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23. Acupuncture and Anxiety With Encircle Acupuncture

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

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

Links and Resources:

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

Encircle acupuncture
Community Acupuncture 

Support the show 

More Podcast Episodes

Transcript of Episode 23

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

So let’s dive right in.

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

Carrie: Awesome and Trey?

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

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

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

Carie: Awesome. 

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

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

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

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

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

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

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

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

Alexa:  Yeah, that definitely has, 

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

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

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

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

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

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

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

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

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

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

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

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

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

Trey: Yeah, worldwide. 

Carrie: Oh, worldwide. That’s awesome. 

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

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

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

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

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

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

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

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

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

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

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

Alexa: Definitely. 

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

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

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

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

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

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

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

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

Alexa: Yes, absolutely. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carrie: That’s very interesting. 

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

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

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

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

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

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

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

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

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

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

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

Carrie: That’s awesome. 

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

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

Carrie: That’s awesome. 

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

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

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

Carrie: You’re welcome.

_______________________

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

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

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

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

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

21. Is Healing from Childhood Wounds the Key to Unlocking Anxiety? With Laura Mullis, LCSW

On this episode, I had the privilege of interviewing one of my mentors, Laura Mullis, LCSW

  • Why Laura switched from weekly therapy to intensive sessions
  • Difference between trauma and attachment wounding
  • How attachment wounding contributes to anxiety
  • How receiving love from God causes us to be able to love ourselves
  • Learning to meet unmet needs as an adult.

Laura’s website: Triumph Center

See more:
Can God Use Your Anxiety for Good?
The Power of EMDR Therapy for Anxiety

Support the show 

More Podcast Episodes

Transcript of Episode 21

Welcome to Hope for Anxiety and OCD, episode 21. I had the absolute privilege to interview a mentor, Laura Mullis and I brought her on the podcast to talk a little bit about attachment wounds from childhood and how these can contribute to anxiety in adulthood. So let’s get into that interview. 

Carrie: So Laura, tell us a little bit about yourself.

Laura: Hello, my name is Laura Mullis and I am a clinical social worker from Moultrie, Georgia. That’s kind of in the Southwest corner of Georgia. I tell everybody about an hour from Tallahassee because I don’t expect people to know where Moultrie is. I am a therapist who offers a different type of therapy in the sense that I had my own practice and the way I set my practice up was that I offer intensive therapy where people come and they book a few days with me at a time and we really dig into whatever it is they want to change in their life. 

The other way that I am probably different is one of my main focuses is not just on helping people heal from the things that happened to them in their life, but also the things that should have happened that didn’t, and that’s called attachment trauma, which is something I’m sure we’ll get into later on into the podcast. 

About me, I have been working in the field of therapy in some capacity since 2004. So that’s 16 years and I started off in the field of substance abuse because in my own personal history, I’m actually in recovery myself. So of course we’re all wounded healers, right? So I went to go try to help people who were in recovery get the same breakthroughs I got. And as I started working in that field, I realized that majority of the people who I worked with had deep, deep, deep wounds that they were carrying from events that had happened to them in the past and just relationships that had really, really, really hurt them and so that sent me on a quest. I went on a quest and I’m still on my quest, but I don’t think the quest is ever done. My quest to try to figure out how to help people really overcome and heal the wounds that caused them to keep recreating patterns in their life or to keep living below what their full potential is capable of. And so until I’d be on a journey of many, many trainings and many, many learnings, I just tell people that I’m eternally curious. I will go learn about anything.

Carrie:  I love that you’re terminally curious because I think the best therapists are the people who are willing to continue learning and continue growing.

I’ve met people in the field, unfortunately, and you probably have too that feel like they’ve already arrived and you can’t teach them anything and that’s very frustrating. So I love it when people love to learn and grow. The quest is never over. And the cool thing about that is that you always run into clients with different issues that come up and it’s like, “Oh, well, I don’t think I’ve quite dealt with this before. This is a little bit new. What are we going to do here?”

Laura:  Yeah. Interesting thing. There’s always something new. I heard somebody say once before “wisdom is knowing you don’t know” and so I always hold that as my motto, that wisdom. I don’t know and if I think I do know then I’m missing a lot.

Carrie: So, let’s get into talking about attachment trauma and how you would define that.

Laura: Attachment trauma is basically I call it attachment wounding because trauma. When you think of the field, it’s so much about what happened and attachment wounding is more about what did not happen. So all of us were born into this world and are raised by somebody. It might not be your parents or paternal parents, but you are raised by somebody and those people who raised you almost leave an imprint on you based on how they treat you or what they don’t do for you and the imprint or the impression or the impact that they leave on you is that attachment wounding. So if you were raised by caregivers who didn’t see you, didn’t hear, didn’t value and, or raised you in a way where it was confusing, sent mixed messages, or raised you in a way where they didn’t know how to manage their own emotions, so then they couldn’t teach you to manage your emotions. Then you almost internalize all of that and you take that into yourself and then you grow up and you repeat all those patterns in your relationship with yourself and your relationship with others.

And so then when you go to a therapist and the therapist says, “well, tell me what happened.” You’re like, “I don’t know. It’s just my exist. Yeah. My childhood was good. I mean, everybody had problems. They didn’t beat me. I wasn’t hurt.” I wasn’t all the things that you think of when you think of trauma and people don’t really know that there’s was anything different because it’s just like the existence I grew up in. And so it’s really hard for people to share what did not happen or what happened that felt almost like it didn’t match what they knew they were supposed to receive. So that’s attachment wounding and attachment wounding I have found is really driven or kept alive by unmet needs.

So our needs did not get met in childhood and that caused a part of our brain to almost get stuck at the age at which the need wasn’t met. And then we are at times in our life responding out of that age or that sense of absence and what we then grow up and do, we then look outside ourselves for somebody else to meet our needs.

So we have these unmet needs. We grow up and we become adults with unmet needs. And then we want other people in our life to meet those needs and that’s just not going to work because they have unmet needs too and this causes a lot of the dysfunction in relationships and the world. In my opinion, everybody wants somebody else to meet their needs.

And so what I do is I help people learn how to start to identify the unmet needs from their past, and then meet their own needs. And as I meet their own needs, it’s almost like a cup of water that’s empty and it fills up one drop at a time and it just feels relieving and satisfying and the person feels more complete because there’s nobody that can meet our needs, but us.

Carrie: That’s interesting. How would you kind of put a spiritual overlay on that as far as God meeting people’s needs versus people meeting their own needs? 

Laura: So when I do the type of therapy, I’m a turn like curious so I have lots of tools in my tool belt, but the one I’ve found to help attachment trauma is called ego state therapy, which is basically like parts work.

And so part of what I help people tap into is almost a resource part of them who has all of the things that they needed when they were a kid and didn’t get. And one of the parts of them that I help them tap into is almost like a spiritual self if they’re open to that. Some people just are not ready to go theorem and I understand that, but if their spirituality is a cornerstone of their belief system then they have a part of them who is able to receive the love of their spiritual source and that part of them has the capacity to really, almost expand to meet their needs in life today. So I see it as in my own personal experience and going through recovery. I saw that in my life, I had first received the love, the unconditional love of God and out of that unconditional love of God, I could then love myself unconditionally. 

Carrie: Yes, that’s so good. 

Laura: And that was my path, I was doing exactly what I described at the beginning. I was trying to have my friends and my family and everybody else love me unconditionally.

And they’re just not capable of that. So it’s really tapping into that unconditional source of love, which then feeds your unconditional love for yourself and then you will just naturally know who belongs in your life. 

Carrie: That makes a lot of sense. I know that I see this with people where there’s a lot of grief that goes on over these unmet needs like “I don’t understand why my mother couldn’t just love me unconditionally. I don’t understand why she couldn’t love me as much as my sibling,” etc, etc. Do you feel like that’s a long-term ongoing process for people that part of this being able to meet their own needs, relieve some of that.

Laura: Yes. Being able to meet their own needs, relieve some of that but when you describe that to me, that tells me that there’s like a younger part of their mind stuck in a place where they may be in their forties, but part of their brain or mind still feels like they are a kid needing a mom to take care of them.

And so part of what I help people do is help those parts of the mind that are stuck in that almost bortecs of why can’t mom love me, because when you’re four, you need a mom to love you for survival. But now that you’re 40, you don’t really need a mom to love you. It’d be nice but you don’t need it. And continuing to try to go back and have a person who’s not capable of loving you, love you is actually causing you to have unmet needs of the present. So I feel like it’s a part of the mind that’s stuck back in that place of feeling it’s like they’re four or whatever age and feeling unresourced and incapable of taking care of themselves.

So part of the work I do is help those parts of the brain realize this is life today and you have the ability to have this for yourself. There is an element of grief to the work, but there’s a difference between grief and almost like avoiding sad and like avoidance sadness. So, some people will stay in this level of sadness and denial, and that’s actually keeping them from the deep grief that they need to come to a place of acceptance. “I can accept who my mom is, and I can accept that whatever happened to her in her past made it to where she just could not pass that down to me.”

Carrie: Do you think that people, even if they don’t get those from their parental or caregiver relationships like these needs that a lot of times they get them met in other relationships, and that provides that internal resource for them to be able to have that?

Laura: Yes. However, I think that a lot of times because of the unmet needs in the past, people can choose people to be in their life out of their wounds, and unfortunately, it just winds up recreating the wounds. So there is that rare bird who comes, who actually has a healthy marriage or healthy relationship and within that marriage in a relationship, they can almost have their adult life had their needs met, but they still have that unmet needs from the past that will crop up sometimes. It will show up sometimes and will wind up causing them to get in fights with their partner or pull away and avoid or shut down or be too anxious.

And about their person’s love and affection for the like this is all the ways that attachment shows up in life today is how we relate to other people. And so if you have a lot of unmet needs from childhood, emotional safety in a relationship is difficult to maintain. 

Carrie: So feeling like this person might leave me which could show up in a lot of different ways. If this person gets mad at me, they might leave me, or if this person gets too close to me or knows too much about me, they might discover my flaws and might leave. 

Laura: Yes, and so then people respond to that in different ways. They either pursue the person harder

and want the person to meet demands or want the person to check boxes, but those boxes aren’t going to bring the relief they need anyway, or they pull into their own shell and shut down, or they do both. This push-pull dynamic that comes up sometimes and all of it is because there’s not a sense of emotional safety inside the person.

Carrie: Right. What’s manifesting outside is reflective of what’s inside. 

Laura: And so I tell people, build the emotional safety inside and then things outside changed. 

Carrie: That makes a lot of sense and I think that sense of the healthier that you are, the healthier people that you attract into your life. 

Laura: Yes you do.

Carrie: And the opposite is true as well. Unfortunately, yes.

Laura:  I have people come to me and they want their spouse to be different. They want their children to be different and they want their family to be different and always say, listen, if you change your family changes, you can’t do it in reverse order.

If you change and who you are is different than they will just start responding differently to you or you will come to the place where you realize in order to get better, you have to create that distance. 

Carrie: Talk with us a little bit about how this issue of attachment wounding can cause anxiety to develop in people.

Laura: The place that we learn to feel internally safe is through our caregivers. So when a baby is born, it doesn’t have any way to manage the emotions or the feelings going on inside their little body. And so they are dependent on the person who is raising them to do things like pick them up and soothe them and rock them and soothe them for them. As that happens repeatedly over time, that baby will internalize the ability to soothe themselves. So if a person doesn’t have a caregiver who has the ability to soothe themselves then they do not have the ability to help the baby internalize that ability to soothe. So if you have a mom or dad or a grandma or whoever is raising you, who, when a baby cries gets anxious and panics or gets angry and then is trying to soothe baby out of that panic and anger, the baby is going to internalize anxiety, anger, frustration.

So we, in some ways, how we cope with the world at the core is a replication of how our parents coped with the world. 

Carrie: That makes a lot of sense. 

Laura: And in order to really develop your own ability to cope with the world, you have to get rid of, or heal what your parents passed down and it might not even be parents it could be bullying in school, could be different things. And what I’ve found is when it comes to attachment wounding, what happens is when we have an event happen in our life that is overwhelming or shocking, it’s like our brain turns on an internal recorder, literally almost like cutting on a recording system and it records people acting in that way and the message that they were sending us and the message at different times in our life. When we go through something that feels similar, we’ll turn it on and start replaying it in our heads as if that thing from the past is happening now. And so then when we have something in our life that’s upsetting or anxiety-provoking, we’re not just responding to it, we’re also responding to the messages inside our head. 

Carrie: The internal dialogue.

Laura: Yes, and that internal dialogue, if you hear it for so long, it gets hard to separate. Is it mine or was it theirs? Where do they even start? And so a lot of the work I do is helping to figure that out and kind of turn that dialogue that does not belong to the person off.

Carrie: The messages that other people have put towards us that weren’t true, but we adopted them as truth for ourselves.

Laura:  Well, we didn’t have a choice. You know, at times in our life we’re like sponges, we just absorb what’s going on around us and so we didn’t choose it, and then it gets implanted in our mind and we just don’t even realize it’s there. 

Carrie: Working with people that have had also major trauma experiences, besides just the attachment wounding. One of the things that I’ve noticed is that sometimes the worst part of that traumatic memory was the attachment piece, maybe where they told the caregiver and the caregiver didn’t believe them or they told the caregiver and the caregiver just didn’t do anything about the situation or they were put in a situation that was unsafe. Sometimes that’s worse than the experience itself. It seems like. 

Laura: Yeah, I agree with that. Also want to say that one attachment wound that I’ve encountered lately, in past few years, is really hard for people to explain is what I call an invisibility wound. So that’s when a child grows up in a home where they just did not feel seen. It’s almost like they existed within the home and parents carried on separate lives and this can come when parents are in the world we live in today. There’s a lot of demands and so parents can work long hours. Sometimes two jobs. Maybe one parent is out of the home all the time working and then when they are home, they’re taking care of the household and trying to maintain an orderly life and so the child’s needs just are not seen. 

Parents prioritize physical needs over emotional needs. And so when the child’s emotional needs are not tended to, they wind up feeling invisible and that invisibility wound causes a lot of anxiety because they now show up in life today and don’t know how to be seen when they are seen, it feels very foreign and unfamiliar and they want to try to hide. And it shows up as anxiety, panic attacks, overwhelmed, shame, all the things that cause people to own their shrink into themselves. 

Carrie: Social interactions 

Laura: Because they didn’t learn how to socially engage. I think that’s so important. So the invisibility of women is a big one. That’s in the attachment wounding family.

I’ve seen a lot of people who struggle with it, really struggled to try to explain what happened because it’s a lot of what did not happen.

Carrie:  A lot of no one asking me how I felt about a situation or what I’m thinking or what I’m needing. It’s just kind of like we all go through the flow of life and this is how it is.

Laura: Yeah, or go play. They’re playing in their room, so they’re fine. They were always quiet and didn’t ask for much. That’s not a child’s natural behavior. 

Carrie: Do you think that this can happen? A lot of times there’ll be a situation in a family where one child may respond externally. Like they may be throwing fits or rebelling at school or getting in trouble and a lot of times the focus is maybe on that child versus the quiet compliant child that just kind of goes along to get along with everybody. 

Laura: Yes, that’s another way that the attachment wounding can occur and that will increase in visibility wounds and the one that goes internal and the one that goes external while a lot of times learn, the only way that I can be seen is if I have to help. So then they grow up to engage in addiction and other behaviors. Same dysfunctional, but haven’t had a reason. One of the things that I always tell people is whatever you’re doing has a good and perfect reason for existing. it served your needs in some way.

Carrie: That’s good. That’s really good because our behavior isn’t just in some kind of vacuum. There’s a reason that we got to where we are and if we can peel back those layers and understand that process, that’s often a key to healing, but not just the inside of it, the actual working through it, working through the woundedness.

So talk with me about the people that come in because I probably have them come to see me and you probably have them come to see you that say, “well, I don’t want to blame everything on my parents. They weren’t that bad. I mean, they’re okay. I’m an adult now and I can’t just be going and blaming everything on them.”

Laura: Yeah, and I completely understand. I think that majority of parents are doing the best they can. And I think that this is another topic altogether but wounds are generational. What they didn’t heal, their parents didn’t heal, got passed to them and get passed to the children. You have to look at it from more of a 30,000-foot view sometimes in order to get the understanding you need.

What I tell people is that we’re not here to put your parents on trial. That’s not what we’re doing. We’re just here to know your truth exactly as you felt it and once we know your truth, we heal your truth and what will happen is that will radically shift your relationship with your parents today. It will radically shift your relationship with your parents today so that you can have a more adult-adult relationship with them. If you have a lot of unmet needs, then in some ways you’re staying in a relationship where you’re still the child and they’re still the parent even though you are an adult and you met. The people I work with, they have professional careers functioning, and raising their own kids, but when they go around their parents, they still act in that parent child dynamic and it continues to replicate the unmet needs. So if we can heal the wounds and just learn your truth, and you could be more adult-adult not just in your relationship with your parents, but in your relationships with others.

Carrie: That’s good because what we’re talking about affects people at work. It affects them at home and affects them in their intimate relationships. It affects them with authority, figures, parents, anybody. It’s really huge and once you kind of get down underneath all of those layers, then it have some healing there of these wounded parts, it can be really true formative. 

Laura: It really can. It truly can. 

Carrie: I’m curious how you got through this process of, cause I’m assuming that you were providing weekly therapy in the past, how did you make that shift from like weekly therapy to just doing intensives? 

Laura: So I was doing weekly therapy and one of the things that I do work with, which is, again, another topic altogether is dissociative identity disorder, which is people who have literal such isolated parts and multiple personalities. And in that, I figured out you couldn’t do hour-a-week therapy with them. It just does not really fit the way that their brain is structured and so I started to do intensives with them all starting with two to three-hour sessions and then working my way up. And I realized that I just like it better. I’m a person who believes that you can’t recreate moments. So what that means is if we’re in a session and we get to a big breakthrough and we have to just keep going through it, if all of a sudden we uncover a layer and it’s a new truth or a new understanding or a new trauma or a new attachment wound that we need to work on.

That it’s really hard to say, “okay, let’s stop here and come back next week and we’ll resume at that spot.” The mind doesn’t work like that almost. I believe once you get there, you just have to keep going and heal that piece, and then you can rest and go back in and kind of work on another layer because I realized with my an hour a week with people that we would get to a point like that and then they’d come in the next week and we’d be off on something else. And even though I said, “but that was really, really, really important.” It’s like, “Oh no, but now this is important.” And so we had a lot of places we got to that were never resolved.

Carrie: And that doesn’t feel good. I imagine not feel good to me. 

Laura: I imagine it didn’t feel good to me and it truly didn’t feel good to the people because I would lose sight of what we were even working on half the time.

I would say, well, what, what exactly are we doing here? So, uh, I’m thankful that my, the DOD clients taught me that the mind truly works better when you do it from an intensive approach. And what that means intensive, just so listeners can understand is people book days with me at a time and we do about six hours of therapy a day.

And I look at the mind almost like a ball of yarn, that’s all tangled up and so in that time we just kind of pull on a string and we just follow the stream and let the mind untangle itself and it’s really, really, really, really cool how the mind untangled itself. 

Carrie: Do people tend to just be really exhausted by the end of that day, after doing six hours of therapy?

Laura: Not really, you’ll be surprised that I think it’s more exhausting to open something up and an hour a week and then close have to figure out how to close it down and exist until another week. When they come, it’s almost like they know I’m coming here to work on this issue, whatever it is they want changed in their life, and I’ll provide it in a setting. It’s almost like a retreat, like a setting where people can go, there’s cabins and they stay in a cabin and we meet in the cabin. So the setup works also with the way the mind works, which is compartmentalization. I’m actually leaving my day-to-day life. I’m going to this place where what I do in this place is I work on myself. 

