Thursday, July 29, 2010

Evaluation...

I have never been good at dealing with negative evaluation, partly because I am constantly measuring my own worth by comparing myself to others and what they think, and because I often feel the need to be the one of the "best" at whatever it is I tackle to feel that I am of value.  However, convincing myself that I am "good enough" by these standards is not only impossible, but exhausting, not to mention a recipe for constant dissatisfaction. This sort of perfectionism is an element of my OCD that I am trying to work on.  Not that I have been a perfectionist in much of anything lately.  On the flip side, because I am trying not to force perfection on so many things in my life, I have probably been engaging in a certain amount of avoidance instead, because, if I don't actually "try," well, then I can't feel like I have failed.

So, instead of living in this all-or-nothing, either it's good enough or it's not, kind of world, I am trying to be more realistic and forgiving of myself.  I am trying to see things more for what they are rather than existing in denial that the things I do or attempt are either not really as good as people say they are, or not really as bad.   I am good at some things and bad at others.  Is it okay to only be good or even only kind of good at some things? Yes.  Going further, is it okay to be truly bad at things?  Yes.  It is natural and human, and I sometimes have to remind myself of this.  At the same time, things that others evaluate as good aren't necessarily good to everyone, and things that others evaluate as bad don't necessarily seem bad to all people.

With this in mind, I recently submitted my blog to a few sort of online blogging indices to try to improve the visibility of my blog and to connect with more OCD sufferers.  One such index gives your blog a rating when you submit it, a rating I didn't want.  I honestly didn't want to know what someone else out there, independently judging my blog on unknown criteria, thought of it.  I have been enjoying this outlet for my thoughts and feelings as a place where I can write without so much concern about how it will be "graded."  My objective is not to produce the best blog ever, or anything of that nature.  Rather, the reason for having this place to write is to give myself a chance to share and sort through my recently overflowing thoughts about my life and the role OCD has played in it.  In addition to that, I wanted to connect with this supportive community of sufferers that I observed for quite a while before actively taking a part in it.

Nevertheless, whether or not I wanted it, when I joined this particular blogging index I was given a rating - "good."  And of course, once translated into the language of my mind "good" no longer meant "good;" it meant something more along the lines of "mediocre" or "could be better."  When I saw the rating "good," I didn't feel "good."  Instead I was upset because "good" didn't seem "good enough" and thus somehow became, in my mind, "not so great."  Suddenly a word that is inherently positive took on negative proportions.

But if I have learned anything in the process of treatment, I have learned how to better recognize my own distorted thought processes, and if I can recognize some of the distortions I am making as I make them, I can then re-evaluate the situation from a more mindful and less judgmental standpoint.  First, I have to remember my objective in starting this blog, which again, was to establish an outlet for my thoughts about OCD and to connect with and support others in their battle with the disorder.  It would be nice if, by general blogging standards, my blog were also considered "good," but at the same time I have to acknowledge that that was not really what I set out to do.  I actually set out to satisfy my desire to capture and share my thoughts and to interact with others who have OCD.  Thus, if I really want to evaluate my blog, those two goals are the measuring stick by which I should "grade" my blog, instead of measuring it by others' standards which may or not coincide with my own.  In that light, I think I have reason to think that my blog is "good" or at least "good enough."  Being able to write my thoughts out here has definitely helped me sort out some of my own confusion and has subdued, to a certain extent, the raging flood of thoughts coursing through my head.  It has also allowed me to interact with others with OCD as I had hoped it would.  I would love to find and be found by even more OCD bloggers out there, which is why, in the first place, I submitted my blog to the index which gave me the anxiety-spurring evaluation.

Learning to evaluate myself on my own terms, rather than on those of others, is an ongoing process.  I have spent years comparing myself to other people in various ways to try to determine my relative worth.  But while this sort of comparison is probably inevitable to a certain degree as part of human nature, I hope to establish greater independence from this type of behavior as I also work to establish autonomy from my OCD.  Thus, tolerating a rating of "good," as determined by someone else in relation to other blogs, is probably a great opportunity for me to practice living that sort of independence that I hope to develop.  In that way, this blog in and of itself becomes another way to challenge the problem, rather than one more way to feed into it!

Wednesday, July 28, 2010

Childhood OCD

Having recently heard and read about others' experiences with having OCD as a child, I wanted to write a bit more about my own experiences growing up with the disorder. I have wanted to share these experiences for a while now, especially because these stories from my childhood are the ones that I have talked about the least, since my therapy and exposure work focuses largely on my current symptoms. But as I have alluded to before, I have had experience with different types of fears - different obsessions and different compulsions to accompany them. Some of these fears lasted for only a short while. Others gained momentum, took over my life, and then gradually faded away over the years. And then there are still others whose tyrannical legacy lives on to this day - obsessions and compulsions that are not my primary problem right now, but which wait in the background to be tackled as I overcome my most recent OCD issues.

As I begin to write, I am realizing that I feel a lot of pressure right now to do this post "right" since I don't have a chance to talk about these experiences much. However, I will do my best to just go with it and not worry so much about whether I have reported my memories "correctly" or the way I wanted to. One of the many benefits of writing this blog is that, for once, I feel free to write without doing so "perfectly." There are no grades. There are no evaluations. There is nothing I have to turn in. It's sort of like a little experiment - a trial in seeing what it is like to write without being so concerned about how the end result will be judged. So far, I am enjoying the results :). So off I go!

The first major "episode" of OCD in my life reared its now-so-recognizable head in first grade, when I was only six or seven. I remember other exaggerated fears and avoidance that occurred around that time, but I am not sure exactly where they fell in my OCD timeline - if they came before or after this clearly defined example of my OCD. Nevertheless, I'll go with this first clear example to kick-off my journey down childhood-OCD memory lane.

This first episode was the classic contamination/hand-washing duo. I was afraid of germs and of getting sick. And when I learned about those dangerous invisible foes that lurked all around our world, when I learned about how they could cause disease and even death, things we did on a regular basis no longer made sense to me.

For example, why did we touch sink handles before washing our hands to remove the germs only to touch the same "contaminated" sink handles again right after washing? I didn't understand. I remember trying to find other ways to turn the water on and off at that time so as not to re-contaminate my hands as soon as I had washed. Often I used tissues to turn the water off and therefore avoid getting the "germs" back on my hands. I was terrified and my dry, red, and scaly hands were a testament to that fear! How did people go about their daily lives without being constantly aware of the threat of germs, without constantly being aware of the possibility of contracting a disease and dying? Other kids seemed to naively float about their worlds, unaware of germs, unaware of the constant threat of death...

Much of this time period is fuzzy to me now (which is probably for the best!), but there are a few incidents that stick out:
  • Lunchtime rituals. I remember one day at lunch asking one of the lunch monitors if I could go to the bathroom. She gave me permission and I headed off to the restroom...to wash my hands. I remember washing, being almost done, and then accidentally touching part of the sink, and starting over. Then I would realize there was a piece of hair sticking to my hand. I would start over again. For one reason or another, I would start over and over and over again, until I was finally able to escape back to the cafeteria. However, I must have been gone for a while, because, upon my return, the lunch monitor who had given me permission in the first place looked concerned. She asked me if I was feeling alright, if I was sick. I told her no, but felt incredibly ashamed and embarrassed! My behavior was attracting attention, attention I didn't want! I certainly wasn't about to admit what was really going on...
  • Spying. I attended daycare at this time in my life, where there were some lovely bathrooms for all the kids. I remember washing my hands in these restrooms and being nervous that someone would catch my erratic washing routine. Or, in order to try to remember how I had washed my hands "before," I would try to surreptitiously spy on other kids as they washed...now that germs suddenly seemed to be everywhere, I couldn't remember how I had washed and when, before I became so acutely fearful.
  • The "bathroom bunny" and I - best pals. In order to go to the restroom in first grade we had the "bathroom bunny" system. If you wanted to go to the restroom, you had to get the appropriate bathroom bunny (there was a little boy bunny and a little girl bunny) and set it on your desk so the teacher would know who was in the restroom and when. Needless to say, the bathroom bunny and I became close friends. I would feel the need to wash my hands and up I went to grab that little wooden rabbit figurine dressed in pink and set her on my desk. Sometimes I became very self-conscious of how familiar I was with Miss Bathroom Bunny. I began to wonder if others noticed - the teacher or other students - how frequently she was to be found on my desk. I didn't want anyone to ask any questions...I wanted to hide my problem. The last thing I wanted was to get in trouble and have to explain my constant need to go the the restroom...
  • Smelly lotion. Finally, I also remember the state of my hands. As I mentioned, they were dry, red, and scaly from my excessive washing habits. I think this is what eventually clued my parents in to my problem. When I asked my mom recently what she remembers about that period in my life, I believe she said that she recalled the state of my hands, as well as how she was unsure of how long I had been at my strange behaviors before she and my dad figured out that something was wrong. When she did begin to notice, my mom would apply this yellow gel-like vitamin E lotion to the cracked skin on my dry little hands. Of course, I was not concerned about the fact that my hands were in bad shape nearly as much as I was concerned about the fact that that lotion SMELLED GROSS. I hated it. And I hated that my mom put it on my hands. All I wanted to do was to hide my washing and hide my chapped skin so that no one would intervene in my washing behaviors and no one would smother my hands in nasty lotion.
Looking back, I can now understand and appreciate my parents' attempts to intervene, though I'm not sure the strategies they employed were the most helpful. They did relieve my symptoms in the short-term, but I still knew nothing of OCD or how my behavior only served to increase my fear. Then again, at that time OCD treatment was still evolving, and effective strategies for dealing with obsessive fears and compulsive behaviors were still young and not so well known. I remember my parents sternly telling me to "stop that!" - to touch the sink handles with my clean fingers, to stop using tissues to turn off the water, and to stop asking if it was okay to touch this or that and not wash. That last part, not answering my questions, whether my parents really realized it or not, was essentially denying me reassurance - the fuel that keeps the OCD alive. By essentially denying me the answers to my questions when I began to ask too many and too frequently, they were forcing me to sit with the anxiety until it diminished. That, and their stern admonishing when I engaged in avoidance behaviors related to my fears, probably created a sort of rudimentary form of ERP for fighting my OCD.

