CBT

“Tell me, Neely.  OCD—do you know about it?”

            Oh wow.  I hadn’t realized that I was going to be quizzed.  “Some,” I said.  “I’ve read a few books, some articles.”

            He nodded his head vigorously.  The sharply combed strands of black hair on his head did not budge.  “Yes,” he said.  “Yes.  Education is critical.  You know how you fight OCD?”

            I wasn’t sure if this was a rhetorical question or not.  I nodded a little, but when I saw that he was waiting for an answer, I said, “With education?”

“With knowledge.  Knowledge is the weapon,” he said, continuing to speak in italics and suddenly launching into war metaphor, “You fight disease—disease fight back.  You have to negotiate carefully.  This is a game of tricking OCD.  Invade without alerting your enemy.  Side-step into enemy territory—your own mind—and take captive a small plot of land, just what you know you can win.  You have to condition your mind to the idea of winning.  Right now, it is used to losing.  What works best is cognitive-behavioral therapy.  You have heard of it?”

The vague sickness I’d been feeling all morning suddenly gathered into a physical reality in the pit of my stomach.  It took only those three seconds to realize that this is what I’d been afraid of.  “Yes,” I said quietly.

“It is the best treatment for OCD that we know of.  Medicine is good, but CBT is better.  There is a man—Jon Foster—you will call him.  He will help you.”  He scrawled the name onto a piece of scrap paper in the messy handwriting of a doctor.  “He is young, but he is good.  You meet with him—I bet he can kill it.”

Dr. Lee met my eye just then, and I could tell he meant what he’d said.  “Kill it?” I managed to squeak out.

“Cognitive-behavioral therapy, very effective,” he said.  “OCD is never cured, but CBT brings it under control.  You will call Jon.”  It was not a question.

“Okay,” I said, taking the piece of paper with Jon Foster scrawled on it. 

I needed to leave.  I needed to process all this.  My indistinct fears now had a name, and I needed to be alone, let my head spin through this like a rolodex.  I started to collect my purse.

            “Listen,” he said, “it will be hell.”  I winced inside and hoped it hadn’t shown on my face.  “Hell,” he repeated.  “CBT is very, very difficult.  You will be asked to do things you cannot imagine doing.  But it is the best treatment.  You have to think like a mother.  A mother would do anything for her child.  You have to do anything asked of you.  But you can do it.  You are Christian.  That is good.  You will need will power and faith to get you through this.”

My heart went into a freefall, and I never felt it land anywhere inside of me.  I swallowed—or tried to.  My throat was suddenly very dry.  “Oh,” I said.  What else was there to say?

OCD101

Hopefully this scene from my novel will give you a better understanding of how OCD works; in it, Neely is attempting to explain OCD to her new friend Gabe.  (By the way, Gabe is just finishing up his chemotherapy– hence the lack of hair.)  Ask your questions in the comments!!  (I would seriously love it if every person who reads this blog asked one question!)

“So, how is Tatum’s Pizza Arcade the best place to tell me about OCD?” he asked while grease from the pizza collected at the corner of his mouth.  He wiped it away.  “I’m … rather curious.”

I’d been planning this for the last week.  “Okay,” I said, “so you get to learn about OCD in three parts tonight.  First, I’m going to tell you about it.  The second and third parts are more experiential.”

“I’m ready to learn.”

“Obsessive-compulsive disorder is basically where you have these intrusive thoughts—they come out of nowhere and assault you—and then to combat them, you perform some kind of compulsion.  Compulsions are more obvious than obsessions—washing your hands til they bleed, checking the oven or the lock on the door over and over and over, being a pack-rat to the furthest extremes, doing weird little rituals.”

“You don’t do any of those things.”

“No.  Well, kind of.  I have my own rituals.  Mine are hard to see because I’m a pure obsessional.”

“So you don’t have compulsions?”  I loved the thoughtful way he chewed his food, the earnest look in those pale blue eyes. 