Carrie: Very specific purpose. 

Laura: And they know that this is what I’m doing here and they don’t have to worry about anything else except for healing. So I have found that it really for the people who are ready for it, because not everybody would be ready for it. But for people who are ready for it and want to take the journey, the intensive approach in my opinion is the best way to go.

Carrie: That’s good. That’s what it’s for. Just very interesting and different. And I think a lot of people don’t know that that’s even an option out there for them because so people have a hard time with like you talked about busy-ness of schedules, just even making an hour of therapy a week work for them and trying to deal with things like childcare and transportation issues and so forth and so on. So, it’s really awesome. We’ll put your links and so forth in the show notes for people so they can find you if they want to look you up that way.

Laura: That’d be great. 

Carrie: At the end of every podcast, since our podcast is called hope for anxiety and OCD, I like to ask our guests, what is a time that you have received hope from God or another person?

Laura: I guess I would say that one of my transformative shifts in my life was when I was in treatment for recovery from addiction. I was praying and I was praying for everybody else in my life, “Oh God, I want you to do this for this, I don’t want you to make sure this person remembers me and I want you to do this.”

And I was telling God exactly what I wanted him to do. It was like audibly, I heard God say, “All right, listen up. First, you work on your relationship with me, then you work on your relationship with yourself. Then you can work on your relationship with your family and then I will add who I want into your life.”

And that moment changed everything for me because I realized that that was the order. That was the order for healing. And I was kind of go top-down rather than bottom-up and I’ve lived my life that way for the past 19 years and every bit of it has come true. 

Carrie: That’s awesome. That’s really, really cool. I liked that God told you to listen up because you’re a very direct person and I feel like you would say that to somebody else.

Laura: I was just and all of a sudden I heard God say, “listen up.”

Carrie: I feel like God knows how to meet each one of us where we’re at and how we are and so you’re like this really sweet, gentle, kind person, but you also have like a directness in you too. And so I was like, “that just so fits”. 

Laura: Yeah. It was like, “boom!” I was like, “Oh, okay, I’m listening.” But it changed everything for me when I realized that and I also feel like in my work, it also shapes how I help people on their process. I feel like it helped me see a clearer path for not only how I got the healing I needed, but how people can get the healing they need.

Carrie: Yeah. That’s good. Well, thank you so much for coming on and sharing with us about attachment trauma. It’s been really good. Really informative. All right. 

Laura: Thank you, Carrie.

_______________

I think it’s so tempting for us to say, you know what childhood was in the past that doesn’t affect me now. All of that stuff is over and I’m over it. But a lot of how we act today is affected by how we were interacted with by our caregivers and the patterns that developed. And I have seen amazing transformation when people unpack those patterns and heal from those past wounds and allows them to move forward into a more healthy adulthood. So I wish all of that for you who are listening.

I have a very exciting announcement, which is that I am going to be doing Hope for Anxiety and OCD is first giveaway, I’m going to be giving away two copies of my ebook, finding the right therapist, which is about how to find the therapist who is right for you in order to enter, you have to be subscribed to the podcast, wherever you subscribe to your podcasts.

It doesn’t matter. Take a screenshot showing that you’ve subscribed or showing that you’ve written us a review. If you have written us a review, you will get five entries instead of one entry. So one entry for subscribers and five, for people who have written a review, you could take a screenshot and send it to the email address, giveaway@hopeforanxietyandocd.com.

Again, that’s giveaway@hopeforanxietyandocd.com to enter and you will have until the end of March in order to enter and I am so excited to be able to give those away. And I hope that that helps someone out there, but also encourages people to subscribe to our show and to tell other people about it.

Thank you so much for listening. 

Hope for Anxiety and OCD is a production of By The Well Counseling in Smyrna, Tennessee. Our original music is by Brandon Mangrum and audio editing is completed by Benjamin Bynam. Until next time. May you be comforted by God’s great love for you.

20. Overcoming Sexual Anxiety and Dysfunction For Women with Kelly Ehlert, PT

Discussion with Kelly Ehlert, PT, DPT, OCD, COMT, CDNT. Kelly is a Pelvic Floor Physical Therapist who works with women experiencing pain during sex. Kelly also opens up about the issues she experienced after giving birth to her daughter.  

  • Different messages about sex that can trip women up (moral, medical, media)
  • Common sexual issues in women
  • What is pelvic floor physical therapy and how can it help women?
  • Connection between stress (fight/flight/freeze response) and desire
  • Why we’re all normal in our own way

Kelly’s PT practice: Priority Physical Therapy
Book: Come as You Are

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Supporting Your Anxious Spouse 

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Transcript of Episode 20

Hope for Anxiety and OCD, episode 20. If this is your first time with us, we are all about reducing shame, increasing hope, and developing healthier connections with God and others. You can find us online anytime www.hopeforanxietyandocd.com. 

Today’s show has a special disclaimer that it may be distressing for some listeners and if you have little ears listening you may want to stop the recording and pick this up at another time when there aren’t children in the room. I have an interview to share with you that I did with Kelly Ehlert. We talk about something that I believe the church doesn’t talk enough about and that is sex. 

Sex is an amazing and wonderful thing, but a lot of times there are mixed up messages that we receive from a variety of sources. We’re going to talk about those on the show, and we’re also going to talk about sexual dysfunction for women specifically. What happens when things go wrong in the bedroom? What do you do about it? How to get help and hope for these situations. Kelly was open enough to share some of her personal story which I think just adds to what she does professionally, which we’ll get to a little bit later. So let’s dive into the interview. 

Carrie: Today on the show, we have Kelly Ehlert, and we’re going to get into what you do a little bit later. We’re going to maybe leave people in suspense for just a little bit to have this conversation about some of the messages that we receive in the media about sex through watching TVs and movies, but also in the church. Some of the conversations surrounding sex and baggage that women specifically can have from some of those messages and also experiences with sex maybe that weren’t positive because not everybody has a stellar, positive experience with sex.

Do you want to talk a little bit, maybe about your background or your experience like in the church, just in general and then surrounding these messages? 

Kelly: Yeah, thanks for having me. I grew up really conservative. I grew up at Church of Christ. I grew up outside of DC, so not quite the Bible belt but where sex was off the table. You did not do that till you got married. I heard things on the bus and behind the bleachers. You hear all sorts of things I don’t think I quite understood until later. I will say my mom was a nurse and I remember asking her about a blow job and why would somebody like that. I remember asking things, I don’t think I felt particularly shameful, but I also didn’t know what to ask or why certain things were. I went to Lipscomb. My husband and I met and we waited to get married. A lot of his background I think was the same. You meet, you wait, and then you figure it out when you get married. It’s kind of what we were joking about. We’re supposed to know what we do once we get married. There’s some magical thing that happens and your brain and your body know exactly what to do and in reality, it’s kind of a learned thing. Some of it to Nate there’s arousal, and there’s a certain procedure that your body goes through, but I think as women, ours depends on context a lot more than I think we realized.

Carrie: I think my messages were similar. I had messages in the church that were no, no, no until you get married and then somehow when you get married, it’s kind of like, “well, you know, sex is good.” All of a sudden this whole thing that I built up this idea around that maybe it was bad or shameful, or just not even knowing what to expect. And then all of a sudden it’s like, “woohoo” your wedding night’s supposed to be amazing and everything they’re following. And I had a really hard time in my first marriage trying to make that shift and switch of even seeing myself as a sexual being. I didn’t. And then from the school system, there was a lot of fear messages around sex and a lot of anxiety, like you could get an STD, you can get pregnant, something awful is going to happen to you if you have sex. So there was not really a lot of positive lingo about some of the things that we want to talk about, like God created us, women and men, as sexual beings. I had someone tell me when I was newly married, they said,” yeah, our parents talk about sex was kind of Adam and Eve figured it out and you can too.”

Kelly: And there’s so much more than that. It should be so much more and I think opening the conversation up earlier with your partner, your spouse rather than later is more beneficial. We have to be enlightened to the idea that communication needs to happen. I think we just assume. We put our assumptions on them when you know my husband and I’ve talked through quite a bit, I’m a physical therapist and we’ll get into some more of that, but I had a lot of issues after I had my daughter and there were several things that, the things that I didn’t like about myself, he had to tell me, “Kelly, I don’t care” or “I still love you despite that.” So I think a lot of the things kind of what I said a minute ago about the context is we sabotage ourselves, assuming that what we don’t like about ourselves is something that they pick apart when in reality that may be something they enjoy about us, or it may be something they don’t even think about.

Carrie: It’s not like even on the radar, one of the things that bothers me about movies and TV shows is there’s this idea or this message that you can just hop into bed with anyone at any old time and have great, amazing sex. It doesn’t matter if you haven’t known them before today, you can have amazing sex that evening, and you’re all wrapped up in the sheets and it’s wonderful. I think that puts a lot of pressure on people to feel like, okay, so then what happens if it doesn’t work that way? For me, what happens if I start to, maybe there’s something wrong with me that I’m not able to do this thing that I feel like everybody else is engaging in and they’re having a pleasurable experience. So let’s talk a little bit about some of the common sexual issues that women face. 

Kelly: Okay. I guess in my field, when I get folks is more postpartum, because I think that’s when people around that area, even if it was an area that was very secluded, you have a baby and all of a sudden everybody’s messing with your stuff.

And so it makes it okay to, to kind of get things checked. So generally I see postpartum pain with intercourse, either penetration, just that initial touch and even deeper. I’ve had some it’s called vaginismus where it’s like the vaginal canal and even everything around it, it’s almost like it shrinks up or tightens up. So anything around that region that whole vulvar region gets super sensitive to touch and a lot of it’s kind of mental with it too, because the body knows it’s going to hurt. So if anybody messes with anything or even just sitting the body tends to cringe and further feed into that. So we’ve got to work usually with one of you guys, a counselor to work through some of the why. And I’ve seen fractured tailbones postpartum where the pelvic floor is attached to the tailbone and it hurts with intercourse that way. I guess mainly kind of to answer your question, I see a lot more pain-driven issues and then the causes can be different, but there can also be a lack of orgasm if the pelvic floor is really, really weak and orgasm is just a contraction of the pelvic floor. So there’s less sensation. The less sense of you that feels good and so if it doesn’t feel good, then why do it? And we kind of go down that rabbit hole, but I’d say the biggest factor and what statistically we see is just a lack of desire due to stress. Your body’s chased by a lion all day long. I wouldn’t want to have sex, but it’s still in that stress mode. And I think all of us can identify with that over the last year where we’re just not in our typical state of mind and workplace. 

Carrie: So tell us a little bit about what you do and then we’ll talk a little bit further about those responses in the body.

Kelly: As a physical therapist, my background is an orthopedic physical therapist. I’m board certified in that. So anything neck, backs, jaws, shoulders, any kind of joint, but then also with my kids, I went down the women’s health path. So that’s an extra coursework to look at the internal aspect of the pelvic floor and the pelvic floor is just the insides of your pelvis. So it’s the muscles that help control your pee and your poo.

It’s the muscles that allow you to have pleasure with sexual intercourse or anything around that. It’s the muscles that help stabilize your pelvis and it’s the group of muscles that also help you kind of support all your organs up and in. So this part of our body, I never realized how important it was.

And I think it’s just a part of our body that I appreciate a lot more after having kids. But when you realize what it does for us, it’s amazing. You don’t realize when something is working well, how much it does until it stops working and you start noticing leaking or pain or heaviness or issues with jumping, that kind of stuff.

Carrie: That makes a lot of, a lot of sense. So do you usually get referrals from say OB-GYN who know that their patients are having issues and they would benefit from pelvic floor physical therapy? 

Kelly: Most recently, I started off more cash pay model. We’re starting to delve into some of the insurance, but most of my clients find me through word of mouth. I have very few referring practitioners. If they are then it’s Kairos and Pilates and massage therapists because they’re dealing with that population. And honestly, a lot of us, I think our generation, the thirties and below are a lot more proactive, so there’s a lot more looking and searching. And this topic, this conversation is way less taboo than the generations prior to us. So I think most of my ladies have found me because they’ve asked questions or they’re on Instagram. So, yes and no. I would say a lot more word of mouth in the last six, eight months span like general providers, like orthopedists and that kind of thing because I am a smaller practictioner but yes, that in the bigger groups, that’s where they get a lot of their clients.

Carrie: How do people know if they might be a good candidate for this type of therapy? 

Kelly: So there’s actually a really good screen that I have on my website. Anything from pain with prolonged sitting, sciatica pain with intercourse, like we mentioned, any leakage, even like abdominal pain and discomfort.

If you have constipation, all that pertains to the women’s health, physical therapy world. Issues with breathing. Any abdominal surgery, I think would be good because what we’re finding is there’s a high correlation with abdominal surgeries even abdominoplasties that scar can add here down. And we get, I think it’s like as high as 40% chance of bladder irritation, like bladder issues and then bowel obstructions.

So there’s a wide plethora of things that we kind of see and work on. 

Carrie: Yeah, let’s kind of circle back to that. Talking about the nervous system response and this stress response that keeps us perhaps out of desire, I guess, is what you were saying like if we’re really ramped up, it’s hard for us to have a desire to engage sexually.

Kelly: I guess the best, I’m gonna bring this book up. You guys can’t see it, but there’s a book called Come As You Are by Emily Nagoski can never say her name and it’s almost 400 pages that she really talks a lot of levels on, one, know your anatomy, which is probably the biggest thing being on this side of it is if you don’t know yourself how are you going to expect somebody else to know you too.

That’s kind of first and foremost, but she talks a lot about the stress cycle and how we, how we either feed into it or how we can work out of it when your body is in that constant fight flight or freeze, or if it’s had a trauma and that’s more what’s your kind of world is, I feel like you can probably speak more to that.

Whether you recognize it or not, the body holds that trauma, or there’s usually something mechanical that occurs whether you consciously or subconsciously recognize that feeds in. So when you’re in that constant stress node, your body’s in fight that fight flight or freeze your body is in survival mode. It doesn’t need to procreate. It needs to survive. Like you said, the last thing we need is to go have an intimate moment. Now for some 10 to 20%, according to Emily’s book, that actually derives sex, like that’s a turn on for them where the rest of us, the 80, the 90% of us, that’s a turnoff when our brain is busy, we’re on that hamster wheel we can’t kind of actively, maybe enjoy and participate as much. And as a female, that’s really what there is no pink viagra because we are so context dependent. we need the sounds. We need the smells. We need the kids in bed. We need to be loved like we need all these things usually in order for that switch to really go off.

And she has a really cool worksheet in there on figuring out what turns your brakes on and what turns your kind of your accelerator on and stress for most of us is a really big break step around or where it just. Your system just dies down and that’s the last thing it kinda needs. You’ve just got to figure out how to break that cycle.

Carrie: That’s interesting because I have had women say, well, I just don’t want to, but they have a hard time maybe even being aware we’re breaking down some of these different aspects of things that keep them in that fight flight or freeze mode or they’re so used to just living in that heightened state. And I don’t know what your experience has been, but I don’t think it always has to be a sexual trauma to cause these types of dysfunctions, it can be other types of situations that were maybe chaotic in your family growing up that leads you to be in that state and that may affect you sexually.

Kelly: Even just your assumptions, kind of going back to our conversation about maybe our preconceived notions. In her book, she talks a lot about gardens like your sexuality is your garden and our society and our culture and our family puts all these little weeds in there and we have to figure out what within that garden is truly what we believe in what was planted there by however we live and whatever we live. And so I wrote this down because it kind of helps me, I guess, break things down and help me identify personally, and then professionally where I believe. So she talks a lot about there’s three types of messages, there’s moral, a medical message, and the media message. And so kind of going back to what you said is that doesn’t matter where you are, just identifying I think what your beliefs are is huge. So she talked about one of the moral messages being were damaged goods like if you have sex or you like it and you lose your virginity, then you’ve lost all value. Maybe a century-old mindset of once you give yourself away, nobody else is gonna want you. You just need to accommodate your partner. I’ve watched a movie on Netflix, it’s kind of their whole role in society is to appease the male and make him feel good. It has nothing to do with what the female’s body is wanting to do. You just check that box.  And the other one is the medical model where you can cause damaged goods. Like you said, you can cause STDs and you can cause pregnancy. And it’s just very medical where you get this, then this, then you get aroused and you ejaculate and then you’re done, but there’s no emotion. And then the third message is around the media where you’re inadequate. You don’t know what you’re doing. If you don’t know 15 different ways to have an orgasm or 15 different positions in which feels good to you and your partner. You’re too fat. You’re too skinny.

There’s all these little messages that feed in too. I think what we, once again, we sometimes can sabotage ourselves. I think we take the enjoyment out of it because we assume that I shouldn’t enjoy it. It should be for him or society says, if I enjoy it, I must let, like, we put these names to it, but why is that?

And I don’t know. I don’t know the answer, I think just identifying the thought, maybe important in the beginning,

Carrie: I think a lot of times we don’t evaluate the messaging has been and so then if we have negative messaging, it’s important for us to say, “what am I putting in that’s different into my mind?” And hopefully something like this is a start to that to help people evaluate. What is it that I really believe about sex? What have I taken from the media from morally, from the church, from my family, from the kids behind the bleachers? And some of that information is way off of where we need to be.

I’m curious for you, how you shifted your thought process maybe on sex or had a more positive view of sex? 

Kelly: So definitely more of a personal conversation, but I think a lot of it is going through that book. I had a lot of pain after my daughter with intercourse and telling my husband, “no.” Being able to say no, gave me more power than I think I realized I had. But then I remember asking the doctor about it and she’s like, ”Oh, well that’s just typical rub some cream on it.” And that was eight, 10 years ago before I think the pelvic health world became so popularized, I guess in the last four to five years, I would hope in the next five years, we’re the first line of defense for postpartum. They clear you and then you come to see us for anything else. But I think being able to shift that mindset of it doesn’t have to be penis and vagina intimacy. It can be anything else like sex doesn’t always have to be, and you don’t have to necessarily get off. Being able to talk through, “I just don’t want it tonight” because I think I went a long time with it. Well, he needs to initiate it like that’s just the man’s role. He needs to want it in order for me to be okay with it. And you know, I have another couple of stats here, but 30% of people are responsive,

My husband comes to me 30% of the time I respond to that, only 15% of us are like spontaneous, where it’s like, “Oh, I want sex like, let’s go get him the rest of us.” They’re like, “Oh, I kind of want it. Oh, but he’s there.” But it’s a combo of the situation. I think for me recognizing that he wants me to want him, like he likes that pursuit as well.

And massaging is good like touch. Just being able to be okay with not just jumping into bed. And maybe I was just super, super rigid in my beliefs, and it was like, you give him what he needs and get out and go rinse off. We’ve been able to talk through some stuff and then being maybe more, let’s say, more experimental, whatever, but being more open with trying different things.

Carrie: I always tell clients, and I’m curious if you agree with this from the medical side of your work. I really believe that great sex requires great communication. I mean, you have to be able to have those conversations, even if they’re hard, or even if they’re uncomfortable to be able to say, “Hey, when you do this, that feels good.” Even just language that we use in the bedroom. I like this type of wording and not that type of wording or these are some things that would be helpful for me to hear from you.” And if you’re not able to have those conversations with your partner. I just don’t think that you’re going to be able to have this expectation that it’s going to be great if you’re not able to communicate and talk about what you enjoy because different people obviously enjoy different things.

Kelly: Yeah, and that was one of my big takeaways from that book too, is everybody is normal within their own realm. We all have similar anatomy. We all have similar kinds of patterns. Anatomically we go through this typical pattern of arousal on through, but we have different things that turn us on and turn us off.

And you can’t expect your spouse or partner to know that If you don’t tell them, “Hey, when you do that, that was good. Do that again,” They have to be told that like a little kid, like they go by your vibes in your words and so the words aren’t present, then you’re not validating them or yourself.

