cared for

My past roommate Becky said she has been reading my blog and is so happy to see that I’m doing better.  She told me, “When we were living together, you were really deep into it.”  It’s true.  The years that I lived with Becky and Tricia (or rather, Biz and Trix) were some of the darkest, most OCD-saturated years of my life.  I am so grateful that God gave those two to me to take care of me in those days when I could not take care of myself.

“Have you had supper?” Tricia would ask.

“Not yet,” I’d respond.  Then I’d begin to consider the whole enterprise.  It exhausted me to ponder opening a loaf of bread, untwisting the twist-tie, pulling out two slices of bread, locating a clean knife, finding a jar of peanut butter, and—it collapsed me—spreading the peanut butter over the bread.  That didn’t even take into account finding a paper plate to put the sandwich on, or cleaning up afterward.  I’d go sit on the couch, my heart racing, a heaviness in my chest.

“Want to make mac and cheese?” she’d ask, browsing through the cupboard’s offerings.

I breathed in and then exhaled deeply.  Macaroni and cheese was so involved—butter and a saucepan and boiling water, milk and cheese mix, and so many dirty dishes.

“Jav?”  (Their nickname for me.)

“I don’t think I’m gonna eat anything,” I peeped from the living room, hoping she would let it go.  I closed my eyes and willed myself to relax.  You’re not going to make anything, I told myself.  You don’t have to do anything.  Just rest. 

“Are you okay?” she asked, poking her head around the corner and seeing me collapsed on the couch.

“Yes,” I said in a voice that screamed, “Not at all.”

She walked over to where I was lying and stood, towering above me, with a frown on her face.  “What is wrong now?”

“Supper overwhelms me,” I said quietly.  “I’ll be okay.”

She rolled her eyes.  “Relax.  I’ll take care of supper.”

“I’ll be okay,” I repeated.

“You have to eat!”

This became something of a routine.  When Tricia and Becky had evening plans, I either didn’t eat, or I tore open a granola bar—something simple.  I lost about ten or fifteen pounds at this time, but I hardly noticed.  But it was an arduous time; I was very dependent and needy, but I was very well cared for.

Thank you, Bizzers and Trix.

me, bec, tricia

therapists

My talk therapist Linda was this kind, gentle, aunt-like sweetheart who loved Jesus and would speak truth over me and pray for me.  I absolutely adored her.

But I was not getting better.

I decided to try out cognitive-behavioral therapy instead.

For those of you who don’t know, this was like stepping from a sweet-smelling meadow into a desolate hell.

My cognitive-behavioral therapist Chris was tough, straightforward, insistent, and unmoved.  And he asked me to do what I thought was essentially impossible.  Idetestedhim.

But this time, I got better.

A year and a half later, I would finally send a thank-you email to Chris Donahue, who had made my life miserable for twelve weeks but to whom I am eternally grateful.  God used him and his no-nonsense ways to unlock my prison.

Now, I am not anti-talk therapy, but I am very pro-CBT.  My feelings in this matter can be summed up best by the title of an Elvis song: “A Little Less Conversation, A Little More Action Please.”

If you suffer from OCD, listen to me: get yourself to a cognitive-behavioral therapist.  Aside from the mighty hand of God, CBT is your quickest ticket to freedom.

“reasonable doubt”

I read an interesting article today called “Casey Anthony, Reasonable Doubt, and OCD” by Stacy Kuhl-Wochner at the OCD Center of Los Angeles — you can read the entire article here.

Just wanted to quote a little bit of it for all you blog readers to consider, especially after having an interesting phone conversation along these same lines with my college roomie Megs.

Being a therapist who specializes in treating those with OCD, I can only imagine what an especially difficult task quantifying reasonable doubt would be for many of my clients.  People with OCD and related OC Spectrum Disorders such as Body Dysmorphic Disorder (BDD), Hypochondria (Health Anxiety), and Social Anxietyare on a constant quest for answers to unanswerable questions.  They seek to quantify that which cannot be quantified, to gain certainty when it is only possible to be “pretty sure.”  These are questions that most people who do not have OCD can accept despite their inevitable doubts.  But for many people who experience OCD or a related spectrum condition, “reasonable” doubt often feels unbearable.

