Sunday, April 24, 2011

Trying to Change

I'm not even sure what to say.  Other than the fact that I'm definitely in new territory.  I'm finally committing to a more extreme method to ERP (at least what seems extreme to me), and I'm not sure what to do or how to feel about it.  Let's just say it's not as bad as keeping myself out of contact with water for days on end, but it feels that way to me.  I still get to shower and wash my hands, but not in a way that really provides any sense of cleanliness.  It seems all wrong, and it's only been a few hours since I started this new regimen.

How did this all get started?  Well, after I ended my outpatient intensive treatment program back toward the end of February, I went back to the standard once a week therapy regimen.  I improved a lot during the few months that I did the intensive treatment, but little by little, things have begun to slip again  over the last month and a half.  So yesterday I scheduled a last minute session with my therapist for this afternoon.  My compulsions were just becoming overwhelming again, and as much as my OCD kept chanting, "Come on.  Just push through.  Just put up with the compulsions for now.  Stay strong and don't call your therapist.  You can get through the compulsions if you just do them already and do them right,"  I went ahead and made the extra appointment.

One thing my therapist and I have recently discussed a bit more seriously is the severity of my OCD.  It's hard for me to see the severity, because, well, compared to how I used to be, I am far more functional and adaptable.  Even so, my symptoms apparently still fall in the range of quite severe.  And I actually find this INCREDIBLY comforting.  It's like someone is telling me that life doesn't have to be this way.  That life isn't actually this hard, and that I'm not just bad at keeping up with the rigors of daily life.  I find comfort in the fact that so many of the things I do are not actual life requirements but those of OCD.  And I find comfort in the fact that so many of the things I do are compulsions, and thus, not necessary to put up with.

I think one reason I often find it so hard to see where I'm at in terms of severity is that I have pretty much ALWAYS had OCD.  It hasn't always manifested itself in this particular way, and thus, I can imagine a life without all my contamination compulsions, but it is deeply rooted in many other areas in my life.  Contamination is just the latest iteration, the latest vehicle through which my OCD has chosen to express itself.  So, while I can imagine not washing my hands all the time or taking super long showers, it's hard for me to fathom living life with relatively minimal OCD, because, well, I'm not sure I ever really have.  And that's a terrifying thought, in addition to being an extremely hopeful one.

Anyways, it's hard to imagine another way of living.  A way in which the OCD part of my brain doesn't commandeer choices and actions so thoroughly.  I have discovered, through the process of treatment, that so many of the strange things I did as a child and later on into adulthood, things that I thought were just "the way I had to do things," were actually deeply rooted in the world of OCD.  I have read chapters from OCD books, blogs, articles, etc. and found perfect descriptions of my own behaviors, behaviors I always knew were strange but just never really thought much about.  I just thought I had to put up with them, or that I "wanted" to do them and could force myself to stop if I really wanted to.  It was jarring, especially when I first began reading and learning about OCD, how well the descriptions fit my behaviors.  Moving from chapter to chapter, I could recognize myself in so many of the pages, in so many of the different types and ways OCD could manifest itself.  Some were compulsions I still engaged in while others were compulsions I had performed in the past and had since faded.  But even so, reading about those compulsions still conjured up a powerful sense of empathy and understanding.  I feel like I KNOW the pain of so many types of compulsions, of how it feels to find yourself doing these strange, nonsensical things without really knowing why or why you just can't seem to stop. 

I KNOW that feeling.  What I'm not sure I understand is what it's like to live without constantly tweaking, navigating, strategizing to appease OCD.  Because the more I learn about OCD, the more convinced I am that I have always had it and have, more often than not, been driven by an attempt to pander to it in so many different ways.

So what does life look like without OCD?  Or even with just well-managed OCD?  I'm starting to feel like I really don't know much about that kind of life at all.

My point in bringing all this up is that my last-minute appointment with my therapist focused a lot on helping me to conceptualize the severity of my OCD, even after all the improvements I have made.  And though this may sound daunting or frightening, it actually seems incredibly helpful and hopeful to me.  It serves as an impetus for change.  I needed that reality check.  I really did.  Because in just trying to get by from day to day, I forget that I am still living a heavily OCD-centered life.

One thing that really caught my attention was when my therapist said, "this is the kind of stuff that gets people into intensive residential treatment programs."  Part of me yearns so much to have just such an opportunity.  The idea of dropping everything, living somewhere else, and focusing solely on fighting OCD seems like a dream.  To have that kind of support.  To have that sort of jarring change in life structure to propel you onward in your fight.  It sounds so nice.   Don't get me wrong, I'm sure it is extremely hard and a lot of work, but all the same, I envy those who can afford to enroll in such programs and devote their time so fully to getting their lives back.  Being able to participate in a residential program seems like it would be such a relief.  I could stop trying to limp by living this double life of working and fighting and hiding my OCD.  I could stop telling myself that my OCD is nothing and that I should just push through the compulsions or not do them.  I could put those burdens down for a moment and admit to myself just how much I need help.  I could turn myself over to process of getting better.

Unfortunately, I'm not sure that's really an option for me.  I keep trying to get by on my own and through what my local treatment center can offer me.  And if I put in the work and actually do what my therapist wants me to do, I know I would get better.  It's just, well, hard.

Anyways, I'm trying a new approach, one that my therapist has long wished he could get me to try but not something I have ever bought into.  It is more extreme.  It turns my showers into 5 minute opportunities to just shampoo my hair.  It means that I don't get to wash my hands with soap, only cold water.  And it's completely turning my world on its head.

