CBT advocacy

I am a huge, huge, HUGE proponent of cognitive-behavioral therapy (also known more specifically as exposure and response prevention therapy), which gave me back my life.

I wrote a story called Lights All Around— fiction that sings the praises of CBT.  Even though I had already experienced CBT, it wasn’t until I fictionalized my experiences that I felt like I really understood what exactly went on during therapy, the reprogramming of my brain.  The scenes that I am hoping to share during OCD Awareness Week detail the moments when CBT and its premise finally clicked.

If you haven’t voted for my entry “Tipping Point” yet, will you take 3 seconds to do so right now?  Just go to http://www.ocfoundation.org/awarenessweek!  I appreciate you!!  (Which 2-3 friends could you ask to vote for me today?  I’d be so grateful!)

“Tipping Point,” my entry

If you like what you read below, then please mosey over to http://www.ocfoundation.org/awarenessweek to vote for my entry!  Voting closes on September 7th, so please don’t wait!!

That Saturday, I went to cognitive-behavioral therapy like a disgruntled cobra, noticeably agitated, ready to strike.  I shifted uncomfortably with each of Dr. Foster’s normal questions and answered in short, sharp responses like a fence made of spikes.  “Is there something wrong?” Dr. Foster asked, setting down his legal pad on the coffee table between us.  He folded his hands in his lap, and I despised him.

“Yes,” I said, my face on fire.  “I can see where this is going, and I don’t think I can do it.  And if I can’t do it, if I’m going to fail anyway, then I want to stop now.”  I crossed my arms across my chest; then, realizing it probably made me look childish, clasped my hands in my lap instead.

He leaned back in his seat.  “Where do you think this is going?”

“You’re going to ask me to swear at the Holy Spirit.”  I could not meet his eye.  My mind raced as it recited its usual mantra—Father God, I love You; Father God, I love You—my talisman against blasphemy.

“Maybe,” he said.  “But not this week.  Can we focus on this week first and cross other bridges when we come to them?”

I snorted out a shock of air.  My right leg began to shake, which thoroughly annoyed me.  “What’s the point if, in the end, I can’t finish the job?”

“You don’t know that,” said Dr. Foster quietly.

“I know that,” I countered as my voice climbed higher.  “I’ve considered it, and there is no way I can do that.”

“I think you should just focus on your current assignment.”

“I can’t,” I said.  Didn’t he understand that there was no point to torture if the end result was not healing?  “All I can think about is that this is the next step.”

“Well,” said Dr. Foster, leaning forward, “I’m not actually sure we’ll need to get to that point.”  I looked at him, sideways, warily.  “I’m not.  I’m seeing how things go.”  I swallowed.  Outside his window, the sunlight battled hard behind the cloudy sky but couldn’t break through.  “For now, when you have your intrusive thoughts, I’m asking you to try to embrace them.”

I can’t,” I repeated.  “I can’t think—that—toward the Holy Spirit.  I really can’t … and I think that might be the community standard in my church.”  I was using his own terminology as a spear, frantically poking holes.  What had I been thinking, attempting CBT in the first place, which was shaping up to be the equivalent of toying with an afterlife toggle?

“Then,” he said, “what I want you to try is this.  When you have an intrusive thought, I want you to think, ‘My OCD is making me think’—he held out his hands—“‘this’—whatever it is.  And name it.  Say it in your head.  It’s a step removed from what I’d like you to be doing, but it might work for you to approach it that way.”

I doubt it.  I pressed my lips together, still sitting rigidly.

“Can you try that this week, Neely?  Creeping toward it?”

“I don’t know.”  My voice was like ice shards.

He pointed to one of his wooden coasters, which was sitting on the coffee table between us.  Just like the others, it also had a quotation etched into the wood, this one from from Antoine de Saint Exupéry: “What saves a man is to take a step.  Then another step.”

“What saves a man is grace,” I spat.

For the briefest moment, the corners of Dr. Jonathan Foster’s mouth hinted at a slight grin, but a second later, I thought I must have imagined it.  Except for his eyes.  His eyes looked at me as if he had a secret, as if I’d said something funny.

I hated him in that moment.  My face burned with anger as I stood up to leave.  “I’m not listening to that thing again,” I said.  “CBT has been the biggest mistake of my life.”

