Monthly Archives: September 2011

bullying my bully

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This post from Pure O Canuck inspired me to post this excerpt from my novel.

There were new magazines on the table beside me but the same display of brochures.  I skipped the
pamphlet about CBT, feeling I knew more about it than I wanted, and chose one labeled “Narrative Therapy.”  I had intended just to skim it, to amuse myself as I waited, but the heading on the inside flap caught my attention.  “The person is not the problem,” it boldly claimed.  “The problem is the problem.”

The brochure shared how narrative therapy assumes that stories shape a person’s identity and has an emphasis on externalizing the problem.  “Name the problem—allow it to have its own identity—so that you can assess and evaluate its presence and ultimately choose your relationship to it.”  I thought briefly about Ellen’s story and the scene she’d written the other night about tricking the wizard into revealing his name.  Name something and steal its power.

On the back of the pamphlet was a photo of a young lady with thin white-blonde hair, and beneath her photograph, there was a quotation: “When I started thinking of my anorexia as separate from myself, the real healing began.  I named my problem Ed (for ‘eating disorder’), and I continually reminded myself that Ed was a liar and started to take back control.”

It all resonated with me.  In fact, it was exactly what I had been doing this last week—employing
Dr. Foster’s strategy, making observations: I am the messenger.  OCD has the message.  We are
not the same.  “The person is not the problem; the problem is the problem.”

“Neely,” said that familiar accent, and I looked up to see Dr. Lee, nodding at me before tearing down the hall like a shot.  I tucked the pamphlet in my purse and made my way, alone, down the hallway to his office.  I knew the next words before he spoke them, and I mouthed them along with him: “Come in.  Close door please.”

            This time he decided to reduce the Prozac, dropping me from thirty milligrams to twenty. 
He typed it into his computer and murmured, “Looking good … looking good …” as he did so.  Dr. Lee swiveled his chair to look at me.  “As we lower your dosages, you’ll have to double your behavioral therapy efforts.  You will do okay though.  This is good.  We reduce medicine side of things.  We are almost there with meds, agreed?”

“Agreed.”

“Almost there,” he said again, looking at me as if my potential were dancing atop my head like a little flame.

 

I noticed the brochure when I searched through my purse for my keys.  I sat in the driver’s seat of
my car, looking at it, re-reading it, thinking about it.  “Name the problem—allow it to have its own
identity—so that you can assess and evaluate its presence and ultimately choose your relationship to it.”  I didn’t know if Dr. Foster would approve, but as I turned the key in the ignition, I imagined my OCD as a little black dot sitting on the passenger’s seat beside me. 

It was the size of a large fist, perfectly round, and it had attitude.  Even sitting in the passenger’s seat, I could feel the way it tried to masquerade as my smarter, oppressive friend.  Its condescending
grin showed it didn’t think much of me, especially in this moment as I left the hospital, the gathering place of the weak.

As I drove, I felt the dot exuding confidence.  It actually annoyed me to the point where I said aloud, “You know what?  You think you’re sooo cool, but you’re a dot.”  Then I realized that I was talking outloud in my car and laughed a little bit.  This couldn’t possibly be what the brochure was talking about, could it? I thought.  Then with only the slightest glance at the passenger’s seat out of the
corner of my eye, I visualized a change in the black dot as I dressed it in baby clothes—a tight little blue onesie and a binky in its mouth.  It was enraged by this turning of the tables.  “Now who looks dumb?” I muttered with a smile on my lips.

what it feels like

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I just had an OCD dream.  Is that even possible?

In it, my mom was talking about Halloween and beseeching me to guard myself against dark powers on that day (my mom is not generally a nut about these kinds of things, but she was very passionate in my dream), and I was telling her that I was protected because I have Christ … when I began to doubt my salvation.  In my dream. 

Weird.  Never have done that before.

And I woke up to those same old feelings of terror that dominated me for so long.

I was reading OCDTalk blog and read a post about what OCD felt like (the link will take you there).  She wrote:

* You have that feeling you get after swerving to avoid a potentially fatal car accident.

* You have that feeling you get when you take your eyes off of your child in a store for one minute, and then he/she is gone.

With the above examples, your physical and mental distress dissipates once the blackboard scratching stops, you avoid the accident, or you’ve located your child. But try to imagine having those feelings of intense anxiety repeatedly, perhaps hundreds of times a day. That is what some sufferers say life with severe OCD feels like.

