by Justin K. Hughes, MA, LPC
Protestant Christians who present with symptoms of OCD often wish to know that their faith will be taken seriously when they are being diagnosed, treated, and ultimately guided towards improved mental health. While some may go to a practitioner without a second thought, others will come with hesitations, at least initially. This brief introduction is written especially for those who are beginning to explore treatment options. It is our hope that this brief introduction might help you get support you need so you can recover that which was lost to the OCD.
What OCD Is and What Is Its Best Treatment?
Though you will find it all over this website, it bears repeating that the gold standard treatment for OCD is ERP (Exposure and Response Prevention, a subset of Cognitive Behavioral Therapy, or CBT), and/or SRI medications.
OCD is not a problem of faith in its own right. OCD can have negative aspects on nearly every domain of life, and obsessions can attach themselves to just about anything- including aspects of one’s faith. Click here to jump to specific articles that discuss this further.
What Are Protestant Christians Looking For In Treatment?
While Protestants will vary in what they are seeking, there are a few things that are very common.
First of all, many are unified by considering problems and their solutions holistically. This is reflected in seeking to have a deep understanding, considering a person to be biological, psychological, social, AND spiritual. You can be assured that many clinicians, appropriately trained and thoughtful, will consider your health holistically.
Appreciation for Individual Responsibility
Protestants often prize individual responsibility and the role they play in being thoughtful and responsible towards themselves, others, and God. Because of this, they may fear that seeking treatment will involve simply "trusting others" while leaving their own personal responsibility behind. It is very important for them to know that this value can not only be incorporated into treatment, but it can also be used as a strength in their journey of OCD recovery.
Interconnected Relationships and Faith Community
As a complement rather than a contrast to individual responsibility, Protestants value operating within a connected faith community as part of the larger worldwide church. They often express a desire to be part of something greater than themselves and to love their neighbor. Therefore, it is vital for them to receive therapy that helps them live this out, emphasizing how their treatment journey is part of the greater good rather than purely an individual endeavor.
We Hear You
We see and hear you that it’s important for at least some of the following mindsets or competencies to be present in therapy:
- Knowledge of Scripture
- The role of community / church
- How to take individual responsibility
- How to transcend a humanistic endeavor and to appreciate a larger purpose of helping, serving others, and loving God
- Values of a moral, sexual, and ethical nature
- Living out faith in Christ
- Considerations of how to suffer well and faithfully
- God’s purpose over personal comfort
- How to ultimately love one’s neighbor through steps in treatment
The Core of Treatment: Developing A Different Relationship To Doubt & Uncertainty
Though experiences of OCD are broad and varied (researchers say heterogeneous), the core of its treatment largely remains the same with minor variations for most. It is largely about changing the behaviors and mental responses that contribute to the maintenance of the disorder (e.g. learning how to experience doubt in uncertainty without engaging in compulsions).
While you will undoubtedly hear different language from expert clinicians as to the “heart” of OCD, most experts share a unified view that learning to respond differently to doubt and uncertainty- all the while maintaining alignment with what the patient values- is essential to treatment.
Common misconceptions about what exposure therapy is, and/or other suggested treatments, can lead to avoidance or delay of treatment. This is a key reason why it’s important for you to know that at its foundation, exposure and related exercises, when done well will help you:
- Take into account your beliefs and actions.
- Better integrate actual beliefs (even if this part of the work is largely outside of the treatment room).
- Minimize impairment and increase engagement with life.
- Tolerate doubt and uncertainty.
- Learn how to live your faith in a way that’s not compulsive.
Just to be crystal clear: you never have to sacrifice actual valued beliefs to effectively engage in treatment. While you will probably feel you are sacrificing your values or beliefs at times during exposure exercises, this feeling is actually just the doubt and uncertainty that OCD produces. In treatment, you will learn to accept and face this feeling without engaging in compulsions. Learn more about how clinicians design exposures in a religiously sensitive way here.
Body/Mind/Spirit Confusion - What Is It We Are Really Doing Here?
Two common reasons Christians may be confused about how treatment fits into recovery from OCD:
- In believing that God is supposed to be sufficient for any problem, Christians can confuse this with thinking God fixes any temporary problem with enough faith and/or wants to use exclusively spiritual means to do so.
- Many Christians have also seen incredible examples, whether through someone they know directly or a testimony," of people who have found incredible freedom from an array of mental health challenges. These seemingly uncommon, or even miraculous stories, are sometimes used as proof that the average person just needs to do what that person did to be delivered from mental health challenges. However, this reasoning is often applied inconsistently, as it is not used as readily in other illnesses, such as cancer, heart disease, PTSD, etc. In contrast to mental illness, these illnesses don't tend to be seen as addressable only through spiritual means.
While this is a rather complex and nuanced topic best addressed in depth elsewhere (see “An Introduction To The Over-Active Conscience”), based on extensive research we can say that doing compulsions makes OCD worse; learning not to compulse improves the condition.
