Thursday, June 3, 2010

VH1's OCD Project: Reactions from Someone with OCD Part 2

VH1's OCD Project premiere with Dr. David Tolin was hard for me to watch. Not because of the shoe licking, but because Exposure and Response Prevention Therapy(ERP) is portrayed as something to be inflicted on people with OCD in a boot camp manner, with a dose of "all or nothing" thinking thrown in--ie. either fight your OCD or get out. If my therapist demanded I do exposures "for my own good" I would flee.

Leonard often says that if clients don't agree to the goal of learning to live with uncertainty, they are not going to want to do any exposures, and his job is work in partnership with clients to understand the nature of OCD and of the need to accept uncertainty. OCD isn't happy with 99.9% assurance that my health symptoms aren't dangerous. It wants 100% certainty, and this can make my life hellish. This is not to say that Leonard isn't frank. He'll tell me that I could worry about one symptom and then have a completely hidden disease kill me, but if a therapist feels their job is to push their clients off a cliff into dramatic exposures, this is inappropriate.

ERP is about starting with what you can and *will* do. What is the first step you can take to fight the OCD? I was often paralyzed with making perfect decisions. I started with a small exposure of choosing something by flipping a coin, at least once a day. Should I wear a green shirt or a blue one? Flip a coin. This created a wave of anxiety in me, but not so much that I was unwilling to do the exposure. Then I moved on to choosing something that didn't feel "perfect." If you find yourself thinking your therapist is crazy for suggesting certain exposures, you need to talk about it--and that in itself is an exposure, if you fear even verbalizing what you are really afraid of. If my therapist yelled at me, or goaded me into an exposure, I wouldn't get the benefit of treatment, because I don't respond well to this style. People with OCD have a range of temperaments, just like all humans.

The irony is that all things considered, if the participants in the OCD Project aren't scared off, and stay in therapy, and do the exposures and don't secretly do rituals to "undo" them, they will be better off than if they went to a traditional therapist who wants to talk about the reasons for the content of their fears. Arine's story is particularly poignant, with her fear of harming someone while driving, after her father and grandfather were killed in horrific car crashes, but making the link between this event in her life history and the manifestation of her OCD is not enough in and of itself to help her break free of the anxiety. There are many ways in which each of us can cause harm to our fellow beings, but to consistently eliminate all risk is both impossible and the attempt erodes our ability to do good in the world.


  1. I totally agree with you as a fellow OCD sufferer. I have been in therapy for almost a year and have had a wonderful therapist. She knows my limits and will push them, but never makes me do something I don't want to do. I think that is where the media gets it wrong. They think it is expose a person to their strongest fear right away and all is better. That is not true. As Bill Murray in ¨What About Bob" said, "baby steps."

  2. Hi ExpWoman!

    Thanks for becoming a follower of my blog. I'm curious how you found it! I'm glad to have found your blog as well. After watching the OCD Project, I was afraid that my OCD tendencies would come back. It definitely reminded me of the pain that I went through. However, the show allows non-OCD sufferers to see how big of a problem it is. I can't wait to read more of your blog posts!

  3. You make some really good points. I have suffered from waxing and waning (currently really bad) OCD for about 17 years. The OCD Project was one of my first experiences with ERP outside of what I have read in books, and the particular approach used in the show seems rather intense. I did have reservations about that, wondering if part of it was for ratings and sensationalism. It probably is. But on the flip side of that, it sort of boosts my urge to push it a bit more. That much? NO! But more.

    Anyway, great blog!!!

  4. Hi I Am Not my OCD,
    Yeah, there is a kind of synergy that comes from watching other people succeed in facing their fears by doing exposures! In spite of the "edited for tv ratings" nature of The OCD Project, I appreciate the chance to watch others be supportive of each other in doing some really scary stuff in relation to OCD fears, and inspired as well.

  5. I find it comforting and inspirational to watch the OCD project. I've had to deal with this for about 17 years...and it is interesting to see other people with this problem, and the ways it can be treated. I hope to get the courage to get treatment some day, but until then...I just have to keep watching and learning more about it.

  6. Sarrah--I'm glad that the OCD Project is inspiring you! No matter my misgivings about the nature of tv, David Tolin is doing real exposure therapy, and that made all the difference in my OCD when I found an exposure therapist. I hope that watching will spur you on to seeking treatment.