No Shortcuts

When Jeff Bell, spokesperson for the International OCD Foundation, spoke for our OCD Twin Cities event, one of the things he said that really stood out to me was that there are no shortcuts in treating OCD.

Woman and maze

That’s true, or at least it was in my case. I wanted easy answers: for deep theological conversations to solve my problems, or for comfort and reassurance from friends to be enough, for an hour-long conversation with a therapist each week to take away the anxiety, for an easy prescription to fix everything.

I definitely did not want the hard answer: exposure and response prevention therapy.

My psychiatrist didn’t mince words in his description: “It will be hell.”

It was one of the hardest things I’ve ever had to do in my life, but one of the most necessary and most rewarding. For me, there was no shortcut to healing, and since I was already living in OCD hell, the best way out was to keep going.

So, believe me, friends: I get it. ERP therapy is hard, so hard. You might think you won’t survive it. You might think your loved ones won’t survive your going through it. You might think it’s sinful or disgusting, and your exposures are probably going to be loathsome and repellent to you.

If you need to, go ahead and look for shortcuts. I know I had to.

But in the end, there were none for me, and I’d only wasted time looking for them.

While experiencing it, ERP was hell. But on the other side? It was my rescue.

 

The Long Journey … to the Starting Line

"Cross That Line" by xLadyDaisyx on deviantArt

“Cross That Line” by xLadyDaisyx on deviantArt

It is SO HARD for OCD sufferers to be correctly diagnosed and then find the right treatment and a good cognitive-behavioral therapist.  In fact, it takes an average of 14-17 years for someone to access effective treatment.

That stat stings my heart.  I feel it deeply because of my own personal struggle.

I developed a sudden onset of OCD at the age of 7.  I wasn’t diagnosed with OCD until I was 22.  I started ERP (exposure and response prevention) therapy at 27.  That’s twenty years, folks– fifteen just till diagnosis alone.

Growing up, I just assumed that I “thought too much”– was an “overthinker” and especially sensitive to issues of morality. I didn’t understand that other people were also undergoing the same doubts as I was but were able to move past them with ease.  I, on the other hand, would get trapped.  The exit door to my brain was stuck shut, so all my thoughts just milled and churned and generated intense anxiety.  I didn’t know that others even had the same thoughts as I did, nor did I realize how it would be possible to let such thoughts come and go.

In childhood, I cried all the time.  In fact, I cried every single night for three years in a row.  I never told my parents about this.  I was so scared that they wouldn’t be able to “fix” me that I preferred to just rest in my own sadness, still clinging to the hope that *someday* I could be fixed.  As long as no one told me it was impossible, it still felt possible, and even thought I was terrifically sad, I kept that hope as my lifeline.

High school was a beast.  I got straight A’s (OCD drove me to perfectionism) and graduated at the top of my class.  I was a class clown, and I had some amazing friends.  But I battled intense spiritual doubts and lived in great fear.  My tenth grade year was one of the hardest of my whole life.  Only those closest to me knew it.

My doubts intensified in college.  They escalated to a whole new level.  Thankfully, I had a solid support system in my new friends (people who remain my support system to this day!).  And though they couldn’t understand what I was going through, they loved me.

After undergrad, things fell apart.  In a nutshell, I lost my grip on reality– my doubts had grown so large and out of control that I no longer knew if I could trust my friends or my own human experience.  Finally, for the first time in my lifesomeone used the words mental illness with me.  It felt shocking.

I was encouraged to meet with a therapist (unfortunately, a talk therapist– not effective for OCD), who also got me in to meet with a psychiatrist, and I was finally diagnosed with obsessive-compulsive disorder.  A diagnosis fifteen years in the making.

