This post is intended for Christians looking to deepen their faith and mental health and may not apply to my entire reader base.
My daughter Hattie went into hoarding mode this Halloween. Within 5 minutes, she was in MEGA-CUMULATION mode. Emily and I got some good parenting moments; “Hattie, you can choose 2 items from that basket.” (We had to say that about 30 times.)
I laugh often when she’s around food, toys, or playground equipment- like an old prospector she stakes her claim. She is offended that others dare lay claim to something she thinks should be hers! How dare they!
Now I’ll point the laughter at myself; I am not really that different. I’ve just become more savvy at being socially adept at my control attempts.
Hoarding of items to feel secure is a fairly natural response of our human nature, ranging in extremes. A scarcity mindset, i.e., “feast or famine” or to obsessively “protect what’s mine,” though, is selfish and self-focused. It does not “love your neighbor as yourself.” I recommend for myself today- and for you- to look in the mirror every once in a while and ask this tough question:
What drives you? Fear-based scarcity? GOD- as your provider? Something else?
A story may help illuminate the question. The Hebrew, ‘man hu’ means “It is manna,” and in English, “What is it?” This manna was an incredible food God provided refugee Israelites fleeing from a brutal autocracy that had enslaved them. It's all part of the incredible history of the Jewish people. God accomplished this over many years and utilized several key players, the most famous being Moses. In delivering Israel from Pharaoh and the Egyptians, God led them out through the leadership of a very imperfect man who likely had Social Anxiety Disorder, fulfilling incredible promises, miracles, and almost unbelievable wonders. It's one of the best deliverance stories, maybe in the history of history. If you haven't read it, please do so in the Book of Exodus.
So imagine being born into slavery, and you gain total freedom from an overbearing despot. But in order to get away, you must go through the desert. I feel tired and thirsty already.
In their refugee state, God promised the Jewish people refuge. But it wasn’t a magical transportation to heaven. Just days after they were freed, they felt the heat of the desert. They had to walk miles and miles. They complained. Only one of the seemingly unbelievable ways God provided for them was through fast, convenient, and sustaining food. It was manna (Exodus 16), which was given in the morning and quail at night. They were already complaing so much they said they wanted to go back to slavery because they had it better in Egypt (*face palm*). In addition to complaining, there was hoarding (Numbers 11) in desperation, lacking reliance on God. I can only guess fear would have been involved.
These details, with thousands of years of perspective can make it seem ridiculous to some when we read on paper or pixels. Why wouldn’t you just trust God when he frees you from slavery and performs many miracles before your eyes? I’m afraid my heart isn’t different. I am the same when I lack trust in God by faith.
What if you have an Anxiety or other Disorder that gives you an extra kick in the teeth? Something that makes these things extra difficult? First of all, God is patient (2 Corinthians 12:7-10; 1 Peter 3:9). Secondly, God asks us to seek Him by faith in all things, just like everyone else (Hebrews 11:6; 2 Timothy 2:4).
I have an anxiety disorder myself. And God has been incredibly faithful and gentle with me, while also lovingly disciplining me (see Hebrews 12), so that I keep seeking him. If you fall into a scarcity mindset [check out my post “Developing A Growth Mindset”], welcome to the club of being human, but if you also have a disorder that makes it even more difficult to walk by faith over fear, welcome to another club that is very large, indeed; close to half of all people qualify for one mental disorder at some point in their lives. Remember, God is patient. God also still asks us to seek Him by faith, just like everyone else. Sometimes walking by faith means praying, sometimes resting, sometimes therapy, sometimes talking, sometimes serving...you get the gist.
As with the Israelites during the Exodus, God accomplished many things over many, many years- and He still is. The Israelites feared, complained, got overwhelmed, and tried to stuff their pockets- directly lacking faith in what God was telling them and showing them. God was patient nonetheless, while he disciplined them. He’s asking us to faith. Faith that God is your provider. Not therapy. Not a nation. Not your employer. Not yourself. Not a president. Not a parent. Not your 401k.
Days out from the "great candy grab of 2020," my child's brain experienced the indelible impact of poignant pleasure: she asked daily after this if she could go to neighbor’s front porches!! As I raise her I am prayerful that she will learn well to take her fears and turn to God (and to never be ashamed to get help through CBT or medications). I pray she becomes aware of her God-given feelings and desires, and can ultimately be led back to the rock that is Christ- who is the realization of her greatest hopes and dreams.
Also, Candy is nice, too. I’ll take both, please. :)
I recorded a full length episode for the OCD Stories with Stuart Ralph, based in London, this summer. He just dropped the final version. You can listen FREE on all streaming platforms.
One of my goals was to speak in a way where most people could connect or find something beneficial in this podcast. I hope you enjoy!
