nOCD, an ERP App/Hero

If you’ve spent time around this blog, you know that I wrestled my life and freedom back from the clutches of obsessive-compulsive disorder in 2008. (Read more about my story at jackieleasommers.com/OCD).

From the onset of my symptoms to my diagnosis: 15 years.
From my diagnosis to appropriate treatment (ERP): 5 years.
From treatment to freedom: 12 weeks. (<–Read that again please.)

Exposure and response prevention (ERP) therapy is powerful, friends.

On average, it takes OCD sufferers 14-17 years to get the correct diagnosis and treatment. This is not okay. 

So many OCD sufferers cannot afford treatment. In some countries, ERP therapy is simply not available. In fact, in some countries, the stigma associated with having a brain disorder like OCD is so strong that sufferers would not dare admit to needing help. This is not okay. 

The creators of the nOCD app felt the same way. One contacted me and said, “Our goal is to reduce the time it takes for people with OCD to get effective treatment (from decades to minutes).” He said, “One thing advocacy has shown me is the need for OCD treatment in other countries! There are people in Bangladesh, India, etc that have literally nobody! My team is actually building a 24/7 support community within nOCD to combat this issue.”

The app is FREE and, I-hope-I-hope-I-hope, going to change the world.

Some of the very best things about this app:

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Right now it’s available for iPhones, but this fall, the Android version will come out. Please check it out here. And be sure to tell me what you think!

xoxo Jackie

Guest Post: My ERP Experience

With her permission, I am sharing a comment from ashley1234567890, one I found particularly insightful.

And here she is …

I went through ERP and had fantastic results. It was a huge blessing for me, and I thank God that he gave me the courage to try it.

I am no expert, but i did have a really bad case of OCD, which got a lot better after ERP, so here are my recomendations, that in hindsight, were key to my success.

NOTE: my ocd did not get worse with ERP (it got so much better) even though the treatment was very intense!

If you qualify for ERP therapy, and you are considering it, then do not let fear keep you from going. The only caveat is to make sure you find an expert who treats ERP because it is specialized therapy. For example, my therapist was willing to meet me outside of their office for exposures, because my ocd spiked at a particular place. I also recommend finding someone who has experience with whatever ocd you are facing. For example, my therapist had experience with germ ocd, harm ocd, religious ocd, sexual oreintation ocd, etc… so i knew they were highly qualified. they should also give you exercises so you can do your own exposures.

As for ERP, It seems counterintuitive at first, since the patient will go through exercises and narrations that are asking them to run towards their fears (instead of running away from them), which in turn causes anxiety to spike, and while super anxious the patient will be asked to temporaily stay in that state while resisting compulsions that are normally used to reduce the anxiety. If you face the obsession and not give in to the compulsion, then the cycle breaks, which in turn makes you less anxious. That is where “exposure and response prevention” comes from.

My treatment was gradual at first (small fears first then you move onto bigger ones) also, my initial exposures were designed so that anxiety was moderate so I could handle it, and then over additional sessions, they were changed to more intense ones.

For me, it took me about 12 sessions to complete treatment. I noticed some big gains after the first couple of sessions so i knew it was helping. After treatment i am a new person. I still have the ocd, triggers, and the spikes, but it does not cause much distress anymore. Before ERP my distress level was a 10 and it was constant. My life sucked.

So heres an example of what what ERP might look like. let’s say you have germ OCD. You may be asked to touch a door knob and not wash your hands afterwards for 5 minutes. As the sessions go on, and you grow stronger, you may be asked to do the same excercise, then refrain from washing for 15 minutes. Eventually, beloeve it or not, you will be able to do the excercise then not wash at all! Or, one exposure may be a narrative, where you write a short story, and in this story you get a little dirty, or exposed to germs, etc… over the treatments, the story may get more and more disgusting and intense, so you will be in a situation that gets really dirty, and theres no place to wash up etc…

As the sessions and exposures go on, the anxiety for each trigger gets weaker, which in turn makes the spikes less intense. Consequently for me, the ocd got better over time.

Again, the key is to find a qualified expert who has a lot of experience in OCD and ERP, because you will be asked to do things that will make you feel temporarily uncomfortable and the therapist will need to work with you at the right pace so that you are not overwhelmed. They should be willing to leave their office to do an exposure where you need it. So for example, if you are afraid of heights they should be up for going with you to a balcony etc… to face that fear.

Like some of the previous comments, I was anxious before starting too, and I was scared that it would make my condition worse. But i was wrong! that’s just the ocd trying to keep you in the bad place.

In fact thats how i first came across this blog. Jackie had wrote some content on ERP and it gave me the confidence to try it. Thank you jackie you are such a blessing from the Lord! Hopefully this post will do the same for someone else!

Perfectionism & Writing [& OCD Too]

messyYou’d think being a perfectionist would be beneficial for an artist, but I really don’t think that’s true.

(Neither, apparently, does Google: search “artists are perfectionists” and you’ll get the following:

 

For me, being a perfectionist means that writing a book can be a slow form of torture. You see, it takes a long time for a book to even begin to resemble perfection. You have to spend months, even years, sitting uncomfortably in the middle of a mess, working through sloppy drafts and chasing rabbit trails into very disorganized forests.

