Monday, December 13, 2010

Bathrooms and Hand-Washing and Exposure, Oh My!!

Today I did a field session with my therapist at the mall where we proceeded to hit up just about every restroom in the place.  Correction, I hit up just about every restroom.  There was no therapist there to hover over my shoulder as I washed my hands.  No one to turn the water off.  No one to wipe the soap off my hands when I used too much.  No one to tell me stop.  No one to make me touch things.  But I did.  I washed my hands in, and even actually used, a public restroom.

Some background:  half the battle for me in using public restrooms is the hand-washing part.  I never know what the conditions will be like:  Will there be enough soap?  Will I have to touch sink handles to turn on the water?  Will I have to touch the paper towel dispenser to get a paper towel?  Will there even be a paper towel dispenser or just those hand dryer things I don’t like to use (partly because you often have to touch them!)?  On top of that there is the even more bothersome question:  Will there be other people there?  Will there be other eyes watching my erratic hand-washing behavior and making me even more nervous?  Will there only be one sink?  Will they be waiting for me to finish so that they too can wash?  Will their presence in line behind me shake me up and make me feel the need to hurry, making it all seem less "complete" and harder to attain that "right" feeling?  All these questions swim around in my mind before using public restrooms.

Well, today I did it.  Four times.  The last time I actually used the restroom, but the first few times I just did basic exposure – I’d go in a stall and touch some of the things I thought were most dirty:  the lock on the door, the toilet flusher, the toilet paper, etc.  Then I’d walk out and do a 30 second hand wash, one squirt of soap, no avoiding touching things after (sink handles, paper towel dispenser, door handles).  Though these are the general standards that my therapist always promotes, I rarely follow them.  I adamantly adhere to my “rules” until we have had the formal opportunity to address each and every one of them.  Then, and only, then, do I feel like it’s alright to take the next “step” and eliminate or cut back on some part of my elaborate hand-washing routine.

So the biggest exposure today was not so much using the restroom as it was choosing to adhere to the my therapist's guidelines even when I had no one there supervising me.  I could have used tons of soap and followed my washing routine to a tee.  I could have made my therapist go over each and every detail of the process with me before I’d be willing to let myself break the rules.  But the point of today was to get used to using public restrooms, because when I go home for the holidays, I will inevitably have to at some point I'm sure.  And when I do, I don’t want it to be such a cataclysmic event, an event that seems to require extensive self-penance in the form of compulsions, as it has often seemed in the past.  I feel the need to flog myself with compulsions not so much because I feel like I am always that much dirtier for using and washing my hands in a public restroom, but because I feel I shouldn’t have let myself.  I shouldn't have allowed myself to waiver from my strict OCD rules just because it was inconvenient to follow them or just because I didn't want to (or just because my therapist would advise it, for that matter...).

That’s the thing.  These days my contamination issues are so much more about doing things “right” than they are about thinking certain things are dirty and certain things are not.  I do feel dirty afterward, but in a way that doesn’t necessarily seem to require washing to fix.  Right now, for example, the perfect way to handle this situation according to OCD would be to change out of my “contaminated” clothing that I wore during the exposures, wash them before wearing them again or before putting them away, and showering before putting on “clean” clothes.  In a "perfect" world, if I were a "perfect" person in the way I did things, this is what I would do, OCD says. 

But I recognize that doing such things would probably be extremely detrimental to the benefit gained from today’s exposures.  I am no longer such a slave to the OCD that I will jump before every hoop it sets before me, jumping because it says jump even if it doesn't make any sense, even to me, to obey.  But just because I am not willing to do things the “perfect” way doesn’t mean that there isn’t still a desire to do something about the post-exposure situation.

Here are the compulsions I am struggling to resist or am still on the fence about at the moment:
  • Washing the pants that I wore today before wearing them again and not putting them back in the drawer with my other “clean" clothes.    
  • Running through, step by step, the exposures that I did today and how I did them.  This means mentally (or in writing) enumerating all the steps where I could have done something compulsive or where I flagrantly violated OCD rules.
The first may not be easy to resist, but there is a very definite distinction between doing it and not doing it.  The mental retracing, on the other hand, is more difficult to resist.  It would be so easy to do, but at the same it would be difficult to do “right.”  I know that I am already, without thinking about it, rehearsing some of the things I did in my mind.  But to do a systematic review of all the events, of each important step, as well as I can remember them, well, that definitely takes concerted effort and is a major compulsion.  To perform that complicated of a ritual, I have to make a definite choice.