“Neely,” he said to my back, “I hope you’ll come back next week.  I’ll leave you on the schedule.”  I did not turn around, and Dr. Foster did not get up from his chair.  I felt only the tiniest pinprick of pleasure knowing that I’d staged a coup.  Resentment piled like an avalanche behind me as I closed the door sharply on a room of awkward, advancing silence.

 

I stopped at my best friend Charlotte’s studio apartment to explain why Dr. Foster was the worst person alive and the exact wrong person for his job.  “I mean, how is someone supposed to confront her biggest battles, her deepest fears, if Dr. Foster cannot even be sympathetic for one minute?  I just want my talk therapist again!  I want her to tut-tut and to pray for me and tell me stories about her babchi and to tell me what’s true and what’s not.”

I seethed about the quote on the coaster and about my rebuttal that men are saved by grace.  “And then,” I said, “he didn’t smile, but he almost looked like he wanted to!  And I just about had a meltdown!  It was like he wanted to laugh at me.”

Charlotte offered her own knowing smile.  “Neely,” she said, “he probably did want to!  He had a lot more self-restraint than I would have.  My gosh.”

“What—what do you mean?”

“You argued with him that we are saved by grace—you!  When your OCD has blinded you to grace!  It was like an atheist saying, ‘Let’s pray’!  Honey, come on, give the man a break.  It was a completely ironic thing for you to say in that moment.  Can you see that?”

I wanted to argue, but I was just so worn out.  I exhaled deeply.  “I still don’t like him.”

“That’s fine,” she said.  “And as your best friend, I will dislike him on principle.”

“Thank you.”

“But,” she said, “if this heals you, I will officially revoke all dislike and fall at his feet in gratitude.”

I couldn’t even crack a smile.  “Char, it can’t.  I’ve already failed.  I’m not even doing it right.”  I put my head in my hands, frustrated.  “I’m supposed to be approaching my blasphemous thoughts head-on, and I refuse.  I’m wasting my time, going through torture for no reason, and I’m just done.”

“Well, hold on now,” she said.  “You say ‘head-on,’ but Dr. Doom said you could side-step, right?  What’s that look like?”

I sighed again.  “It’s where I say—or think, I guess—‘My OCD is making me think blah.’  Fill in the blah with whatever bad thought it is.  Probably cursing at the Spirit.”  Father God, I love You.  Father God, I love You.  Father God, I love You.

            “So why not do it?” she said, glancing at her textbooks.

I ogled at her.  “What?”

“Why not do it?” she repeated, this time looking at me.

“Because it’s blasphemous; because it’s sinful; because it’s unforgivable.  It will condemn me to hell.”  I half expected her to blink her eyes as if coming out of a trance.

“You’re not actually saying those things, though,” she pointed out.  “It’s like, well, let me think … it’s like if I were to say to you, ‘I heard a woman at the mall say, “God is not good.”’  I didn’t actually say God is not good.  I was telling you that a woman at the mall said it.  But at the same time, I was able to say it out loud.”  I continued to stare at her.  “You know?  It wasn’t my personal opinion or even a statement to God, just an observation.”

An observation.  I let the idea roll over my brain.  “It sounds risky.”

“Which is the point, right?”

 

Charlotte had taken most of the venom out of me.  I kept thinking of her summation—how the side-stepping of CBT wasn’t stating a personal opinion or even a statement to God, how it was nothing more than making an observation—and of Dr. Foster, his hands held out, palms up, as if in offering.  “My OCD is making me think this,” he’d said.  “Name it.  Say it in your head.”

But the concept still unnerved me.

Mr. and Mrs. Cook, the newlyweds, invited me over for dinner on Sunday evening.  Stella—her curls somehow managed into a Swiss braid—attacked me with a bear hug that made it seem more like her honeymoon had been two months and not just two weeks.  “Gosh, I’ve missed you!” she wailed.

While we ate dinner, my mind kept flitting back to what Charlotte had said—what Dr. Foster had said as well, only Charlotte so much better.  It’s just an observation.  I ran the idea by the Cooks.  “Okay, this is random.  Help me to think of this right,” I said to them while AJ passed around a plate of baked potatoes.  “If Person A says to you, ‘Person B said you’re an idiot,’ which one do you get mad at?”

