OC87: A Movie About Courage and Living Your Life in the Midst of OCD

My husband was away, and I was feeling anxious.  I've come a long way since the time I walked 7 miles around a lake in order to ward off the anxiety of being alone for a week, but I'd been having physical aches and pains in the weeks leading up to his leaving, and my OCD was stirring.

Feeling achy and anxious, I started searching for movies on Netflix.  This was my way of avoiding searching for the meaning of my symptoms, but still, compulsive and exhausting.  Working my way through the alphabet and the numbers, using the arrow keys to navigate to one letter at a time.

Then OC87: The Obessive Compulsive Major Depression Bipolar Aspberger's Movie came up.  I remembered hearing about it when it came out a couple years ago, but I hadn't seen it.  It was already midnight, but I started watching.

Bud Clayman majored in film in college, but thoughts that scared him, and depression infiltrated his life.   OC87 refers to 1987 when he built his life around attempting to control the world around him, and the thoughts within him.

I was moved by Bud Clayman's persistence in making this film about his life now, after 30 years of OCD, depression and Asperger's, which involved dealing with people, dealing with his intrusive thoughts, indecision, anger and grief.  I particularly liked the scene he wrote where he played both "Good Buddy" and "Bad Buddy" in a riff on a scene from Lost in Space.  Part of this is in the trailer for the movie, the Bad Buddy telling the Good Buddy that he isn't capable of living without him, but Bud Clayman is capable of living his dream, even with the spectre of OC87, in the midst of the imperfections.

What this film reminded me was that to spend the week trying to figure out if my symptoms were a physical problem, or whether it was OCD, and freezing myself into a block of worry was a manifestation of my illness, and not what I want in my life.  

In one scene, Bud asks a woman what films she likes, and she asks him the same question, and his answer is that Ordinary People is the best movie ever made.  He describes how OC87 evolved out of a desire to describe how therapy had helped him, how it was a safe place, and how Ordinary People resonated with him, in its depiction of therapy.

Ordinary People is one of my favorite films, and I hadn't expected it to come up in Bud Clayman's film. I saw it when I was 12 or 13, several times, mesmerized.  Netflix had it, and I watched it next.  I'll write more about that.

Have you seen OC87?

Fear of Thoughts Getting Stuck: The Challenge of Reading OCD Self-Help Books

I had several responses to my review of J.J. Keeler's I Hardly Ever Wash My Hands: The Other Side of OCD, expressing fears that reading the book would give them ideas or cause anxiety.  I've been mulling this over, because it's a challenge to respond.

The simplest answer is that I don't know if J.J. Keeler's account of her OCD, and the specific things she worries about, will "stick" in your mind or create new OCD obsessions.

This is the nature of OCD that one person's trigger can seem completely harmless to someone else with a different form OCD; it's not only those without OCD who think that a particular obsession is incomprehensible.  There is a tendency to assume that other people's obsessions are easier to bear.  Conversely, if we suspect that a person's obsessions might be similar to ours, then there can be a desire to quarantine them, and not get anywhere near, as if the fears were contagious.  Or we are afraid of adding a whole new category of obsessing, and again, stay away.

This is OCD's mode of operation, to convince you that you can avoid the contagion of life, if you just screen out all things that might set you off, and enlist those around you to help in this task.   I know this from the inside.  Public health campaigns to raise awareness about various illnesses seemed designed by very cruel folks to torment me.  I was already highly aware of things that could go wrong, and I didn't want to know of any additional ways to monitor and worry about.  When I was a kid there was no internet but there were posters on the bus, public service ads on tv, special episodes of programs where someone had a disease, and magazine articles.  Women's magazines were the worst, and my mood would plummet if I was in a waiting room, reading one(which I picked up because I was anxious to be in the waiting room to begin with).

In college I was doing fairly well for awhile, avoiding obsessing about moles, until a classmate opened up his datebook, and I could see he'd written in an appointment for a mole removal.  I couldn't have predicted this.  Now, it might seem that you could at least keep yourself safe by avoiding what seems obvious, like Keeler's book or other OCD self-help books, or my blog, or the OCD Yahoo Group, or OCD support groups, but what is your definition of safe?  Avoiding all possibilities of help is not safety.  OCD would have you believe that it is possible to maintain complete quarantine, but triggers are part of life.

