In this article: follow along as I share a detailed and intimate case study of stress and OCD— my own. Let me walk you through the process of how stress activates my obsessive-compulsive tendencies and how I deal with it. I’ll share with you:
- Connections between stress and OCD
- How I walk myself through CBT and ERP
- Biblical truths I cling to when my OCD makes me feel out of control
Everyone’s journey with OCD is a work in progress, and I certainly don’t get everything right along the way. But I hope that by sharing some of my own struggles and victories, I can encourage others who are leaning hard into treatment.
Stress and OCD: What’s the Connection?
Stress? Oh, yes. I can tell you a bit about that.
For the last 7 years, I’ve lived in Beirut. I have a lot of good memories, but there’s also an incredible amount of stress — the traffic, the constant political upheaval, the propensity to take advantage of foreigners, the economic strain, and the fallout effects from the Beirut blast in August.
I’m also in the latter stages of earning a PhD, which comes with unique academic stressors, expectations, and deadlines.
And now my husband and I are in the process of moving back to the United States. So that’s another check mark for life stressors. (Take this stress inventory to rate yourself!)
Life’s complexities, added up, can have consequences for our mental health. Psychologist Jordan Peterson believes that at the root of almost all mental health illnesses is stress — layer upon layer — which causes us to “blow out” at our weakest point, typically at whatever biological predisposition we have (OCD, depression, anxiety, etc.).
Stress doesn’t cause OCD, but it can worsen the symptoms.
But not a lot has been said about why that is the case. However, when we understand the three big lies of scrupulosity, the connection between stress and OCD becomes clearer. Just for review, what are the three big lies that keep us stuck on the obsessive-compulsive rat wheel? They are:
- Doubt/Uncertainty is intolerable
- All guilt is true guilt
- I must always be in control
At some level, scrupulous sufferers buy deeply into one or more of these lies (typically all three, but sometimes only one or two). Put simply, obsessive compulsive disorder is an attempt to placate these underlying beliefs.
And then, along come those major life stressors. Stress reaches in and jams the gears on two of these beliefs — no. 1 and no. 3. Stress brings uncertainty, and stress brings a feeling like we are out of control.
The result is that our “blowout point” receives more pressure than normal, and our symptoms increase.
How I Manage My Stress and OCD with Cognitive Behavioral Therapy
When we have times of high stress in life and our OCD symptoms increase, we can react in one of three ways:
- Wallow in self-pity (“life is so unfair!”)
- Sink into unhealthy escape mechanisms (“I can’t deal with this.”)
- Use the stress as a catalyst for growth (“I will make it through this!”)
Clearly, the most mature and helpful response is to wield our struggles as a catalyst for growth. Unfortunately, it’s not always easy…
Sometimes I cycle through all three of the above — even in the same day! But I do believe my success in overcoming OCD is directly proportionate to the emphasis I place on growth. If we truly believe that God is in control of our lives, we can also believe that He is able to turn our pain into progress.
Self-pity and escapism are easy pits to fall into, but when I realize I’ve slipped inside, I try to get back up as soon as possible and keep going. Let me give you a few examples of how I face the challenges of increased stress and OCD and turn it into an opportunity for growth.
The Misbehaving Brain: How I Do CBT on Myself
My husband (who is German) comes from a large family. He has two sisters and three brothers, and before we move back to the US we are trying to visit as many family members as possible. Right now, we are taking a road trip through Germany and Switzerland to see everyone.
As we go, the stress of travel, family visits, and background anxiety gives me opportunity to do cognitive behavioral therapy (CBT) on myself more often than I normally would. Here’s how I do it.
The Dreaded Disease: I-can’t-stand-it-itis
It’s late afternoon when we arrive at his sister’s home on a picturesque mountainside overlooking snowcapped mountains. The scene from the living room windows is like a postcard that makes me remember reading Heidi as a child.
I ought to feel peaceful. I ought to be enjoying myself. (All those “oughts…”)
But I’m ruminating about our moving situation. There are so many details to figure out, and I’m struggling to not get stuck in my head.
