In today’s episode, I’m joined by my friend Dr. Kelley Kleppinger in a Frequently Ask Questions (FAQ) session on OCD.
Here are some of the questions we tackled:
- What exactly is OCD
- What is the difference between anxiety and OCD?
- How long does it take for someone to get diagnosed with OCD?
- Why can’t we seem to take our thoughts captive?
- How does someone know if it’s the Holy Spirit or OCD?
- How can we help someone with OCD?
More Episodes on OCD
26. A Personal OCD Story of Experiencing God’s Presence and Grace with Peyton Garland
13. Panic Attacks, OCD, and God: A Personal Story with Mitzi VanCleve
8. One Therapist’s Story of Discovering Her Scrupulosity OCD with Rachel Hammons
Carrie: Welcome to Hope for Anxiety and OCD episode 87. I am your host, Carrie Bock, and we have decided at the beginning of the year to take things back to the basics a little bit. So we’re doing an OCD FAQ episode with my friend Dr. Kelley Kleppinger. Kelley and I have been friends for a little while, we were introduced by a mutual friend of ours.
We’ve had fun and going on some double dates with our husbands and things like that. I also wanted to let everyone know that I have a course called Get Out of My Head, coming out in about a month, and I’m very excited about this. It’s specifically designed for Christians who are struggling with OCD.
There’s lots of misinformation out there when it comes to the church and OCD people trying to apply general principles of anxiety to OCD treatment maybe that is found in the Bible, and we’ll talk about that a little bit today. If you guys would be interested in a free download of some things that every Christian with O C D needs to know, you can go to hope for anxiety and ocd.com/free.
And that will also make sure that you are getting updates about the course coming out. Kelley, tell us a little bit about yourself and what caused you to be interested in doing this episode with me because I kind of put out an SOS on there.
Dr. Kelley: I have been in education for 18 years and in those 18 years I have had a lot of children with a lot of different issues. And anxiety is the number one thing that I see in my children right now. So dealing with that on a daily basis definitely made me curious about your podcast and what you do and how you can help people. And also just in general, I think we all deal with a level of anxiety at times. I know I do.
We all did during the pandemic, and your strategies are great for people across that spectrum as well. It is comforting to know that you’re not in it by yourself and that there are things that you can do. Just curious to learn more about it.
Carrie: Awesome. I have recruited Kelley because we’ve decided that Steve has been my Fillin person enough, and so I do much better having people ask me questions or dialogue with me than just solo episodes.
My solo episodes, if you all have listened to them, tend to be very short. It’s just kind of like I get the information out there and I’m done, but I can provide a lot more information and talk more when I’m dialoguing with people. It’s just my nature and what’s a little bit easier for me, I’ve found. What’s the first question that you have? The list today? I kind of gave some questions of things that are frequently asked about OCD.
What is OCD?
Dr. Kelley: Well, the first one is down to the basics. What is OCD?
Carrie: OCD is a mental health disorder that is characterized by someone who has obsessions and compulsions. We can break that down a little bit more.
Obsessions, we use that word sometimes, you might say, I’m obsessed about Kentucky sports. Or someone might say, I’m really obsessed with this musician or musical artist. But when we’re talking about obsessions in an OCD sense, we’re talking about intrusive thoughts. That you can’t seem to get outta your mind.
It’s like they’re stuck in there like chewing gum on the bottom of your shoe that you can’t get off, and they’re very repetitive, or they have repetitive themes. People can have a variety of different obsessions. It can be obsessed about germs. That’s what people commonly refer to or know about with OCD.
They’re a Hollywood picture, it’s someone like Monk that’s going around and he can’t touch the door handle. He is gotta use a handkerchief or something like that. Things have to be in a certain order in his house. That’s not really, OCD is much broader than that. So you can have obsessions about cleanliness, or sometimes it’ll be referred to as contamination.
You can also have obsessions about relationships, and we’re gonna talk about that more in-depth on the next podcast that comes out around Valentine’s Day, relationship OCD and anxiety. And those look more, am I with the right person? What if I marry the wrong person? Do these flaws mean that we’re not meant to be together when really it’s just kind of normal?