“No, I do, I do.  They’re just, well, trickier to catch.  They’re mostly in my head or to myself.  Or well masked.”

“I don’t get it,” he said.  “We’re not off to a good start.  And this pizza sucks worse than I remember.”

“Let me start over.  Okay, so an obsessive-compulsive has an intrusive thought—could be anything—maybe ‘I am going to get sick and die.’  So they hate that this thought keeps hounding them, making them feel sick—so they do something about it.”

“Wash their hands,” he supplied.

“Right,” I said.  “You’re getting it.”

“So what about someone who touches the doorknob forty times or something?”

“Same thing.  There’s some intrusive thought—and they’ll perform the ritual to temporarily alleviate the sick feelings from the bad thought.”

“Okay, so how about you?”

“My intrusive thoughts are blasphemous.”

Gabe raised an eyebrow—or what was left of one.  “Liar.”

“They are,” I insisted.  “I think bad thoughts toward the Holy Spirit, and since I’m scared that doing that is unforgivable and that I’m going to hell if I think those things, my head automatically wants to combat those intrusive thoughts.  So I say a prayer, the same one over and over to bat down those thoughts.”

He frowned.  “And there’s no way to just stop them?”

“Gabe,” I said, borrowing from my old friends Jewett and Nash, “do me a favor and don’t think about a red unicorn.  What are you thinking about?”

The corners of his mouth turned up, just slightly.  “A red unicorn,” he admitted.

“Well, stop it,” I said.  “Quit thinking of the red unicorn.  Stop now.  Do not think about that red unicorn.  Stop—”

“Okay, I get it.”

“So … yeah,” I summed up.

“It’s like warfare up there?” he asked.  I nodded. 

After dinner, I said, “I want to show you something.  Come with me.  Bring the tokens.”

We walked to the kiddie arcade.  I looked around.  “What are we looking for?” asked Gabe.

“There it is!”  I pointed to an arcade machine that came up to my hips, with five small holes in the top.  I took Gabe’s hand and pulled him along behind me toward the machine then maneuvered Gabe into place in front of the game.

“Whac-a-Mole?” he asked, doubtful.

“Whac-a-Mole,” I said, inserting a token into the machine.  “Let’s see you go, Reed.”  I slapped him on the back for luck.

He made a big show of it, shaking out his shoulders, squaring his jaw, performing minor stretches.  I laughed when the plastic moles covered in weathered paint began to pop up randomly from the five holes.  Gabe jumped into action, reached for the foam-covered mallet and began to attack the moles, forcing them back into their respective holes as they showed their faces.

Gabe was pretty good—at least, at first.  The game began slowly, with moles creeping leisurely out of their holes.  But in a short time, several moles began to pop up at each time, and Gabe struggled to keep up.  Before long, the moles were out of control, popping up for only a split-second.  Gabe let out a choked, surprised laugh as the game sped up even faster.  He was wielding the mallet like a boy swiping at the air with a toy sword. 

As the machine lit up and the moles retreated, I laughed at Gabe, who looked legitimately surprised to be getting his butt kicked by five plastic mammals.  Three red tickets popped out of the dispenser attached to the arcade machine.  “What’re those for?” he asked, mallet still in his hand, limp at his side.

“The better you are, the more tickets you get.  Then you trade them in for prizes.”

His jaw dropped.  I threw my head back and laughed.  “Three measly tickets?” he said.  “Put in another token.”  He wound up with the mallet as if it were a baseball bat.

Gabe played a few more games, getting better and better, the red tickets spewing out of the machine like an overgrown tongue.  Still the machine overwhelmed him by the end of every round.

He was no idiot.  “So, this is some sort of metaphor for OCD?” he deduced.  “The experiential part of tonight?”

