Resisting Treatment for a Mental Illness

Posted on November 17, 2013 by Jackie Lea Sommers

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.

Stigma, Part Two: I Don’t CHOOSE to be Unhappy.

Posted on November 14, 2013 by Jackie Lea Sommers

Recently, the following was posted on the Twin Cities OCD Facebook page:

Happiness is a state of mind –

It is important that you understand and appreciate that your happiness lies within. Consider this – no one can make you unhappy if you have decided for sure that you will be happy in every situation. If you have made up your mind to be happy, you can always seek out the positive aspects of a situation and remain happy. Life may throw challenges at you but solutions will come faster and to you if you face them with a smile on your face.
Sounds easy? Its only a challenge at first-then momentum happens.

And while I don’t think the poster meant to be offensive, I deleted it immediately.

People with mental illnesses are not choosing to be unhappy. That is such an upsetting suggestion! It’s like someone has accused me of poisoning myself. Or being too weak or stupid to choose the right option. It’s like saying, “Look, you have to understand that if you just choose every day to not have diabetes, it will get easier and easier.”

I don’t choose to have a body that absorbs serontonin too quickly.

I do choose to take pills to slow that process down. And to seek out therapy that gives me tools to manage my mental illness. I can choose to treat it, but I can’t just choose to not have OCD or depression.

Please stop insisting that I am responsible for my mental illness.

This, my friends, this is stigma.

A Detailed Post about ERP

Posted on November 10, 2013 by Jackie Lea Sommers

I 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.

Depression

Posted on November 8, 2013 by Jackie Lea Sommers

Image from weheartit.com

Believe me, there is hope.

Medication vs. Exposure Therapy

Posted on November 3, 2013 by Jackie Lea Sommers

meds vs erp I have always been honest about my personal experience with OCD on this blog. Faithful readers are well aware of my mama-bear protective instincts in regard to my medication. I take Prozac, Effexor XR, and Risperdal each day and am utterly unapologetic about it.

That said, I completely understand that others have their own reasons (personal, medical, or otherwise) for avoiding medication, and that is perfectly fine by me (so long as no one tries to rob me of my meds, haha!).

People sometimes ask, Is it possible for me to treat my OCD and avoid medication all together?

While the answer varies from person to person, the best response I can give is that YES, it has been done with ERP (exposure and response prevention therapy) alone. In fact, were I pushed to choose between my three daily doses of meds or my 12 weeks of ERP, it would be one of the easiest decisions of my life to choose ERP.

Every person is different. I have an obsessive-compulsive friend who treats her OCD with only meds– she has never undergone ERP. The son of one of my blogger friends uses only his tools gained from ERP– no meds. Then there’s me, a girl who wants(/needs?) a full arsenal to treat her disorder.

So, what will it be for you?

The best treatment is ERP, hands down. Start there. See how you do. If you can find an OCD specialist whom you trust, you may try to fold meds into the mix if you find that you need them. It’s (unfortunately) a trial-and-error kind of thing.

Will you be okay without meds? Maybe. You’ll have to discover that for yourself.
Has it been done before? Absolutely.

Hope that is helpful!

Narnia and Uncertainty

Posted on October 27, 2013 by Jackie Lea Sommers

In my lowest OCD years, uncertainty appeared to be my enemy, and I attempted to avoid it at all costs.

It was a losing fight since we cannot. avoid. uncertainty.

Now that I’ve switched teams and am an official cheerleader for uncertainty, I notice it in the positive sense now. No longer the terrifying stranger, creeping around the corners, I now see it as the exciting flash of risk stealing a smile my way.

“I know what it is,” said Peter; “it’s a beaver. I saw the tail.”

“It wants us to go to it,” said Susan, “and it is warning us not to make a noise.”

“I know,” said Peter. “The question is, are we to go to it or not? What do you think, Lu?”

“I think it’s a nice beaver,” said Lucy.

“Yes, but how do we know?” said Edmund.

“Shan’t we have to risk it?” said Susan. “I mean, it’s no good just standing here and I feel I want some dinner.”

For twenty years, I feared uncertainty. And Susan was right: it was no good just standing there.

P.S. The risk was worth it, and dinner was great.

Interview with a Former HOCD Sufferer

Posted on October 20, 2013 by Jackie Lea Sommers

Hey 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. 🙂

OCD Awareness Week 2013

Posted on October 13, 2013 by Jackie Lea Sommers

awareness week

Welcome to OCD Awareness Week 2013!

Here’s what I’ve got planned:

Monday, October 14, 11am CST
Coming Out with OCD
#OCDchat
Details here!

Tuesday, October 15, 7pm CST
The Loft/Open Book, Minneapolis
Alison Dotson Publication Party
Alison and I will both be reading book excerpts about OCD: non-fiction for her, fiction for me!
Details here!

Wednesday, October 16
I’ll be sharing my OCD journey with two Abnormal Psychology classes at the University of Northwestern in St. Paul.

So excited!

Obsessive-Compulsives are Creative. OCD Itself? Not So Much.

Posted on October 6, 2013 by Jackie Lea Sommers

Obsessive-compulsives tend to be creative, bright, highly intelligent, passionate people– and I love that about us!

Our disorder, on the other hand, is sorely lacking in creativity.

See, the thing is, when obsessive-compulsives isolate themselves, OCD appears to be this extremely creative disorder. We imagine that NO ONE ELSE could think the things we think or use “logic” the way we do or entertain such dark and ugly thoughts.

But when obsessive-compulsives are in community with one another, we realize that OCD really has a limited bag of tricks. Sure, obsessions can wear different costumes, but at the core, they often look very similar from person to person.

I recently spent time with another Pure-O, and we were able to list off our various obsessions with each other, and check, check, check, we had so much in common. And both of us grew up thinking that we were monsters, that no one else would ever think about or struggle with the things that we did. Yet our stories were nearly identical!

When I read a book about OCD, those “wild and outrageous” things I once obsessed over end up being the textbook examples.

I am convinced that the more we with OCD communicate amongst ourselves, the more we will realize that while we are creative, OCD quite frankly is not.

Just One Dose

Posted on September 29, 2013 by Jackie Lea Sommers

I had such a hard day recently– my anxiety levels were higher than usual (“usual” being not too bad for the last four years– thanks, ERP!). I felt this strange depression, a strong desire to sleep, and a hovering sadness that wouldn’t lift. My blood pressure felt through the roof, and the stress took a very physical toll on my body: by the time I crawled into bed for the night, my shoulders felt like cement blocks and my arms were throbbing with pain.

I realized that– while racing out the door that morning– I had not taken my Effexor XR or my Prozac.

Just one dose missed, and it was so terribly evident.

I have acknowledged that I may be on medication for the rest of my life, and I’m okay with it. In fact, I’m quite protective over my right to take medication.

I read this awesome related post on the OCD Foundation’s blog recently. And it turned out that Alison, the blogger, lives in Minneapolis … so we got coffee.* Love my OCD community!

* And since then, we’ve accepted new roles at the Twin Cities affiliate of the International OCD Foundation (I’ll be the communications director) … and have an event planned in Minneapolis for OCD awareness week! Exciting!

JACKIE LEA SOMMERS

Author & Advocate

Category Archives: OCD