March 27, 2024 • 49 mins
Welcome to a profound episode of the Heal Your Roots Podcast, Season 3, Episode 9, where we explore the intersections of Obsessive-Compulsive Disorder (OCD), religious trauma, and pathways to healing. Join us as we sit down with Dr. Katie Manganello, a clinical psychologist specializing in OCD, and Caitlin Harrison, a marriage and family therapist with expertise in trauma, to unravel these complex topics.
This episode dives deep into:
- The essence of OCD and how it manifests through doubts and compulsions.
- Understanding religious trauma: its sources, impacts, and the journey towards healing.
- The concept of scrupulosity: navigating fears around moral and religious purity.
- Approaches to treating religious trauma and OCD, including cognitive therapy, ERP (Exposure Response Prevention), EMDR (Eye Movement Desensitization and Reprocessing), and Internal Family Systems (IFS).
Dr. Manganello and Caitlin Harrison provide insightful discussions on how religious beliefs and obligations can intertwine with OCD, leading to a challenging mental health landscape. They offer hope and actionable advice for those struggling with these issues, emphasizing the importance of understanding, acceptance, and professional guidance.
Whether you're grappling with these issues personally, know someone who is, or are simply interested in the subject, this episode offers valuable perspectives, expert advice, and a message of hope.
Join us on this enlightening journey to better understand the complexities of mental health, faith, and the road to recovery.
Check out the rest of the Heal Your Roots Podcast episodes at our website.
Learn more about Heal Your Roots Wellness
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Kira Yakubov Ploshansky (00:00):
Welcome back to Heal Your Roots Podcast.
In today's episode, we havereturning guests, Dr. Katie
Manganello and Caitlin Harrison,marriage and family therapist,
we dive deep into how OCDoverlaps with trauma,
specifically religious trauma.
We go into more insight intoscrupulosity and real event OCD,
you're not going to want to misstoday's episode. So it really
(00:21):
takes that past event and warpsit until the person really views
themselves as like the worstperson in the world who can
never be excused or forgiven forit. Do you can kind of see how
OCD and religious influencescould lead someone down a path
that might make them reallyoverwhelmed with this idea that
(00:45):
I have to be perfect.
Ladies, thank you so much forjoining us for another episode
today.
Dr. Katie Manganello (00:53):
I'm excited to be here. Yeah, thank
you so much. I'm so excited.
This is one of my favoritetopics, so I'm ready to get into
it. I've been looking forward toit. Awesome.
Kira Yakubov Ploshansky (01:05):
So both of these therapists work at Heal
Your Roots Wellness. Dr. KatieManganello specializes in
obsessive compulsive disorderanxiety disorders PTSD. Caitlin
Harrison Marriage and FamilyTherapist specializes in couples
therapy, trauma, andspecifically religious trauma.
So I'm really excited for todaywe're going to talk about the
intersection between OCD andreligious trauma. So Katie, can
(01:28):
you kind of start with a littlebit of background about who you
are and what you do? For some ofthe listeners that may have not
heard your episode before?
Dr. Katie Manganello (01:36):
Yes, so like you say, Kira, I'm, I'm a
clinical psychologist, I work atHeal Your Roots Wellness. I also
work in a private practice theanxiety and OCD treatment center
that is physically located inWilmington, Delaware, mostly
what I do is individual therapy,focusing on treating OCD.
(01:59):
Sometimes that comes along withother things. There's a lot of
comorbidities. So I also work alot with ADHD, autism spectrum,
body focus, repetitivebehaviors, anxiety, PTSD,
depression, a bunch of differentstuff. And I work with people of
all ages, a lot of times webring couples in or family
members and to assist intreating the OCD or whatever
(02:23):
else the presenting problem is,me as a clinician in general, I
really, I operate mostly under acognitive behavior model. I also
really, within that model,really enjoy Acceptance and
Commitment Therapy. And ofcourse, with OCD, I do a lot of
exposure and responseprevention.
Kira Yakubov Ploshansk (02:43):
Awesome.
Thank you so much for sharingthat. Healing. Can you share a
little bit about yourself forthe guests or for the listeners?
Caitlin Harrison (02:48):
Yeah, yeah. I think Kira, you summed it up?
Well, I do a lot of work withcouples. So systemic therapy
doing it, whether that's likecouples or even families, parent
and child, like grown up, adultsworking on their parent and
child relationship. And then Ialso do work with trauma. So I
(03:10):
do EMDR therapy. And I focus alot on religious trauma, which
is also one of my favoritetopics.
And just like Katie pointed outwith trauma, there's a lot of
comorbidities a lot of thingsthat can come up so that could
look like anxiety, depression,PTSD, even OCD like we're
(03:31):
talking about today. Selfesteem, attachment wounds,
things like that. So that's whatthe work that I do looks like
here at Heal Your RootsWellness.
Kira Yakubov Ploshansky (03:42):
So I think we can kind of lay down
the foundation for listeners toknow what is obsessive
compulsive disorder, somebackground and what religious
trauma is. And then we're goingto talk about like some really
nitty gritty stuff that I thinkis super fascinating that I
haven't actually ever learnedabout before or heard of some of
these words even so I'm reallypumped to learn more about this
(04:03):
so I'm going to have questionslike as an audience member to
see like to learn more aboutthis. So if either of you can
kind of start with what thespecialty is that you have,
Caitlin Harrison (04:13):
So all I guess I can kind of define religious
trauma but Katie just chime inwhenever you feel like I'm
missing something but um, soreligious trauma is just like
any trauma when you experienceharm or abuse from something
outside of you. So when it comesto religious trauma, it's you're
(04:35):
receiving like religious oremotional
or spiritual, I'm sorry, abusefrom
whether it be leadership. Itcould be your parents, an
outside system, even just yourthe culture that you live in.
You're receiving hatefulmessages about who you are as a
(04:56):
person. And that leaves you withemotional
mental, physical symptoms.
So that's kind of how I defineit. Anything you'd add?
Dr. Katie Manganello (05:08):
Yeah. And so I think that's something I
like to tell people too, whenwe're talking about trauma is
that you can experience traumawithout becoming full blown
PTSD, like post traumatic stressdisorder.
I'm thinking, usually when Iwork with trauma, I mean,
there's a lot of people who'veexperienced trauma, right. And
so, just kind of teasing traumaapart, like as a whole, apart
(05:32):
from like, post traumatic stressdisorder that in particular, is
a disorder in which you know,someone has witnessed a
traumatic event, such as likewar, or sexual assault, or you
know, any of the things that youhad mentioned as well, and
includes these recurringsymptoms such as intrusive
memories, flashbacks,nightmares, negative changes in
(05:55):
thoughts and beliefs, and a lotof avoidance around any kind of
cues that remind them of thetrauma. So when I'm talking
about OCD related things, Ithink I'm comparing a little bit
more to a diagnosis of PTSD asopposed to kind of like a
general sense of trauma.
Caitlin Harrison (06:15):
Yes, yeah. And the way that I think about
trauma is sort of on a spectrum,because he talked about these
big, and then slet are causingflashbacks, very marked memories
of specific events. But thenthere's also this complex trauma
that where you receive messagesover and over again, that like,
(06:39):
you can't trust your emotions,you can't trust your thoughts.
So you might not have thesespecific memories that come up
for you when you know, yourpastor told you that. But
there's something in you thatquestions like, Wait, am I
allowed to trust myself? Am Iallowed to trust my emotions, so
there can be not so specificevents when it comes to trauma
(07:02):
as well, which I think isimportant to just know.
Kira Yakubov Ploshansky (07:08):
Sounds like constant messages being
told instead of like an event.
It's just messages that kind ofseep in that create a narrative
and a belief system within you.
Dr. Katie Manganello (07:17):
Right, several little events that can
kind of like pile up. Yep.
Kira Yakubov Ploshansky (07:23):
And what about OCD? Can you share,
kind of like what obsessivecompulsive disorder is for the
listeners?
Dr. Katie Manganello (07:28):
Yes, well, for me, this is such a difficult
thing for me to make a smallexplanation for. So if you want
an expanded definition, golisten to the episode that Kara
and I recorded before I go inway more detail, but to try to
keep it simple. OCD is adoubting disorder. It's fueled
by uncertainty. And it's adisorder in which people
(07:52):
experience repetitive andintrusive thoughts, images,
urges or feelings calledobsessions. And these fears are
ego dystonic, which means thatthey do not align with the
person's values. And everyonehas intrusive thoughts here and
there, but most move on fromthem realizing that these
thoughts aren't reallythreatening or they don't mean
(08:13):
anything about them as a person.
But for people with OCD, thesethoughts feel really significant
and can cause intense negativefeelings. So as a result of that
they engage in compulsions,which are mental or physical
acts performed to relieve thedistress or to keep an unwanted
event from happening.
Kira Yakubov Ploshansky (08:35):
Thank you for keeping it short and
concise. I know that was tough.
So it sounds like even justsharing that there's a lot of
overlap. I feel like betweentrauma and OCD and how it
presents and I know later on,we'll talk about
how to differentiate between thetwo. But I did want to dive into
Scrupulosity. I've never heardof this. I think this is super
(08:58):
fascinating. If we can kind ofjust dive into what is that? And
how does that show up for OCDversus trauma versus the
intersection between the two?
Caitlin Harrison (09:09):
Yeah, so Scrupulosity that is basically
this obsession or this need orthis drive to achieve moral
perfection, or like moralpurity. And so even as I just
say, that sentence, you can kindof see how OCD and religious
(09:32):
influences could lead someonedown a path that might make them
really overwhelmed with thisidea that I have to be perfect.
And so that's what scrupulositycan look like, I mean, we can go
into detail of what that couldlook like for
you know, someone who did have areligious upbringing or was
(09:53):
influenced even in theiradulthood, maybe that's safe for
a little later.
Kira Yakubov Ploshansky (09:58):
We can dive in now if you
If you both want to I think likethis is like I like that this
episode is now the work. We haveeach episode with both of you
kind of going through yourbackground. Now we can get to
like the specifics and thedetails of things because I've
never heard of this. Butthinking about this, I'm sure
this is super common for a lotof folks. So hearing this, I
think was going to be superhelpful and beneficial.
