Kristy 0:06

Welcome to Unshaken, the podcast where unwavering faith is real life. I'm Christy, and together with my husband, Tony, we dive into authentic conversations, offering biblical insights and sharing stories that inspire resilience, especially for families navigating the unique challenges of disabilities. Join us each week as we explore faith with family and the journeys that keep us grounded in Christ. Don't forget to subscribe so you never miss an episode. Let's stand firm together. Hi friends, welcome to another episode of Unshaken. Today's episode is one that feels particularly important to me. I think in Christian spaces we talk a lot about faith or obedience, trust, surrender, terms like this, but we don't always come out honestly with what happens when our own minds feel intrusive or loud, restless. I think there are people that sit in pews every Sunday who love God and at the same time are quietly tormented by thoughts that they don't want to be having. They wonder if they're sinful. Maybe they think they're disappointing God. So this week we've invited our friend Carrie to join us. Carrie understands OCD, particularly scrupulosity, which is when OCD attaches itself to things like faith and morality. She can also speak deeply into what healing and hope can look like. So today our hearts just are very open. We just want to have a simple conversation because we want families to have language around this. We want people to know what it looks like and to know that if you're someone who's in this situation or you love someone who's in this situation, you are not broken or defective, and help is available for you. So, Carrie, welcome. Could you tell us a little bit about yourself?

SPEAKER_01 2:04

Yes, um, my name is Carrie Bach. I am a licensed professional counselor in the state of Tennessee. I have a podcast called Christian Faith and OCD that reaches people who are Christians and committed to their faith but struggling with the diagnosis of OCD. And of course, we also have friends and loved ones that listen who are trying to help others in their family. And we really try to encourage people, say that there is hope out there, share stories of people who are in recovery, and provide some practical strategies to have greater peace and connection with God.

Kristy 2:45

So I guess just diving right in, can we talk a little bit about what OCD is? Yeah. Maybe you should explain in plain language.

SPEAKER_01 2:54

I think most people have this perception of OCD that it's the super organized person, it's the person who has their t-shirts color coordinated, it's somebody that's constantly vacuuming their carpet or is a germaphobe, that they're just Clorox wiping everything. But actually, OCD has a broad variety of themes. People can have relationship OCD where they're very obsessed about offending other people. They may be obsessed about whether or not they are going to marry the right person. You can have um harm OCD, whereas concern that you're gonna harm either yourself or a loved one. Oftentimes this can come out in postpartum OCD where people are afraid of hurting their babies. Of course, that's very terrifying because these aren't thoughts that people want to have. They're intrusive thoughts. And there's sexual orientation OCD, where people may question whether they are straight or gay. There's uh scrupulosity OCD, which is the religious moral version of OCD, and that attacks people's faith where they may question their salvation, whether or not they've blasphemed God, um, like committed the unpardonable sin, whether they have confessed uh the right way, prayed the right way, they may repeat prayers or certain scriptures over in their mind, they may try to rebuke certain thought processes. We have a general uh category of theme called just right OCD, which is kind of more about arranging compulsions and having things a certain way.

Kristy 4:36

Wow. So really broad. So then, with all of those things being on the table, how could someone tell the difference between what's just a healthy conviction and a compulsive fear?

SPEAKER_01 4:48

Yeah, so when we experience conviction as a Christian, this is a positive experience for us because it means that we're connected to God and that God is lovingly trying to correct us. And so when we look at the fruit of the spirit is love, you know, joy, peace, patience, kindness, um, those things are what we look at in terms of conviction from the Holy Spirit versus is it condemnation from the OCD or from um Satan, you know, bringing up our whether it's like a past sin or that we've already confessed, that can happen quite a bit with OCD, where people are confessing the same sins over and over, questioning whether something is a sin or not often comes out. So we're really looking at the creating discernment between what is God, what is the fruit of the spirit versus what is condemnation? We know as Christians, we're not under condemnation. According to Romans 8, 1, there's no condemnation for those who are in Christ. So that's part of how we help um delineate that. Does this is this causing intense fear? Um, intense fear, there is no fear in love, for perfect love casts out fear. So we we know that if there's this intense amount of fear over I have an urge, like I have to confess this, that's probably OCD.

Kristy 6:16

So what does it look like? Like how does this, if uh if you've got maybe a teenager at home, what are signs that parents might see? What does it look like?