The irony is that when I was in an anxiety spike, I would then search out articles about whatever symptom was catching my attention, in order to reassure myself that I didn't have something serious.  There would be an initial calming effect if my symptoms didn't match, but then as I'd keep reading, I'd find something that again put doubt into my mind, or introduced an even more scary possibility.

I am not minimizing the abject fear of being seized by an OCD obsession.  I've been there.
But getting help for OCD is where the true hope of living beyond your obsessions resides.  OCD wants to maintain the status quo.  Don't get help.  Don't learn about how other people have coped.  Don't risk new pain.  

If you can't read a self-help book or OCD memoir because it's too terrifying, then this is a signal to find an exposure therapist, or a self-help group, where other people can help you.  I understand the irony in this.  I was once incredibly shy and my therapist suggested group therapy, and I was appalled.  How could I go to a group for help if I was terrified of groups??  But eventually, I realized that I didn't want to go on the way I was going:  the cost of my fear was too much, I was missing my life.

Keeler, in the preface to her book, writes of having severe fears of harming someone while at Disneyland, and self-loathing for what kind of person she must be, when a toddler ran over and hugged her leg.

It felt like she was telling me I wasn't what I feared.

I have no idea who this toddler was and I never saw her again.

But she saved part of me that day.  

Hopefully, this book can save part of someone else. 

 

 

Intrusive Thoughts and Harming Fears: A Review of I Hardly Ever Wash my Hands: The Other Side of OCD by J.J. Keeler

TLC Book Tours contacted me about reviewing J.J. Keeler's I Hardly Ever Wash My Hands: The Other Side of OCD, and I was intrigued by the title because my OCD doesn't manifest in handwashing rituals, and this is the short-cut metaphor for OCD much of the time.  After reading the book, I felt like I'd found an OCD-Soul-Sister and although I am never glad that someone else has OCD, and I am glad when they can write about it in an articulate and insightful way.  

I had to laugh when J.J. Keeler describes how her twin sister had hypochondria with fear of many diseases(a type of OCD I am very familiar with), but the author had only "had" one disease: AIDS.  In the irony of OCD, in elementary school she is triggered into worrying about AIDS when her parents mention a blood transfusion she had, but what her OCD latches onto is the risk of "dirty needles" which in her young mind means thumbtacks, staples, pine needles, with dirt on them.  Humor is a major component of Keeler's account of OCD, grabbing the edge of ridiculousness about OCD fears and pulling the whole thing apart, so that the sufferer can catch a glimpse of OCD's game of generating endless scenarios and holding life hostage.  

The second chapter, The Bomb in my Teddy Bear, is a marvel of encapsulating the experience of morphing OCD thoughts.  When she was 8 years old, neighbor gives her a teddy bear at a yard sale, and a chain of fears links itself around her.  She started getting a weird feeling about the bear, and wondered why a relative stranger would give her a teddy bear for free.  Then it came to her, "The reason was obvious.  There was a bomb in the teddy bear."  Keeler agonized over how to dispose of the bear, without harming anyone else, and then when it didn't explode, wondered if the neighbor would come back to finish the job.  Her rituals to keep the anxiety from exploding were a constant stream of "figuring out" and "analyzing" combined with tin cans at the door to let her know if there was an intruder, and plotting how she could take the bear on one of her father's fishing trips and throw the bomb overboard.

Eventually, OCD moves onto other topics in Keeler's life, but the same corrosive fear and desperate maneuvers to make the fear go away.  In addition to fears about AIDS(and calling the testing center before her test was even received, to check, check, check), she feared causing harm to others after being deluged with intrusive thoughts.  If you suffer from this very painful form of OCD, please read this book.  Keeler has known the despair that made her consider suicide, because she didn't want to harm anyone and yet these images would pop into her head, and she has survived, and now thrives.  

The most difficult part of reviewing I Hardly Ever Wash My Hands: The Other Side of OCD, is that I want to quote everything, but it would be better for my readers to go find a copy of this book and read it for themselves.  

Read J.J.Keeler's Introduction to Harming Obsessions on her blog.  