Will I perform the compulsion?  I’m not sure yet.  Delay is my weapon of choice for the moment.  Delay the compulsions, and if you delay them long enough, you may no longer feel that you need to perform them, or so they say.  However, even this scares me.  I keep thinking, “but what if I don’t want myself to NOT care!?”  I’m also thinking:  “But even if I don’t care later I will still feel like I should care and will thus perform the compulsions anyway.”

The desire to be able to declare today's events “done” and “complete” in my mind, to close the book or turn the mental page and move on from these exposures, is strong.  And how do I usually make this happen?  By performing compulsions.  Then I feel free to let my mind go, free from the nagging urge to jump through the mental hoops that OCD has already set up in front of me.  Unlike the pants which, once I make my decision, I will largely be done with the matter, the urge to go back and retrace my actions in my head will still be there even if I decide NOT to.  Just because I make the decision doesn't mean I can't go back on that decision a minute later.  I have to keep renewing my determination to resist every time I think about the urge.  The desire to make things feel “right” in whatever way I can is incredibly persistent.   To put solid ground under my feet by performing compulsions, is continually tempting, because in them meantime, I feel like I am floating around in space, and I want so badly to tie myself back down to the ground by mentally reviewing my exposures.

So will I do it?  Will I resist these compulsions, especially mental retracing?  Well, I resisted doing it here.  I could have made this post a compulsive explanation of the exposures I did.  But I didn’t.  From here, we’ll see.

I keep thinking, "But why resist?  What's in it for me?"

The logical part of my brain says, "Duh, you can recover from you latest OCD downward spiral and be free to do what you want and enjoy it.  You can get better and make the choices you want to make without the oppressive rule of OCD controlling every movement."

The emotional part of my brain still says, "Yeah, I know that.  But what's in it for me??"  And the sad thing is, sometimes in the moment, it doesn't seem like there's much in it for me on the emotional front - just the hope for a better future.  And when I question whether I even really want a "better" future sans so much OCD crap, the pillars holding up even that shiny hope of a "better existence in the future" start to seem shaky.  "Do I really even want to be better?"  I question myself.  I know I do.  But the doubt still plagues me as I worry that life will be no better than it is now without so much OCD.

For now I am doing my best to commit to NOT performing the aforementioned compulsions despite the "But why now?  Why should I care?  Why should I do this? What's in it for me?" questioning that is going on in my head.  I just have to trust that living life with less OCD in the future is worth the current trouble.  I just have to trust that I will look at my resistance as something that led to positive changes when I have more distance.  I may feel unsure as to whether I really "want" this at the moment, but I know that in the long run I do want to get better.   I've been saying that for months, for over a year.  And yet I cling to this disorder and my discovery that I have it, fearing that if I get better too fast, it will all disappear - my diagnosis, the self-revelation, the desire and ability to change my life for the better that seems to have finally opened up before me.  I fear losing those possibilities, that excitement, and in response to that fear I ironically delay what I am so excited to discover:  that I finally know what I have, that it has affected many aspects of my life, and I can improve!

I have to remind myself of that sometimes, because the fear of losing my discovery of "the big secret" (as my therapist once called the fact that I have and have probably always had OCD) is insanely frightening.  I am so afraid of waking up from this dream (or nightmare) and realizing that the hope I was given doesn't really exist, the hope that has really changed my perspective on so many aspects of life.  The ironic thing is:  I can't even really embrace that hope without taking that risk.

So there it is.  I will not perform my compulsions tonight.  I will at least delay them one more day and then we'll see if I can't renew that determination tomorrow.

3 comments:

  1. Great work. Luckily, I don't have the "after exposure" issues you have- in terms of whether or not you WANT to care about your compulsions, etc, but I can definitely relate to public restroom stuff. Keep it up!

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  2. I'm a few years late to finding this blog, but just wanted to share an immense thank you for the courage to share your journey. I am currently pursuing treatment for my OCD (which also has affected my life in sad and enduring ways I didn't think possible) and have been struggling with the discomfort that follow my exposures. It's incredibly helpful to know that others have felt what you're going through, as even the most supportive people who don't have OCD will never fully understand. Your posts give me hope to keep moving forward against my compulsions. Thank you!

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  3. I feel the same way!

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