Slow, Blessed Work

I’m writing as much and as hard and as fast as I can, but it’s still painstaking, slow work.

I can’t help but think of how Annie Dillard described it:

At its best, the sensation of writing is that of any unmerited grace. It is handed to you, but only if you look for it. You search, you break your heart, your back, your brain, and then – and only then – it is handed to you. From the corner of your eye you see motion. Something is moving through the air and headed your way.

This feels like blessed work. Slow slow slow. But I can sense the narrative arc taking form; right now I am climbing with it.

Spare a thought for me.

*Special Opportunity for MN Therapists*

Exciting news! OCD Twin Cities has reserved three spots at the Behavior Therapy Training Institute (BTTI), an in-depth three-day intensive training course in cognitive behavior therapy (CBT). That means we can send three licensed therapists from Minnesota to the November training in Houston (November 3-5).

If you’re a Minnesota therapist who’d like to treat OCD, or who does treat OCD but would like specialized training, and you’re interested in applying for this scholarship, please email Alison Dotson, OCD Twin Cities president, at info@ocdtc.org.

And if you know of a therapist who might be interested, consider passing this along!

P.S. OCD Twin Cities is especially interested in sending therapists from rural areas, where it is harder to find an ERP/CBT specialist. If you’re living in such an area and have a therapist who would like specialized training in ERP/CBT, please please please encourage them to respond to this opportunity.

Minnesota’s Own Tragedy

Minnesota Bridge CollapseIt’s been ten years, but I can still remember the fear that froze my heart in 2007 the night the 35W bridge collapsed in Minneapolis during rush hour.

It was like having Pearl Harbor … or 9-11 … or the apocalypse in my own backyard.

I sat alone on the couch in the house I was then living in with Desiree and two others, watching the news in total shock, trying to call my friends before all the cell phone signals were jammed.

Des was in Mankato that weekend.  I knew she was safe.

Another roommate Linds missed the collapse by maybe an hour or so.

My friend Anna missed it by 10 minutes.

Monica, who is mentoring me at work, missed it by 4 or 5.

I was desperate to get ahold of Megs, who was doing a med school rotation at HCMC and who turned out to be fine.  I couldn’t reach her for hours, hours where I sat crying in the living room, staring and staring and staring at the television screen.  This was the bridge I used almost every day.  This scene of absolute chaos was happening ten minutes from my home.

You never expect the ground to give way beneath you, steel beams snapped like barley sugar and bowed gusset plates that no one had noticed.

bridge3

And did you know that there was current construction on the bridge at that time too?  My first thought when I’d heard of the collapse was how it was rush hour in constructionmeaning there would be so many stopped vehicles on the bridge at that time.  I watched the death toll rise to 13.  There were 145 injured.  A school bus was shoved up against the guardrail near a burning semi.  Pieces of the bridge looked like giant tectonic plates that had shifted right over the Mississippi.

The flag will fly at half-mast in Minnesota today.  Today I am thinking of the 13 who died and their families, of those who were injured and are still suffering physical and emotional pains, of all the first responders and rescue teams and volunteers who dove right into the melee to help.

bridge

Question & Dancer: This & That

question-and-dancerI’m an artist not an expert, one who is learning to embrace questions more than answers.

These are some questions I got last month. Ask yours here.

I have hocd, and I’m a 17 year old girl. I was wondering, is it weird if I still get crushes on guys during this? sometimes I doubt if I even do like them and the feelings feel fake and forced. Other times, no. Since my hocd started I haven’t been able to really like a guy. If I do, my crush goes away quickly. This makes me worried and makes me think that I can never truly like a guy ever again. 

Dear one, not weird at all. HOCD will do whatever it can to confuse you. Please be sure to read about HOCD and ERP at http://www.jackieleasommers.com/OCD.

Hi Jackie! My question concerns telling my significant other about my HOCD. I have already told him a bit about my same sex attraction fears (around 1.5 yrs ago) but at the time, I didn’t realize it was HOCD. Now that I know HOCD is the culprit I am wondering if you have any advice as to how to explain… I am afraid he won’t believe its HOCD and indefinitely doubt my affection for him. 