Maybe miscommunications, mishaps. And they’re kind of stereotypical relationships if you would look at them from the outside in. It may look like in friendships, having obsessions about, did I upset somebody? Did I offend someone with what I said? The compulsive piece of that would be replaying conversations over and over and over again.
People can have obsessions about God, Jesus, religion, moral sets called scrupulosity. And we’ve had some guests that have shared some personal stories on the show. I encourage you guys to go back and maybe listen to some of those with Mitzi Van Cleve was on our show talking about that a little bit.
Typically, OCD gets attached to, what you are most passionate about. People can have obsessions also about sexual things, homosexuality. They’ll be like being concerned about if they’re homosexual or not. Being concerned about abusing children harm OCD is really common, even like pedophilia OCD, where people are concerned that they’re gonna sexually abuse a child.
That doesn’t mean that they want to do those things. So there’s a difference between an intrusive thought and a desire. But obviously, these things can be very shameful and scary, so people don’t want to talk about it, especially in the context of the church. Who wants to go say like, oh, hey, I’ve been having thoughts about harming children. And then somebody would probably say, okay, let’s not put you in the nurse. Or even though it could be a person that really loves kids, and they may have their own kids and care very much about them, but live in a constant state of fear of harming those children. When we talk about obsessions and compulsions. Compulsions tend to be things like checking door locks, or I gotta make sure go back in and make sure I unplug the curling iron because the house might burn down.
I’ve gotta make sure that the stove turned off and the TV’s unplugged. Sometimes we would call them rituals that someone may get involved in just to leave their house. So I’ve had clients who come to see me because they’re late to work repetitively, and obviously that’s causing problems with their job because they’re taking 30 minutes to check everything, or they’re leaving the house and then actually coming back and going in the house and checking and make sure all this stuff is turned off.
Sometimes with harm OCD people are afraid that they’ve hit somebody. Like they’ve actually accidentally hit a pedestrian and they will circle their car back around and go check to make sure that they didn’t hit anybody. So that’s another form of checking. Obviously these things are very distressful.
Unfortunately, sometimes we use OCD a little bit more lightly in our society. Like, oh, that person’s so OCD. And what we really mean is they’re particular or they like things a certain way. They’re not actually living with a high level of distress. When you’ve been diagnosed with OCD, you’re typically spending about an hour on some of this stuff, or more I think is the cutoff for the D SM diagnosis.
And some compulsions can be mental. We don’t always see them, and that can really lead to OCD going undiagnosed for a while because there may be certain words that people will repeat in their head to reduce this sense of anxiety brought on by the obsession. They will pray certain prayers, especially confessing.
Confessing can be another compulsion that happens with people, especially happens in children feel the need to go up to you and tell you something bad that they did, and that’s the obsession they’re having in their head. I did something wrong. I have to go tell somebody and get this out of my head. And even reassurance-seeking can be a compulsion in itself, which a lot of people have who have OCD and don’t realize that this is what they’re doing.
They’ll go to their spouse, say if they’re having relationship obsessions and go, honey, do you still really love me? If you were gonna marry me again, would you still do that? Are we okay? Like is our relationship good. And the spouse will be going, yeah. Oh, what’s going on with you? And then they’re probably thinking, is everything good?
I thought it was, but not sure. That’s what you said. That’s the very long explanation of what OCD is. And I went into a lot of different examples because there are so many people who are probably even listening to this and think, well, I just have anxiety. But really when we start to peel back the layers, they have OCD characteristic.
Dr. Kelley: , I just learned a lot. I had no idea there were that many layers and ways that it can go. Just like you said, I’ve had the Hollywood version in my head of what OCD is because people just throw it around so loosely. It is not what we think of all the time. So that was an explanation, obviously, with that explanation, anxiety goes along with that. So what is the difference between OCD and anxiety?
What is the Difference OCD and Anxiety?
Carrie: There’s a lot of overlap. I think just in terms of body sensations, people with OCD still get some of the same, discomfort in terms of their body. They may have body tension, heart rate may increase, they may feel off.
They don’t necessarily always are as tuned in or as honed in on what’s happening in their body as people with anxiety because they’re so used to going in their head and thinking through. And that’s a lot of times the way they solve problems is kind of going in their head. So that’s why sometimes the somatic therapy can really help them kind of sit with some of the body distress.
