Mrs. Beaver’s Concerns
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Monthly Archives: November 2012
all about CBT
Some people have been asking for more details on cognitive-behavioral therapy, the incredible tool that God used to set me free from obsessive-compulsive disorder. It is my pleasure to share with you about CBT! Please note that I am not a mental health professional– but I did have a wildly successful experience with CBT and am a huge advocate.
This is the preferred method of treatment for OCD; specifically, it is called Exposure and Response Prevention (ERP). Long name, but actually, it is exactly what it says! The patient is exposed to something that triggers an obsession and then the response (the compulsion) is prevented. This therapy actually re-wires the brain– the brain physically changes in this therapy– and it helps an OC to live with uncertainty.
CBT either works or doesn’t in 12 weeks. My psychiatrist, national OCD expert Dr. Suck Won Kim, told me beforehand that it would be worthless to meet with a CBT therapist longer than 12 weeks and that Dr. Chris Donahue wouldn’t ask me to meet any longer than those 12 weeks. Three months. You can handle anything for three months, right?
The first couple weeks were most intake. Dr. Donahue asked lots of questions to help assess what my obsessions and compulsions were, and what triggered the obsessions. He was basically probing to find what buttons to push later: “How much would that stress you out if you couldn’t do XYZ after ABC happened?” and that sort of thing. I knew it would all come back to “haunt” me, but I was all in. This honestly felt like my last hope for a normal, happy life.
I took the YBOCS (Yale-Brown Obsessive-Compulsive Scale) test and found out that I was a moderate case, which surprised me. But then again, there are some people who can’t leave their homes, can’t touch a loved one, people who wash their hands with Brillo pads and bleach.
Dr. Donahue outlined the measurable goals of my treatment plan: a fifty-percent reduction in distress when focused on upsetting stimuli and six consecutive weeks of no avoidance or rituals. Three months was starting to sound like a long, long time.
Then Dr. Donahue and I wrote a story together. Well, he started it and it was my homework to finish it. Since my obsessions were primarily focused around hell, we had to do imaginative therapy (since, obviously, there is no way to really, literally expose me to hell). So I wrote this story about an imagined worst day ever (I mean, really bad– I go to hell in it). If you’d like me to share with you the story, I will.
My therapist recorded this story (along with his own additions to it) digitally, and I was sent home with an 18-minute recording from the pit of hell. My job was to listen to it four times a day– two times through, twice a day– every day and record my anxiety levels when prompted. And I needed to do this consistently until my anxiety levels reduced by 50% from what they were the first time through. Oh, and I couldn’t perform my compulsions either to make myself feel better.
It. Was. Awful.
I won’t lie to you, listening to that recording– that exposure– was like torture. It was being triggered left and right and not being allowed to do anything to ease my anxiety. Doesn’t this sound like some type of cruel and unusual punishment? It’s what it felt like, and I honestly wanted to quit at about week 8 or 9 when my anxiety levels weren’t dropping.
I hated it. It made me sick to my stomach, made my heart race, terrified me. I tried to listen to the recording right away in the morning, in order to get half of my required listenings out of the way early in the day, but eventually, I couldn’t do it that way anymore– the weight of beginning my morning in such misery made it hard to get out of bed, and I had to push it all back later in the day just so that I wouldn’t dread waking up.
But something clicked around week 10 or 11. Praise. The. Lord. It clicked, and all of the sudden, I was in the driver’s seat again! I controlled my OCD and not the other way around. One day I was listening to the recording– this device of torture and grief– and I thought, This is so annoying. And then I smiled and thought, Finally.
This, of course, is a brief description of my experience. I could tell you so many more things– about how hard it was, about what other exposures look like for other kinds of OCs, about the tools Dr. Donahue gave me for success. It’s all detailed in my fictionalized account of it, my novel Lights All Around, which you can read here.
It was one of the hardest things I have ever had to do– but not as hard as living for 20 OCD-riddled years without help. I hated to go through CBT, but I loved to have gone through it. It rescued me and those twelve weeks are a defining period of my life. I remember being so angry and upset with my therapist, absolutely despising him and the exposures, and feeling certain that I was going to fail at this, my last shot at freedom. I very nearly quit.
