Welcome to Speak the Truth, a podcast devoted to giving biblical truth for educating, equipping, and encouraging the individual and local church in counseling and discipleship. Hello, hello, hello. It's good to be back. We have a full house this morning. Who's in studio with us today? Oh, I said it. Yay. We're all back together.

Yes, we are. We are. And we, as in Shauna, my beautiful wife and Jeremy. Lelik, who has been out of pocket for a while, but it is a joy to have you back with us, brother. How are you doing? I'm doing great. You're not going to call him your handsome brother? He is handsome. He's a good looking older man. Okay. Now it's getting awkward.

All right. We're excited about today's podcast and we've got some further podcasts to go along with it, but today we're going to be really focusing on anxiety. And I know for most of our listeners, anxiety is a pretty familiar topic as it relates to counseling and counselees that we've dealt with, but Jeremy's got some insight for us today and just beginning to survey what anxiety looks like for the Christian and just the reality of anxiety living in a broken, fallen world.

So Jeremy, you want to let us know a little bit more about what we're going to be jumping into today? Sure.

So as we discussed this topic, it's a major issue in our world right now. And so I thought we would just do a series starting with basically a cultural perspective of how the culture views anxiety.

And then. Jump into more of a biblical framework cause there is a, quite a distinction there. But I think, in my own practice, I'm seeing a lot of people who are really struggling and almost suffocated by their struggle with anxiety.

Hmm. Hmm. Yeah. I know over the years, obviously in your practice that you've, you've obviously dealt with, I mean, could you even off the top of your head, even Think about how many hours you've put in towards counseling through anxiety.

I can tell you

since the pandemic in 2020 I would say almost half of my practice right now is anxiety. The other half probably marriage, but anxiety, I'm seeing a lot of people that are struggling with all sorts of fears and phobias and just imprisoned in some ways. That's why I thought it might be a good topic for us to cover on the podcast here today.

Yeah, definitely. And that is good too because, I think we all, as, as biblical counselors, we have some sort of, grassroots thought process around anxiety, how it works, but then we get some of those tougher cases and it's like we kind of run out of material. I say material, like God's word, like we try to.

We try to use God's word to apply it to the person, and then it just seems okay, we can't go much further. It always kind of feels that way. Yes. Any thoughts on that? Yeah. Anxiety is a very complicated thing. I'm coming at this somewhat from a personal experience perspective because right after I got really sick with COVID and got out of the hospital.

Anxiety became a severe struggle for me even to the point of just paranoid thinking and racing thoughts, intrusive thoughts. Not sleeping well at night. And, it was a really tough monster to fight, so to speak. I have a big compassion and passion for people that struggle with this because it wasn't as simple as just meditating and praying.

It was, it was a exercise in perseverance, really at the end of the day.

Yeah, that's, sorry, go ahead. Go ahead. No, I was going to say that's, it's just, it's tough because, I mean, I'm certainly not. I understand it fully, but I do think at least in the general scope of what that means biblically is just, when you're in a position like that, like you literally have no control.

It felt like that. Yes.

I mean, you're bought, you're at the, you're at the mercy of the doctors, whatever they're able to do going through that process. And it's just like you're in that position where you truly have to rely on the Lord day to day. And you just realize in those moments that you just, you literally have no control.

Yes. Yes. And as a believer and as a biblical counselor, and as someone highly involved in the biblical counseling world, that was the challenge, to, to not feel a sense of condemnation for, for not being able to just snap out of it. But I researched and anxiety was a part of long COVID from what I understand.

So I had never struggled with that. That kind of thing to that extent before I mean everyone experiences some anxiety from time to time But this was a very different animal for me And I'm actually gonna be I'm currently working on a book that I pray and it's a very practical book that I pray Y'all listening and it's on anxiety and it's it's not a book about anxiety.

It's a book about How to how to work through anxiety biblically So when is the release date on that? We shall see. It's a work in progress. It's a work in progress. That's good. Let's specifically jump into sort of kind of what we want to dive into this particular episode. And you alluded to earlier before we hit the record button what that was going to be.

You wanna? Yeah. Want to let us know what we're going to be diving into?

Yeah. So I thought we might just start with a specific case study and then if this person was to go and try to find help in the secular arena, what that might look like. So case study is a woman named Sally and this is a, what I'm about to share is it's not an unusual struggle for people that have a specific form of anxiety that The culture would call obsessive compulsive disorder.