This is definitely up to you. I think this is the one of the hugest fears for someone with OCD. I did write a letter you can give to your SO to try to explain things better. It’s available here: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

I just want to say, a massive thank you. I´ve been on hell for the past six months, or maybe more. i even thought about killing myself. and i trully did search for so many blogs, but they are mostly about guys so i didnt feel like i found answers. But this is the first site that is from a girl. Made me feel like there is hope. I hope eventually i get to tell you how truly straight i feel i am.

Thank you for your sweet message. I promise you there is hope, and I look forward to hearing from you after you’ve undergone treatment. In the future, if you are feeling suicidal, don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat with them here.

I feel like I have accidently made vows to give up things that i enjoy and i didnt want to give them up. I have OCD, but would the vows be binding? For example: “if i step on a crack, i have to stop doing this activity” but sometimes i feel like i mentally agree to it for a split second after the thought comes in my head. Like its 90% intrusive, but 10% my intentional.

I experienced this intrusive vow-making too, back when I was in high school, and it was a dark, dark time of my life. I don’t think that you are bound to these because it is OCD making the vow, not you. In any case, it is better not to focus on “solving” the vow-making but on treating OCD with exposure therapy. Best wishes!

Another vow question. I just feel so stressed because I really feel like I have to give up my two favorite activities according to the vows. After that I am left with no form of enjoyment. Even when I try ERP,  i feel like i am sinning by breaking promises to God and I dont even enjoy doing the activities anymore because of the anxiety.I feel like there is no hope. What do I do?

I also worried that my ERP might be sinful. I hope this post will help you: https://jackieleasommers.com/2014/08/03/ocd-scrupulosity-is-erp-sinful.

Hi Jackie, I have hocd. What worries me a lot is that I don’t have any attraction to guys (I’m a female). I want to like someone but I feel empty and don’t feel any attraction even though they might be perfect for me. What do you think?

Hello lovely, this is perfectly normal for someone with HOCD, and you can defeat it with exposure (ERP) therapy, which you can read about at http://www.jackieleasommers.com/OCD. There are resources there too in case you can’t afford therapy but would like to do it on your own.

Jackie, I’m a female with hocd. I know it is common for people to lose attraction to the opposite sex during this, but will I ever like another guy again?? It honestly feels like I won’t. 

Oh dear one, yes, I truly believe that you will. ERP therapy can help. You are not alone by any means, and I hope that as you read through the questions in this post, you will see that.

Hello! I believe that I have been suffering from HOCD for the past 8 years (this started when I was only 12, unfortunately). I’ve never been diagnosed or treated. However, my question is: is it normal/common for OCD compulsions to change over time?? 

Yes indeed! As obsessions and compulsions shift, we call this “theme hopping,” and you can read about it here: https://jackieleasommers.com/2014/01/19/theme-hopping.

I’ve been told I have HOCD. I have worried about this  on and off. My first time I was 12 & I remember crying to my parents & I think I said something along the lines “I’m staying straight & then I don’t have to be made fun of” now that scares me because that means I’m afraid of society & that’s what gay people go through. Now I feel like I want to be straight just for society reasons. Please help

It is very common for people with OCD to think back on old memories (even ones that have never bothered them before) and suddenly become fixated on them. Sounds like your experience is very consistent with OCD/HOCD. Have you explored ERP therapy? You can read about it at http://www.jackieleasommers.com/OCD!

Hi, I’m a 16 year old girl who has been suffering with HOCD for roughly 8 months now. I have come to the conclusion that the only way to overcome this is through therapy, but I’m scared to ask for help and recieve it. How do I ask my parents? I feel like if I sit them down to ask them for help, they will assume that I’m coming out or they’ll try to get too much information out of me. Help!

I hope that this will help, my dear: https://jackieleasommers.com/2015/07/29/hocd-a-letter-to-loved-ones.

How can I begin ERP for my HOCD by myself?

Hi friend, you can read about self-directed ERP therapy here: https://jackieleasommers.com/2014/10/05/self-directed-erp-therapy.

Should I open up to family & my boyfriend about my HOCD? It terrifies me to think about telling them about it. Can I deal with it alone?

