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Tag: OCD treatment

139. Is There a Test for OCD?

Carrie explores whether there’s a test for OCD and delves into the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Version 2 in this insightful episode.

Episode Highlights:

How OCD assessments can help differentiate between OCD symptoms and other mental health or spiritual issues.

What to expect from the Y-BOCS assessment

The benefits of using assessments like the Y-BOCS 2 to guide treatment decisions

The importance of getting a formal OCD diagnosis from a trained professional.

Episode Summary:

Hi, I’m Carrie Bock, your host of Christian Faith and OCD. Today, we’re diving into an important topic: the YBOCS (Yale-Brown Obsessive Compulsive Scale) and its role in OCD assessment.

In this episode, I’ll explain how the YBOCS 2, an essential tool in OCD treatment, helps identify and measure obsessions and compulsions. This assessment, which you can complete on your own, provides insight into the severity of your symptoms and guides our therapeutic approach. I’ll share how it’s used at different stages of treatment and why it’s crucial for understanding and managing OCD effectively.

Understanding your OCD through assessments like the YBOCS can clarify your symptoms and improve your treatment plan. It’s not about labeling but about gaining insight into your struggles and finding the best path to healing. If you’re interested in learning more about my services or scheduling an intensive therapeutic retreat, visit carriebock.com.

You can learn more about my services here.

Related Resources:

YBOCS (Yale-Brown Obsessive Compulsive Scale)

More Episodes to Listen To:

Episode 139. Is there a test for OCD? Hang on, you’re about to find out.

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

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

We have our first Zoom hangout coming up next week. This is where we let individuals on our email list submit questions for me to do a q and a chat with you once a month. We’d love to have you join us, and there’s still just a little bit of time to hop in on that to be in the know and become an insider.

Join our email list@carriebach.com. I wanted to talk with you today about an important OCD assessment called the YBOX 2. This stands for Yale Brown Obsessive Compulsive Scale. It’s in its second version. We’ll put a link in the show notes for you if you’d like to take it. It can be completely done on your own.

The first section talks with you about obsessions that you may be having and you can answer yes or no depending on your experiences with those. I like it because each one has a little bit of an example with it too that helps. There are questions right after that ask you to rate on a zero to five scale how severe these obsessions are bothering you.

Then the next part of the assessment has to do with compulsions. And once again, there’s a zero to five scale on how badly they’re bothering you or impacting your life. This assessment is scored from 0 to 50, and a lot of times we find it helpful in the counseling process. Usually I’ll give people the Y box at the beginning of treatment.

We can also look at it maybe in the middle to see if what we’re doing is working or see if we need to switch course at all. And then it’s a nice follow up at the end. I don’t usually necessarily give it to people at the end, but if they wanted to see how their scores decreased or were impacted over time, that would be a good objective measurement for you as you’re going through your process.

It’s interesting to me how many people I’ve talked to that have received OCD treatment before, yet never been assessed with an assessment like this, or maybe they did and don’t remember. When we know how much OCD is impacting someone, we can make guidance and recommendations regarding next steps for courses of treatment.

It may be an objective way of saying, hey, this is really impacting you. Have you thought about getting on medication? If the score is very high, it may be a conversation surrounding intensive outpatient therapy or if the person’s just really not functioning well in their environment, they may need some type of residential program until they can get to treatment.

a place where they can function well enough to be at home or to be back in outpatient treatment. Obviously, we want people to receive the best care as possible, so they’re getting everything they need, while at the same time balancing that we don’t want someone to be in what we’d call a higher level of care, like intensive outpatient, if they don’t need to be.

If they can manage their symptoms at home with medication and outpatient therapy, that’s the ideal, right? One thing I hear from people after they take the Y Box, clients that have come in, will usually tell me, wow, after taking that and seeing all the different examples of obsessions and compulsions, I didn’t realize how many of these things were OCD.

I had chalked some of them up to maybe anxiety. So even just taking the assessment provides a greater level of awareness sometimes for people. I find the majority of people with OCD who are coming into therapy are what I call self diagnosed. They found something like this podcast or they found blog articles or talked with other people maybe that have had OCD who guided them down a pathway of receiving information.

I think all of that is very helpful and beautiful because People didn’t have that type of information at their fingertips regarding mental health 20 years ago, probably not even 15 years ago, the same amount of information that’s out there now. It’s not uncommon for people to seek therapy and tell me, I think I have OCD.

But I’ve never been formally diagnosed by a counselor or by a psychiatrist. Having this objective measure of the why box gives us a glimpse inside of what people are thinking and feeling without them having to necessarily name every single obsession they’re having. That’s another thing that I like about it.

It’s a lot easier for someone to click, yes, I’m having harm obsessions. then to verbalize those things to a therapist, that can be really difficult for people to express. If you have a child that might have OCD, there is also a child version of the Y Box, and the questions are better worded and suited for children.

Other assessments that I am not as familiar with are the Dimensional Yale Brown Obsessive Compulsive Scale and the National Institute of Mental Health Global Obsessive Compulsive Scale. So you may be asking yourself, why does it even matter if I have a diagnosis or not? What’s the benefit of having a diagnosis?

I OCD I really struggle with this concept of do I have this OCD diagnosis or am I making excuses for poor behaviors, whatever they determine the poor behaviors to be? Am I saying it’s OCD when it’s really a spiritual, moral issue? Am I saying it’s OCD when really I’m just being reckless, careless, or negligent in some way?

Is it OCD or relationship problems? This is exactly the benefit of a diagnosis. If you sit down, talk with a professional who’s trained in OCD, take some of these assessments, explain to them your symptoms. We don’t just base diagnosing on an assessment, obviously. Obviously, we’re going to talk with you and find out what your experience is like.

Take those two pieces into consideration before making a diagnosis. It’s not about just giving someone a label. It’s about helping you understand and explain your symptoms, helping you know why your brain works the way it does, how it’s getting stuck on certain things, what you’re engaging in to try to relieve that anxiety.

So oftentimes these assessment tools are really the first step in treatment to say, okay, here’s where we are and where can we go from here? It’s very similar. If you went to the doctor and got some blood work done and they said, hey, your A1C is high. Let’s try these lifestyle changes or let’s try this medication, whatever you’re going to throw at that first that you and your doctor determine, and then you’ll go back for blood work in a prescribed amount of time to check your A1C to see if it’s gone down.

It’s the same thing that we’re doing in a psychological sense of, okay, where are you at right now? What’s the best method of treatment for you considering your symptoms? And then we’ll reassess. We can always circle back around and say, Hey, is what we’re doing working? Is this medication that you’re on working?

Is the therapy component, are you really able to utilize the skills that you’re learning? Is that working? Do we need to try something different? Do we need to look at a different kind of care for you? I would encourage you not to see assessment or a diagnosis as a bad thing. It can be a really good thing and a good first step in your journey towards a healthier you.

If you’d like to see what services I provide, you can always go to karybach. com. I would love, love, love to book some intensives this fall, so if you are ready to dive into the deep end of the pool, work through some OCD, tackle some trauma, if that’s part of your story, then I’d love for you to schedule a consultation and we’ll talk about how an intensive therapeutic retreat may or may not be right for you.

We also have a previous episode on this. If you want to go back and listen to it. Until next time, may you be comforted by God’s great love for you. Were you blessed by today’s episode? If so, I’d really appreciate it if you would go over to your iTunes account or Apple Podcasts app on your computer if you’re an Android person and leave us a review.

This really helps other Christians who are struggling with OCD be able to find our show. Christian Faith and OCD is a production of By The Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.

111. Using Humor with ERP with Judy Lair, LPCC

This week, Carrie is joined by Judy Lair, a licensed professional clinical counselor specializing in OCD therapy, to explore how to use humor in ERP therapy and how laughter and creativity can be powerful tools in overcoming challenges on the journey to healing from OCD.