But that moment came right before everything changed.
If OCD is ruining your life, you need to undergo cognitive-behavioral therapy. It will be hard. It will be hell. But it will be worthwhile.
Questions, anyone?
To read a stark account of my life before and after CBT, check out this blog post!
the Great Lion
Image
brought to you by the letter V
I love letters.
AEIOU. I like vowels, but I suppose if they were people, they would be cocky. The jocks or cheerleaders.
What about P? I think P would be a quiet girl who wears glasses and reads lots of books. She would be intimidated by the vowel clique. H would be an overweight boy. F is immature, short, and insecure, telling P and H, “It takes both of you to equal one of me.”
I bet R, S, and T would hang out with the vowels; they are pretty popular letters if you think about it. S’s are vowel groupies.
Y is unsure, a girl in puberty, without a solid identity yet. She fits with the vowels – but only sometimes.
V is the metro boy who wears tight pants and is a mystery. Even the vowels would be secretly jealous of V. V, you must know that you’re distinctive, above the others. Go write your poetry, your song lyrics, a love song for a beautiful girl. Remain a mystery to the others, but share yourself with her.
what it was like
B.C.B.T. (Before Cognitive-Behavioral Therapy):
I was in bondage to obsessive-compulsive disorder for over fifteen years; I was depressed, overwhelmed, scared, sad, and I felt guilty all the time. I was terrified of thoughts and wallowed in grief and terror for over a decade.
Doubt and this lingering wrong feeling were the normal for me; it was only for small periods of time (sometimes even seconds) that I felt peace. I worried about ridiculous things– like that I might cause someone to kill him/herself or that I would sexually abuse a child. I wondered if Jesus was really Satan and if people were really demons, if everyone was pretending to be my friend just so that it would hurt worse when I found out the “truth.” I woke up in the morning and felt sick to my stomach within a few seconds.
I worried about hell, about my soul, about whether or not my prayers could reach God. I wondered if writing fiction was the same as lying and if writing about the hard things in life was displeasing to God.
This niggling feeling of unease was constant– sometimes it was at the back of my mind, lingering there in the background, and sometimes it was at the forefront, screaming at me like a siren that SOMETHING IS WRONG. Peace was fleeting and momentary, and I had to keep asking after it: do you think this is okay? Do you think this was wrong? Do you think I’m going to heaven? Do you think I should worry about this?
I cried a lot. Sometimes I fell asleep with quiet tears, and sometimes I would WEEP and KEEN while my roommates could do nothing to comfort me.
It was a cycle of horror: I would obsess and stress about A Particular Issue for two to three weeks, until I had completely exhausted myself in every way, and then it would fade into the background. But only for awhile. It or another obsession would attack again in a week or so.
I felt alone and scared and not even the gentle hand of a friend on my back could bring relief. I felt deep confidence that I was condemned and doubted everything else. At times, I lost my grip on reality and thought I was really, sincerely losing my mind and would end up in a straightjacket or room with padded walls.
I felt hopeless.
A.C.B.T. (After Cognitive-Behavioral Therapy):
I hated almost every minute of CBT and (at the time) thought my therapist was a BEAST, an unfeeling monster.
But twelve weeks later, I was in charge of my OCD and not the other way around. I knew that I had been a victim and not a monster.
I am living in freedom, I do not suffer from intense intrusive thoughts nor do I feel the need to perform my compulsions to relieve any anxiety, and the quality of my life has improved SO SO SO much. I don’t have to confess everything all the time or seek reassurance from my friends. I don’t doubt the tiny decisions I make each day. I am okay with uncertainty.
And I know it’s not a cover-up! I know that CBT didn’t work like a band-aid, covering up my problems and making me blind to them. It worked like an electrician: it RE-WIRED my brain. Now I can think like a “normal” person.
I still have bad days, just like everyone else. Sometimes I am sad, bored, cranky. I fight with friends and hurt because of it. But it’s all in the normal course of life; I experience these the way that others do. I begin each day at zero instead of at -1000, handicapped so that I have a million miles to make up before I can even deal with things the way others do.
