Ask me a question

Ask me anything.

Ask me a question, and I’ll answer it.

I got this idea from a great blogger, Kim of My Inner Chick, who recently opened her blog to readers’ questions.

I thought this would be fun, plus helpful because it would allow for questions about things that I might not have addressed on my blog but need to.

So ask me anything.

Do you have a question that you’d like to ask about my obsessive-compulsive disorder? Depression? Generalized anxiety disorder?

Would you like to know about my cats? About the place animals have in my life?

Do you have a question about my writing?

Ask me anything.

I will answer the questions in Friday’s post, with a link to your blog, if you have one.

Please ask away!

Top 5 things that have helped my OCD

I have put together a list of things that have helped me most with my obsessive-compulsive disorder.

Other things have been of help to me, including meditation. But the following list includes what has been most important.

Not all of these things are for everyone. For example, I realize that medication is not the right choice for everyone. But these are the things that worked for me.

Once I made the list, I couldn’t rank them. I couldn’t say for sure that one was more important than another in helping me control and live with the obsessions and compulsions. So here’s my list, in no particular order.

Medication

Medication changed my OCD from being debilitating. With medication, I was able to consider that there might be ways to live with this disorder.

I have had to try different medications through the years, mostly because of my co-morbid diagnosis of depression. It’s not an easy thing, to change medications, to wait for them to work, or not work.

But it has been worth it to be able to gain some distance from an all-consuming OCD to an OCD that I can work with.

I’ve written more about my medication journey here.

Therapy

I’ve had talk therapy through the years, but the therapy that has helped me the most has been the practical cognitive behavioral therapy that I’ve had this year.

While it’s not been the formal exposure and response prevention therapy, it included exposures and the whole philosophy of learning to tolerate the anxiety and moving beyond it. The exposures my therapist led me in were helpful and instructive.

While the CBT got waylaid because of other therapy needed for my depression, I look forward to getting back to it. In the meantime, I’ve been doing some of my own exposures.

Brain Lock

I first read Brain Lock: Free Yourself from Obsessive-Compulsive Behavior-A Four-Step Self-Treatment Method to Change Your Brain Chemistry, by Dr. Jeffrey Schwartz with Beverly Beyette, in the 1990s, and I worked on its principles on my own with some success.

The book taught me to walk away from compulsions even though I was feeling intense anxiety, and I learned that the anxiety eventually died down.

I wrote in detail about how I use “Brain Lock” in this post.

Adopting a cat

Adopting Waddles in 2000 changed my life in many ways. One of the ways was to give me almost constant exposures for my contamination OCD and my hyper-responsibility OCD, though I would not have known to call them exposures.

I learned to live with an animal and clean up messes without freaking out. I learned the joy of responsibility, which began to outweigh my fears of responsibility.

Learning that I wasn’t alone

From finding out a person I really respected and liked had OCD to starting a blog and connecting online with others who have OCD, finding out I wasn’t alone in my suffering has been a big component of my OCD improvement.

What has helped you the most in your battles with OCD and other anxiety?

Waiting and delaying: Procrastination

I make a daily practice of procrastination.

I put off tasks I don’t want to do. I lie in bed and sleep until the last minute before I have to get up.

Recently, I was reading through old journals and discovered that I had some of the same goals five and six years ago that I still have today. Unmet goals. Goals I haven’t made much, if any, headway on.

There are things that I should do and want to do that would help my depression and my obsessive-compulsive disorder, things like exercising, getting on a regular sleep schedule, eating a healthier diet, doing more exposures, working more on my writing, getting more involved in my community.

I nap a lot. I usually take a long nap on Saturdays and Sundays. Sometimes I come home from work during the week and take a nap before dinner. I tell myself I’m tired.

But in reality, most of the time I am avoiding doing things, including moving towards goals that would not only help my depression and my OCD but also give me confidence and satisfaction.

I am so frustrated with myself.

What is procrastination?

There is a chapter called “Break a Procrastination-Depression Connection” in The Cognitive Behavioral Workbook for Depression: A Step by Step Program, second edition, by William J. Knaus, Ed.D. He says the following about procrastination:

“Procrastination can be a simple default reaction. You feel uncomfortable about an activity, so you avoid it. More often, procrastination is a complex process that coexists with distress conditions, such as anxiety and depression. You put off dealing with what you fear. You believe you are disabled by your mood. Uncertainty can trigger the discomfort-dodging feature of procrastination. If you view yourself as overwhelmed and unable to perform, you are likely to delay taking corrective actions. As a reaction to anxieties, a negative mood, uncertainty, and other unpleasant conditions, you do something different or nothing at all” (p. 58).