I spent about a year with that first talk therapist, and it was more damaging than anything else.  I finally “escaped” and never again set foot in that clinic.  Meanwhile, I was an SSRI lab rat, trying out a slew of various medications to treat my OCD.  I eventually went back to talk therapy– this time to a much better therapist, who was a true blessing, although she still didn’t truly understand OCD, and so my therapy included a lot of reassurances.  In other words, this kind, amazing woman who loved me was just reinforcing my compulsions.  Not good.  I also took a break from trying out medications after one stole all my energy and made me rapidly gain weight.  I was overweight for the first time in my life– all due to a medication– and have struggled with my weight ever since.

Five years after that initial diagnosis, my psychiatrist was out of ideas.  Literally.  She asked me what I thought we should do next.  I, of course, had no clue.  She referred me to an OCD specialist.

This incredible man– Dr. Suck Won Kim– changed my life.  He got me onto the right medication (almost immediately) and essentially required that I begin ERP, even giving me the name and contact information for the therapist who would ultimately allow me to bottle up my OCD and put a stopper in it.  Dr. Chris Donahue, to whom I’m forever indebted.

Twelve weeks was all it took.  In one sense.  In another, it took twenty years.

My life was a mix of depression, anxiety, compulsions, “bad” thoughts, and wrongness, and then twelve weeks later, I felt the burden of OCD lift from my shoulders.  I was giddy with freedom.  Five years later, I still am.

I hear from OCD sufferers every week who are in their 50’s, 60’s, or even older, who are still seeking appropriate treatment.  This absolutely breaks my heart.

On the flip side, I’ve had the incredible experience of meeting Maddie, 11, and her incredible parents, who leapt into action almost immediately and got her into ERP within months of her OCD onset.  In the same year, she developed OCD, was diagnosed, and was treated.  Marvelous!

That’s one of the reasons I blog about OCD.  To help people to understand earlier what they are dealing with and to encourage them to seek appropriate treatment (ERP, with or without medication).  It still just boggles my mind that in 2013, mental health practitioners still don’t know that ERP is the answer.  People get passed around from talk therapist to talk therapist, when the solution should be so ready, so available.

Resisting Treatment for a Mental Illness

Consistently, I …
* talk to people with mental illness who resist beginning treatment.
* hear from those who’ve gone through treatment who wish they’d sought help sooner.

I get frustrated with the first group, but then I remind myself that I used to be a long-time, card-carrying member.  My college mentor encouraged me time and time again to just meet with a therapist at my school’s free counseling services center, and I balked and balked and balked.

I wish I hadn’t.

Today, I want to address four of the excuses I hear most often for avoiding treatment along with my best argument against them.

Too much money.
First of all, if you had a life-threatening disease, I can almost guarantee you that you’d find the means to get treatment.  Mental illness are often life-threatening– not always in the sense of imminent death, but they reduce the quality of your life and deserve your reaction to their severity.  There are prescription assistance programs, such as Partnership for Prescription Assistance or Walmart’s $4 prescriptions.  More and more, I am seeing churches starting free or pay-what-you-can counseling sessions with highly-trained lay therapists.  Obsessive-compulsives are able to do self-guided exposure and response prevention therapy from their own homes with helpful and inexpensive books like Stop Obsessing! or Freedom from Obsessive-Compulsive Disorder.

Too much fear.
I can absolutely relate to this.  Some fear vocalizing their anxieties; some fear they will do so and be told there is no hope (in which case, it feels less scary to stay silent and hold onto the tiny thread that there may be a rescue coming).  Some fear the treatment itself (I can very much understand this, as ERP, the preferred treatment for OCD, is a particularly challenging therapy that exposes obsessive-compulsives to their greatest fears).

Therapy for OCD was one of the scariest things I have ever had to do in my life.  It was awful– but not as awful as daily life with OCD with no end in sight.  Short of a miracle, your mental illness will probably not just go away on its own.  Now is the time to declare war.

Too much pride.
A blog reader told me the other day that he was disconnected from reality, could hardly talk to his wife, and felt like the loneliest person on the planet– though too proud to see a therapist and admit there is something wrong.