Carrie: Where do people start If they are noticing they’re having sex maybe less and less often? And that might be a warning sign for them or what would be kind of like a good first step if they feel like their sexual relationships declining? 

Kelly: I guess it would be kind of like you were saying as self-assess it. It’s situational because something else has taken that place in terms of time or the stress. There are specific sex therapists out there. I have one friend that I will refer folks to, but I don’t have anybody specific, so that may be better. I’m in kind of stepping back to say, well, I noticed this and figure out. I always like finding the why with everything within the therapy world. It’s I can work your neck out, but if it’s going to come back because you’re pastorally not correcting it, then kind of the same with this it’s I think backtracking to is it because I just had a baby and everything hurts? Is it because your kids just stressed you out and you had to go pull them out of jail and you’re in that fight-flight or freeze? Is it just because you’re tired? Isn’t it hormonal? What’s driving the bus and then from there it will be either probably finding the right practitioner to guide you in that direction.

Sometimes it’s talk therapy. Sometimes it’s an OB-GYN or somebody that can give you a hormone replacement. 

Carrie: I think it’s really important in these types of situations where this can happen for a lot of different areas, but specific sexually, there may be some medical components involved and then there may be some psychological components involved. And when we’re looking at the situation, it’s hard to assess what’s medical and what’s psychological. I think it’s important for the medical community and the counseling community to really work together for us to be able to say, Hey, maybe you need to follow up with a women’s clinic or with your OB-GYN about that.

And for the medical community to say, Hey, has there been any trauma in your past, is there anything that’s been unaddressed that you feel like could be contributing to this issue?” Or do you just need some skills to learn how to calm your body down to like learn how to wind down at the end of the day?

We’re running 90 to nothing too often and so really learning those skills is a good process. 

Kelly: I agree with that. I have a lot of patients that I’ll suggest things to, but nothing is going to change unless you actually try some things and the consistency, a little goes a long way. So being consistent with whatever you’re trying, give it enough time. Going back to your medical model, there’s some skin issues that can cause pelvic floor dysfunction, but that can, the skin issues can turn into cancer. So for me, being able to recognize, “Hey, this is not something that’s within my scope.

You need to go see some, you know, somebody beyond a therapist or a PT. You need to go get some medical treatments.” I think I would say most of us hopefully are able to determine some of that. We got to get a gut feeling in terms of when things are not going right. 

Carrie: But what is a usual treatment length for someone that receives, um, pelvic floor physical therapy?

How long does it take somebody to go through therapy? It’s probably similar. It depends a lot on the situation. 

Kelly: I would say most. So if it’s more of an incontinent. Let’s say the pelvic floor is influenced by your GI system, your endocrine system, your skin, musculoskeletal your integument. It has so many systems that cross up in, and then through that, I find that part of our body to be slower to learn than like a shoulder or neck or something that you can physically see because there are so many other little factors that go in. I usually say two to three months for kind of some of the women’s health issues.

If it’s postpartum, I’ll encourage them, a year and a half to two years for you to get back to normal, to feel normal. Not that they’re with me the whole time, but just giving them that timeline of kind of biological tissue healing, that kind of stuff. But it also does depend on do you need some psychological help. Can I physically help you here and I show you how to mechanically help your body move better but every time you’re stressed it feeds back in how do we take that stressor away or help you recognize when you feed in and in that talk therapy, I’m the catalyst and I see you a month or two, and then you go see somebody else and come back and we revisit or see a doctor. There’s a clinic in downtown Nashville called the WISH Clinic (Women’s Institute for Sexual Health) and they do quite a bit. They do pelvic floor botox, injections, trigger point injections. I’ve actually trigger point dry needled the pelvic floor. They do vaginal suppositories with valium for kind of decreasing. There’s a lot of options. 

Carrie: That’s really good for people to know. I mean, even if people have had problems in the past that they find reoccurring that the growth in treatment options in this area, like you were saying has probably grown exponentially in the last five or so years. I didn’t know that they were using things like botox for that.

Kelly:  Yeah, I’ve got a client right now who had endometriosis then a hysterectomy and everything just got locked up in response to I think the surgery and then all the pain prior. I’ve needled her and we’ve done some really cool stuff in terms of getting her pelvis moving. But she’s done the botox. She’s like 90, 95% better. Now it’s taken us a couple of months because it’s been a couple of year’s worth of issues we’re having to kind of delve through, but they’re phenomenal. And that just knowing the options that are on the table besides just don’t do not let somebody cut something out because it hurts that does not answer all the questions. If you have abdominal pain, do not let them do a hysterectomy without ruling out endometriosis and some of those other triggers or even pelvic floor tone can increase abdominal pain because it irritates blot like there’s so many overlapping things.

If nothing else, do not let them cut on you because scar tissue creates more pain and more attention and more adhesions like, “Can we just go down that cycle?” 

Carrie: That’s really good because I think doctors are just kind of like doing their best and it’s like, well, here’s an option and there’s an option and maybe we should do this. And you go down this rabbit hole sometimes of things that like you were saying potentially may cause more problems than what you had to begin with. But I guess the message that I would want people to take away from the totality of this conversation is if you’re having issues with pain during intercourse, Hey know that you’re not alone, that other women are facing these types of issues. People aren’t talking about it. So you may feel really alone, but these are relatively common things that you see in your practice that I saw in my practice and that there is hope, and there is help and keep knocking on the doors until you get the help that you need.

Go to therapy. See how that does or go to your doctor, talk with them. Talk with them about all the different treatment options that are there for you and ask questions and keep going until you find somebody that can help you. You may not find that person on the first or second try, but you may find them, the third person that you talked to.

So keep it hopeful. I guess from a spiritual, Christian perspective, I’m curious maybe some of your thoughts about that as far as what would you tell a Christian woman who’s struggling with these types of issues?

Kelly: I have a nine-year-old and I’ve been trying to figure out how do I give her the message of your body is beautiful. God created it just for you.

You need to keep it holy like keep it to yourself, but at the same time how do I get her to understand that? She needs to know what it is like. It’s okay to look at yourself. It’s okay. That is your body. You only get one. Kind of what I said earlier is if you don’t know it, you can expect somebody else to either that getting comfortable with your anatomy. Just knowing the difference between a vulva, vagina the canal, the vulva, that whole region and knowing where your pee comes out, where your poop comes out. Knowing you have three holes down there. Knowing just what things are. And I don’t think there should be shame around touching. Guys play, I mean, my son’s do that. He pulls off on that thing all night. Well, what I’m saying that it’s acceptable. Kind of going back to the societal, men are supposed to get off and we’re just supposed to help them. I think we need to have pleasure too and we need to, I don’t know the best answer like I don’t think that masturbation is bad.

I think that’s a message that I have to personally figure out how to communicate with my daughter. That’s something my husband and I have talked about in terms of what I like and what he likes and are we okay doing separate things? Do we want that to be like, that just needs to be a conversation piece within the relationship.

If you’re single, I think it’s fine to explore. You’re not denying. The Bible talks about not denying your partner and not saying being consensual, but not denying your partner there that pleasure. I can’t think of the verse, but something to that extent. And so that’s still a grey area and I don’t have a good answer for you. 

Carrie: Yeah, I think this sense of we were created uniquely by God with a purpose and God created us as physical beings as emotional beings, as sexual beings, as spiritual beings and somehow that’s all wrapped up in the same body and we have to figure out how those pieces in our work with each other. I do believe that sex is a spiritual connection when you’re married between you and your spouse and that’s a picture of our connection and our union with Christ and the church, and something really sacred and valuable and holy about sex. And yet at the same time, It doesn’t always work the way. it’s supposed to because we’re humans and our bodies are flawed and sometimes we go through surgery or childbirth and sometimes things don’t work the way they’re supposed to.

And knowing that, that doesn’t make you like, “Oh gosh, I’ve got this horrible thing wrong with me and I need to have a bunch of shame about it.” 

Kelly: You’re not letting this dysfunction define you. Acknowledging it and knowing you were meant for more.

Carrie: Yeah, and kind of like keep pursuing that journey until that your sex is restored in your marriage and relationship. I think that there’s hope there. 

Kelly: When you look through in Song of Solomon, I mean, he talks about her breasts. God let that be and God allowed that to be in that special and I think part of that is skewed I think, with how we grew up in terms of that, that gets twisted and it shouldn’t be that way, but my husband’s words are God made it and it’s not dirty if God made it that way. 

Carrie: Thank you for sharing some really valuable information. Today I feel like there’s so much that we could go into and really just like we’re able to scratch the surface on things, but I hope that it will be kind of a springboard for people to maybe go get more education or look into some different avenues. 

So since this podcast is called hope for anxiety and OCD at the end of every episode, I like to ask our guests to share a story of hope, a time that you received hope from God or another person. 

Kelly: Sure, I guess kind of what got me into this field, in general, was issues after my daughter and so in terms of that riff between me and my spouse since we’re on this topic, I couldn’t enjoy him. I remember laying in the bed crying and then going like being able to go through courses to help my clients actually helped. It did more, I guess. You kind of grow as your professional relationships with your clients grow. I think that’s why I am like, sex is better because that communication had to occur.

And I was able to mechanically in my brain, went through the coursework, was like, well, that’s why that hurts because this is scarred down and for my brain, I needed the biomechanical. I need somebody to explain it to me on my level that I could. It didn’t hurt just because I had a baby, it hurt because I had scar tissue because of muscle tore and every time he went through that spot, it made it tear more. That made sense to me and I think just being able to break things down on my level gave me that ability to be like, okay, I can do something about this. This is my body. I know how to help myself and that led me down the path of all right now I have a second kid, I want to do this for other moms. I don’t want them to lay in the bed being miserable, dreading, “Oh my gosh, he’s coming. Is he going to want it tonight? Am I going to just cry again?” I want to enjoy sex. I want my partner to enjoy me. I want it to be consensual.

I want to go on a date and come home and be ravenous like the movie. Like I want it to be that way and I want my clients and my patients to be able to understand that it can. It can be that way like there’s my hope.

Carrie: That’s how empowering just to have that knowledge about your own body and why it was responding, the way that it was, and then realizing it, doesn’t always have to be this way and I can get some help and help myself and move forward.

Kelly: That’s far back in your lap and understanding. I just think like you said, keep searching. Be your own advocate. If you don’t think something’s right, we have that good gut-fixed sense as women. I think we just have something, some intuitive, something innately in us that helps us help each other, but also help ourselves. Our body wants to thrive too.

We want that homeostasis, I guess. Keep searching. If you’re getting the runaround and help, there’s a ton of us out there on social media now, that you see something you can go down that path and search a little harder.

Carrie: We’ll put links on your information in the show notes and as well as for the book that you talked about too. Thank you so much for sharing today. 

Kelly: Thank you. I appreciate your time. 

_________________________________

There were so many good nuggets in that interview and I hope it sparks some further thought in conversation in your mind, if you’re a woman about how can I make my sex life better for myself and for my spouse.

Do you have lingering questions from either this episode or other episodes that we’ve done on the show? If you are leaving with unanswered questions or feel like you want to know more about a specific issue I would love to hear your feedback on the show because I want to make it something that you want to continue to come listen to. So you can drop me a line anytime through our website hopeforanxietyandocd.com and I promise to read those and respond to you. 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.

19. Thriving as an Introvert in an Extrovert World with Holley Gerth

On this episode, I had the privilege of interviewing Holley Gerth, author of The Powerful Purpose of Introverts to discuss her own experience of burnout from trying to be an extrovert after becoming a published author.

  • How the introvert brain processes information differently than the extrovert brain
  • Why introverts are more susceptible to anxiety and depression
  • How to communicate to an extrovert who is asking for your opinion on the spot
  • Why you should actually show up early to a party if you are an introvert 
  • Examining the connection between fear and excitement
  • What you might need as an introvert on vacation, during the holidays, or at a conference

Resources and Links:
Book: Quiet
Book: The Introvert Advantage 

Support the show 

See more:

10 Ways to Have a Calmer Mind and Body in 5 Minutes or Less

More Podcast Episodes

Transcript

Welcome to Hope for Anxiety and OCD, episode 19. Today’s show is all about introversion. And if you’re wondering what in the world does that have to do with anxiety, we’re going to explain that in the show that there’s a connection between introverts being more likely to struggle with anxiety or depression.

Sometime back, I had picked up a book, The Powerful Purpose of Introverts and found this book to be so validating of my own experience and also provided some practical tips on how to thrive as an introvert. So I knew that I wanted to ask Holley to be on the show and she so graciously agreed. So here is my interview with author Holley Gerth.

Carrie: So Holley, I wanted to start by telling you a story that I think will help us dive into this conversation about introverts. I was sitting in my friend’s living room and I’ve known this couple for probably about 10 years now. And we were talking about theme parks and they said, “Oh, Hey, you know, what do you think about going to this theme park?”  And I said, well, I said, do you know, that’s a lot of people to be around and it’s outdoors and it’s hot. And I said, if I have kids it might be a different story because I would suffer through it for the kids, but I said it as an introvert with all that activity going on around me, going to a theme park does not sound very fun. And my friend looks at me, the husband’s super serious and says, “You’re an introvert? “Yes, I’m an introvert” but it was just so funny to me because we have all these misconceptions about what it means to be an introvert. And here’s somebody that knew me for 10 years and wouldn’t have pegged me as an introvert.

Holley: Yeah, I think that’s a great story that happens so often. And the example you gave of a theme park is such a good illustration of the brain differences between introverts and extroverts. So they feel best when there’s a lot coming at them because it releases more dopamine in their system, which is their preferred neurotransmitter. And for us, it’s just a little too much sometimes. 

Carrie: Right. The external stimulation of having to process everything that goes on around you and picking up even on little minute experiences, even conversations, sometimes really good conversations with friends that are maybe more rich and deep, I’ll go home and I’ll be thinking about that for a half an hour to an hour, whereas I think other people just kind of they’re like go home and go to sleep. And Carrie has to have like processing time, which is just different. 

Holley: Yes, we do. Our nervous systems are more sensitive. And so we take in more. They’re like nuts with small holes and that’s why introverts reach, they’re done points pasture. And then we need to do that processing, like you described where we empty our net a little by thinking through things, and then we’re ready for more. 

Carrie: Yeah. I know that in your book, you talk about how introverts are more prone towards anxiety and depression. Can you talk a little bit more about that?

Holley: Yeah, it’s actually related. It seems they’re still studying it, but it seems related again to that more sensitive nervous system. So we’re just more impacted by the things that we experience and some of our brain wiring. It’s just a vulnerability and that’s part of my story. And for a long time, I wanted to get rid of that part of me completely. I was like, “God must have messed up” and I want to get rid of it completely. But over time I realized it’s actually tied to my strengths. So if you picture the core characteristics of who you are is like being on a continuum and in the middle would be that nervous system that introverts have. And on the left side of the continuum would be anxiety and that could be labeled struggle.  But on the right side of the continuum, there would be a label that says strength. And that’s where things like you described that perceptiveness and empathy and ability to notice things is. So I think for introverts, when it comes to overcoming anxiety, depression, really saying this is tied to some of my strengths, and it’s not about changing who I am, but moving toward the strength sides of those core parts of who we are that can go in either direction.

Carrie: Yeah. Those strength parts a lot of times are often overlooked in a society maybe that caters a little bit more towards extroverts. 

Holley: Yeah. I think so but it’s surprising that actually about half the population is made up of introverts. We’ve just learned to act like extroverts when we’re in public, because like you said, our culture is more extrovert centric, but I think that introverts and extroverts are actually an intentional, complimentary pairing on God’s part that he made both and we’re better together. So I think that when introverts dare to be who they are and extroverts do the same, then we’re all a lot better off. 

Carrie: I love that because I have had similar experiences I think to what you just shared of I feel awkward in social settings, or maybe I don’t know what to say. I struggled at one period in my young adulthood, really of making conversations with people, not knowing how to do kind of the small talk thing. [00:06:03] I’d love the one-on-one deep conversations but I didn’t know how really to interact in a group of people. I actually went through a period where I made myself talk to strangers which sounds really funny, but it was my way of practicing small talk. And I knew that I wasn’t going to necessarily run into or see these people ever again. [00:06:28] So that made it a little bit easier to kind of like practice some of that stuff. 

One of the things I liked that you said in the book was that you try to bring an extrovert with you to a party but they also appreciate having an introvert, which I thought was really cool too. 

Holley: Yeah. I usually bring, I call them my designated extroverts.

[00:06:52] So if I’m at a conference or somewhere like that, then I look for an extrovert and it does work out well because they want to kind of flip from conversation to conversation and talk to as many people as possible a lot of this times. And then if there’s one person that wants to go really in depth and tell me a long story and talk, maybe and cry for an hour, then they’re like, “you got this one.”

[00:07:16] We both have our strong points. And again, those are stereotypes. Of course, introverts can learn to network, like you said, and extroverts are of course caring people too. I do think that when we come team up and help each other out that that can be really useful. And the reason why we prefer those conversation types for extroverts, they use a brain pathway for processing that shorter, faster, more focused on the present [00:07:46] So they really easily do that quick, small talk. It’s also why they like talking on the phone more than introverts and introverts use a pathway that’s longer, more complex. It takes into account the past, present and future. So we need a bit of time to respond, but often when we do, it adds depth and insight context to what we’re saying in that conversation [00:08:10] So again, it’s something that can be frustrating at times, but it’s also strength. It’s what makes you a great counselor that you have the ability to use that longer pathway and go to those deeper places with your clients. 

Carrie: I absolutely believe that because there will be times where I’m outside of session and I’m thinking about a client and their situation in a little bit more depth, and I’m able to have some mental clarity. [00:08:37] And the nice part about my job is I don’t always have to think on the fly. I can come back and say, “Hey, I was thinking about this thing, and I think it might fall in this area, or I think it might be helpful if we shifted direction over here a little bit.” It’s super frustrating when you’re in a corporate environment or even sometimes in church, you’re in meetings and people are spitting out ideas and sometimes that processing speed is a lot faster.

[00:09:06] And so for the introverts to know, it’s okay I think to come back and say, “I thought about this a little bit more” and to not feel guilty for not being able to think on the fly, like maybe we see other people doing. 

Holley: Yeah, that’s a great tip. One thing that I’ve learned through the process of writing this book is that extroverts just want a response. [00:09:30] They don’t necessarily need the response. And as an introvert, I tend to think I have to have my fully formed as close to perfect as possible response before I say anything at all. But actually extroverts just want to know that we’re engaged in listening. And so I’ve found It’s okay to say I need some time to think about it because it really matters to me [00:09:53] or I want you to know I’m listening to you and I hear you. I just need a little bit of time to work through that. And then let’s set up a time to get back together. And so that was freeing for me. I have a daughter who’s an extrovert. And so I’ve learned to say to her, things like that, “I hear you. I am listening.

[00:10:12] Let me have this a little bit, and then I will get back to you. I promise.” So that is one strategy. Also preparing ahead of time can help us. As little in the moment processing that we have to do that can be helpful. I’m sure you prepare for your sessions with clients. And then, like you said, you think about them afterwards. [00:10:33] That idea of saying especially in a meeting, “Hey, I’m going to get back to you by 8:00 AM tomorrow. I want to dig into this a little more.” So preparation, and then knowing you can just use a response. You don’t have to have the response and then asking for time for followup. Those are three good strategies to help with that.

Carrie: [00:10:51] That’s so good. I like having the practical things to say with other people, and that can help in a variety of different relationships that we’re talking about whether it’s your boss or your spouse, boyfriend, girlfriend, best friend, your child like you named.  This is just applicable in so many different areas.

[00:11:13] I’m curious for you what that process was of really embracing your introversion in a different way other than looking at it as a deficit, going from that to looking at it as a strength or as a God-given blessing. 

