I Confess

Posted on February 2, 2014 by Jackie Lea Sommers

I don’t want to admit this to you. I really don’t.

But I’ve made such efforts to be honest with my blogging community, and the wonderful, encouraging reception I’ve always gotten from you, my beloved readers, has continually encouraged me to continue with that honesty and integrity.

So today I’m going to tell you something that might make you made at me. Here it is:

Sometimes I get really frustrated with people with OCD.

Five years of freedom and already I am so quick to frustration. Shame on me, right? Then again, the last five years of my life (post-ERP) have been so absolutely incredible that they make me even more frustrated with those who avoid treatment.

The truth of the matter is this: exposure and response prevention is the best and most appropriate treatment for OCD. Quite simply, if you’re looking for a “solution” to your OCD, then I have it for you: ERP. I hear from a lot of people who seem to want a different answer, and yet my bottom line remains the same: ERP, ERP, ERP.

I know it’s scary. (Trust me, I know it’s scary!) But it’s the right answer, and I’m not going to send you on a wild goose chase when I know the right answer. That would be like me telling you to go get chemotherapy for your gunshot wound or that you need insulin for your broken arm. It’s obvious that those aren’t the correct treatment for the issue, and I won’t do that to you.

Research shows that ERP is the best treatment for OCD. My life shows that a person with obsessive-compulsive disorder can redeem the years he or she lost to being enslaved by OCD. No matter how many times you ask me, I’m going to give the same answer.

There. Got it off my chest. Don’t worry, folks; I’m still here for ya! I aim to be a voice advocating for our quiet and oppressed community. But just how I refuse to aid someone in compulsions, I will also refuse to send you down the wrong corridor for help. I’m doing this with the best interest of our community in mind, I promise.

My heart and energies and motivations rest in leading those in slavery toward freedom. Know that.

Don’t Push the River [& other advice]

Posted on January 24, 2014 by Jackie Lea Sommers

Last month I was stressing out intensely over writing my next novel. We’re talking panic, high stress, extreme anxiety, the whole shebang. There’s a head game in writing, and I was losing it. Badly.

I reached out to my undergraduate writing instructor, Judith Hougen. She was a mentor to me in college, and in many ways, she still is today, even though I don’t get to see her nearly as often as I’d like. I’ve written about Judy on my blog before: how she is laden with wisdom and creativity, how she loves truth and beauty.

We got coffee, and I shared how stressed I was, then I waited for her wisdom. She said:

InWater1 by carpeemorteem
via deviantART

Don’t push the river.

The full proverb is “Don’t push the river; it flows by itself.”

A river is going to go where it wants, carve out the path it chooses. I’m a fool if I think that I can redirect it– or that I somehow keep it flowing.

It quite fascinated me because one of the things that my cognitive-behavioral therapist said to me (digitally recorded for all time in my ERP exposure recording) was this:

“I want you to close your eyes and imagine you’re standing in a river. The current is strong, and the waters rush past you, pounding you, beating against your legs, hips, waist. Eventually your whole body is fatigued; your legs are so tired you can barely stand. Then you finally turn around and let yourself go with the current.”

His point was plainly and simply that he was offering me relief.

And that’s what Judy was offering too.

Judy said, “If you skip writing one night, you have to trust it’s not all going to leave you.”

Judy said, “Let the writing of this book be its own experience. Don’t compare it to the last one.”

Judy said, “Respect the mystery of writing.”

It was like balm to my anxiety-riddled soul. I am letting her words minister to my writer’s heart. And letting my one word for 2014– grace— work its way into the cold and lonely places in me like an adhesive that holds me together.

The Long Journey … to the Starting Line

Posted on January 12, 2014 by Jackie Lea Sommers

“Cross That Line” by xLadyDaisyx on deviantArt

It is SO HARD for OCD sufferers to be correctly diagnosed and then find the right treatment and a good cognitive-behavioral therapist. In fact, it takes an average of 14-17 years for someone to access effective treatment.

That stat stings my heart. I feel it deeply because of my own personal struggle.

I developed a sudden onset of OCD at the age of 7. I wasn’t diagnosed with OCD until I was 22. I started ERP (exposure and response prevention) therapy at 27. That’s twenty years, folks– fifteen just till diagnosis alone.

