My Experience with OCD
At the age of 40, I developed obsessive-compulsive disorder. It started with vague doubts when I left the house. I questioned if I had locked the door and turned off the coffee pot, stove and lights. I developed a ritual of checking everything in a certain order. If I was interrupted, I had to start over. Often I returned home, after leaving the house, to check something.
When the frequent trips back home began to interfere with my job, I sought treatment. The checking rituals improved, but I developed other symptoms. As I was driving, I would suddenly feel like I had hit someone. Id retrace my path, looking for something or someone. This often triggered an obsessive-compulsive cycle. Id drive back and forth until I was satisfied there was no dead body by the road. I discovered later that acting on the first obsessive thought often triggers a cycle of repeated compulsive behaviors.
I worried about the car door and brakes and made frequent trips back to the car to make sure the door was locked and the brake was set. I had a fear of contaminating food, so I only cooked for my immediate family. I washed my hands frequently during food preparation.
The trips back home to check things and constant checking of my work took its toll on the job. I had told my supervisor about the OCD and she was very understanding. But when my work was affected too much, she asked me to take a leave of absence. Medication and therapy put me on the road to recovery and four months later I returned to work with a reduced work load.
I hope that sharing my story will help others understand obsessive-compulsive disorder and its treatment. If therapy is sought early, treatment is less painful and recovery is faster. In their concern for me, my supervisor and co-workers tried to overlook my behavior. When I returned to work my supervisor refused to enable my constant checking, worrying, repeating myself and demanding perfection. It was much more difficult for both of us, but it was what I needed.
I was on the road to recovery, but the road proved long. I read all I could find about OCD and its treatment. I discovered cognitive-behavior therapy in my reading and put the principles to work in my battle against OCD. It worked! As my OCD improved, I felt a strong urge to tell others about cognitive-behavior therapy. I wrote a continuing education course for my fellow nurses and several articles for the general public. Then, through a series of events, I added my writing skills to those of Bruce Hyman, Ph.D to write The OCD Workbook.
I discovered that I enjoyed writing and changed careers. Since writing The OCD Workbook, Ive coauthored other books: The Habit Change Workbook and The BDD Workbook with James Claiborn, Ph.D., Helping Your Child with OCD with Lee Fitzgibbons, Ph.D., and Loving Someone with OCD with Karen Landsman, Ph.D. and Kathy Rupertus. Bruce Hyman and I also published a second edition of The OCD Workbook in 2005 and Obsessive-Compulsive Disorder and Anxiety Disorders books for teens.
Writing has helped me recover from OCD. Instead of a constant unwanted companion, OCD is now an infrequent visitor. I have only occasional obsessive thoughts and am more able to dismiss them. Rarely, I have problems with checking when Im tired or under stress, but the compulsions are weak and Im okay with checking just once.
A Closer LookOCD is difficult for people without the disorder to understand. Why can't we just turn off the thoughts or stop the compulsive behaviors? What is going on in our heads? The easiest way for me to explain it is to describe the progression of my thoughts and actions when my OCD was at its worst.
Before leaving the house, I would check the appliances, lights, toilets and doors. I checked these things in a certain order, and if I was interrupted, I started over. Often, I would stop and wonder if I really had checked to make certain the stove was off, so I began touching the knobs to make certain. Then I began to question if, while touching the knobs, I had actually turned the stove on. This thought would cause me to check the stove again. Sometimes I would obsess about the stove (or coffee pot or door lock) after I had already left the house. Often, I called my neighbor and asked her to check it. I had a need for certainty. "Probably" was not good enough.
If I was nervous about something or had my mind on other things, it took longer to complete my checking rituals. At first, checking was enough to relieve my anxiety and fear, but soon checking once did not produce the same relief. The continuing anxiety would cause me to want to check again. Before I knew there was a problem, I was checking over and over, with only minimal relief of anxiety.