As I’ve told a number of my clients, obsessives don’t just ruminate about our OCD themes. It’s possible to get obsessive about solving normal, everyday life issues and even exciting personal projects. We don’t just obsess about whether we committed the unpardonable sin and whether we prayed appropriately. We also obsess about crafting projects, birthday plans, shopping lists, and pet care. Even positive thoughts can become obsessive.
The crisp October air and emerald green slopes are beckoning from outside, but I’m glued to my computer. I can’t stop scrolling through real estate listings, looking for the perfect home back in the US.
But here’s the thing: I’ve seen everything in the real estate listings a dozen times already. Nothing is the right fit for us. As I scroll through the listings again, a sense of panic starts to rise in my chest.
It takes a moment of awareness for me to recognize that I am obsessing. I recognize my real estate search is obsessive because:
- Looking at the same listings over and over again isn’t actually helping me make progress, and
- Repetitive searches are only making my anxiety go up.
Once I come to the realization that what I’m doing has crossed a line from a normal, healthy activity to an obsessive one, I step away from the computer and ask myself some tough questions. This is how my CBT process begins:
- What are my internal beliefs that make me feel I “must” do this?
- What kind of self-talk is going on in the background that drives this obsessive cycle?
It isn’t difficult to tune into my internal narrative.
I NEED to know where we are going to live, says my internal self-talk. I can’t handle the uncertainty of being in limbo any longer.
It’s this self-talk that drives my obsessive internet searches. A feeling that uncertainty is somehow unsafe and intolerable, and that I truly can’t stand it. It’s the dreaded disease of I-can’t-stand-it-itis.
This belief leads me to feel that I must work hard (i.e. obsess) in order to save myself from this danger of uncertainty.
These beliefs feel true, but they are not. If I want this stressful time to be a catalyst for growth, my role is to replace the untrue self-talk with truth. Jesus said clearly,
You shall know the truth, and the truth shall make you free.John 8:32
The way to change my mental patterns is to change the internal self-talk that I allow. Just like parents don’t allow their children to use cuss words, I also need to police the dialogue that goes on inside my head. I make progress as I refuse to allow untrue self-talk.
I can’t stand this uncertainty, says the instinctive part of my brain.
Yes, you can stand this, I reply with my logical frontal lobe. It feels very uncomfortable to be in a sea of unknowns right now, but you CAN stand it. You will not die from these feelings.
It doesn’t make my anxiety or obsessions go away, but it completely removes the panic. Talking to myself with truth helps me start calming down.
Stress and OCD: Dealing with Chaos
But why does the uncertainty bother me? I push myself to dig deeper. I ask more uncomfortable questions.
- Why am I so bothered by this feeling of being out of control?
- What is it about a “surprise” future that makes me feel so unsafe?
I think back to my childhood. I pull up memories of chaos, confusion, fear, and disappointment. The emotional memories stored in my amygdala are far more influential than any “logic” I try to relay from my prefrontal cortex. This is why the truth-filled self-talk removes the panic but doesn’t entirely erase the anxious background static.
I work a bit at it until I can summarize my emotional memories in one phrase: chaos is always dangerous.
How many episodes from my young life taught me to associate “chaos” with bad things happening? These emotional associations work faster than logic. As soon as I find myself in an unpredictable, uncertain, chaotic situation, my amygdala activates.
Some people have compared the amygdala — the emotional center of the brain — to a gunslinger from the wild west. It doesn’t need a lot to provoke it, and it will shoot indiscriminately despite the voice of logic.
You can’t talk reason to the amygdala.
And that’s why I don’t waste time trying.
Some people with obsessive-compulsive disorder will get stuck with CBT because they try to force the background anxiety go away completely. While CBT appears to work very well for reducing panic, it isn’t going to restore us to a complete state of normalcy overnight. We have deep emotional memories stored in our brains. These are very powerful. CBT is not meant to help us argue our way out of our low-level background anxiety. It’s meant to help us understand where it’s coming from so that we can begin to build a new, competing set of emotional memories.
