story is somewhat similar as far as the dating goes. I had a lot of people from church trying to set me up and those are always difficult because it doesn’t work out. You don’t want to hurt anyone’s feelings but oftentimes it just didn’t, just something was missing. So that didn’t work and then I tried the online dating apps just like you and I thought here I am spending this money and getting nowhere.

So for me, I struggle my anxiety kicks in on that first date which I guess I’m not the only one that goes through that. I don’t think but just the same, it was very difficult. 

There came a point where Facebook actually emailed me and said, “Hey, we’re gonna start an online dating service that will be free through Facebook and we’re interested in you. You have a nice Facebook page or whatever. It’s clean-cut, and there’s nothing terrible on it. So we wanted to know if you’re interested” and I thought, Wow! I’ve never actually gotten a thing from Facebook like that. I was a little bit special.

So I said, “Whoa, what have I got to lose? Why not?” And then after I said, yes, I thought, Oh gosh, what have I gotten myself into? I didn’t even look at what type of dating is this. What are they going to do? What are they going to ask of me and it wasn’t that bad. They asked me a series of questions and had me fill out the basics. Who am I? Where am I? All the normal stuff that you do on a dating app. So that made me feel good and then they said it might be a while. Well, I’d practically given up on the idea of it after waiting for like three months or something. maybe longer than that, but finally that little heart popped up and I started getting messages and, and then not long after there you were.

And so that’s where it all began. 

How Steve and Carrie Found Each Other

Carrie: Yeah and we found out amazingly that we had a lot in common. We grew up about an hour away from each other in Florida. Even though we’re in Tennessee now. We had both been on mission trips and now we’re talking about mission trips and food and restaurants and other things we enjoyed together. So that was a lot of fun. We had a couple of phone calls and you talked a lot. 

Steve: Yes. Do you want to talk about that? Well, ironically, you’re asking me if I talk a lot and to talk about it. I am one of those people that if I don’t know you or I’m in a big crowd, I probably won’t say much. It’s difficult when it’s like, “Hey Steve, this is a girl and you have to talk to her” and my mind goes, “Nope, don’t want to say a thing,” but then as you get comfortable, as I get comfortable, I had so much to talk about because I hadn’t shared anything with anybody in so long. So all I wanted to do was talk. I thought, “Wow! This woman, she’s a good listener.”

Well, little did I know you get paid to do that? I guess I knew, but anyways, you were easy to talk to. You are easy to talk to and a great listener. 

Carrie: The really scary thing came for me of having to tell Steve that I was divorced because we hadn’t gotten to that part yet in our chats online or over the phone.

Steve: That didn’t bother me because I had the same issue and so the reaction you had was I kind of “felt bad for you cause you’d gotten yourself kind of worked up about it” like worried, and then I’m like, “Nah, it’s not a deal-breaker at all.” You know, I was married too. So that gave us something in common. So it kind of worked in our favor.

Tips for Dating After Divorce

Carrie: There is some stigma in the Christian church when you’re dating and you’re divorced. It’s scary because I did have men say to me, “Hey, I need to pray about this for a few days.” That happened to me at least twice and you’re going to say, “okay, go pray about it.” My conscience is clear with God.

I don’t know. He’s going to have to communicate that to you one way or the other, or I need to know everything that happened and I need to know why it ended. So I guess if I would add just a word of advice thrown out there for people who are dating, if you haven’t been divorced, and you’re potentially dating people who are divorced, give it time for that story to unfold because often that story is pretty personal and pretty intimate like reasons why people’s marriages ending. Sometimes depending on how long it’s been since that point a lot of times those things aren’t relevant anymore at this level. Would you agree with that?

Steve: Without going into details, our stories were so similar, at least with me. I felt like people would come to a conclusion of, there’s gotta be a reason he’s divorced. What did he do? Maybe that’s not what they were thinking but that’s the feeling that I had from them. People, you can’t just jump out there and judge them like that because you don’t know and like you say, give them some time. 

Carrie: Right. I think one of the things that you told me that I felt was very healing was that it takes two people to get married but it only takes one person to get divorced and in both of our situations, it wasn’t our choice. That wasn’t something that we wanted to do and we would have held on and done what we could to make it work, but there was no repair at that point.

Steve And Carrie’s Funny Date Story

Carrie: So then we branched out and met up for a first date at?

Steve: Plaza Mariachi, which if you’ve never been to a place like that. That is a wonderful place for a first date because it’s open. It’s easy to find and there’s so much going on. It offers you a pretty good place to sit and talk, although it did get a bit loud.

Carrie: Yeah. So Plaza Mariachi, for those of you who aren’t in the Nashville area, they basically took an old grocery store and they converted it into kind of an open mall concept. They’ve got a food court and they’ve got, you can get ice cream or tacos or coffee. They also have little shops kind of on the side but one thing that’s really fun that they have is performances. So, Steve, I was like, “okay, will you tell me a little bit more about your salvation story?” So he’s telling me, and he’s going through the process and of course, that’s kind of serious and then all of a sudden I just screamed, “fire!” Because all of a sudden, there’s this guy out in the middle of the food court, throwing around fire and breathing fire and all of this stuff. 

Steve: Which I can’t see by the way. 

Carrie: Because you’re back was to it. 

Steve: Which seems when you’re given a little bit of your testimony, it doesn’t seem so wonderful when somebody else “fire” like, “Wow. I thought my story was good” but maybe I need to pray and start over here. 

Carrie: So our second date, we got lost on a trail. 

Steve: Yes. Mainly because they were doing some work on the trail and they didn’t mark the reroute. So we just kind of literally walked way past it. 

Carrie: We missed the detour or something on the way back [01:00:37] and it’s getting closer to getting dark. This was in the late fall and it was getting dark earlier and so finally we decided to pull up the map and realize we are way down South and we need to get back up the other way to our car. So fortunately that date went well because otherwise, that would have been a long walk back to the car.

Steve: That would have been very difficult. I have to walk back that far with a person you don’t want to be with, that wouldn’t be good, but that was a good test for us because that was kind of a moment where it could have went either way. We’re together and got a few laughs and it was worth it. It was good. 

Carrie: I think the coffee shop type date is good when you’re first getting to know somebody because you can leave in a short amount of time or something, but it’s nice to be able to do things with people, to look at stuff, and see how they interact around other people and also how they interact with you. And we had to problem solve on a date too. So that was actually good. 

Steve: Definitely. I thought it was an easy deal. Just walk this way and make a turn and come back and you’re done. 

Carrie: Yeah, there was a snafu on date three. 

Steve: Yes, which wasn’t all my fault. 

Carrie: No, it was not. You want to share what happened?

Steve: Yeah. I think you had suggested the place and I thought,” Oh yeah, I think I’ve been there.” That’s a great place, I think. That sounds good. The deal is to make it short and simple. There are two restaurants on the same road, not what four miles apart, I think same name. Both of them are Mexican restaurants.

They are almost identical. So I call her and I’m like, “well, I’m here just waiting” and she said, “I’m here at the table.” Wait like, “Oh no.”

That’s when we discovered we were both at a restaurant with the same name on the same street but it was not the same restaurant. So I had to find her. I went to the wrong one, by the way, not her.

Carrie: So that was fun and then we went to go see the Opera Land Hotel where they decorate everything for Christmas, really nice. We just walked around there and we took our first picture together and that was sweet. So time went on in our relationship and we were talking on a regular basis and we were seeing each other a couple of times a week.

Getting To Know Each Other Better

Carrie: One thing that you did relatively early on in our relationship was made a decision to take a night off work per week because you were working in the evenings and I think that was a big sign to me that you were interested in kind of moving the relationship forward.

Steve: For me, any relationship that I had with friends, that was the problem is that I work way too much in my mind. I thought if I’m going to make this work because I do like this girl, and if I’m going to make this work, I don’t think working all the time is going to help our relationship. You can’t just see one another here and there and expect it to work and only do the phones. So I knew I had to take a night off to make that work. I think that benefited us a lot. 

Carrie: Yeah, it really did. I think it kept me going forward because I don’t know if I can do a one-day-a-week relationship or just have a weekend relationship with somebody. I want to get to know them more and have it go deeper.

Seeing A Therapist To Cope With Dating Anxiety

Carrie: So things progressed along and I was working with my therapist off and on but I started to have these awful nightmares.

They would be things like, I went to go catch a flight and I get to the ticket counter and I’ve missed my flight and the lady is saying, “I’m sorry, Ma’am, there’s nothing that we can do for you. You didn’t get here in time” or I didn’t make it to a concert that I had tickets to.

As I was talking through these nightmares with my therapist, I realized that they all had this kind of common theme and it was okay, I’m gonna like royally screw this relationship up and it’s going to be my fault. Something’s going to go bad and it’s going to be on me.

I just decided to tell Steve about these nightmares that I was having and be really honest about it. I’m nervous like I’m getting closer to you and that feels really vulnerable and really scary because I don’t want to get hurt again.

Understanding Your Partner’s Fear and Anxiety

Steve: Absolutely and when you told me, I got it. I can’t say that it was my dream but I completely wanted to understand you. That would be horrible to have to go through that and have that dream and that fear and that anxiety. So for me, I thought the best thing to do was to just be patient and wait.

