Category Archives: Uncategorized

September 11, 2026 · 6:00 am

Will AI engagement make your OCD worse?


I’ve played a bit with AI (Gemini and ChatGPT) and had both some fun and useful “conversations.” Among the fun uses, I had it explain some complicated astronomy research to me as if I was in the 5th grade. I can’t tell you if it was accurate, but it sure made sense and only took 20 seconds to produce! A more useful conversation helped me analyze the difference between taking social security at 62 versus 70 and how long I would have to live to make taking it later to be the better deal. It kept me asking questions on all sorts of possible scenarios I might experience in order to help me make a decision (side note: I didn’t make one!).

If you have used AI you have probably noticed a couple of common features in AI responses:

  1. There are no dumb questions. AI chatbots tend to treat your question as a good question worthy of serious attention. “That is a great question, here’s how I would answer it.” “I think you are on the right track with your thinking.” You know, it is nice to hear that your thought is serious, nice, smart, and on the right track. You can be fairly sure the bot won’t shame you.
  2. There will be an invitation at the end to keep the conversation going. “Would you like me to explore xyz to add to your question or research?” Since there is always more to know, the bot is likely to invite you to continue the conversation.

AI and Mental Health

Based on my anecdotal evidence, more people are using AI to ask personal questions about their mental health and relationship challenges. Some are even asking it to be a second opinion to their physicians and counselors. I can imagine the answers they are getting are probably more consistently empathic, validating, and detailed than what they might get from their therapists. Now, I’m not saying the answers will be better, that the connection they have is as good as flesh and blood, but it would be foolish to say that human therapists will always be better. And some of the examples of responses I have seen have been good!

But I have a serious concern when it comes to use of AI to help people with Obsessive Compulsive Disorder. In my opinion, use of AI to answer obsessional questions is likely to make OCD symptoms worse, not better.

Here’s why:

People with OCD tend to struggle with a search for certainty. They experience repeated unwanted intrusive thoughts and fears, often in the form of “what if” questions. What if I have committed the unpardonable sin? What if I hurt my co-worker’s feelings? What if I accidently gave someone else an illness? What if I forgot to turn the stove off? Most humans I know have had some of these “What if” questions but the difference for those with OCD is how incessant and demanding the questions are. Understandably, you would want to resolve such painful questions. To do so you might to give an answer that would provide some certainty on the matter. This is better known as reassurance seeking. If my spouse or friend tells me not to worry, I might feel better momentarily. If I wash my hands again, I feel better for a bit. If I pray more or double check with the person I thought I hurt, I feel a bit better. The problem is…the feeling doesn’t last and the intrusive negative thought returns with a vengance.

Treatment for OCD often include medications like Zoloft but also require a form of Cognitive-Behavioral Therapy where the person no longer tries to dialogue and engage with the intrusive thought. Read here my brief synopsis of what recovery from chronic anxiety looks like.

So why would engaging AI to help resolve OCD make the symptoms worse?

First, it will likely tell you that your question has merit and is important. And certainly it feels that way!

Second, it then tries to give you an answer (reassurance, information, etc). Just what you were looking for.

Finally, it offers you ways to keep exploring and engaging answers to your obsessional questions.

In the end, it is just a faster more persistent tool to try to get certainty, but certainty is not achievable and won’t ever solve our what if fears.

Could AI help if I don’t have a therapist?

Ultimately, I think human to human contact and presence is what we are designed for. Try to find a therapist who has some experience with OCD. Given telehealth options, there will be quality therapists who can support your recovery. However, If you are someone who has tried to use AI to help you manage anxiety and are still hoping AI can help, consider asking a different set of questions, like

  • Can you help me make a list of 20 things I can do to pivot away from intrusive and unwanted thoughts?
  • Can you help me develop a chart to illustrate the progress I’m making to avoid engaging obsessions and compulsions for the next month?
  • Can you find for me high quality books, apps, and websites that might help me better understand and treat my OCD?