So what is a person to do?

Knaus gives lots of good advice. Cognitive changes are one way to address procrastination. You can change your perspective, he says: “To break this procrastination-depression connection, look for weak points in the connection. For example, if you have the energy to think depressing thoughts, you have the energy to think proactive thoughts, such as ‘I can slowly work my way up from under this malaise’” (p. 60).

He advocates taking actions that are “definable, purposeful, measurable, and achievable” (p. 60).

One way to do this is to use the procrastination flip technique, which is the process of doing the opposite of what procrastination thinking wants you to do.

For example, if you are putting off exercising, something you know could help your depression, you push yourself to go for a walk.

Emotive changes can be used to combat procrastination, too. “A combination of normal discomfort-dodging and depression can be like a double whammy. It will help if you accept that this combination goes with the territory. You are then more likely to feel tolerant of discomfort and more willing to allow yourself to start” (p. 61).

That connects with what my therapist told me about accepting my anxiety and the feelings it causes.

Thirdly, behavioral changes can be used against procrastination. Recognizing the diversions you take to avoid doing what is more important can help in coming up with an action plan. For example, an action plan to help you move beyond mindless diversions may be to do one small productive activity every day for five minutes at a set time.

Taking action is a key component of Knaus’ techniques. Taking action, even small actions, whether or not you feel like it, can help to fight procrastination.

So there are things I can do about my procrastination besides just complain about it and feel bad about it.

I can work to recognize the thoughts that lead to procrastination and talk back to the thoughts. I can accept that my depression and anxiety may make my procrastinating ways worse. I can take small actions every day to combat the problem.

I’m working on it.

Do you procrastinate? How do you get past it? Please share your ideas!

On the job: OCD in the workplace

My desk at work.

Monday was my third anniversary at my current job, and it prompted me to think about ways my obsessive-compulsive disorder affects me on the job.

We spend a significant portion of our time in the workplace if we work outside the home. And if we have OCD, we bring it to work with us.

Some of us may be able to adjust enough to perform our jobs well despite having OCD. For others of us, the anxiety disorder affects our ability to do our job.

How can we cope? What does the law say about OCD in the workplace?

My story

I recently wrote a post about a hectic day I had trying to gather news on a homicide case.

On that day, my compulsive checking of my phone came to light. But there are other ways OCD affects my work.

In some ways, my obsessions and compulsions make me a good employee. I am very careful with the details, with the facts. I am conscientious about doing a good job.

But the OCD pushes my conscientiousness into the negative.

Here’s an overview of what I do in my job. I’m a staff writer for a weekly newspaper called the Altavista Journal.

I’m the county reporter. That means I cover Campbell County government, the sheriff’s office and the courts.

I also do general assignment reporting as needed. I may go to a chamber of commerce ribbon cutting for a photo; I may interview a local author; I may write about a new business in town.

At larger papers, I would probably have just one of those beats, but at a small weekly, a single reporter does a lot of different things.

In addition to covering and writing the news, I help with layout, editing and proofing on Tuesdays, the day we prepare the paper for the printers.

I also upload the stories to our website and prepare the e-edition.

When I write, I am full of anxiety because of all the checking and rechecking of my notes and attributions.

The result is that it takes me longer than it should to write a story.

I’ve never missed a deadline—and sometimes, a tight deadline actually helps me get the job done. But time is wasted.

Accuracy and honesty are keys to good journalism, and I’ll never stop striving for the best I can do. My problem is knowing where “doing my best” ends and “this is OCD” begins.

If I don’t check my notes one more time, am I risking getting a fact wrong? Am I being careless?

Checking also comes into play when I update the newspaper website. I worry about putting the wrong headline or byline on a story or making some other mistake.

How do I cope? I use the same tools that I use with OCD at home and in other parts of my life. I tell myself that it’s OCD and not a real concern. I write a story and stop myself from rereading it for the umpteenth time. I refuse to check behind myself when I update the website. I practice sitting with the anxiety.

Am I always successful? No. But I keep on trying.

The ADA

Michael Tompkins, Ph.D., discusses OCD in the workplace in his book OCD: A Guide for the Newly Diagnosed.

He said when the OCD gets so bad that it interferes with our ability to do our job, it could be time to consider whether or not to tell our employer about our OCD.

