The OCD Stories, Episode #487:

"A Deeper Dive into the Role of Faith (Christianity) in OCD Treatment"

Guests: Justin Hughes, Valerie Andrews, Dr. Alan Noble, Chelsea Risko
Host: Stuart Ralph
Date: May 25, 2025

Episode Overview

This episode delves into the complex intersections between OCD—specifically religious OCD (scrupulosity)—and Christian faith. Host Stuart Ralph is joined by therapist Justin Hughes, lived-experience advocates Valerie Andrews and Chelsea Risko, and academic Dr. Alan Noble. Together, they explore how OCD can latch onto the deeply held values of faith, the balancing act between healthy spiritual practice and compulsive religious ritual, the nuances of evidence-based treatments, and the unique challenges of seeking help as a person of faith. Through candid stories and clinical insights, the episode offers hope, practical guidance, and a message of compassion for those navigating these challenges.

Key Discussion Points & Insights

1. OCD and Faith: Why Does OCD Latch Onto Religion?

• Justin Hughes [02:46]:
  • Explains the CBT model: intrusions can be thoughts, urges, impulses, or images—any "unwanted internal stimuli."
  • Compulsions are attempts to alleviate that distress.
  • "So it need not surprise us…it’s going to start to affect faith, spirituality, religious belief."
• Valerie Andrews [05:03]:
  • Grew up in the church; "my OCD knows that I love the Lord…so it is the number one priority of my life. And OCD knows that and attacks it."
• Alan Noble [06:28]:
  • His compulsions revolve around checking for negligence—repeatedly praying for wisdom or reviewing his behavior.
  • Faith can turn into a compulsion when it crosses the line into excessive ritual.
• Chelsea Risko [07:53]:
  • OCD never fully centered on scrupulosity for her—main themes were self-harm.
  • Struggled with the idea that "God could remove these thorns…we can pray away things."
  • The disappointment when God doesn’t "magically" heal OCD can itself become fuel for doubting faith.

2. Finding the Line Between Spiritual Practice and Compulsion

• Chelsea [10:58]:
  • Describes discerning "valued prayer" from compulsive prayer:
    • If prayer seeks to "make it go away," it’s probably a compulsion.
    • If prayer aligns with gratitude or genuine connection, it’s values-based.
• Alan [12:36]:
  • His rule: "I check once and I pray once…then I trust myself and the wisdom God’s given me."
  • Any additional checking/praying becomes compulsion.
  • Inference-Based CBT (ICBT) helped him trust internal signals and let go.
• Valerie [15:24]:
  • Didn’t struggle with repetitive prayer as a compulsion but resonated with periods of doubt and "Why me, God?"
  • Found comfort in a spiritual message: "my grace is sufficient…and now that you have this, how are you going to use it to glorify me?"

3. How Faith Supports (and Sometimes Complicates) OCD Recovery

• Valerie [18:01]:
  • Letting go of blame ("having OCD or being sick is not sin; it’s a human experience"), embracing advocacy of Christ, and the comfort of faith/community.
• Chelsea [19:22]:
  • "There’s maybe a very small part of me that almost thanks OCD for being here, because of how resilient I’ve become."
  • Her experiences have grown her faith and allowed her to help others (e.g., "someone I know finally got diagnosed after I shared openly").
• Alan [21:49]:
  • ICBT’s focus on the "feared possible self" and how faith counters deep-rooted fears (of being a "bad person"):
    • "When God looks at me, he sees the righteousness of his son…that reframes who I am."
    • Faith in forgiveness supports acceptance of mistakes and fallibility.

4. Therapists, Treatment Options, and Working With (or Without) Faith-Based Providers

• Justin [25:03]:
  • Importance of peer support and breaking isolation in faith communities.
  • Addresses the need for cultural competence in therapy:
    • "No therapist worldwide needs to be asking a Christian with orthodox beliefs to be screaming out blasphemous statements at God."
    • Exposures are never meant to violate true beliefs.
• Chelsea [34:32] & [35:23]:
  • Relayed her initial fear: "Can I trust this therapist who might not be a Christian…to guide me through this process correctly?"
  • Ultimately found that "God knows I have OCD" and trusted evidence-based support even if it wasn’t explicitly faith-based.
• Valerie [37:57]:
  • One of her "biggest regrets is taking so long to allow myself to research and be part of ERP."
  • Internalized stigma and fear of "outsourcing Jesus" delayed effective treatment.
• Alan [42:22]:
  • Worked with both Christian and non-Christian ERP therapists:
    • "If they ask you to do things opposed to your deeply held beliefs…find a different therapist. But that just did not come up."

