Question & Dancer: I Promise There is Hope

question-and-dancerI’m an artist not an expert, one who is learning to embrace questions more than answers.

These are some questions I got last month. Ask yours here.

Ok I am so confused lately. I am a 27 year old male and has had what I consider to be HOCD for at least 4 years now When I was younger people used to ask if I was gay, and that never bothered me until more recently since I started to have this OCD. More recently however I am starting to doubt myself because it is starting to feel realer and realer. Wanna do ERP but I am very anxious about it.
I was so anxious to do ERP too! In fact, I almost bailed partway through– right before everything ended up “clicking” for me. Read up about it beforehand so that you have an idea of what to expect. I always say that you will be ready for ERP when the hell of daily life with OCD is worse than the anxiety over ERP. I will say this: it was one of the greatest things I have ever done for myself. Twelve weeks of ERP vs. twenty years of OCD (with no end in sight)? There’s a clear winner there.
Can HOCD actually begin to feel real? At the start, it caused me loads of anxiety but now I’m starting to believe it and it scary 😦
Hello dear, yes, I think that most people with HOCD get to that point. I’m sorry for all your fear and anxiety. ERP can help.
Hi! I did the harder exposures for HOCD (I’m a girl by the way) and it really terrifies me to the point of tears while doing the exposure of looking at a androgynous female. It bothered me immensely but I stayed with it. However, I felt fearful and anxious at the same time because I actively avoid it because of the fear of attraction. Is that still HOCD?
If you are fearful that you are sexually attracted to females, it’s quite likely HOCD, yes. I remember crying while doing exposures too. Please don’t quit the exposures– but also, please do be kind to yourself. Give yourself a treat: ice cream, a nap, a new pair of shoes. What would you do for your best friend if he or she was going through all this? Treat yourself just as kindly. But don’t give up on the exposures.
Hi Jackie, I’ve had hocd for over a year now and it’s been rough. For the past three months I’ve been using this new medication and I believe I’ve gotten better. But, whenever I get my intrusive thoughts my brain doesn’t spike much of a reaction anymore and I’m not as scared. This is making me worried because I feel like my fear shows I’m not gay but now I’m not so sure. Can medicine do that?
I feel like this is such a nasty paradox with OCD! We get so much torturous anxiety– and we hate it– but then, if the anxiety lessens or goes away, we start to fear there’s a reason behind that. Please remember that the goal is to not have those extreme reactions when you have intrusive thoughts, so you are moving in the right direction! Thoughts are just thoughts. Everyone has weird thoughts, but most people can just let them go, whereas for those of us with OCD, we hold onto them and give them too much meaning and make ourselves sick ruminating. Let the thought just be a thought. It is good that the anxiety lessens in time.
Jackie, is this a compulsion? Every time I get worried about my hocd thoughts, my reaction is to go God and pray that I’m not gay. I know I don’t want to be gay. I just want to be a straight female and have a guy. But I feel like god is my only true hope for getting better although I’ve been doubting him a lot with all of this hocd stuff
Ritualistic prayer was also one of my compulsions. I would pray to “ward off” blasphemous thoughts and curse words that would pop into my head. But I also could tell a difference between my true, heartfelt prayers and the automatic ones that I was using as a compulsion. I kept doing the former, but the latter ones, I stopped. At first, because it was so automatic, it was very hard to stop, but I would actually interrupt myself and think No. I do not need to pray ritualistically. I didn’t think it would work– but it did!
How long did you personally have hocd for?
I had a brief bout with HOCD in junior high. My primary obsessions through the years were religious ones though.
Jackie I feel like my hocd gets MUCH worse when my period roles around. Could this be true? I just feel way more depressed and my intrusive thoughts get more frequent and intense.
I really do believe this can be true, even though I don’t know enough about the science behind it.  But on my period, my hormones are all out of whack, and everything seems more intense and stressful and emotional for me. I feel sadder and lonelier on my period, and sometimes I have bad cramps, so I’m in actual pain and cranky about it. I am definitely not my best on my period or in the days right before it, and I’ve had the same experiences with my OCD being worse then (I’m not sure if it’s worse– or if I’m weaker– during those days!).
Jackie I’ve had hocd for a while now. How did you stay strong? How did you not cave in and truly lose hope by believing you’re gay?
I spent 15 years with OCD before I was finally diagnosed, then another five before I began the exposure therapy that gave me back my life and freedom. How did I stay strong during that time? Honestly, I was not strong a lot of that time. I cried a lot, but I also surrounded myself with the most incredible people: family and friends and mentors and roommates who let me lean on them in my weakness. My Christian faith is also a ballast for me, although OCD went after that pretty hard, and I had to rely on the faith of my friends and family, if that makes any sense. Make sure that you have an incredible support system, one that won’t enable you but that will let you be honest about your struggles and will love you, even in your darkest, weakest, most hopeless moments.
