Learn all about CBT/ERP here!
Learn all about CBT/ERP here!
Tonight, I have been thinking about that deep, dark pit and the moments of my life when I was at the very bottom, nowhere lower to go and my head too heavy to look up. I have been thinking about the things and places that remind me of those times.
You might guess that it was those months after college graduation, when I would wander from the laundry room to look over the balcony to the pool area two floors below and think about what would happen if I let myself fall.
Or maybe that it would be one of those evenings when I was wild-eyed and manic, scream-weeping in the bathroom while my roommate sat outside the door and prayed.
But when I think of myself at my lowest, I always picture myself in the Caribou Coffee in Long Lake, Minnesota. I’d arrived to town too early to visit Orono High School, and so I stopped into Caribou off of Highway 12 (which has since been re-routed), ordered hot cocoa, and sat alone at a table. In my car I had been listening to “Spirit” by the band Switchfoot, letting the chorus hammer into me that all I wanted was Jesus … exactly whom I believed I could not have.
Interestingly, the emotion that I seemed to feel the most was this odd, lonely marvel. Don’t get me wrong– it was not good, as marvel usually is. It was this dark, lost, inconceivable wonder that I could be so damned and that there was nothing I could do about it. I sipped at my cocoa, thinking how there was no joy left available to me, no rescue coming, no prayer I could whisper to make things okay again. A marvel and a sort of understanding washing over me that this was my reality and there was no way out.
For years, I could not listen to that song (which truly is a lovely one!) without feeling a stale depression steal over me. To this day, when I drive by that Caribou, I think to that dark day. Nothing impressive or strange or particularly triggering had occurred, but it is my lowest, loneliest moment of my life.
I could not have pulled myself out of that pit. I didn’t even have the strength to lift my eyes.
(Oh gosh, I’m going to start being known as That Girl Who Cries in Barnes & Noble, LOL!)
Jesus Christ rescued me. He led me to the right medication and the right therapy and carried me out of the pit himself.
In the past couple of weeks, I have gotten several emails from fellow obsessive-compulsives who are in that same pit. I write this post to say that there is hope– and it’s not in ourselves.
One of my friends has had her obsessions flare up again (she is worried that her brother will die on his spring break trip), and she emailed me for prayer and advice. I asked her, “Do you want tough love?”
Her response: “Yes, okay, just hold on a second I have to prepare myself.”
A minute later: “I am ready. Go.”
I wrote back:
I’m not going to reassure you about this because LIFE IS FULL OF UNCERTAINTY, and we have to learn to live with it. I’m not saying this to be mean, but the truth of the matter is that he could slip on the Minnesota ice outside and hurt himself that way just as easily as a trip to California. We DON’T KNOW. We CAN’T know. All we can do is make decisions based on the evidence available. The evidence available suggests he will be fine. Whether you worry about him or not won’t change anything except for how YOU cope with his spring break.
The best thing that you can do for yourself to keep from spiraling is to repeat to yourself, “I can’t know if he’ll be okay. He might be. He might NOT be. Either way, he knows God, and I have to just live my life with uncertainty.”
I want to reassure you. But that would be just silly—who am I (who is any mere human) to reassure you of something like this? Our lives ARE like a vapor! We have no way of knowing.
The evidence available suggests that most healthy young people live till their 70s, so that’s what I’m going to plan for.
My friend thanked me for the tough love; I think I’m allowed to dole it out because she knows about how cognitive-behavioral therapy changed my life. CBT is really just a giant act of tough love, isn’t it? We’re put through torture so that we can barrel through the hell of daily life with OCD. I know I am so glad to have gone through it myself, and that is why I am not willing to reassure someone of something we can’t know.
Life is full of uncertainty, and each obsessive-compulsive wants to eliminate it– which is just not possible. Still, we go to great lengths to attempt this impossible feat. Really, our rescue is in learning to embrace the uncertainty.
If it boggles your mind a little, that’s okay. It still does mine too, and I’m a success story!
For those of you with OCD, is it hard for you to receive tough love from people? For those of you who love an OC, is it hard for you to dole it out?
I first learned of the Live OCD Free app when I was in Boston last October, attending an event hosted by the International OCD Foundation. I was intrigued by the idea of a web app that could simulate or guide Exposure and Response Prevention, so I picked up some handouts to take back to my university, and that was that.
Until I had lunch with Faith, this incredible 9-year-old who is battling with OCD.
Somewhere in the back of my mind, I had stored the memory that this app had a children’s version to it, so I contacted the company and asked if I could have a free trial of the app so that– if I liked it– I could promote it on my blog. I received a very kind email from Dr. Kristen Mulcahy, who also sent me a promo code.