You can choose to do whatever makes YOU feel most comfortable. Please don’t overthink this (I know that’s a silly think to say to someone with OCD, but I want to give you permission to do what you choose). The links in the answers to the two questions just above yours will be useful (I hope!) in choosing whether it is a better option for you to tell your family and boyfriend or whether to go after ERP therapy alone. Best wishes.

Jackie, I’m scared. I had a dream last night in which I married a female I know. (I’m a female with hocd). It was very detailed, including me being with her in bed. This is the second time this female has appeared in my dreams, I have no idea why. I was unhappy in my dream but I’m lost and terrified that this is a prediction to my future???

I know why: because you have HOCD and have been obsessing about this. It makes sense that it would carry over into your dreams. In this interview with a former HOCD sufferer, she talks about having the same experience: https://jackieleasommers.com/2013/10/20/interview-with-a-former-hocd-sufferer. It is not a prediction of your future, dear. It is natural for our waking concerns to sometimes leak into our dreams.

Can HOCD turn into straight OCD, i´ve spent many times on internet which made it worse. and since truly gay ppl have straight ocd, its now like i kinda have that. To be honest i am about to take sleep pills. Hope there is light

There is light. I promise. Firstly, if you are feeling suicidal, don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 or chat with them here. OCD can twist and morph through the weeks and years, so that is not unusual. It will do what it can to make you miserable until you learn to be comfortable with uncertainty. The best method for doing so is the evidence-based approach of ERP (exposure and response prevention) therapy, which you can learn about at http://www.jackieleasommers.com/OCD.

Where’s the best place to get diagnosed in the Twin Cities? I’m positive I have HOCD but I’ve never been diagnosed with any form of OCD and I’m worried I’m in denial.

Hi friend, here are a couple resources for you:
https://jackieleasommers.com/twin-cities-ocd
https://jackieleasommers.com/2017/07/24/qa-with-an-erp-therapist

If I’m struggling with hocd, do you think I should stay away from psych forums? I’m already getting help for therapy and medicine though. But do you think it’s my way of just reassuring myself? 

Yes, I really do think it is unhealthy for you to be on the psych forums. Part of your ERP should be avoiding compulsions, and I think this way of seeking reassurance is one. I’m so excited for you that you’re doing therapy and meds though! Are you doing ERP and not talk therapy, I hope?

Please read the following: https://jackieleasommers.com/2014/11/16/talk-therapy-vs-erp-therapy.

I have Hocd been going for 4 months.i always got aroused from girl and lez porn,but I did not wanted to do anything with girls.I once thought about kissing a girl and these things are fuelling my hocd.Yesterday I was horny.I decided to watch lesbian porn to check and I got really aroused i tried to think about having sex with a girl and I felt real arousal like i feel with men.Is my hocd or Im bi?

Does it feel intrusive and unwanted? This is part of how we define OCD.

What do you think of group therapy like DBT for OCD? Specifically hocd

I’ll admit that I’m not very familiar with DBT, though I have heard great things about it, especially in regard to treating things like borderline personality disorder. The evidence-based #1 treatment for OCD is exposure and response prevention (ERP) therapy, a type of cognitive-behavioral therapy (CBT).

Have you read, “All the light we cannot see” by Anthony Doerr? “Everything Everything” by Nicola yoon? And “Unbroken” by Laura Hillenbrand? Those are very good reads. Also, what’s your most favorite book of all time? 

I have read the first two, and I own the third book, but I haven’t had a moment to read it yet! My most favorite book of all time? Man, that’s difficult! I am going to go with Saving Francesca and its companion The Piper’s Son by Melina Marchetta. But everything Marchetta writes is magical. I also love The Chronicles of Narnia by C.S. Lewis, The Book Thief by Markus Zusak, The Scorpio Races by Maggie Stiefvater, The Last Unicorn by Peter S. Beagle, Peace Like a River by Leif Enger. (Sorry, it’s just so hard for me to only say one!!)

https://jackieleasommers.com/2014/08/04/read-these-10-novels-and-we-can-be-friends

Jackie I’m scared. I find myself constantly fearful because of my OCD. I have hocd, and I’m always terrified of the “what if..” although I have never questioned my sexuality, I feel as though nothing helps convince me I’m not gay. Some days I’m just depressed. My mind also wanders a lot. I’m not ready for ERP, but what should I do?

