December 30, 2010

More Exposure Updates

I watched "The Kids are Alright".  Of course I was very anxious at first, but the movie was actually really good.  Hmmmm....I wonder what it means that I liked a movie about lesbians?  ;o)  By the time I finished I barely had any anxiety, and I was handling my intrusive thoughts fairly well. 

I think I am starting to come to terms with the concept that I might "never know".  I hear so many stories about people (male and female) who are with men (or women) for years, they break up and then start dating someone of the same sex.  There just are no guarantees.  This might happen.  I have no way of seeing into the future, or doing anything to prevent it from happening.  No matter how much I analyze their situations, and compare them to mine - in the end there just isn't an answer. 

I will have to go back to reading coming out stories at some point - probably after my therapy session next week.  It's still hard to continually challenge myself and the urge to avoid is still very strong!!!  That being said - I am able to recognize the things I have done and continue to do that I would NEVER have considered facing about six months ago.  Acceptance that this is a chronic disorder and reminding myself that the goal should not to be getting rid of the thoughts or ever figuring out what they mean - is still something I struggle with. 

I am FAR from out of the woods.  But maybe this time next year I will be.  :o) But given the stress I've got on my plate at the moment I think I'm doing OK.  Though - the perfectionist part of me sure likes to spend a lot of time beating myself up!!! 

I hope everyone had a nice holiday, and enjoys their New Year's Eve. 

December 22, 2010

Exposure Hell

I'm going through Exposure Hell at the moment.  I'm doing some really tough exposure, and I'm really struggling with it.  I’ve worked my way through so many things, and now – funnily enough – those things seem pretty much like no big deal (for the most part!).  BUT – the drive to “figure it out” and “find the answer” is still there, which I guess is just an urge to ritualize, which might take some time to go away. 
I think I deserve a momentary pat on the back so I’m going to list the things that I worked my way through on the hierarchy:
1.       Looking at women in the Victoria Secret catalogue and rating them on their attractiveness.
2.       Wearing a t-shirt that says “I might be a lesbian” around my house.
3.       Walking through the “lesbian” area of Vancouver.
4.       Picking up and reading the gay/lesbian newspaper.
5.       Looking at lesbian personal ads - without photos.
6.       Looking at lesbian personal ads – with photos.
7.       Writing exposure scripts about my feared consequences and reading them (still doing this one).
8.       Reading coming out stories about movie stars.
9.       Reading gay male coming out stories.
10.   Posting photos of lesbian couples and words like “lesbian”, “bi-sexual”, “dyke” throughout my house and leaving the gay/lesbian newspaper on my coffee table (still doing this one).
And now I am reading lesbian coming out stories.  Not only the stories about the girls who always knew, but the ones about the women who were married, had kids and suddenly found themselves in love with a woman.  Let-me-tell-you – it is very hard.  The urge to avoid is immense.  The urge to mental check is immense.  The urge to analyze is practically impossible to resist. 
There are two parts about this exposure that make it particularly difficult for me:
1.       The fact that there are parts of these stories that I can relate to.  Some of the stories I read and I just can’t relate.  For example -  I don’t remember being attracted to women from the time I was young.  Of course – when I say that – my OCD mind wants to pipe in “are you sure?  You don’t remember that for sure.”  I guess inadvertently I am finding some “reassurance” in some of these stories – but how do I not?  How do I stop myself from being relieved that I don’t relate to the experience of every lesbian coming out story?  In my mind – if I can relate to these stories it must mean that I’m a lesbian in denial – surely this is the only explanation.  Of course it would only make sense that if I can say “yes” to some of these key factors – it’s pretty much a certainty that I don’t actually have OCD, but I am going through a sexual identity crisis.  So – the fact that I can relate to some of what these women write about becomes inconclusive proof that I am actually going through my own coming out process.    
2.       The fact that these women find THE ANSWER!!!  So many of these stories follow the same pattern:   I never really felt attracted to women, but I always felt more comfortable around women than men (I can relate).  I married a great guy who was kind and generous etc. (I can relate – though we’re not married), but there was something missing (I can relate – is it the problems we’re experiencing or the fact that I’m maybe a lesbian?).  Our sex life wasn’t great (I can relate – is it our problems or me coming out as a lesbian OR my OCD?).  Then one day I met a woman and we fell madly in love.  Our emotional connection is so intense and our sex life is better than it ever was with a man.   I’ve never been happier.  I’ve found the love of my life and we’ll be together forever.  Wow!  Sure seems pretty perfect to me!  Sure seems like “the answer” to me!  And the worst part of it is – I don’t know how to NOT check/compare!  How do I face this?  “Yeah – well – even though all these women confirm that life with a woman is so much better, I am going to continue to stay with a man for now and sacrifice the chance at true happiness.  At least until the day comes that I just can’t take being miserable anymore, and I throw myself into the arms of another woman?” 

