The Janine Books

 

This week I’m going to shake things up a bit and talk about something not directly related to obsessive-compulsive disorder. Most of us are familiar with some version of the old adage, “It’s not what happens to you, but how you react to it that matters.” This is especially true for those who experience ongoing challenges in their lives.

I recently reconnected with an old friend, Maryann Cocca-Leffler. Maryann has had a long career writing and illustrating children’s books. Her two most recent picture books, Janine and Janine and the Field Day Finish were inspired by her daughter, Janine Leffler, who as a child navigated life with disabilities. Janine has always lived her life with courage and optimism despite facing many challenges. While Janine is now a college graduate who visits classrooms to speak about inclusion and tolerance, in the books she is a spunky, resilient, self-assured eight year old who is often made fun of by the “cool kids.” Because Janine is inherently kind, upbeat, and amazingly comfortable in her own skin, she earns the admiration, respect, and support of her classmates and always triumphs in the end. These books, which are based on real events in Janine’s life, inspire children to be themselves, to be proud of who they are, and to stand up for those who are bullied. Maryann and Janine sum it up by encouraging everyone to BE SPECTACULAR!

 

janinejanine-and-the-field-day-finish

While Maryann had the idea years ago to create children’s books where the main character has a disability, she waited until her daughter Janine was an adult to pursue the project. She felt these were Janine’s stories to tell, not hers. Janine (not surprisingly, given who she is) was on board one hundred percent and has embraced her advocacy role, encouraging others to focus on their abilities, not their disabilities. But it doesn’t stop there. Maryann and Janine educate children, parents, and teachers and because Janine is so willing to talk candidly about her own limitations, she no doubt encourages others to share their struggles as well. Maryann and Janine have also created a website to encourage inclusion: http://janinesparty.blogspot.com/

But the best part? To me, it’s the by-product of HOPE. For children who are hurting, and for parents who are struggling, these books, and Janine, provide a glimpse into the future with the assurance that everything will be okay. HOPE is a great gift for those with challenges. It doesn’t matter what the disability is; we need to believe that we will get through the tough times and the future will be brighter.

I am proud of both Maryann and Janine for being brave enough to share their stories. I can’t help comparing them to those whose lives have been touched by OCD who also willingly share their struggles and triumphs in the hopes of helping others (you know I couldn’t get through a post without relating something to OCD). I highly recommend Janine and Janine and the Field Day Finish for preschoolers, young elementary school students, and their parents. Actually, I recommend these books for everyone. We can all learn a lot from Janine.

 

Maryann and Janine

Maryann and Janine

Maryann Cocca-Leffler is the Author-Illustrator of over sixty books for kids. As well as the  Janine Books,  some recent books include, A Homemade Together Christmas and Bus Route to Boston. Also a playwright, Maryann’s award winning play Princess K.I.M. The Musical is based on her Princess KIM books. This National New Play Festival Winner can now be licensed worldwide through StageRights.com. Maryann creates books in her home studio in New Hampshire.   http://www.maryanncoccaleffler.com

Janine Leffler is the inspiration for the character JANINE. She lives her life focusing on the positive, despite the fact that she has many challenges in life. She has become a role model to children and adults, as she encourages them to focus on abilities, not disabilities. Like her character in Janine and the Field Day Finish, Janine never won a trophy or came in first place in any sporting events, but she was always number one in her gracious sportsmanship and unyielding focus on personal best. Janine has a BA in Communications and visits classrooms speaking about inclusion and tolerance. She lives and works in New Hampshire.

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Should OCD Therapists Participate in Exposures?

by stuart miles freedigitalphotos.net

by stuart miles freedigitalphotos.net

I’ve written a lot about exposure and response prevention (ERP) therapy and how to evaluate your therapist. I’ve said that many good therapists will tell you,“I won’t ask you to do anything I wouldn’t do myself.”

But do these therapists actually go ahead and do these things? Do they, or should they, participate in exposures with you?

In my son Dan’s case, as far as I know, his therapist at his residential treatment program worked on creating a hierarchy with him, but never directly participated in any exposures. The same is true for Dan’s later therapist whom he connected with after residential treatment. Perhaps this was due to the fact that Dan was 100% committed to ERP therapy and didn’t need that type of encouragement. I’m not really sure. There are those, however, who struggle more with ERP and could use all the help they can get.

I have heard from parents who were frustrated because their children were at residential treatment programs, yet refused to participate fully in ERP therapy. One mom described how her daughter just stared out of the window all day because she couldn’t tackle her exposures. “Why couldn’t a therapist have done them with her, at least in the beginning?” this mom wanted to know. She felt that would have been especially helpful for her child. Instead, time and money were wasted, and her daughter returned home with the same severe obsessive-compulsive disorder she went in with.

There are healthcare providers who do exposures along with their clients. Some make house calls, others go out into the world with their patients, and still others participate in exposures in their office. One woman wrote to let me know how helpful it was that her therapist touched a toilet seat in a public restroom while encouraging her to do the same.

