Podcasts about anxiety treatment center

Paul Peterson is a Licensed Clinical Social Worker and the CEO of the OCD and Anxiety Treatment Center. His practice involves mainly working with Anxiety, OCD, Hoarding, and Trichotillomania. He also works with patients suffering from comorbid issues. His practice evolved from his early years of marriage, where he realized his wife and son were living with OCD.  After using the by-the-book methods to treat his son, he realized treatment could be better. Today, he has cultivated methods of treating OCD by learning from different experts in the field and applying what he sees fitting best with each individual patient. In this episode we talk about:  ◾️Peter's personal history in treating OCD ◾️ A deeper dive into OCD treatments ◾️ Finding the right method for your OCD Find Paul here: theocdandanxietytreatmentcenter.com Find Zach here: zachwesterbeck.com/ocd-coaching @zach_westerbeck Discover the transformative power of my Concierge OCD Coaching program, where personalized support meets proven strategies to help you overcome intrusive thoughts and reclaim your life. Experience up to two one-on-one coaching sessions each week, tailored resources designed specifically for your journey, and a customized roadmap that guides you every step of the way. Plus, enjoy text support between sessions to keep you on track and motivated. This isn't just coaching; it's a life-changing opportunity to unlock your potential and embrace a calmer, happier existence. Don't wait—take the first step toward your transformation and apply now:  Disclaimer: Nothing here is medical advice. Please do your own research. The information above is just for informational and educational purposes. If you require assistance with any mental health or medical issue, please contact your healthcare provider for any medical care or medical advice.

In this episode with Dr. Edmund J. Bourne we address the epidemic of anxiety and anxiety related disorders. Edmund has been researching panic, phobias, anxiety and OCD for over three decades and has a comprehensive program for overcoming each one. Edmund is highly researched and detailed and in this episode he describes each detail of the various disorders and the most evidence based research for how to reduce their symptoms and live free of their hold. Edmund has combined best practices to create a holistic prevention, healing, and maintenance plan for these common conditions. You'll want to get your pen out and be taking notes for this one! We cover: Which personality types are more likely to have anxiety and panic Lifestyle changes for decreasing anxiety  Which types of physical exercise are most highly recommended for anxious personality and for how long we should move our bodies. How to do progressive relaxation What to do before trying interoceptive exposure. The importance of alternative coping statements The four-step process to dealing w panic attacks  Exposure response prevention and the differences between incremental exposure, coping exposure, full exposure and flooding. When medication is recommended for the anxiety related diagnosis. And so much more… Make sure to listen all the way to the end where Dr. Bourne shares some important final thoughts on anxiety. Dr. Edmund Bourne, Ph.D. has specialized in the treatment of anxiety disorders and related problems for more than three decades. For many years he was director of the Anxiety Treatment Center in San Jose and Santa Rosa, California. His best-selling anxiety workbooks, which have helped hundreds of thousands of readers throughout the world, include The Anxiety & Phobia Workbook, Healing Fear, Beyond Anxiety & Phobia, Coping With Anxiety, and Natural Relief for Anxiety. Dr. Bourne is frequently interviewed by the media, and his work has been featured in numerous magazines, such as Psychology Today, Natural Health, Cosmopolitan, Fitness, and Bottom Line Personal. Dr. Bourne currently lives and practices in California. He maintains a commitment to helping create world peace by teaching people how to create greater peace in their lives. -------------------------------------------------------------------------------------------------------------- Your support is deeply appreciated! Find me, Lara, on my Website / Instagram You can support this podcast with any level of donation here. Order The Essential Guide to Trauma Sensitive Yoga: How to Create Safer Spaces for All Opening and Closing music: Other People's Photographs courtesy of Daniel Zaitchik. Follow Daniel on Spotify.

Relevance Behavioral Health (866-986-9583) is pleased to be a leader in evidence-based, multidisciplinary, holistic and personalized anxiety treatment in the State of New Jersey. They welcome all residents to get help. Get the leading care you deserve at https://relevancerecovery.com/. Relevance Behavioral Health City: Freehold Township Address: 61 W Main Street Website: https://relevancerecovery.com/ Phone: +1 866 245 1497 Email: info@hucenters.com