When does this horrible urge/need to find the answer end?  And why does it seem like others have found the answer and I can't?  It seems like others are living happily ever after.  Can I say that I feel that way about my relationship at the moment?  Definitely not.  (Spend too much time on that and the ROCD starts up - but that's for another post.)
Yesterday was a particularly difficult day.  Today I woke up and sent an email to my therapist.  As soon as I sent it I wondered if I was looking for reassurance or just some encouragement.   I then went back to the drawing board and did more exposure.  Now that I’ve done that, and written my blog post I know what I need from my therapist – and my virtual blogging friends – support and encouragement.  I know that I am not going to get an absolute, certain answer to these questions.  (I don't quite understand why - it seems like others have it.  But I guess that's just a momentarily feeling and it will come and go.) And I know that I need to continue doing exposure.  I think there is a part of me that every time I send an “emergency” email to my therapist thinks “this is the time she’s going to read what I wrote to her and say – stop all therapy now – I think you’re actually a lesbian in denial so we’re going to change therapy”.   Somewhere inside I'm thinking that if I just give her enough information she'll "diagnose" me.  I guess in some ways it's like returning to your physician for health fears.  The idea that more or new information might provide the proof or "the answer". 
I hope she writes back and says “keep doing the exposure – you’re doing great”.  And maybe a few tips reminding me not to avoid or ritualize.  I need someone to have faith in me right now – especially when I don’t have any faith in myself. 
Tomorrow I’m watching the movie “The Kids are Alright”.  Wish me luck. 

December 11, 2010

OCD & Other Therapies.....

I’m not sure if this is a common symptom of all people who suffer from OCD, or just people who suffer from the Pure O sub-type, but my OCD and anxiety is driven by an urgent need to know, figure it out, or find the answer – now.  I suppose that need is common with everyone who suffers from OCD.  After all – it is an anxiety disorder, and my hunch is that it is the anxiety that is driving the need.   
As I stated in my last post, my OCD has flared up substantially in the last several days.  Which makes me wonder:  “What am I doing wrong?  Why isn’t this going away?”.  One of my big OCD fears is that I am somehow avoiding facing “something” (I’m gay, I’m in the wrong relationship, I’m not living the life I truly want etc.) – or another way of looking at it – that I’m actually avoiding finding the answer.  I cannot deny that one of my main OCD compulsions has been to avoid…..so I guess none of these feared consequences are out of the realm of possibility.    
When I struggle like this I often start to doubt my therapy and the CBT approach.  I have thoughts like: “You’re not getting better – maybe this is the wrong therapy for you.  Maybe you have some real, deep seated issues that need to be resolved in order for your OCD fears to go away.  Maybe CBT helps with OCD, but there are plenty of people out there who claim to have figured out the key to happiness, and life, and anxiety.  Maybe the approach you are taking is wrong, and you’re avoiding trying a different type of therapy because you might find out that deep down inside you’re really a lesbian or you’re really in the wrong relationship and you’ve been lying to yourself all along.”  Psychodynamic therapy is all about “finding the answers” and “getting to the truth”, and for someone with my type of OCD, the option of going to psychodynamic therapy is always lurking in the back of my mind, tempting me during difficult times.  I suppose for me, a psychodynamic therapist is the same as a physician for people with health related OCD;  they go to the doctor to try and find their "answer" when really - no one can tell them with absolute certainty whether their symptons are a sign of cancer or simply an upset tummy.   
Certain people (friends, relatives) really spike me in this area – those who have gone through years of psychodynamic therapy and who claim to have it all “figured out” and who seem to be incredibly happy.  After all – they’ve found the answer – why shouldn’t I?????  My OCD mind goes like this:  “She’s managed to overcome her issues and she’s dealt with it through new age and psychoanalysis methods.  Why do I still have the anxiety defense mechanism that she claims to have let go of?  What’s wrong with me?  What issue in my life am I not letting go of?  Am I still trying to control things too much?  Am I in denial because I’m scared of facing the truth?  Maybe I’m not letting go of my defense mechanism because if I do I’ll realize that I’m a lesbian.  Am I staying “stuck” because I’m not ready to work through some emotional road blocks and face reality? Am I scared of facing difficult feelings?”  And on and on it goes.  Of course – this sets me on an endless quest of mental checking – trying to alleviate some of my anxiety and the horrible questions that spin around in my head. 
To tell myself that I don’t know the answer to these questions just makes me feel horrible.  To hear “it’s not possible to know the answer” doesn’t make me feel any better either.  After all – my friends/family have found the answers haven’t they?  To face the fact that these thoughts might actually be true, that I might never know, and that at the end of the day I really might not find the answer – is hell for me.  Then on top of it all I have to make a choice;  A choice about what path to take – when both of the options seem horrible.  On one hand – I can choose to treat my OCD (if this is in fact OCD) with CBT (the proven technique), and take the risk that I may never figure out the answer or any of my deeply hidden emotional issues (if there are in fact any to begin with), which might completely screw up my life.  Or – I can choose to go to psychodynamic therapy (which is not only known to not help with OCD – it can in fact make it worse) and I could make my OCD worse and go off the deep end and still not find the answer.  Then I think – maybe it comes down to answering the question - What am I treating here?  Am I treating the symptom or the problem?  Ugh!  My mind could go on forever with analysis – just digging myself deeper and deeper into a hole and the depths of hell. 
I’m not sure what my ultimate feared consequence is here – the fear that I’ll live in the dark, unhappy and in denial forever?  Is this just an extension of the same HOCD and ROCD?  And what do I need to do for exposure?  I have been trying really hard not to avoid the people who trigger these spikes, but holy – on top of everything else – this is hard. 
Will a day come that I feel that I too “have it all figured out” and I too learn to “trust the universe”?  That sure seems really hard for me right now. 

December 8, 2010

Finally

As I was compulsively searching the Internet for "answers" to my OCD problems last night, I came across this website.  Wow.  I wanted to share it with everyone because I know that I have struggled with what seems to be relatively little information on Pure O.  The people who started the site also agree, so they took it upon themselves to help increase exposure (excuse the pun!) on the Internet, and hopefully inform and help others who are going through hell.  