Episode Highlights:

The use of humor and creativity as powerful tools in overcoming anxiety and intrusive thoughts.

Customizing ERP techniques based on individual interests and strengths.

Strategies for incorporating creativity to confront OCD challenges.

Insights into the sanctification process and the choice between living in faith or seeking constant certainty in managing OCD.

Episode Summary:

Welcome to episode 111 of Christian Faith and OCD! Today, I’m thrilled to have Judy Lair, a licensed professional clinical counselor, with us to delve into the use of humor in ERP (Exposure and Response Prevention) therapy.

Judy’s journey into specializing in OCD began from her own experiences with anxiety and a background as a litigation paralegal. After a transformative period working with a psychiatrist and discovering her passion for counseling, she transitioned to working in OCD therapy. Judy’s approach incorporates humor as a tool to help clients navigate the challenges of ERP therapy.

In this episode, Judy shares how she uses analogies, like the haunted house, to help clients understand and manage their OCD. By embracing humor and creativity, she empowers clients to face their fears in a more light-hearted and less intimidating way.

Judy also discusses the importance of recognizing OCD’s inaccurate threat levels, likening it to a malware virus that skews our perception of danger. Her innovative methods, including using personal interests and humorous visualizations, make ERP more accessible and less daunting for those struggling with OCD.

Tune in to gain valuable insights into integrating humor into ERP and how it can make a significant difference in the therapy process. Don’t forget to subscribe and leave a review!

Related Links and Resources

www.treatmyocd.com/therapists/76492/judy.lair
Jusy Lair’s Books on Amazon

Explore related episodes:

Welcome to Christian Faith and OCD, episode 111. Today on the show, I have with me Judy Lair, who is a licensed professional clinical counselor, here to talk with us about using humor in ERP therapy. We had a previous episode on ERP that you can go back and listen to; we’ll link that episode in the show notes for you, where we did just a brief overview of what it was. It was also a personal story from Stacy Quick, sharing some of her experiences with OCD and how she became an ERP therapist. Stacy was a therapist we met through NoCD, and we talked about that on that episode. Judy also works with NoCD. 

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Carrie: I’m  happy to have you here today on the show.

Judy: Hi, Carrie. I’m glad to be here. Even with this not being my real voice, I think I can still talk.

Carrie: Yes, she is recovering from a cold here, so thank you for bearing with us on that one. I heard you speak at the AACC conference. That was how we met, and it was exciting to see how many Christian therapists were there interested in a presentation on OCD. That’s not something often covered or has been covered, I guess, at that conference.

How did you specialize in OCD? How did you get that to be a specialty?

Judy: I’ve had a lot of different types of jobs in my life, but one of the things was when I was on the other side of the couch, working through my anxiety and such for about a year, talking to me like, “You can do this, you can be on the other side of the couch.” I’m like, “No, here’s a whole bunch of reasons why, no, it’s not going to be me.” I was never one of those people that everybody came to for advice and stuff; that’s not me. Much more cognitive, I’m much more thinking about thinking, planning, strategic types of things. It’s my forte and stuff. So I’ve worked in a number of areas in different things, especially I was a litigation paralegal in a law firm for a bunch of years.

That was really my background. Then I started working in a doc psychiatrist’s office, and that’s when I kind of got that message from God about, “You really could do this.” So I went back to grad school quite late in life to do that. I found that was my niche, that was the thing I was doing all along; I just didn’t know it. Being a paralegal, educating, and helping people through, I did when people got injured and hurt and helped them through that. That was the start of me counseling. I just didn’t know it at the time.

Carrie: Yes, there’s so many overlaps, I think, between counseling and education and problem-solving. I’m sure that there were things that problem-solving that you had encountered, so I could see how all of the skills would be beneficial.

Judy: Right. I had finished grad school, and I was disappointed because I wanted to work in a Christian counseling agency. Once you spend the time and the money to get your degree, you have to spend extra hours to be able to get your independent licensure. That’s where, at least where I was living, they all wanted independent licensure, and I’m like, “How do I get that if I can’t get that?” It was a quandary. I still worked at the law firm that I was looking at for a bunch of years, and I opened this out of my house. I did evening counseling out of my house. Shortly after I started, there was this woman who came to me and said, “Well, I know I have OCD. I was diagnosed with it years ago. I’ve had treatment at some of the well-known facilities. I now live in my area. So do you think you can help me?” She explained her obsessions and compulsions, and I’m like, “Fascinating. Okay, so when you do this and you do this, then it ends up like this. If you do this instead of this, does it go like this?” She’s like, “Oh my gosh, I have never heard anybody get it who did not have OCD themselves.” I could just get it. It was definitely a gifting from God too. I understand the logic of OCD, which has a lot of logic in and of itself if you understand the root part of it. Once she recommended that, and I started working with her, then I read Jonathan Grayson’s Freedom from Obsessive-Compulsive Disorder. I’m doing everything in the book; I already organically knew what to do and how to walk people through that, which was really exciting. I found my path away. So I eventually took the International OCD Foundation’s Behavioral B2BI training. I spoke at one of their Annual conventions, gave continuing education conferences in Columbus where I was at the time. It just really happened from my niche in my area. Now, 22 years in January, that has been my specialty.

Carrie: That’s awesome. I always used to tell counselors that I was supervising, your specialty kind of finds you; you don’t really find it. I didn’t necessarily think that I was going to be working in the areas that I’m working in now, but I’m happy that God has brought me along this path. Mine kind of branched out of working with anxiety, and once you see enough people with anxiety, you’re going to eventually run into some people with OCD, and it looks a little different.  You have to kind of readjust the toolbox and reexamine some of the things that you’re doing. We talked on that previous episode about creating hierarchies in ERP, the idea behind it that you’re exposing yourself to some things that are uncomfortable, starting with some smaller things and then gradually building up to the scarier stuff. You use a helpful analogy with your clients about a haunted house. Will you go through that with us? Just kind of like you would tell a client.

Judy: ERP, exposure response prevention, seems like anybody who’s heard about it has horror stories that it’s going to be so hard, so scary. But using the framework, thinking about a haunted house, if you’ve ever been to an actual haunted house, there are two things that you know to begin with. 

Number one, you know that nothing in the haunted house is designed to physically harm you. You walk in with that kind of knowledge. Second, the reason why people go to haunted houses is they like the uncertainty. They like the thrill that you get when somebody bumps out, and you don’t know or a noise, and you don’t know when it’s going to happen. You get this feeling, this anxiety. I call it anxiety because it would make me have anxiety, but other people are like, “That’s a thrill.” They get this thrill going on. The first time you walk through a haunted house, it’s full of uncertainty. You don’t know what’s going to happen, but that doesn’t mean that you can’t continue to walk all the way through and get out the back door. 

The good news for us is that God created a program in our brains called the habituation program. I like to call it Pac-Man. I just like the visual. So you’ve got OCD going, “Scary!” and then we’ve got a big old Pac-Man coming up, and we want to close scary down organically by inside, not us internally doing compulsions or something, but letting Pac-Man do that. The way that happens is if you walk through a haunted house the first time, it’s the scariest because you don’t know what to expect. You walk out the back door, come around the front, you walk through the same haunted house three times; you’re not going to be as scared by the 10th time. Pac-Man’s closing it down, closing down the anxiety to the accurate threat level, which generally is zero. But it closes it down so by the 10th time; it’ll be pretty funny. You walk through it; “Oh, the guy with the fair is going to show up. Yeah, then they’re going to dangle these things and go, ‘Boo!'” You can make fun of it, even if there’s still some level of nervousness in there. If we use humor in that way, like, “Oh, this is going to be silly, funny, scary,” it allows your brain to have that Pac-Man to start readjusting what is true about the threat level and close down the feeling, that adrenaline surge that you get, that feeling of anxiety.

