Thursday, August 5, 2010

Trust, Forgiveness, and Relinquishing Control


Like this sign, exposure therapy might seem a bit odd at first glance.  You mean I am supposed to walk through the mud?  You mean I am supposed to not wash when I feel like I should?  Why on earth would I want to do that? 

A big theme for me this week has been the issue of trust, and by that I mean, trusting my therapist.  I agree with his exposure recommendations.  I don't think that the things he asks me to do are ridiculous or unnecessary.  And I really do believe that, if I were to go with his suggestions, I would get better.  I have had enough experience with this disorder, recently and in my past, to feel confident in the use of CBT.  If it means I have to temporarily walk through the mud, so be it, I understand the purpose and know enough to believe that it works.

I have also read lots of literature on OCD, am quickly developing my own little OCD library, and even went to the International OCD Foundation's annual conference to learn even more about the disorder and others' experiences with it.  I feel like I have become a sort of amateur expert on the topic of OCD and its treatment.  So with all that I know and have experienced, what's the hang up?  The thing is, even if I know what I need to do to get better, I'm still waiting for it to feel "right" before I commit wholeheartedly and without exception, especially when it's most difficult.

This is not a new issue for me.  From the beginning I have dragged my feet through the work of recovery.  I have come a long way, but it has been a bumpy road full of OCD potholes, wrong turns that have lead me back to previous points, and lots of second-guessing at every intersection where my OCD urges and my therapist's recommendations have crossed paths and gone off in two different directions.  I have taken a lot of detours that I knew were probably unnecessary, "just to be safe," and I have often come to those intersections, known which way my therapist would recommend, and still turned the other way, convinced that it was not yet the "right" time to commit to my destination of recovery.  "Not yet!" OCD protests, "You're not ready!  It would be careless to set off down that path at this moment in time.  Wait another day, wait until your next session.  When you see your therapist again you can double check that your directions are correct and then you can continue onward in your journey.  Just don't go yet.  It would be irresponsible.  You must wait!"

OCD likes to tell me that it's too late in the day, that I don't have the right supplies, that I may have heard the directions wrong, or that maybe my therapist would change his mind if he knew how this time was different.   These are just a few of the infinite excuses OCD comes up with to stall the journey.  It knows I know the way, so instead of leading me down the wrong path altogether, it does everything it can to stall the inevitable by talking me into waiting, or making a wrong turn just this one time, because, you know, this one, well, "it's different."  Secretly I want to go barreling down the road to freedom, and yet OCD doubt keeps me moving forward at a crawl, telling me that the time will come when I can put my foot on the gas...just not yet, not all at once...

But I am starting to realize that even OCD is running out new excuses to give.  I have built so much trust in my therapist over the last several months.  Even by my standards, I feel that he understands what's going through my head enough to know just how one simple change can wreak havoc on a number of different things in my world in domino-like effect.  At first I felt like he didn't understand, and that often kept me from complying.  I felt like even he, an OCD specialist, couldn't see how one simple suggestion, one exposure, shattered not one, but a thousand OCD rules at once in many intricate and complex ways.  I have spent a lot of time trying to explain, but no matter what, the answer pretty much stays the same - do the exposure.  Whether or not he understands "perfectly" what is going on inside my head, the recommendation remains.  At this point, after all the setbacks and explanations and new strategies to get me to do what I know I need to do to get better, I have faith that my therapist knows what he is doing and that he knows what he asks me to do may be more complicated to me than it outwardly seems.  And yet, the answer, the solution to the problem, again remains the same.

So if time and time again, despite the various excuses OCD comes up with, the directions to reaching my destination remain the same, at what point will I learn to ignore OCD's voice and continue on the path I know my therapist would recommend?  How many books do I have to read?  How many different ways do I have to be given the same answers until I finally believe them?

I have been looking for that missing piece, the answer or that bit of knowledge that will make me feel certain that the the way ahead is correct, so I can head down the road to recovery confidently and in full force.  But this elusive search is the problem in and of itself.  When will enough be enough?  When will I be convinced that the this time the answer is "right?"  I can't ever feel completely sure or completely certain.  It's time to give up the hunt for such unobtainable certainty and buy into my therapist's directions and recommendations, whether they always feel right or not.  It's time to accept that it will feel wrong sometimes, and that's where forgiveness comes in.

Instead of beating myself up for complying when it feels wrong, for being "careless" in the moment and not waiting for a chance to double check, I need to be mindful and forgiving at these times.  If I have made a mistake, if I somehow fail to wash in a circumstance where I really should have, so be it - I am at least still heading in the right direction.

I have waited for the "right" time long enough.  Though it sometimes feels like complete and utter blind trust even with all that I know and have learned, I still need to do what my therapist has recommended.  I need to take that risk, and let him guide me down the road to recovery.  After all, that is what I am paying him for, right? :)  My internal compass doesn't always work quite right, so for a while, I need to trust someone else's.


  1. I am so with you on this post. It was really crucial when my therapist finally said, "If you do *anything* that is an exposure for you." I am so used to waiting, avoiding, putting off--it's how I operate. And wondering if my therapist "understands me perfectly" or the therapy won't work--that was really hard to accept that I could still get better, even without him knowing every single detail of my OCD. It does feel like blind trust, but I also know I've given OCD a lot of blind trust, and my therapist, and the healthy part of myself are more credible.

  2. I like how you say that you have "also given OCD a lot of blind trust," because I think that's so true - when we give in to OCD demands we are basically blindly trusting a disorder known for giving fairly untrustworthy advice! :) But then, that's the logical side of things, and it's hard to remember that in the moment when that OCD voice is so alluring.

    I also love how you're therapist finally told you that just doing anything would basically be an exposure. My therapist and I toyed with the idea of actually doing an exposure to doing exposure (if that makes any sense)! Every time I am assigned something, even if I have done it before, it suddenly seems far more difficult. I have set a not-so-good precedent of "having to" fail to a certain degree. If my therapist says I can only wash for 60 seconds...I wash 90. If I can only shower for 30 minutes...I shower for 35, and so on. And as soon as that time limit is decreased as part of my homework guidelines, suddenly I can wash within the previous time limit. It drives me crazy!! So yeah, just doing my homework, in and of itself, even if it weren't contamination/washing related, would probably be an exposure in and of itself!



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