The website was started by former patients of Dr. Steven Phillipson's.  For those of you who don't know who Dr. Steven Phillipson is, he is the Clinical Director of the Centre for Cognitive Behavioural Psychotherapy, located in New York.  He is one of the foremost psychologists with knowledge in the area of the Pure O sub-type of OCD, and has written numerous articles on the subject.  My new (3 months old) therapist is from the Centre for Cognitive Behavioural Psychotherapy, and she has trained under Dr. Phillipson. 

Please take a time to check out the website, and inform as many people as possible.

December 7, 2010

One Step Forward, Two Steps Back

This has been a horrible two weeks.  I am hoping my “virtual OCD blogging support group” will be able to give me some positive support.  :o)
Those of you who have read my blog since the beginning, will know that due to a flare up of symptoms, I had been unable to work since June of this year.  I started OCD treatment in August, and was making good progress - I thought.  I mean, I had never exposed myself to my feared consequences as much in my ENTIRE LIFE. 
However, there were other factors that contributed to my “breakdown”: I was working at an incredibly stressful job, my boyfriend and I were experiencing relationship issues (more on this later), within three months, three very close friends died, and to top it all off, my family found out that my mother’s cancer had returned.  It was too much for me to handle. 
In November, faced with the reality that my short-term disability was running out, I had a choice – I could either apply for long-term disability, I could go back to my incredibly-stressful-job, or I could quit my incredibly-stressful-job and look for a part-time job.  I chose the latter option - mostly because I was actually feeling pretty good and coping well.  I actually felt like I wanted to go back to work part-time.  Which leads to where I am today. 
In the last couple of weeks, I started my new part-time job.  I actually quite enjoy the job (I’m working at a bank), however, I am not used to having to balance my time, and there is some pressure with learning something completely different.  This stress was hard enough, but then last week I found out that my mother’s cancer has progressed.  The cancer is in-operable, and it is in the lymph nodes close to her liver.  The tumour has now grown to the point that it is impeding the function of her liver.  If some sort of intervention were not to take place, she would lose the functioning of her liver, and die.  The only option my mom had was to do chemo and hope that the chemo shrinks her tumour enough to allow her liver to return to normal function.  She started her chemo last week. 
To add to it all – things with my boyfriend have been difficult.  And the worst part of it is – I never really know whether the problems are relationship OCD oriented, a little bit of “real” problems mixed in with ROCD, or “real” problems only.  (After all - just because I'm obsessing about it doesn't mean that it isn't a real problem or the feared consequence isn't coming true!) But my OCD has come back with a vengeance, and at the moment I feel so completely overwhelmed I don’t know how to cope. 
Since I started my OCD treatment most of my exposure therapy has been focused on my HOCD and as I said before, I felt that I was making very good progress.  However, for me, my relationship OCD is so tied into my HOCD that I don’t know that it is possible to treat one without treating the other.  I have spent so much time in my head lately with thoughts like:  “Look at all the ways that you and your boyfriend have problems.  He doesn’t meet your needs in this way, this way, this way etc etc.  You could probably find someone better and be happy.  In fact – women don’t have a problem at all with these things – if you were with a woman you might have all your needs met.”  I feel tortured.  And then – in my mind – I list off the ways that my boyfriend is so wonderful – all the time feeling horribly guilty and wondering: WHY CAN’T I JUST BE HAPPY?????  The fact that I can’t be happy surely must be an indication that I’m in the wrong relationship AND even evidence that I am a lesbian.  Right now most of my obsessions are around emotional intimacy.  For my HOCD exposure, I have been reading lesbian coming out stories and many of the women say that they are so much happier being with a woman because the emotional intimacy is better.  Since this type of closeness is something that is very important to me in a relationship, and something that I didn’t have in my family, my OCD mind clings to this with a vengeance.  I immediately start going through my check list comparing boyfriend vs. emotional intimacy.  The problem comes in with the fact that my boyfriend – though a very kind, generous person – isn’t the best at expressing himself.  For example – in the last two and a half years that we have been together – we have said the “I love you” words about four times.  I’m sure you can imagine where this is going – can’t you?  How do I deal with this as someone with OCD?  Well – one of two things happen:
1.       I can’t deny that my boyfriends lack of emotional expression doesn’t really support my need for emotional intimacy.  So – if I agree with the fact that we don’t have emotional intimacy – then WHAM – my OCD mind starts up:  “see – you probably would be happier with a woman!  You better talk to your boyfriend about this.  You better work on this.  If you don’t deal with this problem you might end up unhappy forever.  You might become bitter and eventually after years of denying yourself your needs you might just become a lesbian. Are you even really happy right now?  Do you even feel close to him?”  Of course what comes next is massive anxiety, followed by the intense need to speak with my boyfriend RIGHT NOW about our problems and come up with a plan RIGHT NOW to fix them. 
2.       If on the other hand I find a way to disagree with the fact that we don’t have emotional intimacy then my OCD mind always finds a way of disputing me “Come on!  Look around!  Women are so much better at showing their feelings – you know that!  And you feel safer with that kind of intimacy.  Shouldn’t you have your needs met?  You’re in denial!  How can you know that he has only said that he loves you four times in 2 ½ years and think that’s OK?  You’re just justifying it because you’re scared of being alone (or you’re scared that you’re going to become a lesbian, or…..)” 
Can you see what this does to me?  Can you see how I can’t win?  And – neither can my boyfriend.  It seems that we’re doomed as a couple – no matter what we do.  Needless to say – this makes our relationship very difficult.  My anxiety causes me to become incredibly demanding and critical.  It makes him become very defensive and feel like he can’t do anything right.  And we fight.  (Which is a REAL problem.) And I feel guilty.  And my OCD gets worse (“see how much you’re fighting?  How can you honestly justify staying in this relationship? Look at all the ways that he's like your dad/mom.  And you know that they were emotionally unhealthy people and had an unhappy marriage!") But -  are the problems that lead to the fight real or OCD?  I can’t give you an answer, and it seems – neither can my therapist.  When I told her about the fact that my boyfriend hasn’t said that he loves me many times she responded with something like “Maybe you’re someone who needs that kind of verbal expression.”  I am so completely confused and frustrated I don’t even know what to do anymore.  I don’t have any insight at all into this problem, and I feel so hopeless about the entire situation.  I can't tell you how badly I just want to be happy.  How badly I just want to feel happy about my life, feel lucky to have my boyfriend and one day - look at him and have warm feelings - not horrible, yucky doubt. 