Those were the two examples that resonated most with me– I wrote a couple things over the past three years trying to describe what OCD felt like.  Here’s a poem that reminds me of how I just woke up from my dream– the feeling that I’m trying to let drain out of me right now as I blog:

TERROR

 I remember in junior high when for Christmas I received
an old-fashioned alarm clock, two bells like golden mushrooms
and the tiny hammer that trilled between them. 
The alarm was like crashing through four levels of reality
in mere seconds, like being doused with water from the Atlantic,
like defibrillator plates on my chest, shocking me into the morning,
like frozen hands slapping my brain.  These days,
it is as though the golden clock of my childhood has taken up residence
inside my chest, where it is continuously ringing, jolting me back to the
Issue at Hand whenever I forget, for a moment, to be scared.

Here’s another line from my book:

I worked myself into hysterics by that evening, an amusement park ride spinning out of control.  Terror licked at my heart and felt permanent: I just knew that nothing would ever be right again. 

And here’s one last one.  I hope it helps you to understand.

It reminded me of my later years of high school, when Charlotte’s and my friend Terri started to go to parties in our classmates’ cornfields, where she would steal cigarettes from boys’ mouths to take her own drag.  Jeremy Mason’s back forty was the preferred party spot for our small class, although from time to time, the melee would move over to Madison Prewett’s pasture pond.  And sometimes, as if they were begging to be stereotyped, the group would convene for indiscretion at the railroad trestle just outside of the Collins Falls city limits.

At the time, I was stuck in my own paradoxical world—worrying that God wasn’t real, and that because I thought so, He would send me to hell—and so had no time for petty crimes like underaged drinking, which would only muddy my already-soiled “record.” 

            The one time I made it out to the trestle was on a Sunday afternoon, the day after a party where half of my class had gotten minors.  Terri had shirked the police but dropped her cell phone while fleeing the scene, so the next day, she asked me and Charlotte to help her look.  Charlotte, who had just gotten both her license and the Voyager, drove us to the scene in a reckless fashion she’d never outgrow.

            The site had an abandoned, makeshift fire pit and empty cans of Coors Light scattered all around like eggs at an Easter hunt.  The fire pit had a few hay bales around it that someone or another had brought out in his pickup truck, and all this was at the base of the western hill.  From the top of that hill, the trestle bridge ran out straight to the eastern bank, at least 120 feet high in the center of
the bridge and about a quarter of a mile from one end to the other.  It looked rickety and ominous, like the oldest rollercoaster at the amusement park.

            “Call my number,” demanded Terri, as we started to climb the western hill.  “I ran this way, trying to get into the trees.” 

            We were nearly at the top when we heard the old Nokia ring.  Terri located it and wiped it off on her jeans.  “Good as new,” she pronounced.

            The three of us turned around and looked down the hill, then across the long stretch of tracks with the support frames branching out beneath them like Tim Burton’s grotesque version of gothic
giraffe legs or the Imperial walkers on planet Hoth.  “Let’s go across it,” said Terri, her eyes shining.

            “Oh gosh,” said Charlotte.  “Really?”

            “I’ve done it before,” said Terri.  “It’s really not that big of a deal.”

            “What if a train comes?” I asked.

            “That’s the point,” said Terri.  “It’s scary because you don’t know if a train could be coming just around the corner.  I mean, it probably won’t, but you don’t know that.  If a train comes, then you
have to run for it.”

            “Okay,” I said, and the words shocked me as they left my mouth.  I felt as if someone had bumped into me and I’d accidentally burped them out. 

            “Really?” asked Terri.

            “Yeah, really?” asked Charlotte.

            Now my stomach was reeling as I looked down the side of the hill we’d come up.  It was a long way down.  I moved over to the tracks and stood in the middle of them, facing the bridge.  It was so far across, and so terribly narrow.  I wondered briefly if we could somehow climb down the support beams if the worst came to the worst.  “Let’s just do it,” I said.  “Let’s get going.  It’s going to be fine.”

            And so we walked across the trestle then, a quarter mile from safety to safety, and the whole time we marched across those wooden slats, none of us spoke but Terri, who said, “Whoa,” in the
middle of the bridge, when she looked over the edge.  She said, “It’s actually worse in daylight,” and then we continued on, a silent march, ears tuned for any shrieking whistle just around the bend.  I felt bent over with tension, as if my shoulders were knotting up the way water boils in a pot.  My stomach felt hollow and greasy. 