Carrie: Talk about that a little bit more, just the inaccurate threat level related to OCD. Like OCD is telling you that something is going to be super scary, horrible, awful, but like your brain is malfunctioning there.

Judy: Yes, and that is key to OCD versus generalized anxiety disorder. With GAD and other anxieties, there’s still a thought where, “Oh, what if?” kind of thing to it, but your brain is able to quickly, if you use some logic, use some cognitive behavioral stuff, kind of, “Is it really true? Is that really that scary? Has that happened before in the past?” If you use some of those CBT kinds of things, generalized anxiety, your brain is like, “Oh yeah, that’s not really true. Calm down,” but when it’s OCD, it’s like, “No, maybe not that one, but another one and another one and another, and they pop up all over the place like that.” So the key, in terms of understanding if you have OCD, is the inaccurate thread. I call it a malware virus program in your brain. 

If you think of your brain like a supercomputer that God made that always has this underlying operating system running, just like your technology, you’ve always got an operating system running underneath in our brain; that operating system is currently using our senses. What we see, taste, touch, hear, smell. It’s looking for data. Internally, the data it’s looking for are thoughts, feelings, body sensations, and observations. The way it was designed is that if we get one of those pieces of data that pops up, it’s a neutral piece of data initially that brings it to the first program in your brain in the frontal cortex. That program’s design is to say, “Is this piece of data a threat or not a threat?” Definition of threat is jumping out of a plane without a parachute. That is the only definition. There is no other definition that goes with threat. Anything less than that is on a continuum scale of something that don’t really like, gross, that’s really terrible, but none of those are threats. That’s where the malware virus program of OCD gets in there and cherry-picks and hijacks the things that matter to us and skyrockets the threat and says, “Oh, there’s definitely going to be a threat here.” Then it starts pushing those buttons with adrenaline and neurotransmitters, makes you feel like there’s something going on. 

The urgency of now, we have to do it now, we have to figure it out now, know it now. All of that works together to combine to keep the threat being imminent, urgent, right now. That’s the part that with OCD there is no factual evidence that is what is actually true right now. You just think it and feel it, and therefore you feel like you must. Do something to fix it right now, going over and over because you do, you respond to it as if it actually is a threat. Then you create those neural pathways saying this is always a threat.

Carrie: That’s a really great explanation. Originally when I went to a two-day training in ERP with some people from Rogers and I got. Nothing against Rogers, by the way, it was just the training specifically really turned me off to ERP because there were a lot of extremes just we’re going to ban this behavior. You’re not going to be allowed to wash your hands at all, or you’re not going to be allowed to pray because you’re confessing too much to God.  I walked away just feeling not only was this very rigid, but I felt like I was being asked to torture people. And I’m curious, what you’ve done is kind of taken some of these principles and used the scientific evidence of what you’ve learned and yet added humor and made it more fun or let’s laugh at OCD or make fun of it. Tell me about some of those things that you incorporate with your clients.

Judy: I feel like that ERP, if you understand from a faith-based perspective, you know, how God made us and the interaction, learning how to do ERP is very much the same sanctification journey that we want to do in life anyway. We’re always those concepts, the broader concepts of struggling with our fleshly nature. Paul was talking about doing the things he doesn’t want to do and can’t do the things that he wants to do. That sounds very much like doing ERP to me, always has. That’s why I view it in that way. I’m looking at what is the root issue here. And the root issue is that the malware virus is scaring me. That’s something that matters to me is really big and scary. It tells me I should take care of it. I should do it on my own, which is the opposite of what we want to do in a faith-based journey. Yes. In a faith-based journey, we always want to bring God into things. We want to wait on God. We want to hear the truth that God gives us rather than us going ahead and trying to fix things or do it all on our own. So to me, that always made sense in terms of how I do ERP. 

I honestly don’t ever care if somebody who’s afraid of germs is able to reach out, grab a doorknob, and open the door. I really don’t care if they do it with their hand or paper towel. What I do care about is actually finding the courage to get through the door to find out. That really was their brain just scaring them about something and then they’re like, Well, I’m gonna let you do that to my life. I don’t need a paper towel. I’m just gonna keep on moving through. So attitude, that’s the attitude is one of the things that I feel like helps move us through things when we’re nervous and anxious and scared, kind of thing. That way of, let’s go, Jesus, the Rodney staff is with me, let’s go, let’s move it on, get to the banqueting table on the other side. That’s what I’m looking for, is the ability to have somebody be empowered to walk it out. 

Humor and creativity is one of the things I see in the Bible so much. Think about, there’s some amazing, interesting things that, how God does things in the Bible. The biggest one to me is Jericho. Seeing how they won Jericho. That worship band is out front, and all the people are behind singing and worshiping God, and then the walls fall down, like, oh my gosh. 

There’s other things, and I see other stories about how God used different people or situations. We’re very creative that we’re not the norm of how you do that. And that’s what works because God is showing that there’s all of these interesting creative ways of doing things. What I found is humor is really helpful if we can look at OCD. I have people come up with separating OCD as a separate entity and making a Fred Flintstone or one of the funny cartoon characters so that you can like, Fred, I don’t know anything about this thing, germs, or my relationship thing here, Fred Flintstone, what now? Um, and even though inside they’re going to feel like all of this, if you can make fun of OCD in that way and get your family member to say, you leave my wife alone, and then they’re both laughing and the laughter brings that level of urgency and oh no, and oh, it brings it down because you’re like laughing at it. Like you are ridiculous. You just think and think, or “Honey, I think you do,” Yes, you’re the worst thing in the world, being dramatic or silly or whatever. Doing it in these creative, silly ways really helps us as people to move towards something scary long enough for our brain to figure out, like, close it down. It’s not really actually that scary.

Carrie: Yes, I think of the two guys in the Muppets that are up in the balcony, and they’re just yapping around or somebody that’s heckling a comedian, you have that internal heckler, and sometimes it’s helpful to, like you said, create that separation, because it all feels like reality when you’re in what they call the OCD spiral, it just feels like everything’s so real now, but if you’re able to step back and even say, OCD is telling me that I’m going to get sick and die if I don’t do this, or if I go out in public and do these things, Then that helps you kind of create some of that mental separation. I think mindfulness and other activities that we teach clients thought diffusion helps with those things as well.

Judy: It’s really important how God made us and that’s one of the things that I always look for is something that’s sort of organic to how God made us rather than something so rigid and like you said extreme that they’re not, we actually have OCD or not we’re like, that sounds way too far. I would never do that kind of thing. I just feel like that people lost. That’s a little bit too much of the traditional ERP and that makes me sad in terms of understanding that if you work with somebody and with the way we were designed, that it actually helps us to go with the flow. One of the things that when I customize ERP for each client, I always want to find out about their background, things they’re interested in, who they are, if somebody is competitive, say in sports or something. 

I had a teenage client that was like a volleyball player. I’m having her visualize and practice spiking the ball into OCD’s face when it’s trying to give her a hard time because that’s a natural thing that she does and she can use it quickly to say I still feel all of this but I’m going to picture OCD standing there and I’m going to slam this ball in his face. If you’re a sports fan like me and you have your rival teams and you’re like, Oh, that rival team is not going to beat me. No, come on, buddy. You can’t beat me at all. I become animated and silly on purpose so that I can show my client that they can be animated and silly in terms of that. 

We use whatever types of things in that person’s life that they can use as a strength and empowerment strength to stand firm and be able to give some sass and give some, like, you are not the boss of me, give that one to kids a lot. You’re not the boss of me, which they love because they can’t tell that to their parents. They can tell that to OCD.

Carrie: Yes, I love it. I could see my daughter getting in on that if she had all those words right now. She would probably say that. “You’re not the boss of me.”