SPEAKER_01 6:26

Yeah, I think with scrupulosity, it can be hard because um sometimes there will be a lot of mental compulsions that people will do, maybe without even recognizing that it's a compulsion because it's all happening internally. So, like I had said, uh things like rebuking thoughts, and maybe that was something that they were taught in church. You know, if you have a certain type of thought, you, you know, you rebuke that thought in the name of Jesus, you don't accept that thought. Um, they have been taught, you know, you got to take every thought captive, which means that I have to like pounce on that thought and change it into something positive. Like sometimes people may, if they have a harm, for example, OCD thought, they might then try to think of a happy memory or a more positive thought to neutralize. Typically, when you're talking about children and adolescence, uh, signs for parents that are external would be things like reassurance seeking or confessing. So a teenager or a kid coming to you and saying, Hey, I think maybe I might have accidentally ripped this, you know, important piece of paper. And then the parent looks at it and they're like, No, I think everything is fine. Then they have this level, they've confessed, and then they have some kind of reassurance that things are okay. Maybe a child coming and saying, Are you mad at me? Might be like some relational concerns. And you say, No, honey, I'm not mad at you. Everything's okay. They go away and they're fine for a little while, but then they may come back and ask for the same reassurance over and over again. That would be a warning sign of OCD. So those are typically um outward expressions. Of course, if they have something like contamination, you're gonna see an increase in hand washing or an increase in showering, usually like taking longer showers, um, feeling like you know, they have to do things a certain way. If they're spending a lot of time in their room arranging objects, that might be uh kind of a sign of a just right OCD, or they have to have things a certain way in order to feel okay.

Kristy 8:33

Is this something that teenagers would hide?

SPEAKER_01 8:36

You know, depending on how long they've been dealing with it. I think that, you know, if they have been dealing with it from childhood, they may try to hide some of it. Uh, for example, if someone has a long hand washing ritual after going to the bathroom and they're a teenager, they may just not drink as much or not try to, you know, if they have a fear of public restrooms, they may avoid situations where they might have to use a public restroom so that they can hide their OCD better.

Kristy 9:06

What about in adults? What if uh what if it's a spouse or or another adult family member? Does it look different in adults from teens?

SPEAKER_01 9:14

Um, no, I think the compulsions typically are going to look similar. So instead of seeking that reassurance from a um from a parent, the individual might seek the reassurance from their spouse or a loved one and ask questions, you know, it could be a variety of different questions depending on what they're concerned about. It could be, you know, hey, this has been my experience with God. Do you think I'm really saved? Or it could be a situation where they say, um, you know, I did this. Do you think God has forgiven me for this? It could be asking reassurance for a variety of things. And of course, that um over time can be very taxing on spouses and can be somewhat exhausting because then the spouse feels like I'm being put in this parental role to try to make sure that you're okay all of the time. And that can create some relational conflict and strain if that person doesn't seek treatment. I think it's different if the spouse knows, okay, you're in treatment and you're you're trying to work on this.

Kristy 10:17

So then I have to wonder, are there things that the other spouse might say that might accidentally reinforce it? Or is there a right way or a wrong way to respond in that situation?

SPEAKER_01 10:28

Yeah, I mean, I think that you can develop some type of language surrounding it that feels comfortable for the person that's suffering. So if, for example, the spouse might say, Hey, um, you know, do you think that this might be OCD causing you to feel this way? Or do you think that OCD is causing you to ask for some reassurance or I'm noticing that you're asking for reassurance? And it's helpful to kind of talk with the person ahead of time before they get into that intense experience. Um, because if you don't have some type of ground rules or communications or reasonings, you know, and then there may be times where they just say, you know, I know that it's not going to get off of this, like they're going to be stuck on this for a long time unless I reassure them. And so then they'll go ahead and reassure them. But I think if they know that the person can tolerate them not receiving that reassurance, then they may use some other language to kind of redirect them of like, hey, can you can you sit with that feeling that's uncomfortable right now and not receive that that reassurance from me? So even as a therapist, sometimes I will ask people, you know, do you really need me to reassure you about that right now? Um, and then it'll they'll kind of catch themselves because they're so used to doing it over and over, they're not always in awareness that they're seeking that much reassurance or that they're seeking reassurance over about that issue. It's like, oh yeah, I am trying to do that right now. Or after people have been in treatment, they'll say, I really want to ask you for reassurance about this, but I know that that's OCD telling me I need to do that. And so I'm not going to give in to that. And they'll say, okay, good job. You know, good job resisting there.