Holley: Yeah. Well, I did it by pushing myself into burnout. [00:11:39] So, especially when I first started publishing books, I started getting a lot of speaking invitations and I literally told myself I just have to be more of an extrovert now like that’s the job. And I said yes to everything to everyone without being very strategic about it. And at the end of one year where I traveled like 20 times, I was a keynote at a conference and the next morning in the worship service, I just couldn’t stop crying. [00:12:05] And I felt like God saying, “Go home.” And I knew he meant like go home and taking a nap because you are tired, but also go home to who I created you to be. And I realized that each of us are perfectly designed for God’s purpose for our lives not for anyone else’s, but for ours, we have what we need. And so I went home and I went to counseling. [00:12:29] That was part of my healing journey. I told my close people, “Hey, I’m not okay. I need to make some changes. I spent time with God” and just asking, what have I taken on that you never asked me to. And started saying “no” more strategically and started saying “yes” more strategically and realized that I didn’t have to do all those things in order to fulfill God’s purpose for me that I could be an introvert and still make an impact. [00:12:59] It was more than okay to just say this is who I am and I’m going to build my life around that. So it was a long journey and I wouldn’t recommend anyone do it that way but that’s how it worked for me. 

Carrie: I love that. I love that sense of, yes, I can fulfill God’s call on my life. Whoever’s hearing this, no matter what your personality is, no matter whether you’re an introvert or an extrovert, you can still fulfill God’s calling and it’s going to look like

what he intends it to look like for your life instead of trying to follow the pattern of other people. It’s so tempting in the days of social media to look on a profile or a public figure and say that person has it together, or I want to be like them but really we should be striving to be who God created us to be unique and individual. And there’s just everyone, I believe has a gift that they give to the world, that God has given us things to be able to give out to others. And that was just really beautiful how you shared that. 

Holley: Yeah, I agree. And even when we look at those around us, a lot of times we assume they’re extroverts and often they’re not. Some well-known introverts include Oprah, Jerry Seinfeld, Joanna Gaines, Abraham Lincoln, Max Lucado, Michael Jordan, Michael Phelps. The list goes on and on. And because we live in a more extrovert centric culture, we do assume, “Oh, they’re in public. They must be an extrovert,” but there are actually a whole lot of introverts doing really remarkable things. And so I think that is something I’ve learned too, that when I see someone that I think, “Oh, they’re an extrovert” to pause and be like, “maybe not”. [00:14:59] Maybe they’re in their zone of what I call brilliance and belonging, where there’s this thing that they do that brings them into a different place but maybe they’re an introvert just like me. 

Carrie: Do you feel at times, like God’s calling on, on you to do specific things has been totally scary?

Holley: Yeah.

Carrie: [00:15:27] I feel like that too. I wanted to ask you that because even like putting out this podcast, it’s terrifying. The only reason I continued doing it is because, well, one, I believe it’s got what God wants me to do. And two, I’m having enormous amounts of fun with it, talking to people and interviewing them, but it is scary to do new things or to put ourselves out there. [00:15:53] And I think sometimes as Christians, we may be have been fed this lie that if I’m doing something for the Lord or if I’m following God’s calling on my life somehow I’m supposed to have a hundred percent confidence in that, and I’m not going to experience anxiety and I’m not going to experience fear. [00:16:14] I just wanted to just dispel that myth because it’s a myth. 

Holley: Yeah. It is. I once looked at all the verses that say, “do not fear” in scripture and there are almost always to someone who’s already afraid. So it’s not like a command don’t ever feel fear, it’s God saying to us in a reassuring way, you don’t have to stay in that fear because I’m with you. [00:16:40] I realized that we are afraid when something matters to us. We don’t get scared about things we don’t care about, you know? I don’t get scared that I’m never going to get to be an accountant or an engineer. And probably folks who love their jobs are like, they’re not scared.

[00:16:58] They’re never going to get to be a writer or a podcaster. It’s the things that matter most to us that scare us most. So in that sense, the fear is never going away or in a way we don’t want it to, because that probably means that the passion is also going away. And so just recognizing that fear as. As proof that we’re doing work that matters. [00:17:23] And then I would say the day I stopped being afraid is the day I should probably walk away because it’s the day I think I can do it on my own without God’s help like fear keeps us dependent and saying, “okay, God, this is bigger than me. I don’t think I can do it, but I’m going to trust you.” He and through me.

[00:17:41] And then we take the next step forward. But I think fear is just with us when we do things that are worth doing. 

Carrie: Right. That connection between fear and passion is so huge because the passion is the thing that God gives you I believe to help you push through the fear. There’s something in your heart that you feel like you have to speak up about, or you have to share, or you have to do. Sometimes that anxiety is something that’s almost a confirmation for me of like, okay, like you said, this is something that God’s put on my heart and put in my life for a reason and a purpose, but I can also, with his help, move through that and move beyond that to the other side and do things that I couldn’t do on my own.

Holley: [00:18:42] Yeah. And it’s really interesting that from a brain perspective, fear and excitement use the same circuitry. It’s just about how we frame it to ourselves. Whether we tell ourselves like if we’re getting ready to speak. If we’re telling ourselves I’m scared out of my mind, or I’m excited. There’ve been studies that show, if you tell yourself I’m excited that it helps, even if you feel like you’re faking it, you may.  You know what am I saying?

[00:19:11] I’m not excited, I’m terrified but if we just learn even to change some of that language and link it more to that passion and excitement, because it is the same kind of circuitry in our minds that can help also. 

Carrie: I think some people should try that next time before going to a party, “I am so excited to be with my friends,” because that is true. [00:19:32] You’re excited to be with people, hopefully that you love and enjoy. Let’s talk about maybe some practical things that if people are struggling with anxiety in social settings or when they meet new people, those types of things. Are there any tips that you’ve found helpful for you or through your research?

Holley:  [00:19:57] Susan Cain wrote a book called “Quiet” about introverts and also one for kids. And she uses the metaphor of extroverts are like helicopters. Introverts are like airplanes. And so extroverts in social settings kind of immediately lift off. They’re just jumped right in and introverts need a runway.

[00:20:17] So to ease into it a bit more and so if you’re an introvert, it can actually help to get to places a little bit early so that you have time to get familiar with your surroundings, to feel comfortable there. See people come in one at a time instead of walking into a crowded room because it’s tempting right as an introvert to come late because we think that will help. But that any kind of preparation you can do ahead of time even if it’s just researching online the restaurant or the venue, or looking at the people’s Facebook profiles not in a stalkery way. I’m getting familiar with these people then that is helping yourself have a runway. [00:21:03] And so I think that’s one thing or even doing research ahead of time, like saying,” okay, what are some questions I want to ask people tonight,” having some things. So when you’re put on the spot, there’s something in your toolkit for using, and then just honoring your done point.  Knowing that because we process deeply and we take in a whole lot that it’s okay if we’re just done before other people that it’s okay If we’re just like “I’ve had enough, I’m ready to go home.” For socializing to be more about quality than quantity, I think is a helpful shift. And then finding ways to make bigger groups feel smaller.

[00:21:47] So in a group saying, how can I talk to one person at a time or taking on a role or responsibility, like at the holidays saying “I’m gonna wash dishes” because that means I get to stand by at the sink and catch my breath for a few minutes. Or I’m going to take the dog for a walk or I’ll be the one to run to the store often when introverts have a role or responsibility, social settings become more comfortable.

[00:22:15] It’s that unstructured time where it’s just about like the back and forth conversations that aren’t always our favorite, that can be challenging. So give yourself a runway or look for a role or responsibility when you’re in the setting.

Carrie:  One of the things that you mentioned that I’ve found super helpful for me.

[00:22:37] And it seems really silly, but I will become overwhelmed if I don’t look at the menu beforehand. If I’m going to a new restaurant, it’s like there are too many choices and too many options. And I feel like I have to read this whole thing and investigate it. And maybe other people don’t look at menus that way, but when you’re highly sensitive and that’s how you process the information, it’s just easier for me to.

[00:23:05] almost decide before I go to the restaurant, what I’m going to eat, or at least narrow it down to a few choices versus just having to do that all at once. And then usually people are trying to communicate with you as well like “Oh, Hey, how are you doing?” It’s like, okay, I can’t talk and read and think and everything all at the same time.

[00:23:25] I’ve found it helpful at parties. I think I read this in a book a long time ago. I had read a book as part of my process called the Introvert Advantage. I don’t even know if that’s still out but that book really helped me understand myself. And I think one of the things they said was don’t be afraid to sit down and let people come talk to you.

[00:23:48] I had an interesting experience at a networking event one time where everyone was mixing and mingling, and I just needed a break from meeting new people. So I sat down on the sofa and this extrovert woman came over and she started talking to me and I was thinking, Oh gosh, I came over here. So I could like just sit down.

[00:24:08] And she interpreted that as like,” Oh, you’re not having a good time. You’re not mixing and mingling.” And somehow like, “It’s my role in this networking event to come over and rope you back in.” So that was just a little, kind of funny misunderstanding, but I think it’s okay too kind of take a break or observe for a little while. [00:24:30] And sometimes people don’t understand that that that’s what you’re doing. They just think that you’re disengaged or not having a good time. 

Holley: Yeah, and I think that’s a common misconception. I think one reason why is that brain and nervous system wiring differences means that introverts and extroverts experience happiness differently. [00:24:52] And so for extroverts, happiness looks like enthusiasm and excitement and for introverts calm and contentment. And so that extrovert assumed because you were over there being calm and content that you must not be happy at the party. And so our loved ones can do the same.  If you’re in an introvert expert, marriage or friendship, or kids and parents. And so understanding that difference can be helpful. And also as introverts communicating, saying, I’m really enjoying, just watching everyone or just making it overt that we’re in our happy place. It just looks different than it does for extroverts. But a lot of times that’s what’s going on and I love your strategy of menus. [00:25:38] I do the same thing, and I’d never thought about it as an introvert HSP thing, but that makes so much sense. And I think I’m going to do that in broader ways too. Like if I’m going to a conference, I’m going to say this conference is a menu. I don’t have to eat everything on it. What do I most want to consume while I’m here and what will be the right amount for me that I get what I need, but I don’t over indulge in a way that makes me not feel good by the time I’m going home.

[00:26:11] And I think you could do the same with a vacation, with a lot of different things. So I love that strategy. 

Carrie: That’s so true of conferences because they will literally have like, okay, and here’s the breakfast for the new people. And then here’s all of your conference schedule and the special lunch. And then the dinner evening thing. [00:26:32] And I look at that and I’m like, “No, I don’t want to go all all to all of that.” It’s like when you’re having your evening 8:00 PM thing, I want to be in my PJ’s reading and decompressing because I’ve been around people all day long. What are you thinking?” So that’s really funny too, that you mentioned conferences because that’s been my experience of looking at them. [00:26:54] We have way too much stuff on this menu. I’m not going to go to all of that. 

Holley: And so to saying, I’m going to pick and choose. What’s going to add the most value and not worry about the risks. Again, it’s that quality over quantity, such an important strategy, especially for introverts. 

Carrie: I know that things like. [00:27:13] Trips or being around family for long periods, even people that you love and value my spouse. And we have introvert time.  There’s times where we just kind of want to go to a separate space in the house and just read or relax. And we just kind of check in with each other about that. Like, “Hey, are you cool if I go here and read” :Oh yeah.  That’s fine.”

[00:27:37] I just kind of need to decompress. And we don’t always have to be around each other all the time. And there’s a peace and a communication about that. I’ve had vacations with friends where like, I can think my best friend and  we kind of had an understanding of just like, we need time alone at the end of the day, we’re going to be around each other all day, doing fun things, going places and seeing people.

[00:28:05] And then there needs to be some kind of decompression time at the end where we’re not having to be fully engaged or talking to each other or doing an activity every second of the day. I think that’s it. That’s important in terms of when introverts are planning things like vacations, to really take that time and be gentle with themselves. You don’t have to absorb every single moment. You can have some happiness in your peace and contentment and relaxation at the end of the day. 

Holley: Yeah. And I think it can be helpful to ask each other, what will help you enjoy this vacation, the holidays? whatever it is that you’re going into with another person. [00:28:52] And so that gives introverts opportunity to say, “I’m going to need a nap, or I’m going to need an hour to read every day.” And the extroverts will say, “I’m going to need to have a little adventure every day,” whatever it is. And so a lot of times we just assume that other people are wired like us. And so we are afraid to ask for what we need or are we missing what someone else needs. [00:29:16] And so I think just having those conversations can be helpful. 

Carrie: There’s so much about this, as you start to develop an awareness of yourself, your own body even how you feel physically and emotionally, when you’re around other people, how you feel physically and emotionally doing certain tasks. Some may feel more draining to you than others. How you rejuvenate that mental and emotional energy. And if you can develop some awareness over those things, then it allows you to know what you need. And if you know what you need, then you can advocate for what you need. And there’s so many pieces I think that go together with that.

[00:30:06] I hope that some of this conversation helps spark like self reflection in our listeners just of how do I really feel in these situations. With anxiety, there’s a tendency to just avoid and just say, “It makes me feel uncomfortable. I’m not doing it” Party with 20 people and I only know one person, “I’m not going.” And I would just encourage people really to say instead of tapping out and avoiding to say, how can I Set myself up for success in this situation instead like some of the tips that we talked about a little bit earlier. How can I engage socially in a way that’s going to be most comfortable for me understanding that it’s not, it may not necessarily be a hundred percent comfortable.

Holley: [00:31:00] Yeah, that was a big aha for me was my anxiety is realizing that avoidance actually reinforces anxiety because we never learned that will we actually can do it, that we can make it through the party or the speech or whatever it is that’s making us anxious. And so the more we go through things that trigger anxiety and come out, okay [00:31:23] On the other side, that’s what actually decreases it. And so that has been a big aha for me personally, it’s just saying, like he said, okay, this is making me anxious. But I’m going to get some strategies and call for backup if I need it and I’m going to live through it. Usually on the other side, I say “that wasn’t as bad as I thought it would be.” What I come up with in my head is usually so much worse than what actually happens. I think that’s great insight for your listeners that you’re sharing that. Lean into it when it’s tempting to pull away.

Carrie:  Are there things that you tell yourself or to get through some of those situations. What kind of like what the tipping point is? [00:32:12] How do I know that this is too going to be too much for my system or it’s something that I can manage and kind of get through with a little self encouragement?

Holley: Yeah, I think asking, “Am I making this decision out of fear? or out of intentionally taking care of who I am as an introvert?” because those are two different things. [00:32:38] If there’s an event that would probably be beneficial and I know that, but I’m just like, I’m scared. So I’m not going, then I try not to let myself off the hook, but if I’m saying, “I’m exhausted.” And I know the close people in my life need some things for me, and I’ve got to prioritize my energy and this event is just not making the cut because it’s a “want to” not a “need to” then that’s a different thing.

[00:33:09] And just saying it’s okay to prioritize what I spend my emotion and energy on especially as an introvert. And so just asking, where is this coming from? Is it from a fearful place or is it from a proactive place? I think can be helpful. 

Carrie: That’s really, really good. So before we end here at the end of every podcast, I like to ask the guests to share a story of hope, which is a time in which you received hope from God or another person.

Holley: [00:33:41] Okay. So my story of hope is my family story. I went through about a decade of infertility, my husband and I couldn’t have her own kiddos. And so we ended up adopting a 20 year old who basically aged out of the foster system. And so she’s now 27. And so she got married and we are Nana and Papi to Ula and Clement. [00:34:10] And so I literally wore a ring on my finger that said hope for all those years. And the ending to our story is not at all what I would have imagined, but it is now one that I would not trade for anything. So I think about that still when I’m in a situation where I’m waiting or I’m uncertain of the outcome, just knowing that God’s working out something probably better than I could have imagined on my own.

Carrie: [00:34:38] That’s awesome. Thank you so much for sharing that. So Holley, tell us a little bit about your book. 

Holley: It’s called the “Powerful Purpose of Introverts. Why The World Needs You to Be You.” I spent years doing the research behind it. It has tons of information, but I also did a survey of my blog subscribers about their biggest challenges as introverts.

[00:35:02] And I used that. I got thousands of responses. And so digging into that, I noticed patterns, patterns of struggles, but also patterns of strengths. And so the book really unpacks, what are the gifts and strengths the world has to receive from introverts and how can you individually recognize those strengths in yourself and maximize them and overcome the struggles that might get in your way. [00:35:30] And so I hope that it’s both encouraging but also very practical. There’s a lot of interactive tools in it. There’s questions for reflection. There’s all kinds of things like that. And if you’re an extrovert, I’ve heard from several extroverts now that reading it has helped their relationships with an introvert in their life. So if you’re married to an introvert or you’re parenting one, or if you just have a lot of friends that you love who are introverts, I think it can be beneficial for extroverts too. It has been a best seller and resonated more than I even imagined. So I hope everyone can get this message because I think it is something I wish I’d had 20 years ago. [00:36:14] It would have changed the trajectory of my life. It would have protected me from going to that place of burnout. And so I want everybody else to have it so that they do not have to go through what I did. You can let me be your warning. 

Carrie: Absolutely. I’ve really enjoyed it. It felt so validating for me to read.

[00:36:38] And I knew some about introverts from reading that I had done in the past and kind of my own journey of self discovery, but reading the book this time with all of the interweaves that you talked about of the research that you did, and the brain science has been like, “Oh, yeah. That makes so much sense.” And there are little checklists and different things and it’s just been, it’s been a good read. So thank you for writing it and sharing that with us and thank you for being on the show today and just sharing your wisdom there. 

Holley: Thanks for having me. 

_____________________________________________________________

I hope you enjoy listening to this interview with Holly. If there’s nothing else that you take away, I hope that you know that you were created uniquely by God with a purpose and intention in mind. He did not make a mistake by making you an introvert. If you are an introvert and he did not make a mistake by making you an extrovert, if you’re an extrovert, so go and embrace and be all that God has called you to be.

[00:37:47] At hope for anxiety and OCD, we talk about how we are here to reduce shame, increase hope, and develop healthier connections with God and others. If you know somebody that needs this message, I would encourage you to share the show with them. You can also share your support for the show by writing us a review on iTunes.

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 grace.

17. The Power of EMDR Therapy for Anxiety with Sarah Slade, LPC-MHSP

On this episode, I was able to geek out with on of my favorite colleagues to talk about our favorite therapy: EMDR. 

  • Our path to receiving EMDR training
  • What is EMDR?
  • Different types of trauma (little t and big T)
  • Getting to the root of troubling body sensations and 
  • How EMDR can be helpful for people with anxiety 

Resources and links:
Sarah’s Counseling Practice: Willow Tree Counseling, licensed in TN and KY
Sarah’s book: Healing Negative Wounds: The Impact of Trauma
More information about EMDR
Book: The Body Keeps the Score

Support the show

More Podcast Episodes

Transcript of Episode 17

Welcome to Hope for Anxiety and OCD episode 17. If you’re new to the show, we are all about reducing shame, increasing hope, and developing healthier connections with God and others. I’m your host, Carrie Bock. 

And today on the show, I got to interview and have a conversation with my good friend, Sarah Slade. She is like my professional soul sister. She and I do very similar work in terms of the trauma work that we engage in and have a favorite therapy that we’re going to talk about on the show today, which is called EMDR for short. This may be a therapy that you’ve heard of, or it may be completely new to you. But I hope that our conversation is enlightening. Hang around for the end, because I’m going to tell you about some exciting episodes that are coming up in the future. 

Carrie: Welcome to the podcast. 

Sarah: Thanks for having me. 

Carrie: This is going to be a really fun conversation where we get to geek out about some of our favorite topics so I’m very excited about it. 

Sarah: Yes, me too.

Carrie: You and I met several years ago and when we were working in community mental health, we were driving around to people’s homes and working with kids and their families and got into some very interesting situations a lot of times.