Learning mindfulness practices, which is one thing I’m gonna talk about in the OCD course as well. What really is mindfulness breaking that down, and how do you practice it? How do you learn to tolerate that distress that comes up with OCD? I would say with anxiety. Anxiety tends to respond at times to thought challenges.
I can sit with a person with anxiety and we can work through certain things mentally, where I’ll say, okay, so you’re afraid of that. You’re afraid of losing your job. What’s the worst case scenario if you lose your job? Okay, if I lose my job, I’m gonna lose my house. I’m gonna become homeless. Next thing you know, they’re on the side of the street begging for money, and then you’re like, “Okay, how likely is that that’s going to happen?” Because you’ve told me you have some support in your life and other people you can depend on, and people that would help you out if you were really in a bad spot. And they’ll be able to kind of rationalize and realize, yeah, you’re probably right. You probably don’t need to be afraid of losing my job.
And then we’ll go through and we’ll talk about, well, you have some pretty marketable skills, in your field. You’ve been in your field for 10 years is what you’ve told me, so you probably could get another job, right? And they’re like, oh yeah, I could. But if somebody had some kind of intrusive thought it, probably wouldn’t be like, oh, maybe I’ll lose my job.
It probably would be more like, I think I’ve offended my boss. and you could talk with them and you could say some of those same things. Well, you’ve told me that you and your boss have a good relationship. Yeah, I know. What if I just said the wrong thing and he’s really upset and he’s really mad with me right now.
They can’t ever get off of it with the logical reasoning. It’s just not gonna happen because they’ll go back into that loop and almost it can make it stronger. It’s like arguing with back and forth with OCD or trying to rationalize with it can actually increase it and cause more problems. Whereas in a CBT type therapy, cognitive behavioral with anxiety, we can say, okay, tell me about your thought and how that influences your feelings and your behavior whereas with OCD, it’s just kind of, they can’t really thought challenge the same way. It just doesn’t seem to work. And then they get kind of more distressed when you try to do that. That’s one of the main differences. And then I would say too, with anxiety versus OCD, just treatment-wise with anxiety, you’re teaching people really to calm down in the moment.
You can teach them relaxation skills someone with OCD, you’re more kind of teaching them to ride the wave a little bit. You can do that some with anxiety, there’s some overlap, but it’s more about learning to tolerate that distress and knowing that you don’t have to act on it so that you can get out of that loop.
I think there’s some avoidance is overlap. Both people with anxiety and OCD tend to avoid things. There’s definitely are some similarities and differences.
Dr. Kelley: Obviously, therapy can help both OCD and anxiety. You said teach people to learn to ride the wave or push through or tell them that they’re okay.
If someone’s living with it and they don’t know it, you know, to me it’s really sad that obviously, it takes so long for them to get diagnosed. Why is that the case?
Carrie: I think about an average of seven years for an individual to be diagnosed with OCD. What I really believe that is due to lack of education, where we have these Hollywood models, and even people that are famous that have OCD look at, like Howie Mandel won’t shake hands with people. And he’s been great about being open about his OCD, but once again, that’s kind of a stereotype. I don’t know if anybody knows that Mark Summers who did Double Dare actually had OCD and it had to do with cleanliness.
He wrote a book about it. I don’t remember the book, but we’ll put it in the show notes for you. He used to comb the fringes of his rug. I mean, that’s how distressed he was about having to have things clean. And when he was on Double Dare, obviously it was a messy show. Anybody remembers that old Nickelodeon show?
I think he takes his shirt off at the end of every show, and the producers hated that he did that. He talks about that in his book as well. So these are pictures that we have out in public. But nobody famous maybe is talking about their relationship obsessions or about their sexual obsessions that they’ve had.
Some people have definitely talked about scrupulosity in the Christian realm. We have some personal stories like I said before, especially with some of the more shameful thoughts. People aren’t talking about it. It’s not on parents and teacher’s radar because a lot of times kids and teens will start to show symptoms.
And even when I talk with adults, they didn’t necessarily realize that it’s a time, but they’ll be able to go back and say, oh yeah, when I was in school. I used to have all my work perfectly or really bubble in the answers just the right way, or there were certain things that they used to redo work or erase holes in the paper because they erased so much.