I smiled.  “You got it.  Blasphemous thought—mole rising.  Say my prayer—bash it down.  Blasphemous thought—mole rising.  Say my prayer—bash it down.  Now, Mr. Reed,” I said, lowering my voice, “this time, pretend it’s salvation on the line.  If you mess this game up—misstep somewhere—you go to hell.  Hell being where you are forever separated from the person you love the most.”  I dropped another token into the machine; in the middle of the cries of kids and beeps and clangs of arcade games, I could swear that I heard that token hit its fellows in the collection bin beneath the token slot.

Gabe frowned but played his hardest.  In the end, when the game had once again gone out of control, it ended.  Another string of tickets whirred out of the dispenser, but Gabe only looked at me, and even when I smiled at him, his blue eyes were sad.  “I’m sorry,” he said. 

my OCD heroes

 

 

 

 

 

Jesus Christ*                    Dr. SW Kim           Dr. C. Donahue

*not to be confused with Jim Caviezel 🙂

I was diagnosed with OCD at age 22, approximately 15 years into the struggle.  It took another 4-5 to go through about 11 failed prescription meds, 2 psychiatrists, 1 physician’s assistant, 2 talk therapists (one amazing, one horrendous), and myriad debilitating obsessions before I was connected to Dr. Suck Won Kim, a nationally recognized genius in the realm of OCD medication– and working right at the University of Minnesota!

Dr. Kim speedily got me onto the right medicine (the perfect combination of Prozac, Effexor, and Risperdol) and encouraged me to call Dr. Christopher Donahue, a cognitive-behavioral therapist whose practice was located in Edina.

Cognitive-behavioral therapy is somewhat a paradox.  To me, it was hell and rescue, both at the same time.  CBT is one of the hardest things I’ve ever done but also one of the best.  The premise behind CBT, and more specifically ERP (exposure and response prevention), is to face your obsessions head on and be restricted from performing a compulsion to alleviate the stress.  Can you imagine it?  (To be honest, unless you struggle with OCD, you probably can’t.  But trust me, it’s horrible– in a later post, I’ll detail what my therapy looked like.)

Twelve weeks.  In twelve weeks, CBT works or it doesn’t.

And mine worked.

Think about it.  Fifteen years of torment (including a three-year period where a junior higher cried herself to sleep every night) till it was named.  Five years of running in place.  And then … twelve weeks of hell and freedom.

I am a recruiter for Northwestern College, but sometimes I wish that I could be a fulltime recruiter for cognitive-behavioral therapy, the tool Christ used to set me free.

For those of you out there who are living the impossible life right now, saddled down burdens you cannot bear, terror trilling in your heart from morning till evening, there are steps that you can take.  CBT is the number one way to treat OCD, and while it seems impossible, the alternative is living the impossible every day.

As I wrote this post, I realized that some readers will not even understand the basics of how OCD works– how obsessions and compulsions “complement” one another.  In tomorrow’s post, I’ll try my best to give an OCD101 session!

a memory

Highlight of today: watching several adults (including one senior citizen) ballroom dancing to “Tik Tok” by Ke$ha at the state fair.  Wow.  Just wow. 

Desiree and I spent a few hours working at the great Minnesota get-together this afternoon, manning the Northwestern College booth.  You really get the whole range of folks at the state fair.  My favorite visitor to our booth was a five-year-old girl genius (she could read and write at two!), with whom I discussed the American Girls and Little House on the Prairie books.  Gosh, I hope I have a brilliant baby someday.

A memory came to me while I was sitting in the education building.  Years ago, I wore my “Aslan is on the move” t-shirt (yes, I KNOW it’s nerdy … I can’t help it) to a coffeeshop.  The barista was a gorgeous boy who said, “Nice shirt.”  IT WAS NOT CONDESCENDING OR MEAN IN ANY WAY, and yet, when this hottie commented on it, I realized I was the biggest nerd in the room.  I was wearing a NARNIA shirt, for goodness sakes!  I was worse than a Trekkie.