“How did Person A say it?” asked Stella, thoughtfully twirling a green bean on her fork, not at all thrown off guard by the arbitrary inquiry.

“Softly, pained, regretfully.”

“Then I get mad at Person B,” she elected.

“You don’t shoot the messenger,” added AJ, looking a little confused.

“Neely has OCD,” Stella said, as if those three words explained everything.

            I am the messenger.  OCD is the one with the message.  The statement—the blasphemy—it’s not mine.  It’s not my opinion.  I am only making an observation about what OCD thinks.  The separation sounded spectacular.

“So—the wedding.  How do you think it went?” I asked, changing subjects.

“Ah, I think this is the part where you two go to the couch to talk, and I stay here to do dishes alone,” said AJ.

“Isn’t he the best?” said Stella, getting up from her seat, then leaning over and giving him a kiss on the cheek.

“The best,” I said, and Stella put her arm through mine and dragged me out of the kitchen into the living room.  It looked like a whole new house since AJ had moved in.  His furniture had replaced hers.  The bookshelves that had been full of Jolie Brightman and Edna St. Vincent Millay were now overcrowded with graphic design books on typography and design theory.  A new large abstract painting hung above the fireplace mantel—a chaotic mix of what looked like various colored bulls-eyes.  The most noticeable difference came when we sat down and a cat the color of ashes jumped up onto Stella’s lap, as if he’d been waiting for her.

“Henry,” explained Stella.  “AJ’s brother took care of him while we were up north and brought him over here last night.  We thought it would take him a while to adjust to living in a new place, but, well …”  She nodded toward her lap, where Henry sat purring as Stella stroked him.  She nodded toward the painting above the mantel.  “What do you think?” she asked.  “My feminist club girls from college got it for us.  It was purchased from an artist who mixes her own colors, applies paint to her breast, and strokes the canvas with it.”

“You’re joking,” I said.

Stella’s eyes were merry like Santa’s.  “I’m not.”  We both laughed.

“You’re married,” I said, a little in awe.  “You’re roommates with a boy.”

“Yucky,” she said, wrinkling her nose, which pushed the bridge of her pink glasses up.  Then she laughed and hit me lightly on the shoulder.  She reached up into her hair and started pulling out bobby pins, letting her curls fall to her shoulders.  Henry looked affronted that the petting had stopped.  “Oh relax, will you?” she said to him.

I sighed.  “I can’t believe you’ve only been gone two weeks.  Behavior therapy has been awful,” I said surprised at my composure.  It shocked me every time that life could return to normalcy.

I explained to her my fear that CBT was a waste if I couldn’t finish it.  “So, Dr. Foster wants me to side-step,” I said.  “That’s why I was asking tonight about shooting the messenger.”

She nodded.  “That makes sense.  So, you’re supposed to say what?”

“That OCD is making me think … whatever.”

“Totally.  Yes.  And this will heal you?”

“That’s the goal.  I’m not convinced.”

“You’ve got to do it, Neels.  I know you can.  This is a great way ‘out’—I can totally see where you wouldn’t want to actually curse toward the Holy Spirit—but if your head is attempting to do that all the time anyway, then just reporting that inclination to God doesn’t seem like a stretch.”

Reporting … I liked her word choice.  It seemed so passive, so mild.  So opposite of blaspheming.  Confidence was building in me.  I couldn’t describe it exactly, but it felt a little like adding weights to the soles of my shoes, as if it would take more than a breeze to topple me.

I am the messenger.  OCD has the message.  I am only making an observation.  I am reporting an inclination. 

The statements kept repeating themselves in my mind, over and over.  And they were making sense.  It all seemed so logical, so black and white.  For the first time in years, I felt like a person with a disorder, a person oppressed, a victim instead of a monster.

After I was home from the Cook household, I went into my bedroom, lay down on my bed, put my earbuds in my ears to listen to the horrid audio track that Dr. Foster had recorded for my exposures.  My hands were shaking, and my face felt tight, as if I would never be able to wrench my jaw open again.  My shoulders were tense and felt thick as slabs of beef.

