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?

Swing at that ball: Coping with chronic depression

I was 20 years old, walking across my college campus, in front of one of the main buildings. I don’t remember where I was going and or where I was coming from. What I do remember is thinking, I don’t look forward to what the day might bring anymore.

I no longer thought of the day as open to anything good or surprising. It was open to only the same thing, the numbness and sadness I felt everyday.

That is my personal definition of dysthymia.

My therapist has diagnosed me with dysthymia, or chronic depression.

From what I’ve learned in therapy, chronic depression is not an unending bout of deep depression that leaves me unable to function.

Rather, it is a consistent and constant low mood. I may drop into deep depression, but when it improves, it will improve only so much. My mood doesn’t lift above that low level.

My therapist said one of the hallmarks of chronic depression is a sense of hopelessness and of helplessness. People with this disorder tend to believe that no matter what they do, it won’t make a difference. They may stop even trying.

Hopelessness is what I felt that day on campus. No more hope that the day might bring something good.

Another characteristic of people with chronic depression is that they sometimes can’t even pinpoint what they want, because it has never been about what they want. They’ve never seriously considered it, because, again, what good would it do?

My interpretation of chronic depression.

According to the National Institute of Mental Health’s website, dysthymia is defined as “depressive symptoms that last a long time (2 years or longer) but are less severe than those of major depression.”

I like to look at a list of the main signs of depression every now and then and remind myself that it is a disorder with symptoms, not just a word we throw around to describe a bad day.

The NIMH website provides the following information about the symptoms of depression.

Different people have different symptoms. Some symptoms of depression include:

*Feeling sad or "empty"

*Feeling hopeless, irritable, anxious, or guilty

*Loss of interest in favorite activities

*Feeling very tired

*Not being able to concentrate or remember details

*Not being able to sleep, or sleeping too much

*Overeating, or not wanting to eat at all

*Thoughts of suicide, suicide attempts

*Aches or pains, headaches, cramps, or digestive problems.

How has having chronic depression affected my life? I think about that often. And I wonder what my life would have been like if I didn’t have OCD either.

Being depressed and having OCD have affected my life in some concrete ways.

For example, I never finished my doctorate. I was so close. I was ABD, which stands for all-but-dissertation. But I never finished—I never really started writing—my dissertation.

I also never aimed high in my career. I stifled what I really wanted to be—a writer—and did what was safe. I spent years working as a public servant, first at the state employment agency and then as a health educator for the health department. They were rewarding jobs in their own way, and I enjoyed much of the work, but it wasn’t where I wanted to be.

And my interpersonal interactions are affected by chronic depression. I tend not to ask enough questions of others. I make a lot of assumptions. I stuff a lot of anger instead of expressing how I feel because I fear conflict.

The thought and behavior patterns that perpetuate chronic depression run deep, but we can learn new ways of thinking and behaving.

I want to get out of this cycle of chronic depression, deep depression, back to chronic depression. I am afraid that I never will.

But with the CBASP therapy (Cognitive Behavioral Analysis System of Psychotherapy), and what I’m doing on my own with study and practice, I am trying.

My therapist loves the analogy of the baseball player who is afraid he won’t hit the ball. He’s so afraid of not hitting the ball that he won’t even try. So he’s guaranteed never to hit the ball.

But if he goes up to bat, and practices good form, and makes an effort, he might hit the ball. Even if he doesn’t, he tried.

I’m up at bat, and I’m practicing good form. I’m doing the therapy assignment each week, and my therapist and I work hard during each session. I read, I listen, I think, I write. I practice what I’m learning.

And I am getting better. I am feeling more positive. I have more energy. I’m stopping the negative thinking more quickly.

I still have doubts. I still get anxious when I think about the possibility of not getting a lot better. I worry about not trying hard enough, or not doing the right things, or missing something vital my therapist tells me, or not understanding the therapy.

At least part of that doubt comes from my obsessive-compulsive disorder. I want to ensure there is no miscommunication. I want to make sure I’m not doing something wrong. I’m obsessing over it.

But despite my fears, I am doing my best. I will arise above that low level.

And I will look forward to each day.

Is there something you are up at bat for? How do you practice good form and swing at the ball?

Treatment journey: Not straight, and certainly not quick

http://en.wikipedia.org/wiki/File:The_Doctor_Luke_Fildes.jpg

There are two main ways to get from my town to the county seat, where I do a lot of my reporting for the newspaper.

One way is mostly on a four-lane major highway. The speed limit is 60 mph. Even when I have to turn onto a two-lane road, it’s wide and well marked and I can make good time.