Doubt is such an intrinsic part of OCD that the condition has often been referred to as “the doubting disease. Some common doubts seen in OCD and related OC Spectrum Disorders include:

  • Are my hands clean enough to ensure that I won’t accidentally make someone sick through casual contact?
  • Am I straight enough to to be certain that I am not actually gay?
  • How do I know if I really love my spouse?
  • What level of pain is a enough that I should visit a doctor to see if I have a serious medical condition?
  • What is the right amount of eye contact to avoid being seen as socially inappropriate?
  • How do I know whether I am a good person or a bad person?
  • If I become angry at my child, does this mean that I do not love them enough, and that I am close to mentally snapping and harming them?

The only realistic answer to these and similar questions is to accept that nobody has 100% certainty on these issues*, and to stop the mental checking.  The goal is to make decisions based on what is “most likely”, given all the evidence.  For people with OCD, it may feel terrifying** to make that leap and take that chance because their brain is telling them that absolute certainty is required.

*JLS adds: That is why the point of cognitive-behavioral therapy is not to remove uncertainty but to make one okay with uncertainty.

**”Terrifying” doesn’t even touch it.

Thoughts?  What’s the most basic thing you know that you have doubted before?  (I have sometimes wondered if all of life that I’ve “experienced” so far is only a dream.)

lately

I was on the phone with my mom yesterday; she called because she read my last blog post about re-taking the MMPI, so we were discussing that.  I’ve been stressed lately, and struggling with some different things, but the truth of the matter is, I feel lots of freedom and very healthy.  I think it’s because I can compare everything to OCD.

I said to my mom, “Compared to the hell I went through in the throes of OCD, I don’t believe that anything could be worse than hell itself.”

 

 

 

 

 

 

 

That surprised her.  She said, “You always seemed to be so well put together, seemed to cope so well.”

It made me laugh.  Facades can be so strong.  I was an absolute, total, complete wreck during that time.  I said to her, “I think what happens is that, with OCD, feeling awful just becomes the new norm, so it appears that way.”  Sad but so true.

Hillsong was in the Twin Cities, and Erica and I went to their concert/worship experience last evening.  The last time I went to a concert at Grace Church was in college … Audio Adrenaline and MercyMe … and last night we sat near where I sat all those years ago (would have been 2003).  I can remember that night, eight and a half years ago, and how I felt I was on such shaky ground with God.  Last night, I felt redeemed and free and grateful and healthy.

It just gives me so much hope for others who are in a bad place.  Please, Jesus, free those who are held captive by their own minds.  Work mightily through the means of Your choosing– miracles, medicines, therapies– to restore Your incredible freedom to obsessive-compulsives, and please draw all these rescued people’s eyes to You, to clearly see that You are, even now in 2011, in the business of redemption.

today

… was a hard/stressful day and I agreed to see a therapist (but this time NOT for OCD– wow!).

BUT today was also really good in a couple of ways:

1) I re-took the MMPI last week (read here for my past blog about this test), and I went over the results at the doctor’s office today, and they were saying how HEALTHY my results were. I teared up there in his office and said, “You don’t know. I was a MESS. Praise God.” He said, “Good for you for working so hard and coming so far,” which showed me he completely missed my point. It wasn’t me. That’s for sure.

2) My writing group has a write-up on the NWC English department’s blog. Check it out!

One thing that would really be meaningful for me would be for you to post a comment saying that you read my blog.  I can see the analytics, and I know people are stopping by, but it all feels so anonymous, and I need some names and faces please.  I wish I could sit down and have hot cocoa with you blog readers.  With marshmallows.  Lots of them.

CBT prep …

  I looked at the back cover of Freedom for Today’s Obsessive-Compulsive.  Apparently Steve Jewett and James Nash were some big names in the OCD world.  “Open this book,” the back cover read, “and unlock the doors of your mind’s prison.  What lies ahead of you is freedom.”  The goal was appealing, and I liked the confident wording.  Just straight to the point: “What lies ahead of you is freedom.”  Well, okay.

            I opened to a random page and read, If I were to say to you, ‘Don’t think about a red unicorn,’ what would happen next?  Why, immediately, you’d begin to think of a red unicorn!  In fact, I’m sure that’s what’s in your mind’s eye right now as you continue to read this page.  That is what we’re dealing with as we fight OCD.  An obsessive-compulsive experiences an intrusive, unwanted thought, and because it is intrusive, he feels disgusted by it, wants to stop thinking that particular thought.  But just as my telling you, ‘Don’t think about a red unicorn’ results in your immediately doing so, the obsessive-compulsive’s panic and desire to stop thinking the intrusive thought actually drive him to continue thinking about that very thing.”

