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Tag: OCDRecovery

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

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

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

Episode Highlights:

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

Episode Summary:

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

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

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

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

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

Related Links and Resources:

www.brittanybraswellrd.com

More Episodes to Listen to:

Transcript

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

They’re afraid of having a negative reaction.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Brittany: That’s a good question.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Welcome to the Themes and Treatments for OCD series! 

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

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

Episode Highlights:

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

Episode Summary: 

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

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

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

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

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

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

Explore Related Episode:

Accordion Heading

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

152. Struggling with Motivation in OCD Therapy? A 4 step process to get going!

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

In this episode, Carrie shares practical insights on overcoming barriers to motivation, especially when dealing with OCD. She breaks down how to identify what’s holding you back, practice self-compassion, and approach challenges with grace and curiosity. 

Episode Highlight:

  • Why it’s hard to motivate yourself, even when you want to make changes
  • How OCD therapy can be challenging and exhausting, but you can keep going
  • How focusing on priorities, rather than making excuses, can help you make time for recovery
  • Why saying “no”  to OCD opens up time for self-care and better habits
  • How to get specific about what you want in your life and why it’s important for motivation
  • How rewarding yourself and tracking progress can help you stay motivated on your recovery journey

Episode Summary:

Have you ever felt stuck, wondering why you can’t just motivate yourself to do the things you really want to do? Trust me, you’re not alone.

Today’s episode is all about the struggle with motivation. You know that feeling when you have a goal, but somehow can’t bring yourself to take the next step? It’s common in OCD therapy. 

As a counselor, I’ve worked with many people who struggle with motivation because of OCD. They spend hours on rituals like washing or seeking reassurance, leaving little time or energy for the healthy habits that are essential for healing. If you’re feeling stuck or frustrated with your progress, I want to help you shift your mindset. Let’s stop being hard on ourselves and instead ask: What’s in the way, and how can I overcome it with God’s strength?

In today’s episode, I’ll share practical tips to help you stay motivated, whether it’s focusing on therapy, prioritizing self-care, or simply setting small, achievable goals. We’ll also talk about how rewarding yourself for even the tiniest victories can keep you moving forward, one step at a time.

Tune in to learn how to embrace progress over perfection, stay motivated, and lean into God’s strength as you work toward healing.

Explore Related Episode:

130. Need More Than Weekly Therapy? Is a Therapy Retreat Right for You? with Carrie Bock, LPC-MHSP

Transcript

Have you ever felt like, why am I not doing the thing that I say I want to do? Why can I not motivate myself, get my butt in gear to do the things that are important to me? That is what we’re talking about today. Hello and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing.

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

I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode. You may know that Christians Learning ICBT is starting January 13th. And while this training is geared towards lay people, not necessarily professionals, we did have one professional join us this fall.

So I wanted to play you a little snippet of what her experience was like. Hello, I am Erica Kesey. As a therapist and a coach, I have been able to take this information and use it with my clients to be able to actually break them free from those obsessions. It’s been absolutely amazing, and now it has totally unlocked them in ways that we would never been able to do it without this training. To find out more information about Christians Learning ICBT, go to carriebock.com/training. I’m sure you’ve had this experience where you may have had a particular goal in your life that you were wanting to achieve. But then when you actually go to put the steps in place, it seems like you just can’t push yourself to do it.

You just can’t seem to get there. What I see in OCD therapy is a couple different things. One, it’s hard. It’s not easy in this recovery process. You guys, the OCD warriors out there, It’s hard to keep going day after day when you feel like you’re fighting all of these thought processes and you might have struggled to get particular help that you’ve been looking for.

You might have tried a couple things that haven’t worked for you, and it just seems hard to pick yourself up to keep going and going again. With clients, what I see is that, well, I’ll give them homework, or they’ll have a specific goal they’re working towards, or some small actionable step that they’re going to take that week.

It could just be reading their ICBT homework, writing their obsessional story. It could be a goal towards stress management and reducing their stress level at home. And then we come back the next week and maybe they haven’t done the thing. And I think for a lot of us, it goes towards this road of shame.

Like, oh, I didn’t do the thing I said I was gonna do. I feel awful about it. I’d like to take a different perspective and say, okay, well, let’s reduce the judgment and reduce the shame on it and just be curious about it. What got in the way of you doing the thing? Or what do you feel like is the roadblock or the barrier?