The other way is mostly on back roads, narrow and curvy secondary roads. It’s a more direct way to get to the county seat, but narrow and sometimes unmarked roads slow down safe drivers. You will eventually get to the county seat, but it will take longer than if you take the major highway.

Some journeys are straight and true, some not. Figuratively, the same could be said for the journey to effective treatment for mental illnesses.

My fantasy journey

I would have begun exhibiting obsessive-compulsive disorder and depression symptoms, which would have drawn concerned interest from my parents, which would have led them to take me to a doctor, who would have referred me to a psychiatrist, who would have diagnosed me and begun treatment.

Admittedly, since I started showing strong symptoms of OCD in the early 1970s, treatments would not have been what they are today. But as the years passed and knowledge of and research into OCD increased, I would have gotten better and better treatment for both the OCD and the depression.

And so, in my perfect dream, I would have spent my 20s, 30s and now my 40s living a life with OCD and depression, but a life not as greatly affected by them.

Yes, it’s just a dream. My treatment journey wasn’t that straight and true one, and I would bet that most people’s journeys aren’t either.

My real journey

I remember being taken to the doctor when I was about 9 or 10. My mother told me it was because I was crying at night and I wasn’t eating a lot. I don’t remember this. But according to my mother, the doctor said that even though it had been my brother who was in the hospital a lot, I had been through a lot, too, with being away from home and having to stay with relatives.

That was the end of that foray into medical diagnosis. The next time I saw a health professional for anything other than a physical ailment was when I was 25 and started seeing a counseling psychologist for my depression.

That was talk therapy. I talked about my life, and she listened. But she also taught me that my patterns of thinking were not healthy and were not a reflection of reality. For example, just because my mother told me I was lazy didn’t mean that I was.

When I was 26, I saw my first psychiatrist and was officially diagnosed with OCD and depression. I started medication, which greatly improved my symptoms.

In the years after that, I was in a little more talk therapy, but I focused mainly on medication therapy. I thought I was as well as I could hope for.

But in January, 22 years to the month that I was diagnosed with the mental illnesses, I decided to try cognitive behavioral therapy for OCD. Later this spring, I started Cognitive Behavioral Analysis System Psychotherapy (CBAS) for chronic depression, which was getting in the way of my OCD therapy.

I am finally on the road to real recovery.

How can we make it better?

What are some ways that we can better ensure that the road to good treatment is more straight than curvy?

Recently, Elizabeth, of Into My Own, reminded me of the importance of being our own health advocate in a great post.

When I worked as a health educator, I became interested in health advocacy because I saw so much need for it.

Advocacy is “(t)he act of pleading or arguing in favor of something, such as a cause, idea, or policy; active support,” according to The American Heritage Dictionary.

Being an advocate for yourself means asking the questions, educating yourself, and getting the care, including proper diagnosis, for yourself as you navigate the health care system.

Being an advocate for others means doing the same thing, but for others.

Being an advocate or even having an advocate may help you get a diagnosis sooner rather than later and may help you get on the road to recovery more quickly.

The following are ways that I have discovered to be helpful in being your own advocate or an advocate for someone else (Note: I use the term “doctor,” but you can insert therapist or any health care professional):

*Research respected sources for accurate and up-to-date information.

*Before you go to the doctor, make a list of questions to ask.

*If you don’t understand something the doctor says, ask for clarification.

*Take notes and/or ask for available handouts about a diagnosis, test, or treatment.

*Consider taking someone you trust with you to the doctor so you’ll have a second pair of ears to listen and take notes. (I realize this may not be desirable or appropriate if you’re going to a psychiatrist or therapist.)

*Find out the best way to get in touch with the doctor between appointments.

*Don’t be afraid to change doctors if for any reason you are not comfortable or cannot build a trusting relationship with him or her.

Was your road to diagnosis and treatment long and winding, or was it more straightforward?

Do you consider yourself to be a health advocate? How do you advocate for yourself? How have you advocated for others?

Depression: I will not be empty



From http://en.wikipedia.org/wiki/The_Starry_Night



 

February 6, 2007

  I went to see my family doctor today. I told the nurse that I was there for three reasons: blood pressure recheck, antidepressant discussion and my right ear. But I was really there for one main reason—the antidepressants and the fact that they didn’t seem to be working anymore.

The doctor listened to me tell him how I felt empty (I didn’t tell him that my heart felt empty, something that had come to my mind yesterday and seemed to really describe how I felt.)

He talked about upping one medication and keeping the other at the same dose and coming back in three weeks to re-evaluate.

