Washing my hands

Sometimes still I examine my hands and wrists and imagine I see a discoloration, almost like a tight glove pulled up over the area that is slightly darker than the rest of my skin.

My husband doesn’t see it, so I think it must be my imagination, a mental image leftover from when my hands were discolored.

I wash my hands a lot, but not with the ferocity that I once did and not for so long a time. My skin is dry, but that’s probably due more to the fact that I don’t dry them properly and put lotion on them afterwards.

When I was a child, the first manifestation of OCD that my parents seemed to notice was my use of water. When I was around eleven, I began washing my hands with a diligence that I had never had before.

The water had to be hot and running fast, and I had to rub and rub my hands under the water with soap until I got the feeling that my hands were clean enough.

I was afraid that if I didn’t get my hands clean, I would pass my germs on to someone else, or to something else, like a bowl or plate, that someone else might touch and be contaminated with.

The running of the water is what caught the attention of my parents. We lived on a farm and depended on well water. It was a good well, and there was probably little danger of it going dry, but my parents were conservative with water.

So they told me to stop running so much water.

That should have been enough. I was an obedient child ordinarily.

But the pull of OCD was stronger than my parents’ voices, and I continued to run water behind the closed door of the bathroom, washing and washing until I felt clean.

My parents fussed at me and ordered me to stop wasting water.

I had no real sense of the amount of water I was using or the time I was spending cleaning. I was focused on getting my hands clean. Time was not a factor.

Finally my mother had had enough. She brought a gallon plastic jug to me one morning and said that the water in the jug was all that I could use that day for washing my hands. I could flush the toilet and take a bath, but the gallon of water was all I could use for washing my hands.

This devastated me. For one thing, the water was cold, and I knew that cold water was not as effective at killing germs as warm or hot water.

And it was very difficult to first wet my hands, put the jug down, soap up, then pour enough water out to get all the soap residue from my hands. I also had to think about leaving enough water for what I would need for the rest of the day.

I cried and raged against the plastic jug, and after a few days, I abandoned it and went back to the faucet. I was more careful, though, and tried to run the faucet at a slower speed, thus more quietly, so that my parents might not notice it as much.

The compulsion to wash my hands waxed and waned as I grew older and after the first episode in my early adolescence, I didn’t have a noticeable problem with it until I went away to graduate school.

I lived alone in a series of apartments, and I could run as much water as I wanted with no one to fuss at me.

I discovered liquid soap, which I loved. I didn’t have to worry about a wet soap bar dripping from the soap holder, and then becoming sticky with thick residue.

After washing my hands, I didn’t dry them very well. I couldn’t be sure of the cleanliness of the towel I was using, so I preferred to kind of shake them and rub the back of my hands on my clothes.

My hands and wrists became red and raw. Sometimes they would bleed.

I don’t remember any of my friends saying much, if anything about my hands. If they did, I didn’t tell them what I was doing. I didn’t tell anyone that.

Here’s a photo of me from around 1986 or 1987. I was a student at the time and was taking a break in a park with a friend of mine. She took the photo.

I found the photo the other day, and I could see how dark the skin on my hands and wrists was.

The only time I remember someone really seeing my hands as a problem during this period of my life was during a visit to the university health center. I think I was having some problems with my ears.

After the nurse led me to the exam room, she quickly turned and walked down the hallway with the doctor. I turned to watch before I entered the room. The nurse was telling the doctor something while pointing to her hands and shaking her head.

Oh, I thought. She noticed my hands. What was I going to say?

I held my breath when the doctor came in. He didn’t say anything at first, but later on he asked me about my hands in an offhand manner. I told him my skin was really dry and got really chapped in the cold. He didn’t say anything else about it.

Sleep

Sleep lingers all our lifetime about our eyes, as night hovers all day in the boughs of the fir-tree. Ralph Waldo Emerson

I have a love-hate relationship with sleep.