This is so hard for me to understand– even though this used to be me!  To me, it’s the equivalent of breaking your arm and then being too proud to get it set in a cast.  What are you too proud of?  That you are invincible?  No one is, and you are fooling yourself if you think you are.  Ignoring a real problem is nothing to be proud of.  It’s like when you realize you took a wrong turn and are headed the wrong way.  It makes far more sense to turn around than to continue on in the same wrong direction.

Too much doubt.
I have a friend whose life is crumbling right now, yet he refuses to get help because he doesn’t think therapy works.  I want to shake him a little and say, “Look around you– what you are doing right now doesn’t work!”  I know how easy it is to get trapped by indecision and by the feeling that no direction is a good one (that’s why I took one year off from my medication search), but in the end, you’re probably going to have to take some sort of step toward healing.  Even if you take teensy-tiny baby-steps, that’s okay.  Find a trusted friend and work out the best baby-step possible.

I know it is an expensive, scary, humbling, and doubtful enterprise– but please, please keep reaching out for help.

choice

A Detailed Post about ERP

ERPI have written many times about Exposure and Response Prevention therapy, and lately, many people have been contacting me for more details about it, especially how they can do ERP on their own from home.

GIANT DISCLAIMER:
I AM NOT A THERAPIST.  NOT EVEN CLOSE.  

I am an obsessive-compulsive 31-year-old female who successfully underwent a twelve-week ERP experience four and a half years ago.  I say “successfully” because at the end of the twelve weeks, I then spent the next year and a half without obsessions or compulsions.  (Can you even imagine?  It sounds like a different life, right?  It was.)  In the three years after that, I have only had a handful of obsessive bouts (probably fewer than five), which I have been able to manage well with my ERP tools and which didn’t last longer than one day.  You can gauge for yourself if that sounds like success to you.  For me, it has been like happy freedom after spending twenty years in slavery to OCD.

With all of that said, I’m going to give my very best advice in this post.

SKIP TALK THERAPY AND PURSUE EXPOSURE AND RESPONSE PREVENTION THERAPY.  Talk therapy (where you spend an hour with a therapist discussing your problems) can actually, in some cases, perpetuate your OCD, especially if your compulsions include confession and seeking reassurance.  Your talk therapy sessions will essentially become one-hour opportunities for you to confess to your therapist and seek reassurance from him or her.  That is the opposite of what you want to do.

FIND A COGNITIVE-BEHAVIORAL THERAPIST WHO IS SKILLED IN ERP.
Begin by asking him or her questions about the techniques they use to treat OCD.  If the therapist doesn’t mention cognitive-behavioral therapy or exposure and response prevention therapy, keep looking.  You don’t want to waste your time spinning your wheels with someone who doesn’t know how to do exposure therapy.

WHAT WILL USUALLY HAPPEN IN ERP:
Your therapist will begin by asking lots of questions to get a real understanding of your OCD.  Remember, there are several different kinds of OCD, and in order for your therapist to really mold your treatment plan around you as an individual, he is going to need to ask for lots of details.  If it seems like he is zoned in on what will cause you the most anxiety, you’re probably right.  In ERP, your therapist is looking to trigger your anxiety and then prevent you from doing anything to alleviate that anxiety.  (Good times!)

You will probably create a fear hierarchy, a list of various things that would cause you intense anxiety.  Then you’ll probably start with the least scary item and work your way up to the top.  The top item on your fear hierarchy will probably seem IMPOSSIBLE.  Continue anyway.  By the time you actually get to that item, ERP may have already re-wired your brain enough to be able to handle it.  I need to repeat: focus on the item you’re at, even though the temptation is to stress about the next, scarier item.  Your therapist is not going to force you to do anything, and it’s going to be a better experience for you if you simply focus on each individual day and what you have to do that day.