Dr. Katie Manganello (10:20):
Yep, for sure.
(10:48):
I think you did a really goodjob explaining that that's
(11:29):
really very much. So how I wouldexplain it to you know, it's
that you know, this really allor nothing like rigidity around
achieving that like perfectionaround being a perfectly
religious person or moralperson, even it doesn't even
have to just be a religion,which I was. I'm just going to
(11:50):
talk a little bit about badperson OCD, which is kind of the
same thing. I mean, it's verysimilar in the sense of like,
the morality aspect in wantingto just like, even if you're not
following a specific religion,it's more so that moral compass
of doing things perfectly moraltype of thing. scrupulosity OCD,
I actually see this a lot.
(12:13):
I see this a lot within thepractice. And so some common
obsessions around scrupulosityOCD could be fears of committing
a sin.
Excessively striving for thatpurity, fears of going to hell
or being punished by God, beingpossessed fear of death, fear of
(12:34):
a loss of impulse control,doubting what you truly believe
or feel in needing to have thatcertainty around religious
beliefs. And then of course,there's lots of compulsions that
can come along with that thatcould be
if it is something like yousaid, Caitlin around like sex
before marriage kind of thing.
Maybe it's, I'm going to avoiddating in general, because I
(12:56):
don't want to even tempt myself.
It could be excessive praying,it could be I liked the example
you gave to of donating money.
So I can show up in a lot ofdifferent ways.
Kira Yakubov Ploshansky (13:11):
That's so fascinating. And I'm curious
of since it's kind of connectedto this belief of something
higher kind of punishing us insome way, or like judging us or
watching us? Do either of yousee this ever come up with
anyone who might be atheist oragnostic? Or is it very
specific, like, they're kind ofconnected to a religion that's
shared this message?
Caitlin Harrison (13:34):
Something that I see a lot and maybe it's not
so much connected to religion.
For them, it's this idea that Icould make a wrong choice, when
actually the choice the twochoices before them are say,
Should I take this job or thisjob? Both align well, with my
schedule, both are good salary,you know, they they're kind of
equal. There's no right orwrong, good or bad. It's just
(13:57):
what which one do I want? Andsometimes it can be difficult
even outside of a religiouscontext. To to tease that out,
like, Am I really being good orbad by choosing one of these?
It's that fear of the future orfear of like I could choose
something wrong that wouldturment me in the future
Dr. Katie Manganello (14:18):
Yeah that sounds like the perfectionism to
me right?
Like am I making the perfectchoice? The one that's best for
me kind of thing, which is somuch in the same like, yeah, the
realm of that yeah, Kira. I feellike the bad person or like just
moral aspect of this groupphilosophy shows up more so in
like people who don't fall undera specific religion, like they,
(14:39):
they could be a theist, becauseit's it that doesn't mean you
subscribe to a specific god orgods or whatever, it could just
be. I'm here, and I still feellike I shouldn't be nice to
people or I should be, you know,a certain you know, certain
behaviors or whatever. Yeah,that was just interesting and
made me think about if that hada connection to it, but I guess
(14:59):
just I mean,And even people who are atheist
agnostic, right? Like there'sstill a moral compass and values
that we follow. So it's moreabout that all or nothing kind
of thinking around it versus itbeing something specific, like a
religion. So it could just bethe future, how we view
ourselves is kind of what's incontrol of it.
Yeah. And actually, I mean,considering OCD, like I said, is
(15:21):
a it's a very doubting type ofdisorder. If it is a sense,
where you're doubting what youtruly believe or feel, anybody
can experience that atheistscould they could be like, maybe
I am deep down a Catholic whoand I think that I'm an atheist,
right? Like,who knows,
Caitlin Harrison (15:38):
That's part of what makes religion so
comforting, actually, is, Idon't have to fear fear of the
future anymore. I don't have tobe afraid of what's going to
happen to me. All I have to dois, you know, pray this many
times, or live this good of lifeor trust in this certain thing.
And then I have a sense ofcontrol again, over my future.
(16:01):
Andwhen you start to question that,
when that's sort of what youpaid, placed all of your
security in, and that's sort ofwhat made all of your anxiety
subside. before. It's such adisorienting feeling, because
then what can I trust? What canI rely on? What can help me
predict my future? How can Icontrol my future? And you're
kind of like reckoning withthat, like, maybe I can't
(16:24):
anymore, but I used to feel likeI could. It's so confusing.
Kira Yakubov Ploshansky (16:30):
It sounds that you have this
certainty that you trusted inoutside of you. And now that
kind of caught like, it wascrashed. And now it's just, I
mean, it sounds superdisorienting. Now, it's like all
uncertainty, instability, andtrying to like kind of grasp for
an anchor. That does soundpretty traumatic, like
internally.
Dr. Katie Manganello (16:49):
Yeah, I would say a little bit of a
nuance to that with the OCD isthat if people come in with
scrupulosity, it's notnecessarily that it's usually
not that the person is sofocused on.
Will religion is my certainty.
It's, it's more so of like,well, did I do this good enough?
(17:10):
Am I being a good person? Thisor That? opposed to the latter?
Caitlin Harrison (17:18):
Yeah, yeah, I guess I'm I, speaking from a
place of someone who'slike if a client has walked away
from a certain religion, andrecognize that Reckoning and
like, Okay, I used to havesomething that gave me so much
comfort. And now where can Ifind comfort because it used to
be that I did things perfectly.
(17:39):
It used to be that I was thegood Christian girl. It used to
be that all I had to do is notsleep with my partner. And now
who am I? Am I good? Am I youknow
Dr. Katie Manganello (17:51):
yes. And I think that that's a really big
difference and something forpeople to when they're
evaluating for it to kind ofkeep an eye on because for
people who have likescrupulosity OCD, like one of
the main points I like to tellthem is that my goal is not to
take away your religion, becauseagain, OCD targets your values.
(18:12):
So if somebody's experiencingscrupulosity or bad person, it's
targeting something that theyfind to be really important in
their life. So the I always tellthem, the goal is to bring you
closer to your faith rather thanto kind of like stray away from
it if it is indeed that valuefor you.
So that part is reallyimportant. And I also like to
(18:34):
bring up with people to that,with that fear. And that
uncertainty showing up with OCD.
The whole point of religion isto have faith, right. And by
definition, faith is that youare believing something that you
don't actually really know,right? You don't have that
concrete evidence for so kind oflike leaning into that and with
OCD work with scrupulosity. Itis like really utilizing their
(18:57):
their faith if that is somethingthat's important to them as it
relates to the obsessions.
Caitlin Harrison (19:05):
Absolutely.
Yeah, I do a lot of work withpeople who are questioning their
beliefs or change their beliefsystems or things like that. So
speaking from that place, thatcan be a very disorienting like
earth shattering. I used to feellike I had more certainty than I
actually had. But when we'reworking with a client that does
want to maintain that valuesystem, but wants to have it in
(19:29):
a healthier way, in a way thathelps them feel more regulated
and more like just success, likeI can navigate life without
having to worry so much aboutthis being caring so much about
every little thing that I do orthink even I mean, that's
another another thing thatreligion regulates even your
(19:49):
thoughts, like if I thinksomething bad, then I'm a bad
person. If I think about havingsex, then I'm a bad person. You
know thatbut it's a lot of plaguing
thoughts. And so if you can giveyourself a little bit of freedom
and grace, just like most of ourhigher beings give us
(20:11):
that can bring a lot of freedomto.
Dr. Katie Manganello (20:14):
Totally I love that you brought up the
that like some, some religionswill say that like even thinking
about it is a sin. Because youactually we can't control
thoughts that pop up in our headlike you cannot control an
intrusive thought. We cancontrol how we respond to the
thought, but you can't controlit popping up into your head. So
(20:35):
a lot of things I like to saywith people with the
scrupulosity to is like,if we have faith in God, and we
think that God is loving, orwhatever this person's belief
system is, then we can, we canprobably use our best guests to
say that I'm going to believeand have faith that God would
forgive me and understand that Ihave OCD or understand that
these thoughts are popping intomy head, and I can't really
(20:58):
control that.
Caitlin Harrison (21:02):
Yeah. And it's that practice of mindfulness,
like you can notice thosethoughts. And you can notice
what prompted those thoughts,but you can't, you can't make
them go away. You can onlycontrol what you do with them,
and how aware you are of them.
That's really the goal of anyany real any religion, any God
wants you to just be aware andconnected to yourself, to your
(21:27):
mind to your heart. It's thewhole goal is to just be raising
that mindfulness about who youare and how you're doing and
what you're thinking notconstantly fearing what could
happen if you make a misstep?
Dr. Katie Manganello (21:43):
Yes, exactly. So I think that we can
both probably agree that whatwe're saying here is like, it's
not one religion, or anyreligion that we are considering
to be like, that areproblematic. It's kind of more
so the way that people can holdon too tightly.
of those things that are taught,or how they kind of interpret
(22:07):
how to behave as a response ofthat.
Kira Yakubov Ploshansky (22:12):
This isn't really deep and powerful.
This is like very existential, Ican't imagine.
Like on a very,man, I'm like getting chills
thinking about this, likethinking about how I was raised
in different ways of just eventhe thoughts, like I work with
clients for sex therapy. And ifthey have an arose, talking to a
client, like I feel guilty,fantasizing about somebody else,
or having a thought that someoneelse is attractive. And like
(22:35):
working through like, your mindis your playground you're
allowed to have whateverthoughts you have, it's just
what you do with them. And howyou act upon them, is the
difference. But what kind ofgoes on in your mind is yours.
And it's private, and you don'thave to share that with anybody.
And I have so many thoughts inmy head. So I can't imagine,
like having to filter and like,Nate, like labeling this is bad.
(22:57):
This is sinful. This is okay.
That sounds exhausting. And likea job within itself.