I think your first step really is to be curious about this motivation issue. Like if you were an employer and you had an employee that wasn’t working very hard, you could go really hard on them and say, why aren’t you doing the thing that I told you to do? Or you could take a more gentle approach and say, Hey, I noticed your performance standards haven’t really been up to par lately.

Why do you think that is? Help me understand. Tell me what’s going on. Because you might not know. Maybe that person is caring for an aging loved one. Maybe they’re under some health stress that they’re not gonna tell you about. This is a way that we want to be with ourself. Just very gentle, self compassionate.

Okay, so I didn’t do the thing that I set out to do. Let me be curious about that. Are there thoughts connected to that? Is there a sense of hopelessness? Like, I could try this, but I just don’t feel like it’s ever gonna get any better. It could be that you feel like you don’t have any time for your OCD therapy, or you don’t have time to engage in the things that your therapist is asking you to do.

When we say we don’t have time for something, what I hear is, I’m prioritizing other things over that. So what am I prioritizing over engaging in strategies that are actually going to help move the needle and get you to a positive place with your OCD recovery process? And it’s amazing when you say no to OCD, just a little bit, imagine how much time you can get back.

Because what I hear is people telling me that they’re spending two hours washing something. Or they went down the YouTube rabbit hole trying to get some type of reassurance for their relationship issue that could have been funneled into doing something more healthy for their self care or for their OCD recovery.

You might not have time to do things that will be helpful to you, like journal, or meal plan, or other healthy habits, taking a walk, exercise, because you are spending a lot of time scrolling. We have to be honest with ourselves and take a hard look. I took the Facebook app off my phone because I was habitually going into it.

I still struggle some with habitually checking my emails, it’s like, oh, is there a new email in there? I don’t know why I get so excited about email, it’s still gonna be there, it can wait. My point is, how much activity are you spending on things that are mindless and not really helping you with your physical, mental, or emotional health?

I know some of you out there are my caretaker individuals, and you are so focused on taking care of your children, making sure that your household is run well, taking care of your husband, taking care of parents, other people, everybody else but yourself. And so in your curiosity process, as you’re going through and examining, why am I not engaging in things that are healthy for me?

Are you feeling guilty because you’re doing things for you instead of doing things for others? This is where I have to go back to Jesus example, where he took time to retreat, to get away from everybody else, to go spend time with the Father, to fill up before he could pour out. Jesus also said no to people.

He took time to rest. He took time to socialize, slow down, dine with people. He was serving, loving, and meeting other people’s needs, but he also knew that he had physical needs and spiritual needs that needed to be attended to. I think some of us who are knee deep in the trenches, doing a lot of work at church, being involved in a lot of Christian activities, I think we forget that our spirituality and our relationship with God is more about being than doing.

Our doing has to flow out of our being, otherwise we are going to get burnt out because we’re going to be reliant on our own strength instead of plugging in and relying on the strength of God. After you’ve been curious about what’s going on, why am I not doing the things, then we need to go back to, like, get super specific about what is it that you want and why do you want that.

I’ve worked with so many people who will come into counseling and honestly they don’t even know what they want and part of our process is really helping them sink down and tune in and dial into when you say I want to be free from OCD, when you say I want to have peace, Tell me what that looks like. I need to know.

Okay, well, I’m spending this much time taking an hour and a half shower that I could be spending with my child. I’m asking so much reassurance from my spouse that they’re now annoyed and frustrated with me and almost a little cringey when I come to talk to them about something. I need to get back to that friendship relationship with them.

That’s what I want. This is your time to get super specific. You may often look at what you want to remove from your life and I would say that’s not a good place to start because if you remove something from your life, it’s going to have to be like filled in with something else and if we don’t even know what that something else is, there’s not much motivation for us to start removing stuff.

A greater analogy would be that if you have a bunch of weeds in your garden maybe and you want to pull those up so you can pull up the weeds but then if you don’t plant something else there that’s going to flourish and grow and use that soil and expand and spread out eventually like if you were to plant enough plants they would crowd out the weeds logically for the most part.

Or, there might be still a little room for the weeds to grow, but they wouldn’t have the whole garden territory. What are some positives that you can plant in your life that will rowd out the weeds of OCD? I know a lot of you are incredibly smart people, deep thinkers. And you are going to need a healthy way to engage that mental activity.