However, because I was still unaware of how my behaviors and my reassurance-seeking served to heighten my anxiety, I may have gotten better, but I didn't learn how to fight OCD. Thus, I may have recovered from that particular OCD period of my life, but I was really no better equipped to fight my cleverly morphing enemy in the long run. So when he came back again, cloaked in the disguise of a new fear, I was unprepared to fight back...

And that is where I will stop for now! I will save more of my childhood battles with OCD for another day.

I'm curious...did those of you with OCD experience symptoms as a child? If you did, how did you handle it? Did others know? Were you diagnosed? Did you receive treatment? I'm interested to hear about others' experiences!

Monday, July 26, 2010

Does it ever end?

So, does it ever end? I believe the answer is a resounding no.

Let me elaborate. This morning I woke up and dragged myself to the shower like a good hygienic human being only to discover: no hot water. This is fine. I really don't mind. I can wait for the hot water to work again...I didn't want to shower anyway, and now well, I have an excuse to procrastinate it. But I would like to shower at some point today!


The "real" problem stems from the fact that I did laundry last night (Or perhaps the real "real" problem stems from the fact that I have OCD and want too much certainty about certain things...). So the question that arises is: did we still have hot water when I was washing my clothes?

I have become the clothes-shrinking queen since my descent into obsessive contamination concerns. I wash everything on hot!! And sometimes, when doing laundry, I will begin to doubt if I really did use hot water, and will check repeatedly that the correct settings have been selected (this is all even though I know, growing up, my mom rarely washed clothes in anything but cold water unless something was really dirty!). So yeah, hot water has become an important part of my laundry doing rituals, and although I know I can live fine with out it (I mean, I managed to survive growing up at home without feeling constantly dirty...), it has taken on considerable significance over the last year and it's hard for me to accept such uncertainty about the temperature of the water my clothes have been washed in. Oh my...OCD is so nonsensical.

Anyways, I seem to be having a lot of OCD moments these last couple days. I mean, my life is often one big OCD moment, but usually it's just lurking in the background, a constant hum that is ever-present but not debilitating anymore. It's hard to know if there have just been more unusual circumstances popping up left and right recently, or, if my more frequent compulsive responses are leading me to feel like more situations require immediate OCD attention. It's probably a combination of both, and the more I try to figure out "what I would normally do in this situation at this point in my treatment," the more I end up being more compulsive to avoid being "careless" too fast, too soon...before I have to for the sake of exposure... It's a very slippery slope!! A slope that quickly leads to large piles of "dirty" laundry and longer and longer hand-washes...oh, and sinks overflowing with soap suds...


I'm trying to get back on track but sometimes it's hard when OCD says, "No, wait! This situation, this time, is different! No really! You don't have past experience to draw upon to define your course of action for handling this particular circumstance. You can't trust your old pre-contamination self either because back then you did all sorts of things that you would never do now. So do the thing that seems compulsive. You don't know that it's compulsive even do you? Maybe a normal person would do this! How can you take so many other precautions to avoid cross-contamination and then let this violation go? Do the thing that seems compulsive just in case you are wildly off in your guess about what you 'should' do in this situation."


That's pretty much the baseline argument that my OCD uses everyday, and it's one that really gets me good, too. "This time is different! You haven't faced anything like this before! You should wash! Be compulsive! Don't take this risk! Not now! Not with this!" Ah yes, my familiar OCD voice...thank you for the confusion you cause me, and the never ending internal debate that continues whether or not clear-cut anxiety is there. You always keep my mind busy with unnecessary internal arguments. And thus you keep me coming back, even after the anxiety has dissipated, because the voice is still there, tugging constantly, telling me what I "should" do. I give in, just to silence the incessant chatter once and for all...until next time...

Sunday, July 25, 2010

Having a Moment

Today I'm having one of those moments where I feel incredibly presumptuous - presumptuous to believe that I have had a rough time with OCD and even more presumptuous to believe that I ever had an eating disorder. So this is off topic, since this is supposed to be a blog about OCD, but I was reading about EDs today and began to doubt whether I really had a diagnosable case of an eating disorder when I was younger. I mean, I definitely had disordered eating, but I got over it fairly quickly, and though I always believed that I had anorexia nervosa, I'm not sure if I was ever technically diagnosed.

I've been told that people who are anorexic usually have to fight for years to overcome their problem and many never fully recover. I recovered fairly quickly, meaning that I gained the weight back, even if my eating habits didn't really get back to normal for a few years. But I didn't receive extensive treatment. It didn't take endless cajoling to get me to cooperate once I gave up on trying to lose more weight. I was exhausted and couldn't do it anymore. So for a period of time I was very, very restrictive in what I ate and pushed myself to exhaustion with exercise, but I recovered fairly quickly and don't feel like I am likely to fall back into that trap anytime soon.

So did I really have an eating disorder? Or am I like one of those people who complains about their "OCD" when really they don't have anything of the sort and don't really even know what OCD is? Whenever I have seen a new therapist or psychiatrist, they always ask if I have any history of problems or taken any medications. Eventually the eating disorder period of my life comes up because I was taken in for treatment and put on medication at that time. But sometimes I begin to wonder if, when I explain this part of my history, they think, "Oh well, it doesn't really sound like she actually had an eating disorder. She doesn't know what she's talking about. She recovered way too quickly for it to be actually classified as a disorder." I begin to wonder if they are just humoring me by not telling me what they really think. If they are, in actuality, doubting my assumption that I had this problem as I report it, but to be kind, don't challenge me.

So I wonder if they doubt the history that I give them. And then I begin to doubt my own memories of the severity of that time in my life. Was it really that bad? Or am I just remembering it that way? It is sometimes hard to remember how I felt at that time but then little details of my condition pop into my memory that remind me of how terrible it was. My doctors and family were certainly very concerned, but was that concern really a reflection of how bad I was or simply how much they worried? Did I really have an eating disorder? Did I really fit the criteria? Or was it just another manifestation of my OCD disguised as anorexia?

In writing all this it strikes me that these questions, and the need to know the answer to them, is probably an OCD trap in and of itself. I can't know the answers to these things with 100% certainty. Meanwhile, my fear of falsely proclaiming that I have had a disorder and that I have suffered as a consequence falls in line with my general fear of being an overly-dramatic whiner - someone who moans about all the hard things they have been through when really, they know nothing of such suffering. I guess I can't know that I am not such a person and must accept that uncertainty. Maybe it is indeed extremely audacious of me to say that I had an eating disorder. Maybe it is a shameful exaggeration considering the suffering that those who DO have such a disorder face. Knowing how lethal they can be and all the damage they cause to people's lives, maybe I am presumptuous indeed for suggesting that I have had an eating disorder.

All in all today, I feel like I am moving around in a fog. I doubt everything. Nothing feels certain. I wash my hands, and then immediately wonder if I really did. I do my laundry and hang it up or put it away and then wonder if I really washed it. I guess I just have to go with it. Even if I do feel like nothing feels certain I have to do my best to move on and just hope that I did it right. I feel like I should know whether I have done these things and done them right. But the reality probably is that many people do such things without thinking about them. But do they worry about it? Probably not. My attempts to do things over and over again until I am sure I have done them or done them right is probably what led me to feeling like this in the first place today. I'm trying to embrace the fogginess in my head, but it's not always that easy! I feel like I don't know what I'm doing, where I'm going, or who I really am...

Saturday, July 24, 2010

My New Source of Inspiration

I was hoping to gain insight, information, and inspiration from the International OCD Foundation's annual conference, and I think I certainly did just that.  However, the most inspiration probably came from a source that was altogether unexpected:  a newly found friend, an ally, a companion in the fight against OCD.