“The Americans for Disabilities Act (ADA) protects you from discrimination by an employer due to mental illness, such as OCD. In addition, a prospective employer cannot deny you employment simply because you have OCD, if you are otherwise qualified for the position. Although this is the law, many people with OCD have had quite different experiences when they told their employers that they have OCD. For this reason, it is important that you carefully consider the potential costs and benefits of telling or not telling your current or potential employer about your OCD and that you discuss this with your therapist, if you are currently in treatment.” (p. 126)

Tompkins goes on to say that those with disabilities must be able “to perform the essential functions or duties of the job, with reasonable accommodations” (126).

A reasonable accommodation may mean an adjustment in schedule or task: “For example, if getting to work on time is a problem because of your OCD or appointments with your therapist, or if your medication causes drowsiness in the morning, you might ask for a flexible schedule that permits you to come in later in the morning and work later in the day” (p. 129).

I told my boss that I had OCD. When I began having nearly weekly appointments with my therapist, I felt like I needed to explain why I needed to be away from work for them.

Thankfully, he is familiar with OCD and my telling him has worked out well.

I don’t believe I need any other accommodations other than the flexibility to go to my appointments because I am able to perform my job despite the OCD. I’m in treatment, and I believe the OCD will only get better with more work on my part.

I’m grateful for that.

Does OCD affect you in the workplace? Have you told your employer or would you tell your employer about your OCD?

Update: my 50th year

About two and a half months ago, I started my 50^th year with some plans. I thought I’d update you on how I’m doing.

My therapy is continuing. My therapist wants me to make weekly appointments through at least October for the CBASP for chronic depression.

I hope then we will have done enough work that I can focus more on cognitive behavior therapy for the obsessive-compulsive disorder.

My therapist and I are already seeing results from the CBASP therapy, so I feel like my time with him is well spent.

And my own efforts with the OCD, with encouragement from my therapist, are helping me.

One of my 50^th year goals is to get in better physical shape. I am using the plan to participate in the Giblet Jog 5K, on Thanksgiving Day to inspire me. I’m scared to death to participate in a race—I never have.

And I’ve started my “training”—if you can call it that—very slowly, without consistency.

So I’ve got some work to do within the next three months.

Another one of my goals for my 50^th year is to finish a draft of my first book. I’m not aiming for a perfect draft or the last draft, but a first draft.

I have finally written down details of how I’m going to accomplish this.

I will be continuing the writing that I’m doing now—scenes, vignettes and stories—until Nov. 30. I’ll use December to go through everything and find a structure. Then I’ll start the actual draft in January and have it finished by May 30, my 50^th birthday.

Keeping to this schedule will mean early mornings and late nights, but I am quite determined to get it done.

To accomplish these goals, I’ll have to fight the procrastination that seeps into my activities. I’ll be writing more about procrastination in a future post.

If you’ve been reading my blog, you know that a few weeks ago I decided go from posting every weekday to posting three times a week.

That didn’t work out. I just seemed to have more to say than three posts a week could take care of.

I’ve decided to compromise with myself. I will post Monday, Wednesday, Friday and Saturday. That will give me some breathing room while also giving me the time for doing something I love so much, blogging.

Are you working on some projects that you’ve set goals for? What would you like to share about them? Do you have any advice on how to stick to goals?

OCD and the “what ifs”

Last week I was driving from work to meet my husband for lunch in a restaurant in town. I drove down a street parallel to Main Street, the street the restaurant is on.

As I drove, I considered the different intersections I could turn at to get to Main Street.

One has rough patches in the right turning lane. When I make that turn and feel the car go over the rough road, I always have a moment of worry that I’ve hit someone. I drive for a moment afterwards with my eyes in the rearview mirror looking for bodies.

Another way to get to Main Street involves driving in a crowded area beside a convenience store, with people pulling in and out in cars and walking on foot. I worry about running into another car or person.

I thought, What if I take the first way and something happens? I’ll wish I had waited and taken the second way.

Then I thought, What if I take the second way, and something happens. I’ll wish I had taken the first way.

The “what ifs” were valid in that I didn’t know what would happen when I pulled up to either intersection. There was always the chance of an accident. How did I know which way to take to avoid one?

I didn’t. Whichever route I chose, I would have to live with that decision. And wonder if I had made the right one.

Making choices pulls out the old uncertainty quandary. We make choices all the time, some without thinking. With other choices, we ponder which is the best one.

We can’t ever really know which is the best choice. Everything might turn out just fine and safe with one choice. But who’s to say that the other choice wouldn’t have been even better?

So we have to live with our choices. We can do our best in the moment to make the right choices, but we’ll never really know if it was the right one or the best one. Not really.

By the way, I did arrive safely at the restaurant without hurting anyone. As far as I know.