And afterward I sat down at my table in Caribou with my drink, thinking, “If you are embarrassed to be wearing this shirt, then you are ashamed of it.  And if you’re ashamed of it, then you’re ashamed of Aslan.  And if you’re ashamed of Aslan, then you’re really ashamed of Jesus.”  Of course it became an obsession.  It was just the natural chain of events for about twenty years of my life.

But not anymore.  And tomorrow I am going to post about that.  Stay tuned!

the biggie, continued

I tried to explain my way out of it, any way I could.  Maybe because these curses were just in my head and not outloud they didn’t truly meet the “criteria” for blasphemy of the Spirit.  And then there was always the confusing line in the Mark 3 passage:

28 o“Truly, I say to you, all sins will be forgiven the children of man, and whatever blasphemies they utter, 29 but whoever pblasphemes against the Holy Spirit never has forgiveness, but is guilty of an eternal sin”—30 for they were saying, “He has an unclean spirit.”

For they were saying, “He has an unclean spirit.”  Now, what did that mean?  That it wasn’t really a word spoken against the Spirit that was the condemning act?  That it was, in fact, something else– the attributing of the Holy Spirit’s works to Satan.

Well, that’s like laying out a feast for OCD.  It jumped all over it.  Almost immediately I began to doubt if Jesus was really who He said He was.  I let my mind go so far that I started to wonder if Jesus might really be Satan in disguise. 

Now I was sure I was condemned.  One way or the other, I must have committed the unforgivable sin!  Any way you cut that cake, you’d find hell in the center.

I was devastated, hopeless.  Have you been there?  Are you there now?  Leave a comment.  I want to encourage you– because there IS still hope.  My life has turned around, and in spite of OCD, I am confident that my heart belongs to Christ.

the biggie

I can still remember the day at summer camp when a fellow camper first mentioned the unforgivable sin to me.  It sounded completely foreign, like something a cult-member had made up, nothing like what I’d heard my whole life: Jesus loves you.  Jesus can forgive you for anything.  ANYTHING.

Years later, this unforgivable sin (actually mentioned in Matthew 12 and Mark 3) would become the torment of my life.  Nothing has stolen more joy from me than OCD making me doubt my salvation.

Blasphemy Against the Holy Spirit

22 wThen a demon-oppressed man who was blind and mute was brought to him, and he healed him, so that the man spoke and saw. 23 xAnd all the people were amazed, and said, x“Can this be the Son of David?” 24 But when the Pharisees heard it, they said, y“It is only by Beelzebul, the prince of demons, that this man casts out demons.” 25 zKnowing their thoughts, ahe said to them, “Every kingdom divided against itself is laid waste, and no city or house divided against itself will stand. 26 And if Satan casts out Satan, he is divided against himself. How then will his kingdom stand? 27 And if I cast out demons by Beelzebul, bby whom do cyour sons cast them out? Therefore they will be your judges. 28 But if it is dby the Spirit of God that I cast out demons, then ethe kingdom of God has come upon you. 29 Or fhow can someone enter a strong man’s house and plunder his goods, unless he first binds the strong man? Then indeed ghe may plunder his house. 30 hWhoever is not with me is against me, and whoever does not gather with me scatters. 31 iTherefore I tell you, every sin and blasphemy will be forgiven people, but jthe blasphemy against the Spirit will not be forgiven. 32 And whoever speaks a word kagainst the Son of Man lwill be forgiven, but jwhoever speaks against the Holy Spirit will not be forgiven, either in mthis age or in the age to come.

So of course– my intial thoughts were that cursing the Holy Spirit was unforgivable.  To me, this would clearly be “speaking against the Holy Spirit.”  Immediately, my head began to think of curses toward the Spirit.  I was plagued by this for years actually, so much so that I eventually developed a prayer compulsion to combat it.  If I’d start thinking of a curse in my head, I would instead redirect it to a prayer: “Father God, I love You.”  This happened so frequently that it was liking hearing one track in my head overlaid against the track I heard from the real world.

paranoia

The following scene is from my novel, a conversation between Neely and her therapist as Neely explains the time after college she finally CRACKED.  My story is fiction, but this re-telling is VERY true to life for me.  It was a terrifying time of life.  I remember enjoying only food and fiction at the time, the two things I thought I could trust.  I was even scared of my poor roommates.

