Thoughts on ERP, Writing, & Uncertainty

Uncertainty.

For so many years, it was my enemy– or so I perceived it, especially because full-blown clinical obsessive-compulsive disorder made me fear and reject uncertainty even more than the average bear. Everything in my life was about pursuing certainty, answers, black & white.

And, of course, I was miserable.

In 2008, I went through the harrowing but ultimately beautiful process of exposure therapy, which took my OCD out at the knees, giving me the bandwidth to live with uncertainty, questions, and all the shades of gray.

It’s only recently that I’ve recognized exposure therapy as the training ground (or maybe even battle ground) that would let me later pursue my dreams of being an author.

A hard truth: writing is full of uncertainty. 

uncertainty2

Not just writing– but publishing itself too. There is this crazy-making stretch of life in the middle of writing a book that feels both unclear and perpetual. What is this book really about? Who are these characters? Can I do this? Can I finish this? Is this story going to matter to anyone but me? Is this going to even matter to me? Will my writing group like it? Will my agent? My editor? Readers? Will I find success? Will I get another contract?

The writing life is, for many of us (and especially for younger writers), a world in grayscale: a constant state of uncertainty that we have to persist in in order to find any relief or success.

For as many days as I think I’m totally failing at life and writing, I have to remember what it would have been like to be writing and publishing before exposure therapy, back when uncertainty was unbearable. I’m not even sure how it would have been possible to be doing what I’m doing now without exposure therapy laying the groundwork for me to bear the not-knowing, let alone to thrive in it.

“The world doesn’t work that way.” I hear myself and other OCD awareness advocates saying this to sufferers all the time. In context, we mean, “Life inherently is full of uncertainty. You cannot eliminate it.”

The truth of that hits me over and over again in the field of writing.

Exposure therapy was the terrible, grueling practice for the writing life. Uncertainty is rampant; I try to keep my arms open.

 

Worth Saying Again & Again

Exposure therapy is the best avenue we know of for treating obsessive-compulsive disorder.

Close up of hand drawing gears mechanism with chalk

ERP (exposure and response prevention) is what every OCD expert will suggest as the frontline treatment for sufferers.

It works.

It’s hard and scary, but it works.

Catering to compulsions is a band-aid on cancer. It treats symptoms. It cuts leaves off a weed.

ERP is chemotherapy. It goes after OCD itself. It digs out the root.

On this blog, you’ll only hear OCD treatment recommendations for:
1. ERP
2. ERP plus praying for a miracle
3. ERP plus meds
4. ERP plus meds plus praying for a miracle.

You can learn all about ERP therapy at jackieleasommers.com/OCD.

A Reunion with My ERP Therapist

For OCD Awareness Week, OCD Twin Cities had an event– a panel of OCD experts plus one special guest: yours truly. Interestingly, one of the experts on the panel was my own ERP therapist and personal hero, Dr. Chris Donahue. I have not seen him since the last day I graced his office with my presence on the day I finished ERP therapy back in 2008, though we have communicated via email, and I have sent many, many people his way for help.

I only joined the panel for the last fifteen minutes or so. For the majority of it, I was in the audience. There was this weird dichotomy going on for me: on the one hand, I was listening to this man who saved my life, who changed everything for me, who pulled me out of darkness and into light, out of slavery and into freedom; on the other hand, his voice is the voice of my exposures (I did imaginal therapy, listening to an audio recording … and it was in his voice), which were some of the most difficult things I’ve ever, ever had to do in my life. So there was this push-pull thing going on while he spoke.

Then, later, I joined him. I was able to sit next to my hero and publicly tell an audience, “This is what this man did for me. This is what life was like before, and this is what life is like now, and they are unrecognizable.” I turned to him and said, “Thank you.” He said, “You’re welcome.” It was a simple exchange … but so layered. So many things going on in my head and heart.

In any case, I am grateful. With every year that goes by of freedom, I more and more shed my identity as someone in bondage. ERP therapy saves lives. For some of us, it changes everything. It did for me.