Find J.J. Keeler on Twitter

Related Post:

Fear of Thoughts Getting Stuck: The Challenge of Self Help Books for OCD

http://tlcbooktours.com/

Living with Me and My OCD: An Interview for Claire's Documentary

ClaireJaneOCD on twitter is creating a documentary about the experience of having OCD, and invited me to contribute a video.  Claire and Jane are twins in the UK, who just completed running a marathon in order to bring awareness about OCD.  This is my first time recording myself!  And definitely an exposure to make it, but hopefully will be helpful to other people who struggle with OCD.

Wordless Wednesday: Over and Over

Sensitized for Instant Response: Ruining the Day

This week I've been getting stuck in fear of ruining my day, that doing something "wrong" will contaminate the rest of the day. I'm so used to making up rules for myself as to what constitutes a good day, and the OCD has me sensitized to any thoughts of "you did that wrong" or "you should've done something else," that before I even realize it, I'm reacting to the thought, wanting to eradicate it.

When I think those kinds of thoughts, I tend to take them at face value, as if they were true and credible, and with power to change the entire quality of a day. The closest metaphor is contamination. One of my feared consequences is that if I choose an imperfect action, it will spread to the rest of the day, and can't be cleaned up. My compulsion is to undo the thoughts of having messed up by either ruminating on them, analyzing them, or going into habitual websearching as a distraction. And then, ironically, OCD causes the very thing I fear--this compulsing ripples through the day and takes up my time.

I asked my husband yesterday if he thinks this way, and he said no. He might do something that ends up being a waste of time, but then he moves on to something else. He doesn't have fears that if he somehow goes awry, it will haunt him. For me, it's very basic stuff, for which there is no handbook or optimal schedule. When to take a shower. When to eat lunch. When to take a walk. When to run errands.

I have a big fear of wasting time. If I have errands to run, I get mired in figuring out how to do enough at a time so I don't "waste time." The fact is that sometimes we waste time. It's as if the OCD decrees that I live in a universe where I don't ever make a mistake or take up time doing the activities of daily living, and the insidious part is that for a long time I truly believed that I could find certainty as to what I should be doing in any given moment.

In the past, I also feared ruining a day by having intrusive scary and anxious thoughts. I've gotten better at recognizing them as part of my OCD, and not getting into a power struggle with them, and eroding all possibility of being present in my own life, but the thoughts of doing things perfectly slip in under the radar, and I do get into a battle with them. I see more exposures in my future, choosing things to do in a day, and doing them, and facing the fear. I'm edging towards this, in spite of my aversion.

Intrusive Thoughts and the Search for the Answer: Part 2

As I said in Part I, the intrusive thoughts that seemingly took me over as a girl, became a fact of my history that I spent a lot of time trying to figure out. It was a reference point, a mystery, and an indictment in my mind. How could I say I was a feminist? How could I say I cared about women? How could I be a good person? Surely these thoughts and images of violence invalidated anything I might believe about the value of women. In my 30's I started seeing a therapist for depression and anxiety, and worked up the courage to tell her about the thoughts. She did something that many therapists do: she gave her interpretation. Interpretations can yield useful insight if they're not about obsessive thoughts. She said that it sounded like I was angry at my mother.

Although it was reassuring that she didn't think I was a bad person for having the thoughts, the idea that such violence in my mind's imagery was somehow symbolizing anger at my mother scared me. What kind of daughter was I? How could I ever survive such awful anger? Interpretations add fuel to the OCD fire. Each new interpretation brings its own set of things to figure out.

It is the painful irony of OCD that intrusive thoughts often strike at the very things that are most precious to us. A truly pious person has blasphemous thoughts, a gentle soul has violent thoughts, a feminist has thoughts of violent pornography. The other brutal irony of OCD is that even when books or websites that clearly describe the experience of intrusive thoughts, and the fact that they say nothing about you as a person, the OCD latches onto this and sets off a cascade of figuring out: "Do I really enjoy these thoughts? Do I really have OCD? How can I know if the thoughts are actually intrusive?" Or if you see a therapist, you can fall into the "What if I'm not truly expressing my thoughts clearly, so the therapist can't see how truly bad and twisted I am? What if I am deluding them?"