I was tearful and said that I didn’t even know what I was like normal. I guess I was getting that idea from some of the essays that I’ve been reading in that book about depression, writers on depression. The doctor said, probably when you are really low—and he meant the low without any meds—that is your normal.

That struck me. That was my normal? But that wasn’t normal!

But the doctor said that a bright side to it was that there were so many meds that could lift me up from the bottom and things were getting better in the treatments for depression. He said that I would probably always—the rest of my life—have the low times and have to have the meds tweaked and changed. But like people who were born with something physically wrong with them, I could learn to adapt.

So I up the one medication, keep taking the other, try to get more light (because he said that it could be partly the time of year and the darkness that was affecting my mood), and try to have a more positive outlook.

And that I needed to go to work. I asked him if it would be a good idea to miss a few days of work. He didn’t think so, because he said being at home might make my depression worse. He thought I needed to be out there.

That didn’t please me much, because I was hoping for at least a short reprieve from work. He said that he could write a note for work, but that he thought the best thing for me was to work. So I didn’t push it.

He also brought up the possibility of seeing a counselor, preferably a psychiatrist, if things didn’t get better within the next two or three months.

Is my normal depressed and OCD? Or just depression? Is the OCD keeping me from being normal? So many questions. I wish I was a happy spirit. I wish that I had faith and belief in God that would sustain me. I don’t have enough faith or belief though—it’s so fleeting and so nebulous, I don’t think that I can build a life on it. And I don’t like that feeling of not being able to.

I wrote the above in my journal more than five years ago. It’s a picture of one of the many times I’ve found myself sinking into hopelessness. One of the many times I’ve had to admit to myself, I’m depressed again.

I think differently now about those words “depressed again.” I’ve haven’t been “not depressed” for many years, if my therapist is right about my having chronic depression.

Has my life been all bad, all sad? No. I’ve had many good times and happy times. And I believe that there’s a firm base within me that is content and hopeful.

But depression comes calling with more subtlety than the obsessive-compulsive disorder. I feel exhausted even when I’m not busy. I complain more. I sleep a lot. I have a hard time concentrating. I have a hard time caring about my life. I feel like I’m heavy and have a hard time moving. I don’t want to do things that I enjoy other times. My heart feels empty.

And I don’t even realize it until I’ve been experiencing those symptoms for weeks.

I am doing more now to fight the depression, though. My psychiatrist tweaked my meds, and I’m already feeling better. And I am doing the Cognitive Behavioral Analysis System of Psychotherapy. We start the real work on Friday.

I told my therapist that my family doctor had told me that I would have to adapt to life because of the depression. My therapist told me, “Oh, you’ll do better than that.”

I believe I will.

OCD: Struggling to live with uncertainty

A few weeks ago, during a cognitive behavior therapy session, my therapist and I talked about the consequences of following through with an exposure, the one where I would get rid of my pile of unopened mail and other papers.

I could see only a positive outcome from making the paper pile disappear into files and trash bags: I wouldn’t have that task hanging over my head, causing me to feel anxious.

So when my therapist asked me what the consequences would be, I replied, “The anxiety about it will be gone.”

He then brought up a point that I had failed to fully consider: “But won’t you keep on getting mail?”

His point was that as long as I received mail, I would face potential anxiety. I would continue to worry that I had somehow missed something, an unpaid bill, the discovery of something legally important that I had failed to do, etc.

“You’ll never be able to be certain that everything is taken care of,” he said.

He was right. Getting rid of one pile of paper would not take care of any uncertainty I would ever have in my lifetime about my efforts to take care of all my business.

What I had to do, he said, was to learn to live with the anxiety, to feel the anxiety but then refocus my attention and actions and move on.

* * *

This week, a couple of my fellow bloggers wrote about uncertainty and living in the “gray” area. Sunny, of 71 degrees & Sunny, wrote about uncertainty surrounding the health of her cat and her husband’s battle with IBD. Janet at ocdtalk wrote about getting out of the black and white thinking into the gray.

Their posts prompted me to think more about uncertainty and how to handle it.

Those of us with OCD often struggle with uncertainty. One of the reasons we perform compulsive rituals like cleaning and checking is to try to be certain that, for example, there are no germs lingering on the surfaces, that nothing has been left undone that could cause a fire or some other danger.

Compulsive rituals cannot bring certainty, though. OCD thoughts are not rational. They are not rooted in reality. They cannot be tamed with some short-term assurance of certainty. Giving into the rituals doesn’t keep the doubts from returning.

Everyone, not just people with OCD, has uncertainty. There’s just no way for any of us to be certain about many things.