            Well, that was certainly true enough.  When my worst thoughts arose in my mind and I tried to stamp them out, it was a battle of escalation.  The harder I fought, the harder I needed to fight. 

            “In cognitive-behavioral therapy (CBT),” the book continued, “we encourage the obsessive-compulsive to give in to those intrusive thoughts, to stop fighting them.  Time and time again, CBT experts have found that it is when an obsessive-compulsive stops fighting the intrusive thoughts and actually embraces them that he finds freedom from them.”

            Oh gosh.  I set the book down, my heart beginning to race.  It wasn’t new information to me—Ruth’s brochure had given me the basics of behavior therapy—but the way it was worded gave me a chill.  “Give in to those intrusive thoughts.” 

             “So I’m reading this book for Dr. Foster, right?” I said a couple nights later at Rosie’s Place to Stella before she opened her laptop.  “It’s like reading my own biography.”

            “Yeah?” she asked, taking a sip of something foamy.  “What do you mean?”

            “Well,” I said, “you know how all my ‘issues’ seem so bizarre?  Some of them are not bizarre at all, I mean in the world of OCD.  I’m textbook.  It’s crazy really.” 

            “Like?”  Stella began to sort through the tangled mess of beads she was wearing—black, red, maroon, picasso jasper.  These, in addition to a floral chambray shirt and hiking shorts.

            “Okay,” I said, “so there are all these made-up scenarios, and the book circles back to revisit these same examples.  One of them is a dad who’s sure he’s going to kill his baby girl, so he won’t even hold her.  He gets all these images in his head of suffocating her, stabbing her in her little chest, shaking her, drowning her.”

            “Ew,” she said, still fussing with her beads.

            “Yeah, but these thought make him completely sick,” I explained.  “It’s clear to everyone else, including his wife and therapist, that he would never ever hurt his daughter.  I mean, they’re not freaking out.  He’s the one avoiding alone time with his daughter.

            “And there’s this lady who thinks she might be a lesbian even though she isn’t attracted to women.  Every woman she walks by, she thinks, ‘Am I attracted to her?  Do I want to kiss her?’ then she imagines herself kissing that woman.  She’s just sick over it, but instead of thinking, ‘Oh, I guess not.  That’s not a pleasing image to me,’ she thinks, ‘I must be gay.  Why else would I be thinking so much about kissing women?’  This is called HOCD—homosexual OCD.

“But then get this.  One of the example scenarios is about this girl who has these blasphemous images attack her mind.  She … she pictures herself having sex with Jesus.”  Stella looked bemused, but I continued.  “She doesn’t want to think about that, but there are all these triggers in her normal day—when she sees someone praying, or a cross around someone’s neck, or a kissing scene in a movie or on TV.  And whenever there’s nothing else to think about, that’s where her thoughts go.  She believes that her thoughts are blasphemous, so she believes that she will go to hell.  She thinks about hell all the time.  The book even said that she confessed to her priest, and even he said she was fine, but she couldn’t believe it.  Whenever the image of having sex with Christ came into her head, she said a Hail Mary to alleviate her guilt and drive the image away.  Eventually she had to quit her job because she was too distracted saying her Hail Marys to get work done.”

            Stella’s eyebrows furrowed.  “Gosh, that does sound like you!”  She abandoned the necklaces she’d been working on and clasped her hands together on the table between us, leaning forward as she listened.

            “I know!  I mean, elements are different, for sure, but the basic idea is the same.”

            Stella sighed.  “I used to think that OCD meant that people were super clean.”  She chewed on the inside of her cheek.  I knew what she was thinking, even though she didn’t say it aloud: It’s so much worse than that.

            “Yeah,” I said, agreeing both with what was said and unsaid.  “Even the people who are really clean, or who wash their hands all the time—they’re driven to it.  They think something horrible is going to happen if they don’t do it. It’s so much bigger than just being a neat freak.  It kinda drives me nuts when people with quirks say, ‘I’m a little OCD myself.’”