Carrie: Yeah. I know that my therapist helped me realize that it was tied back to some past stuff and then I was in a different place in my life. I was an adult and I really could protect myself if I needed to. Something about what we processed and me coming to that conclusion of “Oh, okay. I’m actually safe.” Not only am I safe but I can also protect myself. That allowed me to stop having those nightmares really after the one processing session which was amazing. I know there were a lot of different points in our relationship where I felt like I was seeking reassurance from you of “Hey, is everything okay?” “Are we good?” Did that frustrate you or annoy you at times? 

Steve: In a way, it was a big compliment because it meant that you were getting to a point where you wanted to trust me and wanted to get to know me. We wanted to grow more as a couple. So it kind of in a weird way. It sort of made me happy because I knew if we can get through this then we can make it. We can grow as a couple. So I was kind of excited but I knew when somebody’s going through something, you can’t get aggravated with them because that’s their something and if you’re going to be a couple, you have to go through things together. I knew that. So I knew I had to just be patient and hear you out. I know that you would do the exact same thing for me. I wouldn’t want you to get all irritated with me and say, “Hey, you jerk.” That’s part of relationships. I think though that’s a key thing.

Respecting Each Other’s Feelings

Carrie: Right. One of the things that really helped me through that process was when I would come to you with something like I’m having a nightmare or I’m scared about this, or I just need to know that our relationship is okay because we got in a fight or something like that, that you are just so open to say, “it’s okay.” However you’re feeling is, how you’re feeling and now we have to figure out what to do and how to move forward because I think so many times, people try to say, “just don’t feel anxious.” like, yeah, I need to worry about that. I mean, everything’s fine instead of just really like allowing it to be there and sitting with it and saying, you know, I know that there were several times that you told me, of course, you’re having a hard time trusting. Of course, you’re having a hard time opening up. This is still somewhat new. 

Steve: I mean if it were anything else maybe this is a bad example, but if you were riding a bicycle and you had just fallen off that bicycle but you wanted to ride that bike, you would get back on it. I think relationships are similar, you have to get back at it and keep trying, or you’re never gonna get through it if you don’t keep trying. That’s my opinion but you did a lot of things for me as well though where I would have a bad day and whatever, and you were very, very patient with me when I would get aggravated, whatever it is. There were days where I thought, why in the world would she want to be with me? But you still, you man, and not to get all sappy, but you made life a lot better. Let me rephrase that, you make life a lot better.

Joy and Contentment in The Lord: From Being Happy To Ridiculously Happy

Carrie: One of the things that I realized was we had taken a few pictures amongst the first couple of months of dating and one day I was just kind of scrolling through those pictures in my phone and I had this realization and this epiphany of I was happy before I met Steve. So it’s not like you made me happy. I believe very much that there was joy and a contentment in the Lord even though I was longing to have a mate which I believe was a God-given desire that I had. But when I looked at those pictures, I was like, “Man, I went from happy to like ridiculous level happy.” And I don’t know do you feel kind of like, maybe talk a little bit about that process for you as far as like where you were before we met versus now? 

Steve: Sure. Prior to us meeting, I was at a moment where I thought I know that God has someone there for me, but boy I don’t know what I’m doing wrong or what I should be doing. There was just this, it’s almost like when you’re driving on the road and you’re going the wrong way, but you keep going and hope that maybe I’ll see a sign soon. Eventually, you came along, but I had to be patient to get to that.

I think there was a waiting period for me to not rush anything, to not force anything to happen because I really wasn’t happy. I was alone. I didn’t like that. I’m not that type of person. I like doing for others and a single person who likes to do for others, that’s not always a great setup. I mean, you can go and volunteer and do all the things you want, but it isn’t necessarily going to be something that makes you happy if you’re longing for someone. So for me, once I met you, I thought, “Wow! I really like her.” There could be something here. It was actually when we took our flight to Florida, then I knew because long story short, what I call my adopted mom she had cancer and I was told you need to go see her because you may not have another chance. I was really, really upset about that and you went with me, you’re like, “well, I’ll just go with you,” and, “Oh my goodness. Really?” This might be the one. I knew then for sure. 

I don’t know if that answers your question but that was definitely a turning point prior to that. I wasn’t so sure before we dated, I definitely felt lost. 

Carrie: Just to clarify, adopted mom is your best friend’s mom. 

Steve Telling His Family About Seeing and Dating A Therapist

Steve: My best friend’s mom basically feeds me because I eat a lot.  She did things for me that I needed in my life as well. So I’m just one of those special people that needed two moms. That’s all. She did not legally adopt me and she was not my birth mom or anything like that.

Carrie: To understand the context of our flight to Florida was literally that week COVID-19 had been declared a global pandemic and like nobody was flying. There were maybe like 20 people on one of our flights and then on the way back, they kept canceling the flight and they consolidated a bunch of flights. So there were more people on that one, but that was scary because we didn’t know at that point in time. Everybody was being told to stay at home. Don’t travel. Don’t go places and life at the same time was still going on and you knew if I don’t go see second mom, I may not get to see her even if she passes. So we prayed about it. I always just said, “God, please protect us and just please shelter us and cover us” and he did and we did not get sick. Praise the Lord. We did wear masks before wearing masks was required.

Steve: I’m going to back up a second on you. You asked me about things before I met you. One of the things was when you introduce someone to your family or tell your family, “Hey, I’m dating someone.” That for me, there comes a point where you say, “Oh, I just don’t know.”

I don’t want to, I don’t know. You want to be sure. All right, this has got a really good chance. Now I will tell my family. Right now, I don’t know if other people do that, but that was me. When I called my parents up and this is such a silly story.

Carrie: I know you got to tell this.

Steve: I would be in trouble if I didn’t tell this. So I thought it would be a good point, I was talking to both my parents as I often do and telling them, “well, guys, I got something I need to tell you.” And so they’re like, “Oh wait, this guy never gets serious. This must be really important.” I said, “I’m seeing a therapist.” And my dad said, “Oh my gosh, is everything okay?” and I said, “Well, yeah, it’s our I guess second, third date” something like that. Now what he said, “Isn’t that a little unethical for you to be seeing a therapist?” And I said,” well, yeah, but no, no, not that kind of seeing our therapist.” I said, “it’s our second date third date, whatever it was.” I wasn’t seeing you as my therapist.

And that took a little while for my dad to kind of get the idea that I was kind of giving him a hard time that I was actually dating a girl who happens to be a therapist, not dating my therapist. Yeah. That’s kind of our fun story.

Carrie: That was pretty funny. I laughed so hard and then I said, “Oh, please tell me, you clarified that with your dad” like you were never my client just for clarification. I was like, your dad does know we met on Facebook, right? Was it weird for you finding out that I was a therapist? Because sometimes that’s weird when you meet people. 

Steve: A little bit. Only because I was afraid that the first date was going to be less personal and more, well, “how does that make you feel, Steve?” and “How do you feel when.” I wanted to be with someone who is real, not someone who is on the other side as a therapist. I was hoping, and you did that, you can let go of that therapist mode to be able to date and be you, but that, honestly, it’s not like that lasted very long. That was just a moment of “Well, therapists are real too.” It worked out great though. 

Carrie: Yeah. We’re human beings. People don’t realize that a lot of times they’re just like, “Oh gosh, you’re going to analyze me or something” and a lot of times I’ll just joke and I’ll say “I’m off the clock”.

One of the other reasons I wanted to have you on the show was really to encourage single people who maybe aren’t even dating right now. Maybe they’re like me and they were hurting and burned and they’re still healing from that. Or maybe they’re in a situation where they just don’t feel like there is anybody to date and you are single for a long time as a Christian. And that’s a hard space to be in because the church and as it should be is so pro-marriage and you feel awkward or like the odd one out, a lot of times.

Steve: Absolutely. I felt like the reject a lot of times, like what is wrong with me? You know, for me, after going through the divorce, I thought, well, let me give this two years before I date at all. A year to get over that situation as best I can, a year to find me and then I thought then I’ll date and everything will be great, whatever, but it didn’t quite work like that. I can’t tell you how many times people would say, “Man, you have really high standards. You’re going to be single for a long time”, but it was important to me to have a checklist.

The first one on there, she’s got to be Christian. That is important. Not go to church. That’s not enough. I mean, Christian, like a relationship. So I went a very long time as a single man and it’s difficult. Part of that is you get this feeling of am I good enough? And there were moments where I didn’t even try.

I just didn’t. I thought, well, I can’t force it. If it happens, it happens. If you’re not doing anything and you’re not even trying, the likeliness of just stumbling upon whoever it is you’re supposed to be dating. That’s not. You have to search, you don’t find if you don’t search typically.

But I was scared, I thought, am I good enough? And all of that. Anyways, I try dating through church and different avenues and they just didn’t fit for me. That’s not saying if there’s a church out there that has a singles ministry, that it’s a bad idea. No, it’s just the ones that I went through didn’t work for me. It took me a lot of tries and a long, long time.

Carrie: I actually met someone in the singles ministry at church, and he had come a couple Sundays, literally to meet a woman I think, and I start talking to him and realize he’s not even saved. Like he doesn’t even have a relationship and so now I’m like witnessing this guy, like do you know, like it’s not just about going to church or it’s not just like, yeah, I believe in God. You’ve got to have a relationship with Jesus and he just did not understand.