Growing up, I just assumed that I “thought too much”– was an “overthinker” and especially sensitive to issues of morality. I didn’t understand that other people were also undergoing the same doubts as I was but were able to move past them with ease. I, on the other hand, would get trapped. The exit door to my brain was stuck shut, so all my thoughts just milled and churned and generated intense anxiety. I didn’t know that others even had the same thoughts as I did, nor did I realize how it would be possible to let such thoughts come and go.

In childhood, I cried all the time. In fact, I cried every single night for three years in a row. I never told my parents about this. I was so scared that they wouldn’t be able to “fix” me that I preferred to just rest in my own sadness, still clinging to the hope that *someday* I could be fixed. As long as no one told me it was impossible, it still felt possible, and even thought I was terrifically sad, I kept that hope as my lifeline.

High school was a beast. I got straight A’s (OCD drove me to perfectionism) and graduated at the top of my class. I was a class clown, and I had some amazing friends. But I battled intense spiritual doubts and lived in great fear. My tenth grade year was one of the hardest of my whole life. Only those closest to me knew it.

My doubts intensified in college. They escalated to a whole new level. Thankfully, I had a solid support system in my new friends (people who remain my support system to this day!). And though they couldn’t understand what I was going through, they loved me.

After undergrad, things fell apart. In a nutshell, I lost my grip on reality– my doubts had grown so large and out of control that I no longer knew if I could trust my friends or my own human experience. Finally, for the first time in my life, someone used the words mental illness with me. It felt shocking.

I was encouraged to meet with a therapist (unfortunately, a talk therapist– not effective for OCD), who also got me in to meet with a psychiatrist, and I was finally diagnosed with obsessive-compulsive disorder. A diagnosis fifteen years in the making.

I spent about a year with that first talk therapist, and it was more damaging than anything else. I finally “escaped” and never again set foot in that clinic. Meanwhile, I was an SSRI lab rat, trying out a slew of various medications to treat my OCD. I eventually went back to talk therapy– this time to a much better therapist, who was a true blessing, although she still didn’t truly understand OCD, and so my therapy included a lot of reassurances. In other words, this kind, amazing woman who loved me was just reinforcing my compulsions. Not good. I also took a break from trying out medications after one stole all my energy and made me rapidly gain weight. I was overweight for the first time in my life– all due to a medication– and have struggled with my weight ever since.

Five years after that initial diagnosis, my psychiatrist was out of ideas. Literally. She asked me what I thought we should do next. I, of course, had no clue. She referred me to an OCD specialist.

This incredible man– Dr. Suck Won Kim– changed my life. He got me onto the right medication (almost immediately) and essentially required that I begin ERP, even giving me the name and contact information for the therapist who would ultimately allow me to bottle up my OCD and put a stopper in it. Dr. Chris Donahue, to whom I’m forever indebted.

Twelve weeks was all it took. In one sense. In another, it took twenty years.

My life was a mix of depression, anxiety, compulsions, “bad” thoughts, and wrongness, and then twelve weeks later, I felt the burden of OCD lift from my shoulders. I was giddy with freedom. Five years later, I still am.

I hear from OCD sufferers every week who are in their 50’s, 60’s, or even older, who are still seeking appropriate treatment. This absolutely breaks my heart.

On the flip side, I’ve had the incredible experience of meeting Maddie, 11, and her incredible parents, who leapt into action almost immediately and got her into ERP within months of her OCD onset. In the same year, she developed OCD, was diagnosed, and was treated. Marvelous!

That’s one of the reasons I blog about OCD. To help people to understand earlier what they are dealing with and to encourage them to seek appropriate treatment (ERP, with or without medication). It still just boggles my mind that in 2013, mental health practitioners still don’t know that ERP is the answer. People get passed around from talk therapist to talk therapist, when the solution should be so ready, so available.

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.

A Metaphor for Obsessive-Compulsives

Posted on July 8, 2013 by Jackie Lea Sommers

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.

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.

ERP & Imaginal Exposures

Posted on June 24, 2013 by Jackie Lea Sommers

I’ve written elsewhere on this blog about Exposure and Response Prevention therapy (ERP) and how different my life is after I underwent an intense 12 weeks of this type of cognitive-behavioral therapy. ERP is exactly what the name says it is: you are exposed to something that will trigger your obsessions and then you are prevented from responding with a compulsion that will relieve your anxiety.