I will leave her unnamed for the sake of her anonymity as well as my own, but let's just say she seems like my OCD soulmate.  What a terrible and at the same time wonderful thing to share!  Terrible in that we both have suffered at the hands of this disorder, but wonderful in that we have each found someone who seems to intuitively understand the daily struggles of our common fears.  Never before have I felt that I could relate so completely to someone else with OCD.  I am sure that I would also have a strong connection with many of you whose blogs I read here, but this was the first time I had spoken, in person, with someone whose contamination fears seemed to manifest themselves in a way that was so similar to my own.  That bond, that chance to finally share freely, in immediate conversation, much that has happened in my life over the last year, was amazing.  So often I feel that with my "normal" friends I have to hide and ignore what has happened in my life over the last year.  It is hard for me to really be myself around them sometimes when I feel that I must constantly pretend that nothing has happened, that everything has been fine other than the normal struggles of daily life.  How am I supposed to pretend that nothing devastating has happened, that I am the exact same person I was before all this happened?  People want the "normal" me back, but the "normal" me now includes this story, this additional chapter that I can't just ignore. 

A lot has happened over the last year.  I got really bad, really fast, but with time and work I have improved to the point where I can often hide my symptoms even if they are still ever-present and on my mind.  I can pretend that nothing unusual happened.  That I didn't essentially lose my job.  That I didn't go on disability.  That I didn't go days on end without showering because I was so fearful of getting stuck.  That I didn't sometimes wash my hands for over an hour at a time.  That I didn't lose 15 pounds because it was so hard to feel clean enough to eat.  That, in general, my life didn't become this world where almost anything could become off-limits

That's a lot to hide.  It's a lot to ignore.  And sometimes it's hard to hang out with "normal" people who know nothing of this.  And of those who do know, I'd really rather not talk about all this because their reactions are those of individuals who care but who don't really understand the disorder and how it feels.  They are the ones who still look at me disapprovingly when I give in and wash when I am around them.  They are the ones who try to be understanding and supportive, but whose "tough love" and strange looks only serve to increase my anxiety.  They mean well, but what I really need is unconditional support.  Positive encouragement to fight back rather than stern comments and bothered looks when I do give in. 

Granted, I may not have given them a fair chance.  I haven't fully opened up to them to tell them more about my experience and the way their reactions serve to sometimes lessen, but more often heighten, my anxiety.  But it is difficult to share this experience when it seems like a certain level of judgment, either real or perhaps just perceived, comes with any explanation of the bizarre and admittedly outlandish trains of thought that lead to my compulsive behavior.

That's what is so nice having the chance to talk at length with someone whose experience has been very similar to my own - instead of a roll of the eyes or a look that says, "Really?  Are you really thinking about that right now?  Are you really bothered by this?" I get a nod of understanding, a "Yes, I know exactly what that's like, and it's terrible!  But you are brave, and you can fight back!"   It's a chance for me to finally tell my story.  It's a chance for me to share what has happened in my life.  And it's a chance for me to hear how someone else has been through and continues to struggle with similar things.  It's a sort of bond that I feel can only really be shared with another sufferer.  Someone who knows what it's like to recognize that their fears are irrational and yet, at the same time, still be terrified.  Someone who knows that awful feeling that can crash over you in an instant wave of dread as you realize something has happened and the only way to fix it seems to be hours of complicated rituals.  Someone who has been through just that and gets it.

I have found all that and more in this person I met at the conference, and I am so grateful for our chance meeting!  I hope that others with OCD have found similar confidantes, someone to support them unconditionally in their battle, whether that person be another sufferer, a support group, a friend, a family member, or someone out here in the world of online communication.  I am indeed very grateful for the all support I have also received here from readers and other bloggers and am always glad to provide support and encouragement to them, as well, when and if I can!  Having the opportunity to share parts of my story both with this person I met at the conference and here online has been a very therapeutic experience, and learning about others' struggles and victories is an inspiring motivator.  Thank you to my newfound confidante and thank you to all those who share your own stories and support here online!  You help me stay positive and move forward in the fight against OCD!

Wednesday, July 21, 2010

Procrastination...


Procrastination. It's what I'm doing right here, right now, at this very moment. I struggle getting myself moving forward when I know, before anything else, I need to shower.

I have always had a hard time forcing myself to shower, but now that showers have taken on OCD proportions it is even more difficult to get myself up and into that little tiled chamber of torture. It's not even that bad anymore. But I still hate it. I still dread it. And I'd honestly rather sit here and write about how I don't want to shower than just get up and do it.

I've learned through treatment one thing that works in this sort of situation, OCD or not - even if I can't seem to summon the motivation to commit myself to the whole event of showering, even if I can't seem to possibly fathom pulling off the act, I can commit to the initial steps. I can get ready to shower. I can turn the water on, set aside my towel, and the rest will inevitably follow. That way, even if the whole task still seems daunting, I get myself to do it anyway by taking the smallest steps forward, which leads, well, to more small steps forward. But soon enough, I have tricked myself into showering and there's no turning back. It's initiating the first small step that is the biggest challenge.

I dread showering. I am not sure if this is an OCD thing or not. I suspect a lot of people don't like showering, but perhaps the degree to which I am averse to it is a product of my OCD and my recent experiences with the disorder. My showering habits are certainly not within 'normal' range yet, I don't think, but they have gotten much closer and far less burdensome. Even so, I still dread them, and I feel like I have no excuse for this failure.

Monday, July 19, 2010

IOCDF Conference and Beyond

I have to say that the annual conference presented by the International OCD Foundation was an amazing experience, and in ways that I didn't necessarily anticipate. It's definitely a bit surreal to go from seeing OCD as this secret and hidden part of life to having it be the focus of an entire conference. I love learning about OCD and this event was definitely the Mecca of OCD information. There were of course the the experts - the therapists, the doctors, the researchers - but there were also a whole community of OCD sufferers past and present who had their own wealth of knowledge to share. Being able to openly affirm my fascination with and interest in OCD simply by being present there, and to be with other people equally interested in the disorder and its treatment, was exhilarating for me in and of itself. I'm sure I'll write more about the experience later...but tonight...

I have renewed motivation to fight back and get better, and I hope that I keep this motivation, but sometimes I fear that life does and will continue to feel empty without rituals around which to schedule anything and everything else. I am so used to framing my productivity around OCD's demands that, and as such demands diminish when I do the homework I am supposed to do, I feel lost. I miss the security of my rituals and the fact that they always gave me something to think about and do. My mind was always going, trying to figure out how on earth I was going to accomplish the tasks of everyday life within the confines of OCD.

I essentially miss my OCD cage. It provided a framework around which I schedule my life. Don't get me wrong, much of that framework still exists, but as it gradually breaks down, as the OCD rules become more like fluid suggestions rather than hard and fast dictates, I become confused. How do I know I have done things right? How do I know if I am clean enough? How do determine if I have tried hard enough? How do I know any of these things if I am not pushing myself to the limit of OCD's demands? Exhaustion or frustration are the indicators of completion for me. Without those, how do I figure out whether something is complete? How do I know when to stop? How do I not feel like I am floating untethered through space? It's just hard to figure out how to do things when they suddenly seem to require so much less effort and time.

I miss the security of rules, the completeness, the defined ways in which things must be done. Again, I miss the OCD cage. The world outside and the wide open space seem overwhelming at times, and I want to crawl back in to feel the comfort of my previous boundaries, the bars that rein me in. I know it's a trap...it's a cage that gets smaller and smaller and smaller the more time I spend in it, until I can hardly move. But sometimes I just want to go back in and bask in the false protection it provides.

Thursday, July 15, 2010

An Appropriate Beginning

So my well planned, well thought out trip to DC for the International OCD Foundation's Annual Conference didn't start off quite as expected.

Let me just start by saying that I can't wait to attend the conference. I'm a nerd, and I find learning about OCD fascinating. From the time I first heard about this annual event, I was intrigued, but I never imagined I'd be going. I tend not to do things like this - things that I secretly would like to do, but am either not brave enough to go for or that I tell myself are too impractical so I shouldn't bother - maybe someday when the time is right. But that is exactly the sort of mindset that I want to work on challenging where appropriate, and I think working on that goes hand in hand with learning to fight my OCD. It’s part of creating a life that is rewarding and exciting that makes fighting OCD worthwhile.

Starting this blog is one such example of something that I secretly wanted to do, but normally wouldn’t try. And I’m glad I did. Writing here is wonderful opportunity to express some of the thoughts about OCD that are bustling about my mind, thoughts that I can’t just share with friends since I am not very open about my experience with the disorder with them. But even more than that, I love the encouraging community of support and the chance to read about others’ experiences with OCD. It’s always amazing to me when I read someone’s blog and it seems to echo so closely with my own thoughts and experiences. It’s eye-opening and empowering to know that there are other who think in the same strange ways :).