November 28, 2010

Obsessive Compulsive Personality Disorder (OCPD)

I’ve often wondered if I have OCPD.  I still don’t know.  None of my therapists have actually said that I have OCPD, but I know that I have perfectionistic compulsions….mostly as they relate to my OCD themes (gay OCD and relationship OCD), but since my OCD themes are so tied into life and relationships, I think it can be hard to distinguish. 
OCPD is a condition where the person is preoccupied with rules, orderliness and control.  Hmmmm….sounds like a lot of us with OCD hey?  I struggle with this definition, and yes – I can become obsessive about trying to “figure out” whether I have OCPD.  I don’t know why it matters so much.  I think because if I do have OCPD, there is less hope for recovery.  (Feared Outcome here – that I’ll suffer from this hell forever, and will destroy more relationships.  That I’ll never find “peace”.)
So – in my compulsive way, I’ve been doing some research on the internet about how to know if one has OCPD.  I’ve also asked my therapist.  She didn’t give me an answer. 
Here are some examples of the common signs of OCPD:
-          Excessive devotion to work.  Not me.  Well……I shouldn’t say that.  I definitely am not a workaholic.  I don’t really garner a lot of enjoyment from my job.  But in my last position, I was so anxious about perhaps being fired, or not succeeding, that I spent a lot of time working.  And when I wasn’t at work, I was thinking about it A LOT. 
-          Inflexibility. Not me.  I don’t think.  But I am (or can be) stubborn.  Do those mean the same things?
-          Inability to throw things away (even when the object is of no value).  Definitely NOT me. 
-          Lack of generosity.  Not me.  I consider myself to be generous.  But the OCD/Doubting side of me says “are you sure?  Do you have any examples of that?  Maybe you should check in your past for examples.”
-          Limited expression of affection.  I wasn’t raised in an overly affectionate family.  But I definitely like affection, and I like to give affection. 
-          Perfectionism.  Yup.  I’m definitely a perfectionist.  In a lot of ways.  People would look in my car and say “no way – you’re not a perfectionist.”  This summer, my niece stayed with me for six weeks and when I mentioned that I’m a perfectionist she said “YOU?!”  But I’m definitely a perfectionist about many things. 
-          Preoccupation with details, rules and lists.  This one is an odd one for me.  I work in marketing, and an attention to detail is important – especially when proofreading an ad prior it goes to print.  However, I suck at this.  My attention to detail is horrible.  But I can walk into someone’s house and immediately pick out if there is a photo hung crooked on the wall.  The preoccupation with rules is tough too.  I’m the first person to break a rule if I think it’s stupid (self-righteousness isn’t listed as a sign of OCPD!), but when provided with the rules for a scenario, I am pretty concerned with sticking to them for FEAR of being reprimanded. 
-          Reluctance to allow others to do things. Another hard one to answer.  I’d love it if everyone else did the things, but really do like it when they do it my way.  :o)

When all is said and done, there is no clear cut “answer”.  How many people - OCD or not - can't look at that list and identify on some level with some of it?  Of course, my OCD wants me to have an answer - to know for sure.  As I write this, I can feel the anxiety building slightly, and a little voice inside my head saying “you might have OCPD.  This would be horrible!  Maybe this would mean that you are receiving the wrong treatment, and you will continue to struggle forever, and continue having difficulty with relationships etc etc!  You better figure this out.”  I’m not going to listen to this voice though.  In the end it doesn’t matter.  I’m doing the best that I can, and having a diagnosis, or another label isn’t going to suddenly cause all of my struggles and issues to go away.  I will continue to plug along with my treatment, regardless of what that annoying little OCD voice says. 

November 18, 2010

Are you "out of the OCD closet"?