For as Dr. Jonathan Grayson says in his book Freedom from Obsessive-Compulsive Disorder: A Personalized Recovery Program for Living with Uncertainty, “while all of us feel certain about many things, the truth is that the absolute certainty we feel is an illusion. An event may be probable or improbable, but neither is an absolute. The inability to feel or be certain is reasonable” (p. 9).

How do we live with that?

A snippet of memoir: Making butter

Me at age one.

The path that took me from the first signs of obsessive-compulsive disorder and the accompanying depression when I was a child to the official diagnosis sitting in a psychiatrist’s office when I was 26 is not a straight one.

Though the OCD and depression have affected me most of my life, I remember times when I didn’t obsess about sin, dirt and danger, when I didn’t wash my hands and pray constantly to try to rid myself of that sin, dirt and danger.

I was born in 1963 and grew up in South Central Virginia, in the Piedmont area of the state about an hour from the Blue Ridge Mountains to the west.

My father was a full time farmer when I was born, and my mother was a homemaker. They brought me home from the hospital to two older brothers, one 11 years older and one two years older.

My mother has told stories about how much I slept as a baby and how the doctor told her to wake me up to feed me because I wasn’t gaining weight as I should have.

I don’t believe my mother was deliberately not feeding me enough or was neglecting me. But I do think it was probably a relief to her that I slept a lot and was a low-maintenance baby. She had a lot of other responsibilities to tend to.

Our farm was a full working farm. We had milk cows, beef cows, pigs and chickens, plus my father raised tobacco. There were animals to care for and crops to tend and things like butter to make and eggs to gather to sell.

One of my earliest memories is watching my mother make butter.

For some reason, I don’t remember her churning the milk from our milk cows, though of course she did. What I remember is what she did with the result of the churning.

I remember her at the kitchen table, holding a golden yellow ball above a glass bowl of water, splashing it and washing it off.

At the same time, she moved her hands quickly, turning the ball and smoothing it.



Butter press.



Then she pushed the ball of butter into the wooden press her father had made. She pushed the butter in tight with a small wooden paddle.

Inside the butter press.

The butter pressed up against a flower design inside, and when she pushed the butter out on wax paper, it was round with petals imprinted on top.

I have that butter press now, and it brings back good memories.

Have you ever lived on a farm? Would you like to? What about living on a farm appeals to you? What old way of doing something, like making butter, would you like to try?

Movement rituals: OCD embedded in the normal

I turn on the shower but don’t get in yet. While the water is getting warm, I squeeze face soap on my hand. I get in the shower.

I wet my face with my right hand. I scrub my face with the soap. Round and round on my cheeks. Over and around my nose. Skim the forehead.

I splash water on my face and start rubbing my eyes. With the tip of my fingers of both hands, I rub each eye inward. I don’t count the number of times I rub them, but I know when it feels right.

I pick up the bottle of liquid bath soap. I squeeze soap into my left hand. With my right arm, I hold the bottle against me and wipe the opening with my right hand. Then I hold my right hand under the water to wash off any soap residue.

I close the bottle top with my right hand, making sure I hear the click of it closing. If the click is too soft, I open the top again, wipe the top, rinse my hand and close the top.

Then I hold the bottle under the water and rinse the whole thing before setting it down.

I wash in the same order using the same motions as always.

After rinsing, I wet my hair. Then I rub my eyes again until it feels right.

I pick up the shampoo bottle, squeeze a dollop into my left hand, hold the bottle against me, wipe the opening with my right hand, close the top and listen for the click, then rinse the whole bottle under the water.

I scrub my hair and then rinse it. Then I rub my eyes until it feels right.

When I’m done, I gather water into my hands from the spray and splash it on the shower floor, trying to get rid of any leftover soap.

I squeeze the excess water out of my hair and splash the floor some more.

I turn off the shower. I push the off lever at least once more to make sure it’s off.

I get out of the shower.

  That’s my shower routine. It’s probably apparent why I don’t take quick showers, why my husband sometimes asks me after I get out of the shower, “Did you fall asleep in there?”

It’s only fairly recently that I realized all my little movements and rituals I do when taking a shower were symptoms of my obsessive-compulsive disorder.

Two weeks ago, I wrote about some of my touching compulsions. Apparently, touching and movement compulsions are similar.

In “A Touching Story,” an article on the Beyond OCD website, Fred Penzel Ph.D. writes that touching and movement compulsions can include a variety of behaviors, including two ways that affect me: moving in symmetrical or special ways and moving in special ways while carrying out certain activities.