Kristy 12:17

So then how do you know? How do I know when something that makes me feel anxious, just like a normal anxiety, when when does it cross that line and begin to be a professional care situation?

SPEAKER_01 12:29

Yeah, I think when when you're noticing that it's taking a lot of time, you know, the clinical threshold is an hour a day, so of of dealing with these obsessive and compulsive cycles that that people go through. So there are people who struggle with OCD, that they're spending hours and hours engaging in some type of compulsive ritual behavior. And I also want to say, too, that rumination, and a lot of times people will call that pure OCD. I don't really like that language because rumination is a compulsion. So it may be that they are sitting there trying to figure out if they've sinned or not, or if they're saved or not, or if they're going to catch some disease because they touched a doorknob. If they're ruminating over that for a long period of time, that's obviously problematic because then maybe we're not able to focus at school or on work or connect in relationships because I'm so much uh in my head about these types of things. And is it caught? A lot of times people will say, Well, yeah, but I'm functional. Um, I think there are many people that may listen to this episode who are struggling with OCD and they think, well, you know, I'm going to work and I'm coming home and I'm spending time with my family, but yet they're riddled internally with a lot of anxiety, fear, and intrusive thoughts all the time and don't know how to handle it. Uh, I would say, you know, you may be functional, but that doesn't mean that you have to live that way. It doesn't mean that you have to continue in that suffering. You know, there is help and there is treatment out there.

Kristy 14:07

What does that look like? So if I were going to pursue treatment, what might that involve?

SPEAKER_01 14:12

Yeah, so there's basically two different evidence-based routes for OCD. Um the oldest in the kind of tried and true way is exposure and response prevention. That is where people are exposing themselves to things that they are afraid of. So if they are afraid of like, you know, catching something from the doorknob, you know, it may, and they're only like using gloves or they're trying to use a tissue to open the door, and it will have the person, you know, use your bare hands to open the door and not wash your hands, not do something immediately after that would be a compulsion so that their brain can kind of rewire and learn that they don't need to be afraid of those things. Now, um, what I practice is called ICBT, which it stands for inference-based cognitive behavioral therapy. What that teaches is it teaches you to recognize the obsession and identify how the obsessional reasoning process leads you into this imaginary worst-case scenario land. So if you can recognize the obsessional reasoning process that gets you there, recognize the difference between that and everyday reasoning process where we utilize our senses to make determinations about what could or couldn't happen, um, kind of appropriate risk taking, then it allows you to recognize that the obsession is really irrelevant. So we say it's working upstream because we're more working on the obsessionary process rather than sitting with anxiety and not giving into a compulsion. Um, ERP is effective, but it also tends to have a high dropout rate and can produce, you know, um, a lot of anxiety for people. They may really not want to do it. And so ICBT is a good option, uh alternative treatment option that has also been researched. ICBT is great for spiritual obsessions because um people don't have to sit with um imaginal script writing about things that aren't true about God, um, you know, scenarios, for example, about them going to hell that they might uh utilize in ERP. So it's uh or like blasphemy, they may have people like write down, you know, uh this one girl was telling me about like writing down cuss words and Jesus or cuss words and God, and that just was not comfortable to her at all. So she pursued uh learning ICBT, and that was really able to help her recognize those intrusions she was having so that she can not give into the compulsive piece.

Kristy 16:54

It's also so it sounds like there's some flexibility, and maybe that it's kind of individually based. Like some of it, I heard you say that one kind is better for for scrupulosity and and some other things, and the other's better, but also that what didn't work for her, she was able to switch. So it just sounds like there's like multiple pathways and you don't have to to know up front necessarily.