In my case, the deep CBT questions help me to isolate and label these emotional memories: chaos is always dangerous. Once I figure that out, I refrain from arguing against it. This will, of course, lead me into another obsessive loop of trying to figure out why I can’t get the emotions to go away. My thought process is more like this:
I’ve had a lot of early life experiences that made me believe that chaos is always dangerous. Right now, my personal life is a bit chaotic and unpredictable, so all these emotional memories are surfacing and making me feel unsafe. I understand why I feel this way, and I understand that it’s not something that’s going to go away overnight. But as I lean into God and work through this transition with my husband, I’ll be able to form new, competing memories of chaos leading to security and joy. And one day, I’ll be able to look at life’s unknowns, not as “chaos,” but as “surprises.”
Creating Obsessional Boundaries
Practically speaking, there’s more that I do to control my compulsion for excessive internet searches. I create obsessional boundaries aimed at keeping transitional activities healthy.
I allow myself to scan new home listings once a day for a brief period. I only check what has been uploaded in the last 24 hours, and then I force myself to exit. This helps me maintain a healthy relationship with a necessary activity (home searching) while not allowing my obsessional tendencies to run away with me.
How I Do ERP on Myself As I Deal with Stress and OCD
Like most people with OCD, I like control.
I like to know what’s coming next. I like to know where I will eat and sleep every day. I like to have time to prepare for anything new or different in my routine.
Visiting family members means that I don’t always have control.
Let me give you a very small example of how I do ERP on myself when I start to get into that OCD spiral. As I’ve learned to deal with my obsessive-compulsive tendencies, these episodes become more and more minor and less frequent — the following example probably isn’t something that will trigger anybody and it is much less significant than some of the exposures I’ve done in the past. It’s not even closely related to religious or moral themes, but it’s an example of how stress and OCD interact to exacerbate anxiety. So I hope you won’t mind this “minor” example — I do try to walk a fine line between giving helpful case studies and not writing about things that will exasperate and trigger my readers!
One day last week, we were on our way through the Black Forest of southern Germany to see family, and since the distance was too much to cover in one day, we planned to find a hotel and restaurant and continue driving the next day.
As we drove, I had trouble focusing on the gorgeous landscape out the window. I was obsessing about where we would sleep and eat.
These details were out of my control, and subconsciously I really disliked that. I wasn’t enjoying the drive at all.
How I Do ERP on Myself: A Brief Walkthrough
As I became aware of the cause for my discomfort (intolerance for feeling out of control, intolerance for uncertainty) I chose to respond with a gentle episode of ERP (exposure and response prevention therapy). It took two forms:
- Exposure: this part was unavoidable. I was in a car with my husband, driving through a landscape of forests and mountains, completely unsure of where I would eat and sleep that day (he didn’t know, either), which provoked feelings of anxiety and obsessive thought patterns. I didn’t choose this exposure, but I chose the next step.
- Response Prevention: rather than trying to regain a sense of control through obsessively trying to “figure out” my day, I chose not to engage. I sat back and prayed silently, “God, I give you complete control over everything that happens today. I will let You solve these problems instead of me.” It was difficult, but I forced myself not to ask my husband a single question or pressure him about booking a hotel reservation or finding a place to stop and eat (this might sound simple but it’s a little more difficult to find places to eat when you’re vegetarian).
This went on for several hours. I pushed through the uncomfortable feelings of “something’s not right and I have a responsibility to fix it.” I chose to enjoy the views and good conversation. When the urge to work on a solution resurfaced, I reminded myself that I’d given this responsibility to God and refused to take compulsive action.
When lunchtime drew near, my husband found a place where we got vegetarian burgers.
Hmm, that wasn’t so bad, I thought to myself. God provided the first need. What about the second?
I’m terrified of chaos — but every time I have a positive experience with God bringing order out of my chaos (instead of ME doing it through obsessive-compulsive action), my amygdala is building a new emotional memory that says, “hey, unknowns are ok. You’ve got God on your side. Life’s unknowns are going to turn out fine if you let go and let Him be in control.”
After lunch we kept driving. Evening drew near, and we still hadn’t made a hotel booking. Of course, I still felt anxious, but my lips were sealed. This was God’s problem, because I’d given it to Him. When the time was right, He would prompt my husband to figure it out (because he’s the booking guy in the relationship, and I’m just the anxious nagger. I assume he probably enjoyed a day off from my OCD-driven pestering).
And, sure enough, evening came, we stopped in a cafe for buttered pretzels and wifi, and he made a booking at a comfortable hotel nearby.