* * *

I made up a list of things that I am uncertain about for myself and for my loved ones:

Will we develop cancer, heart disease, Alzheimer’s or some other serious disease?

Will we have a wreck during any of the many times we travel by car from one place to another?

Where will the next terrorist attack occur?

Will fire, a tornado, a flood or some other natural disaster destroy our home?

Are the decisions we make about our finances the right ones?

Will we always have the benefits of health insurance and access to care?

Will I have a job tomorrow?

* * *

If uncertainty is a given, then how can I live with it in a healthy way?

The only way I know is to embrace the here and now and remind myself that I will handle whatever comes the best I can.

If the only thing I have for certain is the present moment, then I need to fully live in the present moment.

I need to make sure that what I’m doing in the present moment is something good and meaningful and helpful to the world.

I need to say what I need to say now, and do what I need to do now.

I need to be grateful for what I have right now.

Living in the now doesn’t preclude planning for and preparing for the future. What it precludes is worrying about the future.

Of course, all this is easier said than done. But I have hope and faith. They are key for me.

The easiest area of my life to live with uncertainty is my spiritual life. But that is for another blog post, which I will write soon.

* * *

What is your relationship with uncertainty? How have you made peace with uncertainty?

My paper battle

I started to throw down the old bill and run away from the table, literally run away from it.

I could feel the anxiety build to probably an eight, and I told myself that I had to stay until it went down.

That was last Monday as I worked on my pile of mail and paperwork on our dining room table.

I have written about my problem with the stack of paperwork and the way my therapist is leading me to confront it as a part of my cognitive behavioral therapy.

So I stayed and forged ahead. I didn’t clear the table, but I made some headway. I also learned a lot about my reasons for keeping some of the paperwork.

Examples

 Bills: I had to have minor surgery last August, and bills come with surgery. You don’t just pay one person. You pay the hospital, the doctor who performed the surgery, the anesthesiologist and the lab.

The bills are all paid. They’ve been paid. But I haven’t filed the bills and my notes of when I mailed the payments because I like to check afterwards and make sure the payments were received.

I haven’t called. And those papers have been lying on the table. I’ve used the excuse that they’re serving as a reminder that I need to call.

On Monday I thought about that: I wanted to check to see if the payments had been received. I wanted to check. Was that OCD checking?

I think maybe it is in my case. I have not received any notices of nonpayment or phone calls asking for money. My checks have gone through at the bank. That most likely means the payments were received.

So I decided I would not check. I would file all the paperwork in a file folder relating to the August 2011 surgery.

 Requests: I’ve been periodically receiving notices from a national animal welfare organization that I’ve sent donations to in the past, asking me to renew my membership.

This is a wonderful organization, and I don’t fault them for asking me to renew. They depend on donations.

However, I have made a decision, for the time being, to support organizations in my local area. I’ve held onto those renewal notices, though, thinking, I’ll read this and think about it later.

Monday night I considered this: if I’ve decided not to renew the membership right now, there’s no need to keep the notices. When I decide to pick back up, I can find them easily online and send in the money.

So the notices went into the trash.

 It's called avoidance

To aid in the cleanup, I bought some extra file folders and a pack of banker boxes for storage.

I know that waiting to buy what I think are necessary accessories before tackling more of the paperwork is clearly avoidance on my part.

I will do more this week. I need to report back to my therapist. Most importantly, I need to face this.

I don’t officially have my next CBT session until May because my therapist is so booked up, but I’m on the cancellation list, and my therapist told me to call every week to ask about canceled appointments.

Have you ever realized, in the middle of an exposure, some of the OCD thinking that has led you to that place? What did you discover?

Even if you don’t have OCD, have you had to face down tasks that seemed insurmountable? How did you do it?

OCD is hard

I’ve been thinking about what it’s like to have obsessive-compulsive disorder.

How I experience OCD now is different from how I experienced it when I was child, teenager and young adult.

If I compare my life now to how it was when I was in my 20s, I can say with no doubt that things are better now. I cope better. I am able to turn away from the compulsive urges much more easily. I have tools in my toolbox to fight it.

On this blog, I write mostly about what it’s like for me now to have OCD. I continue to have problems with obsessions and compulsions. I am still discovering ways that OCD works itself into my life. My general anxiety and depression can still throw me to the floor and make me think I’ve never moved forward.

But I have moved forward. With medication, cognitive behavioral therapy and personal lifestyle changes, all ongoing, I am moving forward. I am grateful for that.

I know many others are suffering in the depths of OCD, where they are exhausted and in despair. I wish I could wave a wand and take away all their pain.

Because I know how hard it is. That is something I will never forget, no matter how much my own OCD and depression improve.