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May 13, 2026 · 9:59 am

A Poem for Mother’s Day


In the United States, we observed Mother’s Day a few days ago. For many, this may be a day of celebrating your mother or being celebrated by your offspring. But also for many, this is a day of remembering losses and feeling grief over deceased parents, broken relationships, or the pain of not being a mother. It can be a day of loneliness, especially when you see others celebrating, buying flowers, dining out, or posting beautiful pictures on social media.

Let’s be happy for those who can be happy while making room for our own griefs. And notice that we are not alone in the various losses this life has for us. In your grief that you may have related to your mom (her failings, her passing), don’t lose who you are becoming.

Here’s a few thoughts I wrote down as I was processing the day and observing others.

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February 8, 2026 · 3:16 pm

What transports you to your childhood memories?


As part of my work I frequently hear about the powerful ways that trauma and distress create chronic intrusive sensory experiences in the lives of my clients. Flashbacks, intrusive thoughts, and bodily sensations grab traumatized people and yank them back into the worst moments of their lives. Some of my clients wish they could have something akin to the neuralyzer (think Will Smith/MIB memory wipe). I don’t blame them at all, and yet would we also lose our ability to be transported to memories and experiences we would never want to forget?

The same brain and body mechanisms that bring up our nightmare experiences, also trigger positive flashhbacks. Take a moment and think about some situations that send you to your happy place. Is it the smell of rain on asphalt in the summer? Salt in the air when you get close to the ocean? The smell of baking bread? A particular song? Whatever it is, you may find yourself transported to memories you have not recalled for years. And it isn’t usually just a memory but a whole body re-experiencing moment!

For me, it is the cold of snow and winter that takes me back to my youth in Vermont. In Philadelphia, we have had an extended coldsnap since receiving about a foot of snow two weeks ago that has not yet melted. I’ve lived more of my life in this area where snow and cold like this is rare. So, when we get snow and cold temperatures, they take me back to my childhood. Images such as walking in the moonlight on hard crusted snow without breaking in or leaving a footprint…tunneling through mounded up snow…walking in the woods, sometimes on shoeshoes, and stopping to have a fire to warm up next to while you drink hot chocolate from a thermos…the sound of silence while the snow falls around you.

Today as I walked in the woods of the Wissahickon I could nearly taste the smoky flavor of a toasted Peanut Butter and Honey Sandwich. Because it is so cold, I had the woods to myself and it transported me to walks in the woods behind our church where I was alone with my senses or observing what animals prints crossed my path.

Not all of our childhood memories are happy ones. Some of us struggle to remember any place where we felt safe and secure. For you, maybe it was just when a particular teacher noticed your good work…a time when you were alone and not being harmed…a time when you recall your strength and courage…a book that when you read for the first time changed your entire perception of the world.

What senses help you return to that bit of memory? Often, we don’t choose to recall these experiences, they just happen, as involuntarily as the bad experiences. But it is possible to seek some of our positive memories in a more intentional way. Listen to a song that you remember loving when you were a child. Eat a particular food that was a staple for you that you remember loving (anyone know if RC Cola is available today?). You might not still love that song or food but it can be a way to prompt you to remember experiences that have helped you become the person you are today. Even the harder memories can remind you of what you survived and what has shaped your way of being in the world.

I’ll leave you with a few pictures that remind me of memories of being alive in the snow. But ask yourself:

What senses or present experiences take you back to formative experiences of your childhood?

Today
Feb 1 2025, day of my father’s funeral
by John Monroe, snowshoes from earlier generation of Monroes
1971. neighbor Bernice (Dorothy), brother John, and myself

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December 3, 2025 · 10:00 am

Shepherding in crisis: How leaders can respond with courage and competence to sexual abuse in the church–a podcast link


Recently I was invited to participate on an episode of the ServingLeaders podcast. Check out our conversation. We discuss some of the challenges church leaders face and note some common mis-steps. We also talk about some of the opportunities and healthy responses church leaders make that can promote healing, not just for current victims but also for survivors of other abuses. When the church makes its primary ministry the care of abuse survivors, it is doing exactly what it has been called to do. When church leaders prepare for a crisis, they are much more likely to respond well under pressure.

(Website for ServingLeaders here.)