GLORY TO GOD for leading me to CBT, which has UNLOCKED MY PRISON. I am MYSELF now: joyful, creative, secure in my relationship with Christ, and not living behind a mask. My smile is REAL, and I love my life and my God and myself! I give credit to Jesus Christ for such an incredible rescue. Thank You, Lord, for two years of freedom; I am looking forward to an eternity of it.
Would you like to learn more about CBT? I am happy to answer any and all of your questions with complete honesty.
Gala at Death
As I wrote yesterday, sometimes heaven scares me.
Here was an attempt to process my thoughts while in college:
Gala at Death
Consequently, my poems all died—even those unwritten—
when I realized that Revelation promises the annihilation of my pages,
that I will not be archived in Heaven’s library,
my words jacketed in celestial gold.
So now the hollow worth of writing’s result faults me
for delighting in my bookcase of sale-annex idols,
bothered by heavenly boredom—
nothing to read but the Bible for a slow eternity.
The apocalyptic book humbled my hands, but bowing, I knew
I’d wear white to the funeral. There all poems everywhere
then died to me—how easily paper curls and burns.
But literature’s epitaph reads, The Author of Life Wins,
and that graveyard is where writers worship God.
thoughts on heaven
I have heard it credited to Saint Augustine: “Make me chaste — but not yet.”
For a long time, that was my thought about heaven. I wanted to go there someday— but definitely not today.
Heaven scared me, and it still does sometimes. There is so much I don’t understand about it:
* How can something last forever?
* Won’t it get boring?
* If all imperfection is gone, who will I even be?
* Will we have goals?
* Will I still write?
* Will there be any challenges?
* Will I interact with others or only be focused on God?
Even now, thinking about it has made me a little uneasy.
My co-worker believes that heaven will be on earth. I seem to think it will be entirely separate. I know that I will be with Christ, and since He is my true love, I will be happy. But I still get a little scared sometimes. I’m so used to this earth, as messed up and sinful as it is. I know what it is like to desire things and work for them and how to draft and re-draft chapters in a bookstore on the weekends.
I used to be even more scared of heaven– before I read The Last Battle by C.S. Lewis, that culminating seventh and final book of the Narnia series. I won’t tell you what happens in it (my favorite book), but it eases my mind about heaven. It reminds me not of the questions I have but of the JOY I’ll experience being in the presence of my Savior.
Distance
Saturday. “Mail for you,” his dad would say. “On the table.”
“From?”
“Doesn’t say. Minneapolis.”
Interested, he would pick up the small envelope and see his name written in handwriting he knew. It’s been a while since he’s talked with her, so he opens the letter quickly, but he does not tear the envelope. He is a neat man.
He reads her letter and can picture her, sitting in front of him that night at the pub, eyes wide while he talks of Europe and Jesus. She asks great questions. In his memory, her eyes are intense, but he does not know what color they are, and it makes him sad.
The letter is very much her, and she is still praying for him. Not giving up on me. She misses him, wants to see him. I should at least give her a call. But he hasn’t finished processing his thoughts about the Twin Cities and about her, and those eyes of an unnamed color have been in many of his dreams. It is good to be missed.
It’s been a crazy time, but her note is like an anchor—or like a magnet. She makes him feel as if he could tackle life again. She pours spirit back into him; he can feel his confidence stretching against what he feels are his limits. “I’ve missed you,” he thinks. He wants to sit across from her again, hear her stories, regain his energy somehow through their time together, and this time, he will be sure to note the color of her eyes.
joy in sorrow
I grew up hearing that happiness was situational but that joy was not: that joy was this solid rock you stood on, and it never moved, even when everything else around you was crashing down. I was supposed to feel a deep-seated joy, even when I wasn’t happy. I knew this. I tried to make it be true, tried to convince others that it was.
But for much of my life, if you were to strip away all the smiles and masks, I was resting on an uncomfortable bedrock of deep sorrow, bondage, and fear– and oceans below, barely visible, there was a flickering hope. I smiled often– sometimes it was fake, sometimes it was real. There were moments of joy, real instances where it flashed so bright that I couldn’t see the ugliness around me.
It’s different now.