Caitlin Harrison (23:06):
That goes, yeah, right along with what
you're saying. It can show up alot of times too, with that
confession, like you feel thisobsession or this compulsion to
confess any sinful thing youdid, or any bad thing that you
did.
Even thoughts, any bad thoughtsthat you had you feel this
obsession, whether it's withwith a pastor, a priest, mentor,
(23:29):
your spouse, like, Hey, I wasattracted to this person, like I
need to tell you or you know,the privacy and that self trust
can oftentimes just be brokenand you feel so guilty and full
of shame that you could be soevil as to have a thought that
disgusting.
Kira Yakubov Ploshansky (23:50):
It makes me think about so in like
Eastern European cultures, oreven like Mediterranean
cultures, they have like thisthing called the evil eye. And
if either of you have heardabout it before, and so
especially like growing up in myculture all the time, if you say
like a compliment, or you admiresomething, or you're jealous of
something in Russian, you wouldalways say is Glaus it to like,
(24:12):
you would say like, I don't wantto curse it, I don't want to put
a curse. I don't want to jinxit. And like, even my mom, like,
I have a baby now and I'mtelling her how beautiful she
is, and all these wonderfulthings. And she was like nice
guy that Don't say too many goodthings, something bad will
happen. And I'm like, Mom,that's crazy. Like, I want to I
want to see these good thingsand build up her self esteem.
She's like, but you can't saytoo many because then something
(24:34):
bad will happen. I'm like, thisexplains my child. A lot like
you're holding back sharingpositive things because you're
scared that it will jinx it. Andlike even that superstition, I
think is so strong. It makes methink about this, like our
thoughts can be that powerful tocause something bad to happen.
Caitlin Harrison (24:52):
It kind of causes this in authenticity to
like it's disingenuous, like Ican't be honest about my
thoughts.
To other people around me, orbecause it's going to damn Me To
Hell, if I'm honest with aboutwho I am or what I'm feeling,
and when I'm thinking
Kira Yakubov Ploshansky (25:14):
talking about shame, that's like,
Dr. Katie Manganello (25:16):
there's a lot of shame and guilt tied in
with this specific subtype inthe real event subtype that we
can kind of get into wheneverwe're ready.
Caitlin Harrison (25:27):
Yeah, I mean, you can share what that means
the real event.
Dr. Katie Manganello (25:30):
Yeah. So the real event, I think, there,
there's definitely some overlap.
So I really wanted to talk aboutthe real event, because I think
that it can be hard to teasereal event OCD, apart from
trauma and PTSD, because thereis something that happened, like
a lot of times people think,okay, OCD is like, I'm gonna
flip the light switch up anddown to make sure that my mom
doesn't die on her trip to worktoday, or something like that.
(25:53):
So it's more so or I'm going to,like, clean incessantly, so that
I make sure that I don't getsick. But it's like, oh, well,
what if something actuallyhappens? Right?
So real event, OCD is rooted inmemories of events, which have
already happened. So it could bethat someone feels uncertain
(26:14):
about what they've done. So anexample could be like, maybe a
person goes to happy hour withtheir co workers, and has one
drink more than they typicallywould. And then they start to
wonder, ooh, like, Did I saysomething offensive to my
coworker? Did I hit on my boss,like, what if they fire me for
how I've acted. So in this case,the real event is that someone
(26:35):
did indeed get intoxicated withtheir co workers. However,
they're more concerned aroundthe uncertainty of the result of
what their behavior could haveled to, or how that impacted the
others that were with them. And,as you can probably imagine,
this theme specifically happensa lot with drinking because it
(26:56):
like alters your memory, and themore you go back, and mentally
review memories, that alsomesses with your memory. So
there's a lot of a lot of thathappening.
Another thing with a real event,OCD is like a person could feel
consumed with that guilt, thatself doubt about something that
did actually happen. And thatcould in turn result in doubting
(27:19):
who the person is like, as aperson. So an example of that,
that could be more so like,okay, let's say, you steal
something from a store, likecandy or something when you were
younger. And it's not like it'ssomething you do anymore. It's
not something you've done morethan one or two times, right.
But then you start to think,well, I did steal though, and
(27:41):
that means that I'm a thief, andI'm a terrible person because of
that. And, you know, if I havekids, like I shouldn't, because
I could transfer thatcharacteristic to my child, and
it'll be my fault that there'smore thieves in the world. I
mean, it can really like spiralright? So the fear of wrong or
potentially wrong past behaviordrives people with this type of
(28:03):
OCD to engage in compulsionsaimed towards gaining certainty
about what exactly they've done.
And what this means about whothey are as a person. And so
some of the major real eventcompulsions include that mental
reviewing the confessions, likehalen was saying, and
reassurance seeking like, Oh, Idid this, like, do you think
(28:24):
it's okay kind of thing. So thissubject can be incredibly
painful for people andconfusing, because pretty much
everybody experiences regret ordoubt about things that have
happened in the past. But peoplewithout OCD can usually kind of
look back at it and say, like,oh, yikes, I shouldn't have done
that. But reflect on it and moveon. Whereas someone with real
(28:46):
event OCD can have guilt overthis, and feel it in such an
overwhelming way that it couldbe equivalent to the feeling as
if they like committed a murderor something. So it really takes
that past event and warps ituntil the person really views
themselves as like the worstperson in the world who can
never be excused or forgiven forit.
Caitlin Harrison (29:12):
Yeah, one of the examples that shows the
intersection of this real eventOCD, and religious trauma.
I knew someone it wasn't an aclient or anything that felt as
though because they slept withtheir husband when it was just
(29:32):
their boyfriend. So they weren'tmarried yet. They slept
together. And they felt thatbecause they did that their
marriage after they got marriedwas just ruined. And that's why
she was being mistreated by herhusband is because she gave
herself away beforeyou know before that she should
have and so it's sort of thislike fear of I don't think that
(29:54):
my marriage will ever be able torecover. She wasn't like being
abused or anything.
It was just bad conflict styles.
And it was sort of this likewhat's the word fulfilled
prophecy?
Prophecy of like, we can't makeit through this because of past
(30:16):
things that happen to me. Andthat creates this vicious cycle
of kind of proving to yourselfthat see I am bad. See, I did
something wrong.
Does that align well with whatyou're explaining?
Dr. Katie Manganello (30:28):
Yeah. And I think that there's things that
could also just like continue tofuel those types of compulsions
or whatnot. I feel bad for thisperson, especially because, you
know, in the context of it beinga marriage, like, you can't get
divorced, or at least I'massuming that's part of the
religion that or that religiousbelief of like, once you're
together, like, That's it, youdon't divorce or if you do,
(30:50):
like, that's bad. So it's like,oh, I messed up before my
marriage, we got married, andnow I'm stuck and it's ruined.
And I'm, you know, in thisunending sense of doom,
basically.
Caitlin Harrison (31:02):
Yeah, this is I gotta pay my penance now,
because, right, I'm being I didthis for myself. Yeah. Yeah.
Kira Yakubov Ploshansky (31:11):
And so I can see this showing up just
in any trauma, right? Like,especially a lot of this over
section with OCD is like theseintrusive thoughts, these
flashbacks, like having thisnegative belief of yourself, the
self fulfilling prophecy, right?
Especially in like, in terms ofinterpersonal relationships,
like, I'm a bad person, I didthis or something bad happened
to me. And now I'm scarred.
Like, I know, a lot of you know,victims of sexual assault might
(31:33):
feel that way that they'redamaged in some way. And so they
may push other people away,having this belief like so
there's so much overlap that Ithink that maybe a lot of people
may not have recognized betweenthe two. And so I'm curious of
how either of you kind of teaseapart when you see somebody
presenting a lot of the symptomsor issues? How it could be
(31:54):
either? Is this PTSD? Is thisOCD? Is this both? Is this the
comorbidity that we're lookingat right now? And helping them
through that?
Dr. Katie Manganello (32:03):
Yeah, it will, it could indeed be both it
could. It also could not, itcould, so you should try to
tease it apart. First, if thatis the case, the difference
is that like, while there arerepetitive behaviors of OCD that
are performed to like prevent animagined threat from occurring,
(32:23):
or from that perceived all ornothing thought from being true
about themselves, that therepetitive behaviors are showing
up with PTSD are done to avoidre experiencing traumatic
memories. So it's more so well,if it's, if it's PTSD, where
it's one specific event, atleast, that's kind of the case.
Even if it's a collection ofmemories, it's those memories or
(32:46):
those specific, like themes thatthey are trying to avoid. That's
how I would explain thedifference. I think there's like
a lot of overlap, though, andespecially in what we are
saying, like, I think inparticular with religious
trauma,some of the specific OCD themes
discussed, like, there's thislevel of uncertainty around
somebody's identity and aroundquestioning their values and in
(33:09):
learning how to trustthemselves. Like I think that
those are some really commonthemes that show up amongst both
of them that you're going tostill be doing some of that
work.
Caitlin Harrison (33:22):
Absolutely. I think you summed it up well, and
I think that they can existtogether, they can exist
separately. And the importantpart is just understanding the
difference so that you canunderstand yourself better, so
that you can understand yourtherapists can understand how to
help you better.
(33:42):
But if you're having thesethemes, they can show up in
many, many different diagnosiscould show up in anxiety and not
OCD, it can show up asdepression, simply like self
esteem issues. So and
Kira Yakubov Ploshansky (33:57):
So how would each of you kind of go
about helping someone who isexperiencing religious trauma?
Or the Scrupulosity or theoverlap of the two what are some
of your approaches that both ofyou kind of go through that
might help the listeners kind ofthink about this if they
resonate with this episode?