Sarah: Yes, absolutely.

Carrie: Complete utter unpredictability like we could show up at the house and we didn’t know if our client was going to get in a huge fight with their parents or if they had just been suspended from school or there was some other crisis going on. If somebody got arrested. You had to kind of be quick on your feet and we never quite knew what was going to happen.

Yes, complete trial by fire.

Carrie: Yes. You kind of like go out there with the fire extinguisher. Any fun without going into client details. Any fun, random in-home stories that you have. 

Sarah: Some that probably are not one of those therapists humor, probably ones that are not super funny, but I just remember the ones that stuck out to me the most were the ones I remember that were like really dirty places that we had to and then just, you know, we’re therapists. So I want to get on the floor. I want to play with the kids. So just being around on the floor, and some not so clean environments. I remember coming home and stripping in my garage before I went into the kitchen area like just getting rid of all the clothes that I had on and thinking back now, I’m like, that is so bizarre that I would go through that and enjoyed it so much like as much as we did.

Carrie: Right. It was not boring. I will tell you that it was far from boring. I don’t know if you had those rice trays. They were like the mock sand trays, but they would get rice like everywhere and then we’d be like trying to clean it up like discreetly sweep it up at the end of the session or some kind of powder on the rice and the kids would literally dig their whole hand, arm, and everything and come out kind of half white and we’re like, “Wait, stop doing that. Your parents are going to kill me.” Oh, those were good times. So now you still work with a few children, but more so adults and a few adolescents sprinkled in.

Sarah: Yeah, I definitely don’t advertise just adults, but it seems to be that that’s kind of just become my focus or just more of where I’m getting my referrals from. 

Carrie: And so, as we were working in this program, we ended up getting trained in a few different forms of trauma therapy and one was trauma-focused, CBT cognitive behavioral therapy. And we did some arc training, attachment regulation, and competency. And we also got trained separately in EMDR and found that we had a passion for trauma and for EMDR kind of became our go-to therapy that we really utilize probably most often. 

Sarah: Absolutely. EMDR is one of those therapeutic techniques where you either like, are all for it or you’re afraid of it and you don’t ever use it and we would definitely the ones that like dove right in. 

Carrie: Yeah, I think that really came from seeing people who needed relief from their trauma and when we got trained in trauma-focused cognitive behavioral therapy, it was kind of like you have to write this trauma narrative. I mean, you don’t write it, the kids write it and you write it down for them as they tell it to you. You really start to realize that that’s great maybe if you had one traumatic incident that might help clear some things up, but it never really, for me, fully addressed like the body sensations that come with experiencing trauma, like, “Okay. Maybe I can think differently about my trauma. I can see maybe that it wasn’t my fault,” but every time certain memories come up or there’s a trigger then all of a sudden your stomach’s in knots or you start breathing heavily and you get overwhelmed and it seems like some of the cognitive based therapies just didn’t really fully address those. That was kind of one of my problems that I was having and you can speak to this too with the clientele that we worked with. They weren’t single incident trauma folks. They were kids who had maybe foster care and adoption journeys, or they were children that had ongoing sexual abuse or other types of things that weren’t just kind of one or two incidences and they were happening at a time of development, which definitely shaped their development and how they were processing that. I mean, you can kind of speak to that a little bit more about what your experience was with some of those other therapies and things.

Sarah: Yeah, absolutely. I feel like that definitely these sensations, the body sensations piece was missing with your regular CBT, but I also agree we were working with so much complex trauma that narratives didn’t really encompass that or you were trying to figure out how do we write narratives to all of this? Like lifelong trauma. They’re doing a narrative over their whole life so far in and out of foster care trauma after trauma. So, I think that when EMDR came along, I think it was such an easy thing to jump onto because it was like the answer to that problem, addict issues, how do we deal with complex trauma. How do we kind of hit a lot of traumas with one processing? 

Carrie: Right, there was this nice piece too of we can go to kids or families or adults and say, “You can process through this trauma and I don’t have to know every single detail.” Whereas when we did narratives, even for situations like sexual abuse, we were trying to get some pretty specific details and that was rough. It was rough on the kids. It was rough on the families. It was rough on us as the clinicians even having to hear that. There’s something just didn’t quite feel right about that to me, of like, do I really need to know all of those things that happened? Or can we somehow process this without having to know all that information.

Sarah: Yeah, definitely. That was one of the hardest things especially when you’re working with young children and you’re having to get very explicit details of what that was like for them. EMDR, I think that’s one of the things that even now, my clients, even adult clients love the most about EMDR is they’re like, “Oh, I don’t have to tell you what I’m thinking of.” They almost can’t believe it like “you’ve got to be kidding me.”

Carrie: Right, and in your experience, you’re near an army base and so you see a lot of military members, and sometimes they can’t tell you what happened. That is not anything that they can dialogue about, and so to still be able to receive this trauma treatment where they can get relief from that distress is a really beautiful and amazing thing.

Sarah: Yeah, and I think with this population with a military population, first responder population as well, there’s almost like this mentality that they already talk about these events with their comrades and that they almost get kind of put down or it gets desensitized of like, well, that’s not that big of a deal this is what I experienced today or this is what I went through. So the fact of retelling that for a lot of those guys and girls is pretty traumatic in itself. Like that piece of like, I get to keep this to myself.

It doesn’t matter what I bring up. It doesn’t matter if I feel like it’s a huge trauma, big T or if it’s a small T you’re not going to, as a therapist, you’re not going to say anything to them. You’re not going to make them feel bad and they can just process through it. 

Carrie: Right. Yeah. So let’s talk about that a little bit. I think there’s some language in the literature when it comes to trauma where people will talk about the big T trauma. Those are things like where your life was threatened, your life or someone else was threatened or impacted and a lot of times we use big T traumas to determine whether or not people have PTSD. But what we’ve also found is that there are a lot of incidences that profoundly impacted us that are what they would call small T traumas and that may have been something like bullying at school. It may have been a time where you didn’t get something that you needed from your primary caregiver where you really needed to be seen and heard and understood by them, they weren’t available there for you. And I’ve almost kind of shifted some of my language and working with clients to just start saying childhood wounds because when I say trauma, people think, “Oh, trauma”  that’s like a big word. That’s like, send you to the ER or something. That’s what we associate with it.

Instead of no, sometimes like we all have childhood wounds that we have to figure out how to deal with and some were more impactful than others and when you have a thousand tiny cuts through your childhood that’s just as bad as someone who had a big T type trauma. 

Sarah: Yup. Absolutely, and helping clients understand like that the brain doesn’t keep a, it doesn’t keep like a gauge of that. It’s not thinking, Oh, that’s not big enough so I’m not going to raise any alarms or send out the fire alarms. So I think helping them understand the brain doesn’t distinguish between that, you know, trauma is trauma. And when you feel like when your brain feels like there’s a threat, whether it’s a perceived threat or a real threat, your brain doesn’t distinguish between the two. Perceived and real is the same thing and your brain’s going to protect you and both of those situations.

Carrie: Right. So let’s talk a little bit about what EMDR is because maybe there are some people that are listening to this that have never heard of that form of therapy and it’s actually probably the worst named therapy out there because the name doesn’t really help you understand the process. So the name, the EMDR stands for eye movement, desensitization, and reprocessing. I’m curious, what’s your short snippet that you tell to clients about what EMDR is? 

Sarah: Yes, it’s hard to explain. I feel like I always preface it by like, you will understand what I’m talking about once you’ve experienced it one time, then you’ll be like, okay, yeah, I get what Sarah was trying to tell me. But I always try to go with, I liked, I liked the brain I’m a nerd in that way. So I always try to go with that because I think especially, and I’m going to talk about anxiety and your podcast about anxiety, especially my people with anxiety because I feel like they can understand that piece a little bit better than trying to connect it to PTSD cause that’s what people connect it with.

So I like to really try to get them to understand like how the brain processes trauma, where trauma gets stored in the brain, and how we can have those visceral somatic sensations, even when we know we’re safe. So cognitively we’re saying to ourselves, it’s okay, I’m safe, nothing bad is happening, but our body and our amygdala are saying, nope, don’t believe you, not listening.

I’m going to protect myself. So I think I just like to try to get them to understand, like, that’s the body process and that’s what EMDR is doing. It’s trying to get the emotional part of the brain and the cognitive part of the brain to finally talk and listen to each other. 

Carrie: That’s a really great way of saying it. I’ve explained in the past, it’s about getting your body and your emotions and your brain all on the same wavelength. So even though, you know, like you said, I’m safe, I know I’m safe and okay but my body is still holding that trauma and we know a lot more now about how trauma is stored in the body.

You can go read Body Keeps The Score. It’s a great book and I’ll put that in the show notes because we understand that we know we have to do something somatically for our bodies if we’re going to be able to heal from those pieces of trauma. We can’t just talk about it because we’re going to be missing something.

And so what EMDR is using, it’s using what we call bilateral stimulation, and that’s where the eye movements part comes in the name because a lot of times we’re using eye movements, but people also use tapping, there’s little kind of buzzers that you can hold on to. There’s headphones sometimes that’ll play a tone on one side and then the other, and that is helping the brain kind of I guess loosen up some of that material in order to get it stored instead of the short term, the traumas happening now memory section of the brain, and it gets rerouted to long-term storage so that it’s not up on the forefront. 

Sarah: Yeah. Yeah. Absolutely, but definitely one of those where I have lots of clients where they’re like, okay, yeah, now I get it after I did it one time. Now I understand what you were talking about. It seems so strange and bizarre. Yeah. Yeah.

Carrie: It’s really an interesting process because everyone looks a little bit different and I say that because I know some people after listening to this podcast, we’re going to go Google EMDR, and they’re going to find some videos and, you know, people are going to be

you know, super emotional and break down crying, and sometimes that happens and then other people have maybe milder reactions. And so sometimes people will compare, say like, Oh, I don’t even know if this is working, but we’re always able to gauge like in the present, whether or not it’s working by present symptoms.

Sarah: Yeah, I feel like every session is completely different, which is why another reason why I love EMDR so much for a clinician side of it because every client does process different and no one’s going to look exactly the same and the way the brain is going to struggle and how they process and what barriers it’s going to throw up

and how it’s going to try to protect that person. It blows my mind and amazes me every time, how strong the brain is and how much it wants to protect even when it’s doing something that’s negative or negatively impacting the client, it’s trying to protect them. 

Carrie: So some of those, all of those things that were happening during the trauma, like the way that they protected themselves at the time to stay safe and to survive and get through it as well as the body sensations, the emotions, the thought processes, all of those get churned up in reprocessing and people are able to, it’s kind of like the brain digesting material as some people have alluded to in the past. So, yeah, it’s really good stuff. Do you remember when you started using it? Were you skeptical? Like, is this really working? 

Sarah: I think the very first time I remember I did it after that first training. There’s a two-step training with this and so you go to that first-weekend training and you’re like, this is terrifying and then, like go out and do this

like, and you’re like, no, I don’t know what I’m doing. I don’t want to go out and do this, but they’re like, “Yes, you have to. Use it on your first client that you see.” So that’s what I did. I was like I’m either going to be terrified of this or I’m going to jump right in and I remember that client because it was so impactful. She processed so deeply in a level like that I hadn’t experienced, not even at the first training that I like walked out of my office and burst into tears. Wow. I was just like, Oh my gosh, this is amazing. Like what just happened? 

Carrie: That’s incredible. And so to give people an idea, you go on this weekend and it’s like a Friday, Saturday, Sunday, weekend training.

And you’re with a bunch of other therapists and the trainer and there may be a couple of assistants there depending on the size of the group. And the first half you get a lecture on here’s EMDR, here’s how it works, etc, etc, etc and then the second half of the training in the afternoon, you come back from lunch and you’re literally practicing on each other. You have no idea what you’re doing, but you’re diving into emotional deep waters. And so every therapist who does EMDR has had the experience of having it done on themselves, which I feel like is so valuable so that we understand what it’s like going through those waters ourselves. And you’re right, they do tell us, okay, now just go practice on somebody and I’m always like, okay, I’m a little hesitant. So here I am working with people’s children and I went out and I was like, okay, I am really asking parents if I can use their kid as a Guinea pig, that doesn’t feel good. But I did, I asked his parents, I said, Hey, I just learned this new therapy technique

and I think it would be good for your child, you know, do you mind? And it was really like, for me, it was like a God moment alignment where she was like, Oh, I’ve had that. Like the parent had EMDR, so she was like open to it and she’s like, yeah, if you think that would be helpful for my child and, you know, go for it.

So I thought, okay, good. And I always like, whenever I learn something new, I always ask permission for my clients and I always feel like very upfront with them about like, Hey, this is just something new, kind of new I’ve learned. I don’t know all the intricacies of it, but I think I would benefit from you and people have been super receptive to that.

Like, okay, well, you know, if you think it would benefit let’s try it. Like, what do we have to lose at this point? And so, yep I got more experience and more training and you know, you go to a second weekend and then you do the same thing all over again, basically and you learn more in-depth about how to improve your, your EMDR skills.

And then there’s further consultation and, and phone calls and, or in-person meetings that can happen with people that know more about you. So it’s quite a process to get trained in EMDR. It’s not an easy type of thing, but I think there are like you said, there are some therapists that get trained in it and are overwhelmed by it or kind of scared or nervous about it.

And so they don’t really utilize it as much. And then other people really kind of latch onto it as a therapeutic model they want to align with. So talk with me a little bit about how you’ve seen EMDR be helpful for clients with anxiety in your practice. 

Sarah: Yeah, so I just kind of, we’re talking about trial and error or just kind of trying modalities and that’s how I started with clients with anxiety because I tend to get a lot of people with post-traumatic stress disorder, but then I also tend to get a lot of people with anxiety disorders and I was doing some cognitive behavioral stuff with them and then I just decided once I felt more comfortable with EMDR and I felt like, okay, I feel like I can apply this protocol too, because the more I learned about EMDR, the more I felt comfortable.

And the more I just learned about anxiety and PTSD, I was like there, I mean, we know they’re in the same DSM category. PTSD is an anxiety disorder. So they’re all stemming from the same kind of symptoms. So that’s kind of the way that I approach EMDR with anxiety of helping people understand, like we’re going to identify those somatic symptoms that you have with your anxiety and then we’re also going to connect it with a negative belief, because I think most of the time, even if there’s not a traumatic event that they can get to, or like this event happened and that’s what started my anxiety or a phobia type situation, there is still a negative belief. They still feel like I’m going to die

or I’m not safe that anxiety is causing that negative belief to come forward. So I link those two together so we can link negative belief with the body sensations. Sometimes we can have images with anxiety. If they have like an image of the last time or the first time they felt that anxiety just like we do a trauma, I will float them back and get them there. But if not, we stick with just that negative belief and that body sensation. And in my experience, and I know you have experience with it too, they process through almost exactly the same as they would with trauma. 

Carrie: Yeah, really great for panic disorders too. Sometimes we’ll go back and process maybe the first panic attack that someone had, some types of the most recent, just kind of, if someone has panic disorder, this can be very helpful because that is so somatic.

And sometimes people will say, well, I have panic attacks and it just seems to come out of nowhere, but a lot of times we’re able to kind of find some kind of root or something to work with that we can utilize with EMDR, which is really great. I think a lot of the clients that I see have what I would say is developmental trauma, which is really hard to explain to people what I do, because if I say, well, I work with people with trauma

they’re like, oh, like people in the military, like PTSD and I’m like, well, no, not, not typically for me. I’m like typically it’s people who have grown up in a home, say for example, like with alcoholic parents or who’ve just grown up in an environment that was very chaotic. Maybe there was a lot of arguing or fighting in the home or domestic violence, or it could be a variety of different things that happened.

Maybe their parents were depressed and neglectful but there were these incidences where they felt like they couldn’t really get what they needed. And growing up in a chaotic environment can cause people to feel out of control and like they have to latch on to control somewhere that can happen with anxiety, that can also happen with OCD as well.

OCD gives you kind of like this false sense of control at times. Like, oh, okay, well, these compulsions, you know, I can well, lock the door, you know, a few times and that’s something that I, I feel some relief from because I’m engaging in that activity. What’s interesting about the anxiety is a lot of times people feel like, well, you know, I’ve been living with this for so long, I’ve had it my whole life, a lot of times people will say, I remember being anxious as a child and it’s just kind of followed me. And instead of looking at it as, oh, well, this is just something I have to live with and I have to tolerate and manage I’ve seen a lot of clients be able to make huge shifts and larger strides than they had made in the past with talk therapy or just doing some CBT surrounding the anxiety.

And that’s been really incredible to see. Obviously, everyone’s process is different. So there are going to be some people that still have to manage their anxiety, but they feel more confident when they have those symptoms come up. They’re like, okay, but now I know I have some skills at least that I can utilize and I can, a lot of what we do in EMDR in the beginning before we even get to the trauma part is we really work on like those calming down our body, learning to be in touch with our body, and those types of things. So valuable.

Sarah: Yeah, absolutely. I was about to say that, like, that’s what I think, even if the processing doesn’t work for them, they learn self-regulation and they learn that I can be in control of this anxiety, this anxiety doesn’t get to control me which I think EMDR teaches that in such a powerful way with those things at the beginning that you’re teaching them how to build that anxiety up and then calm themselves down and regulate that anxiety.

Carrie: One of the things I wanted to say about EMDR and OCD that I really enjoy is that you’re able to really, and this is true for anxiety too, but like you’re really able to get to the root of the issue. So many times we’re kind of, we’re trying to pull the weed up but we’re not getting all the way down in there to the roots of your emotional and psychological issues. And a lot of times I’ll talk about this on a solo episode because I really want to do a solo episode on this is like ERP is great for a lot of people with OCD, but they are specifically exposing themselves to a variety of issues and it’s like this game of playing whack-a-mole because their obsessions will shift.

So it’s like, okay, I got to expose myself to this issue and then now all of a sudden my obsession has shifted over to something different and I’ve got to expose myself to that now, whereas EMDR really gets to that route. A lot of times has to do something with control, um, a time where somebody felt out of control.

And if you’re able to really get down to that and process through some of those past memories it really helps people be able to engage in the exposure and be willing to do that first of all. But then also it makes that exposure process easier when they go to do it because they’re not fighting all the body sensations. It really helps clear up a lot of that kind of just body stuff that’s in there. 

Sarah: Yeah. Yeah, and I think similar happens with anxiety, like they’re really learning how to control and regulate those body anxieties and figure out where the root cause is. I think you’re right, a lot of times, almost all the time with anxiety, I hear that people say like, I don’t know where it comes from.

I just get anxious out of nowhere, you know? So I think it can be so powerful to work with them, to try to process and figure out, oh, there was a start to this, you know, that this did start at this point in time and try to put some control in them cause it is all about control. They’re trying to get control, but in ways that don’t really work for them.

So finding how they can control and they can control their body and that feels really powerful. 

Carrie: Right. I also just want to make a point too, unrelated to what we were just talking about, trauma therapy really is a process and it’s a paced process and I say that because sometimes people go to a therapist and they get super overwhelmed and super flooded, and that’s not the goal of what you’re trying to accomplish.

You know, this should be paced in a way that feels comfortable to you at some level, I’m not going to say it’s completely going to be comfortable because you’re going to be pushed outside of your comfort zone, but not to the point that you’re overwhelmed or can’t manage it. So if you’re coming out of a session with your therapist and you feel absolutely and completely unglued, it’s super important for them to know about that so that they can help you manage after a difficult session or make sure that you have enough skills to use in between sessions. 

Sarah: Yeah, and I think that’s super important, especially when you have a client that’s very engaged, very motivated. They want to get in there and start working. It’s easy to skip that self-regulation portion and want to go right into processing stuff but EMDR is set up in a way that it stages and that you need to hit those stages for a reason because you really

gauge everybody is different and their self-regulation, and how they can handle what their tolerance is and handling some of those emotions and so you do need to spend some time being really open with a therapist and exploring what your kind of gauge looks like and how you self-regulate.