I think he really thought that he had a saving relationship with Christ and I remember being very discouraged by that because I was like, okay, God, I’m in the church and I’m trying to meet a godly man. I ended up meeting someone who’s not a Christian. So, I would agree with you that I remember there were definitely times where I cried out to God and I just said, “Lord, I don’t see it.”

I don’t see single men out there that are living for you and if that’s the case, then I’ve got to stay single until I find somebody. Finding that you not only went to church, but you were serving in the church already, that you were being mentored and going through continued discipleship with other men in the church. That was really exciting for me. I was like, “How is this man not been snatched up yet?”

Steve: And it was funny to me too, that in serving, I hate to say it this way, but that’ll really make me desirable. It doesn’t work like that but I did think that at a moment and I thought, “yeah, I do missions.” Surely, that’s not why I did missions, but at the same time, I thought this will be great. It doesn’t work like that. It’s what it is. 

Carrie: Yeah. I know that everybody says this. I don’t want to be cliche, but I really feel like so much is about timing and I think about even God’s grace in the timing that we met and we’re able to meet each other’s families before COVID really hit and get to know each other and go out and do things before everything shut down.

That was really God’s grace at that point. When you’re in the middle of something, it’s really, really hard to have perspective on it. So like when you’re in the middle of your single loneliness, sexless life, let’s just be honest and you’re sitting there going, “Oh gosh, like, am I ever going to meet somebody?”

It’s really, really hard. And so I guess if you’re in that place, I just want to encourage you and say like I’ve been there. I’ve been crying in the car or crying in my bed about how I’m never gonna meet anybody. But now when I look back on it, I’m like, “Oh, gosh, God is so gracious and so good to me.” And it’s almost like he had this gift and he was like, “You can’t have it now. It’s not for now, but I have it for you already. I’m going to give it to you when it’s time, when you’re ready to receive that gift and you’re ready to have it. I’m going to give it to you.” I think it’s really shifted my perspective on other things in my life that I’m praying and I’m seeking God for, and I’m asking him for, and it’s allowed me to just really trust in His timing more and more.

Steve: Absolutely and like you say, I think you’re absolutely right, it’s about timing. If I would’ve seen you 15 years ago, would it have been the same? No. Everything had to match up. You had to go through what you went through and I had to go through what I went through.

I’ve matured so much as a Christian since then. So, it’s a good thing that we had to wait, but when you’re going through it, it does not feel like a good thing. No one says, “Oh, I’m so glad to be single and sprinkle…I can’t even talk single and miserable and I’m so glad I have to wait. Yeah, this is wonderful.

I’m lonely. I don’t even like myself. Isn’t this great. You know what I mean? But when you look back, you see how you’re molded and you’re preowned and the right one is there for you. 

Carrie: Yeah, let’s just do some, maybe some general advice for single Christians. I would say really be passionate and dedicated to something specifically God. Obviously putting God first and serving the church. I think too many single Christians I’ve seen are going to this church over here on Sunday mornings and they sometimes hit that church over there on Wednesday nights and they’re not really necessarily dedicated to a church or they attend, but they aren’t pouring into it. They aren’t serving.

I think, any opportunity to be really dedicated and committed and serve others because as a single person, sometimes we can really get self-absorbed and just kind of into what we’ve got going on and just going through the motions and survival. And so being able to be committed to something or committed to the church prepares you for when you’re committed to another person because if you’re willing to carve out, say that time to serve the children’s ministry. Then you’re going to be willing to carve out that time to date someone. You’re going to be willing to carve out that time when you do get married. 

Steve: That will be something that if you’re looking for someone when they see that you’re working in serving in the church and you’re happy and doing it, they’re going to see that as a great gift. That is a wonderful thing. It’s a great attribute versus “Oh, well, look at the desperate one there.” That’s who I want. Nobody wants to be desperate. Serve more because what you need is what you need to do and that’s what they’ll look at.

Carrie: I think for me too, when I knew I was ready to date again, it was because I felt like for the first time, in a long time, I felt like I had something to give. I wasn’t just looking for what I was going to receive as part of the relationship and that was really huge for me.

Steve: I didn’t want to be, for me, that person who is just afraid to be alone because you see people that date and the only reason that maybe they’re dating, maybe this is judgmental on my part, but you get the idea that the only reason they’re dating because they don’t want to be alone. That’s just a recipe for disaster. I think being patient there’s a lot to that. 

Carrie: Any other advice or anything else you want to add?

Steve: We didn’t say this and we should have. Pray a lot. Pray a lot about it and don’t just say, “God help me to find a wonderful, beautiful woman.” Don’t be selfish about it.

Pray that you’ll be the right person for them because he’s got a future for you, but you need to be ready.

Carrie: And you’ve got to be willing to work on yourself and examine yourself and look at how can I prepare myself? How can I surrender to God’s transformation process in my life?

If you’re not a person who’s willing to receive feedback from other people, that’s going to be a stumbling block in a relationship. If you’re a person that has a hard time being honest about what you think and feel that’s going to be a stumbling block, but the good news is that you really can work on those things in your friendships and your relationships with coworkers, in your relationships with family and other people in the church and community and that’s so valuable. Those things are really going to prepare you. I definitely would agree with what you said about praying and really allowing God to bring forth that prayer process, the qualities that you really want to have in a spouse. 

I know one of the things that I prayed for was somebody who would be in love with Jesus, not just go to church who would be serving the church, who would be involved in ministry opportunities and who would pray with me and who would be willing to encourage my spiritual journey as well. 

There were many different characteristics that I was able to pray through and then go back and look at our relationship and look at you and say, “okay, these are the things that I’ve already been praying for and now I’m seeing the answer to those prayers.”

Steve: Yeah. That was important with the prayer was not just me praying. I don’t know for you if this happened, but for me as a guy, I had to open up to someone and say, “Hey bro, do you mind praying for me that I won’t be single and miserable?” I’ll be the man that God wants me to be for whoever or wherever she is. And so I did. There were several people praying, but there were two specifics. One was a former pastor’s wife and another was a very close accountability partner, buddy whatever you want to call them of mine.

And they’re both just two of the most, I don’t know if I could say the most Christian people I know, but definitely there in the word every day they are connected. They are great prayer warriors and both of them prayed like crazy and so, boy did their faces light up when I said, “Hey, guess what? I found someone.”

Get someone to pray with you because it’s not just about you praying. God wants us to include others. It’s not a solo thing. So get someone to pray with you because they can tell you things that maybe you’re ignoring or you’re not seeing. They can go deeper with you. It’s worth it. 

Carrie: We’re both blessed to also have praying parents who watched us go through divorce and obviously were heartbroken because no parent wants that for their kids and they really were praying along with us. 

Steve: Yes. I think my mom is more protective of you than she is of me, which is really saying a lot, but that’s a good thing. She always wants to know, “are you treating her good?” How is she doing? That’s good though. That’s what I want. It’s a good thing. It’s a good feeling.

Carrie: I didn’t tell you were going to be asked this, but at the end of every episode on hope for anxiety and OCD, what we ask is for the guests to share a story of hope, which is a time that you received hope from God or another person.

Steve: Wow. That is a tough question. Probably when my brother died because that was someone who I was extremely close to. I had really more than one person, but there were a few that came up beside me and just kind of said, “Hey, we know you’re not going to open up about what’s going on, maybe, but we’re praying for you.” Specific prayers, very specific. That gave me hope because I had never been through life without my brother. Losing a family member that is so difficult but having people there that said, “Steve, we know that you lost someone and we can’t fix that but what we can do is we’ll be your family.” “Where you had that phone call with your brother, every whatever day we’ll call you. We’ll do this or we’ll do that.”

So that’s part of how my mission family that I have actually grew because that group of people who I did missions with, they would call me and they would just show up and say, “Hey, you want to go out to dinner?” “You want to go out to lunch.” Do the things that my brother and I might do. So that gave me hope. It made me realize if someone’s going through someone or something, you need to do that for them. Stand up and do something. Be there for people. 

Carrie: Just being there is so important. Thank you so much for sharing all of your singleness. It’s always good laughing with you. 

Steve: Yes, always good laughing with you too. 

__________________________________________________________________

I am so thankful that Steve was willing to come on the podcast. He’s a bit more of a private behind-the-scenes guy. So this was really a gift to me to get to interview him and share our story and talk a little bit about what dating was like for us. I hope it provided some encouragement to some other people who are out there maybe who are struggling with anxiety in this area. 

Since this is our 10th episode and we launched with 10 episodes, I really want to hear from you as far as what parts of the show do you really like. What parts do you not like? What things can we improve on and make them better for you?

This is not just about me talking into a microphone, finding some friends to interview, and throwing it out there. It’s really my desire that this information be encouraging, helpful, and hopeful. So whether you think that we’re meeting those goals, or we’re not, please let us know on hopeforanxietyandocd.com.

Thanks so much for listening.

