To Tell or Not to Tell


Yesterday’s book launch was a moving, amazing day for me. Hard to put into words, but I will try at some point. This week I’d like to share a post originally written in June, 2012:

I’m an advocate for OCD awareness. I believe obsessive-compulsive disorder needs to be talked about, openly and honestly, so that we can foster understanding and acceptance. Silence is not an option and only serves to perpetuate the ignorance and confusion that already surrounds this mental health disorder.

So when Dan was filling out employment applications, and they asked if he had any “medical conditions,” what do you think I advised  him to do?

Lie, of course.

No question about it. I’m a hypocrite, and the first to admit it. But as I’ve said before, OCD is messy, and it’s a lot easier to write about my thoughts and feelings than to actually carry out my own advice. I, like everyone else, am a work in progress.

The reason I gave Dan this advice (and I am not going to address the fact of whether he took it or not) is that I thought, rightly or not, that once the employer saw “OCD” on Dan’s application, he would not even be considered for the job. Who knows? That may or may not be true. Maybe the employer has OCD and Dan reporting it would be a plus?!  So I realize that while I have no problem talking about OCD and advocating for awareness when I know I’m dealing with people who are already accepting of the disorder (sufferers, those who care about someone with OCD, health professionals), it is much more difficult, and scary, to be open and honest when you have no idea who you are dealing with or what their reaction will be.

Back to the application. I was surprised to even see this question as I believe, because of the Americans with Disabilities Act (ADA), it is illegal to ask about health conditions in a pre-employment application. However, I know this law is complicated, and I am far from an expert. In fact, I am just learning about how it affects those with OCD in the workplace. Because my son has been in college for the past five years, my interest and knowledge of the ADA has always focused  on disabilities within the higher education system. I have so much to learn!

I’d love to hear from those with OCD in the workforce and how they have handled this issue. Does your employer know you have OCD?  Do you feel you have been treated fairly (or unfairly)? Any advice for those with OCD who may be entering, or considering entering, the workforce? Insight from those who have “been there” is invaluable.

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Events, Reviews, and a Book Trailer

high res photoThe last couple of weeks have seen a whirlwind of activity surrounding the release of Overcoming OCD: A Journey to Recovery, so I thought I’d share some of the highlights with you:

Seth and I had our first author event at Barnes & Noble in Philadelphia, and by all accounts it was a success. We had a great turnout! We each spoke briefly, I did a reading from the book, and then we had a wonderful Q&A session. And of course we signed books and enjoyed refreshments. The only thing we forgot to do was take pictures, but we will be sure to do that at our next event, which is coming up this Saturday, February 28, 2015:

If you’re in the area, please join us from 1:00pm – 3:00 pm at Tatnuck Booksellers, 18 Lyman Street, Westborough, MA 01581. Seth and I will both speak, take questions from the audience, and sign books. I’m looking forward to an exciting afternoon connecting with long-time friends, and meeting new ones as well. I was interviewed by a local newspaper in anticipation of the event; I’m hoping the article will reach some people who might find the book helpful.

We’ve been fortunate to receive some great reviews the last couple of weeks. Publishers Weekly (PW) said the book “will leave readers moved, as well as educated about the nature of a disorder and how to defeat it.” You can read the entire review here. We now also have two wonderful reviews on Amazon. If you’ve read the book, or plan to read it, I’d really appreciate it if you’d leave a review on Amazon and/or Goodreads. Thank you so much!!

Last, but definitely not least, I’d like to share this newly created Book Trailer.







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OCD and Optogenetics

by  renjith krishnan

by renjith krishnan

University of Pittsburgh researcher, Dr. Susanne Ahmari, is using optogenetics to study obsessive-compulsive disorder. In optogenetics, scientists insert genes for light-sensitive proteins into the brains of animals. They can then control and study neurons which have been genetically sensitized to light.

Dr. Ahmari’s lab is filled with mice as described in the article:

“They have an optical fiber painlessly inserted into their brains, and it can be hooked up to a cable that transmits pulses of laser light. The light goes to specific parts of the brain, stimulating or inhibiting certain neurons, and scientists like Dr. Ahmari can then see how that changes the animals’ behavior.”

These types of studies amaze me, and give me hope that someday down the road, we will know more about what causes OCD, and more importantly, what can cure it.

