Guest Post: My ERP Experience

With her permission, I am sharing a comment from ashley1234567890, one I found particularly insightful.

And here she is …

I went through ERP and had fantastic results. It was a huge blessing for me, and I thank God that he gave me the courage to try it.

I am no expert, but i did have a really bad case of OCD, which got a lot better after ERP, so here are my recomendations, that in hindsight, were key to my success.

NOTE: my ocd did not get worse with ERP (it got so much better) even though the treatment was very intense!

If you qualify for ERP therapy, and you are considering it, then do not let fear keep you from going. The only caveat is to make sure you find an expert who treats ERP because it is specialized therapy. For example, my therapist was willing to meet me outside of their office for exposures, because my ocd spiked at a particular place. I also recommend finding someone who has experience with whatever ocd you are facing. For example, my therapist had experience with germ ocd, harm ocd, religious ocd, sexual oreintation ocd, etc… so i knew they were highly qualified. they should also give you exercises so you can do your own exposures.

As for ERP, It seems counterintuitive at first, since the patient will go through exercises and narrations that are asking them to run towards their fears (instead of running away from them), which in turn causes anxiety to spike, and while super anxious the patient will be asked to temporaily stay in that state while resisting compulsions that are normally used to reduce the anxiety. If you face the obsession and not give in to the compulsion, then the cycle breaks, which in turn makes you less anxious. That is where “exposure and response prevention” comes from.

My treatment was gradual at first (small fears first then you move onto bigger ones) also, my initial exposures were designed so that anxiety was moderate so I could handle it, and then over additional sessions, they were changed to more intense ones.

For me, it took me about 12 sessions to complete treatment. I noticed some big gains after the first couple of sessions so i knew it was helping. After treatment i am a new person. I still have the ocd, triggers, and the spikes, but it does not cause much distress anymore. Before ERP my distress level was a 10 and it was constant. My life sucked.

So heres an example of what what ERP might look like. let’s say you have germ OCD. You may be asked to touch a door knob and not wash your hands afterwards for 5 minutes. As the sessions go on, and you grow stronger, you may be asked to do the same excercise, then refrain from washing for 15 minutes. Eventually, beloeve it or not, you will be able to do the excercise then not wash at all! Or, one exposure may be a narrative, where you write a short story, and in this story you get a little dirty, or exposed to germs, etc… over the treatments, the story may get more and more disgusting and intense, so you will be in a situation that gets really dirty, and theres no place to wash up etc…

As the sessions and exposures go on, the anxiety for each trigger gets weaker, which in turn makes the spikes less intense. Consequently for me, the ocd got better over time.

Again, the key is to find a qualified expert who has a lot of experience in OCD and ERP, because you will be asked to do things that will make you feel temporarily uncomfortable and the therapist will need to work with you at the right pace so that you are not overwhelmed. They should be willing to leave their office to do an exposure where you need it. So for example, if you are afraid of heights they should be up for going with you to a balcony etc… to face that fear.

Like some of the previous comments, I was anxious before starting too, and I was scared that it would make my condition worse. But i was wrong! that’s just the ocd trying to keep you in the bad place.

In fact thats how i first came across this blog. Jackie had wrote some content on ERP and it gave me the confidence to try it. Thank you jackie you are such a blessing from the Lord! Hopefully this post will do the same for someone else!

Staying with God

A long time ago, I got this question from a blog reader: How did you make the decision to ‘stay’ with God when your struggles came from that relationship?

I think I’m ready to write about that now.

White wall texture with a chair

So … for those of you who are newer to the blog, a bit of backstory: I battled with OCD– mostly of a spiritual nature– for about twenty years before I finally underwent treatment. While OCD has told me countless lies, the hardest one was that I was not loved and accepted by God and that I was going to hell. Nearly all of my battles with OCD had their root in this lie. It was– and remains– my worst thing imaginable (which, of course, is what OCD goes after).

I know that some people who have battled with OCD of a scrupulous or spiritual nature have eventually walked away from the faith. My understanding (though I could be wrong) is that the guilt and fear and, oh, lifestyle guidelines are too severe, so they end up having to distance themselves from it all in order to maintain some semblance of sanity and freedom.

As I said, I could be describing that wrong. The truth is that I’ve never understood it. My OCD centered around the idea that God was the most important person in my life and my fear was that I did not have him … or could not … or that he would refuse to have me. When that was my most intense terror, where would the relief have come from by choosing to walk away myself? I would have been willfully walking into that which was my darkest fear.

So, for me, clinging to Christ was my only hope in the midst of such darkness. Had I let go, I’d have been choosing the terror I was desperately trying to avoid.

Praise God that– while I was clinging to him, so afraid of falling– I was safe in his hands. I just didn’t know it. There is a difference between fearing that a chair will not hold you and a chair that will really not hold you. A huge difference. That said, the fear alone may keep you from enjoying the chair. But for those of us with OCD, our fears and our reality might be miles apart, but we’ve lost the ability to see that gaping chasm between them.

That’s where treatment comes in. Exposure and response prevention (ERP) therapy saved my life and gave me new eyes to see the difference between my fears and the truth. It was one of the hardest things I’ve ever done, but 5000% worth it. Today I get to enjoy my relationship with Christ in ways my OCD prevented me from in the past.

If you want to learn more about my faith, click here.
If you want to learn more about OCD and ERP, click here.

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

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

 

Not a Therapist, Just a Resource

unsplash5It’s true: I know a fair amount about OCD. I experienced it for 20 years, I successfully went through ERP therapy, I wrote an (unpublished) novel about a character who struggled from it, I am part of the leadership team for OCD Twin Cities, and I blog about it regularly.

But I’m not a therapist.

I’m only a resource. I can tell others what I know, what I’ve experienced, what to look for in an ERP therapist, what books might be helpful, etc.  But I cannot walk them, hand-in-hand, through exposure therapy. I have to remind others AND MYSELF of this. Often.

To those of you who blog about OCD and ERP, do you have this same problem?  How do you handle it?

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

Image credit: Unsplash

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

Theme Hopping

Recently someone emailed me and asked if my OCD was more about worrying about hell than it was about worrying if God was real, and I had to say honestly that after twenty-five years of OCD, there aren’t a lot of themes I haven’t experienced.  Is God real, is Jesus real, is heaven real, is Christianity legitimate, was Jesus really God’s son or was he the devil in disguise, have I committed the unpardonable sin?  OCD can cycle through a lot of themes in a quarter of a century.

That’s the thing with OCD: it often doesn’t remain in one place.  When I was still in high school– and even into my college years– I kept thinking, “If I could just sort out X, then I would be happy.”  So I’d wrestle with X, read books about it, seek reassurance, talk things over with my youth pastor and parents, research things online … and if I was ever able to “solve” it, then … my OCD moved onto Y.

Hitman: Contracts by TheKingArthur at deviantArt

Hitman: Contracts by TheKingArthur at deviantArt

I was in perpetual motion for so many years– but I never got anywhere.  It was all spinning my wheels.

Exposure and response prevention ignores the emergencies that OCD is sparking in every corner and goes after the OCD itself.  Instead of relying on compulsions, which temporarily help to “solve” individual issues, ERP is like a hitman with a mission to assassinate the OCD.

You can see why one is far more preferable than the other.

 

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 an obsessive-compulsive 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 obsessive-compulsives 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.