The learning model of CBT studies how we learn, grow, change, and more. This is not antithetical to a strong faith in Christ alone, but can rather be considered a good gift of God regardless of faith in Him. This is often referred to as “common grace,” other examples being the rain, sunshine, medication, etc.
Missing Pieces and Misapplication
- Many fear that psychology, at its best, will miss a crucial piece of the puzzle. At its worst, they fear that it will work in opposition to faith.
- These fears often appear to be confirmed when a clinician suggests exposures that, to the client unfamiliar with OCD treatment, can sound blasphemous, self-centric, avoidant towards God, and supportive of negative thinking. For example, when a person has intrusive, blasphemous thoughts or unwanted sexual intrusions, exercises like scripting them on paper (imaginal exposure) or simply repeating these back to oneself appear to be agreeing with such thoughts. However, the real goal of such exposures is to learn how not to react and/or compulse in response to the obsession.
- Misapplication of treatment does happen, albeit rarely. To be fair, many of us as clinicians have heard from our clients terrible occurrences of another clinician not properly assessing a client’s faith and religious beliefs and making suggestions that are truly contrary to the valued beliefs of Christians. Hopefully, you will not “throw the baby out with the bathwater” and dismiss all treatment. As expert clinicians, we’ve heard all sorts of examples from clients who were asked to:
- Not attend their place of worship altogether (same applies to Bible reading, prayer, etc.).
- Play with a Ouija board for an exposure.
- Mentally shout things a client and their congregation considers to be blasphemous and they wish not to do.
- View pornography for an exposure.
These appear to be the exception rather than the norm- though it is also important to state that clients must assert for themselves what they are/aren’t willing to do, especially when they work with a clinician who is not familiar with their beliefs.
Some simple questions will help to vet a potential therapist in most cases. See the IOCDF's article on how to find a therapist here.
Not only is it possible to walk faith-congruently while receiving CBT/ERP treatment for OCD, it happens regularly. You can discover more of these through many avenues, not the least of which is actual therapists, but through advocacy organizations like the IOCDF, local/international conferences on OCD, and the resources provided at the end.
Your Best Available Help Might Not Be Christian
Let's face it, none of us can have it all. And the same is true when it comes to finding help. It is possible based on your location, access to care, financial status, and so forth, that you will have to be more open to a provider who might not tick every box but has enough of the essential training to get you where you need to go.
My favorite article on this topic is by Dr. Ted Witzig, Four Things Christians Seeking OCD Treatment Are Looking For.
As a Protestant Christian who loves Jesus, specializes in working with OCD and anxiety, and who has treated countless Christians, I have no hesitation in saying that, all other factors equal, going to a non-Christian therapist who is properly trained in ERP will be more beneficial for OCD treatment than going to a Christian therapist who is not trained in ERP.
This Is Your Journey
I hope you'll take these considerations to heart. Part of what's important is for us each of us to seek what's good and true, with God's help, at the specific place we are in our journey. It is the hope of task force for the “OCD and Faith” page that you can get the best treatments that make a real difference in your life. Perhaps you are early in your journey just trying to discover whether you can do ERP in a way congruent with your faith. Welcome. If you're further along the journey, hopefully you will be uplifted and supported even more in your holistic pursuit of health- body, mind and spirit. Wherever you are, I pray God's grace and peace goes with you today.
Other Articles on Faith, Fear, And Uncertainty:
Ted Witzig, PhD:
- Seven Shifts For Beating Religious Scrupulosity
- Scrupulosity OCD & Mending Your God Image
- Five Keys to Beating Scrupulosity
- Religious and Moral Scrupulosity in Christians
- Coping Statements For Christians With OCD and Scrupulosity
- Principles of Effective And Religiously-Sensitive Exposures
- Four Things Christians Seeking OCD Treatment Are Looking For
- Finding an Intensive or Residential Program for OCD Treatment
- Common Obsessional Themes In Christians With Scrupulosity OCD
- Obsessive-Compulsive Disorder in Adults
- Obsessive-Compulsive Disorder in Children & Teens
- Help for Family Members and Friends of Someone with OCD
- Obsessive-Compulsive Related Disorders
- OCD and Scrupulosity Videos
- The Whirlpool Model For Beating Rumination
- Characteristics of Obsessional Thinking
- The ‘Overactive Conscience’ Part 1 – Introduction
- The ‘Overactive Conscience’ Part 2 – Nature of the Problem
- The ‘Overactive Conscience’ Part 3- Dealing With It
Justin K. Hughes, MA, LPC:
- The Holy Spirit Is Different Than Your Emotions Or Thoughts
- Is Anxiety Sin?
- Intrusive, Unwanted Thoughts and Faith
- Psychological Flexibility and Christians
- A Biblical Rationale for Exposure Therapy
- Face Fear, Flee Temptation
- Fear Not
- Can Christians Be Free From Uncertainty? (4 Part Series)
Ian Osborn, MD:
Mind and Soul Foundation: