Personal Journey

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My Personal Journey with OCD

Before, During, and After Cognitive Behavior Therapy

Nancy

 


I was nineteen years old and working in a chemical plant in West Virginia.  I was feeling very depressed for various reasons, mainly because I could not go to college like my friends, due to financial restraints.

I suddenly noticed that I had an urgent need to go and recheck whether or not I had flushed the toilet at work.  I began to obsess about whether or not I had paid a floral bill and about a white lie I had told.  I barely slept and had to quit work.  My mother kept taking me to our family doctor.  Little did I know, but my journey with OCD had begun.

My family doctor sent me to the local Psychiatric ward to be evaluated since he could not find a cause for my illness.  While there, I was so scared and I started to cry.  They put me in a straight jacket.  My family doctor got me released and I went home to suffer some more.

It is my personal belief that anxiety has to have a way out of the body – whether by OCD, tics, pacing, depression or in my case an emotionally based speech problem. This plagued me for about the next twenty years or so.  Sometimes I could barely say my name.

In 1969, I married my wonderful husband and later had three beautiful children.  I was blessed that during all of those years, while raising my kids, that harming thoughts of OCD did not plague me.  I had an occasional thought or felt like reaching out to touch someone in the grocery store.  I thought it was because I was homesick.  My husband was and is very supportive of me and my thoughts.  Even before we knew it was OCD that I suffered from he told me “everyone has awful thoughts sometimes.”

In 1984, after surgery, I went into a clinical depression.  I barely slept or ate.  I had to do something!  I went to the local psych ward of the hospital in NY.  It was the hardest thing I ever did but the best thing, too.  I stayed there for six weeks.

After going off of the drug, Xanax, I noticed thoughts like being careful around a pair of sharp scissors became, “what if I picked them up and stabbed someone, or what if I stabbed my dog with a knife while unloading the dishwasher.”  But, I loved my pet.  I would never want to hurt her!

A doctor never actually diagnosed me with OCD or even mentioned it.  A friend, who was a psych nurse, gave me info about OCD and thought that’s what it was.  Later, my doctor agreed with the diagnosis.

My life became a nightmare of harmful and sexual thoughts.  These thoughts were everywhere – I might run over someone with a car, touch someone inappropriately, stab the dog, say the “F” word, and on and on.

Then I found a wonderful therapist.  She confessed that she was not well educated about OCD.  But she studied and we had a workbook to go by.

I am also fortunate to find and join the Central New York Obsessive Compulsive Foundation Affiliate support group in Utica, NY.  The leaders of the group attended a national OCD Conference about that time.  They came home and told me about making an exposure tape, writing a detailed story about actually acting out a harmful thought.  I thought, ”How could I ever do this.”  It seemed the direct opposite of what I wanted to do.

My therapist, Susan, and I worked together.  I took my three most disturbing thoughts and used the hierarchy method.  I first made a tape using the third, least disturbing thought, then the second and finally the number one most disturbing thought.

I would sit by myself, or with my dog, and play the tape over and over and over, listening in detail how I would stab the dog, the police would come, everyone would hate me, etc.  The thoughts never became silly or funny or common but HABITUATION occurred.  I got so used to hearing the tape that the thought lost its fear or punch.  I know OCD people don’t act on their thoughts; they react to the fear of the thoughts.  I had learned a coping mechanism.  I had my first glimmer of hope.  Let the thoughts come!

Now I don’t run from the thoughts.  I follow them through – for example, if I see a sharp knife in the dishwasher, I say to myself, “yes, I could stab my dog but I don’t want to today.  I’d rather play with her.”  I breathe deeply and go on about my day.  ( It is also worth noting, that for me , taking 25 mg of Anafranil helped to calm down the thought enough so I could concentrate on the  CBT.)

I was fortunate that my therapist had educated herself about OCD.  In 2007 she attended   the Behavior Therapy Institute (BTI).  The key concepts that she learned or that were reinforced were:

1.      The importance of treatment readiness – working through ambivalence and resistance (exposure therapy is scary!)

2.      Treatment interfering Behaviors

a.      Skill deficits

b.      Treatment of incompatible beliefs

c.      Emotional dysregulation – learning not to overreact to emotions, the patients know the anxiety will eventually come down

d.      Environmental contingencies  (Ex. Parent not on board, stress at work)

3.      Gaining detailed information on developing exposure hierarchies – 3, 2, 1

Susan says “The BTI gives good intensive training, even if you already know CBT for OCD which also involves exposure response prevention.  It’s great for anyone working with an OCD client to have a great network of professionals to draw upon.  Experts are available to share their knowledge of the disease and show how it’s applied specifically to OCD.”  (Authors note:  Susan Dewey has given permission to use her name.) 

From my point of view:  The therapy methods and techniques that helped me the most were the exposure tapes, deep breathing exercises, keeping a journal, continually educating myself by reading many books, challenging the OCD by ‘bossing it back’, using metaphors, etc. 

I know how hard it is to find a qualified person to help with CBT for OCD.  There is a desperate need for providers; psychiatrists are great to prescribe medication but few have the time to dedicate to CBT.  My therapist significantly helped change my life for the better partly due to her experience at BTI.  I would encourage any treatment provider to attend a BTI.

 

 

 

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Created in honor and loving memory of Brian C. Connell