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October 19, 2025 · 5:50 am

Moral distress? Moral trauma? An important update on definitions and concepts


The folks at Harvard’s Human Flourishing Program, led by Dr. Tyler VanderWeale, have published a paper updating the definitions of moral injury and distress. If you work with people suffering betrayal trauma–especially religious betrayal trauma–you may want to take the time to read their piece and recognize the aspects of moral trauma that may not be well addressed in the classic treatment of PTSD.

What is moral distress and trauma?

Years ago, moral injury was something described primarily in terms of an added impact on veterans of war. The symptoms of moral injury were seen to be in addition to PTSD, defined as an added injury when an individual perceived themselves as having transgressed basic human morals (e.g., a soldier is forced to kill civilians who are being used as shields by enemy fighters). It was commonly understood as the idea that I have done something so terrible that it is unforgiveable (or I have supported leaders who have done something that betrays basic humanity). Key features of moral injury focused on the experience of guilt/shame whereas key features of PTSD centered on horror and terror.

As the concept became better understood, we began to understand it’s existance among civilians as well. Here are some examples:

  • Someone who did something wrong (e.g., distracted driving) and badly wounded or killed another person
  • First responders who have to triage and, in essence, decide who lives and dies (e.g., the impossible decision between two terrible outcomes)
  • Victims of abuse who may have enlisted friends who also became victims of abuse
  • Someone who supported and defended a well-known leader who was later found to be harming others

Understanding moral distress of victims of trauma

This paper expands the idea of moral distress beyond the (perceived) perpetrator to that of the experience of victims of trauma/abuse. Consider the new definition offered by VanderWeale and summarized in a recent newsletter,

In trying to bring these concepts together, we conceived of such moral distress as lying on a “moral trauma spectrum” that included matters of both the severity and the persistence of distress. After months of synthesis of prior work, we defined “moral distress” as “distress that arises because personal experience disrupts or threatens: (a) one’s sense of the goodness of oneself, of others, of institutions, or of what are understood to be higher powers, or (b) one’s beliefs or intuitions about right and wrong, or good and evil.” When that distress became sufficiently persistent it would constitute “moral injury.” For such moral distress or moral injury, it was not only that some moral code was violated, but rather that whatever took place somehow challenged one’s whole understanding of right and wrong, or of good and evil, or of the goodness of oneself, others, institutions, or even the divine. That disruption of one’s moral understanding would then give rise to, sometimes severe, distress. When that distress was persistent and would not go away it would be appropriate to speak of “moral injury.” When the distress was sufficiently severe so as to seriously impair functioning over extended periods of time, it might sometimes even be appropriate to speak of “moral injury” disorder.

(Newsletter from Human Flourishing Program, received via email Sept 17, 2025)

Re-read the bolded text. It is not just that some moral code was violated by myself, but that one’s whole understanding of right/wrong of self, others, institutions or the divine has crumbled. Notice how this distress might be observed in individuals having experienced certain types of traumas:

  • Victim of sexual assault seeks help from justice system but ends up feeling blamed for it
  • Whistleblower in a church who seeks institutional support to stop the abuse by a leader but is then scapegoated for disrupting the ministry
  • Someone who is scammed out of money feels they have irreparably harmed others
  • Child experiencing abuse by a family member and when telling a parent is then told to be quiet no longer believes they have value
  • Person prays for justice and expects to be exonerated but ends up feeling abandoned and forgotten by God

How might this change our treatment of trauma?

The treatment of trauma focuses first on the care of one’s nervous system. Learning to modulate and calm one’s body is essential since the very nature of chronic trauma is an overactivated vigilance system even when the danger has passed. As a person develops capacity to return more quickly to baseline then there may be more of a focus on addressing the narrative and memory of how the traumatic experience changed perceptions of self and the world.