This post is intended for Christians looking to deepen their faith and mental health and may not apply to my entire reader base.
If you have obsessions on this topic, please set some boundaries up front as to how you will engage in this content, which can be distressing and triggering especially for those dealing with scrupulosity. You may easily worsen your fear if you allow yourself to obsess on the content or perform rituals surrounding it.
The unforgivable/unpardonable sin (also called the eternal sin or blasphemy against the Holy Spirit) can induce some level of fear for even the most convinced of Christians. To the person who gets stuck on the concept, such as in OCD, Generalized Anxiety, and/or scrupulosity, misery would not be too strong of a word to describe it. Personally, I suffered for several years in my childhood and for passing days in my adulthood with questioning my salvation- so I understand a lot of this on a personal and professional level. So what exactly are we talking about when we say “the unforgivable sin?”
What is the Unforgivable Sin?
Can there be a sin so terrible, horrendous and vile that it leads straight to hell without the option to ask forgiveness? Can this sin be accidental? Is it stated verbally, or through one’s thoughts, or confirmed by actions? Here are the 3 occurrences found in the Synoptic Gospels (Matthew, Mark, and Luke), describing the unforgivable sin:
What does it mean? I would like to offer you a simple explanation and definition that alleviates all fears. But I can’t, literally- I don’t have it. That would be pretty arrogant of me if revered church theologians since the time of Christ still lack a simple explanation. If you’re a super nerd like me, you may find it interesting to know that Martin Luther, John Chrysostom, St. Augustine, John Wesley, Jonathan Edwards, John Calvin (lots of guys named John, right?), and more have all had slightly different takes.
Summarizing 4 key perspectives on what the unforgivable sin is:
Context of the unforgivable sin.
For the sake of brevity and the fact that there are a wealth of commentaries and studies that explore this topic, let me just say that we must look at the whole of Scriptures if we are to take Scripture seriously. A major problem in modern day interpretation lies in “sound bites” and quick references that disregard context. Rule #1: know your context. Context is something you will be unable to get or see if you are LOCKED up in fear. Fear narrows focus. Its purpose, when functional, is to place our focus to a pinpoint so we can appropriately respond. If you have a disorder involving fear, you likely get stuck on a whole host of topics (or one major one) that requires re-learning that those without disorders take for granted.
For those of you looking simply for more knowledge on defining the topic, feel free to check out the great resources I’ve provided at the end to dig into the Scripture passages above, look at original languages and the context, audience of the passage, and so forth.
A remarkable reality is that there is no example in all of Scripture wherein a person who asks God's forgiveness doesn't receive it (which is a large support as to the views espoused in the resources, namely that blasphemy of the Holy Spirit must be a person who has decisively turned against God and rejects the opportunity to be forgiven). There are of course temporary consequences to sin and poor decisions (e.g., Moses not getting to see the Promised Land, David losing a child, Martha missing out on Jesus' presence, Peter feeling intense feelings and shame about denying Christ, etc.).
“All that the Father gives me will come to me, and whoever comes to me I will never cast out” (John 6:37).
If you suffer with the thought of the unforgivable sin and scrupulosity (like many saints throughout history), you'll need different tools to respond- rather than living in fear. 4 suggestions:
Many of you have come to this article to get "the answer" (to feel “just right” or get reassurance). The harder and necessary task of faith may be to discover how to not obsess or feed your fear (which is not God's desire for you, see "Fear Not"). If you came here today with a lack of information, then by all means go to the links below explaining some perspectives on what the unforgivable sin is. But if you're like me at times in my life, or like the clients I see daily in therapy who can get stuck on verses like these, I prayerfully ask that our Lord would grant you strength to sit with difficult Bible passages without reacting out of fear- whatever that looks like today for you, my friend.
For more information:
R.C. Sproul: https://www.ligonier.org/blog/what-unpardonable-sin/
John Piper: https://www.desiringgod.org/articles/what-is-the-unforgivable-sin
David Jeremiah: https://www.crosswalk.com/slideshows/10-things-you-need-to-know-unforgivable-sin.html
This post is intended for Christians looking to deepen their faith and mental health and may not apply to my entire reader base.
America today sees one of the highest levels of anxiety of any place in the world. We are clamoring for attention online, wanting to be seen, to be loved. Suicides by teens and young adults appear to be higher than they’ve been in years. We are the wealthiest nation on the face of the planet, and we can’t rest. We have more than anyone else (as a whole), and we can’t stop. Children who are now becoming adults are feeling this crushing weight of anxiety and expectation (whether on themselves or from outside)- ‘get the degree and the top job, get married, have the house, have children, don’t screw it up.’ And we know that anxiety has biological and genetic influences, but these are not 100% causal by any means. Our response makes a difference.