Some of those things have occurred or they confessed a lot to their parents, and their parents just thought, why is my child doing this? But they didn’t know that was a symptom of OCD, so they didn’t know to necessarily connect to that. I think people haven’t picked up on it as much and what the signs and symptoms are. And then the other piece is that, unfortunately, and this is a sad piece to me as well, is that even counselors who treat anxiety don’t always know how to distinguish when it’s anxiety versus when it’s OCD. I just talked to kind of a local therapist recently because she had a situation. She said I think this person might be showing signs of OCD and can I just consult with you?
And we did that over the phone, just like, Hey, tell me what’s going on. And I can tell you if this lines up with what I’ve seen or signs or symptoms because it is a little bit different. And so most commonly what will happen is people will say, I’m anxious who have OCD? I’m anxious, they’ll go to therapy and tell their therapist, I’m anxious, right?
So then they’ll start to give them suggestions or treatment for anxiety. I had one client who told me that she was in therapy for two years and she goes, now that I look back on it, all I was doing was reassurance. Seeking from the therapist, you basically tell me I’m gonna be okay. I have all these worries and all these concerns, so that’s a sad scenario to me, which is why it’s important if people do have OCD to ask a therapist that you’re looking at seeing.
What’s your experience level been? How often do you see people with OCD? What’s your training like? What’s your approach? Ask a lot of questions because unfortunately there are people out there who will say “Yes, oh, I deal with OCD,” but they really don’t, unfortunately. We don’t get a ton of training in graduate school on this.
We get kind of the broad overview, the large brushstrokes, and then what happens after you get a school is your experience level. And your continuing education really help you narrow down what your focus is and the types of clients that you end up wanting to see or attracting or end up working with.
I think a lot of people think that we all do the same thing, and that’s not really true.
Why Do I Need Help? Why Can’t I Take My Thoughts Captive
Dr. Kelley: If I’m putting myself in the shoes of someone that has OCD or thinks that they may have OCD when they’re thinking, why can’t I just take care of this myself? Why do I need help? Why can’t I seem to take my thoughts captive?
Carrie: I think this is a common question for Christians because, they’ve gone to church and said, Hey, I’m worried about this. And people have told them just common things that we tell people for anxiety in the church. “Cast your cares on the Lord, pray about this. And the God of peace will guard your heart and mind in Christ Jesus.”
Take your thought captive and make it obedient to Christ. So there’s this shame that comes when someone tries to apply that to their OCD and is like, oh no, like it’s not working. I guess one of the things I wanna do with the show is really reduce shame and say, “That’s not you, that’s not your fault.” That’s your brain malfunctioning actually, and that was something I meant to bring up earlier. We were talking about what is OCD is that there are certain parts of the brain that they can actually see on scans that are overactive. That’s just a function of a fallen body that none of our bodies are perfect.
Sometimes things go wrong with our brain, unfortunately, and we’re not able to take that thought captive. And I think with OCD it’s recognizing, “Hey, that’s an intrusion.” And some people will even think too, oh, this is spiritual warfare. This is the devil telling me I’m gonna harm children. Or this is the devil telling me that I’m homosexual when I’m really not, and causing this high level of distress internally.”
I don’t know. You could make arguments about what’s spiritual and what’s not spiritual, and I certainly will leave that for people to judge themselves. But we are looking at a brain condition and we shouldn’t feel bad if you’re struggling with this brain condition.
Dr. Kelley: You were talking about the spiritual connection and what the church says. How does someone know if it’s the Holy Spirit or OCD? Because I can see people getting that blurred.
Carrie: Absolutely. That’s probably one of the biggest questions that I get from Christian clients is how do I know if this thought that’s entering my head is something the Holy Spirit is telling me to do or wants me to question? Or is it something that’s OCD related? What I would say for that is you have to look at, based on the Bible, how is it that God speaks to us? We talk about the still small voice of the Holy Spirit, that even in the Old Testament when God said he was gonna speak to Moses and there was all this big stuff that happened.