In This Episode: Amy Mariaskin, PhD shares her new book, Thriving in relationships when you have ocd What is Family accommodation and how does it apply to ocd Ocd family accommodation vs family support,  What is OCD reassurance and how it can creep into one's relationship Relationship ocd, also known as rOCD Relationship issues with ocd and how to manage them Sexual orientation OCD, Gender related OCD, and Harm OCD and the impact this has on relationships Attachment styles in ocd and how to understand them to help you navigate communication.  Links To Things I Talk About: Thriving in Relationships When You Have OCD: How to Keep Obsessions and Compulsions from Sabotaging Love, Friendship, and Family Connections Amy's Instagram https://www.instagram.com/ocdnashville/?hl=en ERP School: https://www.cbtschool.com/erp-school-lp Episode Sponsor:This episode of Your Anxiety Toolkit is brought to you by CBTschool.com.  CBTschool.com is a psychoeducation platform that provides courses and other online resources for people with anxiety, OCD, and Body-Focused Repetitive Behaviors.  Go to cbtschool.com to learn more. Spread the love! Everyone needs tools for anxiety...If you like Your Anxiety Toolkit Podcast, visit YOUR ANXIETY TOOLKIT PODCAST to subscribe free and you'll never miss an episode. And if you really like Your Anxiety Toolkit, I'd appreciate you telling a friend (maybe even two). EPISODE TRANSCRIPTION This Your Anxiety Toolkit - Episode 312.  Welcome back, everybody. This is going to be a really important episode for you to listen to. Today, we have the amazing Dr. Amy Mariaskin, who is what I consider to be a very dear friend, someone I very much respect. She has written a book about relationships and OCD, and we talk all about it. We go deep into some of the core skills and discussions she has in her upcoming book. And this is just going to be an episode I really feel like you could take away and put some skills together right away. I'm so thrilled. So, thank you, Amy, for coming on this show.  But before we do that, I would like to do the review of the week, and I really hope you listen carefully to this. Not because it's reviewing the podcast, but because I actually think the person who wrote this, who put in this review, is following some key points that I want you to consider. And this is what I encourage a lot of people to do. So, let's go.  This is from Detroitreview and they said: “Thank you, I just started listening today after having a few weeks of anxiety and irregular thoughts that I never experienced. I randomly chose your podcast and am thankful for your experience, knowledge and personal and situations. As a 46-year-old father of two boys and loving wife, your podcast gives me a sense of calming. I'm taking notes on each cast.” Guys, I encourage you to do this. This is a free resource. It is jam packed full of skills. I encourage you to take notes. So, I love that you're doing that Detroitreview. “While I started with the most recent, I have listened to #301/302/303.” And then they went on to say: “And they've already given me strategies that I'm using. I decided to start from your first podcast in 2016.” And that is what I encourage you all to do, mainly because those first 11 episodes are core content. I want you to take the content I talk with my patients about all the time. He went on to say, “I have been so impressed. I've listened to 1-2 daily. I'm up to 10 and 11. There's so many things to listen to and I'm so grateful for you. The meditations are amazing. Keep up the great work.” Thank you so much for that review, Detroitreview. That is exactly my intention. This is a free resource, you guys. I want you to take advantage of the skills and tools so that you can have a toolkit for yourself. And so, I'm so thrilled for that review. It just makes me feel like, yes, that's exactly what I want you guys to take from this podcast. Okay, before we get over to the show, let's talk about the “I did a hard thing” segment. This one is from Kelly, and they said: “I recently faced one of my biggest fears – general anesthesia.” Holy moly, Kelly, I feel you on so many levels with this. “I started struggling with some gallbladder issues and was told I needed to have it removed. I was terrified, and I didn't think I could go through with it. Thoughts were racing out of control. I sought help with therapy and your podcast. Thoughts are thoughts and not facts was huge for me. It was calm the day of the surgery, and I did it. Thank you.” That is amazing. You guys, listen, thoughts are thoughts. Just because you have them doesn't mean they're facts. I love that they're bringing in that key concept as well.  Alright, let's go over to the show. This is the amazing Dr. Amy Mariaskin. She's an OCD therapist. She's an advocate. She's an author of an upcoming book. You must go and check it out. I'll leave the link in the show notes. I am so, so honored to have you on the show, Amy. Let's get over to the episode. Kimberley: Welcome, Amy Mariaskin. I am so excited for this episode today. Can you do a little introduction of who you are and all the good things about you? Amy: Yes. Thank you so much. I'm excited to be here. I'm Dr. Amy Mariaskin. I'm a licensed clinical psychologist and owner and director of the Nashville OCD and Anxiety Treatment Center in Brentwood, Tennessee. I've been working with OCD and anxiety for over 15 years now, and I just absolutely love it. Kimberley: And you wrote a book? Amy: And I wrote a book. I know I need to get better about that. I was like, “Oh, do I say it now or do I say it later?” Kimberley: You say it all the way. Amy: All the time. I wrote a book. It was fun and not fun and everything in between. And I think we'll be talking quite a bit about it. It's called Thriving in Relationships When You Have OCD. Kimberley: Right. Now, when you told me that you were going to write this book, I was so excited because I feel like at the crux of everything we do, a lot of the time, the reason people with OCD want to get better or the thing that propels them is how much their OCD impacts relationships. Not always, but I feel like that's such a huge piece of the work. So, I am so grateful for you for writing this book, and it is an amazing book. I've read it myself. You did a beautiful job. And I want to cover some of the main pieces that you cover in your book today and go from there. So, first of all, congratulations. I know writing a book is not easy. Amy: Thank you. Yeah, it's been a dream for a long time. So, I'm excited about the accomplishment and I'm ready to figure out the next topic. When Ocd Is The Third Wheel Kimberley: Yeah. I love it. I love it. Okay. So, Chapter 1, I think it's funny. I'll have to tell you how, when I was reading your book, I was lucky enough to get an early manuscript. I remember sitting, it was with my kids at track and they were running. And I opened the book and the first chapter said, “The Third Wheel: Understanding OCD's Role in Relationships.” And I was like, “That's exactly it.” So, I was excited right off the bat. Tell me, what do you mean by the third wheel? Tell me a little bit about that. Amy: Yeah. First, I should also thank you for writing the wonderful foreword for the book. So, if anybody is a fan of Kimberley, yet another reason that you might be interested in this book. Well, let me think. So, yeah, the third wheel analogy, it felt very apt because when I work with couples, I often imagine, and sometimes I'll have couples imagine that the OCD is like this other presence in the room sitting there with us. Not physically, but in all the things that are important for relationships, all the ways that we develop intimacy, and that we even structure our time or the activities we choose to do together that OCD can wiggle right in there and can be this like third presence. And the thing is, it's really easy, I think, for somebody without OCD if they don't have good education or they don't understand it, to get that third wheel confused with the person with OCD itself. So, like, “Well, you never want to go out,” as opposed to saying, “We both want to go out.” And here's this other guy, OCD, really bossy, really pushy, really oppressive, who's also coming along with us. And even when you do the things that you love, OCD can come along.  So, it felt to me like this sense of something in the relationship that makes it both unbalanced and is this separate component and that both people, in coming together, have to find creative ways to connect around it or eventually connect and evict it more and more. And so, that's why I chose that metaphor. Kimberley: Yeah, I love that. And it's funny because I remember when I was an intern and I was seeing a family or perhaps the wife who had OCD, what was interesting is I'm sitting in my chair and I noticed that the family members always sat across from her as if it was like her versus them, like who's on which side of the team. And a big part of it was like, all you guys need to be over on that side of the room. You're the team. I'll be over here with OCD and we'll work this out. But I think that that, even metaphorically, is such an important part of how OCD can turn everyone against each other. Is that how you've experienced it? Amy: Yeah, I think at times there are a lot of conversations about how everybody has a common goal to figure out how to live with one another, develop intimacy, connections, be they friendships, parenting relationships, romantic relationships, even work relationships, and things like that, how to form those and how to come together around common goals. And sometimes OCD can be, again, confused as a goal that one person in the relationship has. And the truth is, everybody's suffering in a way, and that everybody can be a part of that process of, again, reducing symptoms or evicting it, things like that.  I do the thing as well when I have people in my office to just look at where are they sitting or when OCD comes up, what is the body language? Are both people really like arms crossed? Is the person with OCD hanging their head in shame, which we know could be such a powerful emotion and such an inhibitor of connection and vulnerability. So, I look for some of those and I remind them, “Head up, we're all talking to OCD right now, and we're all working with that, and we're all on the same team.”  Family Accommodation & Ocd Kimberley: Such an important message. Thank you for that. I think that's beautiful. So, let's say the third wheel, I always think of like you go on a date and the third wheel shows up. And we know that definitely happens with OCD. You addressed a lot in your book about family accommodation. Can you share what that means and how that can impact a relationship? Amy: Yeah, absolutely. Accommodation is this thing where we're extending this metaphor. You're on a date, you're with somebody, and the third wheel rolls on up. It's, “Hey, my buddy from college is here, what's up?” Essentially, accommodation is like, “Hey, why don't you have a seat right here? Here's the menu, here's a place mat.” It is anything that the person in the relationship without OCD is doing to make OCD have a comfortable place at the table. So, that's the metaphorical way. That's abstract, but bringing it down to practically what it looks like, it means doing things generally in the service of what feels comfortable in the moment for the person with OCD. We're going on a trip and I have concerns about contamination and I really want you to check all the hotels, do all this research to make sure that none of these places have ever had bedbugs or things like that. Then when we get there, we're dirty from traveling, so I'm going to need you to take a shower. And so, the person, the spouse is taking showers and doing research and perhaps taking over responsibilities from the person with the OCD in order to provide that short-term relief. But it ends up, again, making a place for OCD in the relationship. And it reduces that motivation for the person with OCD to change.  Family Accommodation is tricky. There are a lot of ways that it can happen. I think reassurance-seeking is certainly one that I think we'll talk about, but providing excessive reassurance about things to the person with OCD in a way to keep them comfortable but keep them caught up in compulsions. And I think it's important to note that a lot of times, partners will hear about accommodation. And just as much as we think being apprised of accommodation and looking out for it is important, it's also, I think, really important that partners understand that that's nuanced and that they don't take it to like, “Well, I'm not going to do that for you. That might be accommodation,” or, “I'm not going to reassure you about anything,” or “Is that your OCD?” I guess I say that to say that it's a little tricky, but it's really anything that is preventing the person with OCD from experiencing discomfort and thereby strengthening the cycle. Kimberley: Right. No, I'm grateful that you bring that up actually, because probably the one that I get asked the most from parents, and this not in every relationship, but with parents, is like, okay, my child is having a really hard time getting homework done, their OCD is impacting them. So, if I don't help accommodate them, if I don't do some compulsions for them, read for them or so forth, they won't do their homework. And then there's an additional consequence. So, they'll say like, “I feel like that's too risky. I could actually be letting my kid fall behind, so I can't stop doing this accommodation.” What are your thoughts on that? Again, how would you approach that type of situation? I mean, there's many examples. Amy: Sure. I think with a situation like that, first, I would validate the parents' love and desire for their child to do as well as possible. Most accommodation is coming from a place of love and not a deliberate enabling or anything like that. Of course not. So, I really provide a lot of validation there. And then I help them reframe it as, “One way to be loving and supportive in the long run is to really cheer your child on in taking over, taking on more and more ownership of that.” So, does that mean, “I know that I've been reading. Right now, I've been reading for you, and that makes it easier to do your homework. We also know that you have OCD and we know that your brain tells you, you've got to reread and reread and reread. So, can we be on the same team together, fight that rereading? I'm not going to read it for you because I love you, because I know you can do this. Boy, is it going to be hard at first and I'm going to be there to cheer you on and motivate you.” I sit with kids, I'm always about gamifying it. “Do we want to just race through this? We don't have to be perfect.” Again, it depends on the symptoms, if it's perfectionism or what's getting in the way.  And then what I say is, if a parent says, “Well, then they're really just not going to get their schoolwork done,” sometimes then I'll say, “Well, if it gets to the point where it is interfering with things like that, then it may be that they need a little bit more support.” Because it's like, with kids, your job is school and with the adults, your job can be a job or it can be care taking. It can be a lot of different things. But if one of those major domains of living is affected, then it may just mean that you need more support. So, we might up the number of sessions per week or refer out to another program or things like that.  But those kinds of things would be the same things I would say in any kind of relationship where there's an accommodator, which is, wow, you love your friend or partner or coworker so much that you're willing to do this stuff for them so that they're not suffering or so that they can demonstrate their potential as in the case of the kid with homework. But here's why that's not the loving response in the long run. Ocd Family Accommodation Vs Ocd Support  Kimberley: Right. You're right. I mean, you mentioned like, then we have the complete other end of the spectrum where people are going, “No, I'm cutting you off completely.” And I think too, I think it's important, as you said. Some accommodation happens in every relationship. I don't particularly like cleaning hair out of the sink drain. That's not my favorite. So, I'm going to ask my husband to do it, knowing that I take the trash out or whatever. We trade-off. So, how might people identify accommodation through the lens of OCD compared to loving exchanges of acts of service?  Amy: Right. Oh, I love that question, because essentially, what we call compromise in relationships could be called accommodation – accommodation by a gentler name. And I think part of that has to do with, what's the motivation there? You do such a wonderful job in your podcasts and online and everything of talking about how doing the hard things are important, and how if you're not doing the hard things and you're avoiding difficult things that can really shrink your world over time and put anxiety or OCD in the driver's seat. So, if the motivation, if a child or a spouse or a friend is asking-- well, if you are asking a child or a friend or a spouse, if you're saying, “Hey, can you do this for me,” or “I'd feel a lot more comfortable if you did this,” thinking about, is it a compulsion or a preference to me? There are so many different ways that we can look into that, but is it in the service of just like, I could, but I prefer not to? Or is it, I feel like if I do that, I'm going to be too anxious or I'm going to do too many compulsions, or something bad is going to happen? So, I think if the motivation there is more avoidance due to anxiety as opposed to just preferences, I think that's helpful.  Sometimes I'll say to people when they'll say to me like, “Well--” and I think division of labor in the house is such a good example. When people say, “Well, I don't ever take the trash out,” I will often ask, “Well, what happens when your roommates are out of town?” Let's say they're living in a roommate situation. And if they say, “Well, it just piles up and I can't deal with it,” then I say, “Aha, this might be a place that we need to work on and chip away.” And again, reducing accommodations doesn't mean like all of a sudden, I'm a garbage master and I'm the only one doing it. It might mean that I'm doing some exposures to get up to the point where I can have that role in the household.  So, I love that question of like, well, what if you had to do it? What would that be like? And if it's really hard, then hey, let's help break down some of those barriers and reduce accommodation. OCD Reassurance Kimberley: Yeah. I usually tell clients like, “Okay, let's just do it so that we know you can, and then you can move on to the next exposure.” Tell us about reassurance. You talked about it a little bit. And in your book, actually, the thing I highlighted, because I read it in Kindle, that I love the most is your reassurance tracking. Tell us a little about that.  Amy: Yes. Because again, I love that you're highlighting this because reassurance is something that is okay. Reassurance happens in all relationships. Again, we might call it by different names. It might just be checking in. It might be clarification. It might be getting information from one another. So, I developed a worksheet that's also available with the book that allows for people to track when they're asking for reassurance from loved ones, and to answer a series of questions that aren't going to give you a 100% certain answer of whether or not it's compulsive, but are going to give you some clues. So, on the worksheet, it says, people write down the situation. So, for example, I was asking my friend if she was mad at me. That might be the situation. And then there's a column that says, what were your emotions?  Again, if we're seeing anxiety, guilt, shame, some of those words might be a clue that our OCD is at play, but not always. And then people track, did you ask only once? Because we also know if it's truly the type of reassurance, “Oh, I just need to know. I'm having a vulnerable moment. I just need to know, is this okay with you? Are you upset?” Then asking once and accepting the answer is generally how it goes. So, if you're asking more than once, if you answer no to that, it's a clue that it could be compulsive reassurance. And then also, was the source credible?  I feel like I talk about this example a lot, but I just love it so much, which is that I worked with a little girl who was really worried about getting strep throat. She would ask everybody for reassurance about her tonsils. I mean, anybody and everyone. At one point, she took a picture and she was just old enough that she got social media. She put it on her Instagram and she was like, “Do you guys think I have a strep throat?” That was the caption. That was the little caption, which is like, she was laughing about it afterwards, but that's not a credible source. I mean, she wasn't even friends with all the docs in town or anything, or ear, nose, and throat specialist. So, was the source credible?  Now, often if it's social reassurance, it is a credible source. If I ask you, if I say, “Kimberley, was I too long-winded,” you're going to be able to tell me. So, you would be a credible source. If I leave this room right now after doing this podcast and I ask somebody, “Do you think I was long-winded? Do you think I was?” and they're like, “Well, we weren't there,” that's that answer. That's that question about credibility.  And then the last one is, did you accept the answer? Anxiety and OCD have this way of undermining. Well, pretty much everything, but undermining any answer we get and countering with it. ‘What if,' or ‘Are you sure?' ‘But I think...' So, if it's starting with a ‘but,' a ‘maybe,' a ‘what-if,' then again, it may not be that helpful reassurance-seeking. Relationship Ocd (Rocd) Vs Relationship Issues With Ocd Kimberley: Yeah, I love that. And thank you for adding that because I just love that template so much. That is just like gold. I love it so much. Alright. So, as you move into Chapter 4, I believe it is, you talk about specific subtypes of OCD that are commonly impacted in relationships. Can you share just briefly what your thoughts are around that? Amy: Yeah. I love this question too because as I've been talking about the book, a lot of people are like, “Oh, great, a book about ROCD, or relationship OCD.” And my answer to that, or my response to that is, “Yes, and...” Just a step back, any subtype of OCD can affect and often does affect relationships. Why? Because OCD goes after what's important to us. And for many of us, our connectedness with one another is just so important. That being said, there are subtypes of OCD that are relational in nature. And so, I do have a chapter that is more devoted to these types, and one of which is relationship OCD. This is a passion of mine. I've done now a few iterations of an ROCD treatment group at my clinic, and I have other plans to expand that group and do some cool programming around that.  But relationship OCD, it's basically when OCD symptoms are about the relationship itself or about the person with whom you're in relationship. So, it could be about-- we think about it a lot of times with romantic relationships, but it could be any relationship. To use a different one, it could be, am I a loving enough parent? Do I love my kids enough? How do I know? Do other parents have these thoughts? So, it could be about the relationship or it can be about the individual. Like, my spouse doesn't like the same music that I do, and are we ever going to get past this? And so, something that might be seen as, yes, it's an actual difference, but then there's all this story making around the difference and how the difference is going to be the demise of the relationship. Those are the two flavors of ROCD, relationship and partner-focused.  I also want to pause here and say that oftentimes when people talk about ROCD, I feel like there's this pull to say, “Well, if you know you have ROCD, if relationship issues come up in your relationship, it's probably your ROCD.” And that's just like another backdoor to the certainty that we all want. I think all relationships have some crunchy bits and some edges that chafe. And so, I want the people with ROCD to feel empowered to also develop the relationships that they want and then notice that maybe the ROCD turns up the volume on some of their concerns, if that makes sense.  Kimberley: It's hard, isn't it? Because so many times a patient will say, “But I don't know if I really love-- is he the one?” And we're like, “Well, we'll never know.” There's no way to objectively define that. And then someone, a friend is like, “Well, if you don't know, it must be a problem.” It's so hard for those people because people without OCD also don't know all the time either, so it's a common concern. Sexual Orientation Ocd & Gender Related Ocd Amy: Right. No, that's a great point. So, I have some stuff about relationship OCD in there and then the identity subtypes of OCD as well. So, sexual orientation OCD and gender-related OCD. I put those in there because oftentimes our identity is the foundation from which we interact with others and create relationships and things like that. So, I talk a little bit about sexual orientation OCD, not just even in dating, but in finding a community and friendship and things like that. SOOCD can rear up and lead to lots of social comparisons or it can just really try to sabotage certain relationships, and with gender-related OCD as well, be it somebody who is cisgender and wondering if they are transgender or vice versa. I've worked with people in the transgender community who have OCD and have these unwanted thoughts about like, “Well, what if this is not who I am? What if I've been doing this for attention?” And then, therefore, are wanting to compulsively disengage from their community because of the feeling of like, “Well, I don't feel authentic enough.” So, that's a way in which that can root in relationally. Kimberley: Right. So, we've got relationship OCD and identity. What are the other ones?  Harm Ocd & Its Impact On Relationships Amy: Yeah. And then the last one that I highlighted in here in that section is harm OCD. And I put that in there because harm OCD, which again is a huge category, which I would say under that are anything that's violent. That could be sexual as well. So, sexual violence toward others or sexual intrusive-- obviously, all intrusive thoughts, but intrusive thoughts about being sexual with children. I would roll all that into the harm OCD category. And this one is just, it's always so striking to me the ways in which OCD can take something that's really important. Like, I want to be a good person, I want to be a kind person and then undermine it. So, the amount of people I've worked with harm OCD who are experiencing isolation and really the self-imposed isolation, the irony of which is “I'm isolating myself because I don't want to harm others,” but then they're withholding themselves as this fantastic person to be out in the world. And so, that's what I always say, is you're doing more harm isolating, but sort of. Get out there. You have so much to offer and in fact, your OCD has attacked this area because it's important for you generally to have relations with others. Kimberley: Yeah, I love that. So, I love how you've given us a way, and as you said, it can impact any relationship outside of those subtypes as well. What I'd love to do is give you the mic and tell us just now, in general, give us your best relationship ideas, advice, tips, tools, whatever you want to call them, for the person with OCD and the loved ones of people with OCD. Amy: Yeah. Thank you. I feel like that's a dangerous thing to be giving me the mic. Kimberley: It's all yours. Go for it. What's the main thing you want people to know? Amy: I think I want for people to be able to-- number one, there's no right or wrong way to have a relationship provided that everything is consensual and respectful. And so, taking a step back-- and actually Russ Harris just put out this. I don't know if you saw this, but this incredible list of relational values words. So, there's an activity where-- or I don't know if it's new, it's new to me. That's clarifying what are your relational values and what are they with different relationships? Is it playfulness? Is it intimacy? And so, figuring out what you want and having your spouse do the same. In our relationship OCD group, most recently, we had people and their significant others, I shouldn't say spouse, do this and figuring out ways to connect around those things. I think it comes down to connection and to supporting each person, like supporting each other's goals.  I think I'm bringing this up in part because I think sometimes there are these narratives out there about like, we have to have all the same interests or opposites attract. And again, to that, I say yes, and... For some people, they want people with really similar interests and for others, they want somebody who's going to be different. But I think what we can do is support each other and try to see the world through your loved one's eyes and try to celebrate when they're celebrating.  I think part of this is like, I'm married to somebody who's a huge thrill seeker. He's paragliding. He just got his private pilot's license. He does things that are not in my nature. If he's gone out and he's done some sort of paragliding trip in a different country, and he'll come back and he'll say, “I found a lift here and there were thermals,” in my head, I'm like, “You didn't die. You didn't die. Yeah, you didn't die.” And I have to stop my own anxious story about it or my own interpretation of “I wouldn't like that” and just be there with him in that moment of sharing his joy. It's finding joy in others' joy. It's being there with other people's emotions about whatever they are. Because I think with anxiety and OCD, it can always be this upper-level analytical process of like, “Oof, I don't like that. Is that okay?” or things like that. I know a lot of the Gottman's research will talk as well about how very important it is to just support one another, be cheerleaders, et cetera.  Attachment Style & Ocd  I think too, knowing your attachment style. And this is a whole topic that we could spend forever on, but knowing if you're somebody who-- when you get close to others, do you feel more resistance in getting closer or do you feel worries about like, “Ugh, I don't want to lose myself by merging with someone else”? Or do you have more resistance around, “I'm worried they'll abandon me, I'm worried they won't love me enough?” And that's a very, very, very rudimentary look at two of the concepts of attachment, that more avoidant attachment where it's, “I'm worried I'll be subsumed by the other person and I value independence,” or more anxious attachment, which is, “I'm worried they won't love me enough or I'll be abandoned.” Knowing that and knowing when those thoughts come up, take a pause, take a step back and check in with yourself and your body and the facts and things like that, instead of reacting in that moment. When anxiety is there, it wants us to just react to every alarming or provocative thought that we have. So, yeah, those are some things. I know that I had them scrolling through because I know I had more in the book from the Gottman. They're top of mind. Kimberley: I think back to when I was first married, I was so young. So, if someone had explained to me attachment styles, it would've made the first five years so much easier. You know what I mean? My husband would go away. He's actually away right now. He would go away because he loves to fly fish. And for me, I would feel anxiety because he would leave and I would interpret, because I'm anxious, and I was like, “No, this isn't hard for me to be alone.” It would quickly turn to anger towards him for having a hobby. I'm totally fine to say this too. I'm feeling anxious here by myself. He's off doing something fun for him. So then I got angry that he's doing fun things and leaving me to have my anxiety. He would come home not to a happy wife. He would come home to wife with her hands on her hips. You know what I mean? And I think that that is so common for people with anxiety. When you're feeling anxious, you feel like they're doing it to you like, “Why are you doing this to me?” And then that can create a whole narrative that can interfere in relationship. So, that's just a personal example of how, if I had have known my anxious attachment early in our marriage, I think that would've saved us a lot of fights. Amy: Yeah. Oh, I love that example. And I feel like for me, as somebody who tends toward the other side, I tend to feel more worried about being stifled by relationships. I want to be fully seen and encouraged. And so, sometimes, in particular with friendships, if I've had people who are like, “I've felt exactly the same way,” or “I had the same experience,” or “We should do this all together. Let's get matching jackets,” I'm like, “I am an individual.” I get really threatened because my feeling is-- my brain's automatic interpretation is they don't see you because they think that you are just-- they assume like we're all the same, whereas they're just like, “We want to affiliate.” So, I've had to do some work there as well, even with friendships, to know like it's not-- people aren't trying to kidnap my identity and merge it with theirs. They're actually just being loving.  Kimberley: Right. But it feels threatening. Yeah, absolutely. I think the last question I have for you is, it goes back to that accommodation reassurance piece, particularly related to these dynamics. And maybe this is just my experience, I'd actually love to hear yours. What I do find is, when the person with OCD is coming from an anxious place, like often overanalyzing things, hyper-attending hyperawareness of things, their need for reassurance or their need for everyone to follow what OCD tells the family to do, I have found that the partner, because it's so overwhelming for them, tends to flip to the other end of the spectrum where they don't worry about anything or they're like, “It's fine.” Or maybe even they're frustrated of like, “It's fine, it's fine.” Have you noticed that as a trend in dynamics of a relationship? Amy: Yeah. Sometimes almost like there's a dismissiveness. Yes, I have noticed that and I think that there are so many reasons why that can happen. And I think for the partner and their experience, getting at what that is and what's motivating that is so interesting because, to the person with anxiety or OCD, it can feel really invalidating, or it can feel very comforting. But I think a lot of the times, it can feel invalidating and the partner might be doing it because they might be having their own feelings come up about, “I don't know what to say.” I've tried to use facts and sometimes facts can bounce right off of OCD if you're not in the mindset to accept them. OCD is skeptical about everything. So, I've tried everything and I'm really now at this place of like, “I am so tired.” And it'll come out. “I'm so tired of hearing you talk about this.” And that's when, as a clinician, I see time out. I think you're both really tired of this cycle that OCD has you both in.  So, yeah, I will see that. And I think sometimes when that's the pattern as opposed to a lot of overly accommodating, I think when that's the pattern, the element for me in working with couples to inject back in there is the validation of, “This is really hard.” And also for them to take a step back and realize, well, not everything is going to be OCD either. Sometimes if there is reassurance-- I mean, again, the irony is sometimes this pattern can lead to more reassurance because then it's like, “Well, you just dismissed me. You said that there's nothing wrong in our relationship that you did it in a manner that felt dismissive. And so, now I'm going to ask again.”  So, yeah, deconstructing that pattern. Does the partner feel angry? If so, you're angry at this pattern, not your partner. Does the partner feel helpless, hopeless? Did they feel scared? Are they grasping at straws? So, yeah, that would be how I would look at that when I see it come up. Kimberley: Oh, thank you. I'm so grateful that you shared all that because I think they are all great questions that need to be addressed within the relationship. Thank you. So good. Okay, tell us about your book. I want to be respectful of your time. Tell us about your amazing book, which I think every family that has members should read. Tell us about it. Amy: It's called Thriving in Relationships When You Have OCD: How to Keep Obsessions and Compulsions from Sabotaging Love, Friendship, and Family Connections. It's available for pre-order as of the recording of this, which is in October, but I think this is going to come out later. It will be hot off the presses December 1st from New Harbinger Publications, available on Amazon, available through New Harbinger, I think available on other websites. People keep sending me links and I'm like, “Wow, that's really cool.”  So, yeah, I tried to cover all different kinds of relationships. We talk about family relationships, parenting, romantic relationships, sex and intimacy and those kinds of relationships, friendships, work, and really just a relational lens to what can be a very isolating and security disorder. And I don't want anyone to feel like they have to go at it alone. Kimberley: Thank you. Again, hats off to you. Much respect. You did a beautiful job writing the book. It's an honor. I was so honored to write the foreword. And I think, again, it's like a handbook I think everybody needs to have on the onset of being diagnosed. Here's the book to make sure you can protect your relationship and nurture the relationship outside of OCD. So, thank you. Amy: Well, thank you for having me.