Generalized Anxiety Disorder (or GAD, the disorder most connected to general worries) is more impairing in higher income countries. The occurrence of GAD (lifetime prevalence) boiled down to:
I think the ultimate answer lies in Christ. Hebrews 4:9 says, “...there remains a Sabbath rest for the people of God.” Matthew 11:30: “My yoke is easy and my burden is light.”
*Insert deep relaxing breath.
God ordained rest from the beginning of creation. Genesis 2:2-3: says, “And on the seventh day God finished his work that he had done, and he rested on the seventh day from all his work that he had done. So God blessed the seventh day and made it holy, because on it God rested from all his work that he had done in creation.” God purposed rest for us, his creation. God wasn’t winded and saying, “Oh boy, that creating sure made me tired...let me sit back and take it easy.” We know he created it for us. Jesus states, “The Sabbath was made for man, not man for the Sabbath” (Mark 2:27). If we back up to the institution of the Sabbath given as law to the Israelites, in Deuteronomy 5:15 we are given a reason why God so seriously wanted His people to be obedient in this: “remember that you were a slave….and the Lord your God brought you out…” So to pause and rest is to say, GOD is my provider, and my striving only results in results because of God (Seriously, check out these passages: Deuteronomy 2:7; 1 Chronicles 29:12; Psalms 23 and 147:8; Matthew 6:25-33; Philippians 4:19).
Observationally, we don’t have to look far to understand our need for regenerative rest. Sleep is one of the greatest things we can “do” for our well being. Our bodies need one third of our day just to be restored. ⅓!! Living to 75 that’s 25 years of our life spent sleeping! When we try to cheat this, various problems ensue. And by the way, the U.S. has a tremendous problem with sleep, as well. It’s hard to even grasp the scope of this due to the myriad ways people attempt to rest that may not be directly researched or studied in any one experiment (sleep aids, watching media, abusing substances- including over-the-counter cough syrup and benadryl).
The Doctor Who episode “Sleep No More” features the attempt to cheat sleep and maximize productivity. Scientists discover a device (“Morpheus”) that takes only a few minutes to compress a month of sleep. Serious problems ensue (enter evil “Sandmen” into the equation, for any of you Doctor Who nerds). Sleep and rest are common themes in literature and life. No doubt, they play a substantial role in our well-being- or downfall.
Though therapy is highly efficacious in addressing disorders specifically and often helpful for much personal growth, it is not set up to be a worldview (a personal understanding or philosophy of the world)- it was never meant to be! Therapy is the clinical application resulting from theories and science on human thought and behavior, just like medical practitioners study from a particular perspective and approach (“Western”, naturopathic, Traditional/Chinese, etc.). Psychology cannot be an entire worldview, by definition, because it’s only one subset of study, research, observation, and experience.
Back to Jesus: “Come to me, all who labor and are heavy laden, and I will give you rest.” (Matthew 11:28).
Are you tired of striving in your own strength? Jesus speaks to the question of trying to be good enough. The Bible presents a very large pill to swallow that is offensive to our Western, pluralistic and politically correct sensibilities: your striving is empty without God. BUT, here is the hope, and this is the Gospel: being made right with the God of the universe through Christ, we have peace. We have freedom. We have hope. We have purpose. We are forgiven. We are loved.
From the poorest and most overlooked member in the slums of Calcutta to the Billionaire on 57th Street in NYC: You are loved. You are valuable. Striving and anxious pursuits are nothing without God- let us seek his rest.
 Newman, T. (n.d.). Is anxiety increasing in the United States? Retrieved October 07, 2020, from https://www.medicalnewstoday.com/articles/322877. “When they compare the levels of depression, no single area has significantly higher rates. When it comes to anxiety disorders, however, it’s a different story; the Americas are head and shoulders above all other regions, including Africa and Europe.”
 This is not to shame you. You may have a legit challenge with anxiety due to disorder- if so, I’m sorry! You may have tried seemingly everything to feel better and it just hangs around. Keep reading, if this is you, because the post still applies, it’s just that I want you to know that you may have it harder than others, and you may need treatment. Truly, this world is not fair. But stay with me; there’s hope.
 The disorder is significantly more prevalent and impairing in high-income countries than in low- or middle-income countries.
 Walker, M. P. (2018). Why we sleep: The new science of sleep and dreams. London, UK: Penguin Books.
 CDC - Data and Statistics - Sleep and Sleep Disorders. (2017, May 02). Retrieved October 07, 2020, from https://www.cdc.gov/sleep/data_statistics.html
All Scripture quotations are ESV.
