Podcast Summary: "Anxiety & OCD Across Generations"

Religion on the Mind with Dr. Dan Koch
Episode #359 — November 10, 2025
Guest: Sarah Billups
Main Topic: Exploring how anxiety and OCD are transmitted across generations—biologically, psychologically, and spiritually—and how individuals and communities (especially the church) can respond with new frameworks for healing and acceptance.

Episode Overview

This wide-ranging conversation between Dr. Dan Koch and writer/podcaster Sarah Billups dives deep into the theme of anxiety’s transmission across generations. The episode explores the mechanisms of intergenerational anxiety—from genetic to modeled behaviors—examines how anxiety manifests in families, church cultures, and American politics, and discusses practices (especially from Jesuit spirituality) for cultivating a posture of “holy indifference” as a way to move toward healing and resilience.

Guest Introduction and New Book

• Sarah Billups is a returning guest, creator of the Bitter Scroll Substack, co-host of the That’s the Spirit podcast, and author of both Orphaned Believers and her latest, Nervous Systems.
  • Nervous Systems is praised for its timely, double-layered title: “What a fucking great title.” — Dan Koch [03:11]
  • Book explores three “nervous systems”: the individual body, the church body, and the wider body politic, and proposes Jesuit “holy indifference” as a spiritual-psychological toolkit.

Segment 1: Intergenerational Transmission of Anxiety

Timestamps: 04:09–29:58

Genetic, Epigenetic, and Behavioral Layers

• Dr. Koch lays out three scientifically-understood pathways for passing down anxiety:

  1. Genetic Heritability: 30-50% of anxiety disorder risk is inherited (“that’s a very significant effect…approaching half” — Koch, [09:54])
  2. Epigenetic Changes: Environmental stress can alter which genes become expressed, affecting future generations (e.g., the methylation of DNA in children/grandchildren of Holocaust survivors).
  3. Modeling and Family Culture: Children pick up subtle and overt scripts for fear and coping from parents and extended families (“families teach each other what to fear, how to respond to threats, whether and when safety is possible” — Koch, [13:11]).

• Personal Story:

  • Sarah describes growing up with a father whose anxious cycles about health and illness became a defining family pattern (“He was modeling it in his parenting, in his husband, his spousing or partnering, and then in himself. So together combined, there were a shit ton.” — Billups, [16:48])
  • These anxieties were inherited, both genetically and through observed behavior, manifesting in Sarah and her own parenting.

• The Cycle of Anxiety & OCD (Explained):

  • Koch draws a parallel between general anxiety and OCD cycles: Fear triggers ritual (doctor visits, confession), reassurance provides temporary relief, but the root issue remains (“the basic cycle of reassurance…you pick up, oh, this is how a person goes through the world.” — Koch, [20:32])

Notable Quote

"There is no guarantee of a long life. Maybe something happens today, maybe we get into a car accident, whatever. But if we have the immense gift of a long life, it means… understanding the loss of capacity, the loss of dignity…and there's an invitation there to hold that and still be able to live well, be present."
— Sarah Billups, [47:27]

Segment 2: Church as an Anxious System

Timestamps: 29:58–40:02

How the American Church Mirrors Societal Anxiety

• Diagnosis: Billups observes that U.S. churches, especially evangelical ones, have absorbed the broader culture’s anxiety, often defaulting to fear and divisiveness rather than modeling peace or reconciliation.

  • “Any issue, the baseline of it is all rooted in anxiety and in fear and in assumption. And so I'm just. So many of us are so tired of it.” — Billups, [31:00]

• Case Study: Same-sex inclusion debates serve as a microcosm—on both sides, individuals’ identities and senses of security are threatened, fueling anxiety and shutting down true dialogue.

• Contagion and Escape: Many seek to distance themselves from “contaminated” institutional church, but Billups remains committed to grappling with it as a vehicle for possible reconciliation (“I have to grapple with it and I grapple with it disar all the time.” — Billups, [32:55])

Notable Moment

• Billups cites the “disgust response” that leads people to ‘opt out’ of church association, paralleling both social and physical reactions to toxicity or danger.
• Social media intensifies these anxieties and polarization.

Segment 3: Anxiety and Politics

Timestamps: 40:02–47:10

The Political Body and Escalation to “Apocalyptic” Stakes

• Koch & Billups note that political polarization now drives the majority of family and church rifts, with all sides adopting apocalyptic language (“It's become our primary source of identity…social media and algorithmic forces…have only intensified it.” — Koch, [41:04])

• Learning to Lose:

  • Billups suggests the best response might simply be learning “how to lose”—cultivating stability, fidelity, and the ability to sit with ambiguity and loss (“The only option…is to know how to lose, to be okay with losing and to live faithfully and locally where I can.” — Billups, [43:21])

• Faithful Presence & Non-Anxious Posture:

  • Turning to Benedictine vows, Billups discusses modeling a “non-anxious presence,” focusing on slow, faithful local relationship rather than achieving dramatic, viral wins.