Penzel writes that there are subgroups of this type of compulsion, including performing the compulsion as a magical or superstitious ritual to keep something bad from happening; performing them to have a sense of completion; and performing them to satisfy an urge.

I fall within the first subgroup. I perform the rituals because not doing so would make me feel like something bad was going to happen.

  I want to take quicker showers, and I don’t want to be driven by OCD, so I’ve been tackling the problem.

Opportunities for exposure come often because I shower every day.

I’ve been trying to stop the movement rituals as soon as I realize I’m doing them. I am refusing to reopen and then re-close bottles of soap and shampoo. I am trying to stop rubbing my eyes beyond getting any water out of them. I am trying to push the off lever of the shower just once. I am trying to refocus my attention and move on.

Some showers are easier than others. I can feel the anxiety when I am not sure if I washed off the shampoo bottle or closed it properly, even though part of me knows I did.

My goal is to not do any of the rituals because I know doing rituals encourages me to do rituals.

I just have to keep working at it.

Do you have movement rituals? If so, how do you manage them?

Cooking was an OCD nightmare, but the food tasted good

I cooked on Sunday. I used the stove. I mixed ingredients. I cleaned up after myself.

On the outside, it probably looked like it went OK, but on the inside, I was a nervous wreck.

If you’ve been reading this blog lately, you know how I feel about cooking and the way my obsessive-compulsive disorder affects it.

Ingredients minus the pasta.

On Sunday I fixed a simple pasta salad. I cooked the tri-color rotini and mixed it with kidney beans (rinsed), sliced black olives and broccoli flowerets. Then I mixed it all with balsamic vinaigrette and chilled it.

Boiling pasta.

It was very easy to fix.

I managed to turn off the stove, but I did turn it back on and then off again to satisfy myself. So that needs work.

I didn’t ask my husband to double-check behind me, so that was a good point.

The finished product.

I made an important discovery, too. What bothers me most about cooking is the cleaning up afterwards.

All during the preparation, I thought about the mess I was making and how hard it was going to be for me to clean it up.

It’s not that I made a huge mess. But after I used the electric can opener to open the can of beans, I had to carefully wipe around its edges. I didn’t see any food on the appliance, but I had to clean it to make sure I was getting rid of any invisible residue.

I was so thankful the can of sliced olives had a flip-up top. I love cans like that because I don’t have to use and then clean a can opener.

While I as cooking the pasta, the water ran over the rim of the pan a couple of times, so I had that to clean up.

And then I had to gauge whether or not I was cleaning every bit of counter that I worked on.

My anxiety level was probably at a 7 while I was cooking and cleaning. But afterwards, I felt relief and the anxiety lessened to about a 3, which for me right now is pretty good.

I clean much easier now than I used to before treatment, but I still worry that I’m missing something, and I know I perform a bit of overkill in wiping the counters.

It was all worth the effort, though, because my husband and I had a salad to enjoy, and I knew I had stepped in the right direction, towards cooking more.

And the salad tasted good.

Which do you enjoy the least, cooking or cleaning up afterwards? Do you have any easy pasta salad recipes or other salad recipes good for summer that you’d like to share?

Books: Wonderful things indeed

Some books on my "read soon" list. My Nook sits on top.

Books on bookshelves and on bedside tables at home; books in the public library; books in bookstores: I love to be surrounded by books.

My love affair with books began when I was a child. I remember taking books down from the bookshelves in the living room before I could read. I searched the pages for the one word that I knew, the word “the.” I ran my finger along the sentences until I saw my word, and then I would say it aloud: “the.”

I don’t remember learning to read. I just remember being able to read and loving it.

Even as a child, I enjoyed reading more than one book at a time. I carried a little stack of three or four books around with me, from one reading spot to another, entering first one world and then another as I switched from book to book.

I probably very much needed books as a child. Sometimes I needed the comfort, and I certainly needed something constructive and beautiful to do while I waited in hospital waiting rooms, doctor’s offices and at relatives’ homes.

I loved mysteries from the start. My favorites were the Trixie Belden books and the Nancy Drew books. I also loved the Laura Ingalls Wilder books, books by Maud Hart Lovelace and any book about horses.

I liked biographies, too, especially about strong women who made their way in the world like Amelia Earhart.

I like to say I practically grew up in our local public library. I loved walking the aisles, looking for something new. I loved the smell of the library. I loved the quiet. I loved the love of books that hung in the air.

During high school, I usually had a pleasure reading book with me so that, if I finished my work in class before everyone else did, I could bring it out and read a few pages before class picked back up.

I loved books so much I majored in English in college and got a master’s in English.