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

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

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

  • Different therapist personalities and styles 
  • Demystifying therapy
  • Finding the therapist who is the right fit 
  • Different kinds of therapies that therapist utilize such as CBT, DBT, IFS, Psychodynamic or Play Therapy 
  • Erica’s experience with mental health in the African American church 
  • Seeing a counselor of a different race 

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

More Podcast Episodes

Transcript of Episode 9

Hope for Anxiety and OCD. Episode 9

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Erica: Not a good fit. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

You have that power as the client. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carrie: It’s very prevalent. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

___________________________________________________________________

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

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

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

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

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

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

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

By The Well Counseling

More Podcast Episodes

Transcript of Episode 7

Hello, Welcome to Hope for Anxiety and OCD Episode 7. 

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

Continue reading

6. The Science Behind Engaging with Music for Anxiety Relief with Tim Ringgold

In episode 6 of Hope for Anxiety and OCD, I interviewed author and speaker Tim Ringold. Tim provides insight into how the brain and nervous system function when a person is stressed. Then, he explains how people can use music to calm down when they feel anxious.

  • Spiritual pain
  • Neuroscience behind how music calms the nervous system
  • Practical ways to utilize music when stressed
  • Difference between listening to music passively and engaging with it

Resources and links:

By The Well Counseling
Tim Ringold
Music Therapy
Adverse Childhood Experiences Survey (ACES)
Book: The Hard Questions

More Podcast Episodes

Transcript of Episode 6

Hope for Anxiety and OCD episode 6      

In today’s episode, I am talking to music therapist and public speaker, Tim Ringgol. Tim has a vast knowledge of how music affects the brain and how we can engage with music and utilize it in a very specific way to help us calm down. I learned so much from interviewing Tim. I’m really excited to share this episode with you. 

Carrie: Hi, welcome to Hope for Anxiety and OCD. 

Tim: Thanks so much for having me, Carrie. It’s great to be here.

What Does A Music Therapist Do?

Carrie: I know a little bit about you but I actually don’t know a whole lot. Can you tell us a little bit about what you do? 

Tim: Sure. I’m a Board-Certified Music Therapist, which is someone like a physical therapist who uses exercise to help people in a clinical setting. I was trained in school how to use music in a clinical setting to help people. People help themselves with music all day long. Sometimes, it’s like tales of the obvious to people like, “Oh yeah, I do that all the time.” There are situations where the targeted use in the hands of a clinician where music really can help people in certain circumstances throughout the lifespan. So that’s what my training is. We all know it’s good for our mood and it’s good for our spirit. 

My training is really how music affects the brain and the body and particularly the nervous system. That’s kind of what I get excited about to kind of empower people to understand their nervous system and how to regulate it with music.

Carrie: That’s really awesome. I’ve been a therapist for over 10 years and I can’t remember ever actually meeting a music therapist. 

Tim: I know we’re a rare breed. There’s only about 8,000 of us nationwide. Contrast that with like there’s 900,000 members of the APA. I am usually the first music therapist someone meets. 

From Rock Musician To Music Therapist

Carrie: So how did you become a music therapist? 

Tim: I started out as a musician first. I started out on stage when I was four and started singing right out of the gate. I was pursuing a career as a rock musician because that seemed like a very healthy, stable financially, no, none of those things apply when it comes to rock music. If you want to get a degree in music performance, it’s either opera or musical theater and I wasn’t interested in either of those. 

So I went rock and roll cause I’m totally a rebel, but I grew up like Catholic, Connecticut, prep school. All the boxes of conformity and then I was just like, “I’m not any of this”  and I kind of exploded when I was 22 and I joke that I came out as a musician and my family was devastated. They were just like, ”Oh my God. It must’ve been the drugs.” No joke. They said that. So I was like, “I’m so sorry to disappoint you” and then there was an intervention with my family because “rock music is crazy and it’s unhealthy.” These things aren’t true. That was my lifestyle. 

When I wanted to settle down, I was engaged and I just couldn’t imagine the future being on the road and being in a committed relationship, having kids, trying to stay sober, trying to stay faithful on the road. 

One day, someone sent us this cute little book for an engagement gift called “The Hard Questions.” A hundred questions every couple should ask before tying the knot. It talks about career and family and yadda yadda.  

My wife, she had her MBA at that time. She could see her future like corporate clear- pie charts, graphs and I just looked into the black hole of the music industry and I was like, “Oh my God. What am I going to do with my life?” and she just encouraged me, “If you want to go back to school, we can afford it.”

I don’t want to marry like a grumpy never-was so I scrolled from A to Z in the index of majors at my local university. I just scrolled like, “Is there anything interesting here?” And sure enough, I bumped into the two words, “music therapy” on this scrolled list. I was like, “Oh, stop it.” I had been a musician and I was an athlete. I used to work in physical therapy, but I found it to be just tissue. It was like, I didn’t touch the emotions. I didn’t touch the spirit. It didn’t go deep enough for me. 

I wrote a paper in college called music versus medicine because I thought I had to choose one or the other. Then I found a field where I could combine the two, and my life literally changed direction in a single moment. I have not looked back since. 

Tim Scaling His Impact By Traveling And Speaking About Music And Mental Health

Carrie: Wow, that’s awesome. So now you actually travel and speak to people about how to reach for music.

Tim: Yeah, that’s it. I noticed early on in my internship that I enjoyed speaking about music. I like doing music therapy, but I also really just love talking about it. One of my colleagues said to me, “You know, you’re a good music therapist, but the American Music Therapy Association should literally just hire you to go around and talk about music therapy because you’re just really good at talking about it” and I was like, “Thank you. I like that idea too.” 

So I got booked in. One day, I got an email and it was the National Hemophilia Foundation who had found my blog that I’d written about my special needs daughter, and then here’s a dad, a special needs dad who knows how to use a non-opioid based approach for pain management. So they said, “We’d like you to come speak at this summit that we’re doing and you’ll be faculty and we pay faculty.” It was like 15 times how much I made an hour as a music therapist. I am a speaker but this is a whole different world. 

That began this kind of quest that I’ve been on for the last seven years to just speak more and more because then I also realized that I could plant the seeds about how to use music yourself to really big groups of people really fast. For me, it’s always been kind of like this journey of wanting to help the most people. [00:07:29] It’s almost like a numbers game. I want to go wide. I like going deep with one person but after a while I was in the treatment room, working with one patient at a time. There are so many patients a week because there’s only so much of me that can go around. I don’t know what the right word is but just I couldn’t scale my impact. I couldn’t clone myself.

When I got up on a stage, I could have 800 professionals in a ballroom all getting the same message at the same time and I was like, “Oh yes, please.” That developed into what I do full-time now. Now I have a clinical staff that does the music therapy and I do all the speaking.

Carrie: Awesome. You’re also the second person that I’ve interviewed who said somebody else told them, “Hey, you should be doing this. You have the talent, skills, and abilities to be doing it” and they weren’t doing it at the time. It’s just always interesting how other people can see things that we can’t see in ourselves. That happens in therapy.

Tim: Totally. There’s a phrase that I use which is, “you cannot see the frame when you’re in the picture.” You have blind spots all around you. Your peripheral vision only sees so far but everybody else sees all that way around. They see a dimension of you, you just can’t see. That’s why being willing to hear what others have to say is a really useful ability because the listener can’t see this right now. We’re on zoom, I can wave my hand to you, but right now I can’t see my hand but you can. In my perception, there’s no hand except there’s a hand, right?

So how many times in life are we walking around and there’s something right there, everybody else can see it, but you’re like the last one to get it. That in and of itself is so much of my work in mental health. It’s because there’s such a stigma around mental health. Unwilling to turn and look and see that there is something amiss right next to him. 

The Importance of Recognizing Mental Health As Essential To Physical Health

I had one teen who told me once, he goes, “Yeah, that’s like addiction man. Everyone else sees it before you.” Oftentimes, we will feel discomfort, “dis-ease” symptoms in our body. We’re the first to know when it comes to our physical health, when it comes to our mental health because there’s such a different attitude about mental health in the culture. When we feel dis-ease or discomfort mentally, we don’t have the same freedom to just go, “You know what, I keep thinking about killing myself.” This is not normal because I’m designed to survive like my DNA is programmed for survival. So why do I keep thinking about killing? That doesn’t make any sense. Being able to have the freedom to just say that out loud and not be institutionally locked up for 72 hours. Your doctor, your physical doctor is not a mandated reporter if you’re having physical symptoms. They don’t physically lock you in a physical hospital for 72 hours for anything. You can get up and walk out at any time. You’re free to be called AMA against medical advice but physically you’re free to do what you want, mentally, it’s another story. 

We have a completely different relationship to mental health in this country than physical health. I think that’s a real challenge for people because the human experience, everybody’s having physical symptoms and everybody’s having mental symptoms.

If you’re not free to talk about the mental symptoms, the way you do with the physical symptoms, what people do is they wait until their body turns it into physical symptoms. Then they go try to treat the physical symptom which is the symptom, but not the source.

Carrie: That happens with anxiety all the time. People will show up at the ER, “I think I’m having a heart attack,” “I think I’m dying” and they will get fully checked out and the result will be, “We think you had a panic attack.” 

Tim: Yes. Anxiety attacks and “I can’t breathe. I physically can’t breathe” and it’s a somatic sensation.

Carrie: Absolutely.