I lived with my friend Desiree for seven years, and she saw me through some of the very worst times with my OCD. She wrote this post about it, in case you’re interested!
Jackie, my therapist and my mom both say I try and convince myself that I’m truly gay ( I have hocd). I just can’t help being very doubtful all the time. Even when I like a guy through all of this I still doubt if everything is fake. Advice?
This is what the doubting disease does– it poisons everything! The very best advice I have is to treat it with exposure and response prevention (ERP) therapy, which can be done with a specialist or on your own with the help of a book from the library. Be sure to check out my posts at http://www.jackieleasommers.com/OCD for more details and book suggestions!
Hi Jackie I’m a female and I have had hocd for nearly 13 months now. I stare at girls so much! In my head I constantly hear myself saying “wow she’s so pretty” and I can’t stop thinking that. It haunts me later in my day as I keep seeing any girl in my head from school. What should I do?
This is what OCD/HOCD will do until you either switch to another obsession or treat it. I recommend treating it with exposure therapy! Please check out my posts about HOCD and about ERP at http://www.jackieleasommers.com/OCD. It changed my entire life.
I’ve had hocd for a long time now and I know ERP is the right thing but I’m too scared to do it. I just don’t feel mentally mature or ready enough to do it. What do you think? Should I just face it head on?
This is such a good question. I didn’t feel ready for it for a while either. When I felt I had exhausted all my other options, I knew it was time. Most of the time, ERP is not done via “flooding” (which is what I think you mean by “face it head on”) but rather via a strategic hierarchy. You start with the things that make you least anxious and work up to the doozies later on. I think this is probably the best way to go after ERP; it builds confidence early on when you win a few smaller victories, plus your brain begins to change, giving you more tools for attacking the harder things later. I remember on my first day with my ERP therapist, he said we would work up to X, and I thought, “If you think that I will EVER, EVER, EVER, EVER do X, you’ve got another thing coming, mister.” And yet, about 12 weeks later, I was there. Terrified, yes. Anxious, yes. But it had gone from being utterly impossible to being possible-but-scary. And after that, my OCD snapped in half. I’ve had freedom for nine years now.
How do I know if my therapist is good? Upon graduating college, I have developed extreme anxiety and HOCD. I found a therapist who preaches ERP but does not have good reviews online. I met him for the initial consult and liked him but how do I know whether I should trust him.
Do the reviews say that they don’t like him personally or that he doesn’t know his practice? You don’t need to like an ERP therapist for ERP to work. In fact, at the time, I thought my ERP therapist was a monster. (Now he is my hero.) Our personalities did not jive and, of course, he was asking me to do things I didn’t want to do (this is the nature of ERP therapy!). Make sure that you have educated yourself on what ERP should look like, so that you will be able to recognize if he is guiding you correctly. As far as whether or not he’s likable … meh. Not what matters in this situation.
Read about my reunion with my ERP therapist, seven years after I last left his office.
I feel really sad. Some days my hocd is not that intense and I’m sure I’m straight but other days its bad.When I’m convinced I’m gay, I get very depressed. I withdraw and stop doing anything, and spend the majority of my time in bed. They tell you in therapy that if you hate the idea of being gay, that you don’t like the idea of being with the same sex then you’re not gay. Do you agree with this?
I hate to speak in too wide of generalities, but if I am interpreting your question correctly, I would say yes IN GENERAL. Again, I don’t know that it is helpful to speak in such wide-spreading generalities. I did ask some of my friends (both with HOCD and others who are gay) to answer a variety of questions so I could compare them. I thought the results were interesting. Friend, please consider exposure therapy to treat your HOCD. It is the #1 treatment for OCD recommended by all OCD experts, and it changed my life. I know those depressed days spent in bed all too well. You can move past this.
Is there really a light at the end of the tunnel? I feel hopeless. I have hocd and hate my life because I just feel depressed. I want to be better but I can’t bring myself to give effort. I get told, happiness is a choice. But I feel like this doesn’t apply to people who suffer from OCD?
Friend, I promise there is light. And hope. And freedom. Exposure therapy can help you get there.
Ahhh yes, the choose happiness thing. Blah. Let me say first that I agree with you.
Here is my post entitled I Don’t CHOOSE to be Unhappy. Later, post-ERP, I wrote a post where I talked about choosing to be happy. The very next day I posted again and this time included what I called a “thoughtful caveat”:
P.S. I want to clarify: this post is not in contradiction to this one. I still believe that many people with brain disorders do not have the capability to simply choose to be happy. But I am finding in my own life that medication and OCD treatment and talk therapy and prayer are tools that are making that more and more possible for me. I am one of the lucky ones who has had so many opportunities and resources. They are opening up new doors for me that were locked even just a year ago. Would love to hear your thoughts.