The article goes on to say:

“Brain imaging studies in people with OCD have shown that a circuit between parts of their frontal cortex and a deeper structure known as the striatum is hyperactive when they are experiencing obsessive thoughts.

But in humans, she [Dr. Ahmari] said, ‘you can’t prove cause and effect.’ In other words, you don’t know if activity in this circuit is driving OCD or is a byproduct of it.

The work her lab has done in mice suggests the circuit helps cause OCD. After inserting light-sensitive genes into the equivalent circuit in mice and pulsing blue laser light into that part of the brain for several days, researchers found that the mice began grooming themselves excessively — the mouse equivalent of obsessive behavior….

…Now that they have evidence this circuit is a trigger for obsessive behavior, her lab is trying to use another kind of laser light to decrease obsessive behaviors in mice, but it’s too early for those experiments to have yielded results, she said.”

I recommend reading the article, which goes into more detail and also discusses the possibility of optogenetics being used someday to treat humans. And optogenetics has not only been used to research OCD; studies on epilepsy, bipolar disorder, and drug addiction are also discussed.

Dr. Ahmari is not only a research scientist, but also a psychiatrist who treats patients with OCD. She says her patients are her motivation for continuing to study OCD using optogenetics:

“I’ve had some wonderful patients who are really interested in what’s happening in their brains because they want to know why they feel compelled to do this thing they don’t want to do.”

Ah, the million dollar question. I’d like an answer to that too!





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It’s Not a Severe Mental Illness, Is It?

renjith krishnan

renjith krishnan

My friend Angie over at OCD In The Family recently posted a video of  Larry King interviewing Howie Mandel about his OCD in 2012. For those of you who might not be familiar with him, Larry King was a renowned radio and television talk-show host for over 50 years.

I have to say I was really surprised at Mr. King’s lack of knowledge about OCD. I expected better from him. The video is only a couple of minutes long but it’s chock-full of typical misconceptions about the disorder:

Larry says to Howie: “It’s not a severe mental illness, is it?”

Larry asks Howie what he’s most compulsive about, obviously not understanding that tormenting obsessions drive the compulsions.

Larry says, “We all have little bits of it.”

While Howie Mandel should be commended for being open about his mental health challenges and fighting the stigma associated with them, I think he missed some teachable moments here (though I imagine it’s incredibly stressful being interviewed about his OCD, so I will cut him some slack).

I watched the video several times, at times trying to perceive what a person with no knowledge of OCD would take away from it. One thing I think might be particularly difficult for viewers, as well as for Larry King, is that Howie Mandel is obviously functioning at a high level. He is a successful comedian, host, and actor, so a natural thought is “How bad could OCD be, if he can do all that?” I’ve written before about how it’s not unusual for people who suffer from severe OCD to get up in the morning and face their responsibilities, even though they might be dealing with non-stop obsessions and hours and hours of compulsions. And while they might seem okay to the outside world, inside they are truly tortured. The bottom line is just because they are functioning, it does not mean they are okay.

While treatment options were not really discussed, Howie did mention a couple of times that he was medicated. I don’t know if he has ever tried exposure and response prevention (ERP) therapy or not, but I’m always disappointed when it’s not mentioned in any discussion about OCD.

Though you probably can’t tell from this post, I really am pleased that OCD is being talked about. And I’ll be even happier still when we can better communicate the truth about what this disorder actually entails.




Posted in Mental Health, OCD | Tagged , , , , , , , , | 28 Comments

OCD and Apologizing

by stuart miles

by stuart miles

I’ve previously written about my son Dan’s tendency to apologize, and how I didn’t initially realize this was a compulsion – a form of reassurance to make sure all was okay. As is often the case, especially in my early days of blogging, I posted about something I felt was unique to Dan’s OCD only to hear from many others with the disorder who had the same symptoms; in this case, excessive, unreasonable apologizing.

But those with OCD are not the only ones who have issues with apologizing. In this recent post on Psych Central, the author talks about six kinds of apologizing and what he feels they mean. The gist of what he says is that people apologize for all sorts of reasons, such as to alleviate their own guilt, appease others, or to just be polite. Still others apologize because they are forced to do so. For example, a parent might say, “Apologize to your sister” to one of their children, but it is easy to recognize this doesn’t necessarily mean the child is actually sorry. The only apology that is a real apology, according to the author, is what he calls “apologizing from love.” He describes this type of apologizing in detail, but to summarize, it is a genuine apology.