Your exposures will be specific to you, though, in general, if you have contamination fears, you will probably have to interact with things that you deem unclean (in fact, probably with things that really are!).  If your OCD is more concerned with order, you may be asked to sit with things out of place.  If you have HOCD, you may be asked to read LGBT literature or to look at scantily-clad members of your same gender.  If you have harm thoughts or other anxieties that you’re not able to actually expose yourself to, you’ll likely need to do imaginal exposures, which may involve writing graphic stories and then reading them or possibly recording the story and listening to it on repeat.

If you’re doing this on your own (and are not guided by a therapist), I recommend doing the recording.  It was more anxiety-inducing for me to listen to a recording than it was for me to quickly read over the story I had written.  Make the story bad– the worst things you can imagine.  And perhaps opt to use lots of details: instead of just using large, blanket statements like “I am thinking a blasphemous thought, and I will go to hell for it,” try “I think of cursing God, and I know I will go to hell, where I will be lost and alone forever.”  Describe it.

The first time you do your exposure, keep track of your anxiety level, 0-100, where 0 is no anxiety at all and 100 meant you were clawing at the ceiling.  Then, every time you do your exposure, rate your anxiety level at the beginning, middle, and end of it.  Keep doing that exposure until your anxiety level is half of what it was when you first started.  Then, you can probably move on to a higher, scarier exposure on your fear hierarchy.

If your exposure (when you start it) is not causing you much anxiety, then chances are you have something a little off.  You’ll need to talk to your therapist or think through your exposure to see if you’re hitting the nail exactly on its head.  (I read a story once where the OC thought her obsession was one thing, say, worrying that she would hurt her child, but the exposures weren’t causing intense anxiety, so she and her therapist took a closer look at it, and together they realized that her actual, larger fear was that she would never know if she would hurt her child … similar but a little different, enough that they changed her exposure to fit better.)  If you have been doing your exposure for a while and the anxiety levels are dropping, then that is a good thing, my friend.  That means that ERP is re-wiring your brain correctly.

Keep all your anxiety ratings in one place so that you have a visual representation of how ERP is working as you watch the anxiety levels drop.  It may be a while before you start seeing a downward movement.  That’s okay.  Keep going.  In my experience, my anxiety levels didn’t start to drop until about week ten.  After that, they plummeted quickly.

ERP is a scary experience, so I do recommend paying the money to see a therapist IF you can afford it and IF the person is well-trained in exposure therapy.  If you decide to create your own ERP experience, buy a book that will guide you, such as Stop Obsessing! by Edna Foa or Freedom from Obsessive-Compulsive Disorder by Jonathan Grayson.  Talk to your friends and family ahead of time and spell out for them what your compulsions are, asking them to not aid you in these, even when it is difficult.  It may be helpful for you to tell them that aiding your compulsions is akin to them being on Team OCD instead of Team You.

Many people choose to pair ERP with medication.  I did.

I spent fifteen years with OCD before I was diagnosed, then another five before I began ERP.  That was twenty years that OCD stole from me, so when I began ERP, I essentially knew it was my last hope, short of some supernatural miracle.  You might not be mentally in that place yet, ready to put your nose to the grindstone and make it happen.  You’ll know when you’re ready.  Just know this: most obsessive-compulsives I talk to who have gone through ERP say their big regret is not pursuing ERP sooner.  ERP is hard … but it is not (not-not-NOT) harder than living daily life with OCD.

And what is happening while you go through these exposures?  I meant it when I said that your brain is being re-wired.  In this therapy, the brain changes, allowing an obsessive-compulsive more room to live with uncertainty (the root of it all).

ERP gave me back my life.  I am happy again, have joy again, love life.  I no longer fight a daily battle with my own mind.

Related posts:
OCD, ERP, & Christianity
ERP & Imaginal Exposures
Preparing for ERP Therapy
Medication vs. Exposure Therapy
All About CBT

Interview with a Former HOCD Sufferer

interviewHey peeps!  Since I’ve been getting so much traffic on my blog in regard to HOCD (homosexual OCD), I thought I’d do another post on it.  This interview is with “Hannah,” who tells me she is ready to bare all (except for her real name, ha!) for the sake of helping others better understand HOCD, that obsessive-compulsive phenomenon where a straight person obsesses over being gay or a gay person obsesses over being straight.  