I’m not.  Well – that’s not true.  My parents and my boyfriend know the details.  A few of my friends know the “basics”.  But, for the most part, very few people know that I have OCD.  There are several reasons:
1.       First of all – there’s the mental health stigma in general.  So many people are “scared” of anything surrounding the topic of mental health.  I don’t know if this is because they have been there once or twice before themselves, and it was so painful that they are afraid that talking about it might “bring it back”, or if people are still fairly non-compassionate about depression and anxiety, and still think that those of us who suffer from mental health issues should just “snap out of it”.  The few people who know the “basics” know that I have depression and anxiety.  That’s it. 
2.       Then there’s the relatively wide-spread misunderstanding of OCD and what it is about.  For the majority of people, when OCD is brought up, they think either “hand washer” or “perfectly clean house”.  Believe me – I am neither of those - and those who know me can see that very clearly.  Don’t get me wrong.  OCD peaks its ugly head up every now and then in those areas too.  I like to “feel clean”, and I like my house to be clean in a certain way - my specific way - but to look from the outside into my life, one would never think “she has OCD”.  Leading me to the primary reason that I don’t tell people that I have OCD. 
3.       Most people know so little about OCD that they have never heard of Pure O OCD – those of us who’s obsessions and rituals are mostly in our heads.  They have never heard of someone who worries that he/she might be gay, or who worries that he/she might act on a violent thought.  Most people with very little knowledge and understanding of OCD probably wouldn’t understand.  They would probably think that those of us who doubt these things are in denial, or are potentially dangerous.  But then again, maybe I’m not giving people enough credit. 
The other day something very distressing happened.  As part of my therapy, I have been trying to immerse myself in my fear as much as possible.  I have put pictures of lesbian couples up on my bathroom mirrors.  I have the gay newspaper laying out on my coffee table.  I have post-it notes spread throughout my house reminding me about ritualizing, and how certainty is an illusion, etc.  On that particular day, I also happened to have Dr. Grayson's book out on my living room coffee table.  Obviously due to being “in the closet” with my OCD (I love that pun given my current OCD fears!), whenever I have friends coming over, I take down all the photos and put away all of the “evidence”.  I knew my boyfriend was coming over that morning, but he is used to all of this.  As I said – he is fully aware that I have OCD and how it is currently manifesting.  He is also usually very thoughtful about warning me if he is coming over with someone else.  But…….the other day he forgot. 
I was in the kitchen and he arrived with his friend Mark.  Panic suddenly hit me.  All I could think of was the newspaper sitting on the coffee table, and that Mark would surely see it.  I desperately tried to signal to my boyfriend my terror and concern, but he did not catch on.  Knowing that strategy wasn’t working, I came up with another one.  Any fly on the wall would have found this scenario laughable.  It was like watching an old “Three’s Company” episode.  I asked Mark if he had tried any of the preserves that I had recently made.  “Have you tried my pepper jelly?  What about my peach jam?”  Mark, confused, said that he hadn’t.  (I’m sure he wondered why I was asking this random question!) So I sent them out to the garage to get some.  “Go on.  Take Mark out to the garage to let him pick out all the preserves that he could want!” And on and on it went.  But not before I saw Mark wander over to my coffee table and take a look at what I had sitting smack dab in the centre – my gay newspaper, and my OCD book. 
Mark ended up leaving very quickly.  It was obvious something odd was going on.  As soon as he left, I let into my boyfriend with intense anger.  I was very anxious.  Mark saw the newspaper and he was going to think that I was in the process of coming out of the closet.  Why else would I have a gay magazine on my coffee table?  He was going to spread the word to all of his friends, and all of our acquaintances in the small community in which we live.  I absolutely freaked.  How could my boyfriend be so careless? 
Of course my boyfriend felt horrible, and apologized profusely.  Somewhere, deep down inside, I knew that I was over-reacting.  I knew that the most therapeutic response would be to take the risk that Mark did in fact see the newspaper, and that he might in fact think that I am coming out of the closet as a lesbian.  After all – as my boyfriend said – there are lots of reasons why you could have a gay magazine on your coffee table.  Perhaps I picked it up because I saw an interesting article on the cover.  Or, even more likely – perhaps a gay friend of mine brought it over.  Can you see how someone without OCD was able to think objectively?  My boyfriend even said that he doubted that his friend Mark even noticed.  There was no way that I was taking that chance. 
In the end I decided that the best thing to do would be to let Mark know that I have OCD, and not mention the gay newspaper.  So, my boyfriend went to see Mark and let him know that the reason things were awkward and weird is because I have OCD, and I had left an OCD book on my coffee table, and felt weird about it.  Mark’s response?  “Yeah – don’t we all have OCD?”  (Which is interesting in and of itself!  On one hand, his response showed acceptance towards me.  On the other hand, it also proves my points above – the lack of knowledge that people really have about the disorder.)
It’s all over now, and later in the day I was able to joke about it with my boyfriend.  I apologized for freaking out, and he apologized for being careless.  This is a perfect example of how people close to people with OCD have to follow along with rituals.  And when they don’t – LOOK OUT.  When I mentioned this situation to my therapist, we laughed.  She said a situation like that is inevitable, and gave me some other examples of similar situations that her clients have had.  I know now that next time I will have to face the anxiety and the feared consequences.  Let's hope it doesn't happen again. 

November 13, 2010

Feared Outcomes - An important step to consider.