As far as like traditional ERP versus using humor and creativity, a lot of times I’ll have people just kind of sit and wait it out, right? Like, let’s wait for this anxiety where you’re trying to make the anxiety board, I guess, traditionally kind of wait it out. So you’re using some visualizations with people or. Some other, like, creative techniques where they can visualize and imagine themselves overcoming OCD in that process.

Judy: When you’re just waiting in the midst of it, you’re white knuckling. I hope it goes away soon. I hope it goes away. How long is it going to be? Is it done yet? Is it still here? When is it going to go away? That does not facilitate habituation, that doesn’t give the room for Pac-Man to go and close things down. We have to approach it, even kind of fake it till you make it, in a more empowered kind of stance. So that’s where, come up with a bunch of different ways that somebody can be active, but active exposing themselves and going towards OCD, and active while you’re waiting for that Pac-Man to do its job, rather than just sitting there and white knuckling. and stuff. 

One of the ways that you can do it is that you can say, “Oh OCD, I’m so glad you showed up. You’re such a good guy. I’m glad you’re showing up today. Let’s watch some TV. Do you want some popcorn? I’m not going to talk about what you want to talk about. Talk about TV. Let’s just look here. Oh yeah. You want to talk about this? Eh, don’t really want to talk about that. You can hang around all day you want, but not going to talk about that. Let’s talk about making sandwiches. What kind of meat do you like on your sandwich? What kind of pizza toppings do you like? No, I’m not going to talk about what you want me to talk about. Let’s talk about ice cream flavors or something.”  That is a more just calm, peaceful way for folks that like to be just kind of chill, calm, peaceful. 

You’re accepting that OCD is there. You’re just refusing to talk about what it wants to talk about. You can move it on to being something like I said before, kind of dramatic, real dramatic. This is such an important thing. “Oh my gosh, you are so helpful, OCD. Tell me every little thing. I don’t quite understand how you know. Do you have a question? It’s a hotline to find. Are you on the psychic hotline? Maybe you’re on the psychic hotline. Maybe I didn’t know that you knew all of those things.”

 Some of this like making fun of it, talking about what you’re not gonna take me on, you’re the opposite team. Any of these kinds of ways where you’re active, you’re active in doing ERP, which means you’re keeping your focus on OCD is there, um, looking at your OCD, I’m talking to you, but I am not talking about the topic that you want me to talk about because that thick is your inaccurate threat level on something, I’m not going to go there, you don’t have a driver’s license. You don’t have legs, and you don’t have arms, and you don’t have a face, and you don’t know how to drive. And kind of make it sort of funny that way. You’re being active while you’re waiting for the habituation to happen.

Carrie: You had talked about in your training singing silly songs like Old MacDonald or just other goofy songs.

Judy: I always have to make sure the clients understand there is, any school can be used as a compulsion, so anything you say or do can be a compulsion. Of course, the definition of a compulsion is doing something to make you feel better to avoid and get away from the anxiety, but anything can be an ERP tool as well. 

There are some people that are very behavioral that say you can never sing a silly song or you can never talk about pizza to things. Because it’s always a compulsion, and I disagree, you can use anything to say, “I’m going to look you in the eye, and I’m going to talk about that instead, because I get to talk about what I’m going to talk about.  This is my brain, this is my body, I’m going to talk about what I want to talk about”, and such. You’re using it to expose yourself, where OCD is trying to pull you to its topic, and you’re like, no, not going there. I feel it, not going there. That’s the key, the habituation. It’s not to have your hand on the doorknob for 24 hours without washing your hands. I guess maybe that eventually gets there. But it’s this struggle, this fleshly nature struggle, that where we choose to live by faith in that way, I’m not giving in to our feelings and our thoughts and our worries. As we do that, and we’re an intentional participant, that’s what makes that work better.

Carrie: Yes, I love that verse that talks about working out your salvation with fear and trembling because it’s God that works within you because we have a part and God has a part. One of the things that you and I run into in working with Christian clients is we’ll have people ask us or say things like, I’m praying, I’m waiting for God to take this away, and we’ve talked a lot about healing on the show. We’ve talked about various theologies and prayer and different aspects, but I love what you talk about with this being part of the sanctification process, because whether you have OCD or not, we’re in a struggle with our own minds on a day to day basis regarding are we going to be focused on the things of God and what God wants us to do? Are we going to be focused on sin and self and what other things that are negative? It really kind of fits in line with that sanctification process. What would you say to someone who says, “I just don’t understand. I’ve prayed and why hasn’t God just healed me from this yet? Or Why isn’t he helping me more through this process?”

Judy: What I’d say is that has to go back to our understanding of our role in God’s role and who he is. We have to broaden that picture too.  The Bible is very clear. Our thoughts are not God’s thoughts. We do not have the understanding, whether it’s about something in our personal life, or why God allows terrible things in the world, and such. It has to go back to, we always make the choice of, are we going to be the ones trying to figure it out and try to get God to answer to us about things that we don’t understand and figure out or if we understand the parental way of doing things. 

If you’re a parent, you understand that there are things that you say you can do with your child that they won’t get. They don’t understand because their age, their developmental age, or they haven’t walked through something yet. We know why we’re asking them to do or not do something, and they just think we’re being mean and they don’t get it and they don’t understand. To me, that’s parallel. “I don’t understand why you don’t take this away from me. I don’t understand why you allow things in the world. That causes me in my immaturity, that’s where I think that comes into our immaturity, back to sort of childishness of like, “I want to understand, I’m going to demand that I have to understand. I demand that you explain it to me”, whatever that might be, which includes that, “why haven’t you healed me” kind of thing, then our immaturity comes out and that’s what I think some of that’s a design to show that coming to the surface again, our fleshly nature is coming to the surface rather than saying, I choose to believe God is my heavenly father, who’s created me and loves me unconditionally therefore, everything he does is for my good. Even though it doesn’t feel like that and they don’t see it that way, I choose in faith to trust that and just walk out. I need to walk out day by day because that’s how I get to a healthier place that God wants me to be. That’s now how we get maturity is choosing to walk it out in faith even when we don’t see that may or may not change at any point in time.

Carrie: How do you work with clients dealing with scrupulosity, who are having some of these difficulties with trusting God, with the uncertainties of our faith and life?

Judy: I have a lot of folks who are like, what if, what I’m thinking or feeling, or even the thoughts that I have are sinful and if I’m not pushing them away, talking about not pushing away the scary thoughts or I’m not reacting to them, then that means, in their mind, that means I’m not faithful, I’m sinning because I’m not trying to push things away.

I go back to the broader concept. We talk about what is their view of God. How do they see God as in a punitive way, as their Heavenly Father? If they’re parents, well, if your child thought this about you, would that be accurate? That kind of thing. Have them understand that this one area that they are worried about doesn’t overshadow all the other things that they actually believe about who God is and how God loves and cares for them.

It’s just out of their fear and anxiety that they want to go out that they want to get certainty and know for sure but nobody has that nobody has that we’re humans and so we don’t have 100 percent certainty of anything honestly about God this side of heaven we really don’t we would like to say we do and folks with especially scrupulosity but let’s see they feel like but my friends or my family say they know what’s Certainty that God loves them or they’re going to have it or whatever they are so certain, well, yes, but no. Nobody has actual sexual certainty and our feelings about anything. If you ask that family member and you track their feeling of certainty from our, to our day to day, year to year, that would change too. It’s just a, a way of speaking at any given time about where we are. feelings but feelings do not equal truth. I broaden it back to how do they want to live out their faith? Do they want to live it out as a faith based journey where they’re walking you know and taking risks in faith or do they want to be the one that trusts in chariots and their own manpower and their own knowledge and their own understanding?

I always bring people back to which one of those two do you want to live out? Well, right now you’re trying to live out your own understanding and getting answer knowing for certain and such and nobody has that, so you can keep doing that if you want your life to keep feeling like this versus choosing to take this risk.