That said. I’m here in DC for the conference, but it wasn’t easy getting here. To make a long story somewhat shorter, I brilliantly confused the departure time of my flight with it’s arrival time at my first connection. Basically, I didn’t realize I had missed my flight until it had already taken off. I was still sitting in my room happily putting the finishing touches on my packing when, suddenly, I realized my tragic mistake.

I don’t know what got into me but I just started sobbing. Sobbing! After all that has happened in the past year, I sob about this being messed up? Nothing in my whole OCD downward spiral has made me sob like this. I don’t get it, but I guess that’s feelings for you. If I have learned anything in treatment, most of the time you can’t control your feelings, and for some reason mine chose this moment to stage a nice little breakdown. So after having to juggle a series of terrible choices, choices that were equally bad and equally good for different reasons (the worse kind of choice to have - either way I was going to wonder if I was wrong and if that remorse would affect my experience here at the conference), I finally did make a choice only to find out that the flight I had chosen had been canceled during my period of debate. But, in the end, after about 3 hours of frantic calling and searching and more frustrating mishaps, I did get a flight. I hopped in the car as soon as I had it booked, quickly grabbing the remaining things I still needed, and got to the airport with time to spare before my lovely overnight journey.

At first I was so upset that my “perfect” and well-organized plans had been turned on their head. I had envisioned everything occurring in a certain way and now that was completely destroyed. But by the time I finally got a flight and realized that yes, I would be able to make it to the conference and wouldn’t have to miss any of it, and that no, I would not have to pay an arm and a leg to get there in time, I was grateful just to have had everything work out! I think it’s an appropriate start to the weekend because it just goes to show that I can live with changes in plans. Though I had to leave for my flight without feeling “ready” and without having finished all my last-minute preparations, it didn’t seem so bad after everything else.

I think once again the universe is just trying to tell me that even if it’s something that I’m really excited for, something that I am really set on going a certain way, it’s not always gonna happen. But whereas in the past I might have dwelled on whether or not this mishap had “ruined” my whole trip until I could compulsively convince that "I was just as happy and excited as before," I can now sit back and think, “hmmm…this seems like the way a trip to an OCD conference should begin.” It wouldn’t be right for me to make everything about going to this conference compulsively “perfect.” That just goes against the fundamental idea of the whole thing. Fate and my screwy brain wanted to make sure that I couldn’t perfect such a thing that shouldn’t be perfected in the first place, and well, they succeeded. A very appropriate beginning, indeed.

Monday, July 12, 2010

Getting Back on the Wagon

So clearly my original plan to report back daily on my success or lack thereof in adhering to my exposure guidelines has not gone so well so far. Let's just say there's not much to report...

I had an unusually long period of exposure in visiting a friend this weekend, and though I stuck it out reasonably well while I was visiting her, when I came home I immediately tossed all the clothes I had worn at her place in the laundry hamper and took a 50 minute shower not long after.

It's the usual few steps forward on one front and a few steps (or perhaps several) back on another. I feel like it's like trying to over-stuff a box or a suitcase. You shove everything in on one side only to realize things have managed to pop out on the other. I chip away at my fears and habits in one way, but end up giving in somewhere else.

Nevertheless, I don't think the work that I did this weekend while away was all for naught. I did several things that I always avoid (playing with a dog, sitting on my friend's bed in regular clothes, sleeping in my friend's bed in clothes worn around the house, using a public restroom, touching books and DVDs at a public library). Those things will now be a little bit easier the next time I face them. What I need to work on now is the response prevention part of things. I did the exposure but then came home and thoroughly cleansed myself. While I don't think that I completely undid the benefit of the exposure, I think I probably greatly decreased its potential to help me move forward. I know now that I can handle the exposure, but I have not yet shown my brain that I can do the exposure without ritualizing later. And that is where the detriment lies. I may have shown myself that I am capable of doing such things, but I have also reinforced the association between doing these exposures and having to ritualize, an association that is already quite strong.

So it's time to get back on the wagon as best I can. Perhaps if I simplify my goals, I will find it easier. I still plan on trying to do all that I am supposed to, but more than anything, I want to focus on washing for just 60 seconds. I know I can do it. It's just a matter of doing it even if it doesn't always "feel right" and even if my OCD mind says, "No, no this time is different! This time is an exception!" I have faced and overcome such arguments before, and I will do it again.

Sunday, July 11, 2010

Sadness: Coming to Terms with My OCD


It's hard for me to put into reasonable perspective what has happened in my life over the last year. It doesn't seem shocking or abnormal or strange anymore...I mean, I have lived day to day with the changes that have occurred over the last several months. It's like watching something grow...if you are watching it all the time it is hard to notice the changes, but if you only see the growth at extended intervals, the change can be quite shocking.

In reading one blog in particular, I have come to realize that this disorder, and particular the effect that it has had on my life, is serious, and not something that I necessarily just have to push away and ignore. Not that I want to do that, in fact, I'm terribly afraid of doing just that. But it is very easy for me to shove away the changes in my life as insignificant or nothing compared to what others go through - to think that my struggles are nothing. That my disorder and the effect it has had on my life aren't that serious. That I should get over it. It's nothing. I tell myself that people with OCD all over the place go through worse. Again, I am convinced my struggles are nothing compared to theirs. I should shove it into the past and forget about it because it is insignificant in the grand scheme of how bad it could have been.

That I was probably just as bad or worse than individuals who were selected to be on a reality show for this disorder is just starting to sink in. I mean, I hate to admit it, but I watch other reality shows that are probably exploitative of the patients in treatment. They are spectacles of the bizarre things that psychological and psychiatric disorders can result in. They are interesting precisely because they are so bizarre, so different from most of our lives. They are the extreme.

Maybe the OCD Project is different. Maybe these patients' lives don't seem as severely compromised to those without the disorder as patients on other shows with disorders that I don't have appear to me, if that makes any sense at all. But sometimes I wonder at the possibility that perhaps OCD really does seem that strange to those without the disorder. Is this secret inner life that those of us with OCD live really that different from what most experience? How do those on the OCD project appear to those without any experience with OCD? Does their fear really seem that bizarre. Do the things they do to relieve their anxiety really seem that odd to the average person? I haven't experienced all the subtypes of OCD that appear on that show, but I can relate to the powerful sense that, if I just do this one thing and in the right way, whether or not it has any connection to reality, I will feel better and will be able to move on.

Sometimes I feel like I have always been so accustomed to hiding the irrational compulsions that I felt needed to be performed (even before I developed severe contamination issues) that I don't understand how anyone could not know what that was like. I have lived this way for most of my life. I have performed varying compulsions to varying degrees for years, especially mental ones. How did I not know that these compulsions didn't have to be done? Why did I never question my desperate need to do them? I feel like I never really thought about it. It was just my way. I had woven dealing with such compulsions into the fabric of my life. I knew how to perform them, and I knew how to hide them.

I think I take for granted how serious a disorder OCD is. I think I also take for granted how severe my bout of OCD became and the toll it took on my life in many different areas. Watching a show where people are affected enough by the disorder to make a TV show out of it perhaps put the severity of the disorder and my particular version of it in perspective. That the individual whose OCD severity seemed closest to my own was give a recommendation to seek residential treatment after the show drives that point home even further. I spent the first several months in OCD treatment, when I was at my worst, believing that I didn't deserve the specialized treatment I was getting. I felt that I was too demanding, too difficult, complaining about struggles with a disorder that must be much worse for everyone else who sought treatment at the particular office I went to. I didn't deserve their highly-skilled and specialized help because my case wasn't that bad. Even when my therapist conceded to me that I was one of his most severe clients I was still doubtful. It still didn't sink in how far things had gone. I think that it is only as I continue to recover that I am able to assess more clearly the severity of the situation. And with my ability to start to see how bad things really were, the sadness begins to seep into the emotional wasteland that was my life when at my worst. I am beginning to feel again.

I feel like writing about these thoughts and feelings here, as they occur, is part of the healing process for me. It allows me to accept and attempt to understand what happened, instead of just dismiss, ignore, and shove away the past as I have done before. OCD has impacted my life, and it has changed my life significantly over the last year. So much of the time I am worried about so many OCD things in the present that it is hard to devote any sort of emotional energy to what I have lost - and what I have gained. But I welcome back feelings from their long, cold winter of hibernation. I hope that if I can feel more sadness, I can also feel more happiness. At any rate, it is an extremely liberating concept that, even if I do feel sad, I don't have to do anything about it. I can be sad. Sadness is not something that must be immediately banished, even if it seems to come from an irrational source or happen at the wrong time. Feelings are feelings and sometimes they occur in strange ways at strange times. With this realization, it is nice to be able to feel sad. Nice to be able to feel sad and not feel obligated to fight it.