Live OCD Free app
What it is:
Billed as “your personal pocket therapist,” this web app allows you to undergo cognitive-behavioral therapy (CBT), specifically Exposure and Response Prevention (ERP), either on your own or with the help of a therapist. With it, you create a hierarchy of exposures, practice your exposures, and record your progress. You can even easily email your progress reports to your therapist! There is an adult version and a child version (both available with just the one purchase).
In the child version of the app, there is a video that shares the story of the “Worry Wizard” with the child– in the video, the Worry Wizard happens to be another person (a bad kid, ha!), which I kind of like. It goes along with the idea of narrative therapy that YOU are NOT the problem, the PROBLEM is the PROBLEM. By showing children that the Worry Wizard is a completely separate entity from themselves, they are able to treat OCD as the enemy and not themselves.
ERP is then made into a game of sorts. Children (along with the help of an adult) create a list of exposures (with simple prompts to aid them). They then can practice their exposure at the click of a button. If there is a need for an imaginative exposure (creating a loop tape/recording), they can do that within this app as well. There are also built-in timers to remind users to practice their exposures and to record their anxiety levels (for the progress reports). It’s really easy to use, very self-explanatory.
The adult version is very similar to the child version except that it just tells it like it is. 🙂
The secret weapons (child version)/toolbox (adult version).
Oh my goodness, I absolutely loved this feature*. When you choose to practice an exposure, you set the timer for how long you’d like to do it. While you are practicing an exposure, you can access the secret weapons/toolbox area, which includes:
1. Reasons for fighting (both versions). A place where you can review and record your reasons for fighting OCD/the Worry Wizard.
2. Uncertainty agreement (adult version). Where you acknowledge that you cannot know things with certainty. This records the date that you “signed on” for this!
3. Relaxation (both versions). Listen to an exercise in muscle relaxation.
4. Motivational messages and inspirational quotes. You can even add your own!
5. Tips from other kids fighting the Worry Wizard. Obviously, this is in the children’s version. Loved it. The quotes were so good and meaningful and encouraging without being enabling at all.
6. Songs (child version). This included two songs for children (although there is a whole CD available on iTunes). I have to admit, one of the songs– “Worry Wizard”– made me cry listening to the lyrics. It just breaks my heart that children have to deal with this crippling disorder. They are so brave!
*When I was doing my own exposures, I was told to focus intently on them … I wonder how this toolbox jives with that, or if that was only my therapist’s method.
Live OCD Free User’s Guide
This is wonderfully written, very clear. If someone is choosing to do ERP on their own and without the guidance of a therapist, this user’s guide will be critical to their success. Since I have undergone CBT, I now find it fairly easy to recognize obsessions and compulsions– and to identify appropriate exposures. However, I would not have been able to do this if I hadn’t gone through ERP myself already. The prompts are very helpful (and OCs often know what things bring them the most anxiety), but this user’s guide will be a huge help in sorting through obsessions, compulsions, and exposures. I emailed with Dr. Mulcahy, and she said that sometimes people will meet once or twice with a cognitive-behavioral therapist just to set up their exposure hierarchy before attacking the actual exposures on their own. Even if you don’t have health insurance, I can see where this would be very helpful. If not, the user’s guide will assist in that matter.
This app makes it easy to see your progress. I love that. A visual reminder of how far you’ve come can go such a long way!
There are very, very few cons to this app. The graphics in the video of the Worry Wizard were not my favorite, and (of course) being a writer, I thought the story could have used a little polishing, but all in all, this app is phenomenal.
The cost is around $80, which at first seemed like a lot of money to me … but it’s really not. Not for what you get. An ERP experience for $80 is a bargain (even with awesome health insurance, I still probably paid about $300 out of pocket to meet with my cognitive-behavioral therapist). And the freedom to be gained through this process is priceless.
I imagine that CBT without the guidance of a therapist would also be more difficult, especially as there is less accountability, but the truth of the matter is that CBT takes a lot of commitment, no matter what. I have said it before and I will say it again, you know you are ready for CBT when the hell you’re experiencing daily is worse than the hell you’ll have to go through with CBT.
All said, I highly recommend this product.
I cannot say enough good about CBT/ERP and how it gave me back my life. Whether someone chooses to go the traditional route of seeking out a cognitive-behavioral therapist (note: NOT a talk therapist) or chooses to use this web app … or chooses to use both in conjunction with one another … I am 110% for it.
The important thing is that you pursue CBT.
Through my website, I can see what search terms are bringing people to my blog, and this week, the number one search term was “OCD torture.” It breaks my heart. But I can completely understand and relate.
For those who are in the throes of such torture:
Welcome to my blog. I know what you’re going through– I was there myself, only about 5 years ago. And the torture was long-lasting for me– nearly 15 years of it. It’s crazy how we can even bear up, isn’t it? Sometimes I am amazed that I survived, was able to get through school, was able to keep my job. Every single day, I hurt so bad. Every single day, I had this feeling that something was wrong, something was off. I felt frantic. The weight of the world was on my shoulders, even from when I was young. Personally, my OCD attacked my Christian faith and made me doubt my salvation, and that doubt is like pure agony to one who loves Christ. So many evenings I spent weeping, almost keening, because I couldn’t handle the thoughts and doubts that were inhabiting my brain, burrowing into it as if they’d stay forever.
My OCD attacked whatever was most important to me. It made me think people were secretly against me, it made me think I shouldn’t tell my problems to my best friend, it made me think it was sinful to write (one of my life’s greatest loves), it made me think I was gay when I clearly was not, it made me think I was a sex offender, it made me think it was wrong to meet new people or to talk to anyone I didn’t know (not helpful when your job is recruiting!). It made me feel guilty if I brought home a STAPLE from work. It made me feel guilty and sinful all the time. And TERRIFIED too. It wasn’t always just a dull agony. Quite often it ramped into a shrill, turbulent nightmare. Overwhelming, engulfing terror would swallow me whole. And then sometimes, to hide itself, it would make me even doubt that I had OCD (tricky bastard!!).
Notice I say it made me feel this way. OCD, my disorder, made me feel this way. The guilt and terror were not from God. The thoughts and doubts weren’t my own. They were given to me, like the ugliest of gifts, from my disorder.
I remember reading blog post about the unpardonable sin, thinking that is me. I am in those shoes, and I will never be out of them. Guess what? I have been delivered from that ugly hold OCD had on me. I still have it. But I’m the boss; it’s not.
How? Cognitive-behavioral therapy, specifically exposure and response prevention therapy, which I’ve explained on my blog here. Now, after twelve weeks of CBT, I have been in control of my OCD for the last four years. It’s like another life. When I feel guilty now, it’s because I’ve done something wrong. When I doubt something, I don’t freak out– I seek out advice from family, friends, and the Holy Spirit. I know my soul belongs to God. I can look at OCD’s silly suggestions and see that they are ridiculous. I don’t have to entertain them. I can toss them aside like I never could before.
And my OCD knows it’s not in control anymore. To be honest, it doesn’t even fight me as much now that it knows it loses every single time. It knows I have the tools to toss it out the window, so it keeps pretty quiet around me.
Meanwhile, it is torturing you. I hate that. I want you to be free like I am. It is going to be a rough road, but there is help. Find a cognitive-behavioral therapist, buckle in, and do whatever you have to do to complete your therapy. And when you want to quit, you can post a comment on this blog, and I will be your cheerleader. Skip the traditional talk therapy. You need someone who knows how to do ERP.
Start today. It’s time for freedom.
Note for those without health insurance: If you can’t afford to see a cognitive-behavioral therapist, and if you’re ready to take back your life, you can try a self-guided CBT experience with an iPhone app like the one at http://www.liveOCDfree.com or by using a book like “Stop Obsessing!” by Edna Foa or “Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty” by Dr. Jonathan Grayson.
When I think of words to describe myself, brave is not one that comes quickly to mind. In fact, I think I’m actually kind of a wimp. A chicken. I read books about crazy adventures because quite often I’m too scared to tackle them myself.
If I’d have gotten my letter for Hogwarts, I’d so desperately have wanted the Sorting Hat to put me into Gryffindor House. But, let’s be honest, I’d have probably been in Ravenclaw. Or Hufflepuff (gasp!).
Movies scare me … sometimes even when they’re not supposed to be scary. Change scares me. Public speaking scares me (although not as much as it used to!). I’m scared of needles, writing criticism, driving in the snow, and going to parties alone.
But last week I was emailing my friend Kyle about various opportunities in my life, and he wrote to me: “It will be a brave decision to stay, or a brave one to go, and for different reasons. You’re a brave person.”
But I thought about it more. I am scared of change … but I am willing to take risks I feel called to take. I am scared of public speaking … but I force myself to accept opportunities to share with crowds (and have really honed my skills!). I’m scared of needles, but I get shots. Of writing criticism, but I invite it, ask for feedback all the time. Of going places alone, but I suck it up, paste on a smile, and meet new people.
Driving in the snow … yeah, okay, I avoid that and just stay in. 🙂
But even more than all of this, I lived for over fifteen years under the tyranny of obsessive-compulsive disorder, and I stood up to it. I tackled cognitive-behavioral therapy, which was the hardest thing I have ever had to do, and came out with OCD under my foot instead of the other way around.
Know how I feel?