I think you’ll enjoy this interview.  Hannah said there was no question too personal, so I really went for it!  🙂  If you have additional questions, leave them in the comment section, and maybe we can force more truths out of Hannah.

Disclaimer: This post is not intended to make a statement on homosexuality itself.  It’s intended to open up our eyes to HOCD, which is a lie that both straight and homosexual obsessive-compulsive people battle with.  It’s not about the morality of homosexuality– it’s about people who believe lies about their sexuality at the hand of OCD.  My blog readers are ahhh-may-zing, so I doubt I even need to say this, but nevertheless: if comments get mean or stray away from the topic of HOCD, they will be deleted.  You’re a fool if you think I’ll let you bash any of my friends, gay or straight.

Jackie: Tell us a little about your history with HOCD.
Hannah: I was in junior high when I first started questioning if I was gay.  It came on really suddenly, like, in a MOMENT.  One minute I was this boy-crazy girl and the next I wondered if maybe I was gay.  But the thing was, I didn’t want to be gay … at all.  AT ALL.

Jackie: What triggered this sudden change?
Hannah: I found one of my (girl) friends attractive.  OCD doesn’t need something big to work with.  It will take whatever you’ll give it.

Jackie: What was your reaction?
Hannah: Cold dread.  I mean, I was terrified.  I didn’t want to be gay.  I wanted to like men– I DID like men– but suddenly it was all I could think about.  Every girl I would see, I would think, “Do I think she is pretty?” and then, of course, I had to take it a step farther: “Would I want to kiss her?”  Every girl, I’d start imagining myself kissing her.  It made me sick.

Jackie: It made you sick?  Readers will wonder how you didn’t realize then that you weren’t gay, you know!
Hannah:  Yes, I know.  Because it doesn’t FEEL obvious.  I kept focusing on what I was doing: thinking of kissing every girl.  That felt like evidence that I was gay.  The fact that it made me sick barely registered, for some reason.  I guess it’s just how OCD works.  It’s all very confusing.  Well, then of course, there was the fact that I DO think girls are beautiful.  Sometimes more beautiful than men.  Their bodies definitely are.  Most of us can agree to that, haha!

Jackie: So there was a part of you that found women attractive then?
Hannah: Yes.  There still is.  Women are hot!

Jackie: But you’re not gay?  Or maybe bisexual?  I know I already know these answers, but I think this will help my blog readers process things.
Hannah: No, your questions are fine.  I told you anything goes, right?  Haha!  No, I’m not gay, and I’m not bisexual either.  I know that now.  And the key to learning that was learning to be uncertain, as opposite as that sounds.

Jackie: Okay, we’ll dive into that more in a bit here.  But tell us more about what happened when you first started wondering about it.
Hannah: Well, I couldn’t STOP wondering about it.  Like I said, every girl I saw, I thought about kissing her.  I think it was like my way of “testing” myself– to see what my instincts would tell me, to see what I really wanted.  I hated doing this though.  This was the compulsion actually for me.  The “testing” was like what you talk about about seeking reassurance.  If I thought about kissing the girl and it still made me sick, then I was still okay, still not gay.  (Again, no offense to your gay readers!  This was just my experience.)  I thought about this so much that one night I had a DREAM where, in it, I kissed a girl.  When I woke up, I thought for sure I was gay.  I was having gay dreams!

Jackie: It carried over from real life!
Hannah: I know that now.  But it felt like this stamp of homosexuality.  I was so scared.  I didn’t want to tell my family that I was gay.  I still didn’t even WANT to be gay.  Oh, and this one thing.  I still liked boys.

Jackie: So, you didn’t want to like women, you felt sick about liking women, you ACTUALLY liked men, but you still thought you might be gay?
Hannah: It’s OCD.  It feels confusing.  You know what it’s like.