There was a lot of thunder or lightning. I can’t remember all the things, but, and God was not in that. But then there was a still small voice, and that’s where God was. OCD tends to be very loud and obnoxious. You need to listen to me. You need to listen to me now, and you need to go do something and you have to do it right now, whereas when you learn to discern God’s voice comes from a place of love and kindness, there’s a verse that says, it’s God’s kindness that leads us to repentance. If God is pointing out something, for example, that we need to confess, that’s a very gentle and loving way that he would do that. “Hey, you hurt that person’s feelings and you need to go to them and apologize.” And then from that conviction, if we did go and apologize, ask for forgiveness. We would expect to feel better. Whereas somebody that’s confessing because they have OCD, that’s not gonna make them feel better. So that’s kind of another indication. If you’re feeling, I think God wants me to pray more, but then you pray more and you don’t feel a sense of relief or you don’t feel that you’re following God still.
Then that’s an indication that might be OCD. If it’s loud, obnoxious, you gotta do it now it’s probably most likely OCD. If you’re in a quiet still moment with the Lord and you feel like he’s telling you something and there is a sense of belief when you do it, then that’s probably an indication that it’s God.
God doesn’t speak to us through OCD. God speaks to us through his spirit. I just wanna jump in here and say too, before, it sounds like I’m talking too much about trusting your feelings related to the Holy Spirit. You do have to make sure that what you believe you’re being told by the Holy Spirit is aligned with scripture and with things that God has clearly commanded us knowing that the Holy Spirit is not gonna ask you to do something in opposition to those things.
How Can We Help Students Who Have These Tendencies?
Dr. Kelley: One question I’ve had throughout the interview as an educator is, how can I help my students who have these tendencies? Because the student population I work with, we do have a lot of anxiety. I don’t have any diagnosed OCD at this time, but I’m definitely seeing some of these tendencies.
So what can I do as an educator to help my students succeed if I see these characteristic?
Carrie: Is your school kind of familiar with the growth mindset versus, I can’t remember what the other piece is?
Dr. Kelley: We’re very much a growth mindset campus.
Carrie: I think that is really helpful. Helping kids know that mistakes often are how we learn, especially when you’re young, it’s okay to make mistakes.
Normalizing that because there is some perfectionism that can come with anxiety and OCD. I think I’m a bit of a recovering perfectionist myself. I want things to be done right and I want it to be done right the first time. I can definitely empathize with that kid that asked for another piece of paper because they messed up on their drawing.
Maybe teaching them, it’s still gonna be a great drawing even if you don’t feel like it came out the way that you wanted it to. Or maybe limiting them. If they’re the kid that wants five pieces of paper, say, I’m only gonna give you two. That’s gonna be it. I’ll give you one extra piece of paper. Or that kid that doesn’t wanna start, maybe because they don’t think they can do it, or they don’t think it’s gonna be perfect.
Just really encouraging them like, “Hey, let’s just get started and see where this goes,” or sometimes you kind of, depending on the kid and what motivates them and those types of things, because sometimes kids with OCD can look more defiant than they actually are. They’re not intentionally trying to be defiant. They’re just really distressed internally. And so if you find a way to validate that, I think that’s important. I’ve noticed that it upsets you or that it really bothers you when you don’t feel like your paper is perfect, or I noticed that you don’t like touching the substance because it just feels too sticky.
Then that will help feel like, “Oh, okay, she gets it, and we have the assignment with the sticky substance. So how can we help you be able to work through this concern? Essentially what we’re trying to do, either with anxiety and OCD is not push people to the brink of panic. We’re trying to push people to the brink of discomfort because a lot of times what we do is when we start to feel discomfort as humans, we just back up and we go, no thank you.
Check out. I don’t wanna do that. That’s uncomfortable. I was working on something for the course and talking about physical therapy. One of the things that I learned going through physical therapy that they told me is that a tight muscle is a weak muscle. So if you’ve had a tight muscle in your body and you know what that feels like, you go, “I’m moving that, no thank you.
I don’t wanna stretch that out. I don’t want to, wait you’re asking me to lift my leg, but my leg hurts right now.” Well, your leg hurts because it’s weak. So can we do five repetitions with no weight to strengthen your leg? But if we put some weight on there and we expect you to lift 10 pounds, then you are gonna be in pain and it’s not gonna be good for you.