It helped immensely when I found an exposure therapist, and he knew that this cascade would appear--he would say, "I bet you are trying to figure out if your thoughts are an exception to the rule, and the OCD is getting louder and louder as we sit here--am I right?" Making the pattern explicit helped me to know it's sneaky insidious ways, and the insatiable desire to prove once for all that I am ok, not bad, not unredeemable.

Intrusive Thoughts and the Fear of Being Unredeemable

Rosalie Stanton recently found my blog and shared a post she wrote about her struggle with intrusive thoughts.

I had no idea my obsessions were perfectly in-keeping with my particular case of OCD until recently. I'm not certain if it helps others afflicted with OCD, but the knowledge that I was NORMAL probably saved my life. For as miserable as I was, thinking I was wrong and twisted and evil, finding out that my disease had a name and there was nothing I could do to prevent it, nothing I was at fault for thinking, was the biggest blessing I've ever received.

The pain of feeling wrong and twisted and evil is something I know as well. When I was 9 or 10 years old, I started having thoughts that most adults would find scary, violent, disturbing, let alone a child. It was as if they were injected into my mind, just suddenly there, in an occupation, a siege. I wondered why I couldn't make them stop. I began to enter the world of my thoughts in a set way, in a ritualistic sequence, as if I was standing in front of a mirror, looking at my face, and crossing through into a world of torture of women, an observer of it all.

How I came back out each time, I don't recall, but I remember feeling defeated when the thoughts came back again. The images spun themselves into a series of stories, expanding seemingly endless to my young mind. It was as if they wrote themselves. They were unfamiliar, alien. Even now, I can't comprehend where they came from. They so crowded my mind, that one afternoon, I asked a friend to play out part of the story where doctors kept women captive. Her look of confusion combined with a stabbing sense of shame, but also gave me a little room, to feel grounded in the actual world, not in my head.

She was completely uninterested in cooperating, and from the day onward the thoughts did not return in that form. I was amazed that I no longer was sucked into the narrative of fear and violence. The thoughts did remain as a memory, as something I wondered about, as a part of my history.

In college, I participated in a survey about women's sexual fantasies, and I was stricken with fear that my old thoughts were a fantasy, that they were something I wanted to think about, something I enjoyed. Filling out the survey filled me with dread about what my thoughts meant. Then I went to a presentation about the destructiveness of hardcore pornography, with a series of slides of some of the most violent images in magazines, and it was as if the images from my past were there right in front of me. I was in a state of anxiety and fearfulness. The slides repulsed me, and yet the old images from my mind were of the same substance. I was startled by the resemblance, and even more troubled about what this meant about me as a person.

I started to worry that somehow I had been subjected to pornographic magazines as a girl, but couldn't remember it. Or maybe I had been sexually abused. Or maybe I was just bad. That all my interest in helping women, the classes I took on women's history, my compassion for suffering, was all a lie and in fact I was twisted, that all girls were twisted in some way. I spent a lot of time in my head, trying to figure out the nature of my soul, the origin of the images, and the new set of horrors that the pornographic slides had introduced into my head, and desperately wanting to make them go away.

To be continued in another post.

Aubrey Lewis on the Nature of Obsessions: Depersonalization and Warding Off

In exploring the history of Exposure Therapy for OCD, I came across Aubrey Lewis, clinical director of the Maudsley Hospital in Britain. Many of subsequent developers of ERP were recruited or encouraged in their work by Lewis. In 1937 he wrote an article on the Problems of Obsessional Illness, where he describes some of the characteristics of obsessions. One definition he liked was by someone named Schneider:

. . .contents of consciousness which, when they occur, are accompanied by the experience of subjective compulsion, and which cannot be gotten rid of, though on quiet reflection they are recognized as senseless.

But Lewis notes that the recognition of the obsession as senseless is not essential, but the aspect of feeling one must resist the obsession is key--attempting to ward off painful and overwhelming obsessions, and paradoxically, ". . .the more overwhelming and painful the obsession, the more urgent and unsuccessful the devices to ward it off."

I recognize my experience in this! I also see the paradox that when I am at my most panicky, it is unlikely I'll get to the point of "quiet reflection", and even in 1937, Lewis recognized the limits of Cognitive Therapy with OCD, stating that, "Critical appraisal of the obsession, and recognition that it is absurd represents a defensive intellectual effort, intended to destroy it: it is not always present, nor is the obsessional idea necessarily absurd."