Stella nodded violently.  “Remember that receptionist job I took at that plastic surgeon’s?  One day this nose-job lady came in, right?  She sat beside a burn survivor, pointed at his dressings, then at her own protective shell covering the bridge of her nose, and said, ‘I know how you feel.  Hang in there.’”

“I don’t believe you,” I said, jaw dropped.  “You’re joking.”

“I’m not,” she said.  “I’ve never been so pissed at a job site before.  I’d take the call center perverts over those rich bastards any day.”  She shook her head in disbelief.  “So … therapy?”

            “Therapy,” I said.  “I guess it’s like a pyramid, and you climb to the top, step by step—if you don’t reach the pinnacle event, CBT probably won’t work.  In the book examples, the dad had to write down all the ways he was going to murder his daughter—graphically!—and then record himself reading it, and he had to listen to it over and over.” 

Stella looked disgusted.

            “The HOCD person had to rate women’s butts and record everything in a notebook, and she had to read a couple LGBT novels.  And the one with religious obsessions had to write a story about having sex with Jesus Christ and then read it over and over again without saying any Hail Mary prayers.”

            Stella made a face but nodded slowly.  “So what will you have to do?”

            I shrugged.  “All I know is that it will be terrible.”

            And for once, I appreciated it when Stella didn’t reassure me.  There was more strength in knowing she agreed.  “I don’t know what to do,” I confessed. 

            “Write about it,” she said.  So I did.


OCD

There he is, that scarlet beast,
black horn like a railway spike.
I check myself against the blood-red giant,
close my eyes, cover my ears,
two-thirds of the famous monkey trio
where I sit cross-legged between cloven hooves.
Do not think of a red unicorn.  Do not do it.
But I can feel his wet, warm breaths like humid whispers

as he lowers his nostrils to my neck, crimson ears at salute
like a maddening accusation.

CBT intake

“This will be different from other kinds of therapy, Neely,” said Dr. Foster, as if he could read my mind and there see my image of Ruth.  “You’ll have homework and be expected to go through various exposures when we meet together.”  He picked up the top coaster off a stack of them on the coffee table between us and set his coffee mug on it.  It had had writing on it.  I looked at what was now the top coaster on the stack.  It read, “Uncertainty and mystery are energies of life. R.I. Fitzhenry.”

For the next hour Dr. Foster tuned in carefully for any mention of rituals, anxiety, and triggers.  I knew that he was combing through my words for his options, already working on his plan of attack for how he would prompt anxiety in me like a gun’s trigger, asking over and over, “If you couldn’t do that, would you have a lot of anxiety?” I blathered, but he was only seeking one thing: what would stress me out to the max.

“When I hear words that start with the f sound, I start praying over and over again in my head,” I revealed.  

“How would you feel if you were prevented from repeating the prayer at those times?”

My heart clenched a little in my chest.  My prayer was the key to counteracting the whole chain of ugliness that lead to blasphemy and hell.  “Um, anxious, nervous, crazy.”

“Mmm hmmm.”  Dr. Foster was jotting notes furiously.

“It’s because of hell,” I shared, explaining how curse words and the sound of the letter f  made me think of cursing the Holy Spirit, which I believed to be unforgivable.  “I’m always scared of hell—only sometimes it’s in the background, like elevator music.”

 He continued to write and encouraged me to keep talking.  “When you’re nervous about going to hell, how do you calm yourself down?”

 “I can’t calm myself down,” I admitted.  “But I ask my friends and family what they think.  Even though it doesn’t convince me, I still like to hear them say I’m okay.”

 “Hmm,” said Dr. Foster in recognition.  “Seeking reassurance is another of your compulsions, another thing you do to ease your anxiety.  Pay attention this week—I bet sometimes you do this passively, like mentioning that you’re a bad person.  Watch for it.”

 We continued on this way, Dr. Foster asking the questions and me providing the answers, feeling ridiculous and unhelpful and as if I were maybe wasting Dr. Foster’s time. 

 “Do you have any questions?” he asked as we were wrapping things up.

 “My faith plays a huge role in my OCD,” I said.  “Do you … ”                                  

 “I believe in God, yes,” he interrupted.  The way he spoke made me certain that he did not feel about God the way that I did.  I gulped.

 “Ninety-nine-point-nine percent of people are skeptical going into this,” he told me, his face like a stone.  I wondered if he ever smiled, even at home.