I love to sleep. Taking naps is a favorite activity. Some days, I come home from work in the early evening, take a nap for two or three hours, get up for a few hours, and go right back to bed for more sleep.

On Saturdays, I like to sleep late and then take a long afternoon-into-evening nap. On Sundays, I look forward to another afternoon nap.

I love the chance to sleep.

But I hate that I want to sleep so much. I would be accomplishing more in my life if I didn’t sleep so much.

Sleep, that deplorable curtailment of the joy of life. Virginia Woolf

I hate that I can even think that napping is a favorite activity.

My husband doesn’t like me to sleep so much. He says he’d like for us to do more together, but I nap away every weekend, every day off from work.

I wasn’t always like this. I didn’t take naps even when I was in graduate school and was exhausted all the time. I didn’t have time for them.

But sometime in my early 30s, I started to love sleep.

It’s frustrating. I make plans to do so many things, but I find myself tired and sleepy, and I give in to it.

I don’t know how much of my craving for sleep comes from the medication I take and how much from habit.

My psychiatrist and I have tried to find a balance with two medications. It’s difficult to take an amount that enables me to have the motivation to not sleep and an amount that wires me.

Am I just lazy?

A life of leisure and a life of laziness are two things. There will be sleeping enough in the grave. Benjamin Franklin

I don’t feel lazy. I have either been in school full time or worked full time my entire adult life, except for periods when I was unemployed and looking for work. I’m a hard worker on the job.

It’s when I’m off the job that I want to sleep. And I want to stop it.

I believe that it’s a combination of things that is causing my problem. Antidepressants are probably contributing, as are the medications for anxiety.

There are lifestyle changes that I need to make. I need to exercise regularly, get up at the same time every morning and have more of a routine of sleep.

But I think my problem is also connected to the OCD-related procrastination I have. If I am sleeping, I don’t have to deal with issues regarding cleaning, reading, writing, checking, etc. I don’t have to face things that I know will cause me anxiety.

I am not saying that I’m not responsible for my behavior. I am. I am just considering contributing factors.

I am hoping that I will be adding more tools to my toolbox to fight the OCD. I’ll be starting cognitive behavioral therapy a week from today. I have to get serious about making lifestyle changes. And I have to push myself more than I am now to break through the procrastination.

I’m the only one that can do it. I need to make this change in my life.

Do you have problems with too much sleep? How do you combat it?

Paying attention

“Mindfulness has to do above all with attention and awareness, which are universal human qualities. But in our society, we tend to take these capabilities for granted and don’t think to develop them systematically in the service of self-understanding and wisdom. Meditation is the process by which we go about deepening our attention and awareness, refining them, and putting them to greater practical use in our lives.”

-From “Wherever You Go, There You Are,” page 10 in e-edition, by Jon Kabat-Zinn

Recently, while in the shower, I’ve been thinking about being aware and what it could do for me.

It’s not that I do all of my deep thinking in the shower. The problem is, I often get lost in thought. The time gets away from me, and I take a long shower and end up running late for work, for church, for everything.

I think that’s part of the cause of my tendency towards procrastination. I don’t stay in the moment enough, but lose myself in thoughts of what I’ve done, what I might have done, what I want to do, what I should do, etc.

I think I’m doing this at least partly to keep at bay anxiety in the present moment, or things I want to avoid in the present moment.

And I have some issues about the shower. I worry that I won’t rinse the soap out of the bottom of the shower and leave it slick, and then my husband might slip and fall. I fill my hands with water and splash it around until it looks OK. And I compulsively push the shut-off handle to make sure it really is off. (I have gotten that down to pushing it two times.)

What I’ve read so far about what Dr. Jeffrey Schwartz advocates is that it can help with OCD if you pay close attention to doing what you know will bring about obsessions and compulsions.

Say I have a problem with making sure lamps are turned off (I do). If I am aware that I am turning off the lamp, I create a mental picture I can later pull up to help me deal with anxiety about it.