Carrie: I think that normalization of doubts and normalization of uncertainty is huge because in certain faith circles, there are things said like, do you know that you know that you know that you know that you’re a Christian and do you know, you know, you know you’re saved and that’s probably like the worst thing that you could say to someone with OCD because we all have to live with a certain level of uncertainty and unanswered prayers and not knowing. We’re not going to know everything, like you said, and we have to accept that, that we’re in the child space in our relationship with God, and we may not know all the ins and outs and the whys and so forth.

I think this episode is going to be really great and helpful for people who are dealing with all different kinds of OCD and maybe some people that are even in ERP therapy that can utilize some of these strategies that you’ve talked about to help them create a little bit more lightheartedness about it and not have to engage with it in such a serious, like you said, scared manner.

People are scared to engage with this type of therapy sometime. I think your presentation and dealing with other mentors that I’ve had have kind of helped me soften a little bit towards my ERP initial standoff ed ness that I had at the beginning of learning about it, I thought, this maybe, I don’t know that I can really do this, but it just kind of opens a doorway for me to be able to integrate some of these things with the clients that I’m working with.

Judy: Yes, at the beginning, the first couple of years, I had somebody, again, not to nullify Rogers, but who was in the Rogers program, and they contacted me for follow up care, and what they wanted me to do was come to their house, time them taking a shower, make sure they got out of the shower on time, and then time them when they were washing their hands to make sure that they got out of it because that’s what they did at Rogers. I did that for a couple weeks and I’m like, this, I can’t, no, I don’t believe in this. I don’t think this is going to help you long term. Have a babysitter stand there and watch you do these things. That’s not how you’re going to learn. You need to learn how to underline. I don’t want this for my life.  I’m not going to let you OCD do this for my life. So I’m going to find some way to give you some sassiness. And some silliness because I don’t want to live this way. That’s what I can provide to people and that has made such a difference. I am so blessed. I feel so blessed and thankful to God that every day I help people get out of these terrible places, these prisons, these torment place because I can help show them the pathway is that God designed this already that there is a way to get there and that you can do it. There is hope. That’s what we bring to folks is the hope that life can change, things can change and God already has it in your head. Let’s go use what God gave you to be able to get you out of this terrible place.

Carrie: Awesome. Well, we’ll put a link to your NoCD profile in the show notes. And I know you’re licensed in several states so people can. Look you up and see you as a option if they’re in one of those states, so that would be awesome too.

Judy: Not bragging, but I have written some books, so if you want to go on Amazon and my name is Judy Lair. I have a series called “Freedom from Fear.” There’s a specific book on OCD. There’s also one in Generalized Anxiety Disorder and one on stress and worry because men do not have anxiety, they might have stress and worry and then have a big one that talks about my journey with anxiety. It also talks about OCD and, and how I’ve come through all of that in the background I came through, how I got here. That talks about my faith and looking at faith in terms of that. You can go on Amazon and find those things if those are helpful resources.

Carrie: Yes, that’s awesome too. I forgot you were an author, so it’s good to put that in at the end. All right, thanks for your time today. 

Judy: All right, Carrie.Thanks!

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Carrie: I wanted to let you all know that we have a new freebie on our website called How to Handle Difficult Thoughts. You can find this at www.hopeforanxietyandocd/free. We have several different free downloads that you can benefit from there, but this download specifically is to help give you a little bit of a taste of our mindfulness course coming up.

This is to give you a little taste of “Reclaiming the Mind: Learning to be Present.” One issue that a lot of clients talk to me about is having racing thoughts, not being able to know how to slow their mind down. Mindfulness is a great way to do that, so this course will be launching soon, and if you get our emails, you’ll be finding out all about it. I Can’t wait to share it with you. 

Christian Faith and OCD is a production of By the Well Counseling. Our show is hosted by me, Carrie Bock, licensed professional counselor in Tennessee. Opinions given by our guests are their own and do not necessarily reflect the views of myself or By the Well Counseling. Until next time, may you be comforted. by God’s great love for you.

107. Impact of Adverse Childhood Experiences (ACES) with Diana Rice, LMHC, CIMHP, CTP, QS

On today’s episode, Carrie sits down with Diana Rice, a licensed mental health counselor and certified integrative mental health professional. They delve into the impact of Adverse Childhood Experiences (ACEs) and their relevance to anxiety and OCD.

Episode Highlights:

  • The impact of Adverse Childhood Experiences (ACEs) on mental health, with a focus on anxiety and OCD.
  • Diana Rice’s personal journey and her path to becoming a counselor.
  • The significance of the ACE study and its ten-question questionnaire for assessing childhood experiences.
  • The distinction between externalizers and internalizers in response to trauma.
  • Strategies for healing, including neuroplasticity and holistic well-being approaches.

Episode Summary:

Welcome to Christian Faith and OCD, episode 107. I’m Carrie, and today we’re diving into the impact of Adverse Childhood Experiences (ACEs) on anxiety and OCD with Diana Rice, a licensed mental health counselor from Through the Valley Therapy in South Florida. Diana, whose journey from a peer counselor in middle school to a seasoned mental health professional is inspiring, shares her deep insights into how early childhood experiences shape mental health.

In this episode, Diana explores how her upbringing as an immigrant child and her ACE score of six have profoundly influenced her therapeutic approach. She reflects on how these formative experiences led her to seek an integrative approach to therapy, highlighting the importance of understanding one’s past for effective mental health treatment.

We also discuss the ACE study’s significant findings, revealing the correlation between high ACE scores and increased risks for chronic health issues and mental health disorders. Diana explains how ACEs can contribute to conditions like high blood pressure, diabetes, and addiction, emphasizing the need to address these early experiences for effective therapy. Diana’s insights into addressing underlying trauma, rather than just symptoms, provide crucial perspectives for managing anxiety and OCD effectively.

Related links and Resources

Welcome to Hope for Anxiety and OCD, episode 107. For anyone new to our show, we are all about reducing shame, increasing hope, and developing healthier connections with God and others. I have with me today on the show a licensed mental health counselor and certified integrative mental health professional, Diana Rice of Through the Valley Therapy in Florida. 

Carrie: Are you in the Miami area? Is that right?

Diana: I’m in South Florida. 

Carrie: Okay. Today, we’re going to talk about adverse childhood experiences. People may have heard them referred to as ACEs. I’m talking about how these things impact us, which is really relevant for conversations surrounding anxiety and OCD.

Diana: I wonder if you could tell us a little bit about your personal story in terms of just what led you to be the counselor that you are today.

Diana: Wow, I could say I could blame my middle school, my Broward County middle school that I went to. Honestly, my father’s family kind of kept me here. My mom is an immigrant from another country and my dad is as well.

I’m originally from New York, and when I came to visit one summer, they kept me, so I was in middle school and then I started middle school here. My mom ended up coming back, but at that time, she didn’t know her rights. It turned out for God’s glory, of course, because here I am now. But in seventh grade, I became a peer counselor.

I think that’s where my love of helping others plus, my mother’s only child and I have older siblings, but they’re from my dad’s side. I just wanted to help people. I could see now back in the past like I had to disentangle what was I trying to heal because of my background and what is actually my calling, how my personality is and what the Lord has given me to do in this place we call earth.

That’s where it all started, and in high school, I was a peer counselor. I remember they interviewed me in the yearbook and asked,, “What do you want to do when you grow up?” I’m like, “I want to be a psychologist.” That time, I was already doing the wrong thing. I wasn’t a Christian then. I was raised Catholic with Santeria, which is a religion. You guys could look it up, but be aware. It wasn’t as bad as you’ll see if you do look it up, but my grandma was a medium.

Carrie: Oh, okay. Wow, so that’s like two different worlds intermingled there.