I have been doing ERP now for about four months.  I have read many OCD books, and all of them discuss the importance of doing Exposure & Response Prevention in order to recover from OCD.  However, Dr Jonathan Grayson takes it one step further in his book “Freedom from Obsessive Compulsive Disorder”.  He emphasizes the necessity of getting in touch with your feared outcome (s) related to your specific OCD fears.  This is particularly important, because one can have several different feared outcomes related to one specific OCD fear, and if they are not addressed, recovery may not be possible, or may take longer. 
Discussing my feared outcome (s) is not something my OCD therapist has initiated, and my OCD therapist is from one of the larger OCD treatment facilities in the United States (we Skype on a weekly basis).  Why hasn’t she delved further into my OCD fears to help me to understand what my feared outcomes are?  I have no idea.  But it certainly does remind me that it takes years of experience in treating this emotional disorder to become thoroughly familiar with the way the disorder manifests, and skilled enough to treat it effectively.  (My therapist is relatively "young" in the field.)  That being said, my therapist is much better than the one I had until three months ago (he was giving me reassurance that my fears wouldn’t happen!), and I am making progress.  So – I have decided to use Dr. Grayson’s book as a “supplemental therapist”, and I have done the “Feared Outcomes Exercise’ myself. 
I have found that knowing and addressing my specific feared outcomes has helped me a lot, perhaps because most of my rituals are mental in nature.  Every time I exaggerate my fear in my head, I exaggerate it to the point of my feared outcome coming true.  I then remind myself that although my feared outcome coming true would not be an ideal situation, that I would have to learn how to cope. 
Two of my feared outcomes related to HOCD are:
1.       That I am in denial about being gay and that someday I will suddenly realize that I am a lesbian and will have to break up with my boyfriend and leave the life we have built etc etc.
2.       That I am missing out on the chance of true (perfect) happiness by not becoming gay (ie: there is someone "better" out there for me and it may be a female)
Two of my feared outcomes related to ROCD are:
1.       That I am missing out on the chance of true (perfect) happiness by not breaking up with my boyfriend. (ie: that there is someone “better’ out there for me)
2.       That I am in denial about loving him, and someday I will realize that and either have to leave him or have to live with him forever, unhappy and unsatisfied. 
I also have the fear that I don’t really have OCD, and that I might be better off in Psychodynamic Therapy.  And the list goes on………
Notice the irony here?  On one hand I’m scared I’ll have to leave my boyfriend because I love him, but on the other hand I am scared that I’m in denial and that I’m missing out on true happiness.  OCD just doesn’t make sense, which is why logic doesn’t work when battling this disorder! 
My next step is to do some script writing.  I plan to do some imaginal exposure, write out some scenarios where my feared consequences come true, and tape them.  I will then listen to the scripts several times per day.  I have been avoiding this task, because I know imagining my feared outcomes so vividly will give me a lot of anxiety.  I have been avoiding my thoughts for so long now that I don’t even know if I will be able to do it.  It’s my goal for this week. 
Have any of you gone through the process of considering your feared outcomes? 

November 8, 2010

Around & around we go - moving up the hierarchy

Well.  Today is one of those days where I can honestly see my progress.  I can logically list all of the things that I’ve done on my hierarchy that I would never have faced a year ago.  But I can’t feel it.  I feel incredibly anxious.  More anxious than ever, in some ways.  How is that progress???  So ironic, that a few days ago I felt like I had “the world by the tail”, and today I feel like I’m right back there again.  I’m trying not to spend too much time trying to figure out why I’m back there.  I’m pretty sure it’s because I’m getting to the top of my hierarchy, and some of my exposures are getting really hard.  When I wrote my last post, I had almost habituated to the item on my hierarchy that I was working on, and I was feeling so confident.  It was time to move on to the next item on my hierarchy.  So I did.  And WHAM!  The obsessing and ritualizing started all over again.  It seems like this is a pattern for me.  As soon as I expose myself to something harder on my hierarchy, my anxiety goes sky-high and therefore it’s harder to not ritualize, and it’s pretty much impossible to exaggerate my thoughts (see previous post). 
Has anyone else had this experience? 
It is so very frustrating and demoralizing.  All the old thoughts come rushing back.  And now there’s even more thoughts to go with the old thoughts.  My mind sure can come up with new ways of presenting the same old doubt.....and that definitely gets my attention! That “elusive uncertainty” that I referred to in my two previous posts seems that much harder to grasp and accept.  I feel like I’m back at “NO WAY – there’s no way I can accept the possibility that these things might happen”.  The “thought stopping”, “analyzing” and “avoiding” starts again.   And I can’t imagine doing any of the things that are further up on my hierarchy.  It just seems far too overwhelming for me.  It’s during times like these that I can really relate to Fellow OCD Sufferer's comments about needing that therapeutic support as she is facing her fears.  The last two days have been very difficult for me, and I still have another day and a half until my next therapy appointment.  Thank God for therapists who know what they are doing.
On the positive side, I am bound and determined to continue doing my exposure – no matter how hard it gets.  No matter how many disturbing, exaggerated, out-of-left-field thoughts come to my mind.  But it sure is hard to not try and find the answer.  And I definitely am taking it one day at a time.  I can’t wait until my session with my therapist on Wednesday.  Wish me luck. 

November 4, 2010

That UNCERTAINTY thing.....