In other words, I can tell myself, yes, that’s OCD, because I remember turning off that particular lamp. I don’t want to check the lamp again. I have a compulsive urge to check it.

So back to the shower. I found I got through the process faster if I kept telling myself things like, “I’m in the shower. I’m taking a shower. Now I’m going to wash my hair.”

Sounds kind of crazy, but I think it may be helpful to me, not just in hurrying myself through the shower process, but in learning to pay more attention.

Does anyone else have this problem with keeping the mind in the present? Do you see it as a problem? What do you do about it?

It's not easy being mindful

Remembering to be mindful, or aware, is not easy.

It’s one thing to read about something. It’s another thing to actually do it, or even to remember to do it.

Relabel. Reattribute. Refocus. Revalue.

Those are the four steps created by Dr. Jeffrey Schwartz to use in cognitive behavioral therapy for OCD.

Now I haven’t read his entire book, “Brain Lock,” yet. I’ve read a good overview of the steps I found online. I have a lot more to learn, and I have a therapist who will lead me through this.

But I want to do something while I wait for my next appointment, so I thought I’d start trying to catch myself in the midst of the obsessions and compulsions and practice the four steps.

I have found that some of my OCD habits are so ingrained in my routine that I don’t always realize I’m in the midst of a ritual until I’ve done it. I’m sure I didn’t even recognize a lot of them today.

I cut down a little on some of the checking, but I still did the compulsions.

I did have what I would call a small success. When I left work this evening, I didn’t go through my maddening ritual of checking my office lamps to make sure they were off. I turned each off, careful to be fully aware of what I was doing, and then I walked away. As I did, I reminded myself that I didn’t really believe the lamps were still on. Rather, I had a compulsive urge to check them. That was OCD, not me. And I haven’t thought much about it since.

I’ve got bigger issues to deal with, but I guess that’s a start.

I’m also reading the book “Wherever You Go, There You Are,” by Jon Kabat-Zinn. I’ll write a review when I’ve finished. So far, it’s very good, and I think it’s going to help me.

If I can remember to be mindful.

Please don't use my bathroom

One of the manifestations of my OCD that has endured since I was a child is fear about bathrooms.

At my worst, when I was a young woman, I spent hours at a time cleaning my small bathroom. I used at least one bottle of cleaner a week, sometimes more. And I went to great lengths to keep anyone else from using my bathroom.

My symptoms have greatly improved, but I still practice avoidance in this area. My husband and I have separate bathrooms, and I still don’t want anyone else to use my bathroom.

I had a revelation about my bathroom fears when I was talking with my new therapist this week. He led me through a series of “what ifs” to get at the heart of my fears.

It’s not really a contamination issue. I’m not afraid of catching some disease or illness from a dirty bathroom. Rather, I’m trying to avoid being disgusted at the sight of a bathroom mess.

My bathroom issues have also played a part in socially isolating me to a degree. If I don’t have really close friends, I don’t have to invite them to my house. If they’re not in my house, they won’t want to use my bathroom.

That’s awful. I don’t want to do that to myself or to my husband anymore.

To give you an idea of how my bathroom fears work, I’ll tell you about when I was in my 20s and living alone for the first time.

Cleaning my bathroom was a weekly ritual that I dreaded. But it would have bothered me more to not do the cleaning.

I slowly wiped down the sink, toilet, tub and floor with a cloth soaked in a solution of water and cleaner. I had to make sure I didn’t miss a spot, not even an inch of space. That meant looking at the surfaces from different angles, making sure each part was wet from my cleaning cloth.

There was never any obvious dirtiness to wipe away, because I was vigilant about cleanliness every time I used the bathroom. I sprayed the seat with disinfectant spray and wiped it with toilet paper after every use.

But I believed that I might have missed something, and I knew that many germs were invisible to the naked eye. So I scrubbed and wiped for hours every week.