I have written before how obsessive-compulsive disorder has affected my reading on and off for years. I obsessed over whether or not I had “really” read every word and would reread passages until it felt “right” to move on.

It’s one of the most awful ways OCD has affected me because it hits at part of what defines me.

Thankfully, I can now usually push through the obsessions and keep reading until the anxiety subsides.

Most of the fiction books I read now are mysteries and thrillers. My favorite authors in those categories include Sue Grafton, Kathy Reichs, Meg Gardiner, Lee Child and Nevada Barr.

I also enjoy memoirs and other nonfiction books. Some recent reads include

*The Mindful Writer: Noble Truths of the Writing Life. By Dinty W. Moore

*The Foreign Language of Friends. By Nadine Feldman.

*Here If You Need Me. By Kate Braestrup.

*Blue Nights. By Joan Didion

*The Memoir Project. By Marion Roach Smith

Some books I hope to start soon:

*Behind the Beautiful Forever. By Katherine Boo

*The Animal Manifesto. By Marc Bekoff

*Freedom from Obsessive-Compulsive Disorder. By Jonathan Grayson, PhD

*The Affair. By Lee Child

*Wild: From Lost to Found on the Pacific Crest Trail. By Cheryl Strayed

  How much do you like to read? What are some of your favorites? What have you read lately? Please share!

Kitty needs a home: June is Adopt-a-Shelter-Cat Month

Waddles

On Wednesdays, I write about wonderful things in my life. Today I’m writing about cats—not just my cats, but homeless cats.

June is Adopt-a-Shelter-Cat Month, and I’m taking the opportunity to encourage you, if you are thinking of getting a cat for a pet, to consider adopting from your local shelter.

I’ve written about my love of cats before. I have a page on this blog devoted to my cats. And I’ve written about my Waddles, who died last November, and how I came to have her.

In a nutshell, my mother adopted Waddles when she was 8 years old, after her original person died.

My mother was not familiar with cats and wasn’t able to cope with having one. She eventually turned Wa in to the local shelter.

I adopted Wa myself the next day from that shelter.

I remember how dreary the animal shelter was then. Wa was being kept in a small room with just two or three cages in it. I was so glad to get her out of there.

That shelter is in much better shape now, and there are many fine shelters around the country and in other countries that are doing good work.

But they can’t keep all the homeless cats and dogs that come to them.

According to the Humane Society of the United States, six to eight million pets come to shelters each year, and half of them will probably never be adopted.

In my own county, during fiscal year 2011, 148 cats were adopted and 1,039 cats were euthanized, and 492 dogs were adopted and 429 were euthanized.

Animals in shelters need homes. Many of them were given up by previous owners for various reasons. They’ve had homes before. Some have never had real homes, but have lived on the streets or on the kindness of people who fed them but never claimed them. They all need forever homes.

Again according to the Humane Society, adopting a pet from a shelter or rescue group can cost less than purchasing one from a pet store or a breeder. And you can find purebred animals in shelters and with rescue groups.

Animals in general and cats in particular are very important to me. They teach me the joy of caring for other creatures. They teach me mindfulness and living in the moment. They remind me of unconditional love.

Spending time with my cats soothes my anxiety and helps to give me a clear perspective on what matters in my life.

Learning to care for Wa and then all of the cats Larry and I have had got me beyond a lot of my contamination obsessive-compulsive disorder symptoms. I don’t enjoy it, but I can clean up kitty poop and throw-up without obsessing over it or getting compulsive.

Caring for cats also helped me with my harm obsessions. I had to learn that the cats needed to be fed regardless of how worried I was about giving them something that would hurt them. And I got a lot of practice doing it.

I got home late Tuesday night because it was layout day for the newspaper I work for. Chase greeted me with happy cries (OK, I interpreted them as happy) and let me hug on him. Sam followed me into the bedroom, and I made over her before giving treats to both cats. Later, Sam and I played with a ball with a little bell in it. That girl is adept at swinging her paw and hitting the ball.

My heart hurts for the homeless animals out there and for those who will never have a home. If you want a cat and you are able to take care of one, please consider adopting.

What place do animals have in your life? What special pets have you had?

Live OCD Free: An interview with Dr. Kristen Mulcahy, developer of a mobile app for OCD

I was recently contacted by a representative of Teak Media Communications, LLC about a new mobile application that has been developed by a psychologist, Dr. Kristen Mulcahy, to help adults and children with obsessive-compulsive disorder.

I was asked to consider featuring the app and Dr. Mulcahy on this blog and was given an opportunity to interview her.