When we make room for the spiritual/moral impacts of both trauma and how communities respond to people who have suffered trauma, we can better address the moral distress experienced. Treatment modalities that only focus on the reduction of nervous system overload may miss addressing the existential and spiritual crises that haunt survivors. This is especially true when (a) faith communities implicitly (or explicitly) discourage expressing doubt about God, or (b) when clinicians ignore spiritual and moral discussions in therapy. Inviting and validating the very deep moral questions of hurting people is essential for their recovery, even when answers are not readily (or ever?) available. Any treatment that ignores moral distress will not be sufficient to the task of recovery. While I am hopeful that some of the recent trauma treatment modalities may speed recovery, I notice that these newer treatments often ignore questions of existence, narrative, and faith and focus almost solely on nervous system function. This may be needed in the first line of care but let us now be more alert to moral distress and injury in those who have survived abuse, assault, and other forms of betrayal trauma.

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August 6, 2025 · 2:01 pm

Have you ever participated in a crisis debriefing session? Informal survey opportunity


Crisis debriefing can take a few different forms and there are several models of crisis or critical incident stress debriefing. These interventions can be helpful to some but for others it can be harmful. Still, they are very popular. I’m participating in the development of a crisis intervention CE program. If you have participated in a crisis debrief session (participated, not led), would you consider completing this informal and anonymous survey? It should take 2-4 minutes to complete. While the results won’t be empirical, they may give us a better picture of common experiences.

I’ll post a link to the results when we have them.

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July 13, 2025 · 3:01 pm

On lymphedema, lament, and looking for beauty amongst these cracked vessels


Can you lament losses AND look for (create) beauty at the same time? Even more pointed, can you lament your own cracks and yet take joy in your current form of being? If not, what might be getting in the way?

I have lymphedema. It is a new diagnosis and one that appears to be something I will live with for the rest of my life. For those unfamiliar with this problem, it is a pooling of lymph fluid in a body part, often a limb, that causes swelling, changes in skin, reduction in mobility, and if untreated, infection. My lymphedema is likely due to successful treatment of a previous cancer. I’m cancer free but now I have this ongoing problem. It is new to me and so far isn’t nearly as difficult as some people’s experience. And yet, it is still life and mindset altering.

What about you? Do you have a change in life or health that now has you “living with” rather than resolving or fixing and “getting back to normal?” Do you have a daily reminder that life is not the way it is supposed to be? For those that do there is a heaviness and an otherness that is experienced. Every decision is now a labor, it must be thought through. If you have this experience, you also recognize that not everyone has this burden–hence feeling cracked and broken compared to those around you.

In some ways, my current treatment has me most discouraged. Treatments (management really) involve tight wrapping of my leg such that it is impossible to wear a shoe. Showering…well that is also next to impossible (apologies to those around me over this next month). There are some possible “fixes” out there that I hold out hope for but this is TBD for me. Currently, I’m on the “live as best you can with it” track. This is an additional form of suffering with chronic illness. Do you hope for change or do you accept management is your new calling in life?

We lament as a way of life

When something is broken, it is a gift to be able to acknowledge the loss. Silencing lament for what has been lost is about as helpful as ignoring cancer. You may be able to ignore it for awhile but it will catch up to you. Sadly, the people closest to us may silence us because either they cannot acknowledge losses or they believe that we’ve had enough time to lament and should now move on in order not to develop a victim mentality.

One summer when I was about 16 I broke my wrist. The cast on my arm made it difficult to enjoy such summer activities as swimming. Though I missed out on swimming, there was always the knowledge that my cast would come off and I could once again function as normal again. What do you do when you know a fix or a repair isn’t going to happen? Maybe you are wheelchair bound and know you cannot ride a bike. Maybe your PTSD means you won’t be able to be in crowds again, even for things like a concert or fireworks display. Maybe you have been betrayed by someone who will never acknowledge or make restitution. What do you do? You lament. You bring your tears and complaints to God and to those around you who are willing to hold and grieve your losses with you. There is no time-limit for this kind of grief. From a Judeo-Christian perspective, your lament is an act of communion with God, always invited, never rejected.1

And we continue to live and look for beauty

A lovely friend of mine gifted me Makota Fujimora’s Art and Faith: A Theology of Making (2020, Yale University Press). I have not finished it but his chapter on Kintsugi–the art of repairing broken teaware with gold–is full of reminders of brokenness AND beauty. He makes many points but here I want to highlight two key points:

  • “Kintsugi does not just ‘fix’ or repair a broken vessel; rather the technique makes the broken pottery even more beautiful than the orginal, as the Kintsugi master will take the broken work and create a restored piece that makes the broken parts even more visually sophisticated.” (pp 44-45)

This reminds me that beauty is not just in the original design but also in what has been made out of the fragments of life. If I only accept my body the way it was originally made then it will be hard to find beauty in what it can do now in my sixth decade. If you only want a body not changed by trauma, then it will be hard to find value in your body that is deeply perceptive of danger. Notice how we must accept losses (still lamenting!) in order to find new forms of beauty we had not yet imagined.