If you are not ready for ERP, the next best thing you can do is start to learn more about OCD and ERP. Education matters. It’s an incredible way to fight back. Track down some books and learn. You begin to steal back power this way.

I’m a female junior in high school, and I sometimes feel hopeless if I will ever get a guy. Every where I look people are in relationships. I’ve never had a boyfriend or even a first kiss. I know god always has a plan, but how can I trust him and know I won’t be alone forever?

Hi honey. I’m 35 and single. I completely get it, I promise. In fact, just this last week, I found myself asking my friends this same question, “will I be alone forever?” I guess that is where trust comes into play. We just don’t know, do we? BUT I do believe that when we love and honor God and follow him, he is the one who gives us our desires– in two ways. He gives us the actual desire– and then fulfills it too. I am being inarticulate. Let me try again. I think that God has given me the desire to be in love. I trust that he will also fulfill that God-given desire with a partner.

Is it normal for HOCD to play a part into ur relationship and make u question ur feelings for a person when u know in ur heart that you love/are attracted to them? Where when ur having guilt&questioning yourself about ur sexuality bc of HOCD u feel like maybe ur not in love w ur s/o or that ur not attracted to them when you know you are but ur intrusive thoughts try to make u think otherwise. 

HOCD and ROCD both cause havoc in relationships, yes. The best thing you can do is to treat the OCD itself with exposure therapy. You can do this, if not for yourself then for your relationship.

I have had HOCD it’s only getting worse. im starting to feel like I’m not in control of my mind. Sometimes Ill convince myself I want to be w a girl when really I just think they’re pretty! I feel like I have to accept being gay to get rid of these awful thoughts&everytime I try to I get so mad bc I know that isn’t me. I’ve always wanted to be with a man, never a woman. I’m scared of my own mind. 

Oh dear one, you are not alone. I promise there is help and hope and light. In exposure therapy (ERP), your brain gets rewired in a healthy way, a way that allows room for uncertainty. That might sound terrible, but it is one of the greatest gifts ever: to be able to let thoughts come and go without having to be sure about everything. It’s a new life. It’s freedom. Please read more at http://www.jackieleasommers.com/OCD.

Thanks for all the questions, folks! If you have questions for me about anything (but especially faith, creativity, and mental illness), add yours here.

As I said, I’m an artist not an expert. I will leave you with these, some of my favorite questions in one of my favorite poems, “Questions about Angels.” Click here to hear Billy Collins himself read it. (P.S. It starts with questions, ends with a dancer.

Q&A with an ERP Therapist

Erin VenkerMeet Erin Venker. I know her through the leadership team for OCD Twin Cities. Erin is lovely, thoughtful, and smart– and she has a unique experience of having OCD and being an ERP therapist. I’m so pleased to be interviewing her on my blog today!

Tell us a little about your background in regard to OCD, Erin.

I first had symptoms in 5th grade but I wasn’t officially diagnosed until 7th grade. At that time, my OCD was mostly rituals of “breathing in” and “swallowing on” the letter A so I would get A’s in my classes. I also did a lot of magical thinking, for example, having lucky and unlucky colors. It soon evolved to include repetitive praying and confessing to mom thoughts, worries, and “bad” things I did, or else I believed something bad would happen. I frequently had horrible intrusive thoughts, both sexual and violent. That period of my life is fuzzy; I just remember it was extremely painful. Daily life was exhausting. I thought I was a horrible person and in constant fear that something bad was going to happen to my family.  I was too embarrassed to talk about my intrusive thoughts, so I didn’t realize that was a part of my OCD until years later.

In college and post-college, my OCD evolved into primarily mental symptoms with rumination, trying to“figuring things out” by replaying scenarios over and over in my head, a constant fear of offending people, and reassurance seeking.

What led you to become a therapist? What are your educational credentials?

I didn’t receive the proper treatment for OCD until 14 years after I was diagnosed. It was at the OCD conference in Boston where I learned that exposure and response prevention therapy was the evidence based approach to successfully treat OCD. I also learned there how common taboo intrusive thoughts were, and that was a huge relief. I decided to become a therapist to help raise OCD awareness and expand the availability of treatment.