Diana: Yes, so I had that kind of spiritual trauma along with other things. I know that we’re talking about ACE, adverse childhood experiences, and my score is a six. I did not know these things when they were happening because most of us when we’re growing up, we think that’s just the norm of what’s happening.  Everybody must be going through that plus our brains aren’t fully developed at that time.

Carrie: Right. I think a lot of people are just like, “Well, that’s just kind of how it was. That was the water we swim in. That’s what maybe all the neighbors were going through as well. Until we get outside of our box or bubble of how we grew up, we don’t really know that things can be different or are different for other children and teenagers out there.

Tell us a little bit about how you got interested in the ACE study because I think when you and I had chatted before, you said you felt like it was kind of a life’s work for you, just really understanding this and applying it in your counseling.

Diana: When I was in college, we have to do our practicum and our internship. I spent a year in a Broward County school that was cognitive-behavioral therapy-based. It is sort of an alternative school, but the students that were there, they were from other schools sort of got kicked out or they needed help and they had to be seeing a psychiatrist. At this school, that was my internship and I was basically for that year, the only intern, but there were like eight other therapists, a psychiatrist, and a couple of psychiatrists.

It was probably one of the best educational times of my life for that year. I learned a lot of what not to do as a therapist, the red tape and the understanding of insurance, sorta there. So basically I was just learning from a lot of different modalities of how people practice back then and that was in 2004. It was almost 20 years ago before social media and it was at school. I was mostly teens. I mean, we had middle school and I think there might have been an area of elementary, but most of my clientele that came to me were teenagers. I realized I was there and I’m not the psychiatrist and I was getting frustrated because it was basically they came to me and a fat file of the student or whatever it is that follows them along the whole system. I’m like, “I don’t want to read it. My supervisor would be like,”Yyou have to read it. That’s your job.  I’m your supervisor.”  I’m like, “I know, but then you’re giving me this.” I’m going in already kind of with a judgment on the student.  I’m from Broward County, so I was a product of the Broward County school system.

 I have that little bit of that sass. Basically though, I was seeing like, why aren’t we listening to these students? I’m seeing these things that are happening and they’re angry and they’re frustrated or they’re not being heard.  I ended up taking what Carl Rogers talks about unconditional positive regard and I was new. I was just new to the game. I just basically started listening and questioning and then I would go home and go to my library and research or go back to my college and ask my professors.  I was just always asking why, why, why would we do this back then? I think the DSM might’ve been three or TR or something like that. I’m like, “Why do you keep telling me this book my Bible?”  That’s what we’re taught in a public secular college when it comes to licensing and everything. And then I would open it up and see all the names and I’m like, no offense. Why are all these white people the ones that are telling me what to do?

Why are we not taking into consideration the cultures? Or the understanding of other people’s backgrounds. I was questioning and questioning. Some of my professors loved, that I was questioning things.

Carrie: And some hated it.

Diana: Oh, some of them were, but I was used to that already because that’s how I’ve learned most of my life, even in high school and stuff. Just like questioning why. That’s just how I still do that to this day.

Carrie: Right, and very valid questions. I think psychology was based off of a bunch of white men at the end of the day. It started, that’s not where it is now, you know, things have progressed, but there’s still a lot of that bias in a lot of the research materials and things of that nature in DSM.

Back in the 90s, just for anybody who’s not familiar with the ACE study, adverse childhood experiences. Kaiser Permanente, which is an insurance company that’s more on the west coast of the U. S., if you’re not familiar with them, they decided they’re going to do this study and try to figure out, we have these people that have chronic health issues that are obviously taking a lot of money to take care of.

People with addiction issues, people with high blood pressure, diabetes, all of those chronic conditions that we think about. They wanted to figure out what makes some connection points between their physical health and their mental health and what they found through questions. They had, I think, 10 questions on there. 

Diana: I have the questions in front of me and it’s basically simple and people don’t understand what it does. It makes you understand things that you never do. That’s the way I like it in a holistic practice because we really touch on some stuff and it does get utilized in my practice anyway. In a way that’s like, whoa, but they don’t ever see the correlation.

The 10 questions are like this, “Did a parent or another adult in the household often swear at you, insult you, put you down, humiliate you, act in a way that made you afraid that you might be physically hurt? And then it keeps going. “Did a parent, or other adult in the household often push, grab, slap, or throw something at you ever hit you so hard that you have marks or were injured?”

I don’t know, I know these could be trigger questions right now for your audience. I want to be careful because now I’ve realized like, okay, because I utilize it so much, every client has to fill this out when they come to me. I’m realizing now that I got to be careful because your listener might never have heard these and they’re going to be like, because if we end up saying all 10 questions and they say, “Oh, yeah.I have seven” then what do we do here as therapists?

Carrie: Yes, people can go look them up online and I’ll link them. Even something like the divorce of your parents is on there and that’s pretty common in today’s day and age.

Diana: Or drinking or alcohol. Anybody had a mental illness or was depressed in your household. “Did anybody go to prison?”  It is questions that are basic, but when you put all 10 of them together and you start seeing the scoring, anything higher than a four, I think is cause for a little bit of concern. The higher the score, of course, the more you going to have to be aware. It’s an awareness. It’s not like you’re doomed.

Carrie: Right. It’s just a look at how that connection is, and they found that people who had scores of four or more ACEs were more likely to have these chronic health issues, the high blood pressure, the diabetes, addiction issues, and it was very significant. It was kind of like the graph was small at 1, 2, 3, and then jumped when it got to 4 and above. It’s a very eye-opening, and it’s not a new study, but I think a lot of doctors don’t take these types of things into account. A lot of individuals who have chronic health issues or chronic anxiety or chronic insomnia don’t take these types of issues into consideration because, like we were talking about before, It was just kind of how they grew up.

It was the water they swim in and they don’t always identify with the word trauma or abuse. I think that’s why some of those questions get very specific. Because if you say, did you experience physical abuse in your household? Someone might just think, well, that was discipline, but yet they ended up with marks, or they ended up getting hit in ways that are clearly not disciplinary.

Diana: What I see in my practice for the last 20 years is that It is a cultural thing at times. I also understand because I use a lot of Myers Briggs too. I try to come up with free assessments so we can have a holistic picture. Say you have this young person who is an introvert and is nervous by nature, like, and that’s okay. All of a sudden the father comes home drunk and is yelling. It doesn’t even have to put hands on, but, your nervous system just gets turned on. All these layers of emotional wounds, that’s how I explain it to the teen or the young adult or the adult that’s come to me is that we have emotional wounds.

We all experience these emotional wounds. The intergenerational trauma. A lot of people want to call it intergenerational sin, generational sin or whatever it is that’s happened. But if we don’t deal with them, then this is why symptoms happen.

Carrie: Absolutely. Those types of things that affect our nervous system and get us into that fight, flight, or freeze energy on the regular basis, that’s almost like teaching our brain for that fire alarm to constantly go off when it’s really only meant to go off in high danger, high-stress situations so that we have that energy to fight, flight, or freeze.

When you’re in a chronic situation like that, and like you said before, your brain is still developing. Now we’re affecting kind of how the brain is developing in these processes with children and teens. Similar to you, I started out working with children and teens, not in a school setting, but in a home setting, trying to prevent them from out-of-home placement.

When I first went into it, I thought, what’s going on with these kids? What is the deal here? Why are they acting up so much? Was it something about how they were raised? I didn’t know. Do they just have no structure in their home or no discipline? But then you start to peel back the layers and you start to look at, we had a, oh, I’m trying to think of what the assessment was.

It wasn’t an ACE assessment, but it was a trauma inventory, and it’s got a really long acronym, but we would go through that with every client and ask about, have you ever experienced this, homelessness, times where you didn’t have enough food, all kinds of different experiences. Has anyone ever hit you? And then you find out all kinds of things that have happened – bullying, abuse that they’ve experienced, and then you go,  “Oh, these kids aren’t bad kids. They’re not behavior problems. They have been through an enormous amount, and their nervous system, like, does not know how to process or handle even day-to-day situations.”