I’ve had the chapped and discolored hands and wrists from having them in water and strong cleaners much of the day.

  I have stood in front of my stove for hours, looking at the knobs from every angle, touching the top over and over, checking for heat, while I tried to reassure myself that the stove was off.

  I have cleaned the bathroom using bottles of disinfect at a time, then made up excuses—lied—to try to keep others from using it.

  I have driven in circles, back and forth on the street, looking for bodies that I may have run over.

  I have picked up sticks and rocks and anything that looked dangerous as I tried to walk from one place to another, backtracking and bending over to examine something that looked like a weed but might be a wire that could stick someone in the foot.

  I have written research papers that said nothing because I was so afraid of plagiarizing.

  I have failed to finish so many books because I couldn’t turn a page until I’d read it multiple times, making sure I’d really read it.

  I have prayed and chanted continuously, thinking I was somehow responsible for keeping everyone safe by doing so.

  I have confessed my sins, or what might possibly be sins, to anyone who would listen.

I’ve prayed for God to just let me die because I didn’t think I could take one more minute of the pain.

Somewhere inside me was a little hope. It must have been there, even though I couldn’t feel it, because somehow I didn’t give up.

It has taken years for me to reach a point where obsessions and compulsions don’t occupy every waking moment. I am getting better faster now, I believe, because I am doing cognitive behavioral therapy, something I didn’t think I needed before.

OCD will always be with me. It will always be with you, too, if you have it.

Hope will get us through, though. No matter how tiny that hope is, even if it’s just a small thought that there must be something better than this. Even if all the hope you have is the knowledge that someone else got better.

I got better. I’m getting better. And you can too.

OCD: An exposure I didn't plan

In my last post, I said I was going to do some exposures that I would write about.

In that same post, I also wrote about some physical health issues I’ve been having.

This post is about an exposure, but not one I was planning when I wrote that post on Sunday.

And it involves those health issues.

I wasn’t going to write about this. It was too personal, I thought, and my readers might not like it.

But this blog is about my life with OCD and the accompanying issues. I decided to share this exposure because it was about real life issues.

When I saw my family doctor last Friday, she ordered blood tests, a urinalysis, and a stool sample.

That last one got me. I could feel my mouth draw up a bit. I thought, doesn’t she remember that I have OCD? I just told her I was having anxiety from starting cognitive behavioral therapy. And she asks for a stool sample?

The doctor, of course, was interested in finding out what was causing my stomach pain and problems that have been ongoing for a while. So she went on talking to me, continuing to tell me what the course of action would be. She said that the nurse would give me what I needed to take a stool sample to the lab.

After my appointment, I walked out to my car and sat there while I talked with my husband on the phone. Then I realized that the nurse hadn’t given me the stool sample kit.

I admit, I wanted to just forget it. I wanted to take that as a sign that I really didn’t need to do it. Obviously, it wasn’t that important if the nurse forgot to give it to me, right?

But my husband said I needed to go back and get it. He was right. And I did.

Back inside, as the nurse told me what to do, I again could feel my mouth turning up.

“I think I’ll just wait until after all the blood work results come in,” I said.

The doctor had told me it would take about two weeks, so I thought that was a safe reprieve. And—this was my really, really good reason for waiting—the blood work results might reveal something that could be taken care of and I wouldn’t even have to do the stool sample.

The nurse gave me a look. She was probably thinking that I was a very weird woman.

“OK,” she said. “But you need to call me and let me know when you’re going to do it so I can fax the orders to the lab.”

All weekend, I ate very carefully, wanting to get better quickly so, again, maybe the stool sample wouldn’t be needed.

The nurse called me yesterday and said my white cell count was elevated.

“When are you going to do the stool sample?” she asked.

I guess she had forgotten my “wait until all the blood work comes back” excuse. I decided that I would try to make myself look a little more compliant.

“I’ll wait until after the urinalysis comes back,” I said.

It was going to be another couple of days, so I could continue to avoid the problem. Avoidance can be so sweet.

The nurse called me today. The urinalysis was negative.

“Then what’s wrong with me?” I asked.

“I don’t know,” she said. “That’s why we want to test your stool.”

I asked her to fax the orders to the lab.

Then I agonized about what to do. With my bathroom and contamination issues, I knew it would be a nightmare.

And there was the logistics matter. I had to get the sample to the lab within the hour of producing it. The lab was a good 45 minutes away.

I just wanted to forget all about it.

But I went to the doctor in the first place to get help. If I wanted help, I needed to follow through. Was I going to let OCD stop me?