            It’s nothing, I told myself.  Nothing is coming.   But it didn’t calm me. My heart beat like a steady roll on a snare.  It was one of the most terrible and memorable experiences of my young life, and my mind was ravaged with images of three bodies lying still in the rushes below.  Every step felt like sheer panic flowing up from my toes to my chest, rattling my heart then moving like a laser beam to my head, where I manufactured nightmares.

            And now, all these years later, this memory was like putting a finger on the pulse of that evening: absolute terror, only this time, there was no safety in sight.  Just the feel of walking on an endless, narrow railroad trestle, listening, straining for the sound of destruction on its way to meet me.

my two cents

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Well, wouldn’t you know it– I wrote up a whole blog entry, and it somehow vanished.  I think I might be due for a new laptop soon.

It’s been so interesting to read the comments on the last post– MLP, keep it up and one of these days you’re going to coax me away from my Prozac and onto a Maximized Living chiropractor’s table!

Let me be honest (and brief, since I’m annoyed that my post disappeared): what do I know about anything?  I don’t consider myself an expert at all.  Meds have been terrible to me and wonderful to me.  Luvox stole my energy for a time.  Salagen gave me a spasm in my back that dropped me to the floor of my apartment.  Paxil made my mind throw up on itself.  Going off of Clomipramine sunk me into a depression.  An allergic reaction to Propranolol almost sent me to meet my Maker.

And  yet the lovely little cocktail I’m on now– Prozac, Effexor, and Risperdal– seems to be going great.  I will say that I believe that the successful completion of cognitive-behavioral therapy, along with a year and a half of successes, has probably done more for me than meds ever will.  (Successes accumulate, you know, tearing away at OCD’s ridiculous pride– I love that it isn’t in charge anymore!)

I thought everyone made such good points!

I will say this one quick thing.  My body reabsorbs serotonin so quickly– is it wrong if I “level the playing field” by taking a pill to slow that down?  I don’t think it’s wrong.  I feel like it is bringing me back to “zero.”  I believe that God can and does use medication to lift sick, broken people in a fallen world out of their deficit and back to square one– in some ways, a “redemption.”  It is, afterall, His business, is it not?

Love to hear your thoughts!

Christians and medication

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First, I’d love for you to read the following by John Piper:

Should Christians use anti-depressants? (by JOHN PIPER … not Jackie!)

It is a gray area. I don’t preach against anti-depressants, though I have mentioned them before and dealt with a good many people who use them.

In the secular world at large there is a huge reaction these days against the overuse and dangers of anti-depressants. The world itself is recognizing that we may be doping up too quick and too superficially.

But still, if you go to a doctor now, very often you’ll be prescribed a medicine for almost any kind of relational, emotional, or behavioral problem that you’re having. That is happening too quickly I think.

I appreciate the concern people have about the use of anti-depressants among Christians. God had something to teach Job—who didn’t have Prozac—through his pain, and he might have something to teach us too.

Therefore, I encourage slowness to use anti-depressants. God may have a way forward for someone before they start altering their mind with physical substances.

However, on the other side, it seems clear to me that the brain is a physical organ with electrical impulses and chemicals, and that mental illness is therefore not merely spiritual. No man could persuade me that all mental derangement is owing to a spiritual cause that has a purely spiritual solution.

There are physical damages that happen in life or that a person is born with that alter the brain’s functionality. The question then becomes whether we should only pray for it to be healed, or whether we might also use medicine to help it.

Just like you take aspirin to get you through a very serious back-ache, you might, for a season, take some kind of medicine that would enable you to get your bearings mentally so that you can then operate without the medicine.

Near our church there is a place called Andrew home and it houses people who are severely mentally disabled. All of them are on heavy medicines to keep them from killing themselves, killing other people, or being totally unable to work.

A few of them worship with us at Bethlehem, and I believe that through their medication they perceive and know God and that God is in fact using them for good. They are seriously mentally ill. I don’t know all of their circumstances, but I couldn’t rule out the option of medicine for them (or for others struggling with certain forms of serious depression) as a means to try and help them get their bearings.

One way medicine can be helpful is if it gets people to a point where they have enough stability to read the Bible. Then, through being able to read the Scriptures, people are able to be refreshed in the Lord and, in time, come off of the medicine. In that case medicine is a means to an end, and that seems perfectly natural to me.