This is where Grayson's book Freedom From OCD really helped me in recognizing that some things I obsess about could actually happen, but that trying to get absolute certainty that they won't is impossible, and that I actually tolerate a lot of risk in the areas not affected by my obsessions, like when I worked in a hospital, and didn't worry about contamination.

Lewis describes the sense of having a part of one's self or mind working independently, not as an integrated part of oneself, and the desire to fight against it. Also, the acute awareness of "internal speech" and having words said outloud come back into one's head. Finally, he mentions depersonalization, where the patient,

. . .is commonly so far from feeling the master of his own thoughts that he has almost no personal or free share in them at all. . .

Lewis believes that depersonalization is a state that affects all thinking, not just parts of it, as in obsessions, but that they are similar. When I start web searching, I feel some of this exclusion from my own self. There are things I actually want to do with my life, and yet these recede in the face of an obsessional thought about needing to do things "perfectly" and subsequent compulsive trance-like searching of the internet. Lewis does not discuss treatment, and rambles a bit, but I appreciate his attention to what the experience of obsessing and compulsing is like.

What do you notice about your obsessional thoughts?

Am I still anxious? Does this still bother me? And other querulous questions.

It's as if I am poking someone who is sleeping, and saying "Are you sleeping?" poke, poke, poke, and then they wake up. The mental ritual of checking on my anxiety level or sensations is one of the hardest to deal with. I'm sure that some of those reading this blog have had the experience of being consumed by anxiety about a particular obsession or topic and then getting up the next day and the anxiety is gone. I assumed that once anxiety set in, only sleep could fix it, and I would long for it to be the next day.

Even more frustrating is waking up calm, and then remembering my anxiety from the day before and having it all kick up again. My immediate response when remembering an old worry is "Damn, there it is again. Why can't I get it to go away?" It's like a staticky bit of plastic that you try to flick into the trash, and it just clings to your fingers. This is followed by having the urge to check if I am still anxious or if a certain symptom or thought still bothers me, and the more I check, the more entrenched it gets.

I would recognize anxieties that would probably fade the next day, like fear that I'd chosen the wrong dish off a menu, and I'd be frustrated by my inability to step away from it sooner armed with this knowledge. Knowledge alone is not a match for the anxiety created by OCD. My theory is that sleeping would give me a break from poking at the anxiety, waking it up, and increasing its noisy dominating behavior. It wasn't a magical cure.

My therapist has encouraged me to let my anxiety producing thoughts into my mental space, letting the noise happen, in fact practicing introducing the noise into my mind, which is an exposure. I usually feel snarly when he suggests this, but I also recognize that the vigilant checking to make sure the intrusive thoughts aren't there repeatedly reminds me of them. And every "Damn there it is again," highlights the thought, magnifies it, makes me exquisitely sensitive to even the threat of a particularly despised thought.

I know this sounds crazy. If you are desperate to avoid a scary thought, and you forget it for a few hours, the last thing you want to hear is the idea of purposely seeking it out, and disrupting that bit of peace. But the peace is fleeting and leads to long term anxiety--I have never been able to force a thought out and make it stay out for good. I have learned that it is possible to enjoy life even with those thoughts making noise.

Relationship OCD: Fear of Choosing the Wrong Person or Gender

My 21st anniversary of being with my husband is coming up. I remember our 3rd anniversary, as we sat on the floor of my dorm room, and I struggled to tell him my fears. I had just gone to a presentation by a "feminists against pornography" group, with a slide show of violent images found in magazines, and the images were stuck in my head. I felt a claustrophobic dread that I would always be trapped by these images, a barrier between me and living my life with any peace or joy.

I had been reading a book on women's friendships, and combined with the scary things I had just seen, my OCD went into overdrive trying to figure out if it was safe to be in a relationship with a man, whether I was making a mistake, showing extremely poor judgement. As my anniversary approached, the obsessing intensified, and permeated all my thoughts and feelings. Was I putting myself in danger? Was I stupid? Was I wrong? Would this man betray me or hurt me?