Silly me, I thought, When has he ever failed to provide a roof over my head?
And when has God ever failed me?
OCD and Stress: Happy ERP Endings
It’s not logic, it’s emotion that drives our OCD. ERP is really about rebuilding emotional memories that teach us it’s ok to live through the experiences that scare us.
As we slipped into a warm, cozy bed in a hotel room with heated floors and a luxurious shower, I knew my day’s ERP had been successful. I felt anxious but prevented my normal obsessive-compulsive response, and things turned out just fine.
Score! One more point for my post-OCD brain structures…
It reminded me of those verses in Scripture that tell us to remember the mighty works of the Lord. As we recall His goodness for us, this is not just a cutesy way of passing our devotional time. We are literally building trust structures in our brains. We are developing a deep ability to lean into God, release that toxic OCD-ish control, and relate to Him as a genuinely dependent child.
I love the Lord, because He has heard
My voice and my supplications.
Because He has inclined His ear to me,
Therefore I will call upon Him as long as I live.
The pains of death surrounded me,
And the pangs of Sheol laid hold of me;
I found trouble and sorrow.
Then I called upon the name of the Lord:
“O Lord, I implore You, deliver my soul!”
Gracious is the Lord, and righteous;Psalm 116:1-7
Yes, our God is merciful.
The Lord preserves the simple;
I was brought low, and He saved me.
Return to your rest, O my soul,
For the Lord has dealt bountifully with you.
The Lord dealt bountifully with me that day, and I can say every day. But ERP has to be an ongoing exercise because it consistently forces me to think through whether my dependence is on myself or on God.
Times of Stress and OCD: Scriptures to Lean On
Here’s a collection of verses I lean on during times when stress brings out my worst mental health weaknesses. Beside each passage, I’ll ask a question that might help you relate deeply with the text.
If you’re going through a time of heightened personal stress, I encourage you to cozy up with your Bible and prayerfully ponder these passages. Allow God’s words to speak to you and soothe your heart.
Passages About Letting Go of Control
- Job 23:14 and Psalm 57:2 — who has ultimate responsibility for solving our problems?
- John 15:5 — how can we embrace our powerlessness in light of this verse?
- Exodus 14:14 — does God still do this today?
- 1 Peter 5:7 — how can you cast your particular obsessive cares on God?
- Psalm 34:17 — what is your only task during times of stress, according to this verse?
- Romans 8:16-17 — how much “control” are children expected to have, and how much control should the parent (our heavenly Father) have?
Passages About Dealing with Stress
- Psalm 62:8 — how do you feel after pouring out your heart to God in times of stress?
- Matthew 11:28 — according to this passage, what will soothe our spirits in times of stress — trying to “figure out” our problems, or coming to the presence of Christ?
- Isaiah 26:3 — what can I do with my mind that will bring relief from worries?
- John 14:27 — can I manufacture my own sense of peace, or must it come from a supernatural source?
Passages About Uncertain Times
- Psalm 131 — this psalm talks about humility in the face of uncertainty. What does the metaphor of the weaned child teach us about withdrawing from our need for absolute answers?
- John 20:29 — when is it a positive thing in our spiritual lives to have a measure of uncertainty?
- 1 Corinthians 13:12 — is it bad to have partial knowledge?
- 2 Corinthians 5:7 — uncertain times give us an opportunity for growth in our spiritual lives; how is God calling you to grow through uncertainty?
In this article I’ve talked about some of the ways stress and OCD interact to bring a flareup of symptoms. We all deal with it at some point. If you find yourself having increased obsessive symptoms during times of stress or life transitions, don’t be discouraged. You are NOT regressing, you are in a stage of faster and more intense growth.
It is during these times that we develop new emotional memories of God’s deliverance and presence. We challenge incorrect thought patterns and refuse to respond to our typical triggers. And we lean heavily on God’s Word to soothe our spirits.
How have you seen stress impact your OCD? If you’ve had moments where you really saw God meet you in your pain point, I’d love to hear about it in the comments section below!
We have no reason to fear these uncomfortable moments, because we have the assurance that God is using them for our growth and sanctification.
Keep going forward, pilgrim. We’re almost home, and God is wrapping up His perfect work in you.
Best wishes on the journey,