February 23, 2011

OCD Odds & Ends

Today I have a few things that I want to comment on.  Just little "tid bits" of things that I want to share.  
FEELING BETTER – Sincere thanks and smiles to all of my blogging friends who can relate to the long road that accompanies recovering from OCD, and who reached out to give me support in response to my last blog post.  You all have great wisdom to impart and I really do appreciate everything that you write!  Not to mention – the “virtual cheerleading” – Keep going!!  Keep going!  Is so important too. 
Since writing that post, I am feeling better.  I received some very insightful comments from my therapist (I also sent him an email when I was in the height of my panic).  His word reminded me that I DO need to be patient.  And yes – in some ways – I am starting anew with a different therapist, but hopefully (and time will only tell) – this experience will turn out to be the one that helps me make marked improvement.  That being said – we have only had two sessions.  And perhaps it is appropriate for us to start at the beginning – even if I’ve been at the beginning several times before.  Where else would we start?  He has already identified so many more errors in my thinking patterns than any other therapist in the past has – so that’s a good step! 

EXPOSURES – I’ve been thinking a lot lately about the purpose of exposure therapy for OCD.  I’ve also been thinking so much about the fact that OCD is chronic and never really goes away completely.  One of the pieces that I think I’m finally beginning to understand is that planned exposure therapy is really just practice.  The idea of it is to help one start to “exercise the muscle” of both not avoiding, and getting used to the scary thoughts being in our head without doing anything about it.  In other words – as I continue on in life – there will be lots of opportunities for exposure – and just because I’m practicing ERP “in vivo” (or in a planned situation) – in order for me to continue to manage my OCD I will have to take those “spontaneous” opportunities on as well.  This is a tough one for me to swallow.  Mostly because I seem to have MANY opportunities in a SINGLE DAY to practice spontaneous exposure.  Sometimes – it just seems like too much.....so overwhelming.  How does one expose oneself “perfectly” to everything?  I’m scared that if I don’t do that then my OCD will gain a foothold.  Expwoman made an interesting comment to me that illustrates my point.  She said: “Never take lightly how much of an exposure it is to just exist in the world when you have OCD.”  She is so right. 

THE LOVE OF MY LIFE – I wanted to share with you something personal that I am incredibly grateful for.  I have written lately about my dysfunctional family, my relationship breakdown, and my loneliness.  I do, however have something very special in my life, and that is my dog.  I have always lived with dogs, and it was my father who instilled in me the amazing value they have as pets and companions.  There was a time period when I was younger, and single, and living in an apartment, that I wasn’t in the right “position” to have a dog.  A couple of years ago, after purchasing my own condo – I decided that I was tired of waiting for the “right time”.  So I got Zoe.  She is a Goldendoodle.  She is now four years old, but acts like a puppy still.  She has personality plus, and absolutely LOVES ME like no other.  She is my loyal companion and comes with me almost everywhere I go.  (She sometimes has to spend some time in the car – but she’s OK with that.)  She sleeps on the bed.  Believe it or not – she actually smiles.  On rough days – when the OCD bully has attacked me as soon as I’ve woken up – Zoe is the one who motivates me to keep going.  EVERY SINGLE MORNING since she was a puppy – she has waited for me to open my eyes up, and say “Good Morning” to her.  She then moves up to the top of the bed, lays down and spoons with me while I give her a belly rub.  She really is my best friend. 

February 21, 2011

Patience?