The OCD Project: Episode 7

Ugh, ugh, ugh. I have things to do today and have already spent a significant amount of time on my computer this morning, so I will try to make this quick. I probably shouldn't even be writing this...I should probably just be sitting with the bothersome feeling of anger and the need to express my opinion about it...since that seems to be my weakness...just sitting with and accepting discomfort. But here I go...but I am giving myself a time limit!

Perhaps it is because I feel that I would have been in the same position, or perhaps it is because I often question whether I am actually trying hard enough in treatment, but the attitude taken towards Kristen's behavior on this episode was extremely frustrating for me. I disagreed with so much that was said and so much that was suggested about her. I have talked to my therapist about this notion that sometimes what someone with OCD needs is a good dose of "tough love." Sometimes I feel like if someone would just yell at me and scare me into submission, I would get better. Sometimes I question whether I need "tough love" and whether I am just putting on a "princess act" as they suggest Kristen is doing here. Sometimes the "tough love" voice in my head berates me for not trying harder, for being non-compliant, but this never helps. It only heightens my anxiety and my anger at myself, which in turn, makes it more difficult to stay calm, stop ritualizing, and do what I know I need to do to get better.

When I suggested this idea to my therapist, that I was afraid that what I really needed was someone to harshly whip me into shape, he told me that he could think of almost no examples of where "tough love" was actually that successful in getting people to change their behavior. I suspect that for me, like Kristen, this sort of either all-or-nothing approach would not have been helpful. But what is most frustrating for me in this episode is the insistence on using this approach over and over and over - either get with the program or forget it! Either fight OCD or don't.

Maybe Kristen could have been working harder. Maybe not. She was probably just doing the best she could. I mean, who really wants to have to perform compulsions? Who really wants to feel like they need to throw away or wash everything they own if they ever want to be able to use it again? That is a terrible, horrible feeling. I have never had to do anything as extreme as the exposures Kristen was asked to do in this episode, but I have still had that feeling of "Crap! Now I am going to have to wash EVERYTHING that has been touched or throw away all sorts of things that I still really want and use!"

Why didn't anyone seem to consider that this approach didn't seem to be working for her? No matter whose fault it is, whether or not you can determine whether someone is working hard enough, or whether or not it is just that much harder for them, shouldn't it be the therapist's job to recognize when the client is struggling and then respond and adapt the approach so that the client can be more successful in treatment? Yes exposure and response prevention is a proven method for reducing OCD symptoms, but does it have to be done in this way? I don't think so.

When I watch Kristen's home visit I see many of my own symptoms mirrored in her protection of her home environment. My therapist made regular home visits when I was at my worst, and when I watch the OCD Project it's hard for me not to think about how I think my therapist would have done things. If I balked at the idea of doing something he wanted me to do, he didn't yell at me. He didn't tell me that I needed to get with the program or fire him. He said, well, if you don't feel that you are capable of doing that much, what can you do that is in the same vein of exposure but not as difficult for you? We would then start with that and gradually work our way up, and often, I would end up doing the hard exposure he had wanted me to do in the first place, but without the yelling, without the crying, and without any sort condemnation of the client, their attitude, or their failure to comply immediately and without protest.

The all-or-nothing point of view is one of the cognitive distortions that OCD feeds on in the first place. And when watching Dr. Tolin attempt to force Kristen to do something over and over and over instead of adapting his methods to suit her needs and to maximize her success, I can't help but be reminded of my stubborn attempts to get a ritual right over and over and over. The answer doesn't lie in a rigid attempt to do something again and again in a certain way until it works. Rather, the answer lies in the ability to recognize that a certain strategy isn't working long enough to step back, adjust your mindset, and try something new. Whether it involves stepping away from the sink before it feels "right" or stepping away from a hard-nosed approach to treating OCD, I think flexibility and the ability to adapt the solution to the problem at hand is an invaluable tool.

Saturday, July 10, 2010

OCD and Weight Gain - Can I Fight One Without Fueling the Other?

My thoughts are somewhat scattered at the moment. I feel like there are so many things I could write about, and my thoughts flit from one topic to the next. Half of me wants to write about recent exposures of the past two days and the other half of me wants to write about something more abstract...we'll see where I end up.

I have been thinking about my weight more lately so perhaps I'll go with that. Like OCD, I could write volumes on my experience with weight control, my acute decline into anorexia (8 years ago now!), and what happened after my fairly abrupt "recovery." It is another one of those mental health issues that I have never gotten to talk about much, one of the elephants in the room from my past that I rarely acknowledge outside of the mental health world. And when I do, I often work daintily around the subject, sort of obtusely hinting at what was actually going on without saying it outright.

One thing that occurred as I spiraled down into severe contamination OCD last fall/winter, was significant weight loss. This wasn't the type of weight loss that I experienced, or rather forced, when I was anorexic. I wasn't calorie counting. I wasn't drastically limiting my diet. I wasn't weighing myself every chance I could get. I wasn't exercising five hours a day. Rather, this significant weight loss was a byproduct of my obsessions and compulsions rather than the focus of it.

At my worst, I spent a lot of time lying in bed or on the couch compulsively avoiding compulsions, trying to figure out how to accomplish parts of everyday living without violating my OCD rules, and finally, doing the compulsions themselves so that I could do things that I needed to do. Such necessary things included activities as basic as brushing my teeth, getting dressed, showering, using the restroom, and also eating.

I got to a point where it was very difficult for me to feel clean enough to eat - to touch things in my kitchen, to prepare food, and to actually put the food in my mouth. Since washing before eating was, according to my treatment guidelines, theoretically one of the few situations in which I was actually allowed to wash my hands, I felt that washing my hands, and doing it well, was absolutely imperative prior to eating. Granted I knew that there were many situations in which people violated this supposed rule for washing before eating, and before my contamination crash early last fall, I did, too, more than I ever probably thought about. But OCD kept clouding my memories and judgment with insidious seeds of doubt and question after question:

What if I just thought that everyone else didn't wash at certain times? Maybe they did find a way to wash or at least put hand-sanitizer on or only touched 'clean' things if they knew they would be eating and wouldn't be able to wash. Maybe I somehow missed this - somehow I might have never learned these basic rules that everyone else apparently follows. Maybe my whole life I thought what I was doing was normal when it actually wasn't, when it was actually atrociously disgusting. Perhaps I am just now seeing the way things really are and how most people really behave.

What if everyone else has been living all this time by these contamination rules that I am just now imposing upon myself? What if I was just blatantly ignorant? Somehow I might have failed to learn to do things the "right" way and was just blind to that fact until now. Maybe what I consider so difficult is just part of everyday life. Maybe everyone keeps track of all the things they touch and when, washing and sanitizing accordingly. Maybe they have done this so long that it is second nature to them, whereas this higher standard of cleanliness, this immense amount of mental energy devoted to recognizing and remembering all that I have touched (and when...and in what order...and what all the potential possibilities for 'cross-contamination' are) is simply new to me, and therefore seems frustratingly difficult. Maybe I'm just defective for not being able to keep up, for not being able to run this draining mental program while simultaneously being as productive as everyone else. Maybe I am just weak. Maybe I just need to stop whimpering under the supposed strain of all this, suck it up, and just do it...just do all the compulsions that everyone else is probably performing all the time, too, and stop complaining. And, if I just paid more attention to my hand-washing, to the things I touched, to the order in which I came into contact with things, like everyone else, the supposed compulsions probably wouldn't be required or at least wouldn't take so long! It is my own fault that I have to wash so much and so rigorously...if I just learned to do it right the first time...if I hadn't been blind all along to the way things are supposed to be done...it wouldn't be so difficult!


That was the cruel, cruel voice of my OCD, trying to convince me that somehow I had missed some giant list of rules that were a part of everyday existence, rules that everyone else somehow learned and now followed religiously, rules that I was just now realizing had to be performed. I still feel this way sometimes. Maybe everyone else does things the "right" way, and I am just defective for being so blind, for not figuring out that I was doing things wrong my whole life.

Anyways, I have veered away from my original topic. Basically, that OCD voice in my head resulted in stringent pre-conditions for eating. I had to wash, but in the "right" way, and of course over time, that "right" way became more and more difficult to achieve. Sometimes I would lie in bed all day, hungry, but I would wait as long as possible to get up to eat because I dreaded the hand-washing and sometimes showering that I felt must be performed first. I just didn't see any other way to get to the point where I could put food in my mouth. There was no way around the ominous and threatening compulsions, no shortcut path that provided an alternative to the ever lengthening, ever more demanding trail that OCD laid out before me. It seemed like there was no way around the dense and disorienting underbrush, the thorny bushes, the false endings of the path. I could only go down it and hope that I made it out on the other side with minimal scarring and without getting lost in an endless loop of compulsions. Basically, I often preferred hunger to having to face the possibility of getting stuck for minutes or even hours while performing washing compulsions in my bathroom.. That was how I ended up losing somewhere around 15 to 20 pounds in a matter of a few months, which was a considerable amount for my fairly petite frame. I wasn't underweight, but I was skinny enough that people questioned my weight loss and warned me not to lose anymore. They were concerned and I acted like I was equally concerned, but inside I relished having finally shed these pounds unintentionally.