I have what I always wanted while growing up, and it is incredible. Even when I am feeling low, depressed, frustrated with friends or with my writing life, or even deeply saddened, I am grounded like an anchor to JOY. I have a permanent seat inside it, and from that seat, I can experience the whole wide range of other emotions, but I don’t move from the chair.
I believe that anyone who loves Jesus Christ can have this be true. In my early life, the problem was that I was convinced by a lie: I believed that my future was not secure in my Savior. Obsessive-compulsive disorder robbed me of that truth. Cognitive-behavioral therapy restored it.
What is at your core today? Are you standing immovable on joy, or something else? Why is that?
as CBT started to work
On Tuesday, the sky was ominously green as Sophie and I walked through the parking lot and into Target; it a way, it reminded me of the sky the night that Trapper called it quits. Once we were inside, the tornado siren began to blare, muted by the walls of the store.
Stella and AJ Cook were in the produce section, checking for a fresh cantaloupe. “Hey,” I said. “Do you know what’s going on outside?”
“My mom just called,” said Stella. “She said a tornado’s coming through Fridley.”
“Excuse me,” said a red-and-khaki worker to our quad. “We’re asking everyone to move to the back of the store, away from any windows, for the next fifteen minutes. There’s a tornado warning.”
Sophie, Stella, and I looked at each other; AJ looked toward the doors. “I suppose we’d better listen,” he said. And so it was decided.
We left our shopping carts by the fruit and headed for the back of the store, choosing an aisle of rugs and runners. I sat down on the bottom shelf. Sophie sat beside me, and AJ and Stella sat on the shelf opposite us. Target employees were milling back and forth, talking into their walkies like police at the scene of a crime. The atmosphere was dry, ready. “I hope that everyone in the store tonight sings a song together before this is all over,” I said. “It just seems right.” AJ sat with his long legs sprawled into the aisle; Stella, beside him, had her knees pulled up to her chest and her chin resting on them. “This feels like the perfect setting for a movie,” I said. I nodded at AJ and Stella. “You two are the Young Couple in Love. You know, like in Armageddon or Poseidon. The young folks so in love when it’s tested by tragedy.”
AJ laughed and dramatically grabbed Stella and shook her. “You stay with me!” he roared. “I’m not gonna lose you!”
“Exactly,” I said, laughing with the others.
An attractive male Target worker in thick black-rimmed glasses marched resolutely through our aisle, between our two groups. I watched him as he walked to the end of the row and turned right. “Someone should fall in love with a Target employee by the end of the movie,” I said.
“Sophie,” suggested AJ.
I scowled at him. “Thanks a lot, AJ.”
“Or you,” he said, shrugging with upturned palms. “Whoever.”
I sighed and leaned my head back against a black shag rug. “No, it’s okay. I will play the part of the Frustrated Writer. The tragedy will be what shakes my character free of writer’s block, and the whole movie will be narrated by me, by what I write in the book.”
“Oooh, I like this!” said AJ. “I dig!”
“We should probably have a dramatic scene where someone loses a phone call,” said Sophie. “Stella’s mom calls back, and over the phone, she’ll hear her mom be … lifted away.”
“Yeah,” I said. “Then Stella will go berserk, screaming all over the place and trying to run out of the doors, but AJ will hold her back.”
“I’ll have to wrestle with her!” he said. “I’ll have to slap her to get her to focus. It will all be so gripping.” He grinned at Stella while she rolled her eyes.
“We’ll call it The Target Zone,” I suggested. “Target Twister? Bullseye Funnel?”
We continued to create an epic tornado-meets-Target screenplay while the muffled siren blared on. And so we effectively entertained ourselves while danger swirled by outside, passing over our building as if we had blood on the doorposts. The thought crossed my mind that this sort of thing—this Passover of danger—was becoming my new “normal.” After only fifteen or twenty minutes, the sirens stopped, and the Target workers let us get back to shopping. So we returned to our carts by the fruit, said goodbye to Stella and AJ, and eventually left Target.
“No singing, screaming, death, or romance,” I said to Sophie. “All in all, a boring night.” We both laughed, and it sounded like tiny bells ringing in the dark.
JACKIE LEA SOMMERS 