© Desiring God

Well, hey there.  Jackie again. What are your thoughts on this?  I’d love to generate some discussion in the comments.  I want everyone to weigh in.  I’ll share my thoughts in another post very soon!

CBT prep …

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  I looked at the back cover of Freedom for Today’s Obsessive-Compulsive.  Apparently Steve Jewett and James Nash were some big names in the OCD world.  “Open this book,” the back cover read, “and unlock the doors of your mind’s prison.  What lies ahead of you is freedom.”  The goal was appealing, and I liked the confident wording.  Just straight to the point: “What lies ahead of you is freedom.”  Well, okay.

            I opened to a random page and read, If I were to say to you, ‘Don’t think about a red unicorn,’ what would happen next?  Why, immediately, you’d begin to think of a red unicorn!  In fact, I’m sure that’s what’s in your mind’s eye right now as you continue to read this page.  That is what we’re dealing with as we fight OCD.  An obsessive-compulsive experiences an intrusive, unwanted thought, and because it is intrusive, he feels disgusted by it, wants to stop thinking that particular thought.  But just as my telling you, ‘Don’t think about a red unicorn’ results in your immediately doing so, the obsessive-compulsive’s panic and desire to stop thinking the intrusive thought actually drive him to continue thinking about that very thing.”

            Well, that was certainly true enough.  When my worst thoughts arose in my mind and I tried to stamp them out, it was a battle of escalation.  The harder I fought, the harder I needed to fight. 

            “In cognitive-behavioral therapy (CBT),” the book continued, “we encourage the obsessive-compulsive to give in to those intrusive thoughts, to stop fighting them.  Time and time again, CBT experts have found that it is when an obsessive-compulsive stops fighting the intrusive thoughts and actually embraces them that he finds freedom from them.”

            Oh gosh.  I set the book down, my heart beginning to race.  It wasn’t new information to me—Ruth’s brochure had given me the basics of behavior therapy—but the way it was worded gave me a chill.  “Give in to those intrusive thoughts.” 

             “So I’m reading this book for Dr. Foster, right?” I said a couple nights later at Rosie’s Place to Stella before she opened her laptop.  “It’s like reading my own biography.”

            “Yeah?” she asked, taking a sip of something foamy.  “What do you mean?”

            “Well,” I said, “you know how all my ‘issues’ seem so bizarre?  Some of them are not bizarre at all, I mean in the world of OCD.  I’m textbook.  It’s crazy really.” 

            “Like?”  Stella began to sort through the tangled mess of beads she was wearing—black, red, maroon, picasso jasper.  These, in addition to a floral chambray shirt and hiking shorts.

            “Okay,” I said, “so there are all these made-up scenarios, and the book circles back to revisit these same examples.  One of them is a dad who’s sure he’s going to kill his baby girl, so he won’t even hold her.  He gets all these images in his head of suffocating her, stabbing her in her little chest, shaking her, drowning her.”

            “Ew,” she said, still fussing with her beads.

            “Yeah, but these thought make him completely sick,” I explained.  “It’s clear to everyone else, including his wife and therapist, that he would never ever hurt his daughter.  I mean, they’re not freaking out.  He’s the one avoiding alone time with his daughter.

            “And there’s this lady who thinks she might be a lesbian even though she isn’t attracted to women.  Every woman she walks by, she thinks, ‘Am I attracted to her?  Do I want to kiss her?’ then she imagines herself kissing that woman.  She’s just sick over it, but instead of thinking, ‘Oh, I guess not.  That’s not a pleasing image to me,’ she thinks, ‘I must be gay.  Why else would I be thinking so much about kissing women?’  This is called HOCD—homosexual OCD.

“But then get this.  One of the example scenarios is about this girl who has these blasphemous images attack her mind.  She … she pictures herself having sex with Jesus.”  Stella looked bemused, but I continued.  “She doesn’t want to think about that, but there are all these triggers in her normal day—when she sees someone praying, or a cross around someone’s neck, or a kissing scene in a movie or on TV.  And whenever there’s nothing else to think about, that’s where her thoughts go.  She believes that her thoughts are blasphemous, so she believes that she will go to hell.  She thinks about hell all the time.  The book even said that she confessed to her priest, and even he said she was fine, but she couldn’t believe it.  Whenever the image of having sex with Christ came into her head, she said a Hail Mary to alleviate her guilt and drive the image away.  Eventually she had to quit her job because she was too distracted saying her Hail Marys to get work done.”