But I don’t get the impression that this is the norm. And as difficult as it is to find a good OCD therapist, my guess is it’s even harder to find one who has the flexibility to do all kinds of exposures with you. Indeed, many times it’s just not possible logistically. For example, if some of your triggers occur in your workplace, it might not be feasible for your therapist to accompany you to work.

I do wonder if some therapists don’t participate in exposures because they might believe it offers their clients reassurance (“Look, I did it, and I’m okay”). According to a study (which I highly recommend reading) conducted by Dr. Seth Gillihan, providing reassurance is one of the most common mistakes OCD therapists make. ERP therapy can get complicated, especially for new therapists, and there can be a fine line between encouragement and reassurance. A good therapist acts as a coach and provides gentle yet firm encouragement – not reassurance.

Good ERP therapy is individualized, and my guess is participating in exposures might be appropriate for some clients and not for others. Certainly if you feel this might be helpful in your fight against OCD, you should discuss it with your treatment provider. I’d also love to hear from those who have had their therapists take part in exposures with them and how you felt, and feel about it.

 

 

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Thanksgiving 2016

cornucopiaThanksgiving has always been my favorite holiday. In addition to spending time with my family, I’ve just always loved the idea of a day set aside to be thankful for all that we have. Mindfulness at its best!

I am so thankful that my son Dan continues to do well, eight years after severe obsessive-compulsive disorder completely debilitated him. I am grateful that Overcoming OCD: A Journey to Recovery, published in January 2015, continues to reach and inspire people, and am also thankful that my blog, after six years, still resonates with those whose lives have been affected, in one way or another, by OCD.

But there is so much work left to do. Obsessive-compulsive disorder is still widely misrepresented, misunderstood, and mistreated. It continues to boggle my mind that so many people are not even aware of exposure and response prevention (ERP) therapy, the first line psychological treatment for OCD as recommended by the American Psychological Association. There is still a serious shortage of qualified treatment providers and a lack of adequate healthcare coverage. On a national level, our country is sure to see changes in these next few years regarding assistance for those who need our help. The list goes on – there is plenty to be concerned about.

But there is also a lot we can do. Each of us can do our part in raising awareness and understanding of OCD and all brain disorders. We can advocate for those who are not able to stand up for themselves and treat others, no matter who they are, where they come from, or what issues they’re facing, with kindness, compassion and respect. While this might not seem like much to some people, I believe it’s the basis for positive change in all of our lives.

In this time of uncertainty and change, I would like to wish all my readers who celebrate Thanksgiving  a happy, healthy, and peaceful holiday surrounded by loved ones.

 

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Gung-Ho About ERP Therapy?

by sattva freedigitalphotos.net

by sattva freedigitalphotos.net

It’s not uncommon for those with obsessive-compulsive disorder to experience recovery avoidance. Fighting OCD is tough to say the least, and it takes a lot of strength and courage to embrace exposure and response prevention (ERP) therapy.

But what if the opposite happens? What if you have been plagued by OCD for years and have not only just received a proper diagnosis but have also been informed that this disorder you didn’t even know you had is treatable. You can get your life back! You hear about ERP therapy and are raring to go! The sooner you can get rid of OCD the better.

Maybe you decide not to waste any precious time finding a therapist who specializes in treating OCD, but rather just read up a bit about ERP and tackle it on your own. No need to create a  hierarchy – you’ll just begin with one of your most anxiety-inducing situations.

There are many variations of the above scenario, where people either jump into ERP full force or are led into it. Perhaps you are working with a therapist who thinks starting at the top of your hierarchy makes sense. Maybe you’re in a treatment program that uses flooding. Or perhaps you’ve had success with ERP therapy in the past and have relapsed a bit. You feel there’s no reason to start “small” again and instead attempt some really difficult exposures.

No matter what the reasons are for this approach to ERP therapy, it is likely to backfire. It’s too much too soon and usually sets up the participant for failure. Those with OCD might become so discouraged by their lack of success that they might deem themselves “untreatable” and refuse to try ERP again. Others might be traumatized, and still others who deal with perfectionism might find this approach particularly taxing.

That being said, there are times when going right to the top of a person’s hierarchy might be appropriate. The trick here is to work with a competent therapist who truly understands OCD and how to treat it. Good therapists will never force any treatment on you. Rather they will discuss their plan and why they feel you should proceed in a certain way (for example, maybe the fear at the top of your hierarchy is preventing you from even functioning, so that needs to be tackled before more progress can be made). They will not forge ahead unless you are in agreement, as good ERP is client-driven.

In general, I think jumping into ERP full force is akin to starving yourself on a weight-loss diet. If you’ve ever approached dieting in this way, you know you are likely to gain back all the weight lost, and then some. In most cases slow and steady wins the race and gradual exposures in ERP therapy will produce the best results.. If you are willing to commit to ERP therapy, you’ve already won a major battle. Now take it one step at a time to win the whole war.