Join the WA Group with this temporary link: https://chat.whatsapp.com/ImKfk9mdJ7vJZoARz38cBn   Volunteer to share your personal story on the Franciska Show - email: franciskakay@gmail.com      About Our Guest: Jed Siev is associate professor of psychology at Swarthmore College, and a licensed clinical psychologist. Previously, he directed the Anxiety Treatment Center and founded the OCD and Related Disorders Program at Nova Southeastern University, after completing training at the Massachusetts General Hospital and the University of Pennsylvania. Jed's research focuses on information processing, judgment and decision making, and meta-cognitive processes involved in the maintenance and reduction of OCD, hoarding, and anxiety, and he has a particular interest in unacceptable thoughts and especially scrupulosity. He is currently writing a book for Oxford University Press on how to treat scrupulosity.   Follow Dr. Jed Siev on Twitter: @drjedsiev    The Podcast DIY Launch Course: https://www.franciskakosman.com/courselaunch If you'd like to book a consult session with Franciska, click here:  https://checkout.square.site/merchant/5BECR8D49NYV3/checkout/FVSNPB7HVW36LOYAR3L7SJMU If you'd like to sponsor an episode, click here: https://checkout.square.site/merchant/5BECR8D49NYV3/checkout/6KYMG7OGFR4Y63C43RREZ5MV   Are you in love with The Franciska Show? You might also like the other podcasts on the Jewish Cofee House network: https://jewishcoffeehouse.com/  

Josh Duricka is back on the pod! We take a deep dive into ways we can begin to discern our anxious thoughts from those of the Holy Ghost. Dr. Debra McClendon has written two AMAZING articles about OCD, Scurpolosity, and anxiety. Check them out below!Discerning Your Feelings: Anxiety or the Spirit?https://abn.churchofjesuschrist.org/study/ensign/2019/04/young-adults/discerning-your-feelings-anxiety-or-the-spirit?lang=eng&adobemcref=https://www.churchofjesuschrist.org/study/ensign/2019/04/young-adults/discerning-your-feelings-anxiety-or-the-spiritUnderstanding Scrupulosity (Religious OCD)https://abn.churchofjesuschrist.org/study/ensign/2019/09/young-adults/understanding-scrupulosity-religious-ocd?lang=eng&adobemcref=https://www.churchofjesuschrist.org/study/ensign/2019/09/young-adults/understanding-scrupulosity-religious-ocdDr. McClendon's Website:https://debramcclendon.com/resources-on-line-courses-book-podcasts-and-more.htmlThe OCD and Anxiety Treatment Center:https://www.theocdandanxietytreatmentcenter.com/#INSTA: @intothelight5024New content weekly!!Did you notice the new fancy intro/outro?? We are so blessed to have an amazing friend and fingerstyle guitarist, Austin Johnson, who made a song for us! It's called (fittingly) "Into the Light". He is an incredible human and has such a gift. Go give his YouTube channel a SUBSCRIBE!!Austin Johnson YouTube Channel:https://www.youtube.com/channel/UCIZLZEAQSRMf4Q1patrTgIf this helps you in any way please SHARE, SUBSCRIBE, and LIKE!! :)We love suggestions, please email us at intothelight5024@gmail.com with anything you feel would help!WE LOVE YOU ALL!!

