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.

Field Guide to OCD: Feeling on Trial

I feel like I'm on trial by OCD. This is one of the clues to recognizing being in the OCD. The OCD thrusts the burden of proof on me. I must prove all things beyond any reasonable doubt, which of course, OCD doesn't ever recognize. When I started Exposure Therapy, my OCD had a lot of power and credibility.

Right now, I am on the computer, after being on Skype. I called at 8:00 am, the time I used to start work when I was employed, and once I got off the phone, I was back in my old work pattern of compulsion, which was to stay on the computer, in a kind of trance, because anything else I might do could be the "wrong" thing, and I would be in for harsh cross-examination from my OCD thinking. I'm doing my mental rituals of checking of what time it is, how many minutes have passed, diverted into the "why am I doing this? What is wrong with me?" line of questioning, followed by, "you can't undo this. you've ruined your day, you can't salvage it. you suck."

This adversarial mode adds more fuel to the OCD fire. And OCD talks a confident way, a dictatorial, demanding way that is intimidating, and uses a kind of brute force, saying the same thing over and over, louder and louder. What if! What if! What if!

A cross-examination complete with, "Just answer the question. Don't explain. Just answer yes or no. Strike everything else from the record." What if I am fucking up my life? What if I am making a horrible mistake? What if I really am bad? What if I don't really deserve any compassion? What if I am wasting my life and this is unforgiveable? What if I am beyond redemption?

Often my own thinking seems pallid and inconsequential, signifiying nothing, powerless. But it's my own thinking that allowed me to get into treatment, and start doing things with my life, and learn to have compassion for myself. This is the act of faith, to trust the quiet still voice, without knowing for sure if it really is my own thinking--the OCD chips away at that too, demanding I know for certain if I'm thinking for myself or if it's OCD.

This is crazymaking stuff. Depending on the context, the my current line of questioning can completely contradict another line of questioning from just a second before. From "Don't trust your thinking" to "What's wrong with you that you don't trust your own thinking?" to "Ok. But are you sure this is your own thinking and not the OCD?"

What is the fruit of your OCD? What kind of fruit does it bear? Does it bring peace or joy or meaning to your life? If I am brave and take a minute to observe, I can see the destruction it wreaks, the poisonous fruit OCD bears, the mess my life became when I was totally in grips of it. OCD certainly promises peace, and promises if I just stay at the computer and answer all the questions, that I will avoid the turmoil of getting up, and facing my day in a backlash of obsessiveness, but I know from experience, if I stay on the computer a few more hours, until my back hurts, and I've thoroughly exhausted myself and my mood has deteriorated, that any peace I get is an illusion.

OCD and Emetophobia: Fear of Throwing Up

Emetophobia is part of my health anxiety history. When I was 11, I got sick to my stomach, and my mother gave me some sort of medicine from a cold spoon, and I promptly threw it up. Maybe I wouldn't have reacted as strongly, if she hadn't given me another spoon of medicine a few minutes later, and of course, back up it came. I vowed from that moment that I would never throw up again. I kept my vow for over 12 years, but this vow came with a cost, as it was intertwined with my OCD. If I felt the slightest twinge of stomach discomfort or nausea, I would keep checking the sensations, trying to figure them out, diagnose them, and this would make my stomach even more tense and uncomfortable. Then I would start drinking water, with the idea that I could dilute the toxins with fluid. I'd be up all night, drinking glasses of water and unable to sleep because of my hypervigilance.

Finally, I ate something that was truly toxic, and my body wanted it out, and I threw up at age 23. It sucked. But once it happened, it was over. The phobia is never "over"--it will expand to fit whatever room there is in your life. I feel sad when I read about people with emetophobia who restrict their lives more and more in order to avoid all possibility of getting sick, or of their kids getting sick. The difficult thing is that most people hate throwing up. It's easy for this phobia to slip under the radar, since it seems logical to avoid getting sick. But a phobia will impinge on valuable things in your life. No trips because you might catch something. No parties. No eating out. No leaving the house.