I’ve been doing a lot better these last few days.  I had a session with my psychologist on Tuesday morning.  We talked a lot about the elusive idea of “accepting uncertainty”.  We also talked about what to do about mental ritualizing. 
I have always been stuck on the ritualizing portion of my OCD.  During times of intense struggle, when I’ve gone waaaaay down the “rabbit hole”, I’ve often thought that this horrible disorder would be so much easier to tackle if my rituals were behavioural in nature.  No offense to my fellow OCD sufferers who have behavioural rituals – this disease is horrible in its own right.  These thoughts come during periods of self-pity when I wish everything in my life were easier.  That being said, several experts in the OCD field have commented that the Pure Obsessional sub-type of OCD can be more difficult to treat, due to the fact that our rituals don’t tend to be behavioural in nature.  Of course, this “black or white” rule is not necessarily accurate either.  I actually think that most people with OCD have some behavioural rituals, and some mental rituals as well.  Anyway – I digress….back to my original thoughts. 
Since most of my rituals are mental compulsions, I have struggled with not only recognizing them and catching my thoughts, I have also struggled with the fact that I can’t do "typical" response prevention.  I can’t stop thinking.  With OCD treatment, we are counseled that we cannot stop our thoughts.  Just as we cannot stop our obsessional thoughts, we cannot stop any thought.  Dr. Jonathan Grayson emphasizes this idea in his book “Freedom from Obsessive Compulsive Disorder”.  So what do I do?  I have been doing exposure for several weeks now, some weeks with greater success than others.  The weeks that I have less success, I know that I am doing a lot more “figuring out”, mental checking and mental reassuring.  However, it sometimes takes me several days to recognize this, and I think this is one of my greatest hurdles that I will need to overcome in order to fully recover.  I brought this concern up with my psychologist on Tuesday and she said that awareness (ie: mindfulness) is essential.   She suggested that whenever I notice an obsessive thought, to agree with it.  She said that not only should I agree with the obsessive fear, that I should EXAGGERATE the fear; take it to the next level.  We practiced a few times during my session.  Wow – did that do the trick!  She could visually see the discomfort I was feeling.  So, rather than arguing with my thought, trying to diminish the importance, or telling myself that this thought will never happen, I am actually purposely making it worse.  I’ve practiced this “skill” for the last few days and it has made such a difference.  It has also helped me to “thicken my skin” with regards to living with uncertainty. 
I am almost finished Dr. Grayson’s book, and I will definitely be reading it again.  There are so many little snippets of information and motivation contained in that book.  In my last post, I wrote about my concern that I may not overcome my OCD because I didn’t feel ready to accept the uncertainty related to my OCD fears.  Dr. Grayson actually includes a great exposure script that addresses this concern exactly.  (Go figure!  I’m not the only person with OCD who struggles with this! Sarcasm.) I read it, and will read it as many times as I have to, especially when I feel myself struggling with this notion again.  I have also been challenging myself a lot more in the living with uncertainty area.  For example, yesterday after I took my dog out to the bathroom, picked up her poop, and dropped it in the garbage can I thought “There could be some germs on my hands now.  I could get worms or something.”  I thought of the OCD sufferers who have contamination issues that would never take the chance that there were germs on their hands.  Or worse yet – worms.  Those sufferers would immediately go into the house and wash their hands, most likely several times over.  I didn’t do that.  I noticed the parallel between my OCD theme and my inability to function with any sort of uncertainty, and compared it to this situation.  I then went inside, went to the fridge and pulled out something to eat. 
I really can’t be sure of anything in life – no one can.  There are some things that I feel sure of, but that doesn’t necessarily mean anything.  I have been reminding myself of this, and though my OCD mind still chirps in and wants to argue with me, it is a fact.  And I can’t argue with that. 
I think I’ve had a few steps forward.  I’ve got a long way to go.  But at least I’m moving in the right direction. 

November 1, 2010

Living with Uncertainty - the goal of recovery

I’ve learned so much about OCD and recovery since my latest "OCD breakdown".  Dr. Jonathan Grayson’s book “Freedom from Obsessive Compulsive Disorder” was very helpful for a few reasons:
1.       Dr. Grayson addresses my sub-set of OCD.  Very few books about OCD actually dedicate much time discussing Pure Obsessional OCD, let alone Gay OCD. 
2.       He addresses the need to be able to learn to live with uncertainty in order to fully recover from this horrible disorder.  I agree completely!  When I initially read Dr. Grayson’s book, I don’t think I fully grasped exactly what he was talking about.  “You mean I have to learn to be OK with the idea that someday I might realize I’m in denial and actually a lesbian?  I have to be OK with the idea that not “trying to figure this out” might cause me a lifetime of unhappiness?  I have to learn to be OK with the fact that someday, I might decide that I’m gay, that might mean breaking up with my boyfriend and not only hurting him immensely, but ending all of my hopes and dreams?”
Learning to accept uncertainty with regards to whatever theme one’s OCD takes seems like a crazy notion.  But I totally get it.  On some days I feel like with this goal I am resigning myself to a life of despair.  LOGICALLY I completely understand what Dr. Grayson is saying.  It makes complete sense to me. After all, he is correct – there is as much, or greater chance that I’ll get hit by a car when driving my car to the grocery store, but I don’t stop driving, do I? 
Dr. Grayson also discusses getting clear about what your feared consequences are and facing those “head on”.  This is something else that I have never done, and when I try to think about it now – whoa!  It’s tough.  This aspect will definitely need to be integrated into my treatment. 
Last night was a rough night for me.  I did some exposure yesterday and immediately started with the mental checking - trying to remember things about my past to decide whether or not I have ever felt any sort of attraction for a woman.  In the middle of the night I woke out of a dead sleep and started ritualizing again.  And I HAD TO FIGURE IT OUT RIGHT THEN.  If I didn’t, wasn’t I being neglectful to myself and my boyfriend?  If there is ANY POSSIBILITY that I might be in denial about my sexuality, shouldn’t I be trying to figure it out RIGHT NOW so as not to hurt anyone?  As you can see, I am still struggling with living with uncertainty about whether or not I am, or will become a lesbian. 
I hate having these thoughts.  But I’ve also realized that because my rituals are mostly mental in nature, I can quickly fall into the “mental checking” and “figuring out” rabbit holes without even realizing it.  And before you know it my anxiety is sky rocketing, and I am not sure why.  Then, I want the thoughts gone even more. 
Ultimately I have to accept that someday I might realize I am gay.  This is a goal I am working towards, but I can honestly say I am not OK with right now.  Wow – that’s a huge risk to take.  Does this mean I’m not ready for treatment? Does this mean that every exposure I do is for naught?  (You don’t have to answer those questions – they have become obsessions too.) 
I certainly hope not. 