So maybe just the physical therapy analogy helps a little bit with kind of, and you have to be really good as the teacher or the parent or the spouse or whoever to know what’s gonna be a little bit of a push. And what’s gonna be, oh no, we’re now having like a full-blown panic attack.
Dr. Kelley: Excellent advice.
Carrie: Does that help?
Dr. Kelley: It really does especially the physical therapy analogy. And like you said too, just validating them saying, I see this. And even the way we say it makes a difference because I think over time in education, the way we talk to children has changed. Some of us are still stuck in that old mindset when we have to push forward into the new, to really better understand our kids now and what they are experiencing in their minds because we want them to be successful.
Carrie: Realistically, when you have 20 plus kids in a class and you just need to get it done, there are times where you don’t have all the time to sit down and maybe give the one-on-one attention and you just wanna say, just sit down, just do what I thought you didn’t do.
Dr. Kelley: We all definitely have those days, but there’s also those windows of opportunity where we can cause we want to see them all be successful.
Carrie: Yeah, absolutely. Kelley has listened to our show before. She knows that at the end of every episode, we like to share a story of hope. Which is a time that you have received hope from God or another person. What do you have for us today?
Dr. Kelley: There’s so many to pick from, I have to say because if you sit down and think about all the ways that God touches your life every single day, that list should be miles long. But the ones coming to mind right now. Is it from work at work In December, we do Secret Santa, which is fun. We’re trying to run around and be sneaky and not find out who has our names.
And December is tough in the educational world. We’re tired. Anytime we get close to a break, we’re tired, we’re exhausted because the kids amp up and our energy is down. My secret Santa giving me perfect stuff and I was like, wow, this is really cool. But the end was what really got me. It turned out to be one of my friends, which I did not know.
But in her final gift when she revealed herself. She wrote the nicest note I think I’ve ever received, and talked about how much I love others and how much I give, and I was just floored. I took it home and I showed it to my husband and I said, this is not me. Why is she saying these things about me? Because I feel like my job is to pour into other people and give to other people all the time.
So it’s nice and very humbling when God gives you that moment of, but wait, you’re doing good things and people appreciate it, and I see you. And it was just one of those nice moments. I still have the cards sitting on my desk because it’s one of the things I like to do at school is write cards to people because we all need encouragement.
So it was just nice to receive that back and God just going, it’s okay. You’re good. You’re gonna make it till Christmas break, and I did. So something small, but still a reminder that he’s there and he uses us all the time to encourage each other.
Carrie: Yeah, that’s really cool because we have a hard time. We don’t have objectivity, right?
This is why people go to therapy because when you’re in the middle of your stuff, whatever your stuff is, a lot of times you can’t see the forest for the trees. So when you’re in the middle of stressful work situation, it’s nice for somebody else to say , okay, but this is my perspective of it and this is what I see you doing.
So that’s really nice that she was able to do that for you. Also because she was your friend. She knew what gifts to give you, so that made it easier for her.
Dr. Kelley: Yes. My pastor was talking about last Sunday, if your God lays it on your heart, if you think, oh, I should call this person, I should write this note. Just do it.
Don’t think about it. Just do it. And I feel like that was a great example and a great reminder of just be there for each other and show my love to everyone.
Carrie: Well, thank you so much for taking the time to be on our show and relieving Steve of having to be the fill-in person all the time. He doesn’t mind. I just figure people might get sick of hearing from Steve. I don’t know.
Dr. Kelley: What was great to be here. I enjoyed it and had a lot of fun and I learned a lot.
Carrie: If you are new to our show, I want you all to know where you can find us. Head over to Hope for anxiety and ocd.com. You can hit me up on the contact form if you have any show suggestions, guests you really want me to interview, or just wanna tell me what you think about the show and anything that we can improve on, or questions that you have about OCD that maybe we didn’t cover today, maybe I can stick those in the course for you, or we can have another episode sometime before too long. Thank you so much for listening everybody.
Hope for Anxiety and OCD is a production of By The Well Counseling. Our show is hosted by me, Carrie Bock, licensed professional counselor in Tennessee. Opinions given by our guests are their own and do not necessarily reflect the use of myself or By The Well Counseling. Our original music is by Brandon Mangrum.
Until next time, may you be comforted by God’s great love for you.