So it's a woman named Sally and she is a she is head of the children's ministry at her church. And she loves to minister. She loves children. But she holds a very dark secret. And that secret is that she constantly has intrusive thoughts. That she has committed the unpardonable sin against God or she has intrusive thoughts where she's literally cursing God in her mind.

And these aren't thoughts that she's contemplating. They just are intrusive thoughts that enter her mind. And so when that happens she gets extremely anxious and feels like God is gonna damn her to hell, basically, because of her thought processes. So imagine that, that you're a believer and you have these uncontrollable thoughts about the very one that you love, but those thoughts are cursing him.

Just how uncomfortable, how unsettling that would be as a, as a Christian.

So I was just going to say that would be hard because, for any Christian who reads their Bible on a regular basis would see that it's pretty clear that scripture reveals the fact that God searches the heart and knows the mind.

And so our thoughts are exposed, Hebrews four, so to speak. And so that it's understandable how somebody could get there.

Yes. And. To complicate things for her often what she tries to do is go to the scriptures and when she starts reading the Bible she'll read a promise, but then she'll have a doubt, which is reinforcing, maybe I'm not even a believer.

Imagine being that person, that the very source of your hope, the Word of God, is actually something when you go to it, it seems to ignite this fear that's going on. And this is more than just a a lack of theology. This woman knows theology backwards and forwards. She's just in this very tumultuous inner battle.

And as biblical counselors we want to be very compassionate about that, but also very robust in the way we come to her. But if she were to go to a psychiatrist, for example the way that our culture is they look at it mainly from what we call a medical model or a disease model. That this woman has some sort of brain disease that is causing all of this turmoil. Would that be, quote unquote, like a chemical imbalance of sorts? Some would simplify it that way. Many in psychiatry would try to be much more thorough in the way they're going to explain that, but historically, now, right now, the chemical imbalance theory is suffering in the literature.

It's, people are realizing that, that was oversold. But it is still something that I hear all the time, that this must be a chemical imbalance. And if you have a chemical imbalance, the idea, you go to a doctor, you get a medication, and that's supposed to cure the problem. My experience in counseling is I'm not opposed to medication at all.

I have a couple of trusted doctors, psychiatrists, that if needed I will refer to. They're believers. They don't over medicate. They're very sensitive to people. But my experience is these meds, they, they'll work initially and then they tend to wear off. They tend to not have the effectiveness with the OCD or obsessive compulsive disorder and the intrusive thoughts as they did initially.

And so people go to the doctors, but they get very discouraged because it isn't a panacea. It doesn't just make it all go away. And if, if this woman were to go to a doctor, she would be assessed through the lens of the Diagnostic and Statistical Manual of Mental Disorders Version 5, we're in the fifth version now.

And what that looks like is the doctor's gonna view her through that lens, and if she meets a certain criteria, then she's gonna receive a medical diagnosis. And this medical diagnosis would be Obsessive Compulsive Disorder. So there are, there are various anxiety disorders that are noted in the DSM.

There are phobias, there's social anxiety disorder. There's panic disorder, generalized anxiety disorder, and then there's obsessive compulsive disorder. And I'll just read the basic criteria here. It's the presence of obsessions, compulsions, or both. Obsessions are defined by recurrent and persistent thoughts, urges, or images that are experienced at some time during the disturbance as intrusive and unwanted.

And the individual attempts to ignore or suppress such thoughts, urges, images, or to neutralize them with some other thought or action. That would be a compulsion. Compulsions are defined by repetitive behaviors, hand washing, ordering, checking, or mental acts like praying, counting, repeating words silently, that the individual feels driven to perform in response to an obsession, and the behaviors or mental acts are aimed at preventing or reducing anxiety and distress.

So that's the basic definition or explanation of obsessive compulsive disorder. Put it very simply the person has, an obsession. I've committed the unpardonable sin. And so they develop some sort of ritual that becomes their compulsion. For this woman it was praying. Okay. And so she would meditate or pray and she would, and that it's very important.

I'm not saying that's not a good thing, but let's ask the question. What was her motivation? Why is she praying? And for her, the motivation was prayer, for her prayer was to get rid of anxiety. It really wasn't about worshiping God. It really wasn't about intimacy with God. It wasn't about experiencing the presence of a faithful God.