Tim: Just like depression can be a somatic sensation of heaviness. Anxiety can be this somatic experience as well of being like, “I can’t catch my breath” and they physically can’t. You can see their shallow breathing and they’re starting to hyperventilate. 

My daughter has anxiety and I watch it and she’s 14. It’s kind of a fascinating journey of adolescence, puberty, hormones, and mental health, and like trying to navigate, when is this hormones of adolescence and puberty? When is this an anxiety attack?

As a clinician, I can tell you, there are times when I can see when we are crossing into the red zone where there were having a panic attack and she cannot recover her breath and I have to work with her and it’s really scary. If we took her to a hospital, they’d check her out and they’d be like, “there’s nothing wrong with you” and then they’d say something like, “it’s a panic attack. We don’t treat that here.” So it’s a real challenge in our culture. 

Tim’s Sex Addiction Experience And Its Connection With His Religious Orientation

Carrie: Absolutely. You talked a little bit about growing up Catholic and I’m curious what your experience of that interaction between mental health and the churches because that’s super interesting to me. 

Tim: I’m happy to tell this story because I think it’s instructive for a lot of other people’s experiences of growing up in a religious family. For me, I believe in a kind of a bio-psycho-social-spiritual model of the self. You’re having this experience of being you in four dimensions and you can experience pain in all four dimensions but that presents in your brain the same way. It doesn’t matter if you’re suffering grief or you’re suffering from a bruise. Your brain doesn’t know the difference in terms of where it shows up as pain. The signal is pain. It could be emotional pain. It could be physical pain. If you’re getting bullied, it’s social pain. You can have spiritual pain. 

I didn’t really understand this until maybe my mid-forties. I’m in long-term recovery for sex addiction. My ACEs score is zero. So I have zero adverse childhood experiences which is a massive predictor of addiction and mental health in adulthood. If those who are listening have not been exposed to ACEs, it’s a really valuable tool to look at. It scientifically validated the adverse childhood experience survey (ACEs).

I would be in 12 step rooms and I’d hear guys talking about physical abuse, sexual abuse, and I felt like, “What’s the matter with me? I don’t have anything wrong with me” and then finally as I started to look in this four-part dimension of spiritual pain, I realized in my house, I was crying myself to sleep when I was eight years old, convinced that I was going to hell because I didn’t say my “Our Father” the night before when I was going to bed.

I had this imagery of me falling asleep. I equated it to falling to hell because I couldn’t stay awake. It was so hard to stay awake to say my prayers but it was so easy to just fall asleep. So I started to see images and arch of hell like they’re the most horrible, glorified, horrifying, traumatic visual things that I’ve ever seen in my life were pictures of people describing this religious thing called hell. So I grew up totally traumatized by the idea that I was going to hell because I was told there were these rules you had to follow. You get one chance and there’s this whole idea of sin. When you grow up in the Catholic and in the Christian world, you cannot walk five feet without having that word thrown at you. As a kid, it was like a math equation. At a certain point, I was doomed. I was doomed by the things that every human being does. I was like, “This is an equation where there’s no way I don’t end up in hell, and wait a minute, I’m not a murderer. I’m not a rapist.” I’m like, “If I’m ending up in hell, everybody’s ending up in hell.”

Now I have an eight-year-old and the image of my son crying himself to sleep because he’s afraid he’s going to hell, breaks my heart. Except that was my childhood and no one knew. I never told anybody because I was scared to death to talk about that kind of stuff.

I think a lot of people leave the church when they get old enough to physically leave the church for a really good reason because well-intentioned people put the fear of hell into them. I mean, we talked about put the fear of God into somebody. I can’t square myself with anybody who thinks that the idea of an all-loving God and the fear of God at the same time can hold the same space like, “Cool. That’s for you.” Great but I’m not signing on to anything where I am afraid of my creator, that I am afraid for my eternal soul like that has no place in inspiring me to be a good person. It didn’t work. All it did is it inspired me to find pornography because as soon as I found it in pornography, I found relief. I found something that captivated my imagination. It took my mind completely out of the terror for a period of time while I was in the very same place that I was crying myself to sleep, alone in my room at night. 

So when people have to understand that addiction is not a problem, addiction is a solution to a problem. People who don’t have a problem, don’t have an addiction. Most adults recreationally use drugs and illegal substances and alcohol and then they spontaneously stop using it after a 10 year period. The data on it is overwhelming. 

Carrie: And food. 

How Does Childhood Trauma Impact The Nervous System?

Tim. And Food. They come to a decision, “Oh, this isn’t working for me” and they just stop whatever it is. They just stopped doing it. For a small percentage of people who have adverse childhood experiences who have trauma, who are chronically stressed, their nervous system has been hijacked by past events and current events, and they’re now reaching for something in an attempt to self-soothe their nervous system. It becomes a feedback loop where they reach for something to self-soothe. It works in the moment. It causes problems afterward. They feel shame, guilt, pain of some sort, disconnection. So then once again, they’re in a stress response their brain craves to be self-soothing. So then they reach forward again and it becomes this vicious circle that they can’t get themselves out of.

When I work with people to help them understand this cycle, it’s like the stressed brain craves relief by design. So when you have depression, when you have anxiety, you have this in your brain and in your body, you feel discomfort. The brain’s job is to comfort itself. A craving is a design, it’s well-built.  The reason we can’t withstand cravings is because they’re supposed to work. We want to self-soothe. We want to self-regulate. 

Our nervous system has three gears. It wants to be in what we would call a safe-default-relaxed-aware” state which would be identified as the ventral vagal state. That’s where our nervous system is running. The parasympathetic aspect of our autonomic nervous system is running the show. Our prefrontal cortex is online. We’re able to be creative. We’re able to connect emotionally. We’re able to consider the past, consider the future, all the best parts about being a human being. Why we’ve dominated the world in terms of the natural landscape. They’re all available to us when we’re in that state. Most of that goes offline though when we are called upon to either outrun a tiger or fight off a tribe. 

We have this second gear, this sympathetic nervous system response, the fight or flight gear where the amygdala suddenly activates and takes over and kicks the prefrontal cortex to shotgun and says, “I’m going to get us out of here.” Now we are in reactive mode. We’re not in creative mode and it changes our body physiologically like blood sugar changes, blood pressure changes. Hormones are released in that moment. That’s really great in the moment and then the moment is designed to pass, but in our chronically over-scheduled, overstimulated 21st-century world, we’re now getting that stress response chronically daily, multiple times a day. 

The brain and the body are not designed to work that way so it’s overwhelmed. It gets stuck. It gets in this feedback loop, and now it’s like, “Oh, I’m stressed out. Why am I stressed out?” Because I’m so used to being stressed out.  

That is a real challenge. It presents huge physical problems like type two diabetes, massive connection to chronic stress because what it does to your blood sugar like the same diet if you’re stressed, versus if you’re not stressed. Your body metabolizes the same diet differently. So it has real health implications, heart implications, stroke implications, addiction, low libido, anxiety, depression get exacerbated. All of these when we get stressed are at risk and we live in a culture where there is no break. There’s no slow down. 

The Science Of Music And Its Impact On Mental Health

For me, my job is to teach people where are these moments happening in their day and then how do we insert music into these moments. The funny thing about music in nature and with our nervous system is that when we make music in some way with our body, or we listen to music that we enjoy, our nervous system regulates. So it turns the stress response off fast. 

Carrie: It’s incredible. 

Tim: It is incredible. We know this intuitively like you’ve been in a funk. A song comes on and there’s transformation like the science behind it. You know how we are in the Western world, we have to study it and then tell you it happened and we’re like, “thanks, I already knew that” 

My whole degree, Carrie is tales of the obvious, chapters one, two, three, four. “Let me tell you about music,“ “I already knew that,” “but here’s how it works,” “Oh, okay. Now it’s real.”

A lot of times I’m telling people what they’ve already experienced and what they already do, but now they understand like it’s legit. That this isn’t wishful thinking. This is a real stimulus-response experience in the body happening at a preconscious level.

I used to work in the hospital where I would go into the ICU. I was referred for patients who had elevated blood pressure, heart rate, and respiratory rhythm. Even though they were in a coma I would slow their heart rate, their blood pressure, and their respiratory rhythms down just with my guitar. 

Carrie: Wow. That’s great. 

Tim: That’s really, you know, really? They’re in a coma but their ears are still receiving these auditory signals from the environment and our bodies is a rhythm machine. You can slow down your body’s rhythms by introducing a slow tempo in the environment around it.

I would just look at their heart rate on the monitor like it was a click track or a metronome, and I’d start playing along with it. After about five minutes, I start to slow down my guitar and their body would slow down in response and that was when I really was like, “Okay, this is legit.”

How To Use Music To Relieve Anxiety

Carrie: Do you encourage people to listen to certain types of music when they’re anxious or when they’re depressed?

Tim: It’s a really great question. People will want to know what’s the right and wrong stuff to listen to. So there’s a couple of things one is with anxiety, a lot of times your focus is no longer in the present. You’re kind of wrapped up. It’s a kind of a disembodied experience as a trigger to an embodied extense of panic. The disembodied part is you’re up in your head, perseverating over a future that you’re convinced is going to happen.