I’m feeling so frustrated and lost.  I’ve been trying hard lately to find motivation and hope.  Honestly though – I’m really struggling. 
Looking back on it – I officially had my “OCD breakdown” in June of 2010.  Prior to that I had been seeing a CBT therapist for almost two years; just after starting a new job, and starting to date my (ex) boyfriend, I had recognized that my OCD was flaring up.  So - I did the right thing and located a CBT therapist to try to prevent OCD from doing too much damage in my life (Nice.  Two years later I had to go on disability due to stress, and my boyfriend and I are no longer together.).  I worked with that therapist for TWO WHOLE YEARS – with no improvement.  Why?  I can tell myself that it was because we didn’t do ERP.  I can tell myself that he was relatively inexperienced in treating OCD.  But maybe it wasn't that at all.      
Last June, after my "breakdown", and after taking it upon myself to educate myself about appropriate treatment for this nasty disorder, I decided on my own to start doing ERP.  At the same time, I changed therapists – hoping for someone who had a better understanding of HOCD and ROCD.  I have done A LOT of work on my exposure hierarchy.  I know that I’ve outlined on previous posts all of the things I have done for exposure.     
BUT I STILL FEEL LIKE CRAP.  PROGRESS AND SUCCESS SEEMS TO STILL ELUDE ME.  WHY?  WHAT PIECE AM I MISSING?     
So what is it?  Is there something wrong with me?  Is my OCD so severe that there is no hope?  Is it the “lack of insight” that I seem to sometimes have regarding my OCD and therefore my need to compulse?  Is it because I have Purely Obsessional OCD?  Is this what I can expect for the rest of my life?  I really hope not. 
Perhaps I have to be a little more patient. 
But – that’s hard too.  It seems like every self-help OCD book I read portrays positive success stories of people with OCD that got better within 5-10 months!  What have I been doing wrong? 
To be honest – I feel like I have just started from the beginning for the THIRD TIME in the last year.  I just started with my new therapist, and we have only had two sessions.  I am trying to trust and have some faith.  I am trying to trust my therapist, and the process and like I said above – try to be patient.
Maybe my lack of progress is due to something I alluded to in my last post.  Maybe I’m scared to overcome OCD because I don’t know who I will become when I am no longer avoiding so many things.  This dawned on me the other day.  That my compulsive avoidance behavior is so entrenched in my life, that even my choice in friends – heck – perhaps even my values have been formed by trying to avoid my feared outcome.  Who the hell am I?    Maybe at the end of the day the pros of overcoming my OCD don't outweigh the cons.  Maybe all of this is just another game that OCD is playing on me trying to scare me into not making changes.  Who knows. 

February 20, 2011

Incessant Reruns of the Mind

I finally found a book written about Pure O OCD.  In fact, it was written by someone who actually has Pure O OCD.  I thought I would give a brief review of it here. 
"Incessant Reruns of the Mind" is told from the author’s perspective, as someone who suffers greatly from Purely Obsessional OCD.  The author, Phineas Michaels, is about 34 years old at the time of writing the book, and he claims to have suffered from OCD since he was four years old.  He has many obsessions, all occurring almost at once:  scrupulosity, harm, sexuality, and even some hoarding.  His obsessions take several forms, so he rates his OCD as extreme. 
The book has three parts:  Part One is meant to describe his OCD, Part Two is excerpts from his OCD journal, and Part Three is transcripts of some questions that an OCD researcher asked the author for a research project. 
It is clear throughout the book that the author does have extreme OCD.  The book is written almost as a “stream of consciousness” – he just writes exactly what is on his mind.  For this reason, the prose can be difficult to follow, and so can his train of thought.  But – I appreciated this, because in some ways, this is the essence of OCD – constant disturbing thoughts streaming through our heads. 
I could identify a lot with his struggles.  The avoidance.  All of the “What if?” questions.  The strong need to FIND THE ANSWER.  The author also discusses something that really impacted me:  the notion of not really knowing who the "real" Phineas is as a person.  He said that he had been suffering with OCD for so long (since he was four), and had so many rituals, and avoidance behaviours, that he didn’t really know who he was anymore.  Some of his rituals were so subtle – how he dressed, how he talked – that he could no longer distinguish the “real Phineas” from the “OCD Phineas”.  I can definitely relate to this in some ways, and it scares me to death. 
Although the book was difficult to follow at times, and didn’t really have a clear, beginning, middle or “happy ending”, I was thankful that someone simply wrote down a representation of what actually goes on in the mind of a Pure Obsessional.  This is not a book about hope, however.  In fact, I think it is a more “typical” representation of someone who has a mental disorder, specifically OCD.  He went for years without being diagnosed, and struggled to find an appropriate treatment provider.  Due to the severity of his OCD, the author felt that he needed in-patient care, however his insurance provider would only pay for two months, so he had to leave before receiving an appropriate amount of treatment.  At the end of the book, Phineas was struggling along, trying to find someone who would help him, and trying to find the money so that he could return to in-patient care. 
This is not a book like Jeff Bell’s “Rewind, Replay, Repeat”.  It doesn’t tell a story of recovery, or victory over the “OCD Bully”.  But it sure does get into a Pure Obsessional’s head. 
Incessant Reruns of the Mind can be purchased by following this link. 
If anyone has any other suggestions for Pure Obsessional books, I would love to hear them! 