 “Okay, because I am,” I said.  It felt appropriate to tell him this, even though I was intimidated by his seriousness.  “I think I understand how this works,” I said, “but I’m a little confused.  Like, for example, a washer would be prevented from washing, and then they’d realize that nothing bad happened when they didn’t wash—they still lived.  So how will that work for me?”

 “You’re misunderstanding a fundamental part of cognitive-behavioral therapy,” said Dr. Foster, folding his hands across his stomach.  “The point is not to take away the person’s uncertainty.  The point is to make him or her okay with uncertainty.”

Well.  That didn’t sound so good.

He continued, “Just because a washer doesn’t get contaminated after being prevented from washing one time doesn’t mean that the person won’t still fear a deadly disease the next time.  Each time is a new adventure.”  He raised his eyebrows.  “And with you, well, we can’t fast-forward to the end of your life and see whether you’re going to heaven or hell.  CBT will teach you how to live with uncertainty.”  He tapped on the top coaster in the pile.  “Energies of life.”

I have a friend who is struggling with depression right now.  She has plans to see a therapist soon, but today, she told me that she feels ashamed.  “Like if Jesus is the savior of my life, why am I like this?” she asked me.

My poor, dear friend.  I’ve been there.  All the questions, most notably: why doesn’t it seem like Jesus is enough?  I am definitely that cheeky pot that sassed back to the Potter, “WHY did you make me like THIS?”  There was no answer for a long time.  But now that I’ve been sharing my story– in chapels, youth groups, online, in personal conversations, and in my novel– and I see the way that God is using it … well, I get it now.

My friend feels ashamed.  I told her not to feel that way.  But as I sat at my office desk and thought about it some more, it settled over me that as sinners, our shame is natural– but Christ has redeemed His people, has lifted up our heads.  Do the two cancel each other out?

And to my mind came this quote from Aslan, “You come of the Lord Adam and the Lady Eve.  And that is both honor enough to erect the head of the poorest beggar, and shame enough to bow the shoulders of the greatest emperor on earth. Be content.”

I am not saying that we should be happy for mental illness. 

But I am confident that God knows what He is doing.  He has His reasons. 

God, give us faith to trust You.

 

MMPI

That is, the Minnesota Multiphasic Personality Inventory.

It’s 567 true-or-false questions, and I had to take it when I started meeting with my first therapist (whom I disliked and called “Shrinkie” behind her back).

567 questions takes a long time.

567 questions for an obsessive-compulsive takes even longer.

I kept running into statements and BEATING THEM TO DEATH WITH MY BRAIN.

For example, I believe one of the questions was similar to the following:
I believe God hears me when I pray to Him.

Thought process:
I am a Christian– I should put yes.  But then again, I have committed the unforgivable sin, so He probably doesn’t hear my prayers.  But do I really believe I’ve committed that sin?  Maybe.  Maybe not.  Probably.  I should just put yes.  They want me to put yes because it will help the test to identify my beliefs.  But what if that is inconsistent with my beliefs?  On the other hand, maybe I should put no, because then it will identify that as an issue for me.  It’s definitely an issue for me.  But could I really, honestly say that I don’t believe God hears me when I pray?  I’m just being silly when I think that, right?  As a Christian, I should put yes.  I believe yes.  But then again, maybe I’m not a Christian.  If I’ve committed the unforgivable sin, then how can I still call myself a Christian?  I should just put my gut reaction.  Which is yes.  But why put a gut reaction down instead of a thought-out answer?  If I really think it through, then I don’t believe it.  Well, I think I do actually believe it– TODAY– but it could very well be a concern for me tomorrow or every day next week.  Should I put down how I feel right now in this moment, or should I put down how I usually feel, which is no?  I guess that’s not how I usually feel– maybe one-third of the time.  But most so-called “Christians” would think that one-third of the time is huge, in which case, it’s a bigger deal, and I should put down no.  Really– one-third?  Seems like a lot more.  If I think about it again, it’s probably more than one-third.  It’s maybe one-third of the time really BOLD– time when I’m terrified.  But even those other two-thirds I’m still doubtful of my salvation.  It’s just quieter.  So how do I interpret that?  One-third TERROR, two-thirds doubt.  Compared to the normal, which is little to no questioning of one’s salvation, that is a LOT.  So I should put no, so that the test correctly interprets that I have major issues with this particular scenario.

Right?

I’ll come back to it later.

You get the point. 🙂