For example, someone who has contamination obsessions and hand-washing compulsions might be made to touch garbage and then is not allowed to wash her hands. Instead, she sits with that anxiety, feeling it intensely. If someone has HOCD obsessions and seeking reassurance compulsions, she might have to look through a Victoria’s Secret catalog and is not allowed to ask, “Am I gay? Am I straight?”

So, what happens when you have Pure-O obsessions? What if your obsession is that you will kill your newborn daughter and your compulsion is to stay away from her crib? What if your obsession is that you’re going to blaspheme God and go to hell and your compulsion is repeating a prayer in your head?

Then what? You can’t really kill your daughter (um, big DUH there, but you get it!) and you can’t really go to hell, so how in the world are you able to practice an exposure then?

“little sad song” by *TrixyPixie on deviantART

Imaginal exposures, baby. Brilliant and brutal.

In situations like these, what you might be expected to do is to write down all the ways you could kill your daughter, read it into a digital recorder, and then listen to it over and over. Or maybe you’ll create a story in which you go to hell, where you’re forever condemned, and you read that story again and again.

If you’re an obsessive-compulsive, trust me, these imaginal exposures are going to FREAK. YOU. OUT. They will be so triggering and so terrifying that your anxiety is going to spike, no problem.

Meanwhile, no compulsions allowed.

Meanwhile, ERP is re-wiring your brain.

Meanwhile, you’re stepping toward freedom. And “all” you had to do was listen to a story.

This was my particular brand of ERP actually. I had to listen to my recording for about 80 minutes a day until my anxiety levels (self-measured at the beginning, middle, and end) decreased by 50%. For the first ten weeks or so, my anxiety levels were NOT dropping, and I very nearly gave up. I mean, why put myself through this misery and terror every day if it was doing no good?

But then.

Sometime during week eleven, those anxiety levels started to drop. I developed a whole new way of looking at my intrusive thoughts. I tiptoed up to OCD. I can still remember the day when I was listening (again) to that horrid recording, and instead of feeling anxious, my thought was, “This is getting so annoying.”

And then I laughed … because … because finally. You know what I mean.

OCD Stockholm Syndrome

Posted on June 16, 2013 by Jackie Lea Sommers

First things first, I am a guest blogger on Monday at my friend Hannah’s blog, Prayers of Light. Over there you can read a little something I wrote about Digory Kirke, about finally getting to hear the rest of the story. Fellow Narnia geeks like me and Hannah are more than welcome to check it out!

Let’s talk about OCD Stockholm Syndrome, yes?

OCD. Obsessive-compulsive disorder.

Stockholm Syndrome. When hostages love their captors/abusers.

OCD Stockholm Syndrome. When obsessive-compulsives ironically cling to the disorder that holds them in bondage.

“OCD Stockholm Syndrome” isn’t a real term, but it’s a real thing– and one I don’t think we talk about that often. It’s confusing and senseless, and I don’t claim to understand it myself. But this blog is in the business of shining light in dark places (mmm, lights all around!), so I thought I’d write about it.

I hate OCD. I really do. I think it is an ugly, vile, reprehensible disorder that steals joy and leaves people in shackles. So, tell me why it is that, after my cognitive-behavioral therapy was over, I asked my therapist, “Do I still have OCD?” and when he said, “Yes,” I felt relief.

I think I was worried about what I would lose. OCD had woven its way through me and entangled itself so deeply through me that a big part of me was worried that I would lose my personality if I lost OCD. I also thought I’d lose my reputation as the “thinker” amongst my circle of influence. As a Christian, I worried that I would lose my desperation for Christ if this disorder vanished because, after all, hadn’t it motivated me toward loving my God?

Once I watched a talk show where an audience member asked a question to the girl on the stage suffering from anorexia. The audience member had formerly been through treatment for anorexia herself, and she asked (with incredible insight), “Sometimes don’t you feel like anorexia is your best friend?” and the girl on the stage answered, “Yes.”

At the time that I watched this talk show, I had not yet undergone ERP, and I remember thinking, I understand that.

It’s bizarre, I know.