Caitlin Harrison (34:14):
Yeah, so like I said, I work a lot with
individuals who are sort ofchanging their belief system or
questioning their belief systemand wondering if they want to
change it.
significant portions of it orthe whole thing entirely. So
like, for example, I'm, I'mquestioning my sexuality, and
(34:36):
I've always kind of suppressedthat part of myself. I didn't
want to confront it because I'vejust been shown that I need to
be straight. And I need to havea nuclear family. I need to want
to have kids you know, all thatthose kinds of things like maybe
my sexuality and my trueexpression of not fitting the
(34:57):
heteronormative moldMaybe I my belief system can
coexist with that. And so I justneed to question a part of my
belief system or hey, I'mactually wondering if there's
even enough evidence to supportme believing this belief system
that I once believed in. And sowhen I approach that kind of
work, it's very slow. And it's alot of grace for yourself. When
(35:22):
we talk about scrupulosity, it'sa lot of slowing down reminding
yourself like, Hey, I know whatvoice This is that's talking.
Whether that you name thatvoice, the OCD Scrupulosity,
maybe you name that, that wasjust my youth pastor that was
(35:45):
making me feel that maybe therereally is somebody that's tied
to that voice or that compulsionor that obsession.
But just starting to recognizeand separate yourself from that
voice, can be really powerful,so that you can notice it as
(36:05):
separate from yourself. ratherthan you being this evil person
that can't manage to live a goodlife, or can't manage to be free
from obsessive thoughts. Ifwe're talking about real event,
OCD, it's kind of where I startsome initial thoughts that came
to mind.
Kira Yakubov Ploshansky (36:25):
Sounds like being really gentle with
themselves and you with them togoing through that.
Dr. Katie Manganello (36:31):
I guess what I would start doing is just
what we already just talkedabout in terms of is this both
is it one or is it the other,and then I would kind of, I
would probably go differentdirections if depending on what
it is. So if it's OCD, I'm goingto be doing exposure and
response prevention treatment,in combination with Acceptance
(36:52):
and Commitment Therapy thatbrings a lot more of that like,
acceptance, gentleness, focus ontheir values, what they want
that kind of thing. If I'm doingit with PTSD, I'm, I always, I
look like a very collaborativetherapist. So I really throw out
what I can offer, and then whatthe person tells me that they
(37:14):
think suits best for them.
That's kind of what we go with.
So if it's if they do want towork on their PTSD, I explained
to them, Hey, I'm trained incognitive processing therapy, I
know how to do prolongedexposure.
This is what each of these looklike, these are evidence based
(37:35):
track, you know, practices thatwe use, which basically just
shows that like, you know,there's been a lot of research
on these treatments, they helppeople.
And I just give them moreinformation around each and then
they can tell me like, Hey, thisis this one seems like a good
fit for me or this one theother, or if they're like, not
even at a place where that'ssomething that they are like
(37:57):
super ready to, like, hit theground running with, I'll just
kind of start out with whateverthey say that they want to work
on and kind of take it fromthere.
Kira Yakubov Ploshansky (38:08):
Can you share a little bit more about
ERP and the cognitive processingfor some of the listeners that
don't know? I know, I keepmaking you explain things and
concise ways.
Dr. Katie Manganello (38:18):
I like it, this could be a whole episode.
So they're, they're bothexposure therapies to an extent.
So cognitive processing, therapyis a treatment for PTSD. A lot
of it is what mostly what we'redoing is we are looking at your
thoughts and beliefs, and howthey relate to the event or
(38:42):
events that have happened, andlooking at how they are not
really helping you in your liferight now. And talking about
like what had happened andrestructuring some of those
beliefswith exposure and response
prevention, that's like the OCDtreatment. That is so the
exposure part and exposure andresponse prevention is targeted
(39:05):
towards the obsessions. So theexposure is we need to expose
people to the fears so that theycan, their brain can actually
habituate to that anxiety andthey can learn to tolerate it,
building that distresstolerance. The response
prevention piece of ERP istargeted towards the compulsions
(39:29):
which is basically eithereliminating the compulsions
altogether or cutting them backwith the goal to really have
them be pretty minimal or gone.
So if you want more informationon that, you can go back and
listen to the other podcastswhen he's talked about that a
lot. I think the biggest thingI'd like to just say in response
to that is I think that all ofthese treatments sound really
(39:51):
scary because they hear the wordexposure and they're like that's
what I'm trying to avoid. I'mI'm doing that. But again, like
we're Working together, it'scollaborative. I'm often doing
exposures with people.
And I'm, I'm never going toforce anybody to do something
that they're unwilling to dolike we will find like little
(40:12):
tiny exposures and thengradually build up like we are
putting our toes in the waterare not just, you know, Cannon
going into that freezing coldice water, we're like, gradually
kind of dipping in. So don't beyou know, it should be
challenging. It should be astress but not a strain.
Kira Yakubov Ploshansky (40:33):
Thank you. I appreciate both of you
sharing that approach and howyou would kind of go about that
game. And I know that you alsodo EMDR. Is this something that
you would do with clients whoare struggling with
scrupulosity?
Caitlin Harrison (40:45):
Yeah, so I without using the technical
terms, what I was talking aboutbefore was internal family
systems. So ifs is sort of thisidea of understanding all the
parts of you that show up andunderstanding why they're there,
what they came to do to help youwith. So what's scrupulosity,
oftentimes it shows up toprotect you from going to hell
(41:09):
for to protect you from beingsocially rejected, to protect
your parent from beingdisappointed in you, things like
that. So it's kind of taking itand putting yourself your true,
like authentic self in charge ofall of these parts of you, but
also appreciating like, Hey, youshowed up for a reason you
(41:31):
showed up to protect me, youshowed up. And you helped me
once upon a time. And now Ithink I want to be in charge.
And so that's a long process.
And it sounds really simple. Andit's not. But that's sort of the
basic theory behind how I wouldoften approach scrupulosity. And
(41:51):
there are times when it's traumarelated that you could use EMDR.
Soif especially with the relevant
or reprocessing, like a specificmemory, or it could be a
negative thought, a negativecognition that you attach to
many different memories that youcould use
(42:15):
EMDR for. So if you noticecompulsions or obsessions that
come up, or memories that comeup often with trauma related
things, then we would use theMDR, if that makes sense.
Kira Yakubov Ploshansky (42:33):
And same thing, if you could share a
little bit I know we talked alot about EMDR in episodes
together, but for the listenersa little bit of like, what that
is and like the like the acronymthat it's for. So they have an
idea, kind of what that means.
Dr. Katie Manganello (42:48):
After this
Caitlin Harrison (42:55):
things, these are things we like talking
about. Yeah. All right. So it'sEye Movement Desensitization and
Reprocessing. So it's amouthful, that's why we just say
EMDR. Um, but basically, it usesthe theory behind bilateral
stimulation. So if you imaginekind of taking your body and
(43:21):
dividing it into two halves,the right side and the left
side, if you stimulate the rightside and the left side, in a
rhythmic motion, it could befast or slow, just depending on
where we're at in the process.
It can help your mind your bodyand your feelings consolidate a
(43:42):
traumatic memory that theycouldn't process that it
couldn't process previously. Andso I think EMDR is a really good
fit for people that haven't hadgood success with talk therapy.
I think it's also a good fit forpeople that are tend to be like
(44:02):
more emotional and creativecreatures. I think it I noticed
that it can tend to be a goodfit for those people who like to
do like visualizations andthings like that. So yeah, it's
it that what that looks like ina session is we do a lot of
skill building at the beginningof treatment. So learning how to
(44:26):
regulate your nervous system,learning how to calm yourself
down. When a traumatic memory isbrought up, or even a stressful
event at work is brought up. Wedo a lot of skill building at
the beginning. It's just likewhat Katie said, we don't just
dive into the deep end and bringup you know, the worst thing
that ever happened to you.
(44:49):
Then we start to reprocess thememories once your whole nervous
system is ready for that and youfeel like you're able to
regulate yourself and you havethose skills that you need.
need in order to do that, onebenefit, I think of EMDR is that
you don't actually have to sayyour memory out loud. Sometimes
(45:10):
that can be powerful for people.
And it's that avoidance thatKatie's talking about,
sometimes, it's actually reallygood for you to be able to say
it out loud and have somebodyelse know what's happening. But
it's kind of cool that in EMDR,you don't have to. And so you
can start slow. And we reprocessthe memories with bilateral
(45:31):
stimulation. So sometimes you'relooking left to right, left to
right, that's the eye movementpiece. But what research has
also found is that any type ofbilateral stimulation works, so
tapping on left knee, rightknee, left knee, right knee, or
your shoulders or even sound inyour left ear, then right your
left ear than right here.
(45:54):
So we kind of do what works forthe client and also the
environment that they're in. Andsome clients have relief in one
session, some clients, it'seight sessions, some clients,
it's many more than that. Butthat's kind of EMDR. In a
nutshell.
Kira Yakubov Ploshansky (46:13):
I appreciate both of you really
sharing that explain, I think hedid a phenomenal job. And I
think this is going to be areally powerful episode for a
lot of people who could bestruggling with this. Or even
folks who know somebody in theirlife they love they could be
struggling with this andunderstanding it a little bit
more and having more empathy. Iwould say before we close out,
is there any, any last bits ofwhether it's like giving hope or
(46:37):
any other thoughts for listenersaround something like this?
Dr. Katie Manganello (46:41):
I think that there is a lot of shame in
some of these, especially whenthere is a real event because
you essentially have to go andtell somebody, something that
you think the worst thing aboutyourself. So I can understand
that this is really, reallydifficult to see help in.
(47:04):
But also like just to know thatyou're probably judging yourself
for it a lot more than anybodyelse would, which is sort of
giving reassurance right now,but I mean, you should you know,
you, I would hope that somebodywould feel comfortable coming
and talking to me about some ofthose things. And just that
(47:26):
having them know that I get howit operates. I know how it
works. And like, we can put thejudgment aside to like, get
through it. So I think that thatis a really important thing with
with PTSD. And with OCD, I thinkthere's often a lot of shame and
guilt tied in.
Caitlin Harrison (47:44):
Yeah, I think just that there is a path ahead,
that doesn't feel sodisorienting. I think that's
what I see a lot with theclients that I see anyway, you
know, that really disorientedfeeling of a foundation I once
had is not here anymore, and I'mkind of grasping for anything
(48:05):
that can make me feelcomfortable again. Um, there is
a path ahead where you don'tfeel so disoriented and so
confused about who you are, whatyou're that like maybe listening
to this and talking about valuesyou're like, that's the last
thing that I want to talk aboutbecause I don't even know when I
think or believe or feel aboutanything anymore.