Carrie: A bad future.

Tim: Yeah, not an exciting future because the brain is designed not to thrive, it’s designed to survive. So the brain defaults to a negative scenario out of survival because a false positive keeps you alive, a false negative, “You’re a lunch for the tiger.”

The way that our nervous system and our brain designed itself for survival was to default to a negative potential. This could be bad. We have a very old operating system. It’s designed to do that. So people naturally default to the negative. There’s nothing wrong with you. That’s your survival instinct. The problem is they get caught in a feedback loop about it and they believe the thought. It’s just a thought and it’s designed in a certain way, but we believe it as the future and then we get stuck in it. Then now we’re no longer present. We’re out of our head. We’re out of our body. We’re up in our head. 

The first thing we want to try to do is when we reach for music the style of music isn’t so important as that it’s something that is enjoyable to me. It’s very personal. It’s like flavor. It’s very personal, but I don’t want to stop with just reaching for it to listen to it.

I want to make music with it. So if I’ve got my phone and I’ve got my earbuds in and I put on a playlist of music that inspires me, that I’ve already put in there for just such an occasion. What I want to do is I want to either tap along on my body with the beat, with the music. I want to hum along with the melody. I want to actually audiate, which is like when you sing in your head but not out loud. So you can sing along with a song in your head and you’re not actually using your mouth but your brain is doing all of the calisthenics to produce the pitch and the tempo and the words in your head. Then what happens is you just activate your vocal cord. If you want to release that out into the environment, you can just sing along in your head. You can sing along out loud, even better, but in any way that you can activate your body to match the music, then your body is involved. That’s a huge component for people with anxiety is because getting back into your body brings you back into the present moment because the only place your body is, is in the present moment. 

So the challenge with remembering that is you got to remember it, but if you just turn on music and you try to play along with the beat or tap along with the beat, you’re just trying to keep the beat and by virtue of trying to keep the beat now you’re back in your body and you’re back in the present moment because music is time-based. When we play music in order to keep the beat, we have to be present. The challenge with listening to music is listening to music can become a very disembodied experience.

Carrie: Passive versus active. 

Tim: Yes. It engages your imagination and your memory. So you can be listening to a song and you can float away. The song can take you to where the song is. It’s a disembodied experience when you just listened to the song. You’ve had this experience where you listened to a song that you have heard before and you have a memory associated with that song. So suddenly you’re no longer in the present moment. You are a back wherever that was, and it could be good, could be bad. 

The same thing can happen in the future. You can hear a song and it can trigger your thoughts and your feelings and your emotions about the future because there’s nothing holding you. The song itself isn’t holding you in the present moment unless you try to engage with it with your body.

When You Have Anxiety, Choose Music That Lifts You Up

So that’s why for people with anxiety, it is really, really critical that you have music you enjoy that you know that lifts you up.  When you put it on, you go move your body to it. What I tell people to do is to have a power playlist. It’s three songs that fire you up. When you feel the anxiety strike, you put the playlist on, put in your earbuds, get up and go for a walk and you walk to the beat because everybody walks in rhythm.

If you can’t go walk to the beat and you have to be stationary then tap along with it or hum along with it, but be in the present moment, making music with the music. You don’t have to be a musician to do this because when you clap to the beat, you don’t consider yourself a musician. If you tap your leg to the beat, you don’t consider yourself a musician, but you’re doing the very same thing. [00:30:55] You’re activating your body in the present moment. I think that’s more important than the actual material that’s in the music.

When it comes to the material, that’s in the music, here’s what we know from research. Typically, if you are struggling with depression or anger particularly, what’s going to happen is the music you reach for might do one of three things. Typically, people will reach for music that matches their mood. That’s normal. We want to validate where we are intuitively. So angry people, if they listen to angry music, it may do one of three things. It may reduce the anger because they now have this resonance with something they feel validated. It’s cathartic, so it actually reduces the anger. Sometimes it doesn’t do anything to the anger. It has no effect at all. They just engage in the music and they feel as angry as they did beforehand. Sometimes it actually exacerbates the feelings of anger. I would submit that anger and anxiety are more related than anxiety and depression, because I feel like anger and anxiety are hyper regulated, hyperactive states. Whereas depression is kind of a hypoactive state. There’s this correlation, but not identical but correlated. So if you’re in a hyper-regulated hyperactive state, there’s the chance that you could exacerbate that. 

We’ve read from research with teens were the same with depression they listen to sad music when they’re depressed. The music doesn’t make them sad. They were sad and they reached for the music that matched their sadness.

The music either makes them feel better, it doesn’t change the sadness, or actually exacerbates it makes it worse. It’s really important for people to notice what’s happening in their body. As they’re listening to the music they reach for because there’s no stamp of this than that when it comes to music. 

We’ve even had anecdotal evidence. Anecdotal evidence is like an oxymoron but case studies where kids will say, “I used this music at one time to actually make myself feel worse” and then the song changed. The meaning of it changed. I felt better. Then the song became like a badge of survivorship that I made it through and the song took on a new meaning. And now when I hear the song, I actually feel more inspired and it’s like, “Wow, that’s really complex.” People don’t want complex. They want simple solutions. 

Difference Between Music-Listening And Music-Making

So when it comes to music listening, music listening is very nuanced. It’s very complex and that’s why I try to encourage people music-making because music-making is a motor cortex embodied physical experience happening in the present moment. It is not really subject to these nuances of context. It’s just, “Here’s the beat.” “The beats happening now.” “Oh, the beats getting faster.” “Okay. I got to keep up with the beat right now.” There’s no emotional discussion about the beat. There’s the beat. I’m going to tap along with the beat.

If you’re feeling elevated and you want to slow your heart rate, blood pressure, and respiratory rhythm down, the principle we use is called the ISO principle and the law of rhythmic and treatment.

So you start with music, that’s uptempo to match how you’re feeling, and then you pick music that gradually slows down. Your playlist would be like the first song is the fastest of the three. The second song is a little bit slower in tempo and the third song is a little bit slower than that but not shocking.

Carrie: Sure. Just gradually going down. 

Tim: Yeah. If you’ve ever been to any kind of cardio class or DJ, if you really pay attention, the music they pick usually starts slow during the warmup and then it picks up but gradually it peaks. Then at the end, during the cool-down, the tempo, the speed of the music slows down. The intensity of the music slows a little bit because we’re warming down or we’re bringing down at the end. That kind of tempo arc or speed arc, if you will, that’s really what your body responds to more than anything. It’s going to respond to that. 

Integrating Music With Spirituality

Carrie: I’m curious about if you could integrate spirituality in that because as someone who’s gone to church her whole life, typically you start out with the fast praise and worship song, everybody’s clapping. Typically nobody starts a worship set with a slow song unless they’re really trying to stir you up.

Tim. No, but I will submit that the band or whoever’s running the soundboard oftentimes has prelude music before the opening song. That prelude is usually lower, slower tempo intensity than the opening song. There is usually some sort of entrance, if you will into this experience and it doesn’t start here. At least that’s been my experience.

Carrie: Yeah. I would agree with that.

Tim: It’s so funny how different aspects of the world of music don’t necessarily talk to each other. In music education, they teach a certain way, but if they knew the research that is in neurologic music therapy, they would teach music completely differently. The two worlds don’t talk to each other. Music ministry doesn’t talk to music therapy. There are two completely different silos. They take completely different classes or we don’t exchange notes. We don’t exchange research like, “Hey, here’s how to use tempo.”

They probably do it intuitively but if you knew, then you would really do this, I would submit that intuitively if I think about the music director at our church. I’ve subbed as the music director and I’ve played in the praise band on and off for several years like there is an ebb and flow of tempo and intensity of the songs based on where we are in worship that tend to match where the worship is.

When we’re doing the anthem either right before or after the message It’s not the fastest tempo song we do. The fastest tempo songs are usually the opening and closing. We’ve kind of more in like a contemplative. It’s like where the ballad is. The anthem is the ballad. It’s the feels where all the feels come in. It’s like back in growing up in music, your first record, the first single from the pop star, it’s upbeat, it’s fun. Maybe the second one’s like that and then they introduce their ballad. It’s like the second, third or fourth, but no artist ever releases their ballad as the first track on their record.

Carrie Absolutely. It’s been absolutely incredible having you on the show. I appreciate so much you taking the time to do this and talk to us about a variety of different things. It was neat to see the interaction between all of them. 

Tim: Cool. Thanks for having me. 

___________________________________________________________________

I really appreciated Tim’s vulnerability and being willing to talk about spiritual woundedness and spiritual pain.

I think that there are going to be other people who listen to this episode and really relate and resonate with that. If you’re in that situation, I just encourage you in Jeremiah 29:13, it says, “You will seek me and find me when you seek me with all your heart.” That’s a promise. 

If you are looking for God with your whole heart, I believe that you will find Him.

How Music Helped Carrie In The Midst Of Divorce

I made a critical blunder on this podcast, just kidding. It’s not a critical blunder but I did forget something. I forgot to ask him,

“What was the time that you received hope from God or another person?” So I thought I would share a little bit with you just personally if you needed a hope story for this week because quite frankly, we’re living in a world where we need more stories of hope.