For lots more information about OCD and ERP, go to jackieleasommers.com/OCD.

dr donahue 2

Thoughts on Freedom of Various Kinds

I moved yesterday. All went quite well.

I first moved into my old apartment in 2008, right as I started to write Lights All Around, my first novel. Those walls have seen so much, including complete and utter breakdowns, my experience with ERP therapy, the writing of Truest, and the writing of first drafts of two other novels. (Whoa– I wrote four novels in seven years? Sheesh. Had not thought of it like that before.)

The new house is still undergoing renovations, and it’s all a big old mess, but it’s my mess that I own, and I love it. I can see its potential so clearly, and I’m so happy.

Moving means packing and unpacking, and that means finding a million lost things in the dark corners. I’ve found so many things– journals, stories, etc.– that show so clearly the pain of and enslavement to my OCD. Today I read a journal entry dated 2006 that said something to the effect of, “I am still the pot who asks the Potter, ‘Why did you make me this way?’ I wonder if I will ever know. I wonder if I will ever experience freedom.”

I want to tell that girl, Two more years. Hold on.

Of course, that’s my past. I know so much more now, nine years after that journal entry was written. I have joy and freedom and a book deal with HarperCollins. I did the hard work of ERP therapy and reaped all the benefits of it– a whole different life. So, I don’t need to say that to my past self; instead, I will say it to you, you who are enslaved to your own obsessive-compulsive thoughts, who are lost and in slavery to OCD, who wonder if there is a point to it all or if you will ever see the light again:

Hold on. There is freedom available. Hope. Joy. Light. You can learn about ERP therapy here. I pray it will be the key that unlocks your prison, just as it unlocked mine in 2008. Today I find purpose in my past of OCD; I find happiness in daily life; I find freedom– or freedom has found me. Thank you, God.

How fitting to be reminded of my freedom on Memorial Day weekend. I am grateful, so grateful, for every freedom. I remember.

Self-Directed ERP Therapy

???????????????????????????????????????If you’ve spent any time hanging around this blog, you know that I’m a huge proponent of treating OCD with Exposure and Response Prevention (ERP) therapy, which is the best treatment available. It’s the first and only* treatment I recommend.

People often balk at it, which I understand: it’s difficult. Very difficult. People want an easier option. But I wouldn’t recommend a bandaid for a cancerous tumor, and I won’t suggest anything else.

But I’m too embarrassed …

But I can’t afford it …

But there are no ERP specialists in my area …

Those are all very valid reasons for seeking another treatment option, but the GOOD NEWS is that you can do ERP on your own, if you are committed to it, and if you’re willing to work hard.

It’s still important to have an expert guiding you, so please track down one of the following books:

Stop Obsessing by Edna Foa
Amazon | B&N | Fishpond
Freedom from Obsessive-Compulsive Disorder by Jonathan Grayson
Amazon | B&N | Fishpond
The OCD Workbook by Bruce Hyman and Cherlene Pedrick
Amazon | B&N | Fishpond
Obsessive-Compulsive Disorders: A Complete Guide to Getting Well and Staying Well by Fred Penzel
Amazon | B&N | Fishpond

With the help of one of these books, you can be starting your own ERP journey for under $50 (most under $20!).

Read the whole book from cover to cover and do all the exercises. Throw yourself wholeheartedly into pursuing wellness, freedom, and peace. You can have your life back. Believe me. I languished in the hell of OCD for 20 years before just 12 weeks of ERP therapy broke that torturous yoke. This can be your story too.

If you’re not convinced, go to jackieleasommers.com/OCD and read my posts about ERP. Then drop me a comment or an email with your questions!

* I think medication can definitely help too– but ERP is a better option than meds, and in my (non-MD) opinion, meds should come alongside ERP, not ever replace it.

Co-Morbidity

comorbidDo you know the term?

Co-morbidity is the presence of one or more other disorders co-occuring along with the primary one. For those of us with OCD, our OCD is often co-morbid with depression. The depression seems to usually be a result of the OCD (as opposed to the other way around).