5. Messages of Hope and Advice for Listeners of Faith

• Valerie [46:01]:
  • "There is hope…we are always a member of the flock, even though sometimes…I’ve sat in those pews feeling like the lost sheep."
  • Advocates for blending therapy and faith: "Therapy has been the greatest tool, but…my biggest go-to will always be my relationship with him."
• Alan [48:32]:
  • "Be your own advocate…being in faith is having a faith community and allowing them to bear your burdens…"
  • Advocates for educating your support system, resisting reassurance, and holding onto hope: "Most days, I’m subclinical. And I did not ever think I would get here."
• Chelsea [50:52]:
  • "Just remember how loved you are, because OCD can make you feel really unlovable…"
  • Encourages openness, spreading awareness, and finding humor: "There is love there. There is hope there."
  • Her story of openly sharing led a friend’s daughter to get help and find hope.
• Justin [53:51]:
  • Directs hope both to Christians and all listeners: "There’s hope—period. It may not be exactly what you had hoped for, but stay with it."
  • On faith: "It’s so important to look to Jesus, period…the church is faulty…But from the personal standpoint, on the hope side, it’s so, so key to be able to look to Jesus, the author and perfecter of our faith…he sees, he knows, and there’s hope."

Notable Quotes & Memorable Moments

• Valerie Andrews [05:03]:
  "My OCD knows that I love the Lord and that, you know, Jesus is important to me. And so it is the number one priority of my life. And OCD knows that and attacks it."

• Chelsea Risko [07:53]:
  "I have to believe that there’s a purpose in that. Like being on this podcast today."

• Alan Noble [12:36]:
  "I check once and I pray once and look for direct evidence, and then I trust myself and the wisdom God’s given me, and then I move on."

• Valerie Andrews [15:24]:
  "My grace is sufficient. But he went on to say, now that you have this, how are you going to use it to glorify me?"

• Chelsea Risko [19:22]:
  "OCD truly has made me into a more resilient, kind, empathetic, patient person…if I’ve done OCD, throw whatever at me, God, like, I can handle this."

• Alan Noble [21:49]:
  "When God looks at me, he sees the righteousness of his son…the intrusive thoughts don’t magically go away, but it does help reframe my thinking about who I fundamentally am before God."

• Justin Hughes [29:45]:
  "Exposures are to never violate values and supportable beliefs…It’s the pursuit of what is true and what is present and what is in reality."

• Chelsea Risko [35:23]:
  "God knows I have OCD…I believe that he puts the right people and things in place to help me."

• Valerie Andrews [37:57]:
  "I think I struggle most with feeling that I was outsourcing or resourcing Jesus by going to therapy, that I was saying…why can’t I pray it away?"

Timestamps for Key Segments

• [02:46] – Justin: Overview of OCD mechanisms and faith themes
• [05:03] – Valerie: Childhood faith and why OCD latches onto religious beliefs
• [06:28] – Alan: Compulsive prayer, scrupulosity, and wisdom
• [07:53] – Chelsea: Faith, suffering, and finding meaning
• [10:58] – Chelsea: Practical distinctions between values-based and compulsive prayer
• [12:36] – Alan: ERP, ICBT, and the process of trusting God’s wisdom
• [15:24] – Valerie: Grace, acceptance, and reframing suffering
• [18:01] – Valerie: Advocacy, faith as support, and moving forward
• [19:22] – Chelsea: OCD, resilience, and helping others
• [21:49] – Alan: Faith, forgiveness, and self-acceptance
• [25:03] – Justin: Role of community, peer support, and cultural competence
• [29:45] – Justin: Explaining ERP to people of faith
• [34:32] – Chelsea: Working with non-Christian OCD therapists
• [37:57] – Valerie: Cultural barriers, stigma, and regret around seeking therapy
• [46:01] – Valerie: Message of hope and being part of the flock
• [48:32] – Alan: Advocacy, educating supporters, and finding hope
• [50:52] – Chelsea: Embracing love, support, and sharing to help others
• [53:51] – Justin: Hope for all and the centrality of Jesus in recovery for Christians

Conclusion

The episode offers a nuanced, supportive conversation for anyone wrestling with OCD and faith, especially Christianity. The guests underscore that:

• OCD often targets what we value most, making faith a particularly sticky area.
• Effective OCD treatment (ERP, ICBT, ACT) is compatible with faith—exposures are calibrated to respect religious beliefs.
• A therapist does not need to share one’s faith to help effectively.
• Isolation is common—finding even one peer or support group can powerfully reduce shame.
• Hope, resilience, and self-advocacy are critical, and faith can powerfully reinforce recovery.

Above all, as Valerie said:
"There is hope that we are always a member of the flock, even though sometimes …I’ve sat in those pews feeling like the lost sheep… But there is always hope because of our relationship with the Father and the Son." [46:01]

Resources Mentioned:

• IOCDF (International OCD Foundation)
• NOCD (online therapy provider)
• Celebrate Recovery (Christian recovery support group)

Listeners of any faith (or none) are reassured that recovery is possible and that compassionate, evidence-based treatment can work alongside their deepest values.