“You want me to do what?!” Many of my clients, and particularly for the sake of this article, Christian clients, are a bit surprised when I ask them to practice exposure. Repeating scary, terrible thoughts on paper or aloud. Doing things that feel risky. It seems as a clinician I’m disrespecting your beliefs and don’t really get it. Maybe I’m asking you to do something unbiblical, blasphemous, against what God would want. But what if I do understand and am helping you live in line with your beliefs? What if exposure is a powerful tool under God’s grace (Matthew 5:45) to help you get over a disorder?
The Great Hesitation. When some clients start their treatment with me, I come across familiar hesitations when we begin discussing Exposure Therapy and facing one’s fears:
Maybe. I of course do not know your (the reader’s) story, so I cannot say for you personally. Though, here’s the problem many of my clients run into: they are reinforcing fear every time they avoid and run from thoughts/urges/impulses/feelings that are out of fear rather than a want (see an important article on this for more: FACE fear, FLEE Temptation). Some basic science is in order here: when you fight and resist a thought, it persists (e.g., don’t think of the pink elephant, trying to get a song out of your head, etc.). That’s the way it’s supposed to work- a threat believed to be a threat is supposed to feel like a threat.
This is where exposure therapy comes in. As a summary, exposure is the systematic and intentional triggering of fear while minimizing- and ideally eliminating- all pathological responses. In the therapy process, when I start to introduce clients to the idea of sitting with fear mindfully and not fighting it, most have hesitations. “You’re telling me to do what?! You want me to repeat these horrific thoughts again and again?!” I get it; it seems paradoxical. Most people can rather quickly wrap their heads around an exposure to an overt situational fear (like holding a kitchen knife when you have an intrusive harm fear) but have a harder time understanding exposure for other “Pure O” intrusions, such as harm and scrupulosity, like the following:
The above are examples of intrusive thoughts; they are counter to what a person holds as their overall value and pursuit, or “ego-dystonic.” If you want to know all about treating these thoughts through imaginal exposure, check out the article “Flip the Script- A Guide to Imaginal Exposure.” And yes, I’ll tell you right now that if a person obsesses on the above or has ritualistic behaviors and avoidances, we are going to work with leaning into the discomfort of these, not ignoring them.
The clinical rationale. In all disorders featuring anxiety and fear, there is a problem with the system that signals something is wrong. It’s broken. Doesn’t work right. It’s a fire alarm that goes off when there’s no fire. A missile alert with no missile. Depending on fear, a person might feel a range of things: fear, disgust, anger, sadness, loneliness, dread, regret, chest tightness, racing heart, sweaty palms, neck and back tension, and extensively more. We tend to feel the feelings that a signal dictates. For example:
In disordered behavior, people become over-focused (or under) on a narrow set of experiences. People who are overly vigilant can run into some of the very problems they seek to avoid, or a different set of problems. Examples:
The Biblical rationale.
If we are to change the outcomes for people who suffer from disorders, psychology has developed some very solid tools. If you believe, like I do, that the Bible is God’s Word and is meant to have authority in your life, then you’ll likely need a good biblical rationale for exposure therapy. Here goes on my end, but I am going to ask you personally to dig in. This is your decision. Don’t rely on some therapist to tell you what to think- talk to God, pray, use the brain He’s given and be open to the teaching of trustworthy others (2 Timothy 4:2).
Truth is very important in the Christian faith (John 17:17; Psalm 145:18; Proverbs 12:22; John 4:24; 1 Corinthians 13:4-6). If part of being the church of Christ is to speak the truth to one another, including difficult things like anger (Ephesians 4:15, 26), I remind clients often that if you have intrusive, obsessive, or otherwise bothersome thought or feeling, being open about them and calling them out is simply being honest. It’s being truthful. God knows what’s going on in your head (1 John 3:20)!
When Philippians 4:8 is brought up, it is sometimes a “proof text” on how you “should always thinking positive.” That’s a remarkably short-sighted, superficial view.
“Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.”
This clearly can’t mean to not think about negative things, evil, or something terrible. If so, we’d never be able to ask forgiveness of our sins by calling them out and repenting! One of the ways that we can think on things like justice, honor, love, etc. is by calling out the opposite: injustice, dishonor, and selfishness. It is in acknowledgement of problems that the solution can be instilled.
God knows our hearts (Proverbs 21:2; 1 Samuel 16:7; Jeremiah 17:10; Acts 15:8; Romans 8:27). If you’re afraid you might do something bad, do you believe God knows that? And if you’re going to do something bad and be unrepentant, then you aren’t going to repent, right? And if that’s the case, why are you trying? If you’re doomed, what’s the point in trying to change that? If there’s a chance- even if you don’t feel like it in the moment- just a small chance that you can take to God your innermost thoughts and feelings and get love and grace and forgiveness and peace and patience, is it worth it to you? Would you be willing to try?