According to a press release that was also emailed to me, Dr. Mulcahy specializes in OCD treatment. She is the director of the Cognitive Behavioral Institute in Falmouth, Mass.

She has a blog called OCD: Real Stories, Real Help.

She created the application through her company, Pocket Therapist, LLC. The app costs $79.99 and is available in the iTunes store.

I was fascinated by the idea of a mobile app for OCD, and I thought you would be interested in finding out more about it. I interviewed Dr. Mulcahy by email, and her responses to my questions are below.

Note: I don’t have the app and have not tried it out.

How does the Live OCD Free mobile application help people with OCD?

  Live OCD Free guides users through the only evidence-based treatment for OCD, called Exposure and Response Prevention (ERP). It interactively helps users set up an exposure hierarchy, which consists of the exercises they will need to practice in order to overcome their fears and worries.

  Once their hierarchy is set up, users can set reminders to practice on a regular basis, goals to try to meet on a weekly basis, and rewards for meeting those goals. There are specific tools, including motivational messages and relaxation/meditation recordings, to help users manage their anxiety and stay motivated.

  The app will also give specific guidance if you are struggling with an obsession or have just given in to a compulsion. Live OCD Free will also create progress reports that may be emailed directly to the user's therapist.

How does the app work for adults and children with OCD?

  The children's version functions the same as the adult version, but it is much more game-like. It is based on an illustrated audiobook housed within the app about the "Worry Wizard." With the help of their coach, Sage the Owl, kids battle the “Worry Wizard.” Every time they master a challenge (or exposure), the Worry Wizard loses a piece of his costume and they get closer to revealing his true identity.

How did you first get the idea for the Live OCD Free app?

  A friend of mine, who struggles with trichotillomania, called me one day and said there really needed to be an app for hair pulling.    

Right away, I started thinking about how the smartphone technology could be applied to create a therapeutic tool for trichotillomania and also for OCD, which is more my specialty.

  That idea launched a nearly two-year journey of creating Live OCD Free.

Why did you want to create something like the Live OCD Free app?

  For several reasons. The first is the fact that there are 4-7 million people estimated to have OCD in the U.S. alone with relatively few therapists specifically trained and experienced in treating the disorder. It is a very underserved population as many sufferers are unable to afford treatment or find someone to treat them in their area. If you do not have access to a therapist, I believe Live OCD Free is the next best alternative.

  I also wanted to create a tool that could potentially make treatment even more effective and efficient. Even if someone is working with a specialist, they are still doing the majority of the work on their own, in between sessions. I wanted the app to function like a therapist in your pocket, giving you the advice and guidance you need when you are struggling and don't have access to your therapist. I love the fact that I can actually record reminders and statements I want my patients to remember when they are on their own.

  I also believe the app can provide a good framework for therapists who don't have training in treating OCD so they are, at least, providing the right type of treatment.

Once they purchase the app, what steps do people take to begin using it?

  If the user is utilizing the app as a self-help tool, it is highly recommended he/she read the 30-page user's guide that comes with the app. This guide provides basic information about OCD and ERP as well as information on how the app may be used for specific symptoms.

There are also tutorial videos, which provide specific instructions on how to set up your self-help program.

The app itself is extremely user-friendly, and can probably be utilized without this support if someone has experience with ERP.

How can therapists work with patients using the app?

  Therapists can set up their patient's exposure hierarchies in the app and set times for them to practice. They can record messages or recordings for exposure purposes.

They can also see how their patients are doing throughout the week via the progress reports created by the app.

Who is the app most suitable for?

  For anyone struggling with OCD. However, for more severe cases or for less straightforward symptoms, using Live OCD Free as an adjunct to treatment with an OCD specialist is ideal.

What kinds of studies are being conducted to test the efficacy of the app? What do the studies show? Will more studies be done?

  We have collected and continue to collect data on our beta test group, looking at how effective the app is as a self-help tool and as an adjunct to treatment with a professional. We will be teaming up with some larger treatment centers, including the OCD Institute at McLean Hospital, to conduct larger, more formal studies. See information about the Live OCD Free Pilot Study below:

Pilot Study to Determine Efficacy of Live OCD Free App as Self-Help Tool

Preliminary Results:

Following a baseline period of 3-4 weeks, participants were provided the Live OCD Free app to use on their personal mobile device. With a sample size of 5 participants, average Y-BOCS scores decreased by close to 34% over a period of 8 weeks. 