SPEAKER_01 17:17

Yeah, and and people are also using pieces from acceptance and commitment therapy as well with OCD, or when appropriate, like pieces from um DBT that are kind of uh what we would call like an adjunct treatment. It's not gonna necessarily like cure OCD or cause you to be in like full recovery, but those some of those pieces can be very helpful at times depending on the person. So yeah, it's looking at what they have going on. I I think you know from what I have heard from client report, um, this isn't necessarily based on research. I think in the future, research will probably show this is that client from what clients have told me, ERP has been really helpful for like their tangible compulsions. Um, like I said, the the maybe things they could touch, the arranging, the contamination, some of those types of pieces. But when it came to rumination or mental compulsions, they found um for themselves personally that ICBT was easier for them to go down that route and more effective. So there are some people that start out with ERP and they are able to get some relief, but then do some ICBT that so that they can kind of get further relief on some of their mental compulsions. So yeah, there's a lot of treatment options there. And we always encourage people that, you know, if if a particular counselor doesn't work for you, you know, continue trying, don't give up. If a particular type of therapy doesn't work for you, don't just throw in a towel and say, like, oh well, I'm just not gonna do that, or there's no hope for me, or I can't get better.

Kristy 18:50

Um So then what would you look for? If if you're someone who has struggles like this and you think maybe you need some support, um, how would you identify a provider that could help?

SPEAKER_01 19:01

Yeah, I think you really have to ask a lot of questions and be really savvy. Unfortunately, there are a lot of providers out there that will say that they treat OCD, but they haven't necessarily been trained in evidence-based practices so um that are researched and shown to be effective. So you want to ask them, you know, what is your typical approach for working with OCD? Approximately how much of your caseload is OCD clients. Like if you were to give it a percentage, you could also potentially ask, you know, kind of over the years of practice, can you estimate about how many people you've seen that have had OCD? And, you know, tell me about um kind of what you feel like some success rates are. And then, you know, asking them, making sure that they have the training necessary to be able to treat you, I think is important.

Kristy 19:52

So I heard you say a few minutes ago that um that it it's it's not necessarily going to be a situation where it's just gone. Is it possible to live a full life with OCD? Is it something that you can whip into shape at, you know, enough to have a better functional life?

SPEAKER_01 20:09

Yeah, I mean, OCD is considered to be a chronic condition. Um, and at the same time, we know that many people with OCD do live full lives. They um work jobs, they have children, they get married. And so, yes, I would say if somebody feels like they're just, you know, in the pit of despair or they're in a really hard season, um, we know that the treatment is effective. Medication and therapy oftentimes working together are helpful for this condition. So, yes, there's lots of people living living full lives with OCD.

Kristy 20:44

I think we've all heard people express concern around mental health care treatment for mental health issues and Christianity. And some people might wonder if they're compatible. What would you say to Christians that might worry that seeking therapy might mean that they are not strong enough in their faith or something like that?

SPEAKER_01 21:06

Yeah, you know, I just had an interesting conversation with a friend and um of our family, and he has terminal cancer. And then he was talking about how, you know, he's he's been on all of these different chemo treatments, you know, some when he was first diagnosed, some very intense chemo treatments, and now he's on a low dose of chemotherapy that is keeping him alive. And and we also talked about healing and that some people are healed on this earth and some people are healed when they go to heaven. But I don't think that anyone in his church is shaming him for taking chemotherapy because he has cancer. And what we know in the that this is a neurobiological condition. So they have done plenty of brain scans to show that OCD does affect to certain. Certain areas of the brain. And we know that medication can be helpful for those areas. So if we're not shaming people for taking chemo for cancer or for taking insulin for diabetes, then in my mind, we shouldn't be shaming people for taking mental health medication. God has given us the incredible amount of wisdom in doctors who can treat these conditions. Let's utilize that as a way of common grace that God has given us to live to live better lives and more abundant lives.

Kristy 22:36

Awesome. So what I think I just heard you say is that your faith can be a source of strength alongside treatment for with professionals.

SPEAKER_01 22:47

I would definitely say that. So yeah, your faith says, you know, God, I know that there are things outside of my control and that you have a purpose and you have a plan. And so guide me in the things that are in my control. What do I need to do? What's my part in this healing process? I think so many times for Christians, we sit back and we say, God, just take it all away, like all the pain. I don't want to deal with this. It's too hard. It's too much, can't handle. Like we get into that type of thing. And then we can get frustrated when God doesn't just immediately take something away. Um, but we know that God is using these things uh to build our perseverance and character. Uh, that's what Romans tells us. That's what you know, the first part of James tells us that um, you know, that suffering produces endurance and God is is doing a work in your life.