Karen Lynn Cassiday, PhD, author of Freedom from Health Anxiety, joins us to discuss health anxiety. Cassiday is the owner and clinical director of the Anxiety Treatment Center of Greater Chicago, the upper Midwest's longest-running exposure-based treatment center for anxiety disorders. She has served as president of the Anxiety and Depression Association of America (ADAA); chair of the scientific advisory board of Beyond OCD; and has published numerous articles, a book for parents of anxious children, and numerous scientific publications that advance the understanding of anxiety disorders. Visit our website at www.newharbinger.com and use coupon code 'Podcast25' to receive 25% off your entire order. Buy the Book: New Harbinger - https://bit.ly/3jDEb8C Amazon - https://www.amazon.com/dp/1684039045/ Barnes & Noble - https://www.barnesandnoble.com/w1139822996 IndieBound - https://www.indiebound.org/book/9781684039043

TW: OCD (contamination, religious, pet), pet death/anxiety, intrusive thoughts, shame, religious trauma, death/fear of deathThis week we chat with Dr. Amy Mariaskin, PhD, founding director of the Nashville OCD & Anxiety Treatment Center (@ocdnashville). Dr. Mariaskin is a licensed clinical psychologist who specializes in OCD & we chat about contamination OCD, religious OCD, pet OCD, and the myths surrounding OCD. Dr. Mariaskin is so knowledgeable when it comes to OCD, and her clinic's account, @ocdnashville, has some amazing and educational resources, including comics that Dr. Mariaskin draws! If you are located in the Nashville/Tennessee area, you can also visit ocdnashville.com if you are seeking treatment! Dr. Mariaskin will also be publishing a book in December titled, “Thriving in Relationships When You Have OCD: How To Keep Obsessions and Compulsions from Sabotaging Love, Friendship, and Family Connections.” Lastly, Dr. Mariaskin will be leading a support group for people who have OCD related to their pets at the online convention for the International OCD Foundation in November 2022. The International OCD Foundation will also be hosting other workshops online in November and will have an in-person conference in July! You can find more at iocdf.org . Mindful Minds is a podcast centered on mindfulness and intentionality. From sex to religion to mental health, we are focusing on how to be mindful & intentional about important topics! Join as we learn and grow together!Please rate us 5 stars and leave us a review! You can find more about Mindful Minds & Serafina Blog on serafinablog.com & on Instagram (@serafinablog). 

Doctor David Carbonell is a Clinical Psychologist who specializes in the treatment of anxiety disorders. With over thirty-five years of experience, Dr. Carbonell offers exposure-based treatment of fears and phobias. He founded the Anxiety Treatment Center in Chicago in 1990, one of the first psychological practices in the United States devoted exclusively to the treatment of clients who sought help with anxiety disorders. He is the author of four anxiety self-help books and he also teaches workshops for therapists who want to learn more about the treatment of anxiety disorders.  We talk about...  What a phobia is What the panic cycle looks like Why safety behaviors can become a problem How panic tricks you Why it's important to do the opposite of what your panic is telling you to do How to navigate a panic attack What triggers a panic attack What a panic attack looks like The importance of breath How someone can best support a person who's having a panic attack Tired of anxiety hijacking your life? I want to be your anxiety coach! Click here to learn more.  COURAGEOUSLY.U SHOW NOTES: https://courageouslyu.com/dr-david-carbonell/   COURAGEOUSLY.U INSTAGRAM: https://www.instagram.com/courageously.u/  

Are you struggling with health or illness anxiety or love someone who is? Do people call you a hyperchondriac? Did you listen to Episode 12 and relate like crazy? My conversation with Dr. Karen Cassiday is not only educational, it's empowering. She gets us! She's like a breath of fresh air. She was born to do this work. She approaches each patient with enthusiasm, persistence, and a keen sense of humor, crafting individualized, research-based treatment plans for each person. Her goal is to make each patient an expert at managing their own anxiety, so that they can face any future event with confidence and courage. Dr. Cassiday received her doctorate in Clinical Psychology in 1990 from the Rosalind Franklin University of Medicine and Science. She is a nationally recognized expert in the diagnosis and treatment of anxiety disorders, the past president of the prestigious Anxiety and Depression Association of America (ADAA), and served on the board of Beyond OCD Chicago. She is a Founding Fellow of the Academy of Cognitive Therapy (A-CBT). In addition, she serves on the faculty of the International Obsessive Compulsive Foundation Behavior Therapy Institute and at the Rosalind Franklin University of Medicine and Science. A sought after national speaker on television, radio and at professional training seminars, Dr. Cassiday has appeared as an expert consultant on Animal Hoarders on TNT and on NBC's Today Show. Her expertise has been tapped through commentary in the Wall Street Journal, New York Times, Chicago Tribune, and numerous other publications. She is a sought after speaker who enjoys talking about parenting, anxiety disorders, obsessive-compulsive disorders, and mental wellness. Dr. Cassiday also founded and owns the Anxiety Treatment Center of Greater Chicago. Don't forget to Rate, Review and Follow the podcast so you don't miss any new episodes! CLICK HERE FOR MORE ON KAREN + the CENTER: https://anxietytreatmentcenter.com/ FOLLOW ME ON INSTAGRAM: https://www.instagram.com/wendy_tamis_robbins WEBSITE (COACHING, BOOK, CORPORATE PROGRAMS): https://www.wendytamisrobbins.com ANXIETY AUDIT FREE DOWNLOAD: https://www.wendytamisrobbins.com/anxietyaudit WATCH DR. CASSIDAY SHARE ON THE TEDx STAGE - Imperfect Fear: Why Parenting Doesn't Need a Handbook: https://www.youtube.com/watch?v=c7OaAO4H_Pc BUY FREEDOM FROM HEALTH ANXIETY: https://www.amazon.com/Freedom-Health-Anxiety-Understand-Obsessive/dp/1684039045 BUY THE NO WORRIES GUIDE TO RAISING YOUR ANXIOUS CHILD: https://www.amazon.com/Worries-Guide-Raising-Anxious-Child/dp/1787758877 --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app --- Send in a voice message: https://anchor.fm/wendy-tamis-robbins/message

There is almost certainly someone in your life who is struggling with OCD, and it could be much more severe than you might imagine. OCD is a serious mental illness, and it's very common for OCD sufferers to experience severe depression and even suicidal thoughts. In a religious setting, it is quite common for OCD to manifest in extreme and very unhealthy scrupulosity. In a previous Faith Matters podcast episode, podcast host Tim Chaves shared some of his own very painful struggles with OCD and scrupulosity. We were amazed by how many people  reached out to us to share their own experiences with OCD. Some had been diagnosed and knew what to call it, but others hadn't replied that what they were suffering from during their lifetime was OCD. Latter-day Saints often start by explaining its symptoms in religious language, or looking only to religious solutions to solve it.This week, we share a truly illuminating conversation we recorded with Paul Peterson, CEO of the OCD and Anxiety Treatment Center.If you know someone who may be suffering from OCD, please feel free to share this episode with them. We want to spread as widely as possible any information that can lead to diagnosis and treatment.This is part of an ongoing conversation Faith Matters is sponsoring about mental health challenges faced by so many of our brothers and sisters, friends, and family members. Find an OCD therapist:https://iocdf.org/find-help/The OCD and Anxiety Treatment Center (Paul's organization):https://www.theocdandanxietytreatmentcenter.com/Single Saints Summit:https://ss.leadingsaints.org/single-saints-registrationMentally Healthy Saints Summit:https://mhs.leadingsaints.org/mental-health-landing48113181