“Okay,” said Dr. Foster’s voice.  “You wake up and immediately you have a blasphemous

thought.  Something that relates to the Holy Spirit, and you’re thinking something horrible and disrespectful toward the Holy Spirit.  And you don’t do anything about it.”  A familiar cadence, a recognized tone by now.

My chest was as tight as a drum, my heart racing like an executioner’s drumroll.  It was that familiar feeling of alarm.  I stared at the ceiling, my heart thumping in my chest, and when the thought came, I altered it slightly.  Very slowly, as if I were watching each individual letter be typed on the ceiling, I thought, My OCD … is making me think … “fuck You” toward the Holy Spirit.  I swallowed hard.  Had it been wrong?  Was it unforgivable?  God, don’t shoot the messenger.

Dr. Foster’s voice droned on.  “You don’t say a prayer; you actually say, ‘I’m gonna take that risk.’  You say, ‘Fuck it.  I don’t care.’  And this stays with you the rest of the morning and sets the tone for your day.”  My OCD…  is making me think … “fuck You, Holy Spirit.”  The room was silent, still, the bed beneath me warm and soft.  The statement—thought as a message from OCD—was the very one that I’d been frantically trying to avoid for years and years.

The audio track continued, but it was in the background for me.  Was I going to hell?  I reminded myself that I didn’t really say it or think it, but that OCD was inspiring it in me.  I felt threatened; the panic remained.  I continued to stare at the ceiling until the track ended.  OCD has the message.  The blasphemy is not mine.

But I fell asleep a lot more easily than I’d have guessed—and my dreams were not troubling, not even memorable.

Keep Calm

I have never really been neutral about anything.  I am an extremist, and I feel things in my bones.

I sometimes have a hard time seeing that the current situation will likely change soon.  This is a burden given to me by obsessive-compulsive disorder.  We OCs think things will always feel this way.

I am a writer.  Creativity is like air to me.

All of these things combine, and you have me, this volatile, passionate artist whose highs are marvelous and whose lows are dark.  When writing is not going well, I sometimes think it will NEVER go well again.

Years of this rollercoaster should have proved to me that things will level out again.  I don’t have to rush every draft like a linebacker, don’t have to wrestle it into shape.  I can relax, breathe deeply, set it aside for a (short) time, think and pray and carry on.

slavery and freedom

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.

not alone

One of my OCD friends just sent me a message that said: “I have also been reading your blog… ha almost like looking at my own biography.”

It reminded me so much that although OCD tries to make us feel like freaks– like we are the only ones who could think such thoughts– like we are unique in our horrors– it’s not true.  All obsessive-compulsives are telling the same story, just with different details.  We are wearing the same outfits but have put on different accessories.  We are not alone.

OCD wears many masks: scrupulosity, checking, ordering, washing, etc.– but in the end it is a neurological disorder that makes us think unwanted thoughts and then perform actions to give ourselves temporary relief.  We are all in the same boat together.

I as a Pure-O can sit with a washer and empathize.  We have a common enemy.

For years, I thought I was some kind of anomaly.  I’m not.  I’m just a girl whose mind has a glitch, and I stand alongside many others who experience the same thing.

Community is important.  I felt validated when I discovered that there were others like myself.  I remember reading Kissing Doorknobs for the first time.  I remember my first conversation with another OC.  I remember reading Stop Obsessing! and seeing myself in the pages, just the way my friend is seeing himself in my blog posts.  Community matters.  And that is one reason that I shout from the rooftops that I have OCD, just in case any other OCs are listening, in case they recognize themselves in me.  Then we can sit down, talk, share stories, and realize that ours are both the same.

 

Cognitive-Behavioral Therapy gave me back my life

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

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.

Christianity and OCD

Continuing the conversation from last Monday …

My friend Rachel is a college student who recently completed a major project during which she had to view obsessive-compulsive disorder through a Christian lens and present her findings in a medium other than the typical college paper.  She created a blog, which you can view at http://christianityandocd.wordpress.com.

The questions that she asked me during this project prompted me to again reconsider the relationship between OCD and Christianity, along with those thought-provoking questions such as “Did God give me OCD?” and “Is CBT enough?” and “What is the cause of OCD?”  Her blog explores some of these questions.

Rachel herself does not have OCD, so all of her research is outside of her own experience.  I invite you to check her blog out and let me and her know what you agree and disagree with!