Jackie: I do.  I really do.  So, what changed?  You’re pretty confident now in your sexuality, yes?
Hannah: I am!  And it feels awesome!  I love knowing I’m straight– and get this, this is so good– I can even appreciate the female body now, and I am not joking, I could see a NAKED WOMAN today and I could GET TURNED ON BY HER and I would STILL know I am straight.  Because I am.

Jackie: And that came about how?
Hannah: Exposure and response prevention therapy.  You preach it.  I preach it.  Cue Hallelujah chorus.

Jackie: You could see a naked woman and get turned on by seeing a naked woman, and you still wouldn’t doubt your sexuality?
Hannah: Not for one second.  I’m as straight as they come.  I love men.  I want to be married to a man someday and have sex with a man and build my life with a man, and it doesn’t make me flinch to say that I think boobs are hot.  Like, super hot.

Jackie: You’re hilarious.  You’ve come so far!  I’m sure there are HOCD sufferers out there who can’t imagine admitting something like that.  And people who are probably thinking you must be bisexual if you feel that way.
Hannah: Haha!  People can think that all they want!  I am FREE from my HOCD and totally straight.

Jackie: You’ve come so far through ERP.  It’s amazing, right?
Hannah: Amazing, for sure.  And hard.  But good.  It made me able to think clear finally.  If I like men and want to be romantic with men and DON’T want to be that way with women, then I am not gay.  It’s obvious, like you said.  And the more I realized that I am in control of my own response to it, the more freedom I found.  That’s why I can say women are hot.  Doesn’t bother me anymore.

Jackie: So, your advice?
Hannah: ERP.  For sure.  Best treatment out there.  For the gay obsessive-compulsives too, the ones who obsess that they are straight and that causes them as much anxiety as the opposite thought caused me.  ERP is absolutely the best treatment for OCD.  I know you know that.

Jackie: I absolutely do.  Do you still struggle with OCD?  Not just HOCD, but other obsessions and compulsions?
Hannah: Rarely.  ERP kinda took care of OCD, you know?  Instead of just one issue, it went after OCD itself.  I know you know these things, but your readers need to know.  ERP is the solution.  A one-stop shop.

Jackie: And you think women are more attractive than men?
Hannah: I think the female body is more attractive, but I am attracted TO men.

Jackie: But you know you’re not gay?
Hannah: Yep.  But that certainty only came through embracing UNCERTAINTY, the whole point of ERP.

There you have it, folks.  

My thanks goes out big-time to Hannah for her willingness to be interviewed and her awesome vulnerability.  The bottom line is ERP is the best treatment for OCD.  

In other words, just what I’ve been saying on this blog for the last two years. 🙂

Related posts:
Another Interview with a Former HOCD Sufferer
No One Wants to Talk about HOCD
A Closer Look at HOCD
A Big Ol’ HOCD Post
A Third Interview with a Former HOCD Sufferer

List-Making as a Compulsion

lists2A compulsion I haven’t talked about very often on this blog was list-making.  Since it was never something I worked on in CBT/ERP, sometimes I forget about all the lists.

Mine would be numbered (though the numbers didn’t mean much), and they were an attempt to bring some sort of order back into my messy thoughts.  They were an attempt to nail down a position or a stance or anything I could stand on.

This was mostly in high school and in college, before I was even diagnosed with OCD.  All I knew was that my doubts were eating away at me.

For example, in college, I didn’t know if I liked one boy (who liked me back) or his roommate (whom I fought with).  I was in turmoil over this (since OCD can’t just play it by ear– let alone see that I didn’t like the roommate, who annoyed me), so I’d go down by the lake with a notebook and start making a list:

1) I think I like James, not Toby.
2) I don’t want to like Toby.
3) I can decide that, right?
4) Maybe I can’t.
5) But I should be able to– right?  That’s my decision, isn’t it?
6) James is so kind.  And cute.
7) Toby pisses me off.
8) I would break James’s heart if I liked Toby.
9) I don’t want to like Toby.
10) Then why do I think I do?
11) I don’t want to hurt James.
12) If I don’t want to hurt James, then I must really care for him.
13) Do I care about hurting Toby?
14) Not as much.
15) I must like James then.