February 14, 2011

Family Stuff

This isn’t directly related to my OCD, but I just have to vent.  I am really struggling with my family these days.  So many emotional things are coming up for me, and as a result – my OCD is affected.    
I definitely came from a dysfunctional family.  My parents had a very co-dependant, traditional “male chauvinist” relationship.  My father is a huge perfectionist (I would say OCPD actually), and was HIGHLY critical of me when I was growing up.  I have no idea why he targeted me – he was critical of my siblings as well, but not as much.  My dad and I fought – LIKE CRAZY – from the time that I was about 10 years old.  He yelled.  And was very threatening.  He never physically abused me.  And he never actually said things like: “you’re a loser and you’re never going to make anything of yourself”.  But he implied a lot of things by the way he said them. 
I have worked for years to come to terms with my father, and my relationship with him.  I am quite certain this is one of the reasons my OCD has latched onto ROCD and HOCD.  Though I now know that the way my father treated me was more due to his limitations than my defectiveness – I have some core beliefs that are tough to change.  For example – it took me a long time to realize that not every man is like my father.  (Due to my relationship with my (recent) ex-boyfriend – I now know this.)  During times of struggle though – this is something that I revert to.  It’s hard for me to trust men.  Since becoming an adult and working through some of this – things at times - have become downright nasty with my father.  I have had to throw him out of my house due to the way he treated me.  Through all of this - I think I have become better at two things:  accepting him (and his limitations) for who he is, and setting better boundaries. 
Now that my mom is terminally ill – a number of emotions and family issues have come to the surface.  My mom has always been my protector.  She’s always seen my side, understood me, and taken care of me.  She has been there for me NO MATTER WHAT.  What will happen when she is gone?  This scares me to death.  Honestly – I don’t know what will happen to my family; especially my relationship with my dad. 
At the same time I am experiencing a lot of feelings about my siblings – mostly feelings of disappointment.  My sister lives thousands of miles away from us, and our relationship has been less-than-ideal for many months due to other circumstances too long to discuss in this blog.  But right now I’m really angry and disappointed with her for the way she has handled my mom’s illness.  We found out in March of 2010 that my mom’s cancer had returned, and since discovering this information, she has not once visited my parents.  She has had a very arm’s length involvement with my mom through all of this. 
My brother isn’t much better.  Though he lives about five minutes away from my parents, his attitude is one of “if I have time I’ll help out”, and it seems that he has resigned himself to the inevitable.  I live four hours away from my parents but it is like pulling teeth to get my brother to attend a doctor’s appointment with them if I am working and unable to make it.  My relationship with my brother in recent years hasn’t been great either.   We are cordial with one another, and he makes absolutely no effort to see me.  If it wasn’t for his kids, I would probably never see him.  But I would like to have a relationship with my nephews, so we cross paths every time I am visiting my parents. 
And tonight – a bunch of “junk” from the past came up with my father.  I still can’t help but be intimidated by him sometimes and it feels horrible.  On top of feeling intimidated – I also beat myself for ALLOWING myself to feel intimidated by him and not being strong enough to have the resolve to say “F YOU.”  My dad has a very passive aggressive (and aggressive for that matter) way of criticizing people.  He had made a very critical comment to me a few days prior, which I chose to not confront him with.  Tonight though, he made another comment, and I just couldn’t let it go.  I had to call him on it. 
I am quite proud of how I handled it.  I let him know that I was certain that he didn’t mean to upset me with his comment, but that what he said really hurt my feelings.  And off it went.  His same old crap.  I managed to hold it together though – and “steer” the conversation in the best way possible, considering that I was dealing with a completely irrational, emotionally inept person.  At the end of the conversation I managed to not give too much of myself, and I think that both of our self-esteems remained intact. 
Why do I feel so crappy though???????
Maybe I feel crappy because I am sad.  I am sad that I will never have a really positive relationship with my dad.  I am sad because this is as good as it gets.  He will never give me what I need from him.  And this is very disappointing for me.  I’m anxious – because all of those old core beliefs that come up  – that men aren’t to be trusted, and that they are all completely emotionally stupid.  And then guess what rears its ugly head?  You guessed it!  The HOCD and ROCD.   What’s the bloody point?  Will I ever transcend my past?  Is it even possible to recover from HOCD and ROCD given my past?    