Walking with God means we are “...casting all your anxieties on him, because he cares for you” (1 Peter 5:7). Nowhere in the Bible does it say you will not feel anxiety or struggle with anxiety. It tells us how to frame it (1 Peter 5:7; Philippians 4:6-8), that fear is not God’s heart for us (1 John 4:19), and that he loves us in it (each of these references prior reflects God’s gentle, patient love). The Bible is not a psychology textbook or methods and techniques class. While we walk with Christ, we learn to depend on God by faith. Sometimes that’s therapy, medication, prayer, community, repentance, exercise, gratitude, acceptance, rest, or any number of things.
Obviously, we are not going to find a passage that says, “do exposure therapy” (and of course, “pay good money for it”, ha!).
Compassion and Understanding to You
When clients come to me with thoughts and behaviors they are bothered by, the last thing they want to do is to look it squarely in the face or write it down or say it aloud (It’s called exposure for a reason). But in reality, this is what helps shine the light on it- calling it out in truth. It calls it to the table to do business. In the end, you must personally seek the Lord, and I hope through prayer, His Word, and community to determine what steps you will take in anything important in life. I do hope that if you can benefit from something like Exposure Therapy, you will find, as I have, that it is a tool, albeit human and imperfect, that God has graciously allowed us to discover, maybe like penicillin, insulin, the benefits of exercise, or Vitamin D.. May the created point back to The Creator and show His goodness and love.
“If you then, who are evil, know how to give good gifts to your children, how much more will your Father who is in heaven give good things to those who ask him! (Matthew 7:11, ESV).
“For he makes his sun rise on the evil and on the good, and sends rain on the just and on the unjust” (Matthew 5:45 b, ESV).
“...He cares for you” (1 Peter 5:7b).
A few extra readings on the Biblical rationale for treatment (medicine and/or therapy):
21 Ways To Thriving Mental Health from an Anxiety Specialist
Katherine didn’t understand why this pandemic hit her so hard. In fact, she was embarrassed that it did. “I mean, my routines and orderliness can be a little overboard, but I’ve never had difficulty getting by day-to-day. I cry at the drop of a hat and just don't know what to do." I was so honored that she admitted she was struggling, because in that honest vulnerability, she is now getting help.*
In this time of COVID-19, there is a common expectation: the misconception that "healthy" means we won't feel anxious - or the opposite: success is defined by feeling completely safe, confident, or certain. That's crap.
Though it’s nice to feel less anxious, it’s not always reality, even if we’re doing all the right things. I mostly work with clients by helping them learn to stay focused on things of value, regardless of how they feel. Overall anxiety reduction is a result of various factors and is rarely immediate. In time, with supportive factors, anxiety often will go down. Jesus himself felt greatly distressed and overwhelmed, at times, too, if you didn’t know. He wept, sweated, pleaded, was scared, bled, and got angry and frustrated. He understands because he can actually relate - physically and emotionally. He gets Katherine's suffering - and yours, too.
Life involves not only facing bad things that don't happen, but also bad things that do. The question is, are you trained and ready? Can you still keep your focus even when the world around you and inside of you seems to be in chaos? Here are some quick tips to help you stay grounded in reality.
1. Be assertive. Routines have changed. We have to communicate to make the covert overt, like telling your loved one if you need a break to recharge (they can't read your mind!).
2. Be careful of untrue thoughts. Unrealistic thought patterns negatively impact our entire life, like All-or-Nothing Thinking. For example, "Since I’ve been eating poorly it doesn't make a difference if I exercise.” Katherine, mentioned earlier, fell into this trap by believing she was doing a terrible job simply because she felt overwhelmed. Mental health is based on grasping reality to the extent we can. Watch your thoughts and line them up with reality as much as possible.
3. Don't over-consume on substances. Caffeine and alcohol are certainly the most popular substances to monitor.
4. Downtime/Mindfulness/Quiet. The importance of giving our brain pauses and rest cannot be overstated. During a crisis, we need more intentionality to slow down unhealthy processes that are automatic or deeply ingrained. Learn to be mindful, slow down the process, and/or meditate on something beneficial- like how much God cares for you and promises to never leave or forsake you. Benefits range from increased focus and function to decreased stress and disease.
5. Emotions, Thoughts, and Behaviors - Tune In. Be aware of your thoughts, emotions, and behaviors. God gave you these - learn to pay attention to them and discover how to respond - sometimes in ways you might not expect.
6. Exercise. Exercise is highly connected to mental health. If you’re stuck in the house, there are ways to get creative. Make a game with a fitness tracker! Compete with others! Set up prizes for yourself or children! Get outside where possible and get moving.