I decided very quickly that I had to do it. I wouldn’t think about it anymore. I finished up some work and then went home.

It was not easy. I pretty much freaked out at one point. I wanted to clean the bathroom from top to bottom. I wanted to take a shower.

I didn’t have time, though. I had to get the sample to the lab, or—horrors—I’d have to do it again.

I made it out of the house after washing my hands only twice. I was feeling anxiety at a scale of about 9 all the way to the lab.

I kept glancing at my car clock, calculating how much time I had left. I worried about possible detours, or doing something that would cause a state trooper to pull me over. That would delay me. Then I figured I would just wave the biohazard bag at him, and he’d let me go.

I finally arrived at the lab, in time, and hurried inside, eager to get rid of that bag.

Ah, but there was a problem.

The woman at the front desk looked through the paperwork and said they hadn’t received the orders. Then she didn’t say anything.

I internally freaked out again, thinking I’d have to do all of this again and come back.

“Can I still leave it?”

“Yes,” she said. “But make sure your name and date of birth are on the cup.”

“It is,” I said, pointing to the label on top.

“It has to be on the side of the cup,” she said, and handed me a marker.

So I had to take the cup out of the biohazard bag and write the required information on the side of the cup.

I doubt if the outside of the cup was contaminated, but I did not want to touch it again.

I followed her instructions and then used the hand sanitizer at the door to the lab. I hoped that since it was in a lab, it would be extra sanitizing.

I thought later that I should have just asked where the bathroom was so I could wash my hands there. Anxiety makes you forget vital things.

Back in my car, I could feel my anxiety going down. I had done it. The worst was over. I didn’t have to do anything else but wait for the results.

I’m very tired, but I’m glad I did it.

Easter on the farm



Ducks feeding on cracked corn by the pond. The photos are not my best because I took them with my phone.

   
    My husband and I had Easter dinner at his cousin and her husband’s farm today.

They live about 30 minutes from our house on a big piece of land with lots of trees, flowers, a garden, blueberry vines and a large pond fed by a creek.

They both love animals, and they have quite a collection: three cats, three dogs, one cockatiel, two parrots and a large tank of goldfish.

At the pond, they have six ducks. Two geese make regular visits.



Ducks in the water.

Added to the menagerie are three baby rabbits. A friend of theirs in a nearby town found the babies in his yard and sent them to the farm, where the cousins have bottle-fed and otherwise tended them. They plant to gradually introduce the rabbits to the outdoors until they are ready to be released.

Right now, they lay close together in a cage, with a light blanket around them to keep them warm.

Before dinner, as some of us sat on the screened-in back porch talking, enjoying the sunshine and breeze, the geese flew in, announcing their arrival with loud voices. We watched them angle down to the pond and skim the water before settling in.

After dinner, my husband and I walked down to the pond and watched the ducks and fed them cracked corn. We laughed at their antics in the water, and I told my husband I could sit there all day and watch and listen to them.



Can you see the goose?



Tulips filled a flowerbed, and dozens of iris plants are set to bloom. A few already have.

What wonderful sights and sounds for a day that celebrates renewed life.

I needed this day. It’s been a hard weekend. I’m having some issues with my physical health, specifically with my digestive process, so I saw my doctor Friday.

It seems like everything I eat makes me feel awful, so my doctor is having me make some big changes: less caffeine, little or no dairy, more fiber, less simple carbohydrates. I am also eating less sugar.

My doctor is running some tests. I hope there’s nothing physically wrong, but I’m not too concerned. I’ve had similar problems before. If it’s something more, I’ll deal with what I have to when I have to.

But I know that anxiety can affect the digestive system, and I know I haven’t been treating my body very well. I don’t eat right and my sleep patterns are all over the place.

I am all for the changes, because I’m tired of feeling like I’ve been feeling. But any changes can have at least temporary disadvantages. I don’t know whether it’s the decrease in caffeine and sugar or just being physically worn out, but I’ve been feeling down too.

The trip to the farm helped. Being amidst so much life, being so close to the natural world, being with family—they are all valuable and important components of a well-lived life, don’t you think?

On another note, I’ll be tackling some exposures this week and writing about them. Wish me luck!

Book Review: Oxford Messed Up, by Andrea Kayne Kaufman

Oxford Messed Up. By Andrea Kayne Kaufman. Grant Place Press, 2011. 324 pages.

The Cadence Group recently asked me to read and review a novel, Oxford Messed Up, by Andrea Kayne Kaufman.

I was happy to read the book, because one of the main characters, Gloria Zimmerman, suffers from obsessive-compulsive disorder, and I was curious to see how that would be portrayed.