Summary: In this episode, we explore the conventional secular and the traditional spiritual ways of understanding scrupulosity, bringing in the experts to define scrupulosity, tells us the signs of being scrupulous, speculate on the causes of the trouble, discuss that standard remedies in the secular and spiritual realms.  Then I share with you my views on it, looking at scrupulosity through an Internal Family Systems lens, grounded in a Catholic worldview.   We discuss how parts have different God images and the role of shame and anger in the experience of scrupulosity.    Description of Scrupulosity Suddenly my stomach tightens up, there's a choking in my throat, and my torture begins. The bad thoughts come. . . . I want to drive them out, but they keep coming back. . . . It is terrible to be in a struggle like this! To have a head that goes around and around without my being able to stop it; to be a madman and still quite rational, for all that. . . . I am double. . . . at the very time that I am trying to plan what I want to do, another unwanted thought is in my mind. . . . Distracting me and always hindering me from doing what I want to do.  --  Quoted in Albert Barbaste, “Scrupulosity and the Present Data of Psychiatry,” TheologyDigest, 1.3 (Autumn 1953) 182. Fr. William Doyle: Around 1900  “My confessions were bad. My confessor does not understand me, he is mistaken in me, not believing that I could be so wicked. I have never had contrition. I am constantly committing sins against faith, against purity. I blaspheme interiorly. I rashly judge, even priests. The oftener I receive Holy Communion, the worse I become,”  Around 1900 My story just turned 19 -- terrible bout of scrupulosity.   Around sexuality Just started dating the first woman I might consider marrying Physical touching -- romantic contact How far was too far? Thoughts of sex with her -- plagued me.   Do I break up with her?  How do I handle this?  What was sinful, what was not?  Was I on the road to hell?  Was I putting her on the road to hell?  I thought I was going crazy.   Review: I encourage you to review the last episode, number 86 -- Obsessions, Compulsions, OCD and IFS That episode went deep into obsessions and compulsions and  serves as a basis for today's episode.   Today's episode, number 87 is entitled Scrupulosity:  When OCD Gets Religion and it's released on December 6, 2021, St. Nick's Day.  I am Dr. Peter Malinoski, clinical psychologist and passionate Catholic and together, we are taking on the tough topics that matter to you.   We bring the best of psychology and human formation and harmonize it with the perennial truths of the Catholic Faith.    Interior Integration for Catholics is part of our broader outreach, Souls and Hearts bringing the best of psychology grounded in a Catholic worldview to you and the rest of the world through our website soulsandhearts.com Overview Start out with definitions of scrupulosity both from spiritual and secular sources, really want to wrap our minds around what scrupulosity is and the different types of scrupulosity. We will discuss the connection between scrupulosity and OCD -- discussion of OCD  We will then move to the signs of scrupulosity -- how can you tell when there is scrupulosity?  Then we will get into the internal experience of scrupulosity.  What is it like to experience intense scruples?  Had a taste in the intro, but we will get much more into that.   We will discuss what religious and secular experts have to say about the causes of scrupulosity  Then what religious and secular experts have to say about the treatment of scrupulosity -- that most recommended therapy approach and the medications typically prescribed.   After we've discussed the conventional secular and spiritual approaches to treating scrupulosity, I will how I think about scrupulosity, the root causes of scrupulosity, and how scrupulosity develops and how it can be treated.  I will give you an alternative view, grounded in a Catholic understanding of the human person and informed by Internal Family Systems thinking.   Definitions:  You know how important definitions are to me.  We really want to make sure we understand what we are talking about.   Scruple comes from the Latin word  scrupulum,  "small, sharp stone" -- like walking with a stone in your shoe. Ancient Roman weight of 1/24 of an ounce or 1.3 grams.     Something tiny, but that can cause a lot of discomfort.   Definitions from Spiritual Sources Fr. William Doyle, SJ.  Scruples and their Treatment  1897: Scrupulosity, in general, is an ill-founded fear of committing sin.  Fr. Hugh O'Donnell:   Scrupulosity may be defined as a habitual state of mind that, because of an unreasonable fear of sin, inclines a person to judge certain thoughts or actions sinful when they aren't or that they are more gravely wrong than they really are… Scrupulosity involves an emotional condition that interferes with the proper working of the mind and produces a judgement not in accordance with object truth, but with the emotion of fear.  Fr. James Jackson, article "On Scrupulosity"  A very good definition Scrupulosity is an emotional condition, an ultra-sensitivity to sin, which produces excessive anxiety and fear from the thought of eternal damnation…This condition is a religious, moral and psychological state of anxiety, fear and indecision. It is coupled with extreme guilt, depression and fear of punishment from God. However, each person who suffers from it does so uniquely. Fr. Marc Foley:  The Context of Holiness: Psychological and Spiritual Reflections on the Life of St. Therese of Lisieux Excellent, very psychologically informed study of the Little Flower  Not only the best psychological profile of St. Therese of Lisieux, but the best psychobiography of any saint from any author I've read.  A very in-depth look at her mother, St. Zelie as well and the limitations and lack of attunement in the Martin family  Highly recommended reading -- all of chapter 12 is on The Little Flower's scrupulosity.   Scrupulosity is an extremely painful anxiety disorder. It consists of annoying fear that one is offended God or could offend God at any moment and that God will cast her into hell. To protect yourself from eternal damnation, the scrupulous person dissects every thought, motive, and action in order to ascertain if she has send. And since she is deathly afraid that she might have sent, the scrupulous person seeks absolute certitude that she hasn't send in order to assuage her fears.   Definitions from Secular Sources Timothy Sisemore, Catherine Barton, Mary Keeley From Richmont Graduate University   Scrupulosity is a "sin phobia."  Jaimie Eckert, Scrupulosity Coach:  Scrupulosity is where faith and OCD collide.   International OCD Foundation Fact Sheet:  What is Scrupulosity?  By C. Alec Pollard:  A form of Obsessive Compulsive Disorder (OCD) involving religious or moral obsessions. Scrupulous individuals are overly concerned that something they thought or did might be a sin or other violation of religious or moral doctrine.   Bridging the Secular and the Spiritual Joseph W. Ciarrocchi's The Doubting Disease: Help for Scrupulosity and Religious Compulsions -- published in 1995, and still the most cited text in Catholic circles, even more than a quarter century later.   Dr. Ciarrocchi, a former Catholic priest, trained as a clinical psychologist and served as professor and chairman of pastoral counseling at Loyola University in Maryland prior to his death in 2010. Scrupulosity refers to seeing sin where there is none.   He viewed scrupulosity as a sub-set of obsessive- compulsive disorder (OCD), basically a kind of “religious OCD.”  He distinguishes  developmental scrupulosity  self-limited form of scrupulosity  often occurring in adolescents  or shortly after a conversion experience (e.g. St. Ignatius of Loyola)  Temporary, usually disappears.   emotional scrupulosity -- symptoms of OCD More enduring conditions  Can vary in intensity over time, from being overwhelming to just mildly irritating  Can last for years.    Core experience of scrupulosity:  "an intrusive idea, often associated with a sinful impulse, which the person abhors but cannot shake."  "The French label the emotional condition which is sometimes part of scrupulosity "the doubting disease."  Signs of Scrupulosity What do we see.  A lot we don't see.  Fr. Thomas Santa, past director of Scrupulous Anonymous and Author of the book Understanding Scrupulosity When people struggle with the scrupulous disorder, most of the suffering, fear, and anxiety they experience happens in isolation. Scrupulosity is mostly an interior struggle, seldom manifesting itself with easily identifiable or observable mannerisms or behaviors. You can't tell if people are scrupulous by looking at them. While some compulsions of obsessive-compulsive disorder are identifiable, most of the suffering associated with the disorder is personal. Only the sufferer fully knows its debilitating nature.   Sources IOCDF Fact Sheet  Jaimie Eckert Scrupulosity Coach  The Gateway institute website  Doubting Disease 1995 by Joseph Ciarrocchi   Obsessions -- excessive concerns about Fears of Blaspheming, accusing God of being negligent or abusive or evil, cursing God  Fears of Sacrilege, abusing our Lord in the Eucharist for example  Fears about impulses -- taking one's clothes off in Church, screaming obscenities during Mass Example of the man concerned about touching his infant daughter's genitals  Sexual thoughts about a romantic partner  Sexual thoughts or images about a religious figure -- Jesus, Mary, a saint, or possibly a priest or religious.   Fears around harming others  I might cause the death of someone if I sneeze or cough during Mass --  I coughed.  Maybe I'm sick.  Maybe I have COVID.  Maybe I'm a spreader.  A pharmacist worries she will fill prescriptions incorrectly and poison customers at her pharmacy.   Fears around aggression -- Driver goes over a bump in the Church parking lot in the dark after the parish council meeting.  Is concerned he may have run over the pastor.   Cooperating in the sins of others "Man participates in a discussion about a historical figure dead for more than 1000 years, who is alleged to have been a homosexual.  He worries that he has committed the sin of detraction." -- Example from Joseph Ciarrocchi.   Being a sinful person, dishonest, lacking integrity -- honesty  Ruminating about past mistakes, errors, past sins  Purity -- looking for moral perfection  Not Loving Others enough -- Mother worrying she doesn't love her children enough.  Going to hell  Death  A loss of impulse control   Cyclical Doubts Often about salvation, selling your soul to the devil, in mortal sin   Intrusive thoughts and images 666, Satan, Hell, pornographic images, etc.   Compulsions  Behavioral Compulsions Excessive trips to confession  Repeatedly seeking reassurance from religious leaders and loved ones  Repeated cleansing and purifying rituals  Acts of self-sacrifice  Repetitive religious behaviors  Avoiding situations (for example, religious services) in which they believe a religious or moral error would be especially likely or cause something bad to happen  Avoiding certain objects or locations because of fears they may be sinful   Mental Compulsions Excessive praying (sometimes with an emphasis on the prayer needing to be  perfect)  I compulsions about praying.  Tithing prayer.  1.6 hours vs. 2.4 hours.   Needing to pray perfectly or at least adequately enough.   Repeatedly imagining sacred images or phrases Repeating passages from sacred scriptures in one's head Making pacts with God to avoid hell or buy time or just to get a little relief in the present moment.   Intense sense of guilt-- feeling guilty all the time -- about things that don't carry moral weight.    Inflated sense of responsibility Not distinguishing between thoughts and actions.   Example: Joseph Ciarrocchi The Smith family traditionally joins hands around the dinner table to give thanks in prayer before the meal. Susie, age 4, and Billy, age 6 sometimes are fidgety (and always hungry). Mrs. Smith worries that Susie, Billy, and perhaps herself haven't not “truly prayed” due to the multiple distractions: Susie is scratching her mosquito bite, Billy is leering at the chocolate pudding, and Mrs. Smith remembers she has a school board meeting after dinner. She doubts that their prayers were “heard,” and so request of the family repeat their prayers. Sometimes she makes the whole family repeat them, and sometimes only the children. Once the children needed to repeat them four times, even the Mr. Smith tried to intervene after the second time. Mrs. Smith sought advice from her pastor who urged her not to repeat the prayers, either for herself or the children. When she attempts to follow this advice, however, her entire meal is ruined as she attempts to sort out in her head whether this is acceptable to God. She will continue to worry about it throughout the rest of the evening, including her school board meeting.   Distinguishing Scrupulosity of normal religious practice IOCDF Fact Sheet:  Unlike normal religious practice, scrupulous behavior usually exceeds or disregards religious law and may focus excessively on one trivial area of religious practice while other, more important areas may be completely ignored. The behavior of scrupulous individuals is typically inconsistent with that of the rest of the faith community.     Internal Experience of Scrupulosity  Plutarch: a first century priest for the Greek god Apollo at the Temple at Delphi. He wrote about the so-called “superstitious” man, who… And so is the soul of the superstitious man. He turns pale under his crown of flowers, is terrified while he sacrifices, prays with a faltering voice, scatters incense with trembling hands, and all in all proves how mistaken was the saying of Pythagoras that we are at our best when approaching the gods. For that is the time when the superstitious are most miserable and most woebegone....   OCD Center of Los Angeles:  One of the first documented references to Obsessive Compulsive Disorder (OCD) was in a 1691 sermon by Anglican Bishop John Moore of Norwich in which he discussed men and women who were overwhelmed with unwanted thoughts, and tormented by feelings of guilt and shame over what he described as “religious melancholy.” Priests had started to notice that some churchgoers were attending confession several times a day, and repeatedly confessing to the same sins and shortcomings that they feared would result in divine judgment and eternal damnation. Their penance and absolution would provide only a fleeting glimpse of peace, and then their fears would come roaring back. William Van Ornum, A Thousand frightening fantasies: understanding and human scrupulosity in obsessive-compulsive disorder 1997 24-year-old computer programmer writes, “what worries me is that at any moment and in only a few seconds I can commit serious sin. The only remedy is confession. I worry about what I've done until I confess it; then it's all over. The problem is that I fall or worry again and need to go back.” Fr. Thomas Santa:   Being possessed by a thousand frightening fantasies Constructing a spider web in the mind. People with the disorder often feel as if they are isolated in darkness. They describe this feeling as a “cloud” that perpetually engulfs them. They feel the disorder constantly and uncomfortably, even in the background of day-to-day living.  Scrupulosity demands constant attention and can feel like a severe and unrelenting master. At best, most people who suffer with the disorder have learned to live with it. They hope it does not get more pronounced or spill into other areas of life. Relief does not exist, so any promises of relief through activities like rituals are essentially dead ends. For those who are religious, consistent spiritual practices can help and at the same time be debilitating. From Joseph Ciarrocchi's Book "Doubting Disease Bob is 28-year-old married Jewish man who works for an accounting firm. He is thrilled with the birth of his first child, a bubbly infant girl. Bob is about to be totally involved with her as a parent and share in all aspects of childcare. He was shocked by the following experience: Bob was changing his daughter's diaper when the thought, idea, or image (he wasn't quite sure which close parentheses flashed through his mind – “Touch her private parts.” The first time it happened he shuddered, tried to dismiss the idea, and hurriedly completed diapering her. All they tried not to think about it. The next time he changed her diaper, however, the idea came back, but this time in the form of a graphic picture of Bob engaging in the dreaded behavior. This time he felt nausea, became dizzy, and called his wife to finish, saying he thought he was ill and would pass out. The idea began to torment Bob. He found himself not wanting to be alone with his daughter, Les T “give in” to the simples. He refused to bathe her or change her diaper. Sensing something was drastically wrong his wife urged him to seek help. He talked to his rabbi who tried to assure him that he was not a child molester and should dismiss the thoughts.  Psychodynamic perspective  Sources Nancy McWilliams Psychoanalytic Diagnosis --  Psychdynamic Diagnostic manual   Thinking and Doing predominate over Feeling, sensing, intuiting, listening, playing, daydreaming, enjoying the creative arts and other modes that are less rationally driven or instrumental  Hold themselves to very high standards, sometimes impossibly high.   Central conflict: Rage and being controlled vs. fear of being condemned or punished.   Cooperation and rebellion Initiative and sloth Cleanliness and slovenliness Order and disorder Thrift and improvidence  Polarizations inside.   Emotion is unformulated, muted suppressed, unavailable, or rationalized and moralized.  Except anxiety and sometimes depressed mood Consign most feelings to an undervalued role, associated with childishness, weakness, loss of control, disorganization and dirt Cognition Condemning oneself for internal thought crimes -- consciously or unconsciously   Body states Hyperarousal -- expressing anxiety through the body  Often health problems due to excessive washing   Difficulties with  Play Humor  Spontaneity Pain about isolation.   Shame about being considered weird and unacceptable to others Capable of loving attachments, but often not able to express their tender selves without anxiety and shame Relational patterns -- seek relationships in which they can control the partner, sometimes partners who can reassure them  Being intimate in relationships Emotional connection  Sexuality   Causes of Scrupulosity  Spiritual Sources  Fr. James Jackson The Fathers of the Church considered scrupulosity – or psychasthenia, as the Greek Fathers called it – to be a spiritual problem which leads to a psychological malfunction.   Timothy A. Sisemore. Catherine Barton, Mary Keeley -- The History and Contextual Treatment of Scrupulous OCD  15th and 16th Century -- connected scruples to moral reasoning, addressed under conscience -- concept of erroneous conscience.  -- frees the person to act without resolving the doubt.   Secular Sources IOCDF Fact sheet:  The exact cause of scrupulosity is not known. Like other forms of OCD, scrupulosity may be the result of several factors including genetic and environmental influences.   OCDUK.com  Lots of controversy. Biological factors  Strep infections affecting the Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infection  -- PANDAS   Genetic factors Runs in families -- 2001 metaanalytic review reported that person with OCD is 4 times more likely to have another family member with OCD than a person who does not have the disorder   Cognitive theory  Everyone experiences intrusive thoughts at times People with OCD have an inflated sense of responsibility and interpret these thoughts as very significant and important Caught up in a pattern of Try to resist, block or neutralize them  What is the meaning of the thought to the person?   Joseph Ciarrocchi citing David Barlow -- OCD causes Those temperamentally disposed to having high levels of nervous energy, more pronounced bodily reactions to stress, greater levels of anxiety   OCD is different from other anxiety disorders because those with OCD believe that certain kinds of thoughts are dangerous in themselves If I think certain thoughts those events will happen.  If I think certain thoughts or spontaneously imagine certain things, or if I have an impulse to do such a  thing, then I am the kind of person who would do such things.   No moral distance between the spontaneous thought or image or impulse and actually doing the act.   I must be bad.  Unclean.  Unworthy.   Model for the development of Scrupulosity Strong belief that certain thoughts are dangerous and unacceptable  Leads to the occurrence of these same intrusive thoughts  This generates significant anxiety  Leading to strong efforts to suppress the thoughts  Which accelerates the frequency of the same kinds of thought   Leading to a need to "turn off" the anxiety by any means Mental rituals  Physical rituals  These rituals are the compulsions   And then there is a temporary respite, a bit of relief.  The compulsive rituals are reinforced because they temporarily decrease anxiety.  But then we loopback to the occurrence of the intrusive thoughts again.     Psychodynamic understanding Nancy McWilliams -- Psychoanalytic Diagnosis Obsessive and Compulsive Personality styles:   Marc Foley's Approach in The Context of Holiness about St. Therese of Lisieux's scrupulosity Parental figures who set high standards of behavior and expect early conformity to them E.g. making little kids sit still during Mass   Strict and consistent in rewarding good behavior and punishing malfeasance Risk of condemning not only behaviors but the feelings that go with them Especially anger   Issues of control in families of origin.   Alternative -- a really lax family in which children are underparented Child concludes he has to model himself after a parental figure that he invents himself  Child might have an aggressive, intense temperament -- projected on to that idealized parental figure.   Self esteem comes from meeting the demands of internalized parental figures who hold them to a high standard of behavior and sometimes thought.   Value self-control over nearly all other virtues.   Discipline Order Loyalty Integrity Reliability Perseverance Is a particular religion a cause?   No: Timothy Sisemore, Catherine Barton, Mary Keeley:  A tendency to blame religion, but no more than counting OCD to be blamed on math class  Joseph Ciarrocchi "Religion doesn't cause scrupulosity and more than teach someone French history causes him to believe he is Napoleon.  All human beings exist in some cultural context.   IOCDF Fact sheet:  Scrupulosity is an equal opportunity disorder. It can affect individuals from a variety of different faith traditions. Although more research is needed to truly answer this question, there is currently no evidence to link scrupulosity to a specific religion. OCD Center of Lost Angeles It is worth noting that Scrupulosity is not partial to any one religion, but rather custom fits its message of doubt to the specific beliefs and practices of the sufferer.  Yes:  Joseph Ciarrocchi …religion may contribute when its content is presented in an overly harsh, punitive manner.  Students of such presentations are likely to associate the context of the religious message with fear and anxiety.   Jonathan Edwards, 18th Century Pastor and Theologian in the Congregational Church The God that holds you over the pit of hell, much as one holds a spider, or some loathsome insect over the fire, abhors you, and is dreadfully provoked: his wrath towards you burns like fire; he looks upon you as worthy of nothing else, but to be cast into the fire; he is of purer eyes than to bear to have you in his sight; you are ten thousand times more abominable in his eyes, than the most hateful venomous serpent is in ours. You have offended him infinitely more than ever a stubborn rebel did his prince; and yet it is nothing but his hand that holds you from falling into the fire every moment. It is to be ascribed to nothing else, that you did not go to hell the last night; that you was suffered to awake again in this world, after you closed your eyes to sleep. And there is no other reason to be given, why you have not dropped into hell since you arose in the morning, but that God's hand has held you up. There is no other reason to be given why you have not gone to hell, since you have sat here in the house of God, provoking his pure eyes by your sinful wicked manner of attending his solemn worship. Yea, there is nothing else that is to be given as a reason why you do not this very moment drop down into hell.   Heresies from Fr. James Jackson: Manicheanism:  Manichaeism states, on principle, that all matter is evil. If, for example, a child grows up with an extreme attitude to modesty – where the flesh is seen as evil because it is the cause of forbidden impulses – then the slightest catering to the demands or needs of the flesh can result in a torment which rejects the goodness of the body.  Pelagianism:  There was once a British monk named Pelagius, who taught that a man can observe God's laws by human effort alone, that grace was not needed to do so. If the heresy of Pelagianism works its way into the soul it is an easy step to thinking that any lack of perfection is entirely one's own fault. One thinks, “this business of salvation is my work, so I'd better be perfect when I …” Thus salvation becomes something one must achieve by personal effort instead of by cooperation with grace.   Jansenism:  Jansenism is another heresy in which scrupulosity can grow well. It emphasizes that Christ did not die for all, stresses man's sinfulness, and requires extreme penances on a regular basis. It leads to infrequent communions and flowers into scrupulosity as a matter of course. Jansenism flourished within Roman Catholicism primarily in the seventeenth and eighteenth centuries, but was condemned as heresy by Pope Innocent X in 1653. Jansenism was also condemned in 1713 by Pope Clement XI in his famous Bull Unigenitus.  Jansenism focuses on how it was impossible for men and women to obey the Lord's commandments and to be redeemed without God's special, divine, irresistible grace. Jansenism taught that Christ died only for the elect -- a real sense of predestination  Fr. Marc Foley agrees:  Jansenism identified as the "remote cause: of St. Therese of Lisieux's troubles growing up.   