 

 

 

 

 

 

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Discount on Overcoming OCD: A Journey to Recovery

book coverI’m happy to report that my publisher is offering a 30% discount on Overcoming OCD: A Journey to Recovery until June 30, 2017. You can access the discount information by clicking here or via the drop down menu on “My Book” tab at the top of this blog.

 

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Do I Really Have OCD?

question markAs many of us know, doubt is the driving force behind obsessive-compulsive disorder. Compulsions are performed to make sure nothing terrible will happen. The problem, of course, is that certainty is unattainable, so when OCD asks the question “Are you 100% sure?” the answer is always “No.” With this answer comes the need for more compulsions and the vicious cycle of OCD begins.

If you have OCD, you know that this doubt can infiltrate all areas of your life. It makes you question your morals, your intentions, and even your relationships with those you love the most. It makes you question everything.

So it’s not really surprising that at some point along the way, many people with OCD will even question the validity of their diagnosis – the legitimacy of their disorder:

Do I really have OCD?

While this question might not seem like a big deal to those of us without OCD, I know it often becomes an obsession for people with the disorder. Someone’s thought process might go like this:

“Maybe I’m being deceitful. Maybe I’m pretending to have OCD so people won’t realize what a horrible person I really am. There’s a chance I really do want to harm someone, and I’m not just having those thoughts because I have OCD.”

Or…

“I bet I don’t even have OCD. It must be a misdiagnosis. I mean I don’t wash my hands compulsively or check the stove or feel the need to perform “typical” OCD compulsions. All my compulsions are in my head, so maybe it’s not even OCD. I’m fooling everybody and I’m nothing but a liar.”

These are just two examples of how this obsession might manifest itself. Compulsions also vary but might include researching OCD extensively to determine if you actually have the symptoms of the disorder, or seeking reassurance from others. You might question your therapist: “So I definitely have OCD, right?” or perhaps ask someone close to you if they think you really have the disorder. Unfortunately many well-meaning loved ones, and even some therapists, will not recognize these questions as compulsions, and will provide the reassurance the person so desperately craves. “Of course you have OCD.” With this reassurance comes a decrease in anxiety, but as we know, it is fleeting. The feelings of uncertainty return and you are back in the OCD loop.

So what’s the answer? How can people be certain they do have OCD so they can put this obsession to rest? Well, they can’t. What they need to do, what we all need to do, is learn to accept the uncertainty of life. If you’ve been diagnosed with OCD, then you should be getting proper treatment for the disorder, all the while accepting the fact that you will never be 100% sure that you have OCD. And really, it doesn’t matter. What matters is you are doing whatever you can to help yourself so that you can move forward and live the life you desire.

 

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OCD and Concentration

by stuart miles freedigitalphotos.net

by stuart miles freedigitalphotos.net

When my son Dan’s OCD was severe, he seemed distracted most of the time. When I’d try to have a conversation with him, he’d either look right through me, oblivious to what I was saying, or he’d stare into the distance, as if he was daydreaming.

I’d get frustrated with him and sometimes lose my patience. “Dan, will you please pay attention?”

What I didn’t realize at the time was that Dan was paying attention. In fact he was paying very close attention – just not to me. His focus was one hundred percent on his obsessive-compulsive disorder.

Some people with OCD complain they have trouble concentrating. But in most cases I don’t think the ability to concentrate or focus is really the issue. The problem, I believe, is that it’s quite difficult to give your full attention to more than one thing at a time. Try watching two different programs on two different televisions simultaneously, and you’ll see what I mean. And for those who are dealing with sizable cases of obsessive-compulsive disorder, the volume on the “OCD channel” is usually much louder than the volume on the “real life channel.”

It’s not surprising that having to fully attend to one’s OCD likely has a negative effect on a  person’s life. For children (or for anyone in school), paying attention to the teacher, reading and completing assignments, and connecting with peers, might be almost impossible with OCD vying for attention. In fact, it is not uncommon for children with OCD to be misdiagnosed with ADHD. Adults who are raising a family, out in the workplace, or just attempting to live whatever lives they desire, face similar battles with attention.

I think it’s also important to note that both obsessions and compulsions can overwhelm our minds and cause problems with concentration. For example, someone who has harming obsessions (fearing they will harm themselves or others) might develop a ritual such as counting to 1,000 to keep something bad from happening. So both the obsession and compulsion here require a lot of attention, with little room left to focus on anything or anyone else. And in true OCD fashion, some people might even develop an obsession about not being able to concentrate, and then engage in rituals to try to monitor their concentration levels. This just adds to the mess of OCD.

So what’s the answer? Some people have spoken favorably about using mindfulness to help with concentration, or perhaps allowing themselves twenty minutes or so at a time to work on a project. But what would be most helpful, in my opinion, would be to shut off that second television. And the way to do that is through exposure and response prevention (ERP) therapy, the evidence-based treatment for OCD. Once OCD’s volume has been turned off or at least lowered, you’ll be able to better concentrate on the things that truly matter in your life.

 

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