Tag Archives: cognitive-behavioral therapy

all about CBT

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Some people have been asking for more details on cognitive-behavioral therapy, the incredible tool that God used to set me free from obsessive-compulsive disorder.  It is my pleasure to share with you about CBT!  Please note that I am not a mental health professional– but I did have a wildly successful experience with CBT and am a huge advocate.

This is the preferred method of treatment for OCD; specifically, it is called Exposure and Response Prevention (ERP).  Long name, but actually, it is exactly what it says!  The patient is exposed to something that triggers an obsession and then the response (the compulsion) is prevented.  This therapy actually re-wires the brain– the brain physically changes in this therapy– and it helps an OC to live with uncertainty.

CBT either works or doesn’t in 12 weeks.  My psychiatrist, national OCD expert Dr. Suck Won Kim, told me beforehand that it would be worthless to meet with a CBT therapist longer than 12 weeks and that Dr. Chris Donahue wouldn’t ask me to meet any longer than those 12 weeks.  Three months.  You can handle anything for three months, right?

The first couple weeks were most intake.  Dr. Donahue asked lots of questions to help assess what my obsessions and compulsions were, and what triggered the obsessions.  He was basically probing to find what buttons to push later: “How much would that stress you out if you couldn’t do XYZ after ABC happened?” and that sort of thing.  I knew it would all come back to “haunt” me, but I was all in.  This honestly felt like my last hope for a normal, happy life.

I took the YBOCS (Yale-Brown Obsessive-Compulsive Scale) test and found out that I was a moderate case, which surprised me.  But then again, there are some people who can’t leave their homes, can’t touch a loved one, people who wash their hands with Brillo pads and bleach.  

Dr. Donahue outlined the measurable goals of my treatment plan: a fifty-percent reduction in distress when focused on upsetting stimuli and six consecutive weeks of no avoidance or rituals.  Three months was starting to sound like a long, long time.

Then Dr. Donahue and I wrote a story together.  Well, he started it and it was my homework to finish it.  Since my obsessions were primarily focused around hell, we had to do imaginative therapy (since, obviously, there is no way to really, literally expose me to hell).  So I wrote this story about an imagined worst day ever (I mean, really bad– I go to hell in it).  If you’d like me to share with you the story, I will.

My therapist recorded this story (along with his own additions to it) digitally, and I was sent home with an 18-minute recording from the pit of hell.  My job was to listen to it four times a day– two times through, twice a day– every day and record my anxiety levels when prompted.  And I needed to do this consistently until my anxiety levels reduced by 50% from what they were the first time through.  Oh, and I couldn’t perform my compulsions either to make myself feel better.

It. Was. Awful.

I won’t lie to you, listening to that recording– that exposure– was like torture.  It was being triggered left and right and not being allowed to do anything to ease my anxiety.  Doesn’t this sound like some type of cruel and unusual punishment?  It’s what it felt like, and I honestly wanted to quit at about week 8 or 9 when my anxiety levels weren’t dropping.

I hated it.  It made me sick to my stomach, made my heart race, terrified me.  I tried to listen to the recording right away in the morning, in order to get half of my required listenings out of the way early in the day, but eventually, I couldn’t do it that way anymore– the weight of beginning my morning in such misery made it hard to get out of bed, and I had to push it all back later in the day just so that I wouldn’t dread waking up.

But something clicked around week 10 or 11.  Praise. The. Lord.  It clicked, and all of the sudden, I was in the driver’s seat again!  I controlled my OCD and not the other way around.  One day I was listening to the recording– this device of torture and grief– and I thought, This is so annoying.  And then I smiled and thought, Finally.

This, of course, is a brief description of my experience.  I could tell you so many more things– about how hard it was, about what other exposures look like for other kinds of OCs, about the tools Dr. Donahue gave me for success.  It’s all detailed in my fictionalized account of it, my novel Lights All Around, which you can read here.

It was one of the hardest things I have ever had to do– but not as hard as living for 20 OCD-riddled years without help.  I hated to go through CBT, but I loved to have gone through it.  It rescued me and those twelve weeks are a defining period of my life.  I remember being so angry and upset with my therapist, absolutely despising him and the exposures, and feeling certain that I was going to fail at this, my last shot at freedom.  I very nearly quit.

But that moment came right before everything changed.

If OCD is ruining your life, you need to undergo cognitive-behavioral therapy.  It will be hard.  It will be hell.  But it will be worthwhile.

Questions, anyone?

To read a stark account of my life before and after CBT, check out this blog post!

joy in sorrow

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I grew up hearing that happiness was situational but that joy was not: that joy was this solid rock you stood on, and it never moved, even when everything else around you was crashing down.  I was supposed to feel a deep-seated joy, even when I wasn’t happy.  I knew this.  I tried to make it be true, tried to convince others that it was.

But for much of my life, if you were to strip away all the smiles and masks, I was resting on an uncomfortable bedrock of deep sorrow, bondage, and fear– and oceans below, barely visible, there was a flickering hope.  I smiled often– sometimes it was fake, sometimes it was real.  There were moments of joy, real instances where it flashed so bright that I couldn’t see the ugliness around me.

It’s different now.

I have what I always wanted while growing up, and it is incredible.  Even when I am feeling low, depressed, frustrated with friends or with my writing life, or even deeply saddened, I am grounded like an anchor to JOY.  I have a permanent seat inside it, and from that seat, I can experience the whole wide range of other emotions, but I don’t move from the chair.

I believe that anyone who loves Jesus Christ can have this be true.  In my early life, the problem was that I was convinced by a lie: I believed that my future was not secure in my Savior.  Obsessive-compulsive disorder robbed me of that truth.  Cognitive-behavioral therapy restored it.

What is at your core today?  Are you standing immovable on joy, or something else?  Why is that?

 

as CBT started to work

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On Tuesday, the sky was ominously green as Sophie and I walked through the parking lot and into Target; it a way, it reminded me of the sky the night that Trapper called it quits.  Once we were inside, the tornado siren began to blare, muted by the walls of the store.

Stella and AJ Cook were in the produce section, checking for a fresh cantaloupe.  “Hey,” I said.  “Do you know what’s going on outside?”

“My mom just called,” said Stella.  “She said a tornado’s coming through Fridley.”

“Excuse me,” said a red-and-khaki worker to our quad.  “We’re asking everyone to move to the back of the store, away from any windows, for the next fifteen minutes.  There’s a tornado warning.”

Sophie, Stella, and I looked at each other; AJ looked toward the doors.  “I suppose we’d better listen,” he said.  And so it was decided.

We left our shopping carts by the fruit and headed for the back of the store, choosing an aisle of rugs and runners.  I sat down on the bottom shelf.  Sophie sat beside me, and AJ and Stella sat on the shelf opposite us.  Target employees were milling back and forth, talking into their walkies like police at the scene of a crime.  The atmosphere was dry, ready.  “I hope that everyone in the store tonight sings a song together before this is all over,” I said.  “It just seems right.”  AJ sat with his long legs sprawled into the aisle; Stella, beside him, had her knees pulled up to her chest and her chin resting on them.  “This feels like the perfect setting for a movie,” I said.  I nodded at AJ and Stella.  “You two are the Young Couple in Love.  You know, like in Armageddon or Poseidon.  The young folks so in love when it’s tested by tragedy.”

AJ laughed and dramatically grabbed Stella and shook her.  “You stay with me!” he roared.  “I’m not gonna lose you!”

“Exactly,” I said, laughing with the others.

An attractive male Target worker in thick black-rimmed glasses marched resolutely through our aisle, between our two groups.  I watched him as he walked to the end of the row and turned right.  “Someone should fall in love with a Target employee by the end of the movie,” I said.

“Sophie,” suggested AJ.

I scowled at him.  “Thanks a lot, AJ.”

“Or you,” he said, shrugging with upturned palms.  “Whoever.”

I sighed and leaned my head back against a black shag rug.  “No, it’s okay.  I will play the part of the Frustrated Writer.  The tragedy will be what shakes my character free of writer’s block, and the whole movie will be narrated by me, by what I write in the book.”

“Oooh, I like this!” said AJ.  “I dig!”

“We should probably have a dramatic scene where someone loses a phone call,” said Sophie.  “Stella’s mom calls back, and over the phone, she’ll hear her mom be … lifted away.”

“Yeah,” I said.  “Then Stella will go berserk, screaming all over the place and trying to run out of the doors, but AJ will hold her back.”

“I’ll have to wrestle with her!” he said.  “I’ll have to slap her to get her to focus.  It will all be so gripping.”  He grinned at Stella while she rolled her eyes.

“We’ll call it The Target Zone,” I suggested.  “Target Twister?  Bullseye Funnel?”

We continued to create an epic tornado-meets-Target screenplay while the muffled siren blared on.  And so we effectively entertained ourselves while danger swirled by outside, passing over our building as if we had blood on the doorposts.  The thought crossed my mind that this sort of thing—this Passover of danger—was becoming my new “normal.”  After only fifteen or twenty minutes, the sirens stopped, and the Target workers let us get back to shopping.  So we returned to our carts by the fruit, said goodbye to Stella and AJ, and eventually left Target.

“No singing, screaming, death, or romance,” I said to Sophie.  “All in all, a boring night.”  We both laughed, and it sounded like tiny bells ringing in the dark.

slavery and freedom

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Last Thursday and Friday, I attended the Global Leadership Summit through a satellite site, and it was incredible.  This was my second year attending, and both last year and this year were phenomenal.  Essentially, the Willow Creek Association pulls together a knock-out faculty of world-class leaders to speak; it’s like being smacked upside the head (in incredible ways) each hour.

On Friday, Pranitha Timothy of International Justice Mission spoke about human trafficking and about her work with IJM to rescue many from slavery.  It stirred my blood.  It always does, to hear stories about slavery and freedom.  I want my life to matter, want to do something important for the Kingdom.  I could almost picture myself going into dangerous situations to pull children out of slavery and get them safely back into school.

On Saturday, I met with a college student whom I have known for about a year and a half, a young man who is living in his own personal OCD hell and is ready to break out of it by pursuing cognitive-behavioral therapy.  We sat together, discussing OCD and how hard it was and how no one understands– but also CBT and how it can give him the tools to step from darkness into light.  I told him that in just a short time, he could be free from OCD’s reign, and I realized …

I am an advocate for those in slavery seeking freedom.

I may not be rushing into workhouses to confront slave-owners or holding children in the midst of a chaotic rescue, but I am a CBT advocate, telling obsessive-compulsives over and over and over again that this is the way to freedom.

I still plan to support IJM financially (and you can too at http://www.ijm.org/give), but I realized that my personal rescue missions will look a little different.

Cognitive-Behavioral Therapy gave me back my life

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Some of you probably think that I am being dramatic.  If you do, I can almost guarantee that you have never suffered from obsessive-compulsive disorder, because those with OCD know that it essentially steals life and joy right out from under you.

I was in a dark place.  My thoughts felt uncontrollable and blasphemous.  I could not take long car rides or fall asleep at night without audiobooks because I needed to give my racing mind something to focus on.  I felt deeply guilty nearly all of the time– and even about small or ridiculous things.  I had an unreasonable weight of responsibility on my shoulders, as if I were somehow the one keeping the world functioning.  I entertained silly and/or terrifying idea of reality.  I felt hellbound and cut off from God’s love and forgiveness.  I was without hope and utterly exhausted.

Cognitive-behavioral therapy was one of the hardest things that I have ever undergone– but those 12 weeks of intense therapy were what God used to set me free from the clutches of OCD.  CBT is a strange concept– give in to your obsessive thoughts in order to gain control over them– but IT WORKS.  I am living proof.

I cannot recommend CBT enough.  It is my mantra to anyone who suffers from OCD: get CBT, get CBT, get CBT.  I feel so much happiness, joy, security, normality now that I want to plead with OCs to come join me on the other side.

Listen up.  If you have OCD and are living in darkness, I know the way out.  I would be happy to sit down with you and tell you all about CBT, answer any questions that you might have, and encourage you as best as I can.  Go to http://abct.org and find a cognitive-behavioral therapist in your area.  There is a light ahead.

my favorite paradoxes

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1) I lose my life to gain Life.

I love that when I surrender my life entirely to Christ, I gain real, true life in Him.

2) Strength through weakness.

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me.

3) When I give in to my intrusive thoughts, they lose their power over me.

Cognitive-behavioral therapy’s premise is a simple one, and though it seems backward, it works.  My life is proof.