Biographer Conrad de Meester: "Zelie's mother, who taught her daughters an excessive fear of offending God, used to harp on the phrase 'that's a sin' to curb the least imperfections."   Zelie had an excessive fear of sin and hell. Zelie was terrified that her five-year-old daughter Helene was in purgatory or perhaps even in hell, because she once told a lie.   Spiritual Means of Recovery Joseph Ciarrocchi “Scruples in the History of Pastoral Care” (chapter four of the Doubting Disease) puts scrupulosity in the context of church history before it was viewed through the modern lens of psychiatric diagnosis.  He describes several principles for the treatment of scruples from the pastoral care tradition. Act contrary to the scruples.   Follow the example of others without lengthy and burdensome moral reasoning.  Rely on the guidance of one spiritual advisor rather than consulting multiple spiritual authorities.  Put oneself in situations that trigger the obsessional thought.  Avoid religious rituals/prayers, which serve as compulsions.   Ciarrocchi writes that these main pastoral principles “contain  the seeds of modern behavioral treatments” that include modeling by  others,  exposure to the upsetting situation, and blocking the compulsive response. Fr. William Doyle 1873-1917 -- more than 100 years ago.   General Remedies from Fr. William Doyle Prayer -- pray in temptation  Vigilance  Struggle against depression -- sadness increases scrupulosity   Obedience to an experienced confessor -- perfect, trustful and blind obedience Obedience of action putting into practice the freedom of conscience  Obedience of understanding -- soul remaining in revolt and persisting in its own erroneous ideas. Vanquishing errors of the intellect.   Generosity in Self-Conquest -- acts of self-denial   Particular remedies from Fr. William Doyle 19th century Doubts must be ignored  Belief in the easiness of forgiveness  Presuming decisions (of the spiritual director)  Lenient view of one's faults -- magnifying glass  Promptness in acting on decisions  Broad-minded interpretation of advice -- broadening the way.   Not piling up questions   Ten Commandments for the Scrupulous -- Fr. Thomas Santa, CSsR (2013) Without exception, you shall not confess sins you have already confessed.  You shall confess only sins that are clear and certain.  You shall not repeat your penance or any of the words of your penance after confession—for any reason.  You shall not worry about breaking your pre-Communion fast unless you put food and drink in your mouth and swallow as a meal  You shall not worry about powerful and vivid thoughts, desires, and imaginings involving sex and religion unless you deliberately generate them for the purpose of offending God  You shall not worry about powerful and intense feelings, including sexual feelings or emotional outbursts, unless you deliberately generate them to offend God.  You shall obey your confessor when he tells you never to repeat a general confession of sins already confessed to him or another confessor.  When you doubt your obligation to do or not do something, you will see your doubt as proof that there is no obligation  When you are doubtful, you shall assume that the act of commission or omission you're in doubt about is not sinful, and you shall proceed without dread of sin   You shall put your total trust in Jesus Christ, knowing he loves you as only God can and that he will never allow you to lose your soul Pastoral approach here.  Predestination for heaven, Jesus will make us go to heaven.  A lot of scrupulous clients are well enough formed to not believe that.   Secular means of recovery IOCDF:  Scrupulosity responds to the same treatments as those used with other forms of OCD.  Cognitive behavior therapy featuring a procedure called “exposure and response prevention” is the primary psychological treatment for scrupulosity. A certain kind of medicines called Selective Serotonin Reuptake Inhibitors (SSRIs) is the primary drug treatment for OCD. Treatment for scrupulosity may also include consultation from  leaders of the patient's faith tradition.  Exposure and Response prevention See the last Episode   Difficulties with ERP for scrupulosity. Joseph Ciarrocchi "Doubting Disease":  My opinion, based on the clinical and theoretical aspects of scruples, is that scruples are resistant to change because their religious nature places many of them in the domain of overvalued ideas. In other words, the person sees the stakes are so high in religious doubts (i.e. salvation depends and being correct) that the senselessness of the behavior is less evidence. After all, faith itself implies looking beyond sensory experiences in the surface meaning of reality. Scrupulous people usually know that their peers do not act the way they do. But since religious salvation is such an individual experience, can one really take a chance and ignore that's “inner voice”? Therefore, the religious aspects of scruples create a motivational drive around the symptoms which become overvalued ideas, and hence resistant to change.  Jaimie Eckert Scrupulosity Coach:  ERP can feel like it has deep moral and spiritual implications. Although it is a method that is helping you develop a normal spirituality, it can feel terribly frightening. For example, the woman who prays compulsively, repeating her prayers dozens of times until she feels they are done “right,” might be asked to pray only once and then stop, no matter how she feels. This can easily feel like a denial of faith. So scrupulous sufferers begin dropping out of treatment when ERP gets more intense.  Kevin Foss, Founder of the California OCD and Anxiety Treatment Center in Fullerton, CA:   People suffering with Religious Scrupulosity struggle with the ERP process because they fear that exposure therapy will result in a genuine sin, convey that they are OK with sin and that they do not respect God or God's will. Furthermore, Scrupulosity sufferers are generally knowledgeable of their faith's doctrine and Biblical texts, so they are quick to present chapter and verse explaining why they should avoid exposure and give in to compulsive acts. Despite my reminders of clients' logical arguments, they respond with “But you never know” and “But what if God mistakes my intention in the exposure and I'm now really guilty of sin?” So, to do anything that could potentially put that into question or undermine it was experienced as possibly damaging the practice of faith, challenging one's fundamental belief in God, or leaving one vulnerable to shifting beliefs and a slippery slope into sin. Psychodynamic approaches for treating OCD but can be applied to scrupulosity.  McWilliams  Ordinary kindness -- they know they are exasperating for reasons that are unclear to everybody Priests get frustrated.   Parents get frustrated   Do not hurry them, advise them, criticize them.   Avoid becoming the equivalent of the controlling, demanding parent -- no power struggles  But still relate warmly.  A lot of acceptance.   Avoid intellectualization  Help them express anger.   Discover their emotions and help them enjoy them.   Joseph Ciarrocchi. Doubting Disease Treatment program is laid out in his book, Doubting disease.  It is essentially exposure and response prevention.   Target the scruples you want to change Identify your obsessional scruples through self-monitoring.  Write them down.   Identify you compulsive scruples -- write them down.  Avoidance acts to reduce anxiety  Record the circumstances surrounding the scruples  Making ratings of the intensity of the anxiety triggered by each of the obsessions and compulsions.   Record the amount of time spent worrying about the scruples  Lots of forms and charts, all in the book.   Increase your Motivation to Change Looking at how motivated you are, and where you are in Prochaska and Di Clemente's stages of motivation to change.   Developing a Personal Motivation Plan Listing the Benefits of eliminating scruples  Listing the Costs of not changing scruples   Preparing for Change Setting up the plan for repeated exposure to the feared object or condition.   From the very start of the fear response, the body actually starts a counter-response mean to return the body to normal activity levels. Habituation.  Nervous system gets bored with the danger, returns to normal.   Example of jackhammer breaking up the asphalt on your road.   Exposure must be prolonged Exposure must generate significant anxiety Exposure must be repeated The compulsive response must be blocked.  Prevented from happening so it breaks the cycle of some relief from the compulsion.  Blocking the physical compulsion or the mental compulsion.   More charts and forms What I think about scrupulosity.  IFS-Informed Approach  I'm going to start with the bottom line.  I think scrupulosity is generated by a desperate attempt to find safety from a terrible, dangerous and uncaring God for shameful, undeserving, despicable sinner Scrupulosity is a twisted, frantic attempt to find some kind of safety from an angry, heartless God for me, a reprobate, a delinquent, an evildoer.  At the core, scrupulosity starts with really appalling, awful God Images -- and the scrupulous person usually isn't aware of the how terrible his or her God images really are, because they are not allowed into conscious awareness.   I discuss God images at length in episode 23-29 of this podcast, a seven episode series, all about God images, so check that out.   God Images =  My emotional and subjective experiences of God, who I feel God to be in the moment.  May or may not correspond to who God really is.  What I feel about God in my bones. This is my experiential sense how my feelings and how my heart interpret God. God images are often outside of our conscious awareness  Initially God images are shaped by the relationship that I have with my parents.     My God images are heavily influenced by psychological factors  Different God images can be activated at different times, depending on my emotional states and what psychological mode I am in at a given time.   God images are always formed experientially; God images flow from our relational experiences and  Also how we construe and make sense of those images when we are very young.  My God images can be radically different than my God concept. God Concept  = What I profess about God.  It is my more intellectual understanding of God, based on what one has been taught, but also based on what I have explored through reading.  I decide to believe in my God concept.  Reflected in the Creed, expanded in the Catechism, formal teaching.   Now I'm really going to apply IFS to Scrupulosity, grounding it in a Catholic understanding of the human person.  Discussed Robert Fox and Alessio Rizzo's Internal Family Systems approach to OCD in the last episode -- number 86 -- Obsessions, Compulsions, OCD and Internal Family Systems. Brief review:  Definition of Parts:  Separate, independently operating personalities within us, each with own unique prominent needs, roles in our lives, emotions, body sensations, guiding beliefs and assumptions, typical thoughts, intentions, desires, attitudes, impulses, interpersonal style, and world view.  Each part also has an image of God.   You can also think of them as separate modes of operating if that is helpful.   Brief review:  Self:  The core of the person, the center of the person.  This is who we sense ourselves to be in our best moments, and when our self is free, and unblended with any of our parts, it governs our whole being as an active, compassionate leader.   Here is the critical idea:  Each Part has a God Image -- each part has a way of understanding God based on its limited experience and how it understands that experience We have as many God images as we have parts.   How God images form in parts.  Parts have distorted God images for three main reasons:  Parts learn via experience and the ways they interpret experience, especially in their spiritual inferences, can be markedly different than what God has revealed about Himself through the Catholic Church -- for example, a part whose role is to be dissociated from the rest of the system so as not to overwhelm the core self and other parts with its burden of interpersonal trauma may see God as distant, disconnected and uncaring, in a Deistic way;  Parts may be very afraid of, angry at, disappointed with or disinterested in God and therefore refuse to connect with Him, preventing them from having needed corrective relational experiences of a loving God Part's understandings of God can vary wildly.  One part may be angry and rejecting of God, another parts may be terrified of God, a third grieving the loss of God, a fourth distant and cold toward God and a fifth part, in the same person, may not believe that God even exists.   As different parts come up and blend with the self, becoming more prominent in the system, they bring their God images into conscious awareness.  That explains how our conscious perspectives of God can shift.  Whichever part of us has taken over, which ever part of us has blended and is driving our bus, that part's God image is dominating in the moment So, in my view, a scrupulous person's parts are in a life and death battle with each other about God.  It's more than physical life or death.  It's about spiritual life or death, eternal life or death, the stakes couldn't be higher.   The scrupulous person's managers believe that if they don't suppress parts with negative God images, the consequence could be to be damned to hell for all eternity.   Manager parts are trying to appease God -- seek his approval, make things all right, strive to meet his demands, to be perfect Fr. Thomas La Santa:  I will make God love me by becoming perfect.  In this way God will have to love me.  An enormous amount of energy is wasted by the scrupulous person trying to "fix" himself or herself or trying to become perfect.   Fr. Marc Foley: The command "Be ye perfect..." does not enjoin us to strive for a flawless performance in the various tasks of life, but to do them as God wills us. We feel driven to do an A+ job on projects in which we have overinvested our egos. But doing God's will often demands the courage to do a C+ job because God bids us to spend our time and energy on other tasks.  In order to do that, the manager parts have to suppress or exile the parts that have "offensive" God images or who may otherwise seem inappropriate or unacceptable to God.   Those that are angry at God Those that are disappointed in God Those who are disgusted with God. Those that are indifferent toward God. Those that don't believe God exists.   All those ways of construing God makes sense if you understand the part's experience and how it construes its experience.  They are not accurate, they don't correspond to how God really is, but the part doesn't know that.   Those that generate impulses to get God's attention via acting out in negative ways.   Manager parts reject any part that experiences God in any negative way.   Parts seeing other parts as evil, harmful, and terrifying.   Demons  Lepers Tax collectors Prostitutes Dangerous sinners -- banishing them.   Manager Parts can speak for God -- they assume they know what God wants.  Not in relationship with him, though.  Really following a code or a list of rules or expectations.  It's not about relationship, really.   First two conditions for secure attachment -- 1) felt safety and protection; 2) feeling seen known, heard and understood.  Drawing from Daniel P. Brown and David S. Elliott 2016 book Attachment Disturbances in Adults: Treatment for Comprehensive Repair.   Felt safety and protection In Scrupulosity, there is no felt sense of safety and protection for so many parts, because of their God images and their fears about the God images of other parts being expressed.  .   The first primary condition of secure attachment is not met.   The most basic relational need is not met -- no felt safety, no felt protection. The first primary condition for secure attachment is felt safety and security.  It has be felt.  And not just by other parts, but by the target part.   We all have heretical God images.   Pastor Jonathan Edwards:  The wrath of God is like great waters that are dammed for the present; they increase more and more, and rise higher and higher, till an outlet is given; and the longer the stream is stopped, the more rapid and mighty is its course, when once it is let loose. It is true, that judgment against your evil works has not been executed hitherto; the floods of God's vengeance have been withheld; but your guilt in the meantime is constantly increasing, and you are every day treasuring up more wrath; the waters are constantly rising, and waxing more and more mighty; and there is nothing but the mere pleasure of God, that holds the waters back, that are unwilling to be stopped, and press hard to go forward. If God should only withdraw his hand from the flood-gate, it would immediately fly open, and the fiery floods of the fierceness and wrath of God, would rush forth with inconceivable fury, and would come upon you with omnipotent power; and if your strength were ten thousand times greater than it is, yea, ten thousand times greater than the strength of the stoutest, sturdiest devil in hell, it would be nothing to withstand or endure it.  How are you going to feel safe with a God like that?   Feeling Seen, Known, Heard, Understood   because there is no feeling of safety and protection for some parts, they don't want to be seen, heard, known and understood by God.  They don't want to be near God, they don't trust him And that makes sense, given how they see God.   Some parts may want to be seen heard known and understood by God, even if they don't feel safe -- they are desperate for attention, any kind of attention from God, even negative attention, so they signal distress by intense impulses toward acting out, especially in ways designed to get God's attention -- blasphemy, for example.  Just like a neglected little kid, desperate for some kind of attention from his father may act out.   Scrupulosity is the son of anger and the grandson of shame.  Core issues of shame that are suppressed and generate anger.  Anger is suppressed and generates fear and scruples.   Shame -- the root of so much psychological and emotional distress -- whole 13-epsiode series on shame, from episode 37 to 49.  All goes back to identity.  Who am I and Who is God.  Scrupulous individuals have a very hard time allowing their anger with God to emerge into conscious awareness and with anger in general.  Dangerous emotion But look at the unreasonably demanding and exacting God images their manager parts have -- Their God images are unjust.   Who would want to be with a God like that?  No part has a really positive God image Not wanting hell  But not really wanting heaven either -- to be face to face with a God like that for all eternity?  So God has no opportunity to show the scrupulous person, in relationship, who He really is.  Self-perpetuating. I wrote a blog on this on the Souls and Hearts website last week, on Inner Pre-Evangelization: A Focus on Internal Trust.  My Approach Lead from Self --The core of the person, the center of the person.  This is who we sense ourselves to be in our best moments, and when our self is free, and unblended with any of our parts, it governs our whole being as an active, compassionate leader.   We want to be recollected, we want the self governing all of our parts Like the conductor -- leading the musicians in an orchestra Like the captain -- leading and governing all the sailors on a ship.   When we are recollected, in self, 8 C's Calm  Curiosity  Compassion  Confidence  Courage  Clarity  Connectedness  Creativity  Kindness   Self as the secure internal attachment figure for the parts.  Parts coming to trust the self  -- Blog on  Working collaboratively with the parts -- contracting with them to not overwhelm Really accepting the parts right now, where they at.  Trusting that God is good enough to understand and tolerate our parts' feelings.   Scrupulosity as a gift, a signal. Look for the disorder underneath it.  Not a question of willpower.   Diabolical aspects Leaving people to their own devices  Discouragement, inward focus, despising self,  Spiritual Approach Not about overcoming scrupulosity  Blessed are the merciful for mercy shall be theirs  Childlike Simplicity and trust lessens our burdens.  Parvulos.  Little Children.  Dust and ashes.   Example of a parent -- would you prefer your child to be working on self-perfection  Perfectionism draws us to be big, perfect, competent, having it all together.  Jacques Phillipe:  The Way of Trust and Love -- particularly helpful for those struggling with scrupulosity.    p. 7 :  The heart of Christian life is to receive and welcome God's tenderness and goodness, the revelation of his merciful love and to let oneself be transformed interiorly by that love.   “We would like to be experienced, irreproachable, never making mistakes, never fall, possess unfeeling good judgment and unimpeachable virtues. Which is to say, we would like to have no more need of forgiveness or mercy, no more need of God and his help.  41 If we accept ourselves as we are, we also accept God's love for us. But if we reject ourselves, if we despise ourselves, we shut ourselves off from the love God has for us, we deny that love. 48-49 We need to practice gentleness toward ourselves so as not to get discouraged and condemn ourselves when faced with their weakness while also nurturing a great desire for holiness. But not a desire for extraordinary perfection. Holiness is different; it is a real desire to love God and our neighbor, and, issuing a kind of halfway love, go to loves extremes. 52 …we shouldn't fall into a kind of stubborn “therapeutic obstinacy,” with the aim of ridding ourselves absolutely of all imperfections or healing every wound. In doing that, we risk becoming impatient and concentrating our efforts on something God isn't specifically asking of us or, ultimately, paying more attention to ourselves than to him. 56-57 The more we accept ourselves as we are and are reconciled to our own weakness, the more we can accept other people and love them as they are. 49 What this podcast is all about.   Contrast that with Pastor Jonathan Edwards -- sinners in the hand of an angry God:  The bow of God's wrath is bent, and the arrow made ready on the string, and justice bends the arrow at your heart, and strains the bow, and it is nothing but the mere pleasure of God, and that of an angry God, without any promise or obligation at all, that keeps the arrow one moment from being made drunk with your blood.  Remember, you as a listener can call me on my cell any Tuesday or Thursday from 4:30 PM to 5:30 PM.  I've set that time aside for you.  317.567.9594.  (repeat) or email me at crisis@soulsandhearts.com.  The Resilient Catholics Community at Soulsandhearts.com/rcc.  So much information there and videos.   I want to invite you to the Resilient Catholics Community The Why of the RCC --  It's all about loving with your whole heart -- all of your being.  Getting over all the natural level issues that hold you back from tolerating being loved and from loving God and others.   Who  Who is the Resilient Catholics Community for? It's for you. If you really are into this podcast, if these ways of conceptualizing the human person and integration and human formation and resilience are appealing to you, then the Resilient Catholics community, the RCC may be for you.   I am looking for listeners who want to be with other like-minded Catholics on the journey, on this adventure of human formation with me.   Who deeply desire a personal, intimate relationship with God and with Mary, a real human, close connection  And who recognize they have some natural-level impediments to that deep relating  and  who are willing to make sacrifices in time, effort, money, humility and courage to grow in human formation and overcome natural-level impediments to being loved and to loving  What want to shore up their natural foundation for the spiritual life, because grace perfects nature.   Who want to become saints.   Who are willing to be pioneers at the cutting edge in this adventure of human formation.  Really at the tip of the spear, the first explorers of this human formation ground for laymen and laywomen.   First of all the RCC is My Tribe, my people, bringing together two groups into one First, faithful, orthodox, serious Catholics who are wounded and suffering and know it  And Second, who are psychologically minded (or at least want to be psychologically minded), who believe in the unconscious and who embrace the unity and multiplicity of the human person  And who want to see through the lens of a core self and parts.  Unity and multiplicity make sense.   What of the RCC $99 nonrefundable registration fee gets you the The Initial Measures Kit -- which generates the Individual Results Sheet and the Personalized Human Formation Plan 5 pages of results about your parts  -- we've done about 70 of these now, and our members are amazed at the results, how accurately we are in helping them identify their parts and how their parts relate to each other, and the why behind their parts' desires and impulses.   Weekly premium Inner Connections podcast, just for RCC community members --Lots of experiential exercises.   A complete course for working on your human formation 44 weekly sessions over the course of a year for $99 per month subscription  Daily check ins with your companion -- accountability and structure  Weekly company meetings with 7 or 8 other members in your small group.   Office hours with me  Conversation hours with me  All this for $99 per month.  And we make it financially possible for anyone who is a good fit for the RCC to join through write-offs and scholarships.  The fees are not the tail that wags the dog.   And there also is opportunities for some parts-based individual coaching as well.   Essentially, the What of the RCC is a pilgrimage together.   The When of the RCC We open twice per year to new members in December and June, open until December 31..  We are open now.  Soulsandhearts.com/rcc to register.  Call me with questions!    317.567.9594.  (repeat) or email me at crisis@soulsandhearts.com.  So sign up Soulsandhearts.com/rcc.   