  • “The ultimate act of a Kintsugi master is not to even attempt to fix the broken vessel, but to behold its potential, to admire its beauty….What kind of church would we become if we simply allowed broken people to gather and did not try to ‘fix’ them but simply to love and behold them, contemplating the shapes that broken pieces can inspire?” (p 50)

Too often we are wanting to fix others instead of creating space for them to be and to discover who they are becoming. Fixing, Fujimora says, is not always a bad thing. You want your mechanic to fix your car. I WANT a fix to my lymphedema. You would be a bit crazy not to want a fix of your health challenge. But the search for a fix sometimes sends a message that what is broken is shameful or something to be hidden. The irony in the church is that it is founded on the theology of scars–the scars of One broken for the healing of the world. Might we find the beauty of these scars that we carry around in our bodies even as we hope for healing and for transformation?

For me, today, I take pleasure that I figured out how to go biking with one shoe and one slide. I felt the air move around me as I rode through the tall shade trees in a nearby park. I sped around corners and marveled at the cacophany of birds singing in the branches and the silent deer peaking between the leaves at this biker with a funny wrap and mis-matched shoes. It might not be on anyone’s list of beauty but for me, it was glorious creation.

How do you hold pain and beauty without minimizing one for the other?

1. Want help writing your own lament? Check out this free resource I and others helped create.

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January 18, 2025 · 7:41 pm

Abusers and true repentance?


Some years ago, I wrote a very short essay about signs of true repentance in those who have abused. Today, we had a conference about church care for women who have been abused. My colleague, Jon Sovocool of Serving Leaders, referenced that essay. So, for ease of those attendees who might like to read it, here it is. (link fixed)

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November 13, 2024 · 9:01 pm

Helping children after disaster: A webinar


Over my many years of trauma care training, I can say that the most frequent question I get is something like, “do you have anything about caring for kids after (or during) traumatic events and disasters. And usually, the answer is there isn’t much. So, in light of that, if you are interested in knowing more about helping kids in a state of crisis and after a disaster, check out this webinar by my colleagues Stacey Sutherland and Misty Bodkins. Free with a suggested donation. When? Nov 21, 7-8:30 EST.

This is the abstract of what they intend to present:

Join us for an engaging online workshop for parents, educators, and those who work with families as we provide training in the basics of crisis intervention for children and teens. Topics to be covered: What is Trauma? How does it uniquely impact children? Trauma-sensitive care principles and practices to effectively support children Collaborative opportunities for parents, educators, and others. Self -care for the caregiver. Who Should Attend: Teachers/Educators Administrators Social workers Parents Anyone who cares for children or works in children support services Faith and community leaders who work with children ministry.

https://crisiscareinternational.networkforgood.com/events/79027-helping-children-after-disaster

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October 26, 2024 · 10:06 am

Can you help the church become a safer place for women who experience abuse? Join us in January 2025 for a one day conference


On January 18, 2025 I and a great list of speakers will address this question. The answer, of course, is YES. Come join us. Register by either this link or the QR code in the image. We will identify some of the common problems and give practical tools to improve the care the church can provide. Sometimes we leave conferences with more questions than answers. It is our goal that you will leave with ideas you can implement that will improve the care of vulnerable people in your congregation. While everyone is invited, we are focusing on the kinds of care church leaders–lay or professional–can provide. So, if you are a small group leader, a lay counselor, a pastor, a Sunday School teacher, this is for you. It will not be livestreamed so if you want to hear what we have to say, come to Willow Grove, PA!

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