When I communicate with other obsessive-compulsives, there is often a theme of therapy-avoidance that runs deeper than just a distaste for the hard work and anxiety that characterizes Exposure and Response Prevention therapy. There is this deep-seated worry that ERP will not only erase OCD and anxiety from their lives– but a part of themselves.

I didn’t like to talk about this with people because it seemed so contrary to everything I stood for. How could I hate OCD with everything inside of me– and yet still cling to it with such a quiet desperation? It made no sense, and even to this day, I still have not figured it out.

freedom

But I wanted to talk about it on my blog because it’s a real thing– a real thing that sometimes prevents sufferers from the relief that is available to them. I don’t know a lot about this strange phenomenon, but I do know this: I was worried about losing my personality, reputation, and desperation for Christ, but now that my OCD is under control, I am finally the Jackie I was supposed to be; I am still a deep thinker but now my thoughts are productive and not circular, and I actually have a greater capacity for deep thought because I am not sent reeling in terror by my thoughts; and I finally feel the nearness of God. Whatever was lost doesn’t compare to what I gained.

Preparing for ERP Therapy

Posted on June 2, 2013 by Jackie Lea Sommers

Lately, I’ve been talking to some brave, amazing people who are planning to tackle cognitive-behavioral therapy (CBT), specifically exposure and response prevention therapy (ERP). I know it’s the right next step, they tell me. Any advice?

Glad you asked. Here are my suggestions as you prepare for ERP.

1. Read and research! Don’t go into this (incredible but difficult) therapy with your eyes closed. I believe that the more you know about what ERP entails and what will be expected of you, the better. In fact, I have a friend who had done enough research on it that he realized only one or two sessions in that he knew more about ERP than the therapist did– instead of wasting time, my friend was able to stop meeting with that therapist and find an expert in ERP.

2. Have an open heart. ERP is not the same as talk therapy. You will be given homework and made to go through exposures that are intended to spike your anxiety. Before I started ERP, my psychiatrist gave me this advice: “Think of a mother, Jackie. A mother would do anything to help her child. You must be willing to do anything to help yourself.” By its very nature, you will be expected to do things that you do not want to do (AT ALL). Do them anyway.

3. Surround yourself with the RIGHT support system. What you need are cheerleaders, people who will be your biggest fans and encouragers. What you absolutely do NOT need are enablers– because they will only be hindering the ERP process. Educate your closest friends about what ERP entails and ask them upfront to not baby you or enable your OCD. When they offer you reassurance or do anything to enable your obsessions and compulsions, they are siding with your disorder against you, instead of with you against your disorder. This is going to be hard for both sides. Tough love is not fun … but it is good.

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

For those of you who have experienced ERP, what advice would you add?

When Thinking Hurts

Posted on May 12, 2013 by Jackie Lea Sommers

I remember days when my brain worked like a manic assembly line, working, working, always working– and not in a good way. Those days, I’d carve out time reserved for obsessions, for list-making, for mental reassurances. Car rides were killer– especially those long stretches on boring I-90– and could throw me into panic mode. At night, I’d lie awake in bed, drowning in circular thought.

And that was the thing: my mind was racing, but it never got anywhere. Ten minutes or an hour or a week later, I’d still be chewing on the same things, exerting so much effort for no gain.

I was programmed. When there was a moment, a pause, a hesitation, my head would fly to a dark place. And then it would battle its way back out. Over and over and over (and over and over and over and over and over …). So useless, so fruitless, and so much energy spent, so much time wasted.

The by-products of OCD are not worth the efforts.

These days, my mind is still working hard– but in a good, healthy, productive way. I listen to audiobooks while I get ready in the morning, in my car, while I exercise, as I fall asleep. I let the wonder of literature engage my mind and thoughts, and it feels healthy, like solving a difficult puzzle or marveling at philosophy. I write every day– blogging, poetry, my novel– and it’s like climbing a mountain. My brain is a muscle, flexing and growing stronger. My conversations with friends are deep and meaningful and far more important than just seeking out temporary comfort.

When thinking hurts in a bad way, you need to re-wire your brain.

Do It Anyway.

Posted on April 30, 2013 by Jackie Lea Sommers

This applies to more than just CBT/ERP. This applies to life.

JACKIE LEA SOMMERS

Author & Advocate

Tag Archives: ERP