Matt Bieber, on his recent podcast, talks about his own experiences with apologizing. He realizes that his own apologies typically fall into one of two categories. The first are illogical apologies which are compulsions related to his OCD and the second are apologies rooted in reality, based on relationships, and genuine.  I recommend listening to Matt’s insightful podcast where he explains his thoughts in more detail.

So why all this talk about apologizing? Well, I think it’s important to try to understand what is actually going on when we apologize, and then we can hopefully figure out if we are dealing with an OCD compulsion, a genuine expression of remorse, or something completely different. What makes something like apologizing so complicated in terms of OCD is that it is something we all typically do, so it might be harder to recognize it as a compulsion. For example, if a person with OCD turns his car around multiple times to make sure he hasn’t hit anyone, it is obvious to many that this is a compulsion. It is not typical behavior. If a young girl has to turn her light switch on and off fifty times at night or else “something bad will happen,” this too is an obvious compulsion. But apologizing? Most of us do it, and even if we apologize excessively, it doesn’t necessarily mean we have OCD.

When I finally realized Dan’s apologizing was a compulsion, I was able to stop enabling him by not reassuring him; there was a little less fuel for OCD’s fire. Once again it comes back to the fact that the more we understand about all aspects of OCD, the better equipped we will be to fight it.

Posted in Mental Health, OCD | Tagged , , , , , | 27 Comments

Overcoming OCD: A Journey to Recovery

high res photoI’m pleased (and excited!) to announce that Overcoming OCD: A Journey to Recovery has been released, and I’ve heard from several readers who have received their copies already. If you haven’t ordered yet and would like to, you can purchase the book through the publisher for a 30% discount, as well as through all major bookseller sites. As of this writing, Amazon is temporarily out of stock, but I’ve been informed that they have ordered more books, so this status should change soon.

Just a few quick updates:

**I’ve created a Facebook page for the book.

**There’s now a “Media” tab at the top of the blog…..check it out!

**Check out the “Upcoming Events” tab by hovering over the “My Book” tab. I’m happy to report that our first event is scheduled for February 18, 2015 at Barnes & Noble in Philadelphia. Hope to see you there!

**Finally, if you’ve read, or plan to read, the book, I would so appreciate your taking a few minutes to post a review on Amazon and/or Goodreads. Thanks so much!




Posted in Mental Health, OCD | Tagged , , , , , , , | 6 Comments

ERP Therapy – So Simple Yet So Complicated

by iosphere.

by iosphere.

As many of you could probably tell from last week’s post, I find it incredibly frustrating that more people (including therapists) are not aware of exposure and response prevention (ERP) therapy, the specific type of Cognitive Behavioral Therapy (CBT) that is the first-line psychological treatment for obsessive-compulsive disorder.

This week I’d like to do an about-face and acknowledge the many dedicated professionals (albeit not enough of them to go around) who work very hard to treat OCD properly. While the basic premise of ERP therapy is simple – facing your fears – its implementation can be quite complicated. As we know, each person who has OCD comes with his or her unique combination of obsessions and compulsions, and treatment with ERP is rarely as straightforward as we might expect. That’s why it is of the utmost importance to find a  healthcare provider who is experienced and well trained in ERP therapy.

Dr. Seth Gillihan, my friend and co-author of Overcoming OCD: A Journey to Recovery has a new blog on Psychology Today called Think, Act, Be which focuses on “Reclaiming Life With CBT.” In his recent post, “Seven Ways Therapists Can Mess Up the Best OCD Treatment,” Seth discusses seven mistakes new ERP therapists commonly make. I think this information is invaluable to heed, not only for therapists, but also for those with OCD and their loved ones. My guess is the more everyone involved in the treatment process understands ERP therapy and how it actually works, the more likely treatment will be successful.

I think one of Seth’s greatest strengths as a writer is his ability to educate and connect with both professionals and lay people. I hope you’ll check out the “insider information” on ERP that he provides in this post; knowledge that is not only useful to those of us whose lives have been touched by OCD, but also to those who are learning how to best help us.

Posted in Mental Health, OCD | Tagged , , , , , , , , | 6 Comments