(48:28):
And so yeah, I think just youcan learn to trust yourself
again, you can learn to bereconnected to all of you know,
your emotions and your mind andyour body and it not feel so
overwhelming.
Kira Yakubov Ploshansky (48:39):
So for listeners, Katie and Caitlin at
this time are both accepting newclients. So if you're interested
in working with either of them,please reach out. You can head
over to our website, heal yourroots. wellness.com Katie, and
Caitlin, thank you so much forbeing on with us again today.
This was
Welcome back to Heal Your Roots Podcast.
In today's episode, we havereturning guests, Dr. Katie
Manganello and Caitlin Harrison,marriage and family therapist,
we dive deep into how OCDoverlaps with trauma,
specifically religious trauma.
We go into more insight intoscrupulosity and real event OCD,
you're not going to want to misstoday's episode. So it really
(00:21):
takes that past event and warpsit until the person really views
themselves as like the worstperson in the world who can
never be excused or forgiven forit. Do you can kind of see how
OCD and religious influencescould lead someone down a path
that might make them reallyoverwhelmed with this idea that
(00:45):
I have to be perfect.
Ladies, thank you so much forjoining us for another episode
today.
Dr. Katie Manganello (00:53):
I'm excited to be here. Yeah, thank
you so much. I'm so excited.
This is one of my favoritetopics, so I'm ready to get into
it. I've been looking forward toit. Awesome.
Kira Yakubov Ploshansky (01:05):
So both of these therapists work at Heal
Your Roots Wellness. Dr. KatieManganello specializes in
obsessive compulsive disorderanxiety disorders PTSD. Caitlin
Harrison Marriage and FamilyTherapist specializes in couples
therapy, trauma, andspecifically religious trauma.
So I'm really excited for todaywe're going to talk about the
intersection between OCD andreligious trauma. So Katie, can
(01:28):
you kind of start with a littlebit of background about who you
are and what you do? For some ofthe listeners that may have not
heard your episode before?
Dr. Katie Manganello (01:36):
Yes, so like you say, Kira, I'm, I'm a
clinical psychologist, I work atHeal Your Roots Wellness. I also
work in a private practice theanxiety and OCD treatment center
that is physically located inWilmington, Delaware, mostly
what I do is individual therapy,focusing on treating OCD.
(01:59):
Sometimes that comes along withother things. There's a lot of
comorbidities. So I also work alot with ADHD, autism spectrum,
body focus, repetitivebehaviors, anxiety, PTSD,
depression, a bunch of differentstuff. And I work with people of
all ages, a lot of times webring couples in or family
members and to assist intreating the OCD or whatever
(02:23):
else the presenting problem is,me as a clinician in general, I
really, I operate mostly under acognitive behavior model. I also
really, within that model,really enjoy Acceptance and
Commitment Therapy. And ofcourse, with OCD, I do a lot of
exposure and responseprevention.
Kira Yakubov Ploshansk (02:43):
Awesome.
Thank you so much for sharingthat. Healing. Can you share a
little bit about yourself forthe guests or for the listeners?
Caitlin Harrison (02:48):
Yeah, yeah. I think Kira, you summed it up?
Well, I do a lot of work withcouples. So systemic therapy
doing it, whether that's likecouples or even families, parent
and child, like grown up, adultsworking on their parent and
child relationship. And then Ialso do work with trauma. So I
(03:10):
do EMDR therapy. And I focus alot on religious trauma, which
is also one of my favoritetopics.
And just like Katie pointed outwith trauma, there's a lot of
comorbidities a lot of thingsthat can come up so that could
look like anxiety, depression,PTSD, even OCD like we're
(03:31):
talking about today. Selfesteem, attachment wounds,
things like that. So that's whatthe work that I do looks like
here at Heal Your RootsWellness.
Kira Yakubov Ploshansky (03:42):
So I think we can kind of lay down
the foundation for listeners toknow what is obsessive
compulsive disorder, somebackground and what religious
trauma is. And then we're goingto talk about like some really
nitty gritty stuff that I thinkis super fascinating that I
haven't actually ever learnedabout before or heard of some of
these words even so I'm reallypumped to learn more about this
(04:03):
so I'm going to have questionslike as an audience member to
see like to learn more aboutthis. So if either of you can
kind of start with what thespecialty is that you have,
Caitlin Harrison (04:13):
So all I guess I can kind of define religious
trauma but Katie just chime inwhenever you feel like I'm
missing something but um, soreligious trauma is just like
any trauma when you experienceharm or abuse from something
outside of you. So when it comesto religious trauma, it's you're
(04:35):
receiving like religious oremotional
or spiritual, I'm sorry, abusefrom
whether it be leadership. Itcould be your parents, an
outside system, even just yourthe culture that you live in.
You're receiving hatefulmessages about who you are as a
(04:56):
person. And that leaves you withemotional
mental, physical symptoms.
So that's kind of how I defineit. Anything you'd add?
Dr. Katie Manganello (05:08):
Yeah. And so I think that's something I
like to tell people too, whenwe're talking about trauma is
that you can experience traumawithout becoming full blown
PTSD, like post traumatic stressdisorder.
I'm thinking, usually when Iwork with trauma, I mean,
there's a lot of people who'veexperienced trauma, right. And
so, just kind of teasing traumaapart, like as a whole, apart
(05:32):
from like, post traumatic stressdisorder that in particular, is
a disorder in which you know,someone has witnessed a
traumatic event, such as likewar, or sexual assault, or you
know, any of the things that youhad mentioned as well, and
includes these recurringsymptoms such as intrusive
memories, flashbacks,nightmares, negative changes in
(05:55):
thoughts and beliefs, and a lotof avoidance around any kind of
cues that remind them of thetrauma. So when I'm talking
about OCD related things, Ithink I'm comparing a little bit
more to a diagnosis of PTSD asopposed to kind of like a
general sense of trauma.
Caitlin Harrison (06:15):
Yes, yeah. And the way that I think about
trauma is sort of on a spectrum,because he talked about these
big, and then slet are causingflashbacks, very marked memories
of specific events. But thenthere's also this complex trauma
that where you receive messagesover and over again, that like,
(06:39):
you can't trust your emotions,you can't trust your thoughts.
So you might not have thesespecific memories that come up
for you when you know, yourpastor told you that. But
there's something in you thatquestions like, Wait, am I
allowed to trust myself? Am Iallowed to trust my emotions, so
there can be not so specificevents when it comes to trauma
(07:02):
as well, which I think isimportant to just know.
Kira Yakubov Ploshansky (07:08):
Sounds like constant messages being
told instead of like an event.
It's just messages that kind ofseep in that create a narrative
and a belief system within you.
Dr. Katie Manganello (07:17):
Right, several little events that can
kind of like pile up. Yep.
Kira Yakubov Ploshansky (07:23):
And what about OCD? Can you share,
kind of like what obsessivecompulsive disorder is for the
listeners?
Dr. Katie Manganello (07:28):
Yes, well, for me, this is such a difficult
thing for me to make a smallexplanation for. So if you want
an expanded definition, golisten to the episode that Kara
and I recorded before I go inway more detail, but to try to
keep it simple. OCD is adoubting disorder. It's fueled
by uncertainty. And it's adisorder in which people
(07:52):
experience repetitive andintrusive thoughts, images,
urges or feelings calledobsessions. And these fears are
ego dystonic, which means thatthey do not align with the
person's values. And everyonehas intrusive thoughts here and
there, but most move on fromthem realizing that these
thoughts aren't reallythreatening or they don't mean
(08:13):
anything about them as a person.
But for people with OCD, thesethoughts feel really significant
and can cause intense negativefeelings. So as a result of that
they engage in compulsions,which are mental or physical
acts performed to relieve thedistress or to keep an unwanted
event from happening.
Kira Yakubov Ploshansky (08:35):
Thank you for keeping it short and
concise. I know that was tough.
So it sounds like even justsharing that there's a lot of
overlap. I feel like betweentrauma and OCD and how it
presents and I know later on,we'll talk about
how to differentiate between thetwo. But I did want to dive into
Scrupulosity. I've never heardof this. I think this is super
(08:58):
fascinating. If we can kind ofjust dive into what is that? And
how does that show up for OCDversus trauma versus the
intersection between the two?
Caitlin Harrison (09:09):
Yeah, so Scrupulosity that is basically
this obsession or this need orthis drive to achieve moral
perfection, or like moralpurity. And so even as I just
say, that sentence, you can kindof see how OCD and religious
(09:32):
influences could lead someonedown a path that might make them
really overwhelmed with thisidea that I have to be perfect.
And so that's what scrupulositycan look like, I mean, we can go
into detail of what that couldlook like for
you know, someone who did have areligious upbringing or was
(09:53):
influenced even in theiradulthood, maybe that's safe for
a little later.
Kira Yakubov Ploshansky (09:58):
We can dive in now if you
If you both want to I think likethis is like I like that this
episode is now the work. We haveeach episode with both of you
kind of going through yourbackground. Now we can get to
like the specifics and thedetails of things because I've
never heard of this. Butthinking about this, I'm sure
this is super common for a lotof folks. So hearing this, I
think was going to be superhelpful and beneficial.
Dr. Katie Manganello (10:20):
Yep, for sure.
(10:48):
I think you did a really goodjob explaining that that's
(11:29):
really very much. So how I wouldexplain it to you know, it's
that you know, this really allor nothing like rigidity around
achieving that like perfectionaround being a perfectly
religious person or moralperson, even it doesn't even
have to just be a religion,which I was. I'm just going to
(11:50):
talk a little bit about badperson OCD, which is kind of the
same thing. I mean, it's verysimilar in the sense of like,
the morality aspect in wantingto just like, even if you're not
following a specific religion,it's more so that moral compass
of doing things perfectly moraltype of thing. scrupulosity OCD,
I actually see this a lot.