February 9, 2011

Changing ERP Therapists

So – I’ve done it.  I’ve changed ERP therapists.  It was a difficult decision.  I was worried that I was making the decision for the “wrong” reasons.  I was worried that my new therapist might not be any better, and that will prove how defective and hopeless I am as a human being.  I might as well give up trying. 
I had some legitimate concerns about my therapist though, which I had almost from the beginning.  First of all - our sessions had very little structure to them.  She did not give me homework.  We never once spent any time analyzing my compulsions.  She never once discussed the idea of "feared consequences", and we didn't even put together an exposure hierarchy.  I don't know - is this common for those of you who are in therapy for OCD?  I was expecting something different I guess.  I was expecting someone who would hold me accountable to.....SOMETHING.  Though I realize that I have to be my own therapist - I also have to learn HOW to become my own therapist.  I do feel that at this point I need some "guidance". 
Secondly, we didn’t discuss compulsions AT ALL.  I remember asking her about it once when we first started working together, and she said not to worry about compulsions, to just do the exposure.  I can appreciate that simply doing exposure can have some sort of therapeutic benefit, and I think for me, it has.  However, the hallmark feature of OCD isn’t having disturbing thoughts, it is the compulsing that we do to “undo” the thought or make it more palpable.  Any progress that I made recognizing my rituals was due from reading Dr. Grayson’s book.  Not once did she ask “What are you avoiding?” or point out any rituals that I was doing.  This caused more of a problem in the Relationship OCD than it did with my gay obsessions.  In fact - I don't think she even believed that I had ROCD at the end.  She said to me that ROCD was wondering if the relationship was right for you because the person has a big nose, or brown hair vs blonde hair.  Yes - I agree - that can be how ROCD presents itself.  But again - that is focusing on the thoughts - not what the person does in response to the thoughts!  I know - from all of the reading that I have done - that I have ROCD.  I am not saying that was the ONLY problem in my relationship.  But my therapist's lack of experience and skill at recognizing compulsive thoughts/behaviours has not helped me to make any progress in this area - boyfriend or not. 
Another concern that I had about her is that she didn’t want me to “externalize” my OCD.  At the beginning of therapy, I wrote myself an exposure script that was based on the examples from Dr. Grayson’s book.  It mentioned things like “I am uncomfortable doing X – but I want to overcome my OCD and learn to live with uncertainty….”, and she asked me to take the part about my OCD out.  I never understood this.  Of course – I understand the goal of therapy is to learn to live with uncertainty.  However, I think that in order to learn to battle this disorder it is very important to have a good handle on how OCD works, and what thoughts/behaviours represent the disorder.  From all of the reading I have done – many of the specialists say that it helps immensely to think of OCD as some sort of monster – an “entity” separate from who we truly are as people.  She didn’t want me to do that and I am not sure why. 
Finally and most importantly, we just didn’t click.  She was a very nice person, but her way of operating didn’t meet my expectations for how I wanted to proceed in therapy. 
Today I am happy to say that I Skyped with my new therapist, and so far I am pleasantly surprised.  He seems to have a really good handle on the Purely Obsessive mind and our rituals.  I am actually EXCITED to work with him!  (I can’t believe I’m saying that – wait till we start exposure….) I “pre-screened” him quite well I think – I have read some of the things he has written about mental rituals, and I emailed with him my concerns about past therapy prior to us starting to work together.  I am cautiously optimistic. 
I sent an email to my old therapist today and let her know that I was going to discontinue therapy.  That was exposure for me!  What if I'm wrong??? I did it though and I feel pretty good.  I haven't heard back from her.  Who knows if I will.