I wanted to tell you about how music has given me hope. There were a couple of songs in particular when I was going through my divorce that were popular at the time. One was The Kari Jobe song, “I Am Not Alone.” That meant so much to me because at that point in my life, that’s exactly how I felt. I felt completely alone and the song just reminded me that God was always with me. 

The other song that was popular that really resonated with me was a Jeremy Camp song called “He Knows.” It was this sense of Jesus knows like every pain and every suffering and every hurt that you’re going through and He can relate to that. He can relate to you in that human nature of suffering. 

Every time those songs would come on the radio and I was driving around for work. I would just sing at the top of my lungs and it was like those words provided such a level of hope and encouragement to me like, “I’m going to get through this.”

So I just want to encourage you. What songs are meaningful for you in this season of your life right now? God can really use music to speak truth over our lives if we will just engage with it. 

You can find helpful resources at hopeforanxietyandocd.com. Feel free to hop on over to the contact form. I would love to hear from you. I want to hear your story of hope and let me know if we can share it on the show sometime. I would love to compile some of those together. What’s a time for you that you experience hope from God or another person? Hit us up on the contact page and let us know. 

Thanks so much for listening. 

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

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

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

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

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

Resources and links:


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

More Podcast Episodes

Transcript Of Episode 4

Hope for Anxiety and OCD Episode 4

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

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

How Jessica View Spirituality

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

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

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

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

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

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

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

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

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

Avoidance In OCD Does’nt Work

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

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

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

How Jessica Recognized OCD in Her Child?

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

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

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

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

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

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

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

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

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

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

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

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

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

Jessica’s Scope Of Work

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

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

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

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

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

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

What is ERP and How Does It Work?

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

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

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

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

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

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

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

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

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

Dealing with Clients With Different Level Of Insights

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

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

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

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

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

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

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

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

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

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

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

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

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

Differences Between Licenses and Certifications In Psychology

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

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

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

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

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

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

Importance of Proper Diagnosis

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

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

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

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

Why Proper Diagnosis Is Important In The Treatment of OCD?

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

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

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

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

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

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

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

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

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

Jessica’s Story of Hope

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

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

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

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

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

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

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

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

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

Jesicca: You’re welcome.

______________________________________________________________

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

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

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

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

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

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

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

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

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

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

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

Transcript Of Episode 5

Welcome to Hope for Anxiety and OCD Episode 5.

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

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

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

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

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

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

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

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

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

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

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

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

Rhett: For sure it does. 

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

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

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

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

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

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

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

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

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

Equipping Pastors To Deal with Mental Health Related Issues

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

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

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

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

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

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

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

Integrating Faith With Pyschological Tools

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

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

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

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

Misapplied Bible Verses About Anxiety

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sitting With Anxiety As A Conversation Partner

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

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

Reframing Anxiety And Following God’s Leading

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

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

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

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

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

How Churches and Pastors Can Support Mental Health

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

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

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

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

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

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

Shame Around Mental Health In The Church

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

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

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

Pastors Need Counseling Too

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

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

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

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

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

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

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

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

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

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

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

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

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

Rhett’s Story of Hope

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

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

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

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

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

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

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

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

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

______________________________________________________________

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

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

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

1. Carrie’s Welcome to Hope for Anxiety and OCD

In episode one of Hope for Anxiety and OCD, Carrie Bock discusses the reason she started a podcast for Christians struggling with anxiety and OCD. She shares her own personal story of loss and how her faith in God got her through it, learning more about His character along the way.

  • Learn the inspiration for Hope for Anxiety and OCD
  • My story of going from a religious person to a spiritual one
  • When life turns out not as you planned it, but somehow better

Resources and links:

By The Well Counseling

For more information on foster care and adoption in the US:

Adopt US Kids

Court Appointed Special Advocates

Wendy’s Wonderful Kids

Listen to more podcast episodes


Transcript of episode 1

Hi, my name is Carrie Bock and I’m the host of Hope for Anxiety and OCD podcast. Two of my most defining characteristics are that I’m a Christian and I’m a Licensed Professional Counselor.

All Truth Belongs To God

It’s been an interesting journey being caught between two worlds, so to speak. If I use anything in addition to the Bible, I’m too secular for some Christians. Don’t get me wrong. I love the Bible. It’s my guide for life. You know, the big stuff like how to be saved, love God and others, find spiritual peace. However, there are many things the Bible never taught me that I had to figure out that was important in life like how to change a tire or pick which college I was going to go to, or how to cook salmon in the oven just right. I’m not going to find these things directly in the Word of God. I have to go elsewhere for that information. That’s okay because all truth belongs to God. Put lemon slices on top of the salmon. Trust me. It’s delicious.

If all truth belongs to God, that includes every psychological study that’s ever been done on how we learn, what motivates people towards positive behavior, how the brain and the body are affected by trauma, [and] the methods of therapy that are effective for different disorders. The list goes on and on. I could totally geek out about all of this, but in certain therapists circles, if you start to mention Christianity, some therapists look at you a little sideways and start talking to you about how many people they have in their caseload who’ve been traumatized by religion. I get it. So now you know, I’m a misfit who doesn’t fit in. I don’t fit in with the Christian counseling community because I’m too secular for them. I don’t fit in with the secular counseling community because I’m too Christian for them. It’s okay. My conscience is clear that I can have all of Jesus and all of the really good therapy techniques too. Enter my clients. Of course, I can’t tell you all about them. That would be a major HIPAA violation.

You Can Have Jesus and Therapy

Let’s just say that I specialize in treating trauma, anxiety, and OCD. My clients aren’t all Christian, but among the ones who are, some have repeated similar statements people have told them about Jesus and therapy. Some are secretly in therapy because it doesn’t feel safe to talk about it in the church. Some are ashamed to be struggling with anxiety or OCD as a Christian wondering if it makes them less spiritual for having these struggles in the first place. They have verses memorized about anxiety. They’ve been told all kinds of things from church leaders about not seeking secular counseling and medication is wrong, and to just pray and read their Bible more. Others are told they’re struggling because they don’t trust God enough.

I’m so sick and tired of these negative, shameful, and non-biblical messages being sent to Christians that I can’t stand it. I can’t stay silent any longer. I want to scream from the rooftops, “You can have Jesus and therapy!”

Anxiety affects people physically, mentally, emotionally, and spiritually. Each of these domains must be addressed in order to find healing. How can I love God with all my heart if I am stuck in anger due to past trauma? How can I love God with all my soul if it is dry and thirsty, lacking connection? How can I love God with all my mind if it’s plagued with worry? How can I love God with all my strength if I don’t take care of my physical body?

Hope For Anxiety and OCD Podcast Is For People From All Walks Of Life

It takes time for my clients to unpack these negative messages and evaluate them based on scripture. I guess you could say this podcast is for my clients, but it’s not really. No offense meant to any current or former clients listening here. This podcast is for all the people I may never meet but who need to hear that it’s okay to struggle, and it’s okay to take steps towards greater health and freedom.

Hope for Anxiety and OCD exists to reduce shame, increase hope and develop healthier connections with God and others. I invite you on this journey as I interview pastors, Christian leaders, therapists, and everyday people who found hope in the midst of their mental health struggles. I want you (yes you) to help me out along the way.

What burning questions do you have about the intersection between faith and mental health? Who do you want me to interview? What topics are important to you?

Feel free to reach out anytime via our website: www.hopeforanxietyandocd.com. I’ve already recorded some shows that I am super excited to share with you. We’re going to be talking about unanswered prayer, how to rule out potential physical causes of anxiety, help for parents who have anxious children, [and] different types of therapy techniques that can be helpful for anxiety and OCD.

Hope For Anxiety and OCD Has Something For Everyone.

There’s something for everyone. Every show is unique and special and I pray it’s a blessing for the person that needs to hear it that day.

There is also something I want you to know about the guests on this show. It would be easy to assume that every guest on a Christian podcast is automatically a Christian. This show is a little bit unique and different because as I talked about in the beginning, we’re combining two different worlds. Some of the guests are Christian and they are combining the worlds of counseling, psychology, the Bible, Christianity, the church, and it’s so valuable for us to hear that information.

There are other people who have valuable, helpful counseling information that I also wanted to include on the show, or who are friends of mine and don’t follow Christ, the Bible, or Christianity.

The really cool part of that I think that has opened up is an opportunity for us to learn how to talk to people who believe differently than we do and how to ask important spiritual questions. I’m fully prepared for this podcast to probably upset somebody, but that’s okay. Jesus ended up upsetting a lot of people. So as long as I’m doing all that God has called me to do, we’re good.

More About Me

Now that I’ve introduced the podcast, I’d like to tell you some background information about myself, so you can get to know me, the host a little bit better.

I grew up as a shy kid seeking to fade into the background. My dad likes to tell the story about how we went to a new church and everyone knew who my brother was and that my parents had a son, but they had to tell people that they also had a younger daughter. Let’s face it, the kid that got seen also got in trouble more.

Growing up in a conservative family, I was pretty conscientious about things like right and wrong. There were lots of fears about doing the wrong thing and getting in trouble.