Diana: On fire, that’s what I say. That’s inflammation and when we understand the science of the mind and the body all together, it’s places of yourself that are inflamed. If your gut is inflamed, you start feeling it in other places. The same with the brain. If your central nervous system is always protecting, I mean, think about back in the day, a long time ago, thousands of years ago, when you have a sabertooth tiger running after the caveman, that’s the alert.

Your adrenal glands are going squirt, squirt, squirt with chemical and it’s fight or flight or freeze or fawn. If you’re on, but the thing is with the chronic, like you’re saying, if it’s happening every day, your system just learns to stay on. And then people that have a safe environment or healthy foods, or they don’t have to worry about resources or gang life or abusive home settings.

They don’t have that understanding and then they’re judging it now. For us therapists, if you’re a therapist listening to this, this is something that can revolutionize your whole practice, understanding the holistic approach to mental health and especially with the ACE, understanding the neuroplasticity and the science behind that, I mean, the brain and the gut connection, things like that.

“If I did not learn these things, I think I would have been, I was a wreck. I mean, I was smoking pot. I was drinking alcohol all through my teen.”  And that’s why they’re like, they’re just teenagers, but if we get to understand the why, why are they taking it so personal? Why are they popping off? I think we’re going to talk about internalizers and externalizers.

Carrie: Yes, let’s go into that. Your externalizers are the poppin’ off kids.

Diana: Yes, the Poppin off kids. The ones that are  people see and they think that they have a chip on their shoulder, like, “What you lookin at”, or whatever it is. If you take those personal, if you’re working with adolescents, or you have one, and you’re taking it personal constantly and saying, well, they’re just teenagers, they suck, or whatever it is or instead of taking a step back and going, “Why are they poppin off? Why are they punching the teacher in the face?” And those are the students that I worked with. I worked from there, and then I worked in a non profit organization that went into the houses, too, into the inner city homes, so I was seeing things we are the richest country and we’re allowing people to live this way.

I don’t get it. I get it, but I don’t. It’s such a system. I’m not even gonna go there. But you have those that externalize, which they’re fighting. They’re angry. They’re the little kid who might be diagnosed with ADHD. They might be diagnosed with a thousand different things and on five different medications. We don’t realize at home they’re eating Captain Crunch and Mountain Dew for breakfast. We don’t see this whole picture because we have to, I get why in the system, if you’re responsible for thousands of kids in one school, you can’t do what we’re trying to do, individualizing therapy for each, so you have to come up with answers quickly so you could keep the fire down.

Carrie: Yes. Absolutely. 

Diana: Those are the externalizers, the ones that you see that are angry or cussing or upset or wanting to fight and you feel it. The internalizers, they’re usually the cutters. They’ll stay in their room all day long playing video games, or they’re doing other things that they shouldn’t be doing. They’re the shy ones, they’re the suicidal ones.

Carrie: Right, they just keep everything inside and bury it as much as possible and even occasionally they may blow up at some point, but it’s usually against themselves, like you were saying.

Diana: Some of them will do both, depending on what’s going on in their own system, like in their own body, their vessel. It depends on how much a human being can take. Each one of us only has a threshold. We only have a certain amount of bandwidth.

Carrie: I’m sure it drove you crazy like it drove me crazy that the trauma wasn’t taken into consideration, so then we were just looking at symptoms. We were trying to match people up with the DSM and trying to match people with medication.

Therefore, there was a turning of students who got diagnosed with ADHD and then bipolar disorder. That’s what we saw all the time. 

Diana: ADHD and bipolar borderline. I’m trying to think there was one more. I mean, when I had anxiety and depression that year. I came and I think I am quite fine, I’m in private practice now. After that, when I was working at the nonprofit, I took a little break because of a certain situation that happened personally in my family, and then I went into a different career. After the Parkland shooting, and the Stoneman Douglas shooting in 2018, I had a couple of parents ask, “Hey, are you still a therapist?”, and I’m like, “no, I’m not.” And then little by little, the Lord kept saying, “You’re going back.  I’m like, “no”, but I see now since 2018, everything. I’m like, Okay, I’m just going to be obedient. This is of service for you. It’s a calling. I’m grateful that I do get paid for it and I get to help others learn about it. When I went back, I ended up in a school being the crisis intervention counselor serving about 200 students and I was the only licensed therapist there.

Carrie: Wow, that’s a lot of students to take care of. What hope is there? Because this is hope for anxiety and OCD, what hope is there for individuals who’ve had these types of experiences?

Diana: There’s so much hope. Listen, I am one that had these types of experiences. Like I said before, I have an A score of 6. It’s reframing what has happened and understanding, but getting the help and doing the work. Because some people do the healing process, they get stuck in the victim. And they don’t know how to get out of it because it’s been their life for so long and they might be surrounded by other humans in their family or in their community.

That’s all they know as well, so it’s understanding there is hope and it starts with you understanding you being that curious observer of yourself watching YouTube videos on CPTSD. Reading books like Dr. Gabor Maté’s book, The Myth of Normal, or The Body Keeps the Score by Dr. Vessel Van de Kock, or CPTSD, From Surviving to Thriving by Pete Walker.

There’s so much information out there. Or listening to podcasts like this, saying, Hey, no, there’s hope and understanding the science of your brain. Neuroplasticity is a real thing. They’re finding it out there in more and more information on the brain and how rewiring your system you can do it. I have done it.

It took a lot of hard work to grieve my childhood to learn to forgive those that hurt me and it’s not only my home. It’s understanding. We’re all raised in a village.

Carrie: Yes.

Diana: We’re all in a village now. If you’re hearing my voice, you’re part of a system. You’re part of a village, but we were also raised by one.

Some people might hurt you which can cause anxiety and depression, which are symptoms of numerous things. Finding out that you are not anxiety and you are not depression. These are just things you’re wrestling with or struggling with. I like wrestling better because wrestling means that you could get up on top of it.

When I use the word suffer, I don’t like that too much because it’s like, “Oh, I’m suffering. Oh, what was me?” To me,  I had to go through that part. I was grateful for EMDR. There are modalities that can help internal family systems, EMDR. I do cold plunges now. I do sauna work, infrared sauna, acupuncture, and things that have been around for thousands and thousands of years that are Westernized medicine. It doesn’t utilize because it’s either free or they can’t make money off of it.

Carrie: The cold plunge. How does that work?

Diana: I just started honestly last month and you go into like 40-degree water and I’m up in 90 seconds. I started off at 30 and I thought it, but it was the weirdest, craziest, most amazing feeling I ever had.

I do Wim Hof breathing. Wim Hof, you should look up his story. I started with the breathing techniques because these things are not taught in churches. They’re not taught our profession either much, and a lot of people see them as woo woo or new age, but I’m like, “No, the Lord made breath.”

Carrie: There are certain breaths that I know, like from yoga. There are certain ways to breathe where you can warm up your body or cool off your body. So are you trying to warm up your body like in those situations or no, you’re trying to take your temperature down?

Diana: Are you talking about breath work or with a cold plunge?

Carrie: With the cold plunge, are you trying to breathe a certain way while you’re in there?

Diana: It is actually trying to wake up my mitochondria to healing. It’s also understanding your mindset. We have a fixed mindset, many of us, especially if we wrestle with anxiety because I do, I wrestle with anxiety, honestly, like I can’t drink coffee. I have to do the work and I have to be okay. Kind of like an alcoholic shouldn’t be drinking alcohol. 

Carrie: Right, yes.

