Wednesday, February 2, 2011

Things I Have Learned The Hard Way

As much as I believed there would come a point in time when I would feel ready to climb the hierarchy of exposure to minimize my OCD, a time when it would feel "right" and "easy," that time has yet to come.  It seems that I can't reach the top without first having to commit to exposure whether or not I'm sure it's "okay" or "right."  I had hoped I would find another way, but it appears the only way to go is, in fact, up. 

Sometimes no matter how many times you read things, they don't start to make since until you've gone through them yourself.  I am admittedly a huge nerd when it comes to OCD and OCD treatment.  I love reading about this disorder - in books, through articles, on others' blogs :), you name it!  And yet, despite all I have learned from all the reading I have done, despite all my time spent in therapy, and despite the fact that I BELIEVED in what I had read and what my therapists recommended, some things just didn't sink in until I'd experienced them for myself.

I have been in treatment for quite some time now.  And I have now been in intensive treatment for about two and a half months and am beginning to taper off.  I have improved vastly and yet there is still a ways to go.  With all this in mind, I thought I'd discuss some of the things I have come to realize in the process of treatment - things that didn't sink in until, oh, fairly recently.  I've probably read them all before or been told them a thousand times in a thousand different ways, but now I've finally come to realize them for myself.  Here's what I have so far.  It's just part of a list I'm sure will never be done as long as I continue to fight my OCD and learn from it in the process.

1.  Almost all exposures seem like "too much" at first.  Unfortunately almost every noticeable jump in improvement has come from doing the exposures that seem like "too much" initially.  It's not that the little, easier ones don't add up, it just goes a lot slower.  Now when I balk at doing an exposure suggested by a therapist because it seems like they are unknowingly asking me to do too much at once, I try to step back and accept that this is how it often feels before progress is made.  This is how I once felt about exposures I no longer find so distressing, so maybe, just maybe, my therapists' really aren't crazier than I am ;).  Maybe, as absurd as it seems, I should do what they suggest, because well, I do want to get better someday as much as I find that idea frightening, too!

2.  To go along with  #1, when I finally do decide to do that "big" exposure, the one I think is going to be THE turning point in my treatment, the one that is going to shatter my world and force me to change entirely in a way that I am convinced I am in no way ready to accept, well, it soon becomes just one more step in the context of my hierarchy and to my shock and relief I am still me and my world hasn't imploded.

Many exposures start out seeming like THE BIG ONE that will turn my world upside down, that will suddenly leave me lost and OCD-less, stranded in the wide open world of mental wellness (Eeek! Mental wellness?...What a terrifying thought!  Why would I ever want that???)...but with time each of those BIG exposures fades into the background.  They become just one more step in the process of recovery.  My conviction that I will have to abandon the "old me," that I will be forever changed in a way that is too distressing to handle if I do an exposure that seems really hard, has again and again been disproved.

I suppose it could happen.  I suppose one day I might do an exposure and suddenly find that I am magically OCD-free in way that is entirely unsettling.  That's part of the uncertainty of it all after all.  It's a risk I just have to take. But when I find myself thinking, "No I can't do that!  That would make me OCD-less and then I wouldn't know what to do!"  Well, I have to recall the other exposures that were supposed to make me become some sort of mutant deformed version of my former self and recognize that I'm still here, still have OCD, and am still plugging away doing exposures.

3.  I will not just "snap out of it" all at once.   The conviction that maybe, just maybe, I could just "snap out of it" has haunted me throughout much of my treatment.  First of all, the belief that I might be able to just "snap out of it" if I tried hard enough, left me feeling terribly guilty much of the time.  It made me feel like a fake.  It made me feel like I wasn't trying hard enough.  Because, when I believed that I could just "snap out of it," it seemed to mean that any attempt to get better short of stopping completely wasn't good enough.  It made it seem like I was wasting money dallying around in therapy.  It seemed to mean that, if just "snapping out of it" was really an option, then I should be able to.  I knew that my compulsions had become more harmful than helpful, so if I were to admit to myself that I was capable of not doing just one of those compulsions, then I felt that I had no excuse to continue with the rest of them either.

Half believing this idea left me paralyzed for quite some time.  I didn't want to do exposure work, because it seemed like an admonition that I really could just make myself "stop."  And if I could stop doing some compulsions, how could I justify continuing the rest?  If I could stop doing some, I should be able to make myself stop doing all them all, right?  "Giving in" and doing exposure work seemed like proof of my failure, evidence that if I really wanted to, if I really tried, I really could stop all at once.  If I didn't do any exposure, well, then I could avoid dealing with that guilt altogether.  If I just didn't start, then I didn't have to face the terror of whether or not I was trying "hard enough."  Problem was, if I didn't start, if I bought into the belief that if I stopped doing one ritual it meant I had to stop doing all of the others at the same time, I was never going to move forward at all.  Facing the discomfort of doing exposure, while recognizing the possibility that I could be doing more, has been one of the many fears I have learned to face in this process.