I received my master’s in counseling psychology at the University of Saint Thomas and have attended several workshops on exposure therapy. I currently work under the supervision of Dr. Vernon Devine who has 46 years experience treating individuals with anxiety disorders while I work toward my license as a professional clinical counselor.

What services do you offer, and what is payment like?

I specialize in OCD, agoraphobia, hoarding, body dysmorphic disorder, social anxiety disorder, phobias, panic disorder, basically all forms anxiety. I use exposure and response prevention therapy and integrate mindfulness and some dialectical behavioral therapy techniques.

Due to the rising costs of health care, insurance benefits have increasingly become more complex. Self pay ensures that the client’s records and diagnoses are entirely confidential documents as I will not have to submit them to insurance or a third party payer. The content of the sessions stays between myself, the client, and Dr. Devine.

Treatment often involves appointments that need to be longer than an hour, multiple sessions a week, at-home sessions, and public exposures. Self pay allows for treatment freedom as well as the time to get to the root of the problems the client is facing. It makes treatment much more effective. Typically treatment lasts no longer than three months before going to an as-needed appointment basis.

What are the benefits of exposure therapy? How does it work?

Exposure therapy works by essentially helping you confront what you fear the most. For example with contamination OCD, I’ll have clients work on touching and interacting with whatever they believe to be contaminated. If a client has a mental obsession fearing that they are attracted to a family member, we will make a script that they are in fact attracted to that family member. Basically whatever they avoid to protect themselves from their fears, we work up to doing that by creating a hierarchy. We start with whatever trigger the client finds the least distressing and expose them to that trigger until their anxiety decreases. We then gradually move up the hierarchy until the client is ready to confront the most difficult exposures.

Can you briefly describe how you guide a patient through ERP, especially what the first couple sessions might look like?

In the first session, I get to know the client, gather some background information, and go over an assessment I have them fill out before the appointment. We go over details about their presenting symptoms and explore their triggers.  We then begin to build a hierarchy of ways to expose the client to the thoughts, images, objects, and situations that they find distressing and provoke obsessions/compulsions. ERP is no walk in the park, but it is an evidence-based approach that has shown to be incredibly effective.

Many of my blog readers are very concerned about being judged by a therapist who doesn’t truly understand OCD. What advice would you give to them?

Know that whatever intrusive thoughts or rituals you have, no matter how embarrassing, weird, or perverted you believe they are, I guarantee they are extremely common in OCD, and thousands of individuals have similar if not the same thoughts and compulsions. Everyone has intrusive thoughts– people with OCD just get them stuck in their head and distressed. Whatever you find most upsetting, OCD will latch onto it and continuously project it in your head like a song stuck on repeat.

Find a therapist who truly understands OCD. It breaks my heart when I hear about individuals who saw a therapist, tell them about sexual or violent intrusive thoughts they are experiencing, and the therapist does not recognize these symptoms as OCD. This can create further isolation, shame, and hinder the therapeutic process.

Erin Venker 2One last question: reassurance is often a compulsion for OCD sufferers. How can a therapist practice compassion without reassurance? What is your approach to this?

I use a lot of humor in treatment. I try to help clients notice when there OCD is sneaking up on them. Depending on the context and the individual, I will push the exact opposite of the reassurance they are seeking.

I have a rule of thumb that in the appropriate moment, I will only reassure once. I know you are not a pedophile, this is the one and only time I reassure you. After that, it’s all about accepting uncertainty. Well, maybe that thought does mean you want to kill someone, let’s make a script of it happening. At the same time, I validate the client that ERP is extremely difficult, and what they are doing is brave and hard work.

Thank you so much to Erin Venker for a great interview! If you are in the Twin Cities and think you could benefit from working with Erin, click here for her contact information. 

On God’s Tongue 

You’re gonna think I’m crazy. 

Maybe I am. 

The image that has been the most comforting to me this difficult week is inspired by Charlotte’s Web. 

Do you remember when Wilbur carried Charlotte’s eggs from the fair back home to Zuckerman’s farm?

This has been my odd comfort: picturing my heart, wrapped in silk, resting on God’s tongue. Safe.

I’ve Long Since Put the Halo Away

haloSociologist Robert Ezra Park said, “It is probably no mere historical accident that the word person, in its first meaning, is a mask. It is rather a recognition of the fact that everyone is always and everywhere, more or less consciously, playing a role.”