Satisfied that I was now certain I liked James, I’d stash my notebook back into my backpack and head to class with a smile.

Except that the next time I saw Toby and James, I’d be confused again.  Time for another list.

List-making was a mix of confession and seeking reassurance, to and from myself.

Did/does anyone make lists as a compulsion?

OCD, ERP, and Christianity

ocd and christianityI often hear from obsessive-compulsive Christians asking, “If my OCD is centered around my faith, will ERP still work even if my therapist is not a Christian?”

I’ve written elsewhere about how OCD is an arsonist, setting fires (obsessions) in our minds and how our compulsions are like shortsidedly trying to put out the fires instead of going for the arsonist directly.  You don’t need a Christian cognitive-behavioral therapist.  You just need someone who knows ERP and knows it well.  In other words, you need an OCD assassin.

If you are obsessing about the unforgivable sin or something else faith-related, you don’t need a great theologian to dialogue with you about it.  (In fact, chances are that you’ve already discussed this with all your Christian friends and maybe even a respected pastor.)  After that conversation with the theologian, you’re probably just going to start obsessing again, either about the same thing or something else.  You need someone who can take out the OCD, and yes, I mean “take out” in a sniper kind of way.

“But I’m worried that ERP is just going to cover up my real issues.  I don’t want to just forget about these things.  I want to solve them.”

First of all, you’re misunderstanding ERP.  It doesn’t sweep issues under a rug.  It’s not like you’re brainwashed into believing that life is now perfect.  Not at all!  It rewires your brain so that you can think the way “normal” people do– less circularly.

Secondly, you’re misunderstanding life and faith.  These things aren’t “solvable”– at least, not generally.  Sure, you might be the one person in a million who has God audibly speak to you one day– but probably not.  Life is full of uncertainty.  It’s a FACT.  And faith is about TRUSTING God even in uncertainty.

You need to get it out of your head that you will ever be rid of uncertainty in this life.

Back to the original question …

Your ERP therapist is not going to talk you through theological issues.  That’s not his/her job, and actually, it would be counterproductive to what ERP is all about.

If you can find an incredible cognitive-behavioral therapist who is also a follower of Christ, then yes, by all means, go to that person!  But if healing and health are your goals, then your first order of business is finding someone who knows how to do Exposure and Response Prevention.  You are looking for an OCD assassin, not someone to have tea and Bible study with.

Thoughts?  Further questions?

 

Satan is the accuser; Christ is our defender.

Recently, one of my blog readers asked me how I could tell when a thought came from OCD or from God, especially because one of my formerly intrusive thoughts was of a Bible verse that seemed to condemn me.  She wrote, “I keep reading that Bible verses spontaneously popping into one’s head is a prime way God speaks to people.”

What a great question.  One I’m not entirely sure I’m qualified to tackle, although I do know that the more I learn about and understand my OCD, the easier and easier it is for me to spot it.  I can recognize its tell-tale voice from a mile away now.  And while I don’t think that OCD = Satan (at all), they are both my enemies and they are both accusers.

Here is the (in flux) conclusion (is that an oxymoron?) I’ve come to:

I guess the big thing is this: when OCD would bring up that Bible verse, it worked like an intrusive thought and brought deep anxiety to me, but with God … his kindness leads us to repentance, not to shame.  The voice of God showers me with kindness, grace, conviction that leads to change … but I don’t think God’s voice is one of shame and accusation. In fact, scripture even tells us that SATAN is the accuser and CHRIST is the one who defends us.

Remember, Satan used and twisted scripture when Christ was going through his temptations, so we know that it’s part of the devil’s arsenal.

frustration4My friend Erica told me something fascinating she’d once heard: “The Holy Spirit does not motivate with guilt.”  Likewise, my incredibly wise writing professor Judy said, “I know the voice of God because that voice invites me to move closer without shame while the voice of Satan fills me with an electric dread that makes me want to hide.”