It's hard enough to have these questions as a 20 year old, in any context, but in the context of OCD, I felt crazy. My first date with this man was to hear a feminist folksinger. I had never met anyone who listened to me like this man did, and took my thoughts seriously. He was compassionate. But my OCD wanted absolute certainty that he wouldn't become a monster. My best guess would've been that no, this was unlikely, but the OCD whittled away at this knowledge, kept demanding I figure things out.

Maybe you should be with a woman? That would be safer. If you stay with this man, you are betraying your gender. Are you sure you feel something for him? Keep checking on this. Any sensations? You are so tense when he touches you, obviously this is a sign that you need to be with a woman. So many horrible things have been done to women by men. You'll become part of that. You will be in collusion and contaminated. What if you stay with him, but you are actually a lesbian and you will lose any chance of happiness?

So, there I sat on the floor, on my anniversary barely able to speak, crying, and my love thought I was breaking up with him. This was the essence of OCD--I didn't want to break up with him. I just wanted the anxiety and intrusive thoughts and endless exhausting dialogues in my head to go away, and to know for sure I wasn't making a mistake.

There's a lot this 20 year old didn't know. She didn't know she had OCD. She knew she was anxious, but assumed that was a sign of her own defectiveness. She didn't know that OCD attacks what we hold dearest, what cuts right to the core of our identity and self. She didn't know that if you constantly check to see if you are feeling anything, you will mostly feel anxiety and fear. She didn't know that some things are incomprehensible, like the violent acts done to some women by some men.

I'm glad that somehow I made the decision to stay with the man who is now my husband. That took a lot of courage, since it meant trusting my own judgment and living with the whole host of anxiety-provoking questions, with no support for dealing with my OCD.

Good Friday and Scrupulosity

I confirmed my faith on Palm Sunday some 30 years ago, and then had first communion on Good Friday. OCD can infiltrate every aspect of your life, and the term for religious and moral obsessions is scrupulosity. Ironically, from the outside no one would ever suspect I had such struggles and turmoil about perfectly pleasing God. I was at church constantly. During Lent I went to every Wednesday night service and every night of Holy Week Services. I wrote prayers and devotionals. I took great pains to never hurt someone's feelings. I was quiet, compliant, conscientious, studious. I didn't swear.

This made my confirmation difficult, because as I knelt down to receive the blessing from the minister, obscenity hurtled into my mind. Suddenly, I was thinking words I would never say. I desparately wanted them gone. I agonized over what this meant about me, and how to make them stay away. I had been looking forward to my first communion, and yet, the first thing I thought of was "Will the thoughts come back?" which immediately brought the obscenities to mind in the self-generating way that OCD has. I couldn't be in the room, in the sanctuary of this church, because my OCD was compelling me into the future.

Existential questions heavy laden with intense anxiety and fear that I was doing everything wrong. Did I feel the "right" way during communion? Did I enjoy writing prayers more than loving God? How can people exist without being Christian? How do they get through life? Would God really reject them? I wrote long journal entries trying to figure this all out, until the point of exhaustion. In my heart, I had a passionate longing for God, and a sense of God's presence, but my constant analysis of every thought and action obliterated the possibility of comfort and peace.

Finally, in my 30's I stopped going to church, because the waves of compulsive figuring out of sermons, and fears of being imperfect and therefore damned and being afraid that if I couldn't figure out the meaning of suffering, or whether Christianity was the only way, or whether God was good, that I would disintegrate from the anxiety of these unanswered questions. I want to honor the heart of the girl I was, who loved God, but I'm still afraid.

Singing from Myself

There was an article in the paper about research on music and the brain, and how trained musicians were better at picking out speech from background babbling. They could cut through the noise to the meaning. Several years ago, I read that singing uses a different part of the brain than the obsessing/compulsing part, and I started singing in the shower in hopes of getting a little peace and to keep moving through my day.

I sang a lot of verses of Kum-by-Yah, the only song I could really sing out, and discovered that it did free up some space in mind from the crowd of intrusive thoughts and compulsive figuring things out. I found a voice teacher, and after much indecision, decided to take lessons, even though I wasn't sure if it was the "right" choice(ie. existential questioning about whether I really wanted to sing, and how did I know for sure, and did I enjoy it enough etc.) Later I joined a choir. In the past, before my therapy with Molly, this was all unimagineable in the midst of my social anxiety, and the novelty of choosing to do something I wanted to do.