When I started to get better, satisfying my hunger, as well as just the pleasure of eating itself, began to outweigh the dread of performing washing compulsions, which I slowly began to gain more and more control over. But as it became easier to get myself into the "right" state for eating, I didn't immediately dive back into a normal eating routine. I rationed my eating. I intentionally ate or drank things that I knew would fill me so I could skip meals or reduce their size. I paid careful attention to calories and a few times even started keeping a food log, tracking what I ate and the approximate number of calories consumed. A slippery slope that could lead back into more and more rigid eating patterns, but it made me feel in control. It made me feel like I had something when so much else was a fight. It also made me feel that I was working on and perfecting something. If I had to let my contamination compulsions go, I wasn't about let myself waste away into sloppy oblivion. If I wasn't going to scrupulously wash, I could scrupulously manage my weight.

I had wanted for so long to lose the additional pounds that I had gained after my recovery from anorexia. I told myself that I wasn't foolish enough to go after thinness as zealously and stringently as I had years before, that I knew better now, but that it wouldn't hurt to do what I could to keep my food consumption and my calorie intake a bit below normal to fend off gaining back any of the weight I had lost. If I gained it back would I ever be able to lose it again without going through another period of extremes?

And now, I fear I have gained some of that weight back. I'm pretty sure I have, but I'm not really sure how much. I never know if I am just distorting things again like I did back when I was anorexic and constantly thought that I might be getting fatter, rather than thinner. I don't know if I am really justified in being concerned, or if my over-attendance to fluctuations in my weight and my fear of gaining it all back is simply magnifying what is only slight gain. It's just hard to tell. I'm almost certain that I have definitely gained weight. But how much? And can I get it off again if I really have gained a significant amount of weight?

These are the questions that come to mind. The only way I feel like I have ever successfully reduced my weight is through drastic dieting, first through anorexia and then as a by-product of OCD (though I think my anorexia was basically another form of OCD for me). I know that eating healthily, getting exercise, and not going to extremes is probably my best bet for weight maintenance, but I feel like I am always yo-yo-ing between extreme dieting and reckless abandon in what I eat. Right now I feel the pressure to become more rigid about my eating habits, but I also feel like I always fail at maintaining any such rigidity or resolution. And this tendency to doubt my ability to maintain any sort of normal diet plan pushes me to crash diet one day and give up the next. Sometimes I wish I could tap into the heartless, rigid, unforgiving mindset of my anorexic days again. But then, I think that is just my OCD saying, "Hey, if you just try harder, if you just do this in this specific way, it will work, you will feel better!" But just as with the washing, the rigidity and the discipline of eating that I wish I could have is not realistic. It cannot be maintained and, if anything, things only get worse and worse and worse. And then, even if I am thin "enough," I can't recognize it and I can't enjoy it. By that time obsession and ritual have swallowed up my life. The compulsive need to lose weight steals away the enjoyment, the satisfaction, of being at a weight I could be comfortable with.

So how do I find a happy medium? Can I reduce my OCD without fueling weight gain? And can I really combat weight gain without triggering my OCD? This is something I still battle with and am still figuring out. But I hope to succeed in learning to use moderation...I just can't go seeking moderation too compulsively! :)

Friday, July 9, 2010

Yesterday's Recap...

So, I actually did do better yesterday. Every time I was tempted to cheat (and even when I gave in), I thought about this blog and how I would have the chance to report my success or would have to fess up my cheating.

Yesterday's scorecard:

Hand-washing:

I sincerely made an effort to try to stop AT 60 seconds. Not 75, not 65, not 61, but 60. As for the other parameters, I sometimes followed the rules and sometimes didn't, as the situation suited me - which is not really how ERP is supposed to work. I should be committing to the rules regardless of the situation, because there will always be a time that OCD says, "Hey! This time is different! You can't follow the rules now!" But those are precisely the times when I should be the most vigilant in enforcing the rules. If I merely do exposure when it seems okay, but readily violate the rules when there is any doubt in my mind as to whether it is "okay" to do the exposure, I am undermining the very purpose of the exposure in the first place. I may be showing myself that I am capable of doing the exposure or following the rule, but at the same time I am reinforcing the idea that I have to disregard the rule when certain situations arise. I let OCD win, and I never get to find out whether I could have made it without giving in, whether it was just OCD or not (which I highly suspect it is, or, if it isn't, I suspect that I can get through it anyway). Playing the challenge OCD game is all good when it's easy, but the moment it gets difficult, I tend to bail all too frequently! Something to work on and something to remind myself of when tempted to give in!

Showering:

Yesterday I took a 35 minute shower in the morning before I went to see my therapist. Not terrible, but certainly not my best. (I think my shortest shower on record since this all began was 23 minutes!) I succeeded in resisting the urge to wash my mesh bath sponge thingy, but washed my hands toward the end of the shower before getting out. I am tempted to shower again today, so that everything seems "right" for my day's adventures (going to visit one of my best friends), but I know that I will want to shower tomorrow after staying at her place (especially if I play with the dog!), so I might as well just make myself wait and shower everyday other like I am supposed to for the sake of exposure.

Bed:

I wore the same pajamas last night as I had the night before. As I write this I am actually trying to decide whether or not to give in and place said pajamas in the dirty clothes hamper and end my two day streak of complying with my guidelines (wear the same PJs every night for a week, even if worn around the house). I fear that my pants may have brushed against the bathroom floor so I am tempted to just condemn these to the laundry hamper and start again with a clean pair. It's hard to resist this sort of compulsion because it really isn't that onerous or time-consuming. I just did laundry so the pair of pajamas that I wore last night could be easily replaced. But as I wrote about how I should be doing exposure earlier in this post (under hand-washing), I think I managed to convince myself this is exactly when I should not give in to this compulsion, even though it would be relatively easy and hassle-free to do so. Look! Writing about my exposures and rules for washing is already motivating me! :)

Laundry:

And last but not least, the infamous laundry! I did five loads of laundry yesterday. I mixed "dirty" and "dirtier" lights, as well as "dirty" and "dirtier" darks. I did separate my jeans and towels into their own separate loads, even though I am not really supposed to, because I had enough of each to make their own loads...

And, my crowning achievement of the day: I wore a t-shirt that came from the dirty pile for several hours with no avoidance because I was wearing it! I may feel like I am a roving source of contamination now, especially because I will not be showering today, but so be it! I can fight back against my OCD!

Related post: New Home, New Rules: Part 2

Thursday, July 8, 2010

New Home, New Rules: Part 2

It's been a week since I moved into my new home, and it's looking more and more like I might stick around for more than just a month. That said, it has also been a week since I saw my therapist for the first time after the move, which was when we devised my new improved rules/exposures system. And while I am slowly chipping away at my OCD as a whole, I am a reluctant and all too often non-compliant participant in my own homework assignments which I agreed to.

Usually I prefer to utilize this space as a place where I can record and share all the random thoughts and musings I have about OCD, thoughts that I really can't share anywhere else (except in therapy...but, uh, there's not enough time in therapy for all the things I wish I could say). This is a great outlet for those things I can't discuss anywhere or with anyone else. There are still many, many aspects of my experiences with OCD that I would love to write about, observations and random reflections, but perhaps I should also put this blog to more immediate practical use as well - as a motivational tool.

I go see my therapist once a week, but I have this bad habit of peaking in compliance and enthusiasm for my homework right after seeing him and then slowly giving up more and more as the week goes on. My motivation begins to disappear as I let one thing slide and then another. And after going against the rules or failing to do my exposures repeatedly, I often feel like there is no reason to fight, no reason to find a way to get back on the wagon, until my next session. Of course, this pattern of declining motivation week to week is frustrating and problematic. I want something to grab onto, a nice handhold on my motivation, as I climb up the OCD mountain and eventually conquer it. But all too often I feel myself slipping, struggling to hang on and regain my hold on my determination, until I finally let go, dangling in space until I can see my therapist again, at which time I recommit myself to the difficult climb.

Anyways, I have a history of wearing out every motivational tool in the book. I have tried many different things, but I always feel like I'm slipping as my determination to improve grows weaker the further I get from my last session. I know I have, overall, made considerable gains. I have improved SO MUCH...so, so much, in just the last 6 months or so. I am in a much better place than I was at my worst. But, even so, it would be nice to feel more productive in my fight, instead of giving up half way through the week, and just waiting for the other half to pass so I can see my therapist again and get back on board with the program.

So, as much as I prefer to use this as a space to reflect on OCD in general, I think it might also be helpful for me to list my rules/exposures here to keep me honest, to make me feel more accountable (since I clearly don't feel accountable to myself or even my therapist). Hopefully by posting my guidelines here and regularly reporting where I succeeded or could have done better, in addition to writing about other things, I will be inspired to stay on track and not break the rules :). That's the plan, anyway! And maybe others will even find my mini homework reports helpful (or incredibly redundant!).