Janet from the ocdtalk blog pointed me to the International OCD Foundation’s website for this list. I hope it will be helpful for you as you seek appropriate treatment for your OCD. I can’t stress this enough: OBSESSIVE-COMPULSIVES SHOULD NOT WASTE THEIR TIME ON TALK THERAPY. YOU NEED COGNITIVE-BEHAVIORAL THERAPY, SPECIFICALLY EXPOSURE AND RESPONSE PREVENTION THERAPY.
“Do you use Exposure and Response Prevention to treat OCD?”
Be cautious of therapists who say they use CBT, but won’t be more specific.
“What is your training and background in treating OCD?”
If they say they went to a CBT psychology graduate program or did a post-doctoral fellowship in CBT, it is a good sign. Another positive is if a therapist says they are a member of the International OCD Foundation (IOCDF) or the Association of Behavioral and Cognitive Therapists (ABCT). Also, look for therapists who say they have attended specialized workshops or trainings offered by the IOCDF, like our Behavior Therapy Training Institute (BTTI) or Annual Conference.
“How much of your practice currently involves anxiety disorders?”
“Do you feel that you have been effective in your treatment of OCD?”
“What is your attitude towards medicine in the treatment of OCD?”
If they are negative about medicine, this is a bad sign. Medicine is an effective treatment for OCD.
“Are you willing to leave your office if needed to do behavior therapy?”
It is sometimes necessary to go out of the office to do effective ERP.
2012 was a good year.
In January, I had just aside my OCD manuscript and was 50 pages into writing adult fiction about a woman who was a late discovery adoptee when I read The Fault in Our Stars by John Green. The book walloped me in the best way possible, inspiring me to drop the LDA story and try my hand at young adult literature. 12 months later, I am head-over-heels in love with writing for this demographic– not to mention deeply in love with the characters in my book.
In February, I posted one of my most frequented links, about how medication is scary.
In March, my friend Ashley encouraged me to get serious about my blogging, and the rest is history. I started blogging with a lot more frequency after that, trying to refine and define what exactly Lights All Around was about. In the end, it boils down to three things: faith, creativity, and OCD.
I believe it was in April that I wrote and submitted a post for the Rage Against the Minivan blog, never guessing that it would actually be chosen and posted months and months later.
In May, I left my job in management, moving into my old role as an admission counselor only. At the time, it was devastating to me, but in the months since, I have come to realize it was a true blessing in disguise. I had wondered if it might, but it was hard to see past the sadness.
In June, I spent a week tucked away in an apartment above a Wisconsin garage, writing like a maniac and finishing the first draft of Truest. It was a bad draft, but that’s what first drafts are supposed to be. At least it was in the computer.
July, I nursed my crush on the Olympian Michael Phelps and posted a mildly scandalous short story about Adam and Eve, one of my most-commented-on posts.
In August, I read The Night Circus by Erin Morgenstern, which, alongside The Fault in Our Stars, was one of the best books I read all year. (I love that I can measure my months by the words I encountered.)
September marked the end of an era as I ventured to the University of Minnesota Medical Center to meet with my beloved psychiatrist for the final time before he retired.
In October, the International OCD Foundation flew me out to an event of theirs in Boston to read an excerpt from my OCD novel that had won an international creative expression contest. There, I fell in love with the IOCDF.
November I decided to speak out even louder than usual about cognitive-behavioral therapy, explaining to blog readers what my life was like before and after CBT and also details of what my CBT experience was like. I got emails from people after this, asking for even more details, even some fellow Minnesotans wondering specifically about my own therapist.
In December, I finished yet another draft of Truest while on an artist retreat I had been selected for. I am committed to this story. My writing group has helped and continues to help me SO MUCH with revisions, and I decided to purchase a short mentorship with a Minneapolis editor.
Which brings us to now. And what’s ahead for me?
I have gotten into the habit of blogging, and I love it. I will keep speaking loudly about OCD and CBT and ERP. God has been so good and so faithful to me, and even today, when I was feeling very low, I was still able to be grateful that I have a permanent love in my savior. I will keep reading as much as I possibly can and review the books here on my blog. I will keep writing– because I love it, and because I crave it, and because I have to. I will continue to meet with my brilliant writing group and start my online mentorship next month.
2012 was good. Here’s to an amazing 2013.
One thing that frustrates me to no end is when people treat mental illness like moodiness, as if you can just snap out of it, instead of like the medical issue it is. This mindset is so pervasive that it has infiltrated even those with mental disorders. It broke my heart to sit across the table from an obsessive-compulsive who thought she should be able to just “pray away” her OCD. Now, of course I think that prayer matters. But I think also that you pray about cancer– and then undergo chemotherapy— and pray some more.
I thought this picture was particularly fascinating because you can replace “creativity” with “cognitive-behavioral therapy.” And those are two of the most important things in my life.
I always thought that certainty was the goal and that doubt was the adversary, but it was just another lie.
What do you think of this quote?