7. Get Support. Use trustworthy support. Few things in life (if any) are done well without support. One place to get support is through an online or in-person Live Second Group.
8. Have fun! We all need reminding to pursue fun. Even the term ‘recreation’ is based on the concept 'recreate '- “to give new life.”
9. Medication. Medication can play a necessary role in well-being. You don’t need to feel shame if you can use a physiological boost for your brain health. Consult a health professional if this would be the right option for you.
10. Normal structure. Our brains integrate information we don't need to remember and becomes second nature. So when you change your routine massively, you will feel out of balance. That’s okay! Try to make use of old structures while learning to develop new ones!
11. Nutrition/Diet. Be careful not to overindulge on carbs and sugars - the snacky & sweet food you may feel the urge to “pound,”which can offer quick energy and pleasure, but overconsumption won’t benefit you. In fact, it will impact you negatively.
12. Prayer. Open communication and presence with the God of the universe is what we access through prayer! His power is what I need; it's really good to follow a big God who is over all our circumstances.
13. Prioritize. Limit inputs of information and stimulation or your brain will do its best to force limits and push you back into what’s called “homeostasis” (or balance), which can lead to feeling burnout and depression.
14. Serve others. Loving our neighbor as ourselves is beautiful. Not only does it help them, but we also can find much encouragement and joy. Learning and growth is often solidified when we can teach, pass along, and serve. Win-win.
15. Sleep. As one of the most important contributors to all aspects of health, good sleep is a necessary foundation to good health.
16. Spend/Save/Give money. Work from a budget. Spending money can be satisfying. Giving it away is powerful to others and ourselves. Taking on unnecessary debts, overspending and being miserly or hypervigilant all lead to stress in different ways.
17. Socialize. We are social beings. Direct contact releases neurotransmitters! But so can positive interactions in this time where we can’t touch much. Wow! For the time being, technology, phones, letters, or writing on messages on cardboard goes a long way.
18. Spirituality/Faith. What do you live for? What do you believe? And are you living congruently with it? Are you allowing yourself to ask questions and pursue guidance, support, and practices around what is good and true and beautiful and lovely? To discover more about what it looks like to follow Jesus watch this.
19. Sunlight. Not only is sunlight important in Vitamin D production, natural light is linked with numerous processes ranging from sleep to mood and much more. If you must be indoors or have limitations on natural light, find ways to maximize it.
20. Supplements. There is good evidence that several supplements can aid in mental health; some linked most commonly to mental health are Vitamin D, B Complex, and Omega-3 Fatty Acids (always follow your doctor’s advice).
21. Your context is your context. Don't compare. "Comparison is the thief of joy." When we look at where we are, don't let expectations crowd out what you're supposed to be about.
Keep in mind this is educational content and not intended as a substitute for professional advice, treatment, or diagnosis. Any of these tips will come across as too simple for someone suffering highly.
*All names and details used are obscured to protect patient confidentiality, including using a mixture of case information.
The Guide above is provided entirely for free to newsletter subscribers.
One of my first questions to a professor in my earliest IOCDF BTTI (Exposure Therapy training) at Massachusetts General Hospital was, “What happens if someone actually gets sick after a contamination exposure?” I haven’t forgotten the simplicity of the answer that went something like this: “People get sick all the time. Yes, that might create some additional hesitancy to face exposures at first, but you have an incredible opportunity for learning.” Life involves not only facing bad things that don't happen, but also bad things that do.
Exposure Therapy involves the systematic confrontation of fearful triggers while reducing and eliminating fearful, pathological responses. In the end, it can relieve a lot of suffering.
During this global pandemic of COVID-19, people actually are getting sick. One might not think the principles of exposure therapy would apply (i.e., "Don't you do exposure therapy for risks that don't happen?"). Quite the contrary. I believe exposure therapy provides one of the best evidence-based ways forward, helping us stand up to fear we need to squarely face. So today, whether you have a disorder or not, there is an opportunity for learning and growth in the face of COVID-19.
This guide, "Thriving Mental Health Alongside COVID-19," is dedicated to my clients and the IOCDF and provides a thorough summary of the main steps of Exposure Therapy with me, with key tips for general mental health. May you be enriched by this!
Whether you have a mental disorder or not, there is an opportunity for learning and growth in the face of COVID-19 (SARS-CoV-2). Now, more than ever, we need stable footing to stand on. People go to every extreme. You don't have to. Mental health is about being grounded in reality, insomuch as we can grasp it.
Getting sick will happen. Yes, people die. Relationships break up and fail. Businesses go under. We might get it wrong. However...many people can experience health. Some people live with purpose and to the full (which is not the same as perfect). Relationships can be incredible. Businesses can thrive. We can get things right.