Welcome back to another segment of "Turning the Mic On To" In this episode, Emma Jane chats with Whitney and Haley of the new, Approaching Normal Podcast. As Whit and Haley have both been diagnosed with OCD, Depression, and Anxiety in various forms, they decided to start a podcast that takes Mental Health out of the shame cloud it often sits in, and starts conversations about the specifics of what Mental Illness is like to various individuals that experience is. In our conversation, they each open up about their struggles and journeys to healing, what OCD is both generally and specific to them, and we even chat about the ways that religion and mental health stigma's can play a negative role, especially in the lives of returned missionaries. As one who struggles with mental health myself, this episode opened my eyes to the importance of really diving in and striving to understand yourself, and your mental illness. Definitely an episode worth listening to.You can find Whitney and Haley on their Instagram, @approachingnormal.pod and their podcast, streaming soon.Link to Whitney's article with LDS Living: https://www.ldsliving.com/ocd-god-and-me-one-womans-experience-with-scrupulosity/s/93988 Link to the OCD and Anxiety Treatment Center: https://www.theocdandanxietytreatmentcenter.com/Find a Therapist through Psychology Today: https://www.psychologytoday.com/us

Paul Peterson, MSW, started working as a therapist in 1998. He was intrigued by OCD from the beginning of his career, and it became more personal to him when several family members were diagnosed. In 2008, he received training from the National OCD foundation that changed the path of his career. In 2015, he officially established the OCD and Anxiety Treatment Center with 100 employees. It has changed countless lives dramatically and given hope to hundreds of OCD sufferers.