Carrie: Absolutely. Do you have any advice for people if they are looking for an EMDR therapist, how do they find the right person for them you think? 

Sarah: Yeah, that’s hard. I think it’s just like any other therapist, right? I tell my clients all the time, therapy is like going on a blind date. You just never know who you’re going to get. You sit down and sometimes you might halfway through realize this is not the best fit for me. A lot of times clients feel very uncomfortable with saying, “This isn’t a good fit. I think I want to find somebody else.” I think they worked really hard to get there. They might have spent months trying to get someone to email them back, trying to get on someone’s schedule. So then I think they are just like, “No, I’m staying with this and I’m going to make it work” when I don’t think that’s how it should be. I think that it should be very open and if they don’t like the therapist, they should try another one until they do. There is a therapist out there that they’re going to click with and feel very comfortable with. So I think same is true for EMDR. You’re looking for people with those qualifications. Definitely, you’re looking for somebody who’s completed both of their trainings and has that certification, I would say. But also just everybody’s style is going to be different.

I’m sure. My EMDR style, even though we’re doing the exact same protocol, my style is different than your style. So just finding somebody that you feel comfortable with and safe with. 

Carrie: Yeah, that’s really huge. If you don’t feel like you click with the person, it’s okay to try somebody else. Sometimes you know that the first session and other times may take you a few sessions to kind of get a good feel and understand that. I think on the counselor side, we’re also trying to get a feel of, is this somebody that’s kind of in my wheelhouse. And usually, we try to do that before the first session.

Are they coming in with an issue that I typically work with or have experience with? Does it look like somebody that I can help because obviously it’s not gonna be ethical for us to take on somebody that we don’t think we can help. Keeping all that in mind. I think this is a really great start. And hopefully people will look more into EMDR therapy If they’ve been struggling with anxiety or OCD, or maybe they’ve tried traditional ERP and it’s been really tough on them and want to look at maybe another option, hopefully, this will open up people’s options to know that there are many different types of therapy out there, and you have to find what’s gonna work for you to get you to where you need to be.

So I know that you wrote a book. Can you tell us a little bit about it?

Sarah:  Yeah. I wrote a book about trauma. It’s been a couple of years now and the goal behind that book was I really just wanted my clients or future clients to understand the trauma process. And in that book, I actually go into detail about different trauma therapies. So the book starts off with explaining the brain, explaining the body and how trauma impacts us and how it might occur. And then I go into what are some different modalities that you could use when you’re going into therapy. I wanted to write it in a way that anybody could understand it. You didn’t have to be a clinician. You didn’t have to love trauma, dealing with trauma like I do that. You could understand exactly what is happening and what these therapies are going to look like. I think it was a good book for clients that may not know what modality might work best for them and they want to know a little bit about what CBT is, what EMDR is, what psycho-education is. Kind of going into all those different things that they could encounter in therapy.

Carrie: Okay and tell us the title of the book. 

Sarah: Yeah, so it’s called “Healing Negative Wounds, The Impact of Trauma.” It’s on Amazon. There’s a Kindle version and then there’s also a paperback version.

Carrie: Awesome. We’ll put the link in the show notes if people want to look it up and so forth. 

So at the end of every podcast, I usually like to ask our guests about a story of hope that they would like to share and it’s just a time where you received hope from God or another person. 

Sarah: Yeah, I was thinking about that and so my story goes back a little bit further because the thing of hope that I wanted to talk to you guys about was something that just happened last month. But I think in order to set up the story, I need to go further back to the original one. So the original was in 2016, I lost my mother-in-law to colon cancer and that was a super hard time for everybody in our family. She was pretty young and I’ve known her since I was 16 years old. So she was definitely like a surrogate mother to me. I’m sure if any of the other listeners have ever watched somebody go through the dying process especially the cancer dying process it’s very heart-wrenching and I think it’s definitely one of those times that people question God. Why is this happening? Why is this happening to us? Why is this happening to her, to a good person? That kind of stuff. A lot of our family members were going through that process.

And she was very much faithful to the Lord, and it was really powerful to watch her go through that process because people around her were questioning, but she never questioned as she went through that process of like, “It’s okay, I’m going to see the Lord.” So that was amazing in itself and then the story I wanted to share with you, which I thought was pretty amazing.

This last month, my sister-in-law, her daughter, was due at the end of the month, I think Thanksgiving time but the baby came early and the baby came on her mom’s birthday. How powerful is that, right? Like God’s timing. 

Carrie: That’s so beautiful. I like that story a lot. Thanks for being on the show and geek out with me about EMDR and just, I appreciate your friendship so much too and that just that we’ve been able to have the comradery that we’ve had for several years. 

Sarah: Yes. It’s so bizarre that we were in the same state, but we’re distantly separated, right? 

Carrie: Yeah, absolutely.

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I hope that interview gave you a brief taste of what it’s like to have EMDR therapy. It definitely is one of those things that’s hard to explain if you’ve never done it. I wanted to let you know that we have some exciting episodes coming up in the future to piggyback off this episode. Next week, I’m going to be talking on a solo episode, more in-depth about utilizing EMDR for OCD. I also have some interviews to share with you on thriving as an introvert. And we’re going to be talking in the future about anxiety surrounding sex within the context of Christianity and I’m really looking forward to that conversation as well.

I don’t want you guys to miss anything that’s coming up on the podcast and the easiest way to do that is to go to our website, www.hopeforanxietyandocd.com and subscribe to our newsletter it’s right there at the top of our homepage. Until next time, thanks so much for listening and being a part of this conversation.

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

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

16. Is Mindfulness for Christians? with Dr. Irene Kraegel

Mindfulness is a buzzword in conversations surrounding anxiety. Dr. Irene Kraegel, writer of The Mindful Christian defines mindfulness in an easy to understand way while explaining how mindfulness fits in with the Christian faith.

Links and Resources:
Irene Kraegel’s website: The Mindful Christian
Book: The Mindful Christian
Free Online Course: Mindfulness Based Stress Reduction
Support the show 

More Podcast Episodes

Transcript of Episode 16

Welcome to Hope for Anxiety and OCD, episode 16. I’m your host Carrie Bock. Today on the podcast, we are talking about mindfulness with Dr. Irene Kraegel. She’s written a book on it and she leads people in how to develop a mindfulness practice. So I think you’re really going to get a lot out of this episode and I can’t wait for you to hear it.

So let’s dive right in. 

Carrie: Tell us a little bit about yourself and what you do. 

Dr. Kraegel: Thanks. My name is Irene Kraegel and I am the author of a book called The Mindful Christian. I teach mindfulness through a counseling center at Calvin University, which is where I also serve as a Director of the Student Counseling Center there at Calvin. I’m also a clinical psychologist by training. I’ve been a therapist for many years and I still do a bit of that on the side and also run some different kinds of clinical groups in the university. 

Carrie: Sounds like you have a lot that keeps you busy. 

Dr. Kraegel: Yes, there’s a lot of good work to do. I feel blessed by that.

Carrie:I also saw on your website that you do training’s on mindfulness sometimes for churches.

Dr. Kraegel: I do as part of my work connected to the book, then I often do speaking engagements or I have a workshop series that’s four weeks long, or sometimes people actually spread it out a little bit longer than that.

It’s really great for any kind of group setting such as a church or a Sunday school or a Bible study. I’ve done it in a retirement home before. That’s a great way for people to get introduced to mindfulness specifically from a Christian perspective if they’re interested in doing that kind of integration.

Carrie: That’s really interesting. Do you feel like the way that you grew up spiritually was very mindful or did that come later for you, like in terms of your spiritual practice?

Dr. Kraegel: I would say it came later. I think I was blessed to be in a few different traditions growing up that did acknowledge the need for silence as part of the spiritual journey. I learned early on that it was helpful to take long periods of time just to be present to God and to engage in different types of spiritual disciplines that you are more than just talking at God but also receiving from God. So I think all of that laid a really good foundation. I’m not sure that I knew exactly what to do with all of that silence.

So I knew that it was encouraged within the Christian tradition that I’d been exposed to, to practice silence, but I wasn’t really clear on how to use that well. I wasn’t really aware at the time of how cognitive my faith was and even in those times of silence, how much I was perhaps overly focused on thinking about God and developing words to say to God. Maybe even trying to hear words from God. I wasn’t really aware that that was even a framework that I was working out of. So I would say it was later after going through mindfulness training, really through a secular perspective that I recognize that there are other ways of relating to the world besides just thinking about it. And that became very relevant to my own faith journey as well, to realize that there were different ways of relating to God, besides just thinking about God or speaking to God. It’s really been my experience of mindfulness that has integrated with some of those early lessons I received in my own upbringing about silence.

It’s been that integration of the two that’s allowed me to feel more connected to God and maybe a little bit less conflicted. It’s about questions of faith and more just present to God in a more kind of communal way. So I’m very grateful for that. 

Carrie: That’s so good because I think I grew up in a faith setting that was more scholastic and it was a lot about learning about God and who he is and thinking and emphasis on even changing your thoughts to make them more godly so to speak. This idea of practicing silence or silence being valued wasn’t something that I grew up around, even though now I would say that I definitely value that.

I’m curious how you got interested or involved in this kind of vein of mindfulness.

Dr. Kraegel: Initially, it was really a professional interest. As I mentioned I’m a psychologist by training and really the mental health field has become very focused on mindfulness over the last maybe 15 years or so and it’s become recognized as one of the main approaches to dealing with depression and anxiety and also some physical concerns, chronic pain, different things like that.

I had been hearing about it working in a university context. I was aware that I wanted to bring the latest and best tools to the students that I work with there. At the same time, it was a time in my own life where I was experiencing some personal suffering and feeling that as circumstances in my life had actually come together and some really great ways, my mood wasn’t catching up with that. And so some of the grief and loss and difficulty that I had experienced in the past wasn’t feeling healed. I sort of felt like I was longing for a deep practice like it helped me to heal in some important ways and learn to experience joy and so both professionally and then also personally, I really felt drawn to this practice of mindfulness, knowing that it involved silence, but not just in a way of sort of gritting your teeth and bearing it, but more bringing us into silence with a specific set of guidelines and techniques that helped us to work well with that silence.

At that point I signed up for a mindfulness space, stress reduction course, which is a standardized approach to teaching mindfulness and found that through the consistent practices of that course and just learning about the framework, that attitude that we bring when we’re practicing mindfulness. Some of the underlying beliefs that all jelled so naturally with what I already believe in terms of my Christian faith, and also what I knew about psychology as a clinical psychologist.

It was a very transformational experience for me to go through that kind of training. I’m not a person who has great habits over time in terms of disciplined practices every single day. I’m always really upfront about that. You don’t have to be perfect. You don’t have to be the person that’s on your mat 20 minutes every morning and every night to get benefit. I always say I would get more benefit in that way and being exposed especially early on consistently coming to those practices. Even over a couple of weeks of meditating each day and trying on these new attitudes and approaches that mindfulness offered, it was a very transformational experience for me.

So when I bring it now to clients and when I work with students around learning mindfulness, I really do it right from a personal passion as much as a professional understanding of the topic. 

Carrie: People who are listening to this podcast probably have heard the word mindfulness or being mindful, and it’s somewhat of a buzzword right now. It has been studied and had good results in terms of what you were saying with anxiety and depression. What exactly is mindfulness? 

Dr. Kraegel: The concept of mindfulness is actually fairly simple. A quick definition is that it’s bringing our attention to the present moment, doing that with intentionality, and doing it with an attitude of non-judgemental, open acceptance, or whatever it is that we find there. So it’s a simple definition. It’s not an easy practice. So we all know that our minds tend to wander very frequently outside of the present moment, we really spend a lot of our time in general, thinking about the past and rehashing what’s already happened. What’s been said, what our experiences were, and then we often spend a lot of time in the future as well, imagining how things will turn out and both when our minds go into the past and when they go into the future. There’s a tendency for us to be wandering around and sort of negative thoughts or negative emotional States, either remembering the worst or preparing for the worst.

And so that’s not great for our mental health. It’s not great for our levels of happiness and contentment and joy. Mindfulness is this idea of noticing that our minds are doing that. We don’t stay in some perfectly present state of awareness all the time. As you said, we don’t have to be perfect with this.

It is actually sometimes helpful to debrief what’s happened in the past or to plan for the future. Mindfulness allows us to notice when is that movement of our mind helpful and when is it not helpful. And to over and over bring our awareness, our attention back into the present moment with quite a bit of focus here on our physical effects.

So we learned to notice thoughts, emotions, and often what’s grounding us is an awareness of our physical sensations. There can be a tendency sometimes to live life kind of neck up, to be lost in thinking lost in sort of a swirling rumination and so mindfulness included this expansion of our awareness to include our whole bodies. So we’re noticing what’s happening maybe on the bottoms of our feet or the tips of our fingers maybe noticing temperature, noticing clothing on our skin, noticing services that were in contact with. All of those things can have a very grounding effect for us emotionally as well. So the simple definition is it’s paying attention. It’s learning to pay attention to the present moment and as we do that, we are coming to the present moment with that attitude of curiosity, openness, non-judgment, and also with kindness and compassion towards ourselves and towards whatever we find in the moment. 

Carrie: Right. That non-judgemental stance piece is really important because sometimes we’re aware of what’s going on in the present, but we’re trying to dodge it and avoid it and hide from it and feeling states may be especially either feeling states or pain like “I don’t want to feel that it’s hard. it’s too much.” Mindfulness is a good way for people to increase their distress tolerance and in my line of work and working with a lot of people with trauma tends to prepare them for the deeper levels of trauma work.

Dr. Kraegel: Absolutely, there are so many ways that when we are experiencing pain emotionally or physically, there can be a very natural response of avoidance and it makes sense. We don’t want to hurt. So if we’re feeling pain, there’s a tendency to turn away from that to try to get away from it.

And one of the foundational philosophies of mindfulness is that resisting our experience as part of what creates added suffering in our lives. And so we can’t avoid experiencing pain that’s out of our control because every human being experiences pain. What we can learn to do is to notice ways that are our avoidance of that, and our resistance to that is actually increasing our suffering. So we talk about ways that our minds create their own suffering that goes beyond whatever is present in the moment and so just like you said, mindfulness is learning then to turn towards those experiences rather than avoiding them to be able to stay present to whatever’s there. That’s very difficult as you mentioned and in cases of trauma or other situations where we may be feel flooded by an emotion that’s associated with a memory, our bodies hold all kinds of experiences in them that sometimes can be triggered without our awareness, even. So when we learn mindfulness and learn to stay present to that, it can be very difficult. Mindfulness is not for the faint of heart. You mentioned it’s a bit of a buzzword these days and I think it has this implication that mindfulness equals calmness or that when we practice mindfulness, that feels good. That’s not necessarily the case. I compare it much more to exercise as someone who doesn’t love exercise myself. 

Sometimes when we work out physically, it feels good, and sometimes that’s pretty miserable, either way, we get benefit from physical exercise and mindfulness as much the same way. There are times where we do practices of mindfulness that lead us to feel calm and joyful and content and grounded and happy. There are other times where it’s miserable. Now, we’re just noticing all the thoughts. We’re noticing those painful emotions coming to the surface that maybe we’ve been trying to avoid. We’re noticing restlessness or just kind of a desire to stop whatever that practice is and even then there’s benefit because it’s bringing awareness to that present moment that has a healing effect for us, even if it’s uncomfortable in the moment, right?

Carrie: There’s this level I think sometimes when people try to practice mindfulness, which is counter to a lot of things in our society, because typically we’re focused on about five things at once and we don’t take the time to pause, but I think there’s this tendency maybe to wonder, “am I doing this right?” Or like you said, to try to make something happen, like, “okay, I’ve got to be mindful now, what do I do? what do I focus on?”

Dr. Kraegel: Yeah, absolutely and one of the things I noticed students saying as they’re starting to learn this practice is it’s not working. So we’ll kind of debriefing a mindfulness meditation and someone will say it didn’t work or it wasn’t, or they’ll also sometimes evaluate the practice in terms of, “was I doing it right or wrong?” And student might say, “I don’t think I was doing that.” 

The beautiful thing about mindfulness is that we’re learning to notice that pressure to do things a certain way to get things right and also that desire for things to be a particular way. So if we say a practice isn’t working, usually what we mean is I didn’t feel calm during it, or I noticed that there was unpleasant emotion there that I had a lot of thoughts. So fortunately mindfulness does not equal clearing the mind. It doesn’t equal being in some sort of perfect state of Nirvana somehow. Really it simply means being present. So you can’t mess it up whatever’s there, and we’re more learning to kind of give up that striving and that need to perform, or that need for things to be a certain way so that we can really practice being present to whatever is there. And for me, a lot of my passion has to do with incorporating mindfulness into the Christian journey. This is where I see this coming together so naturally is that I believe that when we are learning to let go of our grip on things, having to be a certain way, then we’re really creating space to start to notice what God is doing. So we’re creating this awareness of things as they are, where we can start to see God at work more clearly, but we have to get out of the way. First, we have to learn, give up that need to push and pull, and kind of force things to be a certain way. We have to give up some of that control so that we can see more clearly that divine work that’s at play in any given moment. 

Carrie: Sometimes that just means slowing down long enough to examine where God is at work in our situation and our world or surrounding us. 

Dr. Kraegel: Absolutely. For me, I think slowing down with an awareness that lets me receive things in a moment instead of just thinking about them, you kind of going back to that option to learn. There’s a different way of relating to the world, besides just thinking about it. So when I practice mindfulness, I’m recognizing that God is at work in this moment. It’s not about what I think about that, it’s more just, can I slow down and pause and have to open up my hands and receive whatever is there and so that physical groundedness of mindfulness helps here when I become present. For example, to the chair that I’m sitting on. This physical sensation of the chair and the floor that’s under my feet, that’s provision. I actually did not make this chair that I’m sitting on nor did I make this floor heater on right now. And so when I become aware of the solidness of that chair and that floor, when I connect with that and I become aware of my body is sitting upright in this place. These are all gifts that I’m normally not noticing unless I pause to bring my awareness into the present moment without judgment and then that becomes a spiritual practice. Different people may have different labels for that depending on their worldview. When I become aware of something like the chair on the floor, holding me up with so little work on my own part to make any of that happen, I then received that as a gift from God. This is a divine gift. That there were people in the world who made this house, who made this chair and I have this body right now that’s been given to me that I can hold up on this chair as I sit here. That’s a gift. I think that there’s extra power for me and recognizing that when we slow down and open up our awareness. There are gifts in every single moment for us to become aware of.

Carrie: In essence, it opens yourself up to gratefulness and thankfulness. 

Dr. Kraegel: Absolutely, and it’s different than deciding to be grateful. I do know people that seem to have that ability to intentionally turn their mind towards gratitude and that doesn’t come very naturally to me, just to say I’m going to be grateful today because as soon as I start to think of things I’m grateful for, it’s very easy for me to think of all the things that are going wrong. So like, “okay, I have this, but I don’t have that” or “this good thing happened, but that bad thing happened.” And so it can become our circle in my own mind. Practicing mindfulness, it’s a bit different in that it just gets me in touch with what’s right here right now so that there’s no power struggle around it. I’m not trying to think a certain thing about it, that’s grateful.  I’m simply receiving it and that really does then open up my heart to gratitude so that it’s not just a cognition, but it also becomes an emotional and even a physical experience to open up and receive that.

Carrie: I know that mindfulness really has its origins in eastern traditions like Buddhism. I think that has led some Christians to be kind of wary of it, or maybe they’ve been involved in a place where someone did a mindfulness exercise and it did have that Eastern Buddhist type bent to it. 

How do you see mindfulness aligning with the Christian faith?

Dr. Kraegel: Yeah, I think there are a lot of different ways we can approach that. And the definition itself is so simple that I’m not sure we can attribute it just to one religion or cultural tradition. Certainly Buddhism as a tradition that has highlighted present moment awareness and has really built a whole set of spiritual practices around present moment awareness and provided some really beautiful ways to pursue that. And present moment awareness is present in every major world religion. So really wherever people are seeking God, they are going to need to learn to be present in the moment. That’s the only place we can meet that. And so certainly in the Christian tradition, we can see the role of silence and contemplation and present moment awareness throughout scripture, throughout a variety of different traditions within Christianity. Even in modern times, there are some sort of older practices that are coming back that are becoming more popular lately that have this present moment awareness, very deeply interwoven in. So I think of things like the Ignatian tradition. That has a lot of language in it that very much overlaps with mindfulness principles, things like TSA worship, which has a very contemplative present kind of approach. Lexio Divina, where we’re practicing entering into the experience of scripture being read in the moment. Centering prayer is very much a mindfulness type of practice with God really as the object of our attention during those practices. So those are just a few examples, but really I don’t think any one religious tradition can say they have the corner on present moment awareness, but certainly, in the last few decades here in the United States, the popularization of mindfulness principles have very much come through that Buddhist tradition and that can sometimes make it more uncomfortable for people that don’t align with those beliefs or those traditions. And so I often talk about this in terms of culture and needing to be interculturally competent, and also to understand it’s always important for us to be sorting out the differences between culture and theology.

Sometimes when people are reacting to mindfulness with some fear. Sometimes people are fearful. Is this a new-age practice? Is this a Buddhist practice? Is this opening me up spiritually to something that’s not safe?

Then I think it’s important to take a step back and just look theologically at the concept of present moment awareness. Is there anything about present moment awareness that is dangerous in and of itself? And really the answer is no. So becoming more aware is a good thing and for anybody that wants to pursue God to be more fully aware and present to what God is doing right there in the moment is key. It’s crucial. And then from that foundation, there are all kinds of ways that we can integrate these concepts together. I think for me, one of the most powerful things is just recognizing that God is always present. When I’m practicing mindfulness, I’m practicing, being present that is putting my attention where God already is.

I do love in the Christian tradition that we’re often inviting God, maybe at the beginning of a church service, we might invite God to join us or ask the Holy spirit to come. That is beautiful and at the same time, God is already there. God is everywhere all the time. When we’re inviting God all we’re doing is acknowledging something that’s already true, which is like, God is here.

And so mindfulness wakes us up to that and this is kind of the foundation of where this integration occurs, but when we practice being present then we are aware of God being part of the present moment, that can only enhance our spiritual connection than with God and increase our ability to hear and to feel, and to be connected to this divine being. But recognizing that it doesn’t have to be about a certain set of thoughts or that really when we’re present in the moment to God, that’s kind of like being present to somebody that we care about. My husband and I have been married for 20 years. Sometimes we talk, sometimes we don’t and however I feel about him in a given moment, doesn’t change that. He’s my husband and he’s here and I think it’s kind of like that with God. So like sometimes I might be talking to God and we’re having a conversation and I’m feeling things or I’m thinking about things but whether or not that’s happening, God is still here. God is still God, I’m still me and so mindfulness just gives me a chance to notice, to look around and say, “Oh, God is actually right here already.”

Carrie: I want to make this really practical for people. So say someone’s listening to this podcast and they’re like, “yes, mindfulness sounds like it would be really helpful for me.”

Where do people start? How do they get started in developing that on a practical level in their day-to-day life? 

Dr. Kraegel: There are really two different ways of approaching mindfulness that go hand in hand. And so the first piece is a whole set of formal practices that have become kind of traditional, at least in the more modern Western manifestation of mindfulness.

And so a lot of these come out of mindfulness-based stress reduction, which is MBSR for short. MBSR is a very secular approach to teaching mindfulness and for people who really want to have some thorough training that’s often a great place to start. And so a training course like that is going to guide somebody in a set of formal meditation practices that include things like a body scan, where we’re going through our body noticing what’s present my sitting practice, where we’re tuning into our breasts and our physical sensations and noticing thoughts and feelings on sounds things like movement practices. So it’s not uncommon to do mindful yoga as a way of noticing this interaction between our minds and our bodies, as we move things like a walking practice, which can be done with other types of movement as well for people that don’t walk. And so that can help us bring our awareness to different activities or movements we might normally do just without even thinking about them.

So that’s an example of some common mindfulness meditation practices. Those are really best done with a guide, and there are lots of free mindfulness meditation guides online. I’ve collected quite a few of them on my website at themindfulchristian.com. Just looking I’m always on the lookout for guides that I think can be especially helpful for Christians who are either looking for some Christian integration or at least want something that’s kind of secular in nature that they can then integrate with Christian faith as they would like. And so learning those formal practices is important then to be able to develop that other aspect of mindfulness, which is what we generally refer to as informal practice. So if the formal practice is a little bit more like setting aside a certain amount of time where you sit or lie down, or you’re engaged in some kind of intentional practice, usually with a guide, then the informal practice is more bringing your awareness throughout each and every day back to the present moment. Whenever you notice you have an opportunity to do that and so informally in the course of the day. For example, I might choose while I’m brushing my teeth to tune into those sensations and notice what is it actually like to be brushing my teeth right now. What are the direct sensations that I’m experiencing during this simple activity that I do every day? Where are my thoughts going? What kinds of emotions are coming up for me? Or maybe just informally in the course of a day, I noticed a moment where I’m feeling a little emotionally riled up, so mindfulness and that moment might look like, let me kind of turn towards myself right now and just check in what are my emotions?

What are the thoughts that are here? What are the urges or behaviors that I’m noticing in myself what’s happening in my body? That would be sort of an informal, mindful moment and maybe taking a few breaths and then continuing on with my day.

Now the informal application of mindfulness is much more challenging if we haven’t done some of the formal practices first. I know I had started with the informal practices when I was first learning about mindfulness and did not find them particularly helpful. But I wasn’t really aware of how I was triggering and re-triggering thought patterns in my own mind during those practices and it really took me coming back and learning formal practices before I was able to become more aware of my thought triggers which really opened me up to practice informally. Now, I already mentioned that I’m not like the world’s biggest rock star at the formal practices. That’s easy. So they’ll see those as crucial in getting me started and also I know when I need those, so it’s kind of like drinking water where I have to pay attention to like, am I thirsty? I shouldn’t take a drink. And now I can notice those times where I really need to reach for one of those formal practices to make sure I’m grounded. So everybody’s balance of those will look a little bit different. Some people are very heavily focused on the formal practices and others work that in less frequently. It really is just a matter for each person of what they need, but I would definitely recommend that for people who would like to pursue this more, they either look into an MBSR course, if they’re feeling ready for that, or certainly just starting to go through some of the guides that we can find online. Practicing, dipping, our toes into it a little bit can be a great place to start as well. 

Carrie: And I will definitely put those links that you talked about in the show notes too. So if people want to look and dive into it a little bit more then they can. So towards the end of every podcast, I really like to ask the guests to share a story of hope, which is a time that you’ve received hope from God or another person.

Dr. Kraegel: Yeah, that’s really a beautiful question and I’ve given some thought to this because you did give me a heads up you would be asking me this and so as I’ve thought about hope for myself, I do think of particular stories from my life where things felt like all was lost and God came through. I’m thinking of all kinds of particulars like they were years for example where I had multiple pregnancy losses. I write about this in my book as well, too. Not really knowing how that would resolve. God brought us a child and we have this beautiful nine-year-old boy that we love. That’s something that brings me hope or to think about even just my own marriage as being something that’s a blessing to me after going through an experience in early childhood where my parent’s marriage didn’t work out. So to have a marriage now that feels solid brings me hope, but I say all that to say that I’m not sure that that’s what fuels my emotional hope.

I think what actually instills hope inside of my heart is these little tiny micro-moments of provision and the one that came to my mind when I thought what would be the story of hope that I would share is actually just something simple as my morning cup of coffee. I wish I could remember who said this, I know there’s a quote out there from somebody who talked about how his morning cup of coffee is what gave him hope for the world. I really think that there’s some truth in that, that when I bring a mindful awareness to the present moment around those things that bring me joy, something in the morning like a cup of coffee, smelling it, the warmth of the cup, recognizing all the people involved in bringing that coffee to me. All of the growers and the people who worked to process it and the people who packaged it and brought it around the world. The people who made the coffee pot. And I mean, you can kind of go on and on about all the people involved in something as simple as a cup of coffee, and then to be present to that experience that is what actually ignites hope in my heart. Those little things happen throughout the course of every day on those little moments of provision. Those moments of recognizing that no matter how lost things seem in the world, they will always seem broken in the world we live in, no matter how aware we are in any given moment or any given year of how challenging things are, there are still these small pieces of provision every single moment and that truly gives me hope. So that’s what kind of awakens my heart up to say, “Oh, I’m okay.” The world’s okay where I’m being given what I need right now. And I know that in every moment, moving forward, God will continue to give me what I need and that’s a hopeful thing for me. 

Carrie: That’s awesome. Thank you so much for sharing that. I think it’s just very relevant to what we talked about today. 

Dr. Kraegel: Certainly this particular season too as we’re kind of nearing the end of 2020 here, and it’s been a year where we recognized globally so many challenges in terms of health and mental wellbeing and injustice on so many different levels and so many layers of difficulty. It hasn’t been a year that we’ve been able to pretend that things are okay. So something like mindfulness, I think, has been crucial for me and recognizing that we’re not okay because we have it all figured out and we know what’s going to happen. We are okay because God is providing for us in each moment and so mindfulness really helps open me up to that awareness. 

Carrie: That’s so good. I think that the show was very helpful and informative and practical for people and I hope that it sparks a desire and encouragement for them to start practicing mindfulness on their own if they haven’t or if they have started it to know you can’t mess it up.

I love things that you can’t mess up. How great is that?

Dr. Kraegel: Yeah, well, I hope it is helpful for people and I think, you know, for people who pursue mindfulness, oftentimes it’s just finding the right style, the right resource. It’s a very simple concept, but can be practiced in a lot of different ways. So I hope that those listening will give it a chance. So thank you so much for the chance to talk about it today. I really appreciate that. 

Carrie: Yeah, thank you.

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I hope that you all enjoy listening to this interview as much as I did getting to talk to Dr. Kraegel. it was really insightful in how we can meet God in this present moment as he is always with us. That’s so awesome and such a beautiful part of our faith experience. 

Definitely check out the show notes on this episode If you’re looking for more information on mindfulness.

Would you like to give suggestions for future shows, hop on over to hopeforanxietyandocd.com and click on the contact page.

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

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

15. Supporting Your Anxious Spouse with Summer McKinney, LMFT

I haven’t done any marriage counseling since my internship in graduate school, so I asked my good friend Summer McKinney to be on the show to talk about how you can support your spouse who is struggling with anxiety. She provides some excellent tips such as

  • When is it a good time to pursue marriage counseling? Hint: not when most people do!
  • How to be present for your spouse
  • What they might need from you when anxiety hits
  • What to do if you are driven nuts by your spouse’s anxious behavior or OCD rituals
  • Anxiety as a third party in the marriage 

Resources and links:

Summer McKinney
Support the show 

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Transcript Of Episode 15

Welcome to Hope for Anxiety and OCD, Episode 15. I am your host Carrie Bock. Today we are talking about supporting your anxious spouse. I was able to interview my good friend Summer McKinney who is a Licensed Marriage and Family Therapist to have a conversation just in what do you do if you have a spouse who’s struggling with anxiety or OCD. How can you be supportive and helpful to them in that process while at the same time working through maybe some of your own frustrations that you might have with how the anxiety is affecting the marriage? I think there are some good takeaways from this one. So let’s dive right in.

Carrie: So tell us a little bit about yourself. 

Summer: My name is Summer McKinney and I have a private practice here in Smyrna in marriage, family, individual counseling and I’ve been practicing therapy for the past eight years. 

Carrie: Awesome. How did you decide to become a marriage and family therapist? There are many different types of therapists and many different specializations, and some people are licensed clinical social workers. Some people are licensed professional counselors and so you chose this licensed marriage and family therapy route. 

Summer: Yes. I started out working in church high school ministry as a high school girls director. I had gone through and got my master’s in education. I had taught missions and stuff, and God put me in that position, opened up those doors for me to be in that position. I was working a lot with youth and a parent had asked me as I was talking with her child and stuff, she said, “well, what are your credentials?”

I had always wanted to do counseling, but I guess not confident and stuff I had already gone through and I went back and furthered my education, secondary education, thinking that I was going to teach. In the back of my mind, I’d always loved counseling. My dad does counseling at a school corporation and so that was always kind of there but I was really nervous. Just not really confident like, “Do I have what it takes to go and get this degree?” And stuff like that. That kind of question, “What are your credentials” really hit me a lot because I wanted to be able to be credible in that. That pushed me to go and pursue the degree. 

I chose marriage and family because that just hits home with me more so. Relationships, working amongst the family system, the units that people are in. My parents did foster care when I was in high school and so just seeing how systems impact a child or a whole family unit whether does that family system itself or extended family or extended systems. To me, that just made a lot of sense. So that is why I chose marriage and family therapy. 

Carrie: It’s really interesting when you look at how much we’re impacted by other people and other relationships in our life. Looking at somebody as a whole person, who do they have surrounding them and whether that’s supporting them, or sometimes, unfortunately, that’s leading to some of the dysfunctional behavior that they have. It’s interesting to me to what you were saying of when that lady questioned you about your credentials. You already had a master’s degree in education, right? 

Summer: Yes. I’m a life learner, whether it’s back at school or just self- learning and it’s just me, I value education. I value knowledge. Of course, I totally agree with that saying “The more you know, the more you don’t know.” It’s just like, “Wow, there’s so much out there.”  I want to be able to say yes, I have the right to speak into this because I have training. I have knowledge. I have wisdom in this. It’s not just my opinion and so that especially I think in today’s culture is really important because everybody has opinions. Where’s the facts? Where’s the research? Where’s the truth and all of this but it can’t be found. Sometimes there’s multiple truths and things, but that’s really for me that’s something I value.

I think God used that to push me in that direction. Again, knowing that I was not confident in myself at that time and so he used the words of that parent to push me in that direction because I wanted it. I really did want it deep down. 

Carrie: It’s interesting how much overlap to between education and counseling because as counselors, we are educators, we are teaching people new skills. So we are informing them about research. We are talking with them about mind, body connection issues. So that definitely worked well together and you probably see how God has woven all of those things in your life to where you are now.

Summer: Absolutely. Just the marriage of the two. I do a lot of psycho-education and workshops and just speaking whether it’s a school or whether it’s a church. I just love that piece of bringing that knowledge to other people. It’s not like, “Oh, I’m this expert in this area” and counseling as well. You have the same skill sets and knowledge. It’s just we all have different population groups. We all have different spheres of influence that we can take this information that maybe other people don’t know, or maybe they know, but they don’t know how to apply it. I love the marriage between education and therapy. It’s one of my favorite things. 

Carrie: One of the reasons I wanted to have you on the show was to talk a little bit about marriage counseling because that’s not one of my specialty areas. It’s funny and a little bit comical to me that people sometimes will email me or call me and say, “Hey, I’m looking for marriage counseling and we really wanted you to do that” even though that’s nowhere kind of on my online listings or profiles. I’m like, “if only you guys knew the last time I did marriage counseling was in my internship over 10 years ago. I’m pretty sure those couples aren’t together anymore. This is not a good situation.”

Maybe you could answer a little bit for people who feel like they’re struggling in their marriage in some way, shape or form, how do you feel like people know when it’s a good time to pursue marriage counseling? Just in general. 

Summer: I actually start back and I tell people that are even just dating, don’t wait for an engagement to start premarital therapy. You can back up therapy. If you’re really serious, go ahead and go in and talk about some of the things.  Communication is huge. We all think, especially in the initial phase of dating like “yes, we could stay up till four o’clock in the morning talking to the phone.” We’re great communicators and really that’s just talk. That’s not necessarily communication. When you get married, things just exacerbate things from before that maybe were not that big deal, or maybe you just kind of laughed it off, or oh, that’s so cute that they do this. And it really, it becomes that petty that you just want to, “Oh my gosh, just stop.” 

Things when you get married, definitely get bigger. Having some of those tools. It’s just all about utilizing the skill sets and these tools in ways that are going to help build communication, help bring resolve when conflict does come or when there’s differences because you’re not marrying a duplicate of yourself. You’re marrying somebody else with their own background, their own experiences, sometimes their own beliefs, their own values. You can have shared values but a different priority of those shared values, which can create conflict. I think that any time during the course of a relationship it’s beneficial to go to therapy. Don’t wait for a problem to happen.

We take vitamins or we work out. We do all these preventative things in other aspects of our life. So go ahead and do care and enrichment in your relationship, whether it is married or engaged, dating. Go ahead and do those things because it’s only going to help it. It’s not going to hurt it.

Carrie: Right. I know for Steve and I, we had a little bit of premarital counseling and we also met with someone that I considered to be a mentor and it was nice to get some of those hard questions asked by an objective third party. So it would be like, “okay, tell us about a fight that you got in?” How did you resolve that? Or I think they asked what annoys you about the other person. And we were able to hear each other’s answers so that you didn’t just look at everything like it’s all flowers and rainbows and wonderful, like you said with kind of some of the honeymoon glasses on. I appreciate what you’re saying going when you don’t necessarily have a major problem. Maybe you just feel like you’re not seeing eye to eye with your spouse when you’re trying to communicate things and you might be able to learn some skills that could help you moving forward so that you don’t have to get into those big problems. I think sometimes people wait to get marriage counseling until one or both parties is ready to jet out. 

Summer: Right. It’s an ultimatum or the rescue itself. A lot of times there’s such deep wounds there that it’s hard to repair. I mean not always. I mean, don’t lose that hope but it is hard if you keep pushing those things off.It doesn’t get better.

I’m glad that things are changing. The stigma around therapy is improving. The stigma around mental health is it’s getting better. We’re not there yet but I’m so glad that people are open. So many of my clients are like, “I tell everybody that I go to therapy because I want them to know that it’s okay.”

And I love that they feel free to do that and so many of their friends have looked up a therapist in their area to talk with. That just makes me feel good knowing that something that I do is helping another person and that they are then helping other people by normalizing that piece of therapy.

It’s not just when things are bad or you need mental health or whatever it’s like. This is really good for just health for life. 

Carrie: Yeah. That’s so good. I think that was one of the reasons that we’re on this podcast, talking about these things too, is because a lot of times in the church, maybe people haven’t heard those positive messages about therapy, or they think they have to have it all together because they’re a Christian and really we’re just broken people trying to follow Christ and figure out life and how to pursue Him and the calling that He has on our lives.

So that’s so great. The points that you pointed out about we are reducing stigma but we also still have a little ways to go too.

So we’re talking about supporting your spouse when your spouse has anxiety or OCD, or I’m sure some of these things apply for other areas as well like depression. I imagine maybe there are spouses who want to be supportive, but they feel paralyzed or like, “how do I really help my spouse with anxiety?” What kind of thoughts or advice do you have on that? 

Summer: Sure. I think the first thing is to listen and be that support. Listening to hear what are the needs. Don’t be dismissive or minimize the fear or the concern that’s there. Just being able to be a sounding board for them. When you come along you’re like, “Oh, that’s silly. Don’t worry about that.” You minimize something that is very real to them. I think it’s really important just to be that support. You had mentioned Carrie, about being in the church and things around stigmas in the church. A big one that I come across a lot with that anxiety is that “you’re just not trusting God” or “you’re just not praying enough or maybe your faith isn’t strong enough” and that creates even deeper wounds especially if it’s a spouse coming in and bring up or that positivity piece, “You just gotta be positive and think positive.” People with anxiety or really any kind of mental health issues, they don’t want this. They didn’t ask for this. To come at them in those kinds of negative ways just creates even more shame. I think being a good listener, being a good support for them through that is just really foundational. 