It started simple enough: I’d modeled my new shorts in the hall of our post-college apartment.  “What do you think?” I asked Trapper.

“I like them,” she said—but a little off-handedly—as she moved past me and into her own bedroom.

In my room, I examined myself in the full-length mirror, wondering over her tone.  “Do you honestly like them?” I called to her.

“Yes,” she answered from her room.

She’s lying, I thought.  She doesn’t like them.  I frowned into the mirror.  If Trapper was lying about something small like this, what else could she have lied about?  Maybe she didn’t like any of my clothes.  Maybe she didn’t even like me!  I felt suddenly dizzy.

“You ready to go get supper?” she said, appearing in my doorway.

“Oh!  Oh, yeah.  Okay.” 

“You okay?” she asked.

“Yeah.”  Why did she live with me, hang out with me, go to dinner with me if she didn’t like me?  Maybe it was all an act—the whole friendship—and eventually, the truth would come out.  It would hurt worse because I’d believed we were such good friends.  It was a calculated plot to ruin me.

Trapper chattered in the driver’s seat on the way to dinner, but I wasn’t listening.  I was thinking in fast-forward mode, possibilities inciting nausea.  Like a pinprick of light, I wrestled my way to a new “realization”: Trapper McKay was a demon.  Our “friendship” was a ploy that allowed her to deceive me and lead my soul into hell.  I felt sure I was going to vomit. 

She turned the volume up, steering with her right hand while her left raked the air.  “My milkshake brings all the boys to the yard,” Trapper sang, looking over at me and grinning while the breeze from the window whipped strands of red hair across her face.  Meanwhile, I staggered in the knowledge that one of my closest friends was methodically planning my annihilation. 

During dinner, my reeling thoughts crossed another line as I realized that if Trapper was faking, then anyone could beI glanced around the restaurant, realizing a horrendous new truth.  Everyone was a demon.  I was living in a real-life Truman Show, only with more destructive actors, and they with far uglier ambitions.

“Neels,” Trapper said.  “You’re acting really weird.  Whatcha thinkin’ about?”

I couldn’t let her know what I’d uncovered, that I was catching on.  “Not much.  I’m fine,” I peeped.

“You?  Fine?  We should throw a party.”  When I smiled weakly, she said, “Neels, it’s a joke.”

“Yeah,” I said, forcing out laughter.  “Yeah, I know.”  But I spent the next month faking my way through life, shocked at my discovery and desperate to keep it under wraps.

 

“Did it feel silly and serious at the same time?” Ruth asked me.

“Yes!” I said, nodding violently.  “I was ultra-aware that I was being ridiculous, but it just didn’t matter.  My head had gotten stuck in its regular loop, and when that happens, it’s pretty hopeless until it wears me out.  During the workday, I talked with prospective students, joked with my co-workers—but really, I was wondering if they could tell I knew the ‘truth.’”  I made quotation marks with my fingers.  “Sometimes I’d forget—find myself feeling all right—but then I’d remember: these people were demons and trying to trick me into hell.  I retreated from people—even my friends.” 

“This was after college, you said?” asked Ruth.

“Yeah, three or four years ago.”  I was glad Ruth didn’t see me shudder: I didn’t want her to think I was a drama queen.  “My best friend Charlotte—the same girl who was with that first day on the playground?—at the time she was finishing up undergrad in Chicago and applying for med school back here in Minnesota.  She’d call and while she gabbed, I’d think, ‘She’s acting friendly now so that the betrayal will be even more painful.’  Paranoia made me a real loner.”

seven years old

My little sister Kristin (4), baby brother Kevin (1), and me (7) — at least, this is my best guess of our ages at this time.  (Mom?)

