Christian Culture’s (Sad) Response to Mental Illness

It’s in the Title: Mental Illness is an Illness

Salads and sandwiches and a shared mental illness, all of it on the tiny table between us.

“There is help for OCD,” I told her.  “The most effective treatment is cognitive-behavioral therapy.  Between that and my medication, I got my life back.  I know you can too.”  (The evangelical zeal I have for this particular therapy reminds me of the way I love Jesus: both took me from darkness into light, both make me want to throw parades in their honor.)

“Oh, I don’t know,” said my friend, poking at her salad with a fork, sounding hesitant.  “I think before I take any extreme methods, I want to just pray about it more.  I know that God can bring me through this.”

I wanted to say, But you have been praying about this for years!  I also believe God can bring you through this—and I am telling you how.

There is a pervasive and unhealthy attitude in the Christian culture toward mental illness.  Many believe that one should be able to “pray away” a disorder.  Some think that mental illness is, quite simply, spiritual warfare; some think it’s the result of unresolved sin issues.  One of my friends has said before that a real Christian can’t be clinically depressed.  I saw a Facebook status once that read, “Depression is a choice.”

These sentiments light a fire in me, especially for the way that they marginalize a group of people that are often already more susceptible to guilt.  I know that in my OCD hey-day, I felt continual guilt and severe shame; for someone to intimate to me that these feelings were the appropriate ones would only mean that my Christian brothers and sisters were siding with my disorder—and against me.

Mental illnesses are just that: illnesses. 

friendsGod and Satan can work through them just the same way as they could through, say, cancer or diabetes.  All issues are spiritual issues, simply because we are spiritual beings, but it is not helpful to label a chemical issue with a giant term like spiritual warfare.  To say that a Christian cannot be depressed is like saying a real Christian can’t get the flu.  To say that depression is a choice is like saying strep throat is a choice.

If you break a bone, do you get it set in a cast?  If you learn you’re diabetic, do you take insulin?  If cancer steps into your body, do you pursue chemotherapy?

The answer is usually yes.  Yes—and pray.  (Don’t get me wrong: I’m all for prayer!  And for medical innovation!)

That is why I am unashamed of my OCD, my depression.  Instead, I am proud of my God for seeing me through a therapy as difficult as CBT and for being my strength through five years of side effects in the search for the right medication.

Unfortunately, my friend left the sandwich shop that evening feeling obligated to “pray away” a spiritual flaw instead of feeling empowered to fight illness, in spite of my best efforts.  My voice is being drowned out by the multitude of louder voices of the Christian culture, a culture that should be supporting this demographic, not alienating it.

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?

 

How to Care for the Obsessive-Compulsive in Your Life

hugMy friend Amy recently requested that I write a blog post about how to care for an obsessive-compulsive friend or family member.  I thought it was a great idea!  Here’s my best advice:

1. Get them into treatment.

The best, most important thing that you can do for the obsessive-compulsive in your life is to do whatever it takes to get them into a treatment program.  OCD is treatable with Exposure and Response Prevention (ERP) therapy.  Don’t balk at the cost or make them feel guilty about it.  A co-pay in exchange for their freedom and joy?  Throw yourself 100% into the task of getting your beloved OC psyched about therapy.  Read success stories online and share them.  Educate yourself.

2. Find out their compulsions and don’t aid them.

Ask your OC what his or her compulsions are.  Ask again after they’ve started ERP.  And then steer clear of enabling those compulsions.  This is difficult to do, especially if one of their compulsions is seeking reassurance.  With all your heart, you are desperately going to want to reassure them that X won’t happen, or that Y is okay, or that Z won’t end badly.  Don’t do it.  Doing so is siding with OCD against your loved one.  To side with them, you have to stand strong against OCD and not enable their compulsions.  It’s okay to say, “I don’t answer OCD’s questions” or “we can’t know that” or “I’m not going to aid your compulsions.”  Set up a standard answer with your OC ahead of time and then stay strong.

3. Find out their exposures and help them practice.

Ask your OC what their exposures look like and– if possible– help them practice.  Keep your eyes open for opportunities for your OC to practice their exposures, and encourage them to do so.  Stay in the room if they need you to.  Hold them afterward while they cry.  Continue to starve the enabling bug inside of you!

4. Be a cheerleader.

Encourage, encourage, encourage!  Think and speak positively.  Stay excited about ERP, even when your OC feels like a failure.  Don’t let them entertain the thought of giving up.  Remind them of all the ERP success stories.  Believe that hope and health are just around the corner.  Remind them that freedom is so close and so worth it.

5. If you’re the kind of person who prays, pray hard.

“Coming Out” as Obsessive-Compulsive

whisper7Recently on Facebook someone asked, “What about your experience talking to people about your symptoms before you were diagnosed– what was that like? Did you get rejection from people? Sarcasm from people? How was your diagnosis received?” and it made me think back over the years.  This is my OCD “coming out” story.

Growing up, I knew that I thought about things far more deeply than most of my friends– and that’s not a slam on their intelligence or depth.  I just extrapolated one million miles further than everyone else my age, and I worried about things that no one else seemed to be worried about.  This was the case for a lot of childhood and high school and even college.  “You think too much!” was a common thing for friends to say to me.

After college, things spiraled out of control, and before I knew it, OCD had backed me into a corner of paranoia.  I had had this “realization” that I couldn’t truly know what people were thinking; my obsessive-compulsive logic prompted me then to believe that my so-called “friends” actually probably didn’t like me … maybe even hated me … in fact, maybe they weren’t even human, but they were demons, and their whole goal of “befriending” me was to trick me into hell.

I was a mess.  And whom could I turn to?  I half-believed I was surrounded by demons.