The novel is about two people who consider themselves messed up. Though very different from each other in background and personality, each shares a love of Van Morrison’s music.

His music serves as a background and almost as a character, as the two help each other to transcend their demons.

Gloria Zimmerman is a Yale graduate and a Rhodes Scholar at Oxford University, where she is studying feminist poetry and serving as a research assistant with an expert in the genre.

Gloria has suffered from OCD since she was in seventh grade. Although she has been prescribed Luvox, she doesn’t take the medicine on a regular basis.

Gloria’s OCD, which she calls Oliver, revolves around contamination. She is terrified of germs and goes to great lengths to avoid them or to rid herself and environment of them.

She cleans the bathroom every day, scrubbing already clean surfaces again and again. She avoids people as much as possible, and finds herself happiest when she’s in the sealed environment of a rare book room in the library.

Gloria keeps a huge supply of cleaning products, antibacterial wipes and, her favorite, hand sanitizer.

As a result of all her cleaning, Gloria’s hands are red and raw, immediately noticeable to others, a visible sign of her inner suffering.

One of the only ways she can comfort herself is by listening to the poetry of Morrison’s music.

Henry is also an Oxford student. He is studying music, but not the music he loves, Morrison’s. He is an academic mess, avoiding the library, research and writing. He has no confidence in himself as a scholar.

Henry is a recovering drug addict, and has the track marks on his arms as a reminder. He has other secrets, too, which keep him from having motivation to do much more than listen to his Morrison records.

When Gloria arrives at Oxford, she discovers that she will be sharing a bathroom, or a loo, with Henry. Oliver is disgusted by this and by Henry’s messiness and “his dirty, feces, germ-infested hands.”

But Gloria and Henry become friends, on Gloria’s terms. She allows herself to interact with Henry but keeps herself distant and doesn’t confide her troubles to him.

They spend hours together talking and sharing their love of the music and poetry of Morrison and others.

In anger after Gloria rebuffs his offer to take her to a Morrison concert, Henry urinates in their shared bathtub. Gloria responds by flying into a rage and then having a meltdown.

This is a turning point in the story, because it brings Gloria and Henry together in a more honest way. They agree that he will be her coach in cognitive behavioral therapy, specifically exposure and response prevention, and she will be his dissertation coach, helping him pull together a new topic based on Morrison’s fatalistic optimism.

Though they have many setbacks and face new issues as they reveal more of themselves to each other, Gloria and Henry are able to transcend the problems that they have and begin to enjoy and find happiness in life.

The novel moves along quickly, with short chapters and lots of different scenes. The viewpoint switches from character to character, each chapter told from the point of view of Gloria or Henry or, in a few chapters, other characters.

The writing is concise and evocative.

Kaufman does a fine job in describing what it’s like to suffer from OCD. For example, her description of the process by which Gloria cleans the bathroom, and the way she rubs her hands together with hand sanitizer while chanting to herself, will resonate with people who have OCD.

Henry is a tortured but loveable character. It’s a little hard to believe that Gloria, steeped in years of OCD, would so immediately be drawn to someone like Henry, but their relationship develops believably.

The book takes place over about five months, and that’s the only real quibble I have with it. Gloria takes Luvox regularly and works on her cognitive behavioral therapy for just two months. Yet, she has almost a complete recovery from OCD. In fact, I think most readers of the novel would say she was cured.

During the two months, Gloria also gets professional help at Oxford, but her quick recovery is still unbelievable.

This may give readers who suffer from OCD and those who don’t the impression that OCD can be easily overcome in just two months, while in reality, it can take longer to reach a place where OCD does not control a sufferer’s life.

I love how the story intertwines with Morrison’s music and women’s poetry. There are many metaphorical layers in the story that enrich it.

Study questions are included at the end of the novel, and these could be helpful for a book club or a class.

Anyone who likes a good love story and who delights in seeing characters overcome great obstacles will enjoy this novel. The book could inspire readers who happen to have OCD and inform others about the disorder.

For more information about Kaufman and about how to purchase the book, go to her website at http://andreakaynekaufman.com/. The book is available as a hardcover, paperback and as an e-book.

CBT Session #6: Facing the anxiety

A bit of spring: dogwood blossoms.

How wily are the ways of obsessive-compulsive disorder.

I had another cognitive behavioral therapy session today, and I left my therapist’s office with a new understanding of how subtle avoidance can be.

I have compulsive rituals that I perform to try to lessen the anxiety caused by obsessive thoughts. I also avoid doing certain things because of the anxiety caused by whatever it is that I’m avoiding.