Notable Quote

“If anxiety is about kind of control and not being able to sit with ambiguity, of course we are not naturally wired…to be able to lose. And…being crucified to empire was certainly the way of Jesus.”
— Sarah Billups, [45:10]

Segment 4: Solutions—Jesuit “Holy Indifference”

Timestamps: 47:10–65:34

Introducing Holy Indifference

• Definition: Jesuit holy indifference (or detachment) isn’t apathy. It’s an open-handed willingness to accept either outcome (health/illness, fame/disgrace, long/short life) because one’s identity and value are grounded elsewhere.
  • “Can you be so convinced…that this is all going somewhere good, that you can have the capacity to then release or let go of the outcome, which was like next level stuff for an anxious person.” — Billups, [60:30]
• Contrast to Assurance-Seeking:
  • Instead of constant reassurance (from doctors, God, others), the invitation is to sit with uncertainty, practicing loving presence (“It was a very different kind of posture of learning how to listen. Sometimes I just sat there and quiet for a long time, and didn't really say or think anything.” — Billups, [54:49])

Practical Application

• Spiritual Exercises:

  • Billups describes a transformative nine-month journey with the Ignatian Spiritual Exercises: writing, reflection, silence, presence, learning to coexist with uncertainty.
  • Reframes prayer from “pleading” to “listening.”

• Parallel with OCD Treatment:

  • For her son’s OCD, Billups learned to break the pattern of reassurance and instead help him tolerate not-knowing. This same muscle is exercised in spiritual detachment.

Notable Quotes

“Indifference is not about not caring, it's not about checking out. And I think that indifference to outcome… is about our posture and whatever happens while staying engaged and being present.”
— Billups, [63:24]

“A good sign that a topic is a good candidate for acceptance and detachment is whether it is entirely outside of your locus of control… what the fuck are you going to do about it anyway?”
— Koch, [64:11]

Segment 5: Integration—Therapy, Meaning-Making, and Communal Regulation

Timestamps: 65:34–74:37

How Contemplative Practice Helps

• Koch summarizes scientific findings on contemplative and Ignatian practices as benefiting:

  • Present-moment attention & emotional regulation
  • Downregulation of anxiety physiology
  • Meaning-making around suffering and difference
  • Integration of self-understanding
  • Improved relationship with others and healthy, non-anxious agency

• Billups emphasizes the slow, compassionate journey toward self-acceptance and holy indifference, noting the importance of not sabotaging progress with perfectionism, guilt, or shame:

  “We all can be nicer to ourselves about…having better days than other days. There’s a call towards compassion and kindness in any of this work, to be able to really see it as a slower journey.” — Billups, [73:18]

Recurring Themes & Memorable Moments

On Generational Shifts

• Facing an anxious parent’s end-of-life raises poignant questions about acceptance, boundaries, and letting go of “fixing” old wounds.
  • “As a loved one nears the end of their life… the things that never made it to the spot we wanted them to be, these go from tentative to final or increasingly final.” — Koch, [22:31]
  • “I see myself reacting in a similar way as I did when I felt bound to them at end of life… There are some visceral, real care that happens as well.” — Billups, [27:36]

On Church and Society

• “Disgust by association” and polarization drive people out of community, yet there is hope in faithful, humble presence and new spiritual practices.

On OCD and Parenting

• The experience of parenting a child with OCD re-wires how we understand assurance, control, and detachment—impacting both the child’s healing and the parent’s own spiritual growth.

Notable Quotes by Timestamp

• [03:11] Koch: “What a fucking great title. Come on, Sarah.”
• [08:40] Billups: “There is something there that I couldn’t not pay attention to, that I see in myself. And as a parent, I can now see in my kid. And that felt worthy of exploring, I guess.”
• [16:48] Billups: “He was modeling it in his parenting, in his husband, his spousing or partnering, and then in himself. So together combined, there were a shit ton.”
• [31:00] Billups: “Every [church split, political fight], the baseline…is all rooted in anxiety and in fear and in assumption. And so many of us are just so tired of it.”
• [45:10] Billups: “If anxiety is about…control and not being able to sit with ambiguity, of course, we are not naturally wired as people if we're anxious to be able to lose…being crucified to empire was certainly the way of Jesus.”
• [54:49] Billups: “Sometimes I just sat there and quiet for a long time, and didn't really say or think anything.”
• [60:30] Billups: “Can you be so convinced…that this is all going somewhere good, that you can have the capacity to then release or let go of the outcome, which was like next level stuff for an anxious person.”
• [63:24] Billups: “Indifference is not about not caring, it's not about checking out…it's about our posture and whatever happens while staying engaged and being present.”
• [73:18] Billups: “There’s a call towards compassion and kindness in any of this work, to be able to really see it as a slower journey.…We just kind of want to get better and be relieved.”

Final Segment: The Examen and Future Conversations

Timestamps: 74:37–End

• Koch and Billups briefly discuss the Ignatian Examen as a practical, five-minute daily practice aiding mindfulness, gratitude, and values-centered living.
• Billups mentions she sometimes practices the Examen alone, sometimes with her husband or kids (“It’s just a nice way to talk after if you want to. And there’s even a kids one…” — [77:22])
• Plans for future deep-dives into discernment, Quaker practices, and continued conversations.

Episode Takeaways

• Anxiety is a multi-layered, inheritable experience shaped by genes, epigenetics, and family/church/political culture.
• The cycle of assurance-seeking and avoidance can be observed in everything from family health worries to church splits to political battles.
• Jesuit “holy indifference”—remaining deeply engaged but unattached to outcome—is proposed as a hopeful framework, both ancient and relevant, for responding to personal and societal anxiety.
• Healing is possible, through both contemplative spiritual practices (Ignatian exercises, Examen) and evidence-based psychology.
• Letting go—learning to lose, to be present, and to process loss—is essential for maturing personally, spiritually, and communally in a polarized, anxious age.

Further Resources

• Nervous Systems by Sarah Billups — link in episode notes
• [Examen Prayer] — Simple daily practice, easily found online
• Sarah’s Substack: Bitter Scroll
• That’s the Spirit Podcast

(Contact: dan@religiononthemind.com)