So here they are...my rules and my exposures, divided into four overarching categories: hand-washing, showering, bed, and laundry.

Hand-washing
  • No more than 60 seconds per wash (including rinsing).
  • Only use cold water.
  • Only use 1 pump of soap per wash.
  • Touch the faucet with HANDS (I'm the master at inventing inconvenient ways to turn on faucets.)
  • Dry hands w/towel (not paper towels).
  • No more than one cycle (soap, lather, rinse) per wash.
  • Only one hand wash at a time (I am also the master of sneaking in the so-called "pre-wash" which makes all of the above rules much easier to follow when I get to my "actual" wash...)
  • And finally, the somewhat ambiguous "no washing when anxious" - I find this one difficult to understand because I start to think, well, at what point does my concern cross over into full-fledged anxiety? I mostly conceptualize this one as, "no washing when I'm SUPER anxious and know I shouldn't and would normally be able to resist..."
Showering:
  • Less than 30 minutes in length (I was doing really well with this one regularly but then started slipping...trying to get back on track because I know I can!)
  • No hand-washing during shower
  • No washing mesh bath sponge thingy (only allowed to rinse it for 10 seconds before beginning to wash)
  • Only shower every other day
Bed:
  • Wear pajamas to bed even if worn around house prior to going to bed
  • Only go through one pair of pajamas a week (I can go through a new pair every single night or more than one pair each night because of my tendency to condemn sleeping clothes that come into contact with things outside my bedroom...thus the reason for the first rule).
Laundry:
  • Clothes can only be separated based on color - lights and darks - for washing; no separating clothes based on relative cleanliness within these two categories; basically, mix "extra dirty" lights with "dirty" lights and "extra dirty" darks with "dirty" darks (this makes laundry SO much simpler when I actually do it!)
  • And an actual exposure: wear a new article of clothing from the dirty laundry hamper everyday for at least an hour, regardless of what it has touched in the hamper; no washing because of putting on said article of clothing, and no avoiding things because of it
That, is my new, compact rule/exposure list. My goal is to maintain my motivation to adhere to these rules as best I can, throughout the week, and not just at the beginning of it. I think I have managed to do every one of these things at one time or another, but not consistently or on any sort of regular basis. So here's to hoping that writing these goals down here and reporting daily on my progress, will increase my rate of compliance!

And now, time for some laundry!

Related post: New Home, New Rules: Part 1

Monday, July 5, 2010

Learning to Advocate for Myself

It seems like the default state of my mind is often that others are right until proven wrong, and that I am wrong until proven right. I hate arguing about things that are important to me because it becomes very difficult for me to internally support my opinion or my view of a situation. I want to see something one way, but as soon as someone starts pointing out all the holes in my argument or view, I cave internally, agreeing that they have a point. Their version becomes right and mine becomes wrong. It's not until someone else points out the flaws in the other person's point of view, as well, that I begin to see that their stance may be just as fallible, or more fallible, than my own. But until that third party steps in, I have a hard time standing up for my point of view internally or even distancing myself enough to recognize that what that other person says is their opinion and not necessarily fact.

Of course, this is not true across the board. There are certainly those occasional situations in which I feel I am hands down right, or there are those situations in which I can at least say, hey maybe they're right and I'm wrong, or maybe they're wrong and I'm right...doesn't really matter. I can live my life my way and they can live their life their way. But when it comes to subjects where I feel my knowledge and ability to judge is inferior or to situations in which I already struggle with myself on an issue (like whether or not I have OCD), I am very sensitive to others' comments and have difficulty defending my own beliefs. They point out the flaws in my perspective and rather than recognizing that their opinion is just that, an opinion - one way to look at the situation that may or may not be "right" - I take it as truth. They are right. I am wrong. Their external doubt compounds that doubt that I already feel internally.

Needless to say, people who are very confident in their opinions or who have steadfast views about how things should be done can drive me insane. They make me feel dumb, inferior, wrong, etc, if my point of view differs from theirs. While some may be able to dismiss such a person as overconfident or just plain wrong, I feel my confidence in my own opinions beginning to erode away before the assault of such assuredness. They are like the live, real life manifestation of my OCD voice, challenging the way I do or perceive all sorts of things that are important to me.

I'm not really sure what the solution to this problem is, and it is probably a common sentiment that extends beyond the realm of OCD, but I feel like OCD can make it harder to challenge. OCD agrees with the other person and tells you that, yes, you are wrong and they are right. End of story. Instead of your views versus those of another person, a fair one-on-one game, it quickly becomes 2 versus one with OCD siding with the opponent, leaving you outnumbered and struggling to defend your ideals against two foes, one external and one internal.

This is something that I certainly need to work on - learning to emotionally distance myself from others' points of view and to internally advocate my right to have my own opinion, but it can certainly be difficult when OCD puts a metaphorical megaphone to others' lips, amplifying their argument in my own inner world.

Saturday, July 3, 2010

OCD and Eating Disorders...

I realize that I have already written far too many times today, but I have also been productive in other ways, so I suppose I will allow myself excess in this area (as long as I move on to a few other things I need to do after this).

So I was reading a blog about eating disorders. When in high school I had my own stint of excessive dieting and exercise that eventually landed me at my doctor's office and then in therapy...the latter of which I considered pretty useless. Now had that therapist recognized my co-existing OCD, she probably would have been of much greater help. I know eating disorders and OCD are considered separate disorders, but I feel like the way I went about my anorexic behaviors was very OCD in nature, and simply encouraging me to return to normal eating habits did nothing to address the debilitating perfectionism in other aspects of my life.

One of the triggers for eating disorder behaviors that this blogger mentioned caught my attention as I could relate to it both in that context and in a similar way with my OCD. She mentioned that seeing other people relapse into disordered eating could trigger her own desire to return to such ways. I can definitely understand that in terms of what I experienced. If I knew of or saw someone else who appeared to have an eating disorder and I thought they looked skinnier or ate less than I did, then self-loathing was triggered and all I wanted to do was eat less, exercise more, and achieve the same level of thinness.

It is very similar with my OCD. I am getting better. I can't deny it. But when I see or read about people whose contamination issues are now worse than mine, I freak out a little. Usually the freaking out manifests itself in one of two ways (or both at the same time):

1. "Oh no! Maybe I should be more cautious about that! Maybe I'm a hypocrite for not worrying about touching that, too! How could I have overlooked that! I have to be more vigilant, wash more, and live up to my own claim to have contamination issues!"

2. "Oh no! Maybe I don't have OCD anymore! Maybe I have forgotten what it's like. Maybe I need to go wash my hands for 10 to 15 minutes at a time to remember what that sort of torture feels like. I don't want to forget what I went through! I don't want to forget how that was! Or maybe I should force myself to wash in my old ways just to see if I still have the self-control to do it. I should just see if I can still take 2 hour long showers and do 30 minutes hand-washes a couple more times...just to see if I still can. To make sure I'm not getting soft!"

Those are the things my OCD says to me, the reasons why I should ritualize. Of course this is complete OCD nonsense. I do not need to prove to myself that I can still take 2 hours showers. What's the point of that? OCD is telling me I won't feel right unless I know that I am still capable of that, but I just have to take that chance. Is taking a 2 hour shower and risking falling back into old habits really worth it? Probably not. As much as OCD seems to be daring me to try and telling me that I won't feel right if I don't, I think I have gotten to a point where I can take feeling "not right" over enduring a washing binge.

As for needing to be more vigilant and to avoid the same things that others with contamination issues avoid, well, that's just an endless, bottomless pit of a trap. I can never, ever succeed in avoiding all that others avoid because one person with contamination problems will avoid this but not that and another person will avoid that but not this. Everyone is different, and though OCD tells me that I need to acquire others' avoidance patterns if I am not a fake and if I really have contamination issues, I think I am just fine with my own triggers, thanks. No need to add on. I can never be the best at being OCD.

Anyways, reading that ED blog just brought these thoughts to mind. The dangers of comparing yourself to others are apparent for both disorders, and I think recovery from either probably involves a certain degree of being able to accept that there will always be someone that is "more (add your own adjective here)" and that you just have to focus on what's best for your own health, both physical and mental.

Watching the OCD Project

Normally I like watching the OCD project, not because I like to watch people suffer, but because it is comforting to see people doing such hard exposures and succeeding. It is also nice to see others that I can relate to, people who struggle with things I have struggled with or still do.

Today I realized that watching this show is starting to cause me some amount of anxiety. I look at the participants' reactions and think, maybe I don't know what that is like anymore. What if I can no longer sympathize? What if I never really had OCD?