As I wrote about two weeks ago, my therapist and I decided that I would work on clearing my clutter of papers.

I did one 15-minute session of clearing clutter two weeks ago, and I haven’t done any more work on it since then.

Let’s change course

Today, I decided I would tell my therapist that I wanted to change course. Several things fed into my decision.

·        I have been feeling a lot of anxiety lately, even waking up with it.

·        I have had no interest in continuing to clear the clutter.

·        I have felt overwhelmed by the fact that I’m trying to work on several things at once—my issues with clutter, with writing, with checking, with rituals that slow me down.

It would be better if I just focused on one OCD manifestation, I told him. I would work on checking.

Not so fast

He sat back in his chair and smiled a little.

“OK,” he said. “You want to focus on one thing, the checking. So what happens when you come in here next time and want to work on something else?”

I was taken aback. I wasn’t sure what he meant. Or, rather, I was afraid that I knew what he meant.

What he meant was that he believed I wanted to change course because I didn’t want to face the clutter. I didn’t want to face the anxiety of cleaning it up because it was not going to be easy.

It’s all about the OCD, he said. It was about my scrupulosity, my fear of finding something in the clutter of mail and papers that showed I had missed paying a bill, missed doing something that I was supposed to have done.

I immediately knew he was right. Apparently, I’m pretty good at finding ways to put off OCD issues that I don’t want to face.

Face the anxiety

My therapist said the only way I was going to get over this anxiety was to face it. The 15-minute rule wouldn’t work after all, because though I got anxious during the clutter session two weeks ago, I moved away from the anxiety after 15 minutes.

What I had to do, he said, was to keep on working on the clutter, even with high anxiety, until it started to go down on my 1 to 10 scale.

Focus on what I could control now. I could deal with future problems when they happened, he said.

So, here I go. I have to face the anxiety. I don’t want to. But to get well, I have to.

What about you? Do you practice avoidance? How do you face the anxiety?

Fighting OCD and depression: I make the decisions

Two things my therapist taught me have been on my mind this week.

“Willpower is not a feeling you have. It’s action you take,” he told me during last week’s cognitive behavioral therapy session, which I wrote about here.

And during a February session, he taught me that the only things we can control about our thoughts are which ones we attend to and how we respond to them: our attention and our behavior.

Willpower, attention and behavior. The common factor I began to see is that I make the decision about putting one foot in front of the other and acting. I make the decision of what to pay attention to. I make the decision of how to respond to my thoughts.

I make the decision.

I haven’t been making good decisions in regards to my obsessive-compulsive disorder and other anxiety. I also recognize that I haven’t been making the best decisions regarding my depression.

I avoid doing things that I know will help me. I’m trying to figure out how I can do better.

To be more specific, I’m trying to get out of bed at the same time every morning, at 6. I’m trying to be more diligent about setting a deadline for myself in getting my work writing done and not put it off until I have to do all of it in one day. I’m trying to be more consistent in things like working on my own writing and clearing my clutter.

When my alarm goes off at 6, my arm reaches automatically over my head so I can hit the snooze button. I hit the button every 15 minutes for the next hour or two.

Early this morning, I was awakened by Chase Bird, one of our cats. He was crying his distressed cry, which usually means he’s getting ready to throw up.

I got up and cleaned up the poor boy’s hairball. It was 5:40 when I came back to bed. I knew I could decide to just stay up. But I consciously made the decision to get back in bed. When the alarm went off, I knew I could decide to get up. I consciously made the decision to hit the snooze button.

Why can’t I make the right decision?

I am able to get up when someone else is depending on me to get up. When I have a work-related reason for getting up early, such as an interview or a trial to cover, I get up. When I have a doctor’s appointment or even a haircut appointment, I get up.

Basically, when I am responsible to someone else, I am able to put one foot in front of the other.

So why can’t I do that for myself? Why can’t I make decisions to do things such as cleaning up clutter, writing in spite of my anxieties and exercising, things that will help me?

I’m not sure.

My sleeping in is likely due to the fact that I dread having time on my hands. If I get up early, what will I do with my time until I leave for work? Well, I might have time to do something like write. But that causes anxiety. I might have time to exercise. But it will be difficult because I’m out of shape, and I won’t get in shape overnight.

It’s much easier to hit that snooze button.

I’m still avoiding. I’m still placing too much emphasis on how I feel. I’m still paying attention to the thoughts that tell me I can’t feel anxious.

This cognitive behavioral therapy is hard. Changing my life is hard.

I have to keep on trying. But I am looking for insight from you. How do you push through and do what needs to be done? How do you make the right decisions for yourself?