My OCD struck at age seven.  I had curse words running through my head as if I were some foul-mouthed sailor, when the truth of the matter was that I was a shy (Yes, really!  Hard to believe now!) girl from a conservative home, who would have never DARED to utter those phrases outloud.

I drew on real life as I detailed this scene about my protagonist Neely in my book:

“On summer vacation, I’d lie on my back outside and picture the sky littered with profanity.  Then I’d erase it with my mind until it was clear again.  This would maybe take ten minutes.  Then I’d pick up my book—all I ever did was read—and immediately, all those words would swarm back.  Seven years old,” I said again, making a face.  “I felt stained.”  I glanced again at her notes, wondering if she’d written down the word stained, if she’d underlined it. 

“I’m sorry, Neely,” said Ruth, narrowing her eyes at me slightly.  They were outlined in dark eyeliner and, although apologetic, they were also at peace, as if nothing in the world could truly surprise her. 

“My brother Joseph was two years old at the time, just a baby.  I’d watch Joseph playing—usually the sandbox—and be so jealous: his mind was so uncluttered!  I mean, he was thinking things like ‘digging is fun’ or ‘I have to go potty’—my head was a garbage dump. 

“At the time, my mom and I thought I was going crazy.  She said she barely got a minute of peace that summer—I was always looking for her and confessing, ‘Bad thoughts!  I’m thinking bad thoughts!’”  I felt sorry for myself, a seven-year-old wracked with guilt. 

I have this image in my head of running to find my mom under the clothesline, smacking my fist against my forehead, and confessing.  My poor mom.

I wish we’d known then.  It would be another fifteen years before my OCD would be named, but I’ve wondered what life would have been like had we caught it back in the summer of 1989.  Drat you, internet, for coming along too late!  Out of curiosity, I googled “my daughter is attacked by bad thoughts”– just to see what would have popped up had Mom had access to the world wide web back then.  Four or five of the links were about OCD.

My heart breaks for the obsessive-compulsive children out there, wild minds racing, hearts terrified, robbed of childhood.

stolen hours

I was pretty sure I’d read it in a Joan Didion essay, although now that I try to track it down, I can’t find it.  Of course.  But I thought that Didion, who suffers from migraines that annihilate her world, had once mentioned that while a normal person notices when he gets a headache, someone with chronic headaches notices when she feels well

It resonated with me.  A normal person notices when life gets chaotic, but an obsessive-compulsive notices when things seem calm

Isn’t that sad and crazy and hard?

Life with OCD is like living on turbulent waters– you take notice when the sea is still.  And then you barely want to breathe for fear you’ll disturb it.

What I am trying (and perhaps failing) to say is a word to those who do not suffer from OCD: I don’t think you can understand what it’s like to be tortured by your own mind for so long that the continuous agony of thinking becomes the new norm.

another blog– really?

Yes, really.  I hope you’ll find a home here.

First post.  It’s a bit stressful really.  There’s a lot of pressure to kick this thing off with a beautiful fanfare.  Instead, I think I’ll tell you a little bit about me and about what this blog will become.

I’m Jackie.  I love Jesus, words, creativity, certain kinds of awkwardness, and teenagers with bad attitudes.  I am the biggest Narnia nerd you’ve ever wanted to avoid, and I love life, including but not limited to the color red, my alma mater Northwestern College, art magazines, cherry wood, Edmund Pevensie, Stargirl, Gilbert Blythe, Peace Like a River, Ron Weasley, summer camp, C.S. Lewis, ministry, babies, summer, chocolate, antiques, sarcasm, audiobooks.

I hate OCD.

But I love my story of OCD because it’s a love story, a rescue.

This blog is so that I can share my own journey with OCD, encouragement for others, scenes from the book I’m writing (which features OCD as the villain), and my general thoughts on life.  I hope you’ll enjoy it!