I am doing so much better, even in just the last couple days. The ease with which I have transitioned and started to change my ways frightens me. I feel like there should be a giant wave of anxiety that I have to overcome. This seems too easy. What if I forget how it felt to have that much fear of irrational things? What if I never really had it as bad as they did and was just acting like I had really bad OCD, when actually, I could have gotten out of my rut at anytime if I had just decided that I didn't want to act like I had the disorder anymore.

Guess this is good exposure, watching the show, because one of my fears is discovering that I don't really have OCD, or that I am suddenly over it and don't remember what it's like to have the disorder. I want so desperately to be able to relate to others with OCD because discovering I have this disorder means so much to me. It explains so much, both past and present. The last thing I want is someone telling me, nah, you don't have OCD...see look at those people...now that's OCD!! Then I'd be back at square one with no excuse not to do the things I feel I must do and no excuse for not trying to do things perfectly, even if I know that that perfection cannot be achieved.

Having this fear definitely makes me feel more alone and more like I don't have OCD, too. What sane person with OCD clings to their disorder if they know they are capable of more improvement? It seems like most people that I hear and read about just wish they could banish their anxiety, the symptoms of their OCD. They wish that they could go back to a time before the disorder emerged, a happier time when they were free.

For me, though, I feel like there is no such time. I feel like I have always had the disorder in one form or another ever since I can remember. There were certainly times when it was a lot worse than others, periodic flare ups that caused a lot of distress and noticeable problems, but it was always there in the background even when it wasn't bad, directing my actions and decisions and forcing me to do things I didn't really want to do. Knowing now the more subtle intricacies of this disorder gives me the hope of having a happier life even when my OCD is not particularly destructive or obvious. I am afraid of having that hope stolen from my grasp with proof that I don't have the disorder or that the disorder hasn't affected my life to the degree I thought it had. As long as I continue with my washing compulsions I have the comfort that I, as well as everyone else, can see that something is off. But as the visible compulsions slip away, I know longer have proof that I have the disorder, and my own doubt, as well as others', begins to eat away at me.

As usual I just have to keep going anyway, pushing forward despite my inability to know beyond all doubt that I have OCD.

Motivation


I can feel my motivation to get things done flagging, but for once, not in terms of my exposures. That part, I am happy to say, is going quite well! I am doing things that I stubbornly resisted doing for so long, and sometimes I do them without second thought. However, the real challenge is then resisting the urge to go back through my actions, step by step, touch by touch, to trace the mental history of all that I have come into contact with and the order in which I touched things. When I do this sort of mental retracing, it is because I have an urge to know whether I have "cross-contaminated" things or violated my rules about what can be touched and when, even if I plan on doing nothing about it if I have. It is just comforting to know, I guess, what things might be "dirty" by my standards, just in case I really feel that something needs to be done. I feel somewhat careless and untethered when I don't do this, but those feelings are quite tolerable compared to other forms of anxiety that I have experienced.

I love my new home, but it is certainly a different sort of environment. In my old place, I didn't feel weird at all staying at home all day, but I think that was also because I lived in an apartment complex full of friends and people I knew, so that, even if I didn't hang out with them nearly as much as I used to, I knew they were there. I didn't feel isolated. I felt connected by their presence, even if I didn't actually make an effort to connect and spend time with them once my OCD got pretty bad.

I now live in a house rather than an apartment complex. I live with two roommates, a good friend that I have had for several years now and another person that I just met but would consider a friend at this point already. The first friend is gone for most of the day...like from before I am up to late at night, so I don't really see or hang out with him much on a regular basis. The other guy is here almost all the time. Granted, it is summer and he is still in school, so this is his time off, but it weirds me out a little watching someone else sit a home all day, cloistered in their room, venturing out really only for food or to talk to me. I wonder if this is how my old roommate (a friend that I absolutely adore!) perceived my descent into OCD-land and the resultant increase in the time I spent at home. Surprisingly it really didn't bother me back then! But then, I was consumed almost constantly with following my OCD rules. They occupied so much of my mind that I never really felt bored or like I had a lack of stimulation. There was always more to be done just to carry out the things that need to be done as a part of everyday living - brushing my teeth, showering, getting dressed, doing my laundry, and so on. Getting those things done, was almost enough in its own right. These are all very mundane things, but they were often projects in my mind. They were items on the daily to do list that I didn't always get done.

But now that I have begun a revised version of my exposures (that I am actually adhering to for once) a lot of time and mental energy has been freed up. There is also the fact that I do not yet feel like the cleaning that needs to be done in this house is yet my burden. The mess that is already here is not my job to clean (though I wouldn't mind doing it at all, and might even enjoy it, if I could just commit to not doing anything compulsive and could get past my initial anxiety). So there is a limited number of things that I feel need to be done and the focus is on making my room feel like my room while keeping in mind that I may only be here for a month.

What I really do need to do is look for a job or at least take up volunteering at places where I think it might be interesting to work. I began the job search back when I resigned from my old position, but after the first round of applying to just a few places, I decided it was time to make packing and finding a place to live a priority.

Getting a job still scares me. I'm not sure if it's because I'm still not really ready and functional enough for a job, or if it is just because I have grown accustomed to adapting my time to my compulsions, compulsions that I don't want to be forced to stop completely just yet. I'm not sure at what point I need to push myself into the stage of recovery where I return to work (assuming I can find a job!). I would really prefer a gradual re-initiation to the working world, and volunteering seems like a good next step in the process.

Anyways, I find that just pushing myself forward moment by moment, even if I seem to lack the "right" motivation, is often the best strategy, which is exactly what I intend to do today!

Thursday, July 1, 2010

New Home, New Rules: Part 1

One all-nighter and two very sore feet later, I have completed my move!! I have a new home - at least for the time being.

Along with this new home comes a revision of my exposures. A new more compact, to the point plan that challenges me but is still within my reach. I hope to improve my rate of compliance and push my reluctant self forward into the unknown of recovery. It may sound strange but one of my biggest fears is success in treatment! Who will I be? What will I become?

Though, at its worst, my relapse incapacitated me to say the least, I fear getting better. Why? I'm not exactly sure, but I think that it has to do in part with the happiness that discovering I have OCD has brought me. This may also seem paradoxical, but learning that I have this disorder has been a true source of relief. I have struggled to fight my most recent spate of contamination concerns, but on the other hand, learning about OCD has allowed me to eliminate many other compulsions I was constantly battling, things I didn't recognize as compulsions until reading more about this illness and the various ways it often manifests itself.

One of these little compulsions that I have had for a while has to do with saving a picture in my mind of places and events - mentally capturing them and their essence and stashing them away for future reference. Most of it goes on in my head, but when it gets bad it can crossover into the realm of physical compulsions. I will actually take pictures of things simply to remember them, which I suppose is often the purpose of photos, but I think for me it really takes on a compulsive nature.

For example, before I began dismantling my apartment for the move, I took pictures of each room from multiple angles so as to have a digital representation of my home "as it was" in case my mental picture of it failed or grew fuzzy. I think I probably took around 50 pictures. I even took a picture of the bathroom. The bathroom! My little palace of cruel and inhumane torture. Why would I want to remember exactly what my bathroom looked like? No idea. That is, no idea other than to quell the fear that I might one day want to be able to remember this particular bathroom and won't be able to do so. Sounds silly but I think it's a manifestation of the classic "but what if I want it later? but what if I need it in the future?" hoarder attitude, except with thoughts and mental imagery.

Anyways, I still did some of this as I moved out (obviously, since I took the 50 pics) but to a much lesser degree than in the past. I saw the greatest difference in my ability to limit the length and degree to which I performed this compulsion, even if I engaged in it just as frequently as in the past. Before I would often do such things again ... and again ... and again. I would take my mental picture, and it would feel right for a flash, but as I would turn around to bolt from the scene to escape yet another repetition, it would suddenly seem incomplete. So I would turn around and do it again, and again, and again, until I built up enough frustration to just force myself to walk away.

This time around after the first or second time or turning back, it might still feel incomplete, but I could just remind myself that this was OCD telling me that I needed to get this right, otherwise I wouldn't feel right, or worse, that I would have to keep mentally picturing the place after I had left it behind until it felt "right," if I didn't manage to capture that feeling in the actual presence of the scene. Though most of my work in treatment has focused on contamination concerns, the small victories I have had, and the realization that I don't have to do every little thing my mind tells me "must" be done to feel okay, have allowed me to move forward far more easily. This is what brings me happiness. The small victories and the realization that I don't have to do the million and one little compulsions that I hardly realized I was doing.

Thus, finding out I have OCD has brought me this happiness, and I fear that as I get better I will lose touch with this joy that I now find in such small things - the excitement of simply being able to carry out everyday activities that "normal" people do without second thought. I don't want to lose that appreciation, that thrill. But at the same time, is it worth maintaining or not fighting new compulsions just to feel that joy? Probably not. But still, it is something I fear.

There are other reasons I fear success and getting better, but this is more than enough for today! For now I will try to keep pushing forward, living life in this "new place" both physically and mentally.

LinkWithin

Related Posts with Thumbnails