When I utilize the method of Exposure Therapy in counseling (a subset of Behavioral and Cognitive Behavioral Therapy), it involves the systematic confrontation of fearful triggers while reducing and eliminating fearful, pathological responses. It is Gold Standard treatment for OCD & Phobias, and is a first line treatment for all Anxiety Disorders and PTSD. What we think happens is that relearning occurs, which for most increases confidence and decreases disruption in life when they follow the treatment. Exposure, then, gives us two opportunities:
2. To learn we can face it anyway.
Its principles connect us to some of the best of life: face the thing you have reason to face; gain the opportunity to live more fully.
This guide is a very brief summary of the main points of the exposure therapy process with me, particularly with clients who have OCD and Anxiety. Many of my clients actually are faring better in this crisis than people I have talked to and seen in the general public- and why wouldn't they?! They've been training and learning- and now it's game-time.
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I am honored to be surrounded by incredible people who exhibit incredible strength and faith in the most trying circumstances. These past few weeks as the Coronavirus has led to increased fears, panic, product hoarding, and expressed racism, I have seen the stellar example of many clients and friends wading these uncertain waters with confidence, skill, and calm.
Many of you know that treating OCD and Anxiety Disorders is how I spend most of my time clinically. Despite the fact that the 'neurotypical' person may think those with disorders are probably “going crazy” right now with the Coronavirus (and it’s definitely been really hard for many), I have found in my practice much the opposite. I am observing right now during the Coronavirus pandemic how those who have trained themselves to persevere through difficult stressors and triggers- with intentional acceptance of uncertainty, mindfulness rather than obsession, and valued action rather than compulsion- are revealing how beneficial the training of the mind and heart is. I have personally experienced more frantic, panic-induced efforts by folks I’ve come in contact with outside therapy than inside my office. I’ve also seen several of my Christian clients reveal an incredibly deep faith that inspires me (even if they suffer with worry and anxiety).
For those of us as Christians, we can rely on awesome skills we develop in therapy, and it also needs to go deeper than skills. Here are some questions to help you consider the truth we stand on:
Are we walking by faith, not by sight?
“So we are always of good courage. We know that while we are at home in the body we are away from the Lord, for we walk by faith, not by sight” (2 Corinthians 5:7, ESV).
Do we believe nothing- nothing- can separate us from the love of God?
“For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord” (Romans 8:38-39).
Do we practice mindfulness in what's true?
“Finally, brothers [and sisters], whatever is true, whatever is honorable, whatever is right, whatever is pure, whatever is lovely, whatever is admirable—if anything is excellent or praiseworthy—think on these things. Whatever you have learned or received or heard from me, or seen in me, put into practice. And the God of peace will be with you” (Philippians 4:8-9).
Are we loving our neighbor (which is everyone- see Luke 10:25-37)? Considering others’ needs?
“Each of you should look not only to your own interests, but also to the interests of others” (Philippians 2:4).
I hope you are encouraged- as I have been by others’ faith today- in where our focus as believers is to be. Faith. Hope. Love. The greatest is love.
Justin K. Hughes
This post is intended for Christians looking to deepen their faith and mental health.
The Bible has a lot to say about fear and anxiety. In fact, some variation of “do not be afraid” is the most common directive in Scripture, occurring in some fashion more than ‘do not steal,’ ‘do not kill,’ and even ‘love your neighbor.’
How do anxiety and fear work? When we study these constructs in research, we are understanding mechanisms through which the body/brain is informed to face a threat or danger. We can argue these responses are inherently good, with their purpose being survival, protection, and preparedness. Its activation results in the sympathetic nervous system being primed: adrenalin and noradrenalin are produced, cortisol increases, heart rate increases, blood flow moves to muscles and away from extremities, speed and depth of breathing increases, and many other physiological changes occur. I’m grateful to have these responses- when they are in context. Out of context, they suck, to put it bluntly. Problems like panic attacks, worry, phobias, obsessiveness, skin/hair picking/pulling, preoccupation, social fears, avoidance, and more can be quite terrible.
One of the things I love most in my walk with Christ is context. Direction.
“The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God” (Philippians 4:5b-6, ESV).
What is being said here? Partly, “Do not be anxious about anything.” Since anxiety is a feeling of imminent threat- or in other words, it’s at hand- it’s very interesting that immediately before this phrase in Scripture we have another observation revealing a different type of imminence: “The Lord is at hand.”
In the context of the Lord being near we are told, “Do not be anxious.” This Greek word for ‘be anxious,’ μεριμνᾶτε (transliterated as “merimnate”), means to be divided and distracted, fearful, and caring for things that are out of context.