            Stella’s eyebrows furrowed.  “Gosh, that does sound like you!”  She abandoned the necklaces she’d been working on and clasped her hands together on the table between us, leaning forward as she listened.

            “I know!  I mean, elements are different, for sure, but the basic idea is the same.”

            Stella sighed.  “I used to think that OCD meant that people were super clean.”  She chewed on the inside of her cheek.  I knew what she was thinking, even though she didn’t say it aloud: It’s so much worse than that.

            “Yeah,” I said, agreeing both with what was said and unsaid.  “Even the people who are really clean, or who wash their hands all the time—they’re driven to it.  They think something horrible is going to happen if they don’t do it. It’s so much bigger than just being a neat freak.  It kinda drives me nuts when people with quirks say, ‘I’m a little OCD myself.’”

Stella nodded violently.  “Remember that receptionist job I took at that plastic surgeon’s?  One day this nose-job lady came in, right?  She sat beside a burn survivor, pointed at his dressings, then at her own protective shell covering the bridge of her nose, and said, ‘I know how you feel.  Hang in there.’”

“I don’t believe you,” I said, jaw dropped.  “You’re joking.”

“I’m not,” she said.  “I’ve never been so pissed at a job site before.  I’d take the call center perverts over those rich bastards any day.”  She shook her head in disbelief.  “So … therapy?”

            “Therapy,” I said.  “I guess it’s like a pyramid, and you climb to the top, step by step—if you don’t reach the pinnacle event, CBT probably won’t work.  In the book examples, the dad had to write down all the ways he was going to murder his daughter—graphically!—and then record himself reading it, and he had to listen to it over and over.” 

Stella looked disgusted.

            “The HOCD person had to rate women’s butts and record everything in a notebook, and she had to read a couple LGBT novels.  And the one with religious obsessions had to write a story about having sex with Jesus Christ and then read it over and over again without saying any Hail Mary prayers.”

            Stella made a face but nodded slowly.  “So what will you have to do?”

            I shrugged.  “All I know is that it will be terrible.”

            And for once, I appreciated it when Stella didn’t reassure me.  There was more strength in knowing she agreed.  “I don’t know what to do,” I confessed. 

            “Write about it,” she said.  So I did.


OCD

There he is, that scarlet beast,
black horn like a railway spike.
I check myself against the blood-red giant,
close my eyes, cover my ears,
two-thirds of the famous monkey trio
where I sit cross-legged between cloven hooves.
Do not think of a red unicorn.  Do not do it.
But I can feel his wet, warm breaths like humid whispers
as he lowers his nostrils to my neck, crimson ears at salute
like a maddening accusation.

The Column

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If only I’d read this article back in college …

by Jackie Lea Sommers, guest writer

 

Obsessive-compulsive disorder (OCD) first showed its ugly face in my life at age seven, although I wasn’t diagnosed until fifteen years later.  Fifteen years of being attacked by intrusive, unwanted thoughts—Do I actually love God?  Is God real?  Have I committed the unforgivable sin?  Am I going to hell?—before what I’d always taken as “craziness” had a new, more appropriate name.  Add to that a not-so-fun five-year search for the right medication and three months of cognitive-behavioral therapy (CBT).

But God has set me free from this long-time tyrant.

A 2003 grad of Northwestern, I loved my time at this school—don’t get me wrong—but I was living in an OCD-enforced prison.  This is the article I wish would have appeared in the Column.

Picture this anxiety disorder as cause and effect: you have an unwanted, intrusive, repetitive thought—and then you perform some ritual or action to provide yourself temporary relief.

Common themes of obsessions include worrying that you have harmed or will harm someone (purposely or not), recurrent doubt over your sexual orientation, unwanted blasphemous thoughts, upsetting sexual thoughts,
contamination fears, a need for symmetry or exactness.  Common compulsions include washing and
cleaning, checking, counting, repeating certain prayers or phrases, confessing and seeking reassurance, arranging.

One quick note: I believe that most people have quirks.  Obsessive-compulsive disorder is different in that it causes major distress.  OCD disrupts life.  Interestingly, most people who struggle with OCD are also able to recognize that their obsessions and compulsions are overboard and ridiculous—which doesn’t mean that they can stop themselves from doing them!