(12:13):
I see this a lot within thepractice. And so some common
obsessions around scrupulosityOCD could be fears of committing
a sin.
Excessively striving for thatpurity, fears of going to hell
or being punished by God, beingpossessed fear of death, fear of
(12:34):
a loss of impulse control,doubting what you truly believe
or feel in needing to have thatcertainty around religious
beliefs. And then of course,there's lots of compulsions that
can come along with that thatcould be
if it is something like yousaid, Caitlin around like sex
before marriage kind of thing.
Maybe it's, I'm going to avoiddating in general, because I
(12:56):
don't want to even tempt myself.
It could be excessive praying,it could be I liked the example
you gave to of donating money.
So I can show up in a lot ofdifferent ways.
Kira Yakubov Ploshansky (13:11):
That's so fascinating. And I'm curious
of since it's kind of connectedto this belief of something
higher kind of punishing us insome way, or like judging us or
watching us? Do either of yousee this ever come up with
anyone who might be atheist oragnostic? Or is it very
specific, like, they're kind ofconnected to a religion that's
shared this message?
Caitlin Harrison (13:34):
Something that I see a lot and maybe it's not
so much connected to religion.
For them, it's this idea that Icould make a wrong choice, when
actually the choice the twochoices before them are say,
Should I take this job or thisjob? Both align well, with my
schedule, both are good salary,you know, they they're kind of
equal. There's no right orwrong, good or bad. It's just
(13:57):
what which one do I want? Andsometimes it can be difficult
even outside of a religiouscontext. To to tease that out,
like, Am I really being good orbad by choosing one of these?
It's that fear of the future orfear of like I could choose
something wrong that wouldturment me in the future
Dr. Katie Manganello (14:18):
Yeah that sounds like the perfectionism to
me right?
Like am I making the perfectchoice? The one that's best for
me kind of thing, which is somuch in the same like, yeah, the
realm of that yeah, Kira. I feellike the bad person or like just
moral aspect of this groupphilosophy shows up more so in
like people who don't fall undera specific religion, like they,
(14:39):
they could be a theist, becauseit's it that doesn't mean you
subscribe to a specific god orgods or whatever, it could just
be. I'm here, and I still feellike I shouldn't be nice to
people or I should be, you know,a certain you know, certain
behaviors or whatever. Yeah,that was just interesting and
made me think about if that hada connection to it, but I guess
(14:59):
just I mean,And even people who are atheist
agnostic, right? Like there'sstill a moral compass and values
that we follow. So it's moreabout that all or nothing kind
of thinking around it versus itbeing something specific, like a
religion. So it could just bethe future, how we view
ourselves is kind of what's incontrol of it.
Yeah. And actually, I mean,considering OCD, like I said, is
(15:21):
a it's a very doubting type ofdisorder. If it is a sense,
where you're doubting what youtruly believe or feel, anybody
can experience that atheistscould they could be like, maybe
I am deep down a Catholic whoand I think that I'm an atheist,
right? Like,who knows,
Caitlin Harrison (15:38):
That's part of what makes religion so
comforting, actually, is, Idon't have to fear fear of the
future anymore. I don't have tobe afraid of what's going to
happen to me. All I have to dois, you know, pray this many
times, or live this good of lifeor trust in this certain thing.
And then I have a sense ofcontrol again, over my future.
(16:01):
Andwhen you start to question that,
when that's sort of what youpaid, placed all of your
security in, and that's sort ofwhat made all of your anxiety
subside. before. It's such adisorienting feeling, because
then what can I trust? What canI rely on? What can help me
predict my future? How can Icontrol my future? And you're
kind of like reckoning withthat, like, maybe I can't
(16:24):
anymore, but I used to feel likeI could. It's so confusing.
Kira Yakubov Ploshansky (16:30):
It sounds that you have this
certainty that you trusted inoutside of you. And now that
kind of caught like, it wascrashed. And now it's just, I
mean, it sounds superdisorienting. Now, it's like all
uncertainty, instability, andtrying to like kind of grasp for
an anchor. That does soundpretty traumatic, like
internally.
Dr. Katie Manganello (16:49):
Yeah, I would say a little bit of a
nuance to that with the OCD isthat if people come in with
scrupulosity, it's notnecessarily that it's usually
not that the person is sofocused on.
Will religion is my certainty.
It's, it's more so of like,well, did I do this good enough?
(17:10):
Am I being a good person? Thisor That? opposed to the latter?
Caitlin Harrison (17:18):
Yeah, yeah, I guess I'm I, speaking from a
place of someone who'slike if a client has walked away
from a certain religion, andrecognize that Reckoning and
like, Okay, I used to havesomething that gave me so much
comfort. And now where can Ifind comfort because it used to
be that I did things perfectly.
(17:39):
It used to be that I was thegood Christian girl. It used to
be that all I had to do is notsleep with my partner. And now
who am I? Am I good? Am I youknow
Dr. Katie Manganello (17:51):
yes. And I think that that's a really big
difference and something forpeople to when they're
evaluating for it to kind ofkeep an eye on because for
people who have likescrupulosity OCD, like one of
the main points I like to tellthem is that my goal is not to
take away your religion, becauseagain, OCD targets your values.
(18:12):
So if somebody's experiencingscrupulosity or bad person, it's
targeting something that theyfind to be really important in
their life. So the I always tellthem, the goal is to bring you
closer to your faith rather thanto kind of like stray away from
it if it is indeed that valuefor you.
So that part is reallyimportant. And I also like to
(18:34):
bring up with people to that,with that fear. And that
uncertainty showing up with OCD.
The whole point of religion isto have faith, right. And by
definition, faith is that youare believing something that you
don't actually really know,right? You don't have that
concrete evidence for so kind oflike leaning into that and with
OCD work with scrupulosity. Itis like really utilizing their
(18:57):
their faith if that is somethingthat's important to them as it
relates to the obsessions.
Caitlin Harrison (19:05):
Absolutely.
Yeah, I do a lot of work withpeople who are questioning their
beliefs or change their beliefsystems or things like that. So
speaking from that place, thatcan be a very disorienting like
earth shattering. I used to feellike I had more certainty than I
actually had. But when we'reworking with a client that does
want to maintain that valuesystem, but wants to have it in
(19:29):
a healthier way, in a way thathelps them feel more regulated
and more like just success, likeI can navigate life without
having to worry so much aboutthis being caring so much about
every little thing that I do orthink even I mean, that's
another another thing thatreligion regulates even your
(19:49):
thoughts, like if I thinksomething bad, then I'm a bad
person. If I think about havingsex, then I'm a bad person. You
know thatbut it's a lot of plaguing
thoughts. And so if you can giveyourself a little bit of freedom
and grace, just like most of ourhigher beings give us
(20:11):
that can bring a lot of freedomto.
Dr. Katie Manganello (20:14):
Totally I love that you brought up the
that like some, some religionswill say that like even thinking
about it is a sin. Because youactually we can't control
thoughts that pop up in our headlike you cannot control an
intrusive thought. We cancontrol how we respond to the
thought, but you can't controlit popping up into your head. So
(20:35):
a lot of things I like to saywith people with the
scrupulosity to is like,if we have faith in God, and we
think that God is loving, orwhatever this person's belief
system is, then we can, we canprobably use our best guests to
say that I'm going to believeand have faith that God would
forgive me and understand that Ihave OCD or understand that
these thoughts are popping intomy head, and I can't really
(20:58):
control that.
Caitlin Harrison (21:02):
Yeah. And it's that practice of mindfulness,
like you can notice thosethoughts. And you can notice
what prompted those thoughts,but you can't, you can't make
them go away. You can onlycontrol what you do with them,
and how aware you are of them.
That's really the goal of anyany real any religion, any God
wants you to just be aware andconnected to yourself, to your
(21:27):
mind to your heart. It's thewhole goal is to just be raising
that mindfulness about who youare and how you're doing and
what you're thinking notconstantly fearing what could
happen if you make a misstep?
Dr. Katie Manganello (21:43):
Yes, exactly. So I think that we can
both probably agree that whatwe're saying here is like, it's
not one religion, or anyreligion that we are considering
to be like, that areproblematic. It's kind of more
so the way that people can holdon too tightly.
of those things that are taught,or how they kind of interpret
(22:07):
how to behave as a response ofthat.
Kira Yakubov Ploshansky (22:12):
This isn't really deep and powerful.
This is like very existential, Ican't imagine.
Like on a very,man, I'm like getting chills
thinking about this, likethinking about how I was raised
in different ways of just eventhe thoughts, like I work with
clients for sex therapy. And ifthey have an arose, talking to a
client, like I feel guilty,fantasizing about somebody else,
or having a thought that someoneelse is attractive. And like
(22:35):
working through like, your mindis your playground you're
allowed to have whateverthoughts you have, it's just
what you do with them. And howyou act upon them, is the
difference. But what kind ofgoes on in your mind is yours.
And it's private, and you don'thave to share that with anybody.
And I have so many thoughts inmy head. So I can't imagine,
like having to filter and like,Nate, like labeling this is bad.
(22:57):
This is sinful. This is okay.
That sounds exhausting. And likea job within itself.
Caitlin Harrison (23:06):
That goes, yeah, right along with what
you're saying. It can show up alot of times too, with that
confession, like you feel thisobsession or this compulsion to
confess any sinful thing youdid, or any bad thing that you
did.
Even thoughts, any bad thoughtsthat you had you feel this
obsession, whether it's withwith a pastor, a priest, mentor,
(23:29):
your spouse, like, Hey, I wasattracted to this person, like I
need to tell you or you know,the privacy and that self trust
can oftentimes just be brokenand you feel so guilty and full
of shame that you could be soevil as to have a thought that
disgusting.