I made the decision to follow Jesus and make Him Lord of my life at eight years old, but I put on Jesus, my experience with other adults. If I do wrong, I’m going to get in big trouble and God will be really mad at me. He seemed harsh and mean in some of the Bible stories, and I was scared of Him. What did God want from me? Whatever it was, I knew I was probably going to mess it up.

Being the quiet shy kid also made me the observer. I was keenly aware and had a heightened sensitivity to other people’s emotions, and I didn’t know how to handle them at all. My sensitivity caused me to take everything personally.

It’s a little rough in the making friends’ department when you’re quiet, and you tend to get bullied more. I used to replay social interactions over and over in my head and always felt a little awkward.

How Did I Become A Therapist?

Did I become a therapist because I was the person everyone naturally gravitated towards with their problems? No way. But if I had studied the DSM at the time, I probably could have diagnosed my high school class. All joking aside, it was the opportunity to take psychology in high school that steered me away from the path of becoming a sign language interpreter towards well, I don’t really know, other than I thought psychology was the most interesting thing I’ve ever studied, and I wanted to help people. Mom said helping people is not a career. So you have to narrow that one down a little bit more.

I was a religious person into adulthood, running around, doing the good things, hoping that my works were going to keep me in right standing with God. I believe I was saved by grace but after that, it felt like I was under the law all the time, and God was just waiting for me to mess up. That’s a non-biblical, messed-up theology by the way.

As a religious person, checking boxes of all the things I was supposed to be doing, was exhausting. I completely missed the heart and intimacy of having a relationship with Jesus.

My Experience As A Foster Parent

In 2013, my husband and I had gotten the phone call we’d been waiting for. Department of Children Services or DCS asked us if we would like to take two girls: a five-year-old and an eight-year-old into our home. We were ecstatic. I had a dream previously that I believe to be from God about having two daughters. We were led to believe by DCS that these children would most likely not have an appropriate family placement to go back to.

We gave the girls several different options of things they could call us, and they decided they wanted to call us mom and dad right away. I was not expecting that. We all seem to be enjoying the new normal of our instant family life. I even got asked where babies come from on my first week of parenting.

The girls came during the summer and we helped them get ready to start a new school year, at a new school. There’s something really profound about having two children call you mom, eat at your dinner table and play in your front yard. But at the end of the day, they aren’t your children. My heart didn’t know the difference, and my heart would be completely broken six weeks later when DCS lost in court, and the girls immediately went back to their family. We weren’t even informed there was a court date, so we were in complete shock to find out that we had a few hours to pack up all their stuff and get them to the DCS office.

My husband and I came home to two empty rooms, one decorated with Monster High and the other with decals of a boyband. I can’t even remember which one now. A behavior chart was stuck on the door. Whatever we were trying to correct at the time, suddenly didn’t matter anymore. I wasn’t prepared at all for how to handle this and the physical pain of loss was so deep that it sent me to the doctor’s office. I had never felt anything like that before. I now jokingly say that was the day I spent $200 on bloodwork to find out that I was going through grief.

Other foster children came in one over the next year. Meanwhile, several foster parents we were connected with were in the process of adopting their first placements. I was very discouraged. Why wasn’t God allowing me to have the gift of family? I felt like God called us into this foster care and adoption journey but really questioned His plans.

Questioning God

In the fall of 2014, we received another sibling placement; this time, a boy and a girl. It was looking like they might become a part of our forever family, but what happens when you check all the religious boxes, believing you’re doing the right thing, and then something goes terribly wrong? It happened to me on what should have been a normal Sunday in January of 2015.

I threw my cell phone against the wall and swore before bursting into tears. I’d gone in my bathroom in hopes that my foster children wouldn’t hear the phone conversation. My husband of nine years was telling me that he was done and wanted to divorce.

I knew that our marriage wasn’t perfect, but I didn’t see divorce in our future anywhere. That hadn’t even been discussed at all. Wait a minute God. I married a believer. We’re in church every Sunday. We’re in a small group. We pray at every meal. We read Bible stories with our foster children. How in the world did this happen?

My head was spinning. I had so many questions for God and most went unanswered. Why didn’t he answer my prayer to restore my marriage? Then divorce devastated me. Not only did I lose my husband, but my dreams of having a family were gone in an instant.

Overcoming A Divorce

I went from being a household of four to all alone, looking for roommates to pay a mortgage, in survival mode. My thoughts kept me up at night. Where did I go wrong? What should I have done differently? I couldn’t sleep or concentrate at work. I had no energy and felt hopelessly sad, all symptoms of depression.

I made the decision to take an antidepressant for six months and I can confidently say it was one of the most healthy decisions I’ve ever made for myself.

I carried around a lot of shame regarding being a divorced woman in the church. I remember thinking “my life is over now.” I didn’t mean that in the suicidal sense, but I didn’t see any kind of positive future for myself. What godly man is going to be with someone who’s been divorced?

Unpacking Emotional Baggage and Experiencing God In New Ways.

I had a lot of emotional baggage to unpack from childhood and beyond. Sometimes, that meant talking through my thought process, and sometimes that meant reprocessing trauma with EMDR therapy. It was this process of unpacking the baggage that caused me to experience God in new ways. It was as if there were clouds blocking my view of the sun and when they moved, I could see the sun clearly. God hadn’t changed, but my view of Him is less cloudy now. My faith doesn’t just have knowledge and rules. It has heart and understanding of the depth of the love of God, and the promise that He would never leave me.

I found God as a good father who had blessed me in many ways, and some I just couldn’t see yet. I also had a greater understanding of grace that God showed me as I walked through dealing with my own sin and how that impacted my relationship. I could connect with Jesus knowing that He understood suffering and pain that’s both physical and emotional.

I’m thankful for my pastors, divorce care recovery group, therapist, primary care, physician, and close friends. They all played an important role in my recovery process.

Jesus Transformed My Tears into Triumphs

Today, I am thankful for my divorce, not that it happened but how God used that experience to shape my character and view of him. I’m a more thankful, positive, and compassionate person due to what I’ve been through. I want to help Christians recognize that they can have the abundant life Jesus talks about in John 10:10.

I invite you to think through what is holding you back from that abundant life. I’m happy to tell you that five years after my divorce, I met the most amazing man, and we were married in October of 2020. You’ll get to meet him soon on the podcast as he’s graciously agreed to appear with me on an episode about anxiety and dating, more my anxiety than his.

Thank you so much for listening. I pray that this podcast is a blessing to you today, and whatever you’re facing, know that you are loved by God and never alone.

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

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


2. Unanswered Prayers for Healing with Pastor Troy Powell

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

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

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

Resources and links:

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

More podcast episodes

Transcript of Unanswered Prayers for Healing with Pastor Troy Powell

Welcome to Hope for Anxiety and OCD Episode 2

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

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

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

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

Pastor Troy’s Journey to Becoming a Pastor

Carrie: Welcome to the podcast.

Pastor Troy: Excited to be here.

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

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

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

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

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

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

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

God Called Pastor Troy To Plant A Church

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

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

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

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

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

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

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

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

Building Relationship Is Vital In Church Planting

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

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

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

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

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

Taking The Prayer Relationship To A Different Level

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

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

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

Hearing God’s Answer Audibly

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

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

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

Walking The Track With God

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

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

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

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

Carrie: Wow. That’s awesome. 

Listening To The Same Praise Worhip Music List Helps

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

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

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

Carrie: That’s awesome.

Checkbox To Highlight Answered And Unanswered Prayers

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

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

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

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

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

Carrie: That’s awesome. 

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

Experiencing God While Working Out Put Things Into Perspective

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carrie: Yeah, absolutely. 

Lamenting To God Will Draw Us Closer To Him

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

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

Being Vulnerable with God Will Deepen Our Intimacy With Him

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

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

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

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

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

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

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

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

When God Doesn’t Answer Your Prayers…

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

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

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

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

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

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

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

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

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

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

God’s Gift In Unanswered Prayers

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

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

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

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

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

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

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

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

Pator Troy’s Story of Hope

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

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

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

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

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

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

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

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

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

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

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

Pastor Troy: That’s so true.

______________________________________________________________

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

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

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

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

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

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

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

Resources and links:

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

More podcast episodes

Transcript of Episode 3

Hope for Anxiety and OCD Episode 3

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

Getting To Know More About Melanie Lowe

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

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

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

Different Titles In The Medical Field

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

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

Benefits of Seeing A Nurse Practitioner

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

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

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

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

How Melanie Started A Christ-Centered Clinic

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

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

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

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

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

Melanie’s Chosen Ministry

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

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

Why having a primary care physician is important?

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

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

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

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

Annual Screening Is Necessary

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

Ruling Out Anxiety and Other Health Conditions

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

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

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

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

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

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

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

The Relationship Between Anxiety and Sleep Apnea

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

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

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

How Important Is Sleep To The Body and Mind?

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

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

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

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

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

More Patients Are Coming Out About Mental Health Conditions

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

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

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

Presenting Different Treament Options To Patients With Mental Health Conditions

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

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

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

Explaining Medications To Patients

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

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

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

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

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

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

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

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

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

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

Healthy Lifestyle Can Help Improve Mental Health

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

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

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

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

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

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

Melanie’s Story of Hope

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

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

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

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

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

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

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

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

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

Carrie: Absolutely. I enjoyed this interview.

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

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

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

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

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

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