But then, if want to recreate for myself what it might be like in a residential treatment facility, I suspect this might be how things would go.  So I wish I could afford and fit that sort of treatment into my life?  Well, then I might as well do on my own what they would ask me to do in that sort of environment.

So I'm doing what my therapist has asked me to do.  It may be extreme, but honestly, trying to whittle away at my OCD bit by bit has been a slow process.  I'm trying to take the severity of my OCD more seriously and meet it with more serious treatment strategies.  I'm not sure how I feel about all this extreme-ness at the moment, but all I am asking myself to do is to commit to these exposures for the next few days until my next appointment.  I'm tired of backing down and giving in.  I'm tired of letting my OCD find ways to work around my exposures and minimize their effectiveness.  I'm trying to create a break with my OCD and a sense of change.  And I suppose this is a great way to do just that.  I wanted an impetus for change; well, here's my chance.

Thursday, April 7, 2011

White Hot Anger

I don't know how to handle my anger sometimes.  It's both OCD related and not I think.  The OCD part comes in with beliefs like, "I must never show my anger."  "I must, at all times, maintain composure."  "I must act cordial and polite even if I am incredibly furious."  "Letting anger affect your actions and decisions is unacceptable."  "As an adult, you cannot let emotions affect your ability to do your job and do your best."  "You can't show your anger or express your frustration unless completely, 100% certain you are justified in being upset."

These are the kind of should/must type statements that I have known as a common OCD pitfall ever since the day my therapist handed me a list of some of the cognitive distortions often found in OCD.  The perfectionism takes the original anger and fuels it.  It stokes the fire by adding to the initial anger another kind of anger:  anger at myself for not being able to stay completely emotionally detached, anger at myself for giving in and letting my anger get the best of me.  Basically, it's anger at myself for getting angry.

Why am I bringing this up?  Well, I got incredibly angry yesterday.  And in the process, I actually said aloud, to a friend, a small fraction of the things he does or says that piss me off.  Like REALLY piss me off.  I finally just let it out.  I couldn't take it anymore.  Or that's how it felt anyway.  Something he did and a few things he said just finally broke my self-control.  I picked a fight with him.

I don't fight with people.  I just don't.  But I picked a fight with him.  A very loud, angry, no holding back kind of fight.  And yet he still insisted that he had no idea why I was mad at him, which just pissed me off more, because a large part of my anger at him stems from his seeming inability to go out of his way to consider others' feelings, to do things, not because he has to, but because he wants to show that he does consider others and how they might or might not be affected by his actions.  His inability to understand why I was angry was the perfect example of why I was angry in the first place.  I just wanted him to put himself in my shoes from a moment, to at least TRY to see things from my point of view, rather than dismiss my concerns as nonsensical.  I wanted him to show some sense of apology.  I wanted him to meet me halfway.  I agreed that he had a point on some things, but he was too stubborn to even give consideration to my way of looking at things.  He just dismissed me again and again and showed no remorse and made no attempt to apologize for having hurt me, whether or not it made sense to him.

Anyways, I let it affect my choices, my behavior, and that really bugs me.  If I like a sense of control, well, anger and making choices because of anger seem like the exact opposite of self-control.  And that made me even more angry - at myself and at him for having the power to unleash such strong feelings.  I don't really know what the "right" thing to do would have been in this situation.  I will concede (and did) that he had a number of good points.  But he refuses to acknowledge or consider any of my own.  For every reason I gave him for my anger, he proposed a counter reason, a defense.  All I wanted was an, "I see, well, I may not agree, but I acknowledge your argument.  And you might have a point since I know that others may see the world differently and I may not always be right.  I may not be able to put myself in your shoes, but I'm sorry."

But all I got was a dodge, a dodge, and another dodge, followed by, "I still don't understand what we're fighting about."  He didn't understand what we were fighting about because all he was willing to consider was his own side.

I think what gets me more riled up is his seeming lack of self-doubt.  I say "seeming" because I know part of him is deeply lacking in self-confidence.  I hate that, even if any of my arguments do reach him, he certainly won't ever show it.  Besides, I'm not sure he believes any arguments or is willing to believe any arguments other than his own.  So he won't budge, staunchly assured that he is right, leaving me fuming because he keeps questioning why I'm angry and then discounting all the reasons I give him and claiming that he still doesn't know why we're fighting.

The fact is, whether or not he understands it, I am extremely angry with him.  Furious actually, in a way I don't often become.  And the fact that he won't come down from his tower of superiority to stop and think for a moment that he might not always be right, well, that just compounds the anger further.

Anyways, I don't know how to handle anger.  I spend most of my time telling myself that I should not be angry, that I should keep my frustrations to myself.  That I should be able to keep a civil outward facade at all times.  But the anger slowly wears cracks in that facade.  And well, yesterday, it came bursting out.

I feel both dumb and yet also justified.  However, I hate how I am already beginning to feel like I am the one that should apologize, like I am the only one in the wrong.  He seems to in no way think that he could be wrong, and it infuriates me that, even now, I am losing grip on my feeling of being justified in my anger.  I am beginning to believe him.  I am beginning to succumb to his confidence again.  And that just spurs more anger.  More anger, more anger, more anger.  Anger that he provoked me, anger that he can't seem to understand how he provoked me.  Anger that he doesn't seem to doubt his arguments in the slightest.  Anger that in his facade of certainty, my ability to justify my anger seems to melt away. Anger that he doesn't seem to feel he could be wrong in the slightest, and anger at his unwillingness to really consider my thoughts and how I might have been hurt rather instead of just throwing out counterarguments about why I can't be angry with him.  Because the fact is:  I am angry.

Angry.  Angry.  Angry.

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