After I finished the cleaning part, I doused all the surfaces in the room with disinfectant spray, using it as a blanket way to get any germs I had missed.

Even though I was particular about my own use of the bathroom, I couldn’t be sure that other people would be as careful as I was, and I would have to clean the bathroom once they were through and gone.

It was easier for me and for my peace of mind if I could just keep people from using my bathroom.

One day when I was still in my 20s, a friend stopped by my apartment to pick me up. We planned to go shopping together.

She asked to use the bathroom. I didn’t want her to use it, even though I had no rational reason to believe that she wouldn’t be clean in her use.

I lied to her and told her that I’d just cleaned the bathroom and that it was damp and couldn’t be used.

She suggested that she could wipe the toilet seat with toilet paper to dry it for use, but I still resisted, telling her no.

My friend had to use a public bathroom at the store we went to rather than use my bathroom. I was embarrassed but too ashamed to tell her the truth.

In later years, sometimes I had to share a bathroom, and it was a nightmare. I tried to shut down my senses when I used the bathroom and not notice any possible stains or dirt.

I want to work on my cleaning issues, especially with bathrooms, with my new therapy. I’d like to be able to better handle these fears that I’ve carried for so long and stop them from isolating me.

Start of a worthwhile journey

I had my first session with the psychologist today who will be leading me in cognitive behavioral therapy.

I won’t be doing exposure response and prevention therapy after all. Rather, the doctor will be providing what he referred to as the “third wave” of CBT. It’s the therapy Dr. Jeffrey Schwartz outlines in his book “Brain Lock.”

Let me say first of all that I felt comfortable with the doctor and believe we can work well together. He is a clinical psychologist who is very familiar with OCD. He has written about religiosity in OCD in particular.

He asked me a lot of questions, and we talked about what areas of OCD were affecting my life the most.

Just talking out loud about what I obsess about, what I worry about, and how I live my life was revealing to me.

I talked about the “what ifs” that I fear with writing, with cleaning, with checking. I talked about the avoidance and procrastination that I practice in order to avoid the anxiety that writing and cleaning stimulates in me. I also told him about my religious doubting.

He explained how we would work on a focused area that was causing me, on a scale of one to 10, about a six or seven anxiety level. (Based on one being no anxiety and 10 being the worst ever.)

Bringing that the level of anxiety down for that area would in turn help the other areas too.

He said it sounded like I had some social anxiety in addition to the OCD and generalized anxiety. That and the OCD have isolated me in a lot of ways.

At our next visit, in two weeks, we’ll prioritize what I aspects of OCD I want to work on the most. I already know it will be the writing and the cleaning.

The treatment usually runs from eight to 16 sessions. I like having an end in sight.

Meanwhile, my doctor suggested I read the first couple of chapters of Schwartz’s book. He said that when Schwartz came out with his book, it was rather radical because it wasn’t thought that the brain could be changed. That’s why he made his case in such a “long winded” manner, my doctor said. Now, his ideas don’t seem so radical.

I’m still getting my head around today’s session. I will write more specifically about things as time goes on.

I feel like I’m starting a worthwhile journey.

I start ERP on Thursday

I will start exposure therapy for my OCD on Thursday.

I wrote a post when I decided to make the plunge, but I didn’t think I would start so soon.

I had an appointment with my doctor, a psychiatrist, on Monday and told him I wanted to start. Another doctor in the practice does the therapy, so we thought I’d have to wait a month or so to get an appointment.

Turns out he had an opening this Thursday, so I’m all set up.

My psychiatrist will continue to monitor my medication. He said medication could take me a certain distance, and therapy like the ERP could take me further. That made me feel better. I like the idea of the medication and the therapy complementing each other.

I’m nervous about the challenges, but I’m excited about the possibilities. I like the idea of setting priorities and goals as part of the therapy.

Do you have any suggestions on preparing for my first appointment?