As always, I encouraged this blog reader to explore Exposure and Response Prevention therapy.  In the four years since my ERP, the voice of OCD has become so easy to recognize.  I finally know my enemy’s voice.

And better yet, I know my savior’s.

 

Do I have OCD?

Before my diagnosis and, hence, before I’d done a lot of personal research on obsessive compulsive disorder, I thought of OCD as “that disorder where you wash your hands a lot” or “the one where people tap the doorknobs” or “when you’re a really big neat freak.”  In some ways, my diagnosis was a surprise to me because I didn’t do any of those things.  But on the other hand, just the term obsessive sounded so much like my situation that I was willing to listen.

Maybe a year or so into my original search for medication (I ended up taking a year-long hiatus from the search after Luvox stole all my energy), I suddenly started worrying (or maybe even obsessing) that what I had wasn’t really OCD.  I seem to talk to a fair amount of obsessive-compulsives who also reach this point, worrying that maybe someone has plastered a name on them that is incorrect.  The interesting thing about this is that the OC usually feels guilty about it– as if they are receiving compassion and medical advice and help from friends and family for nothing, or what they are worried is nothing.

Interestingly, such a huge worry and incredible guilt only point to OCD all the more.

The more I have learned about OCD, the easier it is for me to see it in others.  Though I am by no means a doctor, I now believe that OCD is pretty easy to diagnose.

birdcage2

 

It’s all in the name.

Obsessive-compulsive disorder.

 

1) Do you have obsessions?  Basically, do you have intrusive thoughts that you find ugly or disturbing but that you can’t seem to stop thinking about?  Common themes center around questioning your sexual orientation or if you really love your significant other, thoughts about harming yourself or others (even children), blasphemous or sinful thoughts, worries that you or people you love are going to die, sexual obsessions, intense fears about contracting a disease.  Ask yourself, do I have intrusive thoughts that cause me serious anxiety?

2) Do you have compulsions? The answer to this question might not come as easily, but what it is really asking is this: when I have those intrusive, anxiety-causing thoughts, what do I do to attempt to relieve that anxiety?  Maybe your fears about germs cause you to wash your hands, making you temporarily feel a bit of relief about that possibility.  Maybe your fear about harming a child means that you won’t allow yourself to hold your baby girl.  Maybe it even means that you avoid driving down the street where a lot of children play.  If you have blasphemous thoughts, perhaps you repeatedly ask God for forgiveness or you’ll ask other people if you think that means you are now going to hell.  Sometimes compulsions seem a little “magical” too– for example, you relieve the anxiety caused by your intrusive thought by tapping your foot a certain number of times or by avoiding stepping on cracks.  Even if it doesn’t logically make sense, it’s still something providing you some temporary relief.  Seeking reassurance is a huge compulsion for a lot of different kinds of obsessions: we glimpse relief when friends reassure us, No, you’re not gay.  No, you’re not going to get sick.  No, you would never hurt a child.  No, you’re not going to hell for that.

There is a third question to ask too, although this one may or may not be reached immediately, which is
3) Have your compulsions gotten out of control?
Most obsessive-compulsives reach a stage where the compulsions (that began as an anxiety-reliever) become too much and begin to add to the anxiety: you can’t stop washing your hands, you ask for reassurance so constantly that your friends are annoyed, you are driving a long way out of your way to avoid the street with children, you are tapping doorknobs and counting and repeating phrases in your head to the point that you’re starting to look a little silly.

Like I said, I’m no doctor, but when I talk to someone who wonders if they have OCD, these are the three simple questions I ask.  If you can answer yes to the first two, then you have OCD.  

So, what next?
1. Get an official diagnosis from someone who went to school for it. 🙂
2. Skip the talk therapy and go right for cognitive-behavioral therapy.  This is treatable.