October 29, 2010

OCD on Vacation

I just got back from a holiday in Hawaii, Kauai to be exact.  I went with my boyfriend, another couple, and their daughter.  I’ve never been there before, and it was absolutely heavenly.  Our weather was (mostly) great – warm and sunny.  The beaches were unbelievable, and the people and small towns throughout the Island were quaint and down-to-earth. 
I was very anxious before leaving on vacation.  I never know if my OCD will ramp up or not.  I’ve had several vacations where I was so anxious from OCD that I thought I would have to go home.  This was before I had any sort of treatment for this horrible disorder and my “goal” was to not have any obsessive thoughts anymore.    
This time, as you know – I’m in treatment and doing ERP.  I had a session with my therapist before I left and she reminded me that it was important for me to be doing exposure all the time – even while on vacation in heaven (AKA Hawaii).  I found this challenging for three reasons:
1.       I still like to “get away” from my OCD, and if I notice that the thoughts are gone, I’m happy, and don’t want to do anything to bring them back.  Plus, I was on vacation and really was thankful for the break from all sorts of reality.
2.       We were with friends who don’t know a lot about my OCD and it was awkward to find an appropriate time to leave the group for an hour.
3.       We were so busy!
I am sure that I am going to pay for this little break.  It’s not that I didn’t do any exposure.  I definitely worked on allowing the thoughts to be there, and when I was inadvertently exposed to some triggers, I think I handled it really well.  But – I only did true, purposeful exposure once.  I actually find exposure hard.  Not for the obvious reasons, that it creates a high amount of anxiety.  But also because I find it really hard to purposely bring these thoughts to my mind.  I’m sure that has something to do with the fact that one of my rituals is to “thought stop”.  I definitely tried to so small exposures, and bring some thoughts on while I was sitting on the beach amongst my friends, but it definitely didn’t do the trick for me.  I really have to separate myself from distractions for at least an hour and focus heavily on bringing about my horrible thoughts. 
Another thing I realized though, is the fact that I was thankful for some respite from my horrible OCD thoughts.  This probably isn’t great from a "therapeutic progress" perspective.  From what I understand, the goal of therapy is to not care about the thoughts that pass through my head.  To have, essentially done enough exposure, and purposely brought the thoughts on myself, that the thoughts no longer give me any distress, and I don’t feel the need to do any rituals.  Clearly, I’m not there yet, which is discouraging, given how much I feel I have exposed myself to. 
Today I read Jonathan Grayson’s latest blog  - “Obsessing about Obsessing”.  Some things I read in his post really hit home for me, mostly the wishing ritual.  I think this ritual applies to me and was playing out while I was on vacation.  I still wish that someday these thoughts will go away completely and I will no longer have to deal with this horrible disorder.  Clearly, I am still working on accepting the reality of having OCD.....through good times AND bad. 

October 16, 2010

The Blessing & Curse of the Internet

If you’ve read my first post, you know that I have gay OCD (HOCD) and relationship OCD (ROCD).  Both are primarily mental in nature – both mental obsessions and compulsions (though I do have some visible compulsions).  For the most part, it really is “all in my head”.  I believe this is why it took so long for me to “discover” that I have OCD.  I use the word “discover” because although it was a psychologist who suggested that I might have OCD, any of the books that I read on the topic, covered only the traditional types of rituals such as washing, checking, ordering etc.  It took a lot more extensive research (mostly on the Internet), for me to confirm that her hunch was correct.   
I only saw that psychologist once.  That was the first time that I had ever been to a psychologist, and I didn’t know that there are differences between the types of therapies that they practice.  At that point (over 15 years ago), I was filled with anxiety, guilt and shame.  I didn’t want to talk to anyone about what was going on in my head.  There was no way that I was going to risk having some psychologist tell me that she thought I might be a lesbian, and perhaps I should consider coming out of the closet.  This would be going against all of who I believed I was.  I just knew it had to be something else. 
I am thankful for that psychologist, though, because she knew enough about OCD to know that there was such thing as obsessing about one’s sexual orientation.  Her comment sent me on a quest to learn more about OCD, and especially HOCD.  (Not initially of course.  Initially I thought that just having the knowledge of "what was wrong with me" would be enough for me to get better.)
From where did I gain most of my information?  From books, and the Internet, of course.    
I would be willing to bet that most of us who have OCD have used the Internet at one time or another as a vehicle for checking for evidence to support or disclaim our fears.  I have to be very careful about this.  Though the Internet has provided me with a wealth of information and ammunition about OCD, and how to fight it, the world-wide-web also very generously supplies many coming out stories and “how to know if your relationship is the right one for you” articles that I can easily become swept up in.  Though it is helpful to stay on top of new information about OCD, it is not helpful to constantly be searching for “the answer".  Until recently, (having gained a better understanding of how OCD works), I would spend hours searching for information to help me figure out if I had to leave my boyfriend and declare myself to be gay. 
The flip side of this though, is that if it wasn’t for the Internet, I wouldn’t have gained the knowledge that I have about this debilitating disorder.  I wouldn’t have learned that there is such thing as relationship OCD (discovered only one year ago).  I wouldn’t be receiving treatment from a therapist who has direct experience treating my type of OCD.  And I wouldn’t have found my own little support group of OCD bloggers who have given me an even better understanding of what goes on in the OCD mind.    
Now that I know that “figuring out” is a ritual, it requires a great amount of mindfulness and self-awareness to stop myself.  Some days are better than others, but I know that it sure feels good when I have some success. 
Some websites that I have found helpful: