OCD and The Solving Ritual

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When someone is diagnosed with obsessive-compulsive disorder, education is essential. Understanding what the disorder entails and how to best treat it are key components to recovery. As we know, however, OCD can be very sneaky, and sometimes this quest for knowledge can go awry. Sigh. Just when I thought OCD couldn’t get any more complicated…..

In this excellent post written by Stacey Kuhl Wochner, LCSW, Ms. Wochner explains that sometimes OCD sufferers (many who have had previous success with Exposure and Response Prevention Therapy) begin to feel that therapy is not helping as much as it used to. Why isn’t it working? Maybe they aren’t doing it right? Maybe they don’t truly understand everything about their OCD and treatment and need to learn more? What is happening is the uncertainty about keeping OCD in check is turning into an obsession. Sufferers believe they will never be able to beat OCD; their lives will be horrible.

So they begin a quest to research, learn and discuss everything there is to know about every aspect of OCD. Ms. Wochner calls this “the solving compulsion.” Sufferers might even attempt to engage in ERP therapy, but  for the wrong reasons. Exposures now become a compulsion, a way to reduce anxiety, instead of the anxiety provoking act they are intended to be.

How is this type of OCD dealt with? As Ms. Wochner tells us: “Having unwanted thoughts and feelings about losing control of your OCD is not the problem. Your effort to rid yourself of your thoughts and feelings is the problem.”  So really, it’s no different from other examples of the disorder. Sufferers need to feel the uncertainty about their OCD without allowing themselves to engage in any solving rituals. By doing this, they will be engaging in ERP Therapy in the right way and for the right reasons. Of course this will be anxiety provoking at first (which of course means you are doing it right) but eventually your OCD will lose its power.

I highly recommend reading her post, as I’ve only touched upon some of  the basics. What really became clear to me while reading this article is how crucial it is to have a therapist who truly understands OCD. My guess is there are plenty of health care providers who deal with patients with solving rituals (Ms. Wochner does a great job of describing a typical therapy session) and don’t even realize it. Therapy sessions with these providers will hurt, not help, OCD sufferers.

So yes, OCD is complicated, but not so complicated that it can’t be outsmarted. If you’re armed with a competent therapist and a willingness to face and accept the uncertainty of life, OCD doesn’t stand a chance.

Brain and Behavior Research Foundation

The Brain & Behavior Research Foundation is a New York-based nonprofit organization that has awarded nearly $300 million in mental illness research grants since 1987 to scientists around the world.  They are “committed to alleviating the suffering caused by mental illness,” and offer free webinars, information resources and activities to the public.

I’ve recently been asked by a representative of this foundation to spread the word about an upcoming free webinar about OCD. This webinar is part of their Tuesday series that features leading mental health researchers presenting the latest in new technologies, diagnostic tools, early intervention strategies and next generation therapies for mental illness. I am happy to help spread the word:

The following webinar will be presented on Tuesday, May 14, 2013, 2:00 p.m.-3:00 p.m. ET:

   “OCD & Anxiety: Symptoms, Treatment & How to Cope” with Dr. Helen Blair Simpson

If you have the opportunity to listen to this presentation, I’d love to hear your thoughts about it!

OCD, Career Choices, and Limitations

I’ve written before about my son Dan’s almost lifelong dream of becoming an animator. When his OCD was severe, he came very close to giving up on this dream. My husband and I kept the bar high for him because we knew it was what he really wanted. We realized he was committed to continuing Exposure and Response Prevention (ERP) Therapy and so we encouraged him to go back to school. If it didn’t work out, at least  he would have given it his best shot. Though there were some difficult times, one year ago Dan received his Bachelor of Fine Arts degree in computer animation, and he now works in his chosen field.

During his stay at a residential treatment program for OCD following his freshman year, Dan’s therapist suggested he become an art teacher; he felt that road would be less stressful for Dan . While an art teacher is a great job for someone who wants to be an art teacher, Dan never had the slightest interest in the teaching field. I am thankful he decided to stay on track and pursue his dream.

For some OCD sufferers, however, original educational and/or career plans might not work out. Maybe college is too stressful, maybe a particular work environment elicits a multitude of triggers, maybe a job is just too demanding. Maybe those with OCD might have to work toward their goals differently, at a later date, or not at all. A competent therapist who knows the sufferer well and specializes in treating OCD can help decide which paths to take. But is having to alter life plans a sign that OCD is “winning?”

Not in my opinion. Because really, don’t we all have limitations? I would have loved to have been a nurse, but blood and needles make me squeamish. Whether it is due to illness, life circumstances, or just who we are, most of us face detours as we travel through life. We compromise, we adjust, we revise our dreams. Even as an animator, Dan has realized there are certain aspects of the profession that aren’t a good fit for him, and so he is steering his career path accordingly.

Because obsessive-compulsive disorder is an illness which can totally control a sufferer’s life, and successful treatment involves not letting it, I think there might be a tendency to feel defeated if OCD has to be factored into the equation when making these life decisions. Again, I think it’s important to remember that we all have challenges that need to be considered when making life choices; what we desire might not be what’s actually best for us. While those with OCD might need to acknowledge their disorder, it doesn’t mean that OCD is “winning.” It means they are being honest with themselves. And if OCD sufferers, indeed if all of us, maintain a positive attitude and endeavor to live a fulfilling, productive life, the real winners will be ourselves.

OCD and Time Management

Clock in Kings Cross railway station (Photo credit: Wikipedia)

Time management is a hot topic these days. Whether related to the workplace, school, homemaking, child-rearing, or our personal lives, there just never seems to be enough time to do all the things we need, or want, to do. We are so overloaded that there are self-help books, as well as experts and entire companies dedicated to this subject. When did it all get so complicated?

And if you have obsessive-compulsive disorder, there’s a good chance you’ll have even more obstacles to overcome.

To me, one of the most frustrating aspects of my son Dan’s severe OCD was how much time he appeared to spend doing absolutely nothing. He had schoolwork and responsibilities to attend to, yet he’d just sit in a “safe” chair for hours and hours on end. I now know that he spent this time focusing on his obsessions and compulsions, which were in his mind and not obvious to me. As Dan’s OCD improved, the chair sitting stopped, but he still often took longer than others to complete his school assignments. This seemed to be attributed to his difficulty balancing details within the big picture as well as over-thinking.

While Dan’s problem of apparently wasting time is common for those with OCD, the opposite end of the spectrum can also be an issue. Some OCD sufferers might feel the constant need to be busy and productive, as well as having every event and task of the day carefully planned. For Dan, spur-of-the-moment plans were not even a possibility when his OCD was in control.

Something else OCD sufferers might deal with in regard to time management is lack of punctuality. This might be because they feel the need to finish whatever task they are working on before they can move on to something else (even if most people wouldn’t consider it important), or perhaps due to trouble with transitions. Of course, time spent attending to obsessions and compulsions can always account for any struggles with time management.

From what I’ve written, it is easy to conclude that those with OCD do not manage their time well. But actually, I think the opposite is true. OCD sufferers are excellent time managers. Look at everything they have to manage! For example, even though my son Dan sat in his “safe” chair for hours on end, somehow he was still able to meet all his responsibilities. Many of those with OCD not only fulfill their own obligations, they meet the “obligations” of their disorder as well. Of course, not surprisingly, this load might finally become too much to handle.

In my opinion, those with OCD don’t need lessons in time management. What they need is to fight their OCD. Obsessions and compulsions are time-consuming, as is constant worry. Getting back the time that OCD consumes is nothing short of a gift and can open up a world of possibilities to not only OCD sufferers, but to the people who want to spend time with them.

I’d love to hear your thoughts on the subject.

OCD Network to Recovery

Thank you to everyone for the great response to last week’s post, both via comments and email. Several readers thought my idea would be a worthwhile one for IOCDF Affiliates to adopt, and I hope these organizations will consider it. Additionally, many readers appealed for something to be implemented as soon as possible. With this in mind, I’ve created a new page on my blog called OCD Network to Recovery. If you click on this tab, you will find links to two forms. One is for those who have not yet been able to embrace therapy for OCD, and the other is for those who have undergone Exposure and Response Prevention (ERP) Therapy and found it helpful. The page has instructions for getting the forms back to me, and I will do my best to match people.

I’d like to stress that what I am doing is simply facilitating connections, and I cannot make any guarantees regarding how successful, if at all, this networking will be. But I think it’s worth a try. As I look back on the horrific events of this past week, I am in awe of all those who risked their lives to help others. While I am in no way equating this network with these heroic acts, the simple lesson of helping others whenever and however we can rings true. To me, that’s what it means to be human.

So we will see how it goes, and I will keep everyone posted.  Certainly if you have any comments and suggestions as to how these forms could be improved, I’d love to hear them.

Helping Those With Recovery Avoidance

As I’ve said before, one of the most heartbreaking aspects of OCD is the frequent occurrence of recovery avoidance. Obsessive-compulsive disorder is a potentially devastating disorder, but it is treatable. Yet so many sufferers are so terrified of treatment, and perhaps of even getting better, that they cannot bring themselves to even attempt Exposure and Response Prevention (ERP) Therapy.

So what can we do when someone we love has OCD but is not “ready” for treatment? The above article gives suggestions which include expressing our concerns to our loved ones, not enabling them, and continuing to live our own lives in a positive manner. So many families of those with recovery avoidance follow these recommendations as best they can. Sometimes there are positive results, and other times, the OCD sufferer continues to deteriorate before their very eyes.

It’s hard, especially for parents who are used to making everything “all better,” not to intervene. How can we just sit around and watch our loved ones get sicker and sicker? And so we continue to search for therapists, continue to learn everything we can about OCD and its treatment, and continue to look into every program and facility out there. These are all positive actions but the truth is unless the person suffering from OCD is ready to accept help, our efforts are likely to be futile.

To me, the big question is how can we persuade OCD sufferers to commit to treatment? We try talking to them, and taking them to a myriad of health-care professionals who also try to get through to them. We feel desperate, and resort to begging, pleading, and even yelling at our loved ones because we don’t know what else to do. They say we don’t understand, and it’s true, we don’t. Who could understand?

Other OCD sufferers. What if we could form a network of those who have suffered severely from OCD and have found their way back to good health? What if these people were willing to have a conversation or, as long as I’m dreaming, even visit with those who do not yet have the strength to fight? Certainly we have seen how blogging, connecting at conferences, and attending support groups can be beneficial. What I envision is an established resource, a speaker’s bureau of sorts, comprised of people who are willing to use their own experiences with OCD and successful treatment to help others gather the courage to pursue wellness. Not so much speaking to an audience, but one-on-one. Is this feasible? Does it already exist and I don’t know about it?

I’d love to hear your thoughts about this idea, as well as any other suggestions you might have as to how we can help those who avoid recovery. There must be a way we can make a difference in the lives of those who are trapped by severe OCD.

“Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the only thing that ever has.” – Margaret Mead.

OCD and Pets

When my son Dan’s OCD was at its worst, his anxiety levels were sky-high and he could barely function. It would have been ludicrous for me to suggest he try yoga, or meditation, or any other stress reduction technique to help him feel better when, in fact, he could hardly get off the couch.

But he could pet our cats.

Our two cats (Smokey and Ricky), both so lovable with distinct personalities, helped Dan immensely during those dark days. Whether they sat on his lap, just curled up on the couch next to him, or purred so loudly they sounded like engines revving, they allowed him to relax and brought him momentary peace. Other times they would engage in various cat-like antics, inciting a rare, but oh so cherished laugh from our son.

They didn’t bombard him with questions, asking if he was okay, or if he was hungry, or what was wrong. They were just there with Dan, and for a short time, his focus was diverted from his obsessions and compulsions. Smokey and Ricky were able to care for Dan in a way the rest of our family could not. A new article in the April 15, 2013 issue of Time magazine called “The Mystery of Animal Grief,” explores how animals grieve. I found it fascinating, and no matter how you might interpret the various studies discussed in the article, I think it is hard to argue with the belief that animals do indeed form relationships, and are empathetic. What more does it take to comfort someone?

Certainly, there are many concrete examples of how pets can affect the lives of those with OCD. For example, if you have obsessions revolving around germs, I would think having to empty a litter box, or having your dog lick your face, would be quite an exposure.

When Dan moved into his own apartment last year, one of the first things he did was foster a cat from a shelter. He has always been an animal lover, and was looking for a furry friend to keep him company. As he knows, life is full of surprises, and come to find out, his new companion, Cody, has a host of medical problems, and needs to take medication to control her seizures. Instead of returning Cody to the animal shelter (something I very well might have done) he has embraced his role as caretaker. Whether we have OCD or not, I believe this experience of putting another’s needs ahead of our own is so worthwhile; focusing outward instead of inward can give us a different perspective.

So it works both ways. We take care of our pets, and our pets take care of us. They often force us to slow down our lives, make us laugh, and give us unconditional love. And for those who are suffering, they provide the much-needed comfort and serenity that can’t be found elsewhere.

I’d love to hear from those with OCD about how pets have affected your lives.