Kira Yakubov Ploshansky (23:50):
It makes me think about so in like
Eastern European cultures, oreven like Mediterranean
cultures, they have like thisthing called the evil eye. And
if either of you have heardabout it before, and so
especially like growing up in myculture all the time, if you say
like a compliment, or you admiresomething, or you're jealous of
something in Russian, you wouldalways say is Glaus it to like,
(24:12):
you would say like, I don't wantto curse it, I don't want to put
a curse. I don't want to jinxit. And like, even my mom, like,
I have a baby now and I'mtelling her how beautiful she
is, and all these wonderfulthings. And she was like nice
guy that Don't say too many goodthings, something bad will
happen. And I'm like, Mom,that's crazy. Like, I want to I
want to see these good thingsand build up her self esteem.
She's like, but you can't saytoo many because then something
(24:34):
bad will happen. I'm like, thisexplains my child. A lot like
you're holding back sharingpositive things because you're
scared that it will jinx it. Andlike even that superstition, I
think is so strong. It makes methink about this, like our
thoughts can be that powerful tocause something bad to happen.
Caitlin Harrison (24:52):
It kind of causes this in authenticity to
like it's disingenuous, like Ican't be honest about my
thoughts.
To other people around me, orbecause it's going to damn Me To
Hell, if I'm honest with aboutwho I am or what I'm feeling,
and when I'm thinking
Kira Yakubov Ploshansky (25:14):
talking about shame, that's like,
Dr. Katie Manganello (25:16):
there's a lot of shame and guilt tied in
with this specific subtype inthe real event subtype that we
can kind of get into wheneverwe're ready.
Caitlin Harrison (25:27):
Yeah, I mean, you can share what that means
the real event.
Dr. Katie Manganello (25:30):
Yeah. So the real event, I think, there,
there's definitely some overlap.
So I really wanted to talk aboutthe real event, because I think
that it can be hard to teasereal event OCD, apart from
trauma and PTSD, because thereis something that happened, like
a lot of times people think,okay, OCD is like, I'm gonna
flip the light switch up anddown to make sure that my mom
doesn't die on her trip to worktoday, or something like that.
(25:53):
So it's more so or I'm going to,like, clean incessantly, so that
I make sure that I don't getsick. But it's like, oh, well,
what if something actuallyhappens? Right?
So real event, OCD is rooted inmemories of events, which have
already happened. So it could bethat someone feels uncertain
(26:14):
about what they've done. So anexample could be like, maybe a
person goes to happy hour withtheir co workers, and has one
drink more than they typicallywould. And then they start to
wonder, ooh, like, Did I saysomething offensive to my
coworker? Did I hit on my boss,like, what if they fire me for
how I've acted. So in this case,the real event is that someone
(26:35):
did indeed get intoxicated withtheir co workers. However,
they're more concerned aroundthe uncertainty of the result of
what their behavior could haveled to, or how that impacted the
others that were with them. And,as you can probably imagine,
this theme specifically happensa lot with drinking because it
(26:56):
like alters your memory, and themore you go back, and mentally
review memories, that alsomesses with your memory. So
there's a lot of a lot of thathappening.
Another thing with a real event,OCD is like a person could feel
consumed with that guilt, thatself doubt about something that
did actually happen. And thatcould in turn result in doubting
(27:19):
who the person is like, as aperson. So an example of that,
that could be more so like,okay, let's say, you steal
something from a store, likecandy or something when you were
younger. And it's not like it'ssomething you do anymore. It's
not something you've done morethan one or two times, right.
But then you start to think,well, I did steal though, and
(27:41):
that means that I'm a thief, andI'm a terrible person because of
that. And, you know, if I havekids, like I shouldn't, because
I could transfer thatcharacteristic to my child, and
it'll be my fault that there'smore thieves in the world. I
mean, it can really like spiralright? So the fear of wrong or
potentially wrong past behaviordrives people with this type of
(28:03):
OCD to engage in compulsionsaimed towards gaining certainty
about what exactly they've done.
And what this means about whothey are as a person. And so
some of the major real eventcompulsions include that mental
reviewing the confessions, likehalen was saying, and
reassurance seeking like, Oh, Idid this, like, do you think
(28:24):
it's okay kind of thing. So thissubject can be incredibly
painful for people andconfusing, because pretty much
everybody experiences regret ordoubt about things that have
happened in the past. But peoplewithout OCD can usually kind of
look back at it and say, like,oh, yikes, I shouldn't have done
that. But reflect on it and moveon. Whereas someone with real
(28:46):
event OCD can have guilt overthis, and feel it in such an
overwhelming way that it couldbe equivalent to the feeling as
if they like committed a murderor something. So it really takes
that past event and warps ituntil the person really views
themselves as like the worstperson in the world who can
never be excused or forgiven forit.
Caitlin Harrison (29:12):
Yeah, one of the examples that shows the
intersection of this real eventOCD, and religious trauma.
I knew someone it wasn't an aclient or anything that felt as
though because they slept withtheir husband when it was just
(29:32):
their boyfriend. So they weren'tmarried yet. They slept
together. And they felt thatbecause they did that their
marriage after they got marriedwas just ruined. And that's why
she was being mistreated by herhusband is because she gave
herself away beforeyou know before that she should
have and so it's sort of thislike fear of I don't think that
(29:54):
my marriage will ever be able torecover. She wasn't like being
abused or anything.
It was just bad conflict styles.
And it was sort of this likewhat's the word fulfilled
prophecy?
Prophecy of like, we can't makeit through this because of past
(30:16):
things that happen to me. Andthat creates this vicious cycle
of kind of proving to yourselfthat see I am bad. See, I did
something wrong.
Does that align well with whatyou're explaining?
Dr. Katie Manganello (30:28):
Yeah. And I think that there's things that
could also just like continue tofuel those types of compulsions
or whatnot. I feel bad for thisperson, especially because, you
know, in the context of it beinga marriage, like, you can't get
divorced, or at least I'massuming that's part of the
religion that or that religiousbelief of like, once you're
together, like, That's it, youdon't divorce or if you do,
(30:50):
like, that's bad. So it's like,oh, I messed up before my
marriage, we got married, andnow I'm stuck and it's ruined.
And I'm, you know, in thisunending sense of doom,
basically.
Caitlin Harrison (31:02):
Yeah, this is I gotta pay my penance now,
because, right, I'm being I didthis for myself. Yeah. Yeah.
Kira Yakubov Ploshansky (31:11):
And so I can see this showing up just
in any trauma, right? Like,especially a lot of this over
section with OCD is like theseintrusive thoughts, these
flashbacks, like having thisnegative belief of yourself, the
self fulfilling prophecy, right?
Especially in like, in terms ofinterpersonal relationships,
like, I'm a bad person, I didthis or something bad happened
to me. And now I'm scarred.
Like, I know, a lot of you know,victims of sexual assault might
(31:33):
feel that way that they'redamaged in some way. And so they
may push other people away,having this belief like so
there's so much overlap that Ithink that maybe a lot of people
may not have recognized betweenthe two. And so I'm curious of
how either of you kind of teaseapart when you see somebody
presenting a lot of the symptomsor issues? How it could be
(31:54):
either? Is this PTSD? Is thisOCD? Is this both? Is this the
comorbidity that we're lookingat right now? And helping them
through that?
Dr. Katie Manganello (32:03):
Yeah, it will, it could indeed be both it
could. It also could not, itcould, so you should try to
tease it apart. First, if thatis the case, the difference
is that like, while there arerepetitive behaviors of OCD that
are performed to like prevent animagined threat from occurring,
(32:23):
or from that perceived all ornothing thought from being true
about themselves, that therepetitive behaviors are showing
up with PTSD are done to avoidre experiencing traumatic
memories. So it's more so well,if it's, if it's PTSD, where
it's one specific event, atleast, that's kind of the case.
Even if it's a collection ofmemories, it's those memories or
(32:46):
those specific, like themes thatthey are trying to avoid. That's
how I would explain thedifference. I think there's like
a lot of overlap, though, andespecially in what we are
saying, like, I think inparticular with religious
trauma,some of the specific OCD themes
discussed, like, there's thislevel of uncertainty around
somebody's identity and aroundquestioning their values and in
(33:09):
learning how to trustthemselves. Like I think that
those are some really commonthemes that show up amongst both
of them that you're going tostill be doing some of that
work.
Caitlin Harrison (33:22):
Absolutely. I think you summed it up well, and
I think that they can existtogether, they can exist
separately. And the importantpart is just understanding the
difference so that you canunderstand yourself better, so
that you can understand yourtherapists can understand how to
help you better.
(33:42):
But if you're having thesethemes, they can show up in
many, many different diagnosiscould show up in anxiety and not
OCD, it can show up asdepression, simply like self
esteem issues. So and
Kira Yakubov Ploshansky (33:57):
So how would each of you kind of go
about helping someone who isexperiencing religious trauma?
Or the Scrupulosity or theoverlap of the two what are some
of your approaches that both ofyou kind of go through that
might help the listeners kind ofthink about this if they
resonate with this episode?
Caitlin Harrison (34:14):
Yeah, so like I said, I work a lot with
individuals who are sort ofchanging their belief system or
questioning their belief systemand wondering if they want to
change it.
significant portions of it orthe whole thing entirely. So
like, for example, I'm, I'mquestioning my sexuality, and
(34:36):
I've always kind of suppressedthat part of myself. I didn't
want to confront it because I'vejust been shown that I need to
be straight. And I need to havea nuclear family. I need to want
to have kids you know, all thatthose kinds of things like maybe
my sexuality and my trueexpression of not fitting the
(34:57):
heteronormative moldMaybe I my belief system can
coexist with that. And so I justneed to question a part of my
belief system or hey, I'mactually wondering if there's
even enough evidence to supportme believing this belief system
that I once believed in. And sowhen I approach that kind of
work, it's very slow. And it's alot of grace for yourself. When
(35:22):
we talk about scrupulosity, it'sa lot of slowing down reminding
yourself like, Hey, I know whatvoice This is that's talking.
Whether that you name thatvoice, the OCD Scrupulosity,
maybe you name that, that wasjust my youth pastor that was
(35:45):
making me feel that maybe therereally is somebody that's tied
to that voice or that compulsionor that obsession.