I feel good when I sing. It's not that the anxiety and obsessiveness disappears, but that I can find myself in the midst of it, and be present in the room, in the moment, be someone beyond my OCD. Like the singers in this research study, I can pick out what is meaningful when I'm singing.

Talking to OCD: The Hazards of Talk Therapy

Before I started Exposure Therapy with my current therapist for my OCD, I had been in psychodynamic therapy for 6 years with Molly. She was a good therapist. I changed my life in many ways while seeing her. I started driving again. I began making art. I became closer to my husband. I began to believe that I mattered, and joy was possible. I wouldn't have recognized myself if I could've seen into the future.

But the OCD persisted. Although Molly was the first therapist, among the 8 previous ones I had seen, to recognize I had OCD, her strategy was to encourage me to avoid my triggers, and to offer reassurance. She had a down to earth grittiness mixed with intense compassion, and enough of this quality allowed her to provide some Exposure Therapy inadvertently by guiding me to do things rather than intellectualize everything. She had no training in Exposure and Response Prevention Therapy, but most therapists are lacking in this training.

There are aspects of my therapy that dragged on in excruciating barrages of OCD. It was like running a race through quicksand, expending great amounts of energy and getting deeper and deeper into obsessing. This can happen with any therapist, but Molly's inexperience with treating OCD contributed to a feeling of hopelessness. If she could help me with so much of my life, but the obsessing remains, then what was I doing wrong? My perfectionism said, "You are defective. Just try harder. Obsessively research OCD."

When I finally joined an OCD support group a couple years ago, I was saddened and angered by the number of people who had been in psychodynamic therapy for years as they progressively became more entangled in their OCD. One woman had intrusive thoughts that she might hurt a child, and after 12 years of therapy, had quit her job as a teacher, was terrified of having a child of her own, and sinking deeper and deeper into depression.

Telling someone over and over that they are not a dangerous person, and feeding the OCD desire for absolute certainty is not benign. Directing a sufferer to dig for the roots of why they are having these thoughts, and what they mean is not benign. The harder the search, the more room for the OCD to escalate as the brain gets the message, "These thoughts must mean I am a bad person, since I am trying so hard to disprove them."

The OCD needs to be addressed directly, or it will go underground and the unraveling of lives will continue. It's one thing as a starting point to tell someone that research shows that people who have intrusive thoughts never act on them, but it's another to expect that that will magically make the OCD go away. OCD isn't about rational thought; it's unalloyed fear.

Indecision at the Library

I loved going to the library as a girl. My father was willing to take me since he was always reading, and needed his own fix. I'd get 10 or 12 books and line them up along the side of my bed, a wall against anxiety, fear and parents who could barely take care of themselves let alone me and my sister. OCD latched onto this love when I was in my 20's and still reappears, like today, when dh and I went to the library. I'd already started the day with intrusive thought #1, "You've ruined your day by websearching for 1/2 hr while eating breakfast." I'm savvy enough to recognize that this is a thought, not necessarily reality(though it could be, who knows), but still scared enough to want to do a thorough autopsy and determine if I have indeed ruined my day.

At the library I started strong, but then moved to the fiction section and couldn't find the right book. I started the "searching without cause" dance of indecision. Look at every book on a section of the stacks. Pull multiple books off the shelf and flip through them trying to decide if they will be disappointing. Pull some of the same books off again. Scan the titles slowly, in case I missed something. I believe if you mapped out my footprints like do with dance instruction, the ground would become obliterated with all the repetition and retracing. It seemed an eternity, but according to my dh it was about 10 minutes.

He came over and asked me if I was done, and I took my out, and said yes. I was on the verge of saying, "No. I wasted 10 minutes and didn't find anything, so I need to rescue those 10 minutes by searching for another 1/2 hr." I think this is referred to do as "sunk costs" and you can't get that back, although OCD would like me to think it is entirely possible and I am defective in giving up.

Trips to the library work best when I go in ready to flip a coin if I am stuck on a decision, and to randomly pick a few books without knowing for sure that they are "right" and generally taking my chances. OCD takes a lot of energy. I was ready for a nap when I got home, and had some OCD backwash about my imperfections, but I'm on to the idea that I can spin straw into gold by looking at the same books over and over.