As an obsessive-compulsive, I felt guilty all the time, could not stop thinking, and was wildly aware that I worried a lot more than my friends—and over the strangest things too, things that none of my friends would even consider!

Does this sound like you?  There are things you can do.

First, you should talk to someone who understands OCD.  Take advantage of the free assistance offered by our very own Counseling Services!  Have someone name it—I think diagnosis alone is a significant blow to a
mental disorder.

Second, find other people who understand you—swing by the admissions office and commiserate with me a little while or be vocal about your disorder and locate OCD companions who can identify with you.

Third, and some might argue with me on this, have a psychiatrist help you find an appropriate medication.  My daily “brew” is 20mg of Prozac and 75mg of Effexor in the morning, and one teensy little .5mg pill of Risperdal before bed.  This step can be very difficult—as I’ve said, it took me about five years to find the right medication (and that included a whole parade of terrible side effects and one near-fatal allergic reaction).  Was it worth it?  Yes.  I mean that.

Fourth, if your OCD is ruining your life and freedom (as was mine), then consider cognitive-behavioral therapy, a form of psychotherapy where you face your obsessions head-on.  Does it sound terrible?  Oh believe me, it is.  For my CBT, I had to listen to a recording of my therapist telling me I was going to hell.  Four times.  A day.

It was torture, but CBT was ultimately the tool Christ used to set me free from OCD’s reign.  While it is a lifelong disorder, OCD can be maintained (think of diabetes—while one always has it, if he is getting insulin, eating well, exercising, he need not worry about it).  If you’ve been attacked by your own unwanted thoughts and frustrating rituals, this article is for you.  After twenty year of tyranny, OCD no longer masters me.  Those of you currently in bondage can imagine what an incredible, unbelievable freedom I’ve been given.  ALL GLORY TO GOD.  This can be your story too.

Those curious about OCD may be interested in checking out Jackie’s OCD blog: lightsallaround.wordpress.com. 

thought for today

Quote

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A writer — and, I believe, generally all persons — must think that whatever happens to him or her is a resource. All things have been given to us for a purpose, and an artist must feel this more intensely. All that happens to us, including our humiliations, our misfortunes, our embarrassments, all is given to us as raw material, as clay, so that we may shape our art. -Jorge Luis Borges, writer (1899-1986)

Thank You, Lord, for my OCD.  Thank You, Potter, for making this vessel exactly as is.

PANDAS

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The PANDAS that I’m talking about has nothing to do with these guys …

 

 

 

 

 

… and everything to do with childhood strep throat.

PANDAS = Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections

Say what???

PANDAS describes a set of children in whom an ordinary bacterial strep infection can turn into a neuropsychiatric disorder.  The strep seems to cause the body’s immune system to build up antibodies that – who knows why – turn traitor and attack the basal ganglia in the brain.

In other words, a simple case of strep throat gone to hell.

Sometimes a child gets strep throat, and the body gets confused– instead of fighting off the bacteria, it attacks the basal ganglia … which leads to obsessive-compulsive disorder.

The first time I had an intake with a psychiatrist, she asked about my past medical issues.  “Ummm … I broke my elbow twice,” I said, thinking how a broken bone had nothing to do with my head issues.  I reached: “And I’ve had strep throat like a million times.”  I felt a little stupid and way too thorough.  Keep it to related issues, I thought to myself.  Duh.

But my psychiatrist perked up.  “Did you know there’s a strong connection between strep throat and OCD?” the doctor asked me.

Apparently, this is a little controversial, and some doctors aren’t convinced.  But come on– how many cases of strep-followed-by-rapid-onset-of-OCD do you have to see before you raise an eyebrow at the connection?

My doctor– Dr. Suck-Won Kim, the absolutely brilliant OCD expert at the University of Minnesota– believes there is a strong correlation, and I’m in his court.

A scene cut from my book:

“You have heard of PANDAS?” he asked.

            “I have,” I said, although I couldn’t remember at the moment what it stood for.  “It’s when kids get strep throat and then OCD.  Or something like that.”  I realized that I probably sounded stupid, explaining PANDAS to an OCD expert.

            “So many PANDAS studies … it has to be solved because far more OCD cases are strep-linked than people know.”

            “Yes, I had strep a lot as a kid.”

“YOU DID? YOU SEE?!”  Dr. Lee became animated as if a moment ago I’d said no such link between strep and OCD existed but now he was proving me wrong.