Frequent hand washing started in the same way. I washed my hands before meal preparation. When I touched the refrigerator, my hands were now "dirty" again. So I washed again. Soon, meal preparation involved washing my hands a dozen times. I did not prepare food for anyone outside my family to avoid the possibility of harming others.
I worried about everything. Not the kind of worrying that everyone does at times. Constant, continuous worrying and obsessing. When the day was over, and I sat down to relax, I worried. I would go over the events of the day, my mind searching for a mistake, a potential problem, or something to "fix." Something would stand out; something left undone, or something done imperfectly. A phone call might solve the problem. At first this was enough, but soon it was followed my more phone calls because it took more and more to satisfy my need for certainty. Maybe I said the wrong thing or left something out in the first phone call. Often the worrying went on into the night and into the next day. Entire days were filled with worrying and phone calls.
I think my strangest obsession was a fear that I had run over someone. The first time it happened I was driving on a busy city street in the dark. A man stood by the side of the road and ran behind my car as I passed by. "What if I had hit him," turned into, "Maybe I did hit him." I turned the car around and went back to make certain I had not hit him. I didn't see anyone in the street. No emergency vehicles gathered, so I drove on. But it was dark. Maybe I didn't look well enough. I went back two more times before it "felt right," and I was certain no one was hurt. After that night, this fear would pop into my head often. Going back to check the road once was sometimes enough.
At other times, I went back several times. The progression of my checking rituals increased my anxiety, rather than alleviating it. This is because the rituals only produce short term anxiety relief. My obsessions and compulsions usually started with a somewhat reasonable worry. Many people with OCD have obsessions that are completely out of character for the person to have, such as thoughts of harming a parent or child. The compulsion is meant to relieve the distress that accompanies an obsession. Often it is a ritual unrelated to the obsession, such as tapping, counting, saying certain words or praying.
My OCD is almost in total remission now. Sometimes OCD raises its ugly head, especially when I am tired or under stress. For the most part, however, Ive broken free.Let me illustrate the cognitive-behavior therapy principles I utilized in my journey to break free from OCD.
One Sunday morning my OCD tried to come back. I checked everything before leaving the house. I still check stuff but (usually) only once. Both cats were sitting by the door when I left for church. I drove a half a block when I thought, "Maybe one of the cats got out." These cats never go out. They never even try to get out. But maybe they did this time. I obsessed for about three blocks.
Then I prayed, "Lord, if the cats got out, please protect them. No, that's silly, I know they didn't get out. But just in case. Well, just protect them wherever they are. Wait, protect Jim and James too, and get them home safely." That's when I realized I wasn't worried about the cats, but about my husband and son. They were Boy Scout camping. And they had guns. So I prayed for them. And I prayed for myself and to be rid of the OCD. The obsession about the cats lingered a while, but I refused to go back.
I was gone for about five hours and the thoughts came back occasionally. But each time the pull of the obsession was weaker. The cats are fine, my husband and son are fine, and I am fine. The OCD is not so fine. Why? Because I fought off the OCD one more time. Each time I fought OCD it became weaker and weaker. I fought off the urge to go back and check on the cats. How?
I saw this as an opportunity to use EXPOSURE. I exposed myself to the obsession.
I used RITUAL PREVENTION. I refused to allow myself to go back and check. Over a matter of minutes the obsessive thought weakened.
I RECOGNIZED THAT THIS WAS MY OCD. I knew from experience that, if I gave in this time, I would be obsessing over something else tomorrow. Next time the urge to check would be even stronger. Giving in will take me back down the road to constant obsessing and checking.
I REFOCUSED. I went on to church. I went to Sunday School and morning service and onto a potluck after church. I focused on what I was doing.
I PRAYED. I know this isnt one of the principles of CBT, but it works for me. I gave control to God. Thats when I realized I was probably more worried about my husband and son than the cats. So I gave God control of them all.
A word of caution . . . praying can become a compulsive behavior or ritual. I gave it to God and left it there. I didnt pray over and over when the obsessive thoughts occurred.
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