If we just say, okay, let’s just pluck out the OCD and then you don’t have any other way for your brain to be challenged, that might really hurt you and the OCD just ends up creeping back in there because it’s a way of your brain, like, expanding and problem solving and mulling over things. You might need a healthy project that you can get knee deep in the weeds with and have that level of focus and instead of it going towards OCD problem solving, have it go towards a hobby or a new skill that you want to learn.

Before my daughter was born, I was really engaged in trying to learn Spanish, and I was on the app, and I was playing the different games and trying to figure out what was going on. I have not kept up with that, but my point is, when you are really focused in on a task like that, you’re expanding your brain, you’re using your mental energy, but it’s really hard to focus on anything else at that point, to have other things competing.

So what is it that you really want? Is OCD keeping you from engaging socially? Is it keeping you from dating? Is it keeping you from having more friends? Or going out to restaurants? My point is, you don’t just want OCD to go away, just like someone doesn’t just want to lose weight. There’s a reason they want to lose weight.

They’re looking for more confidence, or for greater health numbers, or the ability to do certain things that they’re not physically able to do now. When you dial into what you really want, it helps you know And stay motivated to move forward. If you can visualize yourself in these positive avenues that you’re looking for, if you can visualize yourself getting in a dating relationship, for example, and I know that that may seem really far off.

It may seem super hard. You may feel very insecure about being able to do something like that because of OCD. For some people, I know it’s having children. They feel so nervous about having children because they’re struggling with OCD. Whatever the thing is, if you can picture it and have that positive picture in your mind going forward, that’s so going to help you stay motivated.

That’s what I’m after. That’s what I’m moving towards. It’s a new identity. A lot of times it’s a new version of yourself. Once you have that positive picture in mind, then I want you to think about what is going to actually motivate you to get there. Now, motivation is interesting because different people are motivated by different things.

There might be something that motivates me that really doesn’t motivate you. And this goes back to what do you want? There are all kinds of different things that you can use to celebrate or reward yourself along the way. We do this with children all the time and we forget to do it as adults. I had a cousin that worked for a major brand, I probably shouldn’t say it, but anyway, this individual worked for a major brand and my aunt said one day, they run that place like a kindergarten classroom.

And I thought, Well, they haven’t been in business for a long time, so there must be a really good reason why they’re running it like a kindergarten classroom. What she meant by that was it wasn’t like they were talking down to them. She meant it in a positive that they had all kinds of goals and rewards and stars and swag that they could get.

Because it works, because those types of things motivate people. So for you, it might be a coffee, it might be, let’s go to this new restaurant that I’ve been wanting to try, let me go get a pedicure. Some of those rewards might be naturally built into what you’re wanting to do. So for example, if someone’s afraid of flying and we help them work through that, They’re able to now go on vacations that they weren’t able to go on before.

Some of the rewards might be naturally built in, but if they’re not, then that’s an opportunity for you to say, Okay, how am I going to make sure that I’m tracking my progress? That I’m really celebrating that I’m talking, it could be as small as when I have a victory over OCD, for example, if Googling is a problem when I say every time that I say no to Googling.

I’m putting a sticker on my calendar, or every time I get away from the sink in ten minutes or less, I’m putting a sticker on my calendar. I’m gonna really celebrate that, and then when I get a certain number of stickers, I’m gonna have this type of reward. Kindergarten classroom it for yourself. Some of you are really motivated by positive words, or by verbal praise.

That’s great. You can do that for yourself or you can have other people around you engaged in that process. Like if you tell your spouse, Hey, whenever you see me really struggling and I don’t ask for reassurance or you see me like, say, start to ask and then stop. Will you please acknowledge that? Will you please say something positive?

Or will you write me a note when you feel like I’ve been doing a little bit better with OCD? It is helpful to have others acknowledge when we’re doing a little bit better, but it’s also important to be able to acknowledge your own accomplishments in this area. When we have praise, that reinforces and makes us want to do that more.

Like I said, we have no problem doing this with children all the time. We’re like, good job, kid. You put your plate in the sink after dinner. My daughter right now, we’re doing the whole like potty training deal. Here’s a gummy bear if you sit on the potty, like, woohoo, we have songs, we have a little book with plays music, all the things to make it a positive, happy, praiseful experience so that she wants to do that more.