Sounds a lot like anxiety disorders, right? Yep. Or even just day to day worry/anxiety? Yep. When a person feels anxiety and fear and misinterprets this as significant, a person’s entire life and values can shift to focus on whatever is the subject of their fear, whether classified medically as a disorder or not. This can lead to a preoccupation with avoiding something or someone (spiders, relationships, sex, social situations) to obsessively checking to make sure everything is okay (car, stove, locks, bodily sensations, health, perfectionistic behavior), or pursuing something (money, security, approval of others)- and MUCH more.
To help work through these things and avoid pathological responses, I believe we need supports like therapy, help from friends, breathing techniques, mindfulness, exposure techniques, etc. This only underscores our complexity (we are “fearfully and wonderfully made” yet simultaneously all messed up) and highlights what we are told in Scripture about our limits. We can rightly use these tools to help us, just as we do nutrition, medicine, community, and so forth. But there is one thing these tools can’t do on their own: attach us to the very God of the universe and give us a lasting hope and focus- with meaning and purpose at the highest level.
So God gives us a jewel of a passage in Philippians 4 where we are kindly reminded what our attention is to be on (context), and a little bit of how we can live it out (practice). It is well known within the anxiety treatment world that even the most effective therapies (here’s looking at you, classic CBT, which I love and specialize in) often need supports to connect to larger beliefs, values, and commitments (ACT, DBT, and MI are some of the most common modalities). If we don’t connect a person to larger motivations and goals than “I just want to feel better,” it is often near impossible for a person to grow with sustainable change for the long term because they don’t have a sufficient reason and value to keep them invested. God gives us this.
Want more? Well, there’s two tips in the next two verses, Philippians 4:8-9
“Anxious for nothing” will take a lifetime to put into practice. I’m grateful to have the opportunity.
 Continued misinterpretation and repetitive experience of these symptoms worsens disorder, like in Panic Disorder, GAD, Phobias, OCD, PTSD, and more.
 Bible Hub. (n.d.). 3309. merimnaó. Retrieved July 13, 2019, from https://biblehub.com/greek/3309.htm
 I think it’s very important to note that we have to be very careful with saying anxiety/fear is sin- and what we mean by this. A lot of Christians get tripped up on this, and many, ironically, become more anxious. The extent of this point would likely require an entire book, so I will not take the space here to elaborate.
 Psalm 139:14; Genesis 1:26-27
 Jeremiah 17:9; Romans 3:23
 Psalm 73:26; 2 Corinthians 12:9-10
 Oh yes, there’s a whole lot more in Scripture on this topic. Let's not reduce a couple sentences into a "how-to-manual."
“Gotta go!” Dave looks at his watch, kisses his wife, and walks out the door. With just enough time to get ready and leave for work, Dave doesn’t have any time to reflect on the day and pray. “I’ll do it later,” he thinks to himself. At lunch, quickly bowing his head over his chicken casserole leftovers, he says a perfunctory, “Thanks, God. Keep me focused today on what I need to get done. Amen.” As with most days, since the job is particularly tiring, once Dave gets home, he relaxes with some TV, dinner, and conversation with his wife. Exhausted when he heads to bed, he says a prayer before he jumps under the covers, but he loses his train of thought. “Goodnight.” On to the next day.
Noted speaker, author, and pastor- John Ortberg- asked of his good friend and spiritual mentor, Dallas Willard, what he needed to do to be spiritually healthy. Expecting some bullet points and great wisdom from this spiritual giant, Willard said, “You must ruthlessly eliminate hurry from your life.” After pausing and a re-emphasis of the same statement by Dallas, John wrote it down. In a hurried fashion, then he asked what was next. “There is nothing else,” said the wise man he spoke to. “You must ruthlessly eliminate hurry from your life, for hurry is the great enemy of spiritual life in our world today.” (Find the story here.)
This hurry is the same thing that keeps us running around with just one more thing to do and one more place to go. It is a problem of a hurried heart. It is not the same as having many responsibilities. Hurry is the rush of “one more thing,” being busy is having a lot to do. The latter can be done with peace, a calm heart, rest, and love. The former cannot. It is not settled, is not content, and it does not rest.
How does hurry hurt us? It keeps us thinking outside of the moment. It requires another accomplishment to be satisfied. It has no end. It does not fulfill. We cannot have a close relationship without spending time, without sitting and listening and being with someone. The hurried spiritual life is as fallacious as the hurried relationship. Sprinkle a few minutes in here or there, say some nice things, and be on your way. It does not work.
Distractions abound. Tasks require our attention. There is a limitless ocean of needs. But a healthy spiritual life requires slowing down. It re-prioritizes. It takes a breath. To quote Psalm 46:10 (ESV): “Be still, and know that I am God.” I am now closing my computer to do just that.
A Psychotherapists' thoughts on healthy living.
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