Carrie: I think we underestimate whether it’s in our relationship with our spouse or in friendships or in people that we encounter in the church.

I think we underestimate the power may be of presence, of just giving our time and our attention and really listening. Not listening for what’s the right answer, “Do I say back to you?” But listening for like, “I hear you. I see your story. I’m so sorry that you’re struggling with that. How can I help you?”

Summer: Absolutely. I think we are in a culture that’s busy. We strive to achieve and there’s so much stress. We wear stress as a badge of honor. 

Some of the things that I do with my clients is it’s just helping them to be present and to be able to know their bodies because we’re just so accustomed to stress that it’s normal. It’s like, wait, that’s not normal. Just because society or culture say that this is normal to feel this way but no. You need to be able to hear your body and, you know, “Oh my shoulders are really heavy. Okay. Well, I need to be able to rest or decompress or find some peace” because stress creates a whole lot of health issues. It can further that anxiousness. I think stress, the busyness, we don’t have time for people. We do those, those cordial, you know, “We’re in the south

and so it’s, “I’m just being nice and asking, but I don’t really care.” “How are you? If you go beyond fine. “I gotta go here or there.” And so we’re really missing connection on those deeper levels and so I do think that even a family unit could be like ships passing in the night with whether it’s kids or work and different things going on.

Being able to take time for each other to hear each other, to be present, as you said. It’s okay to not know, it’s okay to be there, “I don’t know what to say to you.” “I don’t know how to help.” I say that sometimes even just those words, “I’m not sure what to do” can be refreshing because too many times, people try to come and fix it. [00:17:32] I don’t need a fixer. You need somebody who can just be in it with you. 

Carrie: Right. Do you find that, not to pick on husbands, but I think sometimes husbands tend to be more of the fixers and women tend to be a little bit more emotional. Do you find that husbands a lot of times want to put a bandaid on it or say like, “Hey, it’s okay” or “Oh, don’t worry about it.” And they’re trying to keep it like you said, “positive and lighthearted” but really what the woman might be experiencing is, “Oh, he just totally dismissed what I just said or my feelings.”

Summer: I know that there is the stereotype of men being that way and women. I think it’s more personality because “I am the fixer” trying to help him fix things, but I’m the one that tries to solicit that advice that’s most of the time unwanted. I think it’s more of the personality traits that come into play on those things and so it’s being mindful. It’s being aware of, “okay, I need to step back. It’s not about me trying to fix it.” That’s not what that person needs. Well, actually, what I need to do is ask them what they need.

It’s both on communication. It’s the job of the person who is presenting whatever symptom it may be, whether it’s anxiousness or depression, or anything to communicate, “Hey, this is what’s going on with me.” And it’s also on that end of that person who’s receiving and hearing this, or even saying it to say, “Hey, what do you need?”

How can I help you?” rather than inserting what they think is needed because what I would want can be completely different than what my husband wants. And honestly, most of the time it is completely different than what my husband wants. So I think we need to do more of asking than assuming or fixing how we would want it fixed.

Carrie: I think you bring up a good point there of like support looks different for different people. And I don’t know if that’s related to love languages at all, but for some people, they may want someone to talk them through a situation. For other people, they may just want that person to not really talk a whole lot and just let them vent or let them get it out.

And so by saying, “What do you need me to do?” Like for example, when you’re having a panic attack, “how would you like me to respond?” “What do you think might be most helpful?” That person may not know right away. There may be some trial and error that has to happen in order to figure out what works best.

Summer: And that is a huge piece of being able to identify “What is my need?” This goes beyond me. This is anybody. When I can identify my feeling, what is that feeling communicating what’s going on? What is that anger saying? Or what is that fear saying? [00:20:52] And then being able to say, “okay, what does it need? What do I need?” Sometimes you’re right, we are not sure what it needs and how to help ourselves, but sometimes we do sometimes it’s “I just need a hug.” “I need that reassurance.” And it is scary to communicate that because we fear rejection. As people, no matter what age we are, we fear being rejected [00:21:18] and so it can be scary to communicate those feelings and those needs at that moment, but if we don’t take the risk and this is a huge part of marriage therapy is we have to take the risk to be vulnerable because if we don’t take that risk, then we’re totally missing out on something that could be amazing and great. The very thing that we need is that support, we could be missing out on that. 

Carrie: Yeah, it’s so good because I think a lot of times people may have been in situations where they felt guilt, either over having needs or guilt over expressing their needs. Sometimes telling clients it’s normal to have needs, that’s a part of being human and not only is it normal and okay to have needs, but then it’s okay for you to ask someone else for what you need. And that doesn’t make you selfish or an awful person, but sometimes we can get in this caretaker mode of that causes and creates insurance up anxiety of “okay I have to take care of everybody”

and then myself is like totally last. I don’t take care of myself and then nobody’s advocating for myself or what I want or need. 

Summer: Yeah. That self-care is so important. When you get on an airplane, put on the oxygen mask first, before you get other people, and it goes against our instinct especially if you’re a parent with children. It goes, we want to

[00:22:59] get to them first that were of no help if we passed out. And so that same thing in your relationship, or as a caretaker, any of those aspects of dynamics that come into play, if you’re not making yourself a priority, you are not going to be the best version of yourself that you can be for your family unit, for your relationship and so you have to have self-care. You have to make yourself a priority in that. I do want to say when you are being vulnerable and sharing those things, you need to make sure that it is a safe person. If you are in an abusive relationship or a relationship where there are certain areas that maybe it’s not safe emotionally or spiritually or mentally. That would only do further damage. 

Some of these skill sets, being vulnerable, sharing the needs and stuff, it’s important to be in that safe environment because if it’s not a safe partner or safe family member, it’s only going to cause more damage. 

Carrie: Absolutely. I think there may be people who are in situations as well that aren’t necessarily to that extreme where they’re unsafe, but they may feel like, “Okay, I’ve tried to open up to my partner before, or I’ve tried to talk with them about what’s going on with me and it just kind of falls flat” or “I don’t get the emotional response or the support that I’m looking for.” I think in those situations, it’s really great as far as having a marriage counselor who’s a third party to be able to comment and say like, “Hey, did you see what your spouse was just trying to communicate to you there?” You see what you need from this person now and it helps bridge a gap of communication for them to be able to receive that support. 

Summer: Absolutely. I think that part of my job is to feel those pieces where things maybe start to heighten a little bit, soften those areas, and allow that emotional engagement in a new way to take place. Because so many times we are in that negative mindset that it can’t happen because “it didn’t happen before and see all those times in the past when we tried and I was minimized.” And so being able to allow a new experience of doing that is still important. That’s why therapy is really great to help give new experiences to the old so that you know, “we can do this.” You’re setting up some wins in there for the relationship and it’s so beautiful to see those happen and the connection and just the love that takes place whenever couples finally, “Oh wow. He does care.” “She does respect me or love me and value me.” It’s just so neat to see some of those things take place because a lot of times these wounds have been going on for years and so to finally be met with what you’ve been desiring all along, it’s just beautiful to see. 

Carrie: Yeah. I know too that there can be situations and maybe you’ve experienced this with some of the couples that you’ve worked with, sometimes anxiety can drive the other spouse a little nuts because they feel like either the person who’s anxious is maybe asking a lot of questions or they’re trying to control things out of their anxiety. [00:26:56] They may be asking for a lot of reassurance and it might be exhausting or wearing on that spouse. And I’ll throw into for OCD, sometimes people with OCD will rope their spouses into their process, into some of their compulsions and want them to engage in some of those with them. So I guess talk a little bit about that. Maybe some help for those spouses who feel like I’m just being driven badly by this anxiety. 

Summer: I think it’s really important to have boundaries. Sometimes those can be hard to define and so I think again that can be where therapy can help. Individual therapy for the person with the anxiety, so that they can gather their own coping mechanisms and skill sets. Those self-regulating self-soothing kind of skill sets. Couples therapy can help them to communicate together, to help establish some boundaries. It’s not that you can’t ask any questions, but when you have 30 questions, that is exhausting.

Rather than being dependent on that person to rescue you or to somehow fix or change what’s going on, being able to say, “okay, what do I have within myself to help me where their support is an aid to it.” So the partner is not the savior, not the rescue.

It’s really important when you get into knowing your cycle. So if you’re anxious, knowing your anxiety cycle, that’s there knowing your couple dynamic and your couple cycle. There is going to be really important too because then you can start to identify it earlier and catch it before it spirals and so that’s really important too is to identify that.

Carrie: I think probably one thing that would be really loving for a spouse maybe to say to someone is, “Hey, I’m noticing that this topic of conversation or this situation that you’re dealing with, or maybe a problem that we’re trying to solve, it seems like, it’s ramping up your anxiety.” Because the spouse may notice possibly before the individual that they’re getting anxious, just depending on people’s awareness levels. A lot of times people can see things we can’t see in ourselves. 

Summer: Yeah. It’s when we identify those pieces, sometimes the other person’s maybe not aware of it, but we’re on the outside and we can maybe bring that to attention or if that person identifies those pieces, being able to communicate that. So for example, my husband deals with some anxiety. At night, if I bring up bills or money or financial talk, like it just kind of just gets his mind, he has a hard time shutting it down and so I have learned, and sometimes I have to be reminded not to talk about this at night. For me, I’m just so busy through the day that whenever I’m finally in bed and my mind coming down from the business of the day, all of the different things start coming into play and I’ll be like, “Oh, hey, did we?” and I’m gonna be up for a little bit longer just processing for himself.

We need to be respectful of the requests of our partner, whether it’s, “Hey, at this time of day, I don’t want to have these kinds of conversations” or, “Hey, I get really stressed out” or “we go on a trip.” I’m kind of a crazy person before we go on vacation. I want to make sure the house is good.

So whenever we come back home, I don’t have to do any cleaning, you know and just packing and all that kind of stuff and so my husband knows I just sometimes need space and so if he takes our child and goes out for a little bit just to give me the house to myself so I can be my crazy self by myself for a little bit.

It’s kind of knowing the needs of your spouse, knowing your spouse and being able to respect and give that space or whatever the request is that they have to help them in that process, whether it’s just stress or whether it is that full-blown anxiety or those panic attacks.

You know, if it’s social anxiety being able to say, “Okay, here’s a code word that we have a little bit like I’m, I’m starting to feel certain things.” Let’s start heading out kind of a thing. So it’s not like everybody else, you know, cause embarrassment is a big thing. It’s just between you guys, “Okay. I heard the code word. All right. We’re going to celebrate it by and we’re gonna start to head out.” 

So there’s different ways that you can accommodate and support each other based on those requests, those needs. It’s both communicating when you are aware of those things, but then also for the partner to maybe inquire like, “Hey, I’m noticing this, do you find that to be true for you?”

That way, because you’re exploring it together you’re a unit. Anxiety can be like the third person in the marriage. The worst thing is just to dismiss it and act like it’s not there. Acknowledge it and give it a name if you want to. I have a client that her anxiety is called “the jerk.” The jerk went with me today to the grocery store and I love it and I encourage that even the couple dynamic. Rather than pitting at each other, the blaming, and stuff like that, let’s call our cycle. It’s the cycle doing this. It’s not you. I think that that can really help to alleviate because it is a third-party in the marriage. It is a third party in the relationship and so I think that being able to put that some shift, that blame so to speak where it goes rather than the person allows room for grace. 

Carrie: Yeah. That’s so huge because if you look at it “as my spouse is not what I’m fighting against” like I’m wanting to maybe work with this anxiety and manage it differently, not my spouse. And so that takes the attention away and maybe eases some of those conflicts that may occur. I think accommodating each other in marriage is a huge thing and being willing to sacrifice your own interests at times. You may want to stay at the party for three hours, but you know, you’re like, it’s going to be amazing for your spouse to tolerate one hour. Sometimes you may just have to be like, “Hey, let’s just go to the party for one hour or we’re just going to quickly drop in and drop out.” And it’s not a big deal, but also encouraging someone with maybe some social challenges to still get out there, “Okay. Let’s not stay home because that would just be giving into the anxiety.”

Summer: Yeah, that only perpetuates the cycle. I think it’s identifying that there is a shame piece that comes into play here. You feel bad that you are impacting your partner’s life in this way. You feel guilty about different things and then you feel just an adequacy of yourself as well. And so while you’re trying to find relief from the negative and unwanted feelings that you have, the way that your partner interacts with you can really make a difference on that shame piece because it can perpetuate it. If you come at with those accusations or just that resentment and that bitterness, it can really perpetuate those wounds that are there.

Carrie: Right. So we talked a little bit about listening to your spouse. We talked and he like really, truly listening saying, “how can I help you and support you in this?” Maybe sometimes making compromises or meeting halfway there. Anything else that you’d add to that advice?

Summer: I think just the acceptance. Accepting them, accepting your partner for all who they are. That’s important regardless of having anxiety or not having anxiety. I think sometimes we forget, we only see the negative things that come into play or the external stressors that impact relationships and family units and we forget the good. And so I’ve seen loving, accepting all of who they are and anxiety is a piece of who they are. It doesn’t define them. That doesn’t define who you are, but it shapes an aspect of who you are and so being able to accept that piece of them and loving them through whatever episodes or symptoms they are displaying. It kind of goes back to just some pieces of those attachments of feeling worthy, feeling loved, valued. 

As spouses, as partners, as family members, as we interact with each other, being able to dig down into those deeper aspects of acceptance and love and, and worth I think that’s just really huge. 

Carrie: We don’t realize how accepting people where they’re at is transformative. We think if I accept you where you’re at then that means you’re just going to stay stuck, [00:37:24] but really it’s that beginning point that stirs up something within you of like, “I want to grow. I want to be a better person. I want to have positive outcomes because this person is really seeing me for who I am and they are totally loving me and totally accepting me and now I want to be a better person.” I think that that happens in marriage. I really think that that’s a parallel of what happens in our relationship with Christ, like part of this sanctification process. 

Summer: Yeah. I totally agree. It makes me think of Paul in Acts and he comes across, I can’t remember the name of the man that he was baptized by John the Baptist and he was teaching and he was having people that were coming to followers and he was teaching, but Paul approached him and he was like, “No, you stopped. You heard from John the Baptist and then you just stopped and you didn’t know about Christ.”

I mean he just stopped right there and it’s like, “Whoa! no hope.” A whole bunch of stuff has happened since then but he was stagnant. He was stuck at so he was misleading people based on the very limited information and things that he had and so Paul was able to tell him the truth about Jesus Christ and even John the Baptist pointed to Christ. He didn’t just stop there. I think that is so true. Don’t stop. Don’t stay where you are, even as a believer, don’t just, “Okay. Yep. I already know about Jesus. I know this. I know that. I’m good. I’m good.” It’s like, “Whoa, but you’re missing out on so much more.” 

I think that when you look at relational health, sometimes we’re like, “Yep. I got the tools. I got the skill sets. I’m done. I’m good” but wait, you’re missing out on so much more just because you have these things here. Are you actually applying it? Are you continuing to grow in that? Education is so huge with anything but especially mental health. 

I’ll ask people when they come in and said, “Okay, so you got this diagnosis. What do you know about it?” I am sometimes surprised at some people like, “I don’t know. This is what I was told.” And I was like, “okay, let’s explore.” or I will have a partner who says, “well, this is my wife she struggles with anxiety.” And I’m like, “okay, well, what do you know?” And like, “no, that’s her thing” like, “I don’t need to educate myself about it. I live with it.”

I’m like, “No, you need to educate yourself as well” and really that speaks volumes to your partner. If you were to say, “wow, okay, let me learn about this. Let me get in a support group with people who are married to somebody with bipolar or anxiety.” It builds a deeper support of like, “wow, you’re actually trying to understand me” and not just that, but you are accepting this part of me. You’re not just in this denial that this is going on. You’re actually accepting this and you are wanting to learn more about it, which is going to benefit the marriage itself. 

Carrie: Right. Absolutely. I love that. So we’re kind of winding down towards the end. So I’ll ask you the question that gets asked of everyone on the show. So since it’s called Hope for Anxiety and OCD, I’d love for people to share a story of a time in their life where they received hope from God or another person. 

Summer: It’s hard to narrow. I don’t wanna say narrow it down, but when we actually stop in and give that gratitude and that praise. It’s just amazing how much God is in the detail of things. A  lot of times when I think of the hope or just the faithfulness of God in my life, I have to look at my own marriage. I was single until 28. I got married at 29. I came from a very large family and always wanted many children and of course the older I got, I could do the math in my head. “Okay, Lord, this isn’t like going to happen. Of course, that was before like people in their forties started having kids and stuff but there’s like, “okay, wait my large family is going to happen” but God was in the details of my husband and I knew each other from way back when, but just went our own separate ways but we reconnected. I inherited three amazing children in our marriage.

My deal breaker was I wanted a child and so if my husband were going to get married, he would have to agree that we could have a child together and he said, “okay”. So again, “Okay, Lord. I have three children and I want that camaraderie. I want them to grow up with a younger sibling.” And so my timing was shortly after, “let’s settle in to married life and blended family life,” but few years were going by and it’s like, “Okay, Lord, is this going to happen?” Just a lot of questions. My husband kinda gave up like, “okay, it’s not going to happen around him” and it took us a few years. God knew again, being in the details and perfect timing. The bonding that I was worried about. The boys were in high school whenever we had our son and through college, one of the boys stayed home and commuted and the bonding was just amazing.

It was just all of those fears and all of those concerns or those questions. It wasn’t my timing but the timing was just perfect. It wasn’t always my way, but God knew what he was doing and just being in the details. And so that to me was just the hope of a large family, the hope of the bonding and that unity among the family and God just blessed it. When those doubts or when fears or things come into play, whether you’re single or whether you’re in an empty marriage or divorced, and you still have that desire I think that God is in the details and his timing is amazing. It’s not always our time where I think about the big things in my life where desire and hope and blessing come together. I would say it’s definitely my family unit.

Carrie: It’s amazing how God will give us those desires like for you it was for to have a large family and God totally filled that in a way that you couldn’t have imagined at that point in time like you were thinking that all of those children would be completely biologically yours and you ended up with a beautiful family picture and it’s amazing how God’s dreams are much better than things that we could dream on our own. And when we try to do it our ways or in our timing, it just never quite shakes out and we can become disappointed. I appreciate that story cause I do believe it’s hopeful and will be hopeful for many people listening.

Thank you so much for taking the time to be on the show and share your wisdom with us now. 

Summer: Thank you for having me here. I appreciate that. 

____________________________________________________

Summer and I have had lots of conversations off the air about reducing shame and stigma in the church in regards to mental illness. So it was an absolute treat to be able to have some of those conversations on the air to be able to share those with you all.

I wanted to share some feedback that I received today regarding the podcast. Erica writes, “I enjoyed your first podcast about your life. It was so inspiring. It had it all. I laughed. I cried and I got goosebumps with your transformation.”

Thank you so much Erica for sharing that. I really appreciate it. 

If you want to share what the podcast has meant for you, you can either write a review or you can go on hopeforanxietyandocd.com and reach me in the comments section. 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.

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

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

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

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

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

By The Well Counseling

More Podcast Episodes

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

Transcript Of Episode 13

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Carrie: It just makes the problem worse. 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Hope for Anxiety and OCD is a production of By The Well Counseling in Smyrna, Tennessee. Our original music is by Brandon Mangrum and audio editing completed by Benjamin Bynam.  Until next time.  May you be comforted by God’s great love for you.

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.

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.

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