“The first time I met with a psychiatrist, she asked about my medical history.  I didn’t have a lot to share, but I happened to throw it out there that I’d had strep throat a lot, and she said it was probably connected.”

“She knew that?” asked Dr. Lee, impressed.  “That is uncommon.  Most doctors have no clue.” 

For more information on PANDAS, feel free to check out

I think I had strep throat nine times as a child.  Can anyone beat that?  Leave a comment!

quote for ya

Quote

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“As we discussed in Chapter 1, the more you fight an obsession, the more frequent and intense it becomes.  This is called a paradoxical effect, something we all experience at times.  For instance, if someone commands you, ‘Do not think of a red elephant,’ you will automatically respond by thinking about a red elephant.”
Edna B. Foa, Ph.D., Stop Obsessing!

CBT intake

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“This will be different from other kinds of therapy, Neely,” said Dr. Foster, as if he could read my mind and there see my image of Ruth.  “You’ll have homework and be expected to go through various exposures when we meet together.”  He picked up the top coaster off a stack of them on the coffee table between us and set his coffee mug on it.  It had had writing on it.  I looked at what was now the top coaster on the stack.  It read, “Uncertainty and mystery are energies of life. R.I. Fitzhenry.”

For the next hour Dr. Foster tuned in carefully for any mention of rituals, anxiety, and triggers.  I knew that he was combing through my words for his options, already working on his plan of attack for how he would prompt anxiety in me like a gun’s trigger, asking over and over, “If you couldn’t do that, would you have a lot of anxiety?” I blathered, but he was only seeking one thing: what would stress me out to the max.

“When I hear words that start with the f sound, I start praying over and over again in my head,” I revealed.  

“How would you feel if you were prevented from repeating the prayer at those times?”

My heart clenched a little in my chest.  My prayer was the key to counteracting the whole chain of ugliness that lead to blasphemy and hell.  “Um, anxious, nervous, crazy.”

“Mmm hmmm.”  Dr. Foster was jotting notes furiously.

“It’s because of hell,” I shared, explaining how curse words and the sound of the letter f  made me think of cursing the Holy Spirit, which I believed to be unforgivable.  “I’m always scared of hell—only sometimes it’s in the background, like elevator music.”

 He continued to write and encouraged me to keep talking.  “When you’re nervous about going to hell, how do you calm yourself down?”

 “I can’t calm myself down,” I admitted.  “But I ask my friends and family what they think.  Even though it doesn’t convince me, I still like to hear them say I’m okay.”

 “Hmm,” said Dr. Foster in recognition.  “Seeking reassurance is another of your compulsions, another thing you do to ease your anxiety.  Pay attention this week—I bet sometimes you do this passively, like mentioning that you’re a bad person.  Watch for it.”

 We continued on this way, Dr. Foster asking the questions and me providing the answers, feeling ridiculous and unhelpful and as if I were maybe wasting Dr. Foster’s time. 

 “Do you have any questions?” he asked as we were wrapping things up.

 “My faith plays a huge role in my OCD,” I said.  “Do you … ”                                  

 “I believe in God, yes,” he interrupted.  The way he spoke made me certain that he did not feel about God the way that I did.  I gulped.

 “Ninety-nine-point-nine percent of people are skeptical going into this,” he told me, his face like a stone.  I wondered if he ever smiled, even at home.

 “Okay, because I am,” I said.  It felt appropriate to tell him this, even though I was intimidated by his seriousness.  “I think I understand how this works,” I said, “but I’m a little confused.  Like, for example, a washer would be prevented from washing, and then they’d realize that nothing bad happened when they didn’t wash—they still lived.  So how will that work for me?”

 “You’re misunderstanding a fundamental part of cognitive-behavioral therapy,” said Dr. Foster, folding his hands across his stomach.  “The point is not to take away the person’s uncertainty.  The point is to make him or her okay with uncertainty.”

Well.  That didn’t sound so good.

He continued, “Just because a washer doesn’t get contaminated after being prevented from washing one time doesn’t mean that the person won’t still fear a deadly disease the next time.  Each time is a new adventure.”  He raised his eyebrows.  “And with you, well, we can’t fast-forward to the end of your life and see whether you’re going to heaven or hell.  CBT will teach you how to live with uncertainty.”  He tapped on the top coaster in the pile.  “Energies of life.”