With, while you're having anxiety, it was to make it go away. And the terrible cycle here is that she feels better for maybe 10 minutes and then here we go again. And so a person like this, if it's really severe, this could be like every 10 minutes she's having to battle. So it could literally take up hours of her day.

I've had, I've had people that I counseled that they have a ritual with so many obsessions in terms of just getting ready for the day. It would take them like five hours to get ready, to go out, to go to work because they had so many rituals. So it's very enslaving, very sad.

Yeah. It reminded me of an episode of I forgot the show, but it was a guy that would work out over 40 times a day.

Oh, wow. And the motivating reason as to why is because he had a fear of death, but the way that it manifested itself is, is he would go and work on it literally would take five or six hours out of his day. He would go work out at a place for 10 minutes, do a quick exercise. And from there, knowing that he has to go to the grocery store, he'd stop at two other places to go work out.

He had gym memberships at 10 different gyms. Wow. But just, just to put that in perspective of what you're saying. Yeah. Obsessed. Yeah. I'll have to check that out. Yeah. It is actually, we would just watch it because for us it's, I mean, those are case studies like with real people. And you get to watch how that, how that actually plays itself out in their lives to your point.

Like something that we take for granted, like something that takes us 10 minutes to do could literally take. hours for somebody else to do who struggles with those sorts of things. Yes. That's good.

Wow. And, that, right there sounds like a classic issue of obsessive compulsive disorder.

There's this obsession about death and the compulsion was to spend all that time and energy trying to avoid it through working out or prolong prolonged prolonged the eminence of death. Yeah. When culturally we come at people in this diagnostic fashion what we've actually done or what I've explained, and I'm simplifying things, I'm not trying to diss any profession or anything like that.

But in a general sense, this is not really getting to the heart. For Sally to go to the doctor, get some medications because she fits in a description those descriptors aren't giving us any information about etiology. And etiology is what's causing this? What's good. Why is this happening? So biblical counseling, we want to go a bit deeper and I'm a firm believer, especially with something like this.

That we have to look at both the physiological implications of what might be going on as well as obviously, and most importantly, the spiritual. But, in a nutshell, Sally, if she were to just approach her struggle from a secular perspective, this might be one of the avenues that she would go to.

If she went to a therapist, she would learn all kinds of, probably, Cognitive behavioral mechanisms to try to navigate that issue.

Yeah, that's interesting. Coming back to the motivation factor. So it's as you, as a biblical counselor understanding the causation of it, and having biblical categories like sin in the general sense that physiologically things are broken, things are, and that impacts the immaterial, right? So there's a lot of things to consider. In processing that. Yes. And that's the task that's before us.

And I think it's important, even as we're using God's word, we want to be careful that that doesn't just become another compulsion to make the anxiety go away.

We would never send someone, or I wouldn't, send someone with cancer to just memorize Bible verses and that's going to make it all better. It's, it's more about Being conformed into the image of Christ as you're grappling with that issue it's more about Questioning, identifying your own blind spots in terms of weaknesses in faith because these kind of things do expose us.

Yeah. So when you're thinking about OCD, there is a strong physiological So we wouldn't want to send someone to the Bible with a OCD and just say, read these passages and hopefully it'll make it go away that that's not a good cause in

your case studies, that's what she did because she was a Christian is prayer became.

That compulsion to respond to the anxiety that was upon her. Yes.

And in that she's missing the depth of relationship available to her to the very creator who is even using those obsessive compulsive issues to conform her into the very image of Christ.

Right. In that particular case, the object of her concern and motive was the anxiety itself and not the Lord.

That's right. Yeah. And when we're, when we're parsing those things out with these folks, we want to have a lot of compassion. They need to, it needs to be highlighted. Yeah. But within the safety of the gospel. Yeah. There's no condemnation here.

If the gospel is that safety net, that's actually a really good point.

Yes. Yeah. That's good. Do we want to suspend it here for the next one as we get into the next part of this, but starting with the, the diagnostic and statistical manual and just kind of how our culture navigates that and how they would try to help people and really the cure of that soul and their approach to that cure.

So that's good. Anything else? All right. Thank you for listening and we'll see you guys next time. ​