Kristy 24:03

That's awesome. So if somebody who is listening to this right now feels shame or just some sort of uncertainty around whether they should ask for help, if what would you say to that person?

SPEAKER_01 24:17

Yeah, I would say, you know, God, God loves you. I mean, I think if we're if we're connected to the love of Christ, that can really help us reduce a lot of shame. Shame makes us want to hide and run away and pretend like we don't have problems or we don't have sin in our life. But God wants it's God goes all the way back to the Garden of Eden when Adam and Eve ran and hid. That that was shame, right? But God wants us to bring everything to Him as a loving father to be to be able to say, Hey, God, I'm a mess in this situation, whatever it is, like if that's your mental health suffering, I feel like a mess. And, you know, please help me, help me with this. You don't have to be afraid to run to God with that. You know, um, everyone has intrusive thoughts, um, but people with OCD get stuck on their intrusive thoughts more than the average person. And so that's something that's important to remember that helps hopefully you feel more human in this process. But yeah, it can be very feel very frustrating for a believer to feel like they can't control the things that are coming into their head.

Kristy 25:28

Is there anything that we haven't talked about that you feel like is just really important that our listeners should hear today?

SPEAKER_01 25:37

Um, I think one of one of the reasons that I started my podcast was because I really saw a void when it comes to strong uh clinical information and uh all of Jesus, that you can have all of Jesus and all of therapy put together. And that's that's the message of hope that I want to give to people is that um you can seek help, support, treatment. And it doesn't mean that you have weak faith, it doesn't mean that you don't love God. It just means that, you know, there's is wisdom in an abundance of counselors, as Proverbs tell us. And I have people that that I've worked with in my life, whether that's been physical therapists in the past, doctors who have helped me get into a better place physically. And I think it's okay to ask for help emotionally as well. Um, another thing that I that I do is intensive trauma therapy retreats for people that are working through some intense trauma with EMDR. And oftentimes I'll see people that have uh trauma and OCD combined. So if that is helpful for anybody, they can check that out on my website.

Kristy 26:50

So tell us one more time about your podcast. What's it called and how do we find it?

SPEAKER_01 26:54

Yeah, it's called Christian Faith and OCD. You can find it wherever you get your podcast or by going to carryboch.com.

Kristy 27:02

And if someone wanted to approach you about uh potentially talking about treatment for something that they're struggling with, could they reach you that way as well?

SPEAKER_01 27:10

Yes, I have a contact form on my website where people can reach out to me.

Kristy 27:13

Awesome. Carrie, we appreciate this so, so much. Truly thank you just for your honesty, for the work that you're doing and for helping people to not feel alone with this kind of struggle. And if you're listening today and you've ever felt afraid of your thoughts or ashamed about the way your brain works, I hope that this conversation has given you some, I guess, some language around that, some relief, because OCD is not a moral failure. You're not, it's not sinful, it's not anything like that. It's seeking help is not outside of God's will for you. I I would argue, and I think you know, Carrie kind of told us the same that that it is God's will for you, that he wants what's best for us, he wants abundance. And if healthcare helps you have abundance in life, then I think God's all for it. So if this episode has resonated with you, if if it just touched something in you, then we're grateful for that. And if you think it could help someone that you know and love, please share it. And as always, unshaken family, we love you. And Carrie, gonna put you on the spot. Would you mind praying us out today?

SPEAKER_01 28:24

No, no, that's fine. Um, dear Heavenly Father, I'm just uh thankful for these wonderful friends that you have connected me with in the podcasting community. Uh, I ask that you would bless their ministry. And I know that they have big hearts for people with disabilities and family members of those individuals. I ask that you would take this message of encouragement and bring it to whoever needs to hear it today, that you would um encourage people to seek help, to take the hard steps and to talk about the hard things that they need may need to talk about in order to get that help. Um, and that you just give them the strength to keep going each and every day as you're as you're molding us and shaping us to become more like Christ. Um, I ask all this in Jesus' name.

Kristy 29:18

Amen. Carrie again, thank you so much for being with us and just for sharing the benefit of your expertise. Unshaken family, thank you for being here and for giving us a little bit of your of your week. And we hope you enjoy the rest of your week, and we'll talk to you again soon. Bye, friends.