Or maybe that’s just me.

In any case, it’s a continual lesson in learning to enjoy the process and not just the product. If I only enjoy the product, I will get to be happy about 24 hours out of every three years. This is a journey of embracing uncertainty, letting myself wait in the cold water till I begin to adjust.

And that’s the story of my life with OCD too. Heck, the story of my life, period.

I– a perfectionist, an OCD survivor– want pretty things in pretty boxes with pretty bows on top. I– an artist, an OCD survivor– know that’s not what life looks like. Life is full of doubt and wrong directions, wasted time and imperfect choices. Life is full of discomfort and years and years and years of tolerating discomfort … with the hope there is a pretty thing in a pretty box with a pretty bow at the end. But it is not guaranteed.

So, is art in general– or writing specifically– a difficult career choice for a perfectionist? Heck yes. But it’s fulfilling, worthwhile, hard, dirty, beautiful work– and it is helping me appreciate this fulfilling, worthwhile, hard, dirty, beautiful world.

 

Why Meds?

A blog reader emailed me and asked, “If you are okay with sharing this, could you tell me why you chose to stay on your medication after ERP?”

My response:

For me, meds are a chemical tool to slow my serotonin reabsorption. ERP is a physical tool in that it rewires the brain and a mental tool in that it gives me a new mindset toward uncertainty. I’m grateful for ALL my tools. 🙂

 Also in my toolbox: prayer, deep friendships in which I can be vulnerable, essential oils when needed, Ativan when needed, talk therapy for non-OCD anxiety, and self-care (i.e. naps and ice cream).


 What I’m trying to say is that God has given me an extensive amount of assistance. Some tools only come with privilege or money (having insurance and a paycheck to pay for meds and therapy … and ice cream, ha!); some from transparency (I have the greatest friends); all are sheer grace.


I’m at a stage of my life and faith where my hands are open to all the grace I can get.

Thoughts on ERP, Writing, & Uncertainty

Uncertainty.

For so many years, it was my enemy– or so I perceived it, especially because full-blown clinical obsessive-compulsive disorder made me fear and reject uncertainty even more than the average bear. Everything in my life was about pursuing certainty, answers, black & white.

And, of course, I was miserable.

In 2008, I went through the harrowing but ultimately beautiful process of exposure therapy, which took my OCD out at the knees, giving me the bandwidth to live with uncertainty, questions, and all the shades of gray.

It’s only recently that I’ve recognized exposure therapy as the training ground (or maybe even battle ground) that would let me later pursue my dreams of being an author.

A hard truth: writing is full of uncertainty. 

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Not just writing– but publishing itself too. There is this crazy-making stretch of life in the middle of writing a book that feels both unclear and perpetual. What is this book really about? Who are these characters? Can I do this? Can I finish this? Is this story going to matter to anyone but me? Is this going to even matter to me? Will my writing group like it? Will my agent? My editor? Readers? Will I find success? Will I get another contract?

The writing life is, for many of us (and especially for younger writers), a world in grayscale: a constant state of uncertainty that we have to persist in in order to find any relief or success.

For as many days as I think I’m totally failing at life and writing, I have to remember what it would have been like to be writing and publishing before exposure therapy, back when uncertainty was unbearable. I’m not even sure how it would have been possible to be doing what I’m doing now without exposure therapy laying the groundwork for me to bear the not-knowing, let alone to thrive in it.

“The world doesn’t work that way.” I hear myself and other OCD awareness advocates saying this to sufferers all the time. In context, we mean, “Life inherently is full of uncertainty. You cannot eliminate it.”

The truth of that hits me over and over again in the field of writing.

Exposure therapy was the terrible, grueling practice for the writing life. Uncertainty is rampant; I try to keep my arms open.

 

A Reunion with My ERP Therapist

For OCD Awareness Week, OCD Twin Cities had an event– a panel of OCD experts plus one special guest: yours truly. Interestingly, one of the experts on the panel was my own ERP therapist and personal hero, Dr. Chris Donahue. I have not seen him since the last day I graced his office with my presence on the day I finished ERP therapy back in 2008, though we have communicated via email, and I have sent many, many people his way for help.

I only joined the panel for the last fifteen minutes or so. For the majority of it, I was in the audience. There was this weird dichotomy going on for me: on the one hand, I was listening to this man who saved my life, who changed everything for me, who pulled me out of darkness and into light, out of slavery and into freedom; on the other hand, his voice is the voice of my exposures (I did imaginal therapy, listening to an audio recording … and it was in his voice), which were some of the most difficult things I’ve ever, ever had to do in my life. So there was this push-pull thing going on while he spoke.

Then, later, I joined him. I was able to sit next to my hero and publicly tell an audience, “This is what this man did for me. This is what life was like before, and this is what life is like now, and they are unrecognizable.” I turned to him and said, “Thank you.” He said, “You’re welcome.” It was a simple exchange … but so layered. So many things going on in my head and heart.

In any case, I am grateful. With every year that goes by of freedom, I more and more shed my identity as someone in bondage. ERP therapy saves lives. For some of us, it changes everything. It did for me.

For lots more information about OCD and ERP, go to jackieleasommers.com/OCD.

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