4.  Sitting with discomfort post-exposure is not the same as sitting with the discomfort of performing mental ritual post-exposure.  This has been a pretty recent realization, like, sometime in the past month.  For the longest time, I didn't understand how I was supposed to get myself to do a hard exposure, knowing that I was supposed to just sit with the discomfort afterward.  That's because I was doing some pretty onerous mental rituals post-exposure and thinking that the discomfort of performing those rituals was what I was supposed to deal with.  Exposure has recently become MUCH easier with the realization that this isn't what "sitting with the discomfort" means at all.  Now I know that I was forcing myself to sit with the discomfort of doing even more ritual rather than the discomfort of NOT doing any rituals. It's much easier for me to get myself to go into an exposure knowing that I only have to deal with unwanted feelings afterward.  On the other hand, getting myself to do exposure when I think I have to endure endless mental rituals afterward to make things "right" - that's much more difficult. 

So anyways, now that I know that "sit with the discomfort" doesn't mean "force yourself to put up with the unpleasantness of demanding mental rituals," and now that I have begun to recognize and resist those mental rituals for what they are, well, things are starting to get easier. Being able to recognize my rituals for what they were and that they weren't the discomfort that was being referred to was the hard part.

5.  Getting better "someday" means progressing "too much" today.  Do I want to get better?  Of course!!  Someday, that is.  Someday in the future I would like to be able to do all that I cannot do now.  Someday I will feel ready to be whole and unencumbered by OCD limits.  Etc. Etc. Etc.  The problem is, I thought that "someday" would have already arrived long ago.  But here I am, much better but still very limited by the confines of my disorder.  The thing that I kind of overlooked was that whole middle part - you know, the part where you have to do the work and you don't like it and you feel like it's "too soon" or "too much" or "not time yet."  Yeah, I kind of forgot about that part.  Somehow I thought a day would just eventually arrive when the work would suddenly seem easy or when the motivation to overcome the OCD would push my to barrel through the work even if it was hard.   But as far as I can tell, that hasn't happened yet and may not ever.

Waiting for the day when I feel like being "better" to take action, waiting for a time when I'm 100% sure I want to be well and want to do exposure, isn't exactly a sure-fire strategy.  In fact, in retrospect, it's almost doomed to fail.  It is unlikely that there will come a day when suddenly getting "better" seems easy or completely "right."  If that day does come, it probably means that I'm doing something wrong...  So anyway, lately when I have had the thought, "I can't do that yet!  That's asking me to move forward way too fast!  Faster than I need to in order to get better in the near future," I try to remind myself that I have followed this mantra for quite some time.  And guess what?  That day where exposure and getting better seems like the 100% "right" thing to do, well, it hasn't come yet. So I have come to the hard-learned conclusion that it's time to start doing even if it seems like it's too much too soon.   It's time to go with the assumption that maybe my therapists DO know what they are doing and are helping me in well-planned and appropriate ways.

Then again, my therapists could just be crazy sadistic tyrants who don't know what they are doing and enjoy watching me squirm.  Guess that's just a risk I'll have to take ;).

Anyways, I hope that someone out there might find this helpful, that maybe someone will be spared some of the trouble of figuring these things out on their own.   Then again, I probably read almost the exact same things in a million different ways and in a million different places and still didn't really get it for myself.  Sometimes the only way figure things out is to do it for yourself, to take the chance and finally just do the exposure whether or not it seems "right."


  1. This resonates with me BIG TIME. Thanks for the tips - some of them I have yet to "realize". I can understand the idea that your realizations have taken a while for you to come to terms with and perhaps - accept? I am right there with you. My last post - when I described two big exposures that I did - oh boy - did I struggle BIG time for about 24 hours after that. But the anxiety went away. And I'm fine now. I'm proud of myself actually. :o) Great post!!! I will re-read it again I'm sure.

  2. Hi! I just wanted to thank you for commenting on my blog several months ago, and let you know that I responded to one of your comments.
    This post really resonated with me, too. I bookmarked it to read more closely when I'm a little less tired (it's 2 am!)... But from what I read so far, I totally agree. If an exposure doesn't seem impossible (or nearly so) at first, it's not going to yield the results you're hoping for. I think having OCD has completely changed my understanding of what it means for something to be impossible.

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  4. Good post. My therapist told me last week that she didn't think the "right time" would ever come, that we should just start doing exposures. Sometimes it seems like ERP is just a form of torture, though. :)
    And I also feel like if I can through my efforts get better, that just shows it's all my fault and I should be able to get over this right now.

  5. Fellow Sufferer--Wow. This is really big! I also resonate with it! Waiting to do exposures until I can do them "exactly right" or waiting until I'm 100% ready. Thank you for articulately this all so clearly, and congratulations on your hard work in this middle time.

  6. Really great blog! Thanks, I was looking for strength when sitting with my discomfort after doing one of the top things which horrify me on my hierarchy....What i felt was WAY too early on, so seeing your blog and the comments are helping me to sit with my anxiety. im dying to wash my hands like crazy i must admit....its nice to see others feeling the same as me...i wonder how my therapist lives with herself when she sees how upset and tortured i am...i too am trying to believe she knows what she's doing! :) Thanks very much to all of you and take care and good luck as we all continue our personal battle.

  7. One thing to think about -- don't get too OCD on resolving OCD. :) I think the best thing to do is remember that everyone can have a nugget of OCD in their lives... and that the big thing is, to always WANT to do things that you DON'T want to do. Almost for the sake of it by itself in the beginning... because once you get more used to doing things you DON'T like, and thrown out of your comfort zone, your comfort zone becomes less rigid.



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