In my life, the mask that was my biggest temptation was spiritual superhero. My writing instructor Judy Hougen described it this way in her book Transformed into Fire:

“We’re all haunted by some image of the perfect Christian – the person who is rarely ruffled, full of right answers, and tirelessly ‘there’ for everyone.  Such people glide through life with a two-inch gap between their feet and the ground.  They pray for ten hours a day and can recite the New Testament over coffee.  And, most important, they seem to have no needs, no obvious wounds or weakness.  They’re always cheerful, never touched by depression, loneliness, or other heavy emotions.”

Nope. No way. Not anymore.

It has been in sharing my wounds and revealing my weaknesses that I have been the truest version of me— and in doing so, I welcome others exactly as they are. And even scripture says that it’s in our weaknesses that God’s power is made perfect. So, like the Apostle Paul, I will boast all the more gladly of my weaknesses.

Someone made a joke a couple weeks ago about my halo. I was quick to correct him.

I have set down the halo (which was itself a mask) so that I could take up freedom.

Reviews (Plus: What Should I Read Next?)

flame in the mistFlame in the Mist by Renee Ahdieh | As the self-proclaimed biggest fan of Ahdieh’s The Wrath and the Dawn series, I was so, so, SO excited to read her next series. Flame in the Mist is a re-telling (of sorts) of Mulan: although this book is set in feudal Japan, not in China. Mariko is on her way to be married to one of the princes when her caravan is attacked. She ends up cutting her hair, dressing as a boy, and joining a group of outlaws, a la Robin Hood style.

This book was super interesting and very romantic. One of the things I liked best about it was that it was not immediately apparent to me who Mariko’s love interest would be. Indeed, she and that person had such a unique relationship that was so not stereotypically romantic that it made it all the more hot when they fell for each other. Very excited to see how this story ends. It’s a duology and the second book doesn’t even have a publication date listed yet. (Patience is not my strong suit.)

5 to 15 to 1 by Holly Bodger | This book was so unique! I purchased it after I was on a writers panel with the author, and when I finally had the chance to read it, I tore through it so fast! Set in the future in India, it takes India’s current issues with gender selection and female infanticide and reverses them: now that there are 5 boys to every 1 girl, society is run by women and men must compete to be worthy of marriage. The book is told in alternating chapters: poetry for the young bride watching the “Tests” and prose for Contestant 5, who is competing– but who does not want to win.

I enjoyed the story very much, and it definitely made me think!

art of writingThe Art of Writing and the Gifts of Writers by C.S. Lewis | This was an audiobook collection of Lewis’s shorter essays and talks on writing, and it was super enjoyable! Ralph Cosham/Geoffrey Howard, the narrator, is the familiar voice from the audio versions of Lewis’s Space Trilogy, and so it’s easy to feel like you’re listening to Lewis himself. This was an intriguing and useful set of essays, advice, and criticism on various aspects of writing, including fairie stories, writing for children, and thoughts on his friend J.R.R. Tolkien’s Lord of the Rings. If you’re a fan of Lewis (or any of the Inklings), this will be a fun and fast read for you!

the names they gave usThe Names They Gave Us by Emery Lord | In this book, Lucy– at her mother’s request– agrees to spend the summer as a camp counselor for kids from at-risk backgrounds. This is a deviation from her usual: the Bible camp just across the lake, where her mom and dad will be. What makes it even harder is that Lucy’s mom’s cancer has just come back, which has shattered Lucy’s faith and has her living in fear.

There were so many things that felt SO familiar to me, who was a volunteer camp counselor (at a Bible camp, no less!). I really liked the ending, when ends (that I didn’t even know were loose!) started getting tied up. The ending is also abrupt, but in the best way.

shrillShrill by Lindy West | This book. This. Book. I loved it. So much. It spoke to me on so many levels– as a woman, as a curvy girl, as a feminist, as a writer. I laughed aloud. I cried real tears. I felt empowered.

I went to my therapist on Thursday, and– no joke– spent about 90% of the time talking about this book and how it impacted me, all the things I am learning.

Please. Read this. Then let’s get coffee to discuss.