But just starting to recognizeand separate yourself from that
voice, can be really powerful,so that you can notice it as
(36:05):
separate from yourself. ratherthan you being this evil person
that can't manage to live a goodlife, or can't manage to be free
from obsessive thoughts. Ifwe're talking about real event,
OCD, it's kind of where I startsome initial thoughts that came
to mind.
Kira Yakubov Ploshansky (36:25):
Sounds like being really gentle with
themselves and you with them togoing through that.
Dr. Katie Manganello (36:31):
I guess what I would start doing is just
what we already just talkedabout in terms of is this both
is it one or is it the other,and then I would kind of, I
would probably go differentdirections if depending on what
it is. So if it's OCD, I'm goingto be doing exposure and
response prevention treatment,in combination with Acceptance
(36:52):
and Commitment Therapy thatbrings a lot more of that like,
acceptance, gentleness, focus ontheir values, what they want
that kind of thing. If I'm doingit with PTSD, I'm, I always, I
look like a very collaborativetherapist. So I really throw out
what I can offer, and then whatthe person tells me that they
(37:14):
think suits best for them.
That's kind of what we go with.
So if it's if they do want towork on their PTSD, I explained
to them, Hey, I'm trained incognitive processing therapy, I
know how to do prolongedexposure.
This is what each of these looklike, these are evidence based
(37:35):
track, you know, practices thatwe use, which basically just
shows that like, you know,there's been a lot of research
on these treatments, they helppeople.
And I just give them moreinformation around each and then
they can tell me like, Hey, thisis this one seems like a good
fit for me or this one theother, or if they're like, not
even at a place where that'ssomething that they are like
(37:57):
super ready to, like, hit theground running with, I'll just
kind of start out with whateverthey say that they want to work
on and kind of take it fromthere.
Kira Yakubov Ploshansky (38:08):
Can you share a little bit more about
ERP and the cognitive processingfor some of the listeners that
don't know? I know, I keepmaking you explain things and
concise ways.
Dr. Katie Manganello (38:18):
I like it, this could be a whole episode.
So they're, they're bothexposure therapies to an extent.
So cognitive processing, therapyis a treatment for PTSD. A lot
of it is what mostly what we'redoing is we are looking at your
thoughts and beliefs, and howthey relate to the event or
(38:42):
events that have happened, andlooking at how they are not
really helping you in your liferight now. And talking about
like what had happened andrestructuring some of those
beliefswith exposure and response
prevention, that's like the OCDtreatment. That is so the
exposure part and exposure andresponse prevention is targeted
(39:05):
towards the obsessions. So theexposure is we need to expose
people to the fears so that theycan, their brain can actually
habituate to that anxiety andthey can learn to tolerate it,
building that distresstolerance. The response
prevention piece of ERP istargeted towards the compulsions
(39:29):
which is basically eithereliminating the compulsions
altogether or cutting them backwith the goal to really have
them be pretty minimal or gone.
So if you want more informationon that, you can go back and
listen to the other podcastswhen he's talked about that a
lot. I think the biggest thingI'd like to just say in response
to that is I think that all ofthese treatments sound really
(39:51):
scary because they hear the wordexposure and they're like that's
what I'm trying to avoid. I'mI'm doing that. But again, like
we're Working together, it'scollaborative. I'm often doing
exposures with people.
And I'm, I'm never going toforce anybody to do something
that they're unwilling to dolike we will find like little
(40:12):
tiny exposures and thengradually build up like we are
putting our toes in the waterare not just, you know, Cannon
going into that freezing coldice water, we're like, gradually
kind of dipping in. So don't beyou know, it should be
challenging. It should be astress but not a strain.
Kira Yakubov Ploshansky (40:33):
Thank you. I appreciate both of you
sharing that approach and howyou would kind of go about that
game. And I know that you alsodo EMDR. Is this something that
you would do with clients whoare struggling with
scrupulosity?
Caitlin Harrison (40:45):
Yeah, so I without using the technical
terms, what I was talking aboutbefore was internal family
systems. So ifs is sort of thisidea of understanding all the
parts of you that show up andunderstanding why they're there,
what they came to do to help youwith. So what's scrupulosity,
oftentimes it shows up toprotect you from going to hell
(41:09):
for to protect you from beingsocially rejected, to protect
your parent from beingdisappointed in you, things like
that. So it's kind of taking itand putting yourself your true,
like authentic self in charge ofall of these parts of you, but
also appreciating like, Hey, youshowed up for a reason you
(41:31):
showed up to protect me, youshowed up. And you helped me
once upon a time. And now Ithink I want to be in charge.
And so that's a long process.
And it sounds really simple. Andit's not. But that's sort of the
basic theory behind how I wouldoften approach scrupulosity. And
(41:51):
there are times when it's traumarelated that you could use EMDR.
Soif especially with the relevant
or reprocessing, like a specificmemory, or it could be a
negative thought, a negativecognition that you attach to
many different memories that youcould use
(42:15):
EMDR for. So if you noticecompulsions or obsessions that
come up, or memories that comeup often with trauma related
things, then we would use theMDR, if that makes sense.
Kira Yakubov Ploshansky (42:33):
And same thing, if you could share a
little bit I know we talked alot about EMDR in episodes
together, but for the listenersa little bit of like, what that
is and like the like the acronymthat it's for. So they have an
idea, kind of what that means.
Dr. Katie Manganello (42:48):
After this
Caitlin Harrison (42:55):
things, these are things we like talking
about. Yeah. All right. So it'sEye Movement Desensitization and
Reprocessing. So it's amouthful, that's why we just say
EMDR. Um, but basically, it usesthe theory behind bilateral
stimulation. So if you imaginekind of taking your body and
(43:21):
dividing it into two halves,the right side and the left
side, if you stimulate the rightside and the left side, in a
rhythmic motion, it could befast or slow, just depending on
where we're at in the process.
It can help your mind your bodyand your feelings consolidate a
(43:42):
traumatic memory that theycouldn't process that it
couldn't process previously. Andso I think EMDR is a really good
fit for people that haven't hadgood success with talk therapy.
I think it's also a good fit forpeople that are tend to be like
(44:02):
more emotional and creativecreatures. I think it I noticed
that it can tend to be a goodfit for those people who like to
do like visualizations andthings like that. So yeah, it's
it that what that looks like ina session is we do a lot of
skill building at the beginningof treatment. So learning how to
(44:26):
regulate your nervous system,learning how to calm yourself
down. When a traumatic memory isbrought up, or even a stressful
event at work is brought up. Wedo a lot of skill building at
the beginning. It's just likewhat Katie said, we don't just
dive into the deep end and bringup you know, the worst thing
that ever happened to you.
(44:49):
Then we start to reprocess thememories once your whole nervous
system is ready for that and youfeel like you're able to
regulate yourself and you havethose skills that you need.
need in order to do that, onebenefit, I think of EMDR is that
you don't actually have to sayyour memory out loud. Sometimes
(45:10):
that can be powerful for people.
And it's that avoidance thatKatie's talking about,
sometimes, it's actually reallygood for you to be able to say
it out loud and have somebodyelse know what's happening. But
it's kind of cool that in EMDR,you don't have to. And so you
can start slow. And we reprocessthe memories with bilateral
(45:31):
stimulation. So sometimes you'relooking left to right, left to
right, that's the eye movementpiece. But what research has
also found is that any type ofbilateral stimulation works, so
tapping on left knee, rightknee, left knee, right knee, or
your shoulders or even sound inyour left ear, then right your
left ear than right here.
(45:54):
So we kind of do what works forthe client and also the
environment that they're in. Andsome clients have relief in one
session, some clients, it'seight sessions, some clients,
it's many more than that. Butthat's kind of EMDR. In a
nutshell.
Kira Yakubov Ploshansky (46:13):
I appreciate both of you really
sharing that explain, I think hedid a phenomenal job. And I
think this is going to be areally powerful episode for a
lot of people who could bestruggling with this. Or even
folks who know somebody in theirlife they love they could be
struggling with this andunderstanding it a little bit
more and having more empathy. Iwould say before we close out,
is there any, any last bits ofwhether it's like giving hope or
(46:37):
any other thoughts for listenersaround something like this?
Dr. Katie Manganello (46:41):
I think that there is a lot of shame in
some of these, especially whenthere is a real event because
you essentially have to go andtell somebody, something that
you think the worst thing aboutyourself. So I can understand
that this is really, reallydifficult to see help in.
(47:04):
But also like just to know thatyou're probably judging yourself
for it a lot more than anybodyelse would, which is sort of
giving reassurance right now,but I mean, you should you know,
you, I would hope that somebodywould feel comfortable coming
and talking to me about some ofthose things. And just that
(47:26):
having them know that I get howit operates. I know how it
works. And like, we can put thejudgment aside to like, get
through it. So I think that thatis a really important thing with
with PTSD. And with OCD, I thinkthere's often a lot of shame and
guilt tied in.
Caitlin Harrison (47:44):
Yeah, I think just that there is a path ahead,
that doesn't feel sodisorienting. I think that's
what I see a lot with theclients that I see anyway, you
know, that really disorientedfeeling of a foundation I once
had is not here anymore, and I'mkind of grasping for anything
(48:05):
that can make me feelcomfortable again. Um, there is
a path ahead where you don'tfeel so disoriented and so
confused about who you are, whatyou're that like maybe listening
to this and talking about valuesyou're like, that's the last
thing that I want to talk aboutbecause I don't even know when I
think or believe or feel aboutanything anymore.
(48:28):
And so yeah, I think just youcan learn to trust yourself
again, you can learn to bereconnected to all of you know,
your emotions and your mind andyour body and it not feel so
overwhelming.
Kira Yakubov Ploshansky (48:39):
So for listeners, Katie and Caitlin at
this time are both accepting newclients. So if you're interested
in working with either of them,please reach out. You can head
over to our website, heal yourroots. wellness.com Katie, and
Caitlin, thank you so much forbeing on with us again today.
This was
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