I could never have predicted what made me sick at age 23. This is the sucky thing about being human. We get sick. The world isn't a clean place. Exposure therapy for emetophobia isn't about making someone sick. This is the first thing people think of when imagining treatment. Exposure therapy is about doing those things you are avoiding because you *might* get sick, and not doing rituals like constant sanitizing and hand washing. If your first thought is, "Well, I'll never get treatment, because if I have to take the chance of throwing up, there is no way I will do that"--I encourage you to think about all you are losing to this fear. If you get sick, you will deal with it then. You are stronger than you think.

OCD Cartoon by John Spottswood Moore

Dr. Michael Jenike on the Yahoo OCD-Support Group mentioned this short animated video about OCD. I resonated with the spreading nature of the character's fears. I don't have contamination OCD, but the process of OCD thoughts multiplying was very familiar.

AIYH Sample from John Spottswood Moore on Vimeo.

My Experience with Exposure Therapy for Health Anxiety, OCD and Perfectionism on Health Place Radio

My radio interview about Exposure Therapy on HealthyPlace Mental Health Radio Show is up, so check it out.

Listen to the HealthyPlace Mental Health Radio Show

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Your one wild and precious life: OCD and Trusting Your Heart

My exposure this week has been to get into my studio first thing in the morning, rather than get on the computer. In the irony that is OCD, I love being in my studio, but the ritual of distracting myself on the internet has worn a groove in my brain, so I put off making art. I've been leaving a voicemail with my therapist once I get myself into the studio. My mornings have been a chant of "eat breakfast, go into studio, call Leonard" with varying amounts of squawking from the OCD, but I've made a lot of art, which is good, because starting next weekend I have 7 craft shows in 7 weekends!

My love of art gives me a lot of strength for fighting the OCD. When I make art, I am in the present moment, and I rely on my intuition, my eye, my hands, my heart. Yes, the OCD intrudes, with delaying my studio time, or getting stuck on what to make next, or not wanting to take a break because I might not get myself back to the studio. But the self I am when creating art, is the self that is whole, and strong, and wiser than my OCD.

It took a long time before I let myself be an artist. When you've had OCD as long as I have, it intertwined with so many aspects of my being, and with my troubled family. I assumed that if I liked doing something, that this was irrelevant. I've met others recovering from OCD with a similar sense, and who also, like me, felt lost when contemplating what they might like to do, rather than what the OCD wants. Combined with my perfectionism and wanting to do things right on the first try, and my fearful thoughts of worthlessness, it was a struggle to experiment and try things out, but I loved art, and this love gave me strength to persist in making it, even though I wasn't certain it was what I "should" be doing.

The OCD chimes in with "Are you sure you love art? Maybe you don't really. Maybe you can figure this out. Start assessing the quality of your passion. What if you really should be doing something else, like when you felt called to be a minister. Maybe God is angry with your decision to be an artist." I did two semesters of seminary in a quest to banish the persistent thought that God wanted me to be a minister, in spite of my lack of any real desire to be one. I feel closest to God when I am creating art. My leap of faith is to trust my experience. This is akin to standing too close to the edge of a steep path up a cliff, and feeling woozy, but this is my one life, and OCD is lying when it promises complete safety.

I'd love to hear your story of what you love. Take your best guess, the smallest inkling if that's all you have. Think of it as an exposure.

Here are some lines from a poem, "The Summer Day," by Mary Oliver, that speak to me, and hopefully to you:

I don't know exactly what a prayer is.
I do know how to pay attention, how to fall down
into the grass, how to kneel down in the grass,
how to be idle and blessed, how to stroll through the fields,
which is what I have been doing all day.
Tell me, what else should I have done?
Doesn't everything die at last, and too soon?
Tell me, what is it you plan to do
with your one wild and precious life?