Thursday, June 3, 2010

VH1's OCD Project Premiere: Reactions From Someone with OCD Part 1

I've been hearing a lot about the OCD Project on VH1. I don't have cable, but found the premiere online. The host is Dr. David Tolin, a clinical psychologist, founder of an Anxiety Center and who teaches at Yale. He's got credentials. He knows what OCD is and he knows how to do Exposure and Response Prevention(ERP) Therapy, but throw in the world of reality television and things get dramatized. The trailer for the show has Tolin licking the bottom of a shoe.

ERP is hard enough without it being portrayed for maximum revulsion. Exposure Therapy is about learning to live with uncertainty about how clean, safe, or right things are, and no human enjoys thinking about this kind of uncertainty. I am disturbed by the paradox that a tv show is actually showing a proven treatment for OCD, but in such a way that some people will be scared away from trying it. Not everyone will be scared--some people are so tormented by their OCD and combined with a certain personality, kick OCD to the curb with big gestures, but most of us take small steps at a time.

How often do you need to lick a shoe in real life? Treating OCD is more about the subtle issues in daily living. Dr. Jonathan Grayson has a vignette on his blog, entitled "'Normal' People Don't Know What They are Doing, "about pouring potato chips on the floor at a lecture on OCD and proceeding to eat some, and offers to share. There's a general "ewww" response from the college kids, but then he asks them if they sit on the floor at parties, and many say yes. Then he asks if they wash their hands before eating snacks at a party, and many do not. As he says,
”Normals” may say they won’t eat after touching the floor, but they don’t really know what they are doing.

I don't have contamination OCD, and this vignette made me think of how I put my shoes on, and then later might lick my finger to get a plastic bag open, or pick something up from the floor and then later pop a piece of candy into my mouth, all without washing my hands first. I'm inconsistent. If I pet the cat, I wash hands before food prep. This is salient in my mind, but if I pet the cat and then walk by free cookies, I'll pick one up and eat it without thinking about it. I'm not talking about a wanton recklessness here. If we were to be 100% consistent about avoiding contamination, we would be paralyzed by the "dirty world" we live in.

I joked with my therapist that our sessions wouldn't work on tv, and he said, "On PBS!" which made me laugh.

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