Although the sample size is too small to produce any statistically significant results, this preliminary data seems indicative of some meaningful treatment effect as generally a 35% or greater decrease in Y-BOCS scores is generally deemed clinically meaningful. Of further note is the fact that participants initially scored in the severe range on the Y-BOCS but were able to reduce OCD symptoms to score within the mild to moderate range by the end of 8 weeks time.

Although these results seem very promising, additional research is needed to better understand the efficacy of the Live OCD Free app as a self-help tool.

What kind of feedback have you received from people using the app?

We have been getting excellent feedback from both therapists and sufferers. Testimonials for the app can be found here: http://liveocdfree.com/index.php#

  

Is the app useful for mental health disorders other than OCD?

  Yes, the app can be used for any disorders that you would create an exposure hierarchy for, including body dysmorphic disorder, hypochondriasis, hoarding, specific phobias, social phobia, and separation anxiety. There is specific information on how to use it for several of these different disorders in the User's Guide.

How can people find out more about the app?

www.liveocdfree.com

How do people get the app?

  Through the iTunes store: http://itunes.apple.com/us/app/live-ocd-free/id509337840?mt=8

  Readers, what do you think? Did you ever think you would see a mobile app for OCD? Do you think you would find it helpful? How do you think this new technology would help you?

How I use "Brain Lock" to fight my OCD

   I’ve turned off the shower, but I want to push on the water turn-off again to make sure it’s off.

I’ve turned off the light in the laundry area, but I want to turn around and check and make sure it’s off.

I’ve turned off the ceiling fan, but I want to check one more time to make sure the blades aren’t moving anymore.

Are those blades moving?

I want to pray again for forgiveness, for the safety of Larry and the cats and my relatives and the whole world. And again. And again.

I want to drive back and make sure the pothole in the parking lot that I see everyday really isn’t a person that I just hit with my car.

The role of “Brain Lock”

These all are daily, or almost daily, compulsions that I feel the urge to do. Slowly, but surely, I’m following through with the urge to do the compulsions less and less.

The steps that Dr. Jeffrey Schwartz outlines in his book “Brain Lock: Free Yourself from Obsessive-Compulsive Disorder” is helping me to do that.

When I started cognitive behavioral therapy, I wrote about how my therapist uses a form of the four steps Schwartz advocates in fighting OCD: Relabel, reattribute, refocus and revalue.

Basically, to relabel is to recognize obsessions and compulsions and call them what they are, OCD.

To reattribute is to name the cause of the obsessions and compulsions: a medical condition.

To refocus is to do something else instead of giving in to the compulsion. It’s learning to shift the attention elsewhere and tolerate the anxiety until it goes down on its own, without doing the compulsion.

To revalue is to place a lower value on the obsessions and compulsions because you know what is causing them.

My therapist taught me to combine relabeling and reattributing and then move on to refocusing.

How I do it

Here’s an example of how I do that.



Is the water turned off?

   After my shower, I turn off the faucet. I want to keep pushing on the turn-off handle. I’m afraid if I keep doing that, though, that I’ll break it. And it’s unnecessary and takes up time. Most importantly, it’s giving in to a compulsive urge.

So after I turn it off, I make myself get out of the shower. I feel some anxiety because I am afraid it’s not turned off properly. I want to reach back and push it one more time. Instead, I focus on drying off and then start blow-drying my hair or getting dressed.

Another example: I turn off the light in the laundry area in the basement. I see the darkness. I turn around and start walking up the basement steps. I really want to turn back and look again. I feel anxious, and I think I won’t be able to relax or forget the light unless I do.

But I keep moving and don’t allow myself to look back. I get to the top of the steps, turn off another light and close the basement door behind me. Then I go off to do something else.

What I’ve learned

What I’ve discovered is that the anxiety doesn’t last very long and I actually forget about the obsession pretty quickly.

If I do give in and perform the compulsion, I still try to tell myself that it was the OCD that wanted me to do it, not me. That’s something that Schwartz recommends.

If I give in to the compulsive urge, I have also discovered that I get more anxious and it’s harder to turn away from it. It’s just not good for me to give in.

I’ve learned the following:

*I can tolerate more anxiety than I thought I could.

*Uncertainty is not fatal.

*I don’t have to have an in-depth thought session on every obsession and compulsive urge. I don’t have to resolve anything about it. I just have to move on.

*The anxiety will eventually go away if I don’t perform the compulsion.

*Focusing on something else is the key to my forgetting about the obsessions and compulsions.

*It’s not the end of the world if I give in and do a compulsion. It just means that I will learn better for the next test.

Have you tried the “Brain Lock” steps? If so, how did it go? How have you learned to tolerate and deal with anxiety that is a part of everyone’s life?