The other thing that we do with rewards very easily is we can say, let me get this done and then I’ll go do that, a less preferred task and to a more preferred task. For example, if I say, oh, I’ve really got to write this email out or I’ve really got to work on this report, let me do this first and then I’m going to take a break and do that and go outside and rest for a little bit.

Let’s work really hard as a family to clean the house together and then we’ll order a pizza or go out for dinner. Maybe you’re working on exposures or you’re working on ICBT homework and you say okay after I do this Then I’m going to do something more preferable I’m not gonna watch that show that I have saved in my queue until I’ve done this piece right here So now that we’ve talked about rewards a little bit, and rewarding yourself to be motivated, I want to talk to you about who is on this supportive journey with you.

Do you have friends that know that you’re going through this? Do you have family members? Do you have a spouse? Do you have parents? Like, who is on the journey with you? That you can have healthy accountability with that you can say to that person, like, Hey, ask me, have I done this thing next week? When you see me, I have a business bestie.

We meet once a week and we just talk about it. What are you doing in your business this week? What are you going to be working on? What’s the next step? And just having that healthy check in accountability regularly is so important. And it has helped both of us be able to move our businesses to a healthier place.

You can do that in your OCD recovery process, you can get some friends or family together to check in with you, that you can provide information, I don’t think it’s always just having somebody else, like, ask you, you need to be able to share yourself and be okay asking for what you need, like, hey, hey, Whether that’s what we were talking about before, like asking for praise at certain times, asking, can we go do this together if I meet these certain goals?

I would love to be able to support you in January with Christians Learning ICBT. I am in Tennessee, but we have people from all over that are going to be on there just learning these modules together, learning how to have a healthier, relationship with their OCD, learning to manage their thought process differently, and to say no to OCD’s demands, to give in to compulsions.

I would absolutely love to have you on there. If you go to karybach. com slash training, we’ll also put that link in the show notes for you. But it’s karybach. com slash training. You can find out all about Christians Learning ICBT. You’ll find out when we’re meeting once a week, but even if you aren’t able to meet at that time, we’ve had several people, this cohort who weren’t able to make the lives, but they did go back in and watch the course material.

They set aside an hour and a half a week to really engage with the video and then do the homework and have seen progress. 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.

108. OCD Personal Story with Michael Kheir

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

On today’s episode, Carrie sits down with Michael Kheir, the author of “Waging War Against OCD: A Christian Approach.” Michael shares his personal experience with OCD, shedding light on the challenges he faced. He delves into how faith and a deep understanding of God’s grace were pivotal in his journey towards healing and recovery.

Episode Summary:

  • The importance of reducing stigma around mental health, particularly OCD and anxiety.
  • How OCD can lead to obsessive thoughts and compulsive behaviors, even over seemingly insignificant matters.
  • The impact of strict religious upbringing on OCD and the concept of legalism.
  • The power of understanding and embracing God’s grace in dealing with mental health challenges.

Episode Summary:

Welcome to Christian Faith and OCD, Episode 108! I’m Carrie Bock, and today I have the pleasure of speaking with Michael, the author of Waging War Against OCD: A Christian Approach. Michael was kind enough to send me a copy of his book, which has been incredibly insightful for our discussion.

In this episode, we dive deep into Michael’s personal battle with OCD. He shares how his journey began in childhood and has evolved through adulthood. Michael has extensively researched OCD from both Christian and secular perspectives, and his book reflects this thorough exploration. He recounts a poignant story from his college days, where a seemingly small incident triggered a flood of obsessive thoughts and compulsions.

Michael also opens up about the stories he revealed for the first time in his book—stories he hadn’t shared with his family before. His openness underscores a crucial point: mental health struggles do not define our worth or intelligence. Instead, they are a part of our journey, and understanding this can help reduce stigma.

Michael’s reflections on his experiences highlight the importance of embracing God’s grace rather than being trapped by rituals and compulsions. This conversation is a powerful reminder that faith and understanding can guide us through the complexities of OCD.

Join us as we explore these themes and more. If you find this episode helpful, please subscribe and leave a review to support our mission of breaking the stigma surrounding mental health.

Related links and resources:

www.wagingwaragainstocd.com

More to listen to:

26. A Personal OCD Story of Experiencing God’s Presence and Grace with Peyton Garland

Transcript