You're stuck at home, your economic future is uncertain, and it's difficult to plan more than one day at a time. To make things even more challenging, the people and activities that bring you the most joy might be unavailable. What do you do? How do you manage your emotional health during times of such unrest?  On this week's podcast, you'll meet a psychologist whose entire career has been focused on the management and treatment of anxiety.  Listen & Learn:  How to differentiate between danger and discomfort The power of acceptance  Navigating fear, loss, and change  Understanding the emotions around your fears Links & Resources:  Dr. Carbonell's site  ABOUT OUR GUEST Doctor Carbonell is a Clinical Psychologist who specializes in the treatment of anxiety disorders as a therapist, author, and teacher. He founded the Anxiety Treatment Center in Chicago in 1990, one of the first psychological practices in the United States devoted exclusively to the treatment of clients who sought help with anxiety disorders, and continues to offer treatment today. Nutritional Tip of the Week: Supplements for COVID-19 Got Questions? Send me a voicemail here: Ask Lucas a Question Or write to us: podcast@yogabody.com  Like the Show? Leave us a Review on iTunes

Dr. Edmund Bourne, Ph.D. has specialized in the treatment of anxiety disorders and related problems for more than two decades. For many years he was director of the Anxiety Treatment Center in San Jose and Santa Rosa, California. His best-selling anxiety workbooks, which have helped hundreds of thousands of readers throughout the world, include The Anxiety & Phobia Workbook, Healing Fear, Beyond Anxiety & Phobia, Coping With Anxiety, and Natural Relief for Anxiety. Dr. Bourne is frequently interviewed by the media, and his work has been featured in numerous magazines, such as Psychology Today, Natural Health, Cosmopolitan, Fitness, and Bottom Line Personal. Dr. Bourne currently lives and practices in Northern California and Florida. He maintains a commitment to helping create world peace by teaching people how to create greater peace in their lives. The Anxiety Phobia Workbook is a practical and comprehensive guide offering help to anyone who is struggling with panic attacks, agoraphobia, social fears, generalized anxiety, obsessive-compulsive behaviors, or other anxiety disorders. Step-by-step guidelines, questionnaires, and exercises will help you to learn skills and make lifestyle changes necessary to achieve a lasting recovery. Comprehensive in scope, this workbook covers a broad range of topics and treatment approaches, including some not found in other books on anxiety disorders. A partial list of topics includes: Detailed treatment outlines for each of the seven major anxiety disordersCauses of anxiety disordersRelaxation techniquesPhysical exerciseCoping with panic attacksNew research on exposure techniques for overcoming phobiasOvercoming negative self-talkChanging mistaken beliefsVisualizations for anxietyExpressing feelingsSelf-esteemHow to create your own recovery programComprehensive information on medication In the past fifteen years, the Anxiety & Phobia Workbook has become the book on anxiety most often recommended by therapists to their clients in the US. Since its first edition, it has become a bestseller and helped over a million readers throughout the world. Whether a mental health professional has recommended this book to you or you've chosen it yourself to support a self-care program, it will provide you with sound, proven techniques for overcoming anxiety, panic, phobias, and other anxiety conditions. If anxiety is causing you to miss the best parts of your life, the last thing that you need to do is spend countless hours plumbing the murky depths of your childhood for causes of the disorder. You need dependable, powerful solutions that you can put to work right now to cope with the problem and start living again. A no-nonsense synopsis of the most effective treatments available, this book contains everything you need to know to move beyond anxiety. Learn ten simple solutions for the physical, mental and emotional symptoms of anxiety. Find out how to achieve relaxation. realistic thinking, and a reasonable response to your fears by employing in-the-moment techniques. All the theoretical information in this book is simple, concise and jargon free—limited to just what you need to know to start your recovery.

This episode features Leah Jaramillo, LMFT. She has a Master's Degree in Marriage and Family Therapy, a Bachelor’s in Psychology and an Associate’s in Criminal Justice. She works at The OCD and Anxiety Treatment Center in Bountiful, UT. You can find her and the clinic at: www.theocdandanxietytreatmentcenter.com In this episode Leah brings so much clarity to what is OCD and Anxiety. We talk about how to properly diagnose someone and that it's much more involved than a 10min visit and a survey. We also talk youth suicide, why it's on the rise and how to help. The OCD and Anxiety clinic specializes in exposure therapy and they’ve seen great results through their methods.  I learned so much from chatting with Leah and I'm excited for her and this clinic to get more exposure for the great work they're doing.  If you're needing help in anyway with mental illness or for a loved one, they are a great resource, so check out their website or give them a call. Their Instagram is @TOATC Thanks for listening to the podcast, if you're enjoying it please give us a rating and review on whatever platform you're using.  Contact us: Email: TheInMyHeadPodcast@gmail.com IG & Twitter: @InMyHeadPodcast Facebook: @TheInMyHeadPodcast

Jacob Felson of William Paterson University on American views on marijuana. Hany Farid of Dartmouth College on the science of detecting fake videos. Ryan Tuohy of Starship Technologies on robots ferrying food. Georg Petroianu of the Florida International University School of Medicine on hiccups. Debra Kissen of Light on Anxiety Treatment Center on coping with panic attacks. Rachel Wadham of Worlds Awaiting on African American illustrators.

This week on Relationships 2.0 I'm replaying a previous episode with David A. Carbonell, PhD author of The Worry Trick: How Your Brain Tricks You into Expecting the Worst and What You Can Do About It About the book: Are you truly in danger or has your brain simply “tricked” you into thinking you are? In The Worry Trick, psychologist and anxiety expert David Carbonell shows how anxiety hijacks the brain and offers effective techniques to help you break the cycle of worry, once and for all. Anxiety is a powerful force. It makes us question ourselves and our decisions, causes us to worry about the future, and fills our days with dread and emotional turbulence. Based in acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT), this book is designed to help you break the cycle of worry. Worry convinces us there’s danger, and then tricks us into getting into fight, flight, or freeze mode—even when there is no danger. The techniques in this book, rather than encouraging you to avoid or try to resist anxiety, shows you how to see the trick that underlies your anxious thoughts, and how avoidance can backfire and make anxiety worse. If you’re ready to start observing your anxious feelings with distance and clarity—rather than getting tricked once again—this book will show you how. About the author: David Carbonell, Ph.D., is a Clinical Psychologist who specializes in the treatment of anxiety disorders. He is the founder and director of the Anxiety Treatment Center, Ltd., a small group of psychologists which offers treatment of all manner of fears and phobias at several locations in and around Chicago, and the “coach” at www.anxietycoach.com, a self help web site for people troubled by fears and phobias. Dr. Carbonell is a recognized expert in this field, and has conducted training and seminars for a variety of professional groups, including the Anxiety Disorders Association of America; the International Association of Cognitive Psychotherapy; the United Airlines Employee Assistance Program; the Rockland County and Suffolk County Psychological Associations in New York; the Illinois Alcohol and Other Drug Abuse Professional Certification Association; the Illinois Employee Assistance Professionals Association; the Illinois Psychological Association, the New York Psychological Association; and Northwestern University Medical School, among others. He regularly offers a day-long workshop for professional therapists on the treatment of anxiety disorders at locations around the country, sponsored by Pesi Healthcare, Inc. Dr. Carbonell is the author of Panic Attacks Workbook (Ulysses Press, 2004) and The Worry Trick (New Harbinger, 2016). He is a member of the American Psychological Association; the Anxiety Disorders Association of America; the Association for Behavioral and Cognitive Therapies; the Association for Contextual and Behavioral Science; the International Association for Cognitive Psychotherapy; the Illinois Psychological Association; and the Obsessive Compulsive Foundation. He is licensed as a clinical psychologist by the States of Illinois and New York.

Sue Bethanis hosts Dr. David Carbonell, Founder and Director of the Anxiety Treatment Center, which offers treatment of all manner of fears and phobias, and the “coach” at www.anxietycoach.com, a self-help website for people troubled by fears and phobias. Dr. Carbonell is a recognized expert in this field and has conducted training and seminars for a variety of professional groups, including the Anxiety Disorders Association of America, the International Association of Cognitive Psychotherapy, the United Airlines Employee Assistance Program, and Northwestern University Medical School, among others. He is the author of Panic Attacks Workbook and the The Worry Trick: How Your Brain Tricks You into Expecting the Worst and What You Can Do About It. David and Sue discuss: + How worry stems from irrational thoughts + Why the harder we try, the worse it gets + The “trick” behind chronic worry + How to train yourself to respond to anxiety

Show #160 | Guest: Dr. Robin Zasio visits In Deep with insight and advice. The hour will also touch on her work in reality TV - Hoarders and My Extreme Animal Phobia. Dr. Robin Zasio specializes in cognitive therapy in the treatment of anxiety and compulsive behaviors, and the founder of The Anxiety Treatment Center, The Cognitive Behavior Therapy Center and The Compulsive Hoarding Center, all in Sacramento. | Show Summary: One psychologist called it "Election Stress Disorder"; others call it "The Trump Effect". Before, during, and after the election, mental health professionals nationwide reported increased anxiety in their clients - and anxiety has terrible, even life-shortening effects on the human body and mind. What's the healthiest way to cope with anxiety, and what special challenges arise when that stress derives from world events?

This week on Relationships 2.0 my guest is David A. Carbonell, PhD author of The Worry Trick: How Your Brain Tricks You into Expecting the Worst and What You Can Do About It About the book: Are you truly in danger or has your brain simply “tricked” you into thinking you are? In The Worry Trick, psychologist and anxiety expert David Carbonell shows how anxiety hijacks the brain and offers effective techniques to help you break the cycle of worry, once and for all. Anxiety is a powerful force. It makes us question ourselves and our decisions, causes us to worry about the future, and fills our days with dread and emotional turbulence. Based in acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT), this book is designed to help you break the cycle of worry. Worry convinces us there’s danger, and then tricks us into getting into fight, flight, or freeze mode—even when there is no danger. The techniques in this book, rather than encouraging you to avoid or try to resist anxiety, shows you how to see the trick that underlies your anxious thoughts, and how avoidance can backfire and make anxiety worse. If you’re ready to start observing your anxious feelings with distance and clarity—rather than getting tricked once again—this book will show you how. About the author: David Carbonell, Ph.D., is a Clinical Psychologist who specializes in the treatment of anxiety disorders. He is the founder and director of the Anxiety Treatment Center, Ltd., a small group of psychologists which offers treatment of all manner of fears and phobias at several locations in and around Chicago, and the “coach” at www.anxietycoach.com, a self help web site for people troubled by fears and phobias. Dr. Carbonell is a recognized expert in this field, and has conducted training and seminars for a variety of professional groups, including the Anxiety Disorders Association of America; the International Association of Cognitive Psychotherapy; the United Airlines Employee Assistance Program; the Rockland County and Suffolk County Psychological Associations in New York; the Illinois Alcohol and Other Drug Abuse Professional Certification Association; the Illinois Employee Assistance Professionals Association; the Illinois Psychological Association, the New York Psychological Association; and Northwestern University Medical School, among others. He regularly offers a day-long workshop for professional therapists on the treatment of anxiety disorders at locations around the country, sponsored by Pesi Healthcare, Inc. Dr. Carbonell is the author of Panic Attacks Workbook (Ulysses Press, 2004) and The Worry Trick (New Harbinger, 2016). He is a member of the American Psychological Association; the Anxiety Disorders Association of America; the Association for Behavioral and Cognitive Therapies; the Association for Contextual and Behavioral Science; the International Association for Cognitive Psychotherapy; the Illinois Psychological Association; and the Obsessive Compulsive Foundation. He is licensed as a clinical psychologist by the States of Illinois and New York.

Karen Cassiday is the president-elect of the Anxiety and Depression Association of America as well as owner of the Anxiety Treatment Center of Greater Chicago-the first private clinic in the Chicago area to offer exposure-based treatment for anxiety disorders. Karen has multiple published articles in the area of anxiety disorders, and is an internationally recognized expert on the treatment of anxiety and related disorders in children through adults. In this episode Live Happy magazine Science Editor Paula Felps talks with Karen about the causes and difficulties with worry and how to overcome it.