Diana: Someone like me that has anxiety and wrestles with it. I have to do the work and understand like, “No, I can’t touch that substance because that substance is going to make my anxiety worse or depression or whatever symptoms being exasperated by whatever’s around you. With the cold plunge, I am trying to, first of all, wake up myself and at the same time realize that I have the power in my mind to do this. Tthat is the rewiring of the brain that is creating new neurons to be able to connect.” Whatever fires together wires together.” That’s what Jim Quick says.

Carrie: Right. Yes.

Diana: I love to listen to and it’s true. If I would have stayed like, “Oh my gosh, I’m going to be a pothead of all my life, or I’m going to be depressed, or I’m never going to be able to be around my family because they trigger me too much. I had to rewire my brain. I have also been diagnosed with SERS, Chronic Inflammatory Response Syndrome, but I also know it’s because of how high my ACE score.”

It’s an autoimmune, so I have to do the things to keep that fire down because it’s inflammation. And I do the work and it was trying to shrink the inner critic because you grow up in that kind of environment with a high A score. It’s constantly like, I’m not worth it. It’s attachment issues,

Carrie: Putting yourself down a lot from things that you’ve heard from other people and just kind of repeating those things to yourself.

Diana: Because it’s been chronically done constantly, you start believing and that is something I had to realize with my walk with the Lord. To me, guilt and shame, because that’s what most of us who have anxiety, a lot of these diagnoses come and they’re really in guilt and shame. Guilt and shame is from the world. Conviction comes from the Lord.

Carrie: Right. That’s good.

Diana: It’s different. If you’re going against God’s word, then of course you’re going to get convicted.

Carrie: That’s a good thing.

Diana: Yes. If you’re feeling guilt and shame constantly and you’re blaming God and you’re not understanding, like, where is that voice coming from?

Who said those things? And you start recognizing those voices, the inner critic, and then you just sit with it because a lot of people that have anxiety, that I’ve come to find out in this 20 years I’ve been doing this, is they’re storing these emotions in their bodies, so they’re either so depressed and sad about it, and they’re just giving up with no hope, or it is stored so deeply that it’s like when a deer gets hit by a truck, or any animal. 

Carrie: They’re sort of shaking.

Diana: That’s our nervous system, which causes the anxiety, or the OCD. I still struggle with that too, and I have to realize, I got bad news. This is an example that happened lately. My sister was put in hospice.  My husband, because he has done his work with me and understands he or she is starting to clean everything and make everything perfect. She took everything out of the gap because that’s what I did. Then he took me and was just like, “Honey, you’re going to have to go see your therapist. Please calm down. I could tell because it happens.”

Carrie: Fall back into those patterns. I really like what you’re saying on a spiritual sense of that there’s a verse that talks about work out your salvation with fear and trembling for it’s God that works within you and you’re talking about really partnering up with God and the Holy Spirit to do the work, not just kind of sitting back and being a passive observer and say, God, just come over me and just fix all the brain cells, just make them all like wired together the way they’re supposed to and heal up this yuck stuff that happened to me.

You’re like, “No, I’ve actually sought the Lord, but I’ve also gone to counseling and I’ve also done these other healing modalities and read a lot or watched a lot of videos and really absorb the Information because knowledge is really helpful in these types of things and it does help reduce some of the shame so that you’re not thinking why in the world am I responding in this way?

Why in the world am I acting like this? When you understand, you can peel that back and say, “Oh, okay, now I get it. Now that I get it, I can start to take a step towards change.”  If a lot of times we don’t understand what’s going on in the first place, it’s really hard to make changes into it. If we don’t sit with it and go, “Oh yeah, this is what happened to me. This is how it affected me. This is how my relationships have gotten so hijacked for the last 10 years.”

Diana: We have to remember as believers that Satan’s only reason is to steal, kill, and destroy every relationship that you have, including and especially the one with yourself.

When you notice that and you realize, like, this is why I really am a mind, body, spirit connecting therapist here. When people come to me, they understand my position in Christ. I do not force. I’m not a biblical counselo. People argue with me all the time and we all have our journey. To me, what has worked thus far with people. I have quite a few people with a lot of spiritual abuse from church where I have to disentangle because some people don’t understand they grew up and was forced into some kind of say religion or whatever it is. And then they come to me with this hatred towards God and they want to deconstruct. I’m there going, okay, I think you want to disentangle and understand your situation that happened in ACEs is not only in inner cities, I mean, there’s higher scores there because they have fewer resources. It’s just how our system in this society has been for so long. And this is. In the last three or four years, that’s the uprising that we’re feeling and people misunderstanding.

That’s why I encourage those to educate themselves, but it starts within ourselves. Psalm 139 verses 23 and 24, search me, Oh God, and know my anxious thoughts starts with us being responsible for us. Despite anything that has happened to us. That’s the power we have.

Carrie: Towards the end of the podcast, I like to ask every guest to share a story of hope, like a time where you received hope from God or another person.

Diana: Wow. I could actually talk about this morning. I had a client, mostly my clients gave me hope due to them doing the work and seeing the progress. I’m very grateful for that. Just like this morning, I had a client that came to me two months ago and she was in a very, very bad place. When I say very bad place, it was just, I don’t know if I could. It takes energy.   I think the listener needs to understand we’re humans with our struggles and we care about our clients, or we would not be in this. And we care about them, not just for the hour or 90 minutes we have them.

Carrie: True. Very true. 

Diana: We’re trying to find other ways to help them. I’m in a lot of prayer. If you come to see me, I’m praying for you before you come in. We pray together and then when they leave, I pray, “All right, Lord, what do I have to do for the next session? Or what do I do next?” This person came in and I’m just like, I don’t know if I can help them. I can’t after crying out to God for a while.

I’m like by this time, if I can’t help and she came in today and I was just blown away with how much progress it was amazing. It’s like every time I want to quit, I honestly want to retire or go back to the other career I was at because this is heavy work for us.

Carrie: It’s not easy.

Diana: It’s not easy. It is a calling because I’m sure that if you are a therapist listening, you did not get in this for the money. If you got in it for the money, then your heart is not in the right place to be a therapist. If you’re coming in thinking you’re going to make a lot of money, then you’re not seeing your client as the human that we should be seeing them as.

To me, I’m talking to my husband, “Shiver. I’m older now. I’ve done some time already.” The second I think that, a client comes in and boom, something out. I’m like, “All right, Lord. Okay. I hear you. All right.” He reminds me, it’s not about me. It’s not even about the client. All of that price and utilizing our gifts and talents, which each one of us have, and it’s just getting in tune with that. The only way to get in tune with who you are to heal is to sit alone and be still with the Lord.

Carrie: I love your office too. For those that are just listening, she has lots of plants all over her office and natural lighting is a very warm and inviting therapy space. I really like that. I’m still working on my office, I moved into it a few months ago, and it’s just not quite where I want it to be. There are still some tweaks that need to happen, but I’m going to get it settled, and it’s going to be great when it gets done.

Diana: You have to send me a picture of it.

Carrie: Okay, we’ll do. Thanks for being on the show today and sharing your wisdom with us.

Diana: Carrie, thank you for having me.

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Carrie: I loved interviewing Diana because it’s always great to find another therapist with a similar heartbeat about treating trauma and letting people know that is possible for them to have a better life moving forward, even if their background has been kind of rough.

As some of you know, I do EMDR intensives with clients who are looking to process trauma in a short, condensed amount of time, instead of having to spread that over weeks and weeks and open up issues and close them up. If you want more information on that, feel free to check out my counseling website at bythewellcounseling.com. I am also working on longer intensive packages specifically for clients who are dealing with the intersection of trauma, childhood wounding, and OCD. If any of that is of interest to you, definitely contact me and I would love to share more about it with you.

Christian Faith and OCD is a production of By The Well Counseling. Our show is hosted by me, Carrie Bock, a licensed professional counselor in Tennessee. Opinions given by our guests are their own and do not necessarily reflect the views of myself or By The Well Counseling.

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