Thanks for all the questions, folks! If you have questions for me about anything (but especially faith, creativity, and mental illness), add yours here.

As I said, I’m an artist not an expert. I will leave you with these, some of my favorite questions in one of my favorite poems, “Questions about Angels.” Click here to hear Billy Collins himself read it. (P.S. It starts with questions, ends with a dancer.)

Dear 16-Year-Old Me

Dear sophomore-in-high-school Jackie, who just spent Thanksgiving sobbing on Grandma’s bathroom floor,

I promise you: it won’t always be like this.

It’s hard to imagine that now, I know. Doubt has been clawing at your mind for nearly a decade already, and now, this holiday, it seems like it’s finally captured you, a relentless grip you can never escape from. Everyone else is upstairs eating turkey and playing dominoes. Soon you’ll have to gather yourself together—thank goodness you don’t wear mascara yet—and head back upstairs to fake it. All you know is that something is wrong with you—your mind is in slavery, and you fear you’ll never find freedom. It’s not true. Oh, it’ll be a while still, about twelve more years, but you’ll find freedom. Believe me.

Here’s the truth. It’s OCD. Obsessive-Compulsive Disorder. You always thought it meant someone who washed their hands too much, someone who was a neat freak—and that was absolutely not you (I hate to tell you this, but even in your thirties, you still can’t keep your room clean), so you never gave it a moment’s thought. And now, in 10th grade, you’re only starting to learn how to use this wild thing called the internet. I know it’s not going to occur to you to Google “I think bad thoughts.” Scratch that. Google won’t even exist until next year.

Unfortunately, it’s going to get worse before it gets better. You’re going to wander down so many ugly alleys, obsessing over hell and your identity and the nature of reality. You’re going to believe that you’ve literally gone crazy, and no one on earth can keep record of the tears you’ll cry. But you’re going to write about it—all of it—and it’s going to be such lovely therapy for you in the interim. (Minus, of course, those months when that bastard OCD made you wonder if fiction was sinful like lying and you couldn’t go near your poetry or prose without feeling sick over it.)

You’re going to fill notebooks in high school with dramatic diary entries and over-the-top poetry. You’re going to go to college and study writing and pour your heart and energy into the creative work you’ll encounter there. You’ll even center your senior project—a memoir piece—around your battle with OCD, only you won’t have a name for it yet. But when the bottom drops out of your life in those years after college, you’ll finally be diagnosed, and it’s then that you’ll turn to writing novels.

Exposure therapy will save your life. And so will writing. So will Mom and Tracy and Megan and Cindy and Erica and Desiree and Ashley and God.

This holy amalgam will make you free. You won’t even know what to do with all the freedom, a surfeit of it, washing over you like a baptism, swilling out the pain, leaving behind … writing.

And so you’ll write. You’ll write stories that are raw and painful but hopeful. You won’t be able to write the ending to your first novel without having gone through the hell of OCD first. You’ll look back and say, Now I see. Same with your second novel.

So, for right now, teenage me, hold on. Find hope wherever you can, especially in others—they will keep you alive. And write. In every moment, good and bad, write. Let writing be your refuge and rescue. Give up the stupid show of pride. You’re going to need so much help; learn to ask for it. Find a place in your life for gray; throw your arms open wide to uncertainty. This will save you.

Love,

Jackie, now 35, free and writing

teen me.jpg

The [Beautiful] Paradox of ERP

paradox of ERP2Exposure and response prevention therapy. ERP.

The hardest thing I have ever chosen to do in my life.

And one of the best.

But that’s not actually the paradox I’m talking about. The paradox of ERP that fascinates me most centers around uncertainty.

The whole point of ERP therapy is to teach someone to learn to live with, accept, even embrace uncertainty. ERP actually re-wires the brain to help the OCD sufferer with this. Before I went through ERP, I wanted to know everything with 100% certainty. Anything less would cause intense havoc in my mind, heart, and body. Because of this intense desire to know everything with certainty, I so often felt gobsmacked by uncertainty. I lived as if, without total certainty, I could barely know anything. Doubt pummeled me like a linebacker. My life was ravaged by uncertainty.

But once I went through ERP therapy and learned to accept uncertainty, the bizarre thing is that my confidence returned. I suddenly felt surety and certainty again– after I realized I didn’t need it.

When I demanded 100% certainty, what I ended up with was often something in the 25-40% range. Or lower.

When I abandoned the need for 100% certainty, I ended up in the 90-99% range. Sometimes less, but usually way, way up there.

That’s weird math. Backward logic. A paradox.

One I love.

99% sure,
Post-ERP Jackie

P.S. If the need to know for sure is ruining your life, you need ERP. Read more about it at jackieleasommers.com/OCD.

P.P.S. I’m a follower of Jesus Christ, and I can’t help but be struck by the similarity of this to “Lose your life to gain it.”

Image credit: Nicu Buculei, modified by me