I took a risk and talked to Judy, my college mentor, who insisted I see a therapist.  The therapist insisted on meds, and the psychiatrist I met with finally used the words “obsessive-compulsive disorder.”

To be honest, I was a little shocked.  OCD?  Not me!  Obsessive-compulsives were those neat-freaks who had to touch doorknobs forty times and stuff like that.  I didn’t do anything like that– or so I thought– and my bedroom was a pit.

And yet, it was freeing to have a name attached to it.  Naming steals back power.

I told my closest friends and family.  I’m not sure, but if I had to guess, I’d say that they were relieved– relieved that whatever-it-was had a name and that I was meeting with a psychiatrist and a therapist and turning things around.  My dad was not particularly happy about it, though; he comes from a background where you pull yourself up by your bootstraps, and he used to have a hard time understanding how I could be so depressed.  I did, after all, have a wonderful life.  I just also had OCD and that cancelled a lot of things out.

I didn’t go public with my diagnosis until a couple years later– the summer before I turned 25– and boy, did I choose to go PUBLIC.  I decided to share that I had OCD while I was sharing my testimony with a group of summer campers and counselors.  I had struggled with this in preparation for it.  I was going to be standing up front asking the campers to be real and vulnerable with me that week– and I just knew I couldn’t do that with integrity if I wasn’t willing to share my own story with them.  So I decided to go for it.  I was terrified, but I practiced and practiced until I pretty much had my talk memorized, and I thought I was ready to go.

I wasn’t ready to go.  I did it anyway though.  I was shaking as I stood in front of the camp, reading my once-memorized talk, and when it was over, I walked from the front of the room all the way straight out the door and wept.  I knew that there was no going back after I let them know.  I think what I was most scared about was having others treat me differently.  I thought that maybe they would baby me or talk down to me or tiptoe around me (since now I was camp’s resident crazy person).  I thought they would smile placatingly and treat me as if I were going to shatter.

Instead, what happened is this: almost immediately afterward, a longtime camp friend of mine, who was also a counselor that week, asked if we could chat.  We went down to the dock, and there he told me that he also struggled with OCD.  In fact, he had checked the door at his parents’ house so many times that he broke the handle.  He had never told anyone about his struggles at that point– I was the very first person he’d admitted this to– and I know I was given that honor because I spoke up first.

It gave me courage.  A tiny bit, at least.

That fall, as I recruited at Midwest high schools, I asked for opportunities to speak to the student body, and what I shared with them was about my OCD, about being real with one another, about how freedom begets freedom.  And the reactions were almost always positive.  Students would come up to me afterward and share with me about their struggles– me, a stranger!– because I’d shared first.

So I started sharing closer to home too.  When I’d meet up with someone for coffee, I’d drop the letters OCD into our conversation.  When I’d be on a roadtrip with someone, I’d say the words.

And people started to share back– about their struggles, their problems, and sometimes their own battles with mental illness.

The more I shared, the more others shared.  It was like I was finally living in my true self, and it was drawing that out of others.  It became almost a game to me– I couldn’t wait to tell people that I had OCD!  Who knows what they might need to get off their chest, and I would be opening up a path for them to do so.

It is easier to say, “Me too,” and that’s an advantage I want to give to others.  That’s why I blog about OCD and HOCD and questions I have about God.  That’s why I share about my own self-doubt and the rollercoaster of my life.

Because I want to give people every opportunity to say, “Me too.”

I feel blessed.  I and my OCD have been well-received by most people.  The hardest issue I have to face is the ignorance so many people have about OCD.  But I can gently (or forcefully– ha!) educate them that OCD is more than being clean and organized, that OCD is an illness like any other.

I’m incredibly grateful for my marvelous support system.  I’m indebted to God for my life and my rescue(s).  I count it a privilege to share what once were my secrets, and if that sharing allows even one person to say, “Me too,” then I am blessed.

A Metaphor for Obsessive-Compulsives

A new friend came over to my apartment the other week, and we got to talking about Exposure and Response Prevention (ERP) therapy, and I shared a metaphor with her that I’d like to share with you now.

We put out fires, but what we need to do is shoot the arsonist.

arson

The problem with attempting to “solve” an OC’s obsession is that, as soon as it’s solved, a new obsession will take its place.  In that way, you’re only putting out fires, not dealing with the root issue, which is an inability to handle uncertainty.  For years and years, I watched my obsessions hop from one thing to the next.  My compulsions– and even my talk therapy sometimes– were shortsightedly stamping out the flames in one corner of my mind while OCD set a new fire in another corner.

How can you possibly manage to keep up that way?  It’s not sustainable.

That’s why I agree with so many of the OCD experts in this country that the best way to fight OCD is with Exposure and Response Prevention therapy.  ERP is so very different from most standard therapies.  In it, obsessive-compulsives are exposed to a trigger that prompts in them deep anxiety; then they are not allowed to respond with an anxiety-easing compulsion.  Instead, they are forced to sit in that discomfort.  Doing this repeatedly actually re-wires the obsessive-compulsive’s brain in a way that they learn to live with uncertainty and their quality of life improves dramatically.

It’s been four years since I turned my attention from the bonfires to the disorder that was setting them.

It’s been a good four years.

Redeemer

I am being mentored at my workplace, and Monica, my brilliant mentor, said to me the other week, “If we are being conformed into the likeness of our Redeemer, then we should be little redeemers.”

I like that idea.  I think.

Remember John Coffey in The Green Mile?  How he could siphon illness and even death from people with his touch– and then would expel it from his mouth like ashes?

Sometimes I wish I could do that for the readers of this blog.  Just steal your suffering away.

Reminds me of the verse from Galatians 3: “Christ redeemed us from the curse of the law by becoming a curse for us” (emphasis mine).

I love that RESCUE is God’s work, and I will count it an honor if he grants that I be used as a tool in that work.

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