ocd

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Dissociation and Depersonalization

I have had occasional occurrences of disassociation in my life, but it was not until the most recent and scary one that I felt prompted to ask my therapist about what was happening to my consciousness.

Disassociation describes an interrupted state of consciousness usually accompanied with a feeling of being detached from one’s emotions, body and/or immediate surroundings.  This is often a coping mechanism to deal with overwhelming experiences and is often seen in people responding to trauma, but sometimes it just happens.  A dissociative experience could be as common and casual as driving on auto-pilot.  You know, when you drive from point A to B and you really don’t remember the drive at all.  A more severe form of disassociation might involve fragmented emotions, multiple identities and a loss of the sense of self.

I remember day dreaming a whole lot as a kid.  I remember looking in the mirror on occasion and not recognizing myself or walking down the street feeling as though I was walking on the set of a movie in a haze.   I used to say I responded poorly in emergencies like when I started a small kitchen fire; I just stared blankly, completely frozen.  Really, I wasn’t dumb or responding poorly, I was checking out because it was too overwhelming for me.

Most recently I went to a yoga class.  I do not meditate as I would like to because it actually really stresses me out so yoga sounded nice, but I was nervous.  I breathed deeply during the class as instructed and felt incredibly irritated.  I do not know why, but when trying to relax in this capacity was making me upset.  Toward the end of class, I was exhausted and we laid on the floor in “corpse” pose.  I began to feel “out of it” and then my thoughts turned very dark, including suicide ideation.  I cried quietly and felt as though some other voice was talking in my head. I knew it was my brain, but I felt no sense of control.  I just listened to my cruel thoughts.

Class ended and I walked out in a daze, seeing the world in a fog.  I walked around passing people, staring them down because I thought I was invisible.  I got home and slowly came out back to my normal conciousness.

My therapist told me I had experienced depersonalization which is a type of dissociation with symptoms like what I had described.

As you might guess, I have been instructed by my therapist to avoid yoga and similar mindfulness based activities for now.  We are working on me becoming more comfortable with my mind so I can handle feeling emotions without “checking out”.  And that’s kinda how treatment works for this.  Treatment is dependent on the underlying condition so the therapist will decide the best course of action.

Disassociation can be a one-time occurrence or once in a while thing or its own disorder.  It can also be a prominent symptom in other non-dissacociative disorders like OCD, Borderline Personality Disorder, Bipolar Disorder and Depression.

 

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To Keep or Dismantle My Network of Vices

I have never considered myself to have an “addictive personality”; whatever that means.  For most of my life, I could take or leave alcohol, cigarettes and food, but more recently things have looked very different to me.  I wasn’t using the classic poisons to escape my emotions, but rather self-destructive habits like starving, cutting or casual sex to get out of my conscious.   I have also noticed that when I drink alcohol, a story of regret usually follows.   I do not know if this means I would be better off avoiding my vices or just dealing with it for the time being.  After all, cutting out alcohol, sugar, sex, smoking weed and self-harm sound like a lot.  Logically, I know that I need healthy ways to cope with my emotions, but I feel addicted to my tendencies and am intimidated by the work ahead of me.  I anticipate being alone for quite a while.

One step at a time I guess.

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Self Harm – Sometimes Scars Are Not Worth Having

I have always felt the need to punish myself.  Even as a child in a non-practising religious family, I felt compelled to confess my sins.  Not knowing what I actually wanted was reassurance for my shamefully obsessive thoughts, I wanted justice and forgiveness for thinking the worst things ever to be thought.

It started out with food.  I would deny myself.  I would use the ache of hunger to take my mind out of the mental loops.  Even if I knew I had not done anything terrible, I still wanted to make things “right’.  I felt guilty all the time, even hearing a story on the news about something a thousand miles away.  I started piercing, over and over again.  Letting the piercing site heal and then doing it again.  I started to enjoy the pain.

Then I cut myself.  Drunk, on the floor with a blunt kitchen knife on my wrists.  I had no intention of suicide, it was just a place.  I wanted the scar.  I couldn’t stop and then my legs looked a mess.

I wear pants almost all the time now as I wait for the scars to heal; the scars I wanted as a way of proving that I had atoned.  It was not until something clicked with the help of a councilor that I realized that pain did not mean healing.  It blew my mind.  Pain did not mean healing and it was then that I did not want my scars anymore.  For the first time, I felt that I had hurt myself and that it was wrong.  I felt bad that way I would feel if someone else had hurt me.

I cant even fathom cutting myself again, until those days when I am depressed; then I feel the desire come back a little, but not even close to enough to go through with it.  I can’t accept that anymore.  It’s almost like I am two people at times.

I am now learning to respect myself and it is so challenging in some ways.  I just want to be normal.

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OCD on Glee

Ever see Glee?  I was excited to see it when it first came out since I had heard there would be a character with OCD on the show.  Unfortunately I am mostly disspointed with how they have chosen to portray OCD.

For those who don’t watch or who haven’t seen it, that character is Emma, and her OCD mostly manifests in mysophobia (more commonly known as germaphobia).  The pilot showed Emma getting quite anxious after stepping on a piece of gum.  Many episodes show her cleaning fruit with moist towel-ettes and gloves.

Most recently aired season three: episode three, where Emma’s parents come over for dinner which stresses out Emma to the point of compulsively arranging and rearranging her silverware.  Her parents are mean and make fun of her.  A flashback scene then shows Emma as a child sitting at the table of a restaurant.  Her parents hand her the familiar moist towel-ette and she begins cleaning her cup as her parents do; implying that Emma developed OCD because of the way she was raised by her parents.  I did not appreciate this as it sends a strong message that OCD is someone’s fault, when it is not.  Later in the episode, Emma is seen compulsively rubbing her hands together, before she kneels to the ground to pray.  Will is with her, and says “I wish I could make things better for you”, not knowing what to do.

I thought that scene was sweet and probably the closest the show has come to portraying OCD in a realistic way, but overall Emma falls short.  She is often seen cleaning or compulsing, but she always seems quite calm performing her rituals, and I think most of us don’t really recognize that feeling while compulsing.  Thus, further supporting the false idea the OCD is about perfectionism, cleanliness and anal retentiveness rather than anxiety.  At the heart of it, OCD is about trying to make the anxiety go away.  When an obsession or intrusive thought pops into the mind, the person becomes anxious and tries to get rid of the feeling with compulsive behavior.  Emma rarely seems anxious, as most of the time during her cleaning, she is chatting with great ease.  After a while you don’t even notice her cleaning because it comes across like she is simply overdoing it.

Without too many shows highlighting OCD (besides some exploitative reality show garbage), I am less than impressed, and I really don’t relate to the character.

You ever watch Scrubs?  That scene with Michael J Fox was what helped me realize I had OCD. It was a very realistic representation as he showed anxiety, stress, frustration, shame and strength.  Emma is pretty flat as a character and while I think it’s nice they have an OCD character…yawn.

Here’s the clip from from Scrubs that really changed my life.

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“The OCD-Girl”: Identifying with OCD

The idea that OCD and I had this almost Jekyll and Hyde relationship defined me more than I would care to admit. Because of therapy and tending to all my health problems, my OCD is at a minimum. So much so, that I rarely see it as part of my life anymore. This was amazing; not having OCD steer my ship anymore, but it wasn’t that simple. Who was I now that my OCD was mostly gone? I had such severe OCD, that I had trouble keeping a job, few friends, and threw out stuff (opposite of hoarding). I dressed plainer than Jane, hated traveling and feared everything. Now that I was not this girl anymore, I hated my clothes, hated how I acted, hated that I had no career…It was like that movie with Val Kilmer where he plays a blind man, but gets his vision (not as extreme, but you get the idea). He was confused by shadows and mirrors and though he could see, he still lived the life of a bind person. I felt like I was still living the life of OCD and I hated it.

I am sad. At first, I felt spoiled for not being full of pure glee for my new mind, and I assumed that the adjustment period was to blame. I then realized that this sad feeling is too much. For years, I have been told I had depression and I would always deny it. For some reason, I refused to admit to it. Now that OCD is not the main issue, I feel like these other issues are coming to the surface which, though painful, is for the best.  Now I am in therapy again for the depression and continuing to work on my physical health.  That was the biggest difference for me, healing the body as a whole.

I am not the “OCD-Girl” and though it makes me a little unnerved to feel like I don’t know who I am anymore, I feel hope in knowing that I am now free to find out.

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How to Find a Good Therapist for OCD?

Ok, you have decided you are finally ready for therapy.  So, how do you find a good therapist?  And when I say “good”, I don’t mean qualified, because most practicing therapists are legally qualified; I’m talking about someone who listens, respects you, has beneficial input and someone with whom you are comfortable with.  It is important that you are comfortable with your therapist because if you don’t have a framework of trust, it’s not going to work.

You can call your insurance company for a list of names, you can seek free or low cost therapy, you can ask your school councilor for referrals, you can google “ocd therapist near….”

Phew!  So, now you have some names, and then you make the calls.  When I called the therapists on my list, I left messages with almost every single one of them.  Many returned my call and when they did, I had a list of questions ready:

  1. Do you have experience treating OCD? If not, then don’t even bother.  Not all therapy is equivalent.  Some types can actually make things worse; so stick with what’s been proven to work.  If they say “no”, you can ask for referrals or advice on how to find one.  This is actually the way I found mine.
  2. Are you accepting new clients? If not, but you really want them, you can wait.  Or move on.
  3. What kind of therapy do you use to treat OCD? i.e. ACT, CBT, EMDR…It is wise to do a little reading on the difference between these types of therapy.  You can always ask the therapist as well.  My therapist asked if I would prefer to go with the ACT approach or the CBT approach.  He explained both and I picked the one that sounded best to me.
  4. What are your rates and do you accept insurance or offer sliding scale?
  5. Ask to setup an orientation or first meeting if you think everything sounds good.  Keep in mind, a first session is most often you discussing your history, filling out a questionnaire and feeling things out.

The first therapist I tried out was awful.  She seemed nice, but when I talked about my history, she made comments that really just pushed my buttons.  I felt judged.  At the end of the session, she gave me some pages from an OCD workbook to do as homework.  I was less than impressed.

I left, not really sure if that was normal or not.  I didn’t like her, I knew that much, but I wasn’t sure if I should give her a few sessions to make sure.  I also wondered if maybe I was trying to get out of therapy subconsciously.  I told the story to my husband and sister and I realized that the more I talked about it, the more it bothered me and I decided not to see her again and to look elsewhere.

I started calling other therapists and I began asking the ones who said they had no experience in treating OCD if they could recommend someone.  One suggested I check with anxiety center in my area and I found a therapy group specifically geared to treat OCD.  I spoke to one on the phone and decided to give him a try.

I had my first session with him and I knew he was going to be the one I wanted to help me.  I felt comfortable and agreed with his philosophies on treatment.  Everything felt “right” and I have been seeing him for a few months now.

The search may be frustrating as it was for me, but when you find a good one, it will be worth it.

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ACT – Acceptance and Commitment Therapy

I was absolutely terrified to begin therapy. O man, was I pulling out every excuse in the book to avoid it. I thought it wouldn’t work, that CBT would be painful with short term results, and that the fear of exploring my mind would be too intense.

In an effort to avoid therapy, and still get some help, I talked to a school counselor about some tricks she might have in terms of coping with stress. I explained about my OCD and she told me simple stress reduction exercises weren’t going to help me and she recommended I try exposure therapy. I told her I saw “Obsessed” on TV and there was no way I was going through that. She responded:

“I think it’s great that there is awareness being brought to OCD, but the shows on TV are so extreme.  The exposures they do are intense and much of the time irresponsible.  In real life therapy situations, things go much slower.  The problem with shows like that is that they make people afraid to seek treatment.”

Over the next few weeks, I decided I was ready and thus began my search for a therapist.  My first therapist was a horrendous bitch and I didn’t give her more than one session.  I found a new one who is compassionate, trustworthy and whom I have good chemistry.

I have been in therapy now for nearly four months. I think it’s helping a lot. I have noticed some pretty cool changes, but I’m not gonna lie; it’s difficult. I have experienced some painful situations, opening doors to my mind I never wanted to, but I am becoming a stronger and happier person.

The therapy I am doing is called “ACT”, short for “Acceptance and Commitment Therapy”. It is similar to CBT in that it incorporates exposures, but the main difference is that instead of trying to control or fight thoughts like in CBT, ACT promotes accepting the thoughts as merely thoughts.  ACT also focuses on helping the individual discover his/her core values and goals about life and ways to take action in achieving those.

I don’t take SSRIs.  The rate of them being effective is pretty low, while the risk of developing side effects is pretty high.  I think it’s awesome that some people have found them to be helpful, but they aren’t right for me.

I know many of us wish there was a pill that cured OCD, that had no side effects and didn’t lose potency or trigger dependency over time.  The truth is that there really aren’t many medications in life that are like that.

Therapy is like exercise.  Everyone wants a magic diet pill, or a 10 minute workout, but the answer is and always will simply be that you gotta do the work.  Yes, it will hurt, but the journey can show you how strong you never thought you could be.

Therapy is a great option and the success rate is impressive.  Maybe give it a shot when you’re ready.

I still have a long way to go, and I will no doubt stumble along the way, but my happiness is worth fighting for and so is yours.

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HOCD – Horrified to be gay (or straight).

I was trying to explain what this was like to a friend the other day, and it was a bit challenging.  Not only was I trying to simply define the term, I was trying to explain how I figured out I was bisexual despite my obsessions.  I came across this article that I’m not going to even try to sum up because it is THAT GOOD.

Click here to read “Sexual Orientation OCD, aka HOCD / Gay OCD – Part 1” by John Hershfield of the OCD Center, LA.

I learned a lot about myself from this piece and hope others find some interest as well.