On their website, the Stanford School of Medicine writes:

Patients with OCD are at high risk of having comorbid (co-existing) major depression and other anxiety disorders. In a series of 100 OCD patients who were evaluated by means of a structured psychiatric interview, the most common concurrent disorders were: major depression (31%), social phobia (11%), eating disorder (8%), simple phobia (7%), panic disorder (6%), and Tourette’s syndrome (5%).

They also say:

In Koran et al.’s 1998 Kaiser Health Plan study, 26% of patients had no comorbid psychiatric condition diagnosed during the one year study period — 37% had one and 38% had two or more comorbid conditions. These proportions did not differ substantially between men and women. The most commonly diagnosed comorbid conditions were major depression, which affected more than one-half, other anxiety disorders, affecting one-quarter, and personality disorders, diagnosed in a little more than 10%.

OCD is enough of a beast on its own, but the truth of the matter is that many who struggle with OCD are fighting other demons too.

In my experience, OCD and depression teamed up against me, though, as I wrote before, the depression was secondary to the OCD (in that it was caused by the OCD). Some days I would be full of intense, manic fear caused by OCD, and other days all my sharp edges would be dulled by depression and a feeling that nothing in the world sounded exciting or worthwhile.

I’m so grateful that when ERP helped me steal power away from OCD, the upshot was that depression was defeated too.

For (lots!) more about OCD and ERP, go to jackieleasommers.com/OCD.

 

Image credit: Gerald Gabernig

 

Sweet Freedom

freedom in redAlison Dotson, president of OCD Twin Cities, and I were emailing recently about how sometimes we feel as if we say the same thing post after post, article after article, especially since they usually involve our own stories with OCD, and history doesn’t change.

But I reminded her that even if we’ve heard our stories over and over, someone else might be hearing it for the first time. Not to mention that sometimes those of us with OCD need to hear the truth multiple times before it is finally able to sink into our heads and hearts.

So here it is again:

I was in bondage to obsessive-compulsive disorder for twenty hellish years. I was plagued by ugly, intrusive thoughts that caused me intense anxiety and even terror. Many days I felt completely out of control of my own thoughts, and I hated the ugliness that polluted my mind. I was sad, lonely, depressed, lost, engaged in an ongoing war where the battlefield was my own brain.

And then an amazing psychiatrist named Dr. Suck Won Kim gave me not only a prescription but also the phone number to a cognitive-behavioral therapist in the area, along with the warning that ERP therapy “will be hell” and the encouragement that I had to do it anyway.

And I did. For twelve grueling weeks, I practiced the exposure therapy assignments set out by Dr. Christopher Donahue, and after twelve weeks of hell … I was free. Free for the first time since I was seven years old. I could barely even remember what freedom felt like, what it felt like to be master of my own thoughts, to rule over my OCD instead of having it rule me, and so it was actually a little scary at first.

But let me tell you: you get used to freedom, joy, and light pretty darn fast.

The last five years have been magnificent.

Please, please ask me questions if you have them.

For (lots!) more about OCD and ERP, go to jackieleasommers.com/OCD

Image credit: Jesus Solana

Choosing Treatment: a Parable

bandaidOnce there was a man named Mr. Jones.  Mr. Jones found out he had a brain tumor.

Experts told him, “Mr. Jones, you need to have surgery, followed by chemotherapy.”

But Mr. Jones said, “No thank you.  Surgery is hard.  Chemo is hard.  I’d prefer to just meet with someone to discuss my cancer once a week.  Also, I’ll apply a fresh bandaid to my forehead every few days, for good measure.”

“That won’t help, Mr. Jones,” the experts told him.  “You really do need a very specific treatment for your condition.”

But Mr. Jones was insistent: he preferred the easier “treatment.”

So he met with a therapist to discuss his cancer, and he applied and reapplied bandaids whenever he was feeling worried.

It didn’t work.

And the moral of the story is this: ERP is the best way to treat OCD.

 

For (lots!) more about OCD and ERP, go to jackieleasommers.com/OCD.

Image credit: F2 Images

The Long Journey … to the Starting Line

"Cross That Line" by xLadyDaisyx on deviantArt

“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 lifesomeone 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.