“What if the exposures don’t work?” I said–cringing as I contemplated the possibility of more mental anguish.
Sensing my trepidation, the St. Louis-based counselors assured me that the exposures would, indeed, work. These exposures, she reassured (yes, I know that is loaded word) me, would temper my OCD.
Grudgingly, I acquiesced. As the counselors watched, I exposed myself to my most dreaded fears: the horrifying thoughts; the jarring physical sensations; the pulsating anxiety. With each additional exposure, the objective was to ratchet up the anxiety to increasingly unbearable levels. In time–and through these all too vivid exposures, the scary thoughts wouldn’t seem so terrifying.
Or so I thought.
As I preserved through these daunting exposures, I hoped for–even anticipated–that long awaited OCD breakthrough. My mind, unfortunately, had other ideas. Spanning ethical dilemmas to sexual concerns to tingling physical sensations to whatever else my mind could concoct, OCD proved too skillful–too experienced at tormenting me–to habituate to any of the ready-made exposures.
Optimism fading, the counselors and I grew increasingly frustrated. Despite our best efforts, my anxiety remained a constant; the OCD thoughts continued to bully. After two months of minimal progress, the counselors, in essence, threw up their collective hands. While I “graduated” from treatment, the outpatient program prompted more questions (and soul searching) than answers.
Had my mischievous OCD mind outmaneuvered exposure and response prevention? Was my OCD incurable? What could I do to temper my raging OCD inferno?
The short answer: Kind of, no, and time to revisit my OCD coping strategies.
The longer answer: While the St. Louis counselors extolled the power of response exposure prevention, I found it difficult to habituate my mind to the distressing thoughts. My mind would default to whack-a-mole mode–vanquishing the latest (and greatest) OCD thought while a new, more sinister thought would emerge. Just like my “stuck” mind, I was caught in a perpetual game of chasing my OCD tail–and becoming increasingly hopeless and embittered as a result.
As I marinated in self-doubt and pity (for, well, about seven years), enter Dr. Barbara McCann. Under her helpful tutelage, I learned that yes, you can talk back to the simmering doubts. For years–even decades, the thoughts pummeled me; I lived in fear of my mind. When a thought entered my mind, I cowered–paralyzed at the thought’s piercing words/images. Now confronting the thoughts for the first time, I learned to challenge their stranglehold. Instead of debating the, at times, deafening OCD roar, I applied my cognitive behavioral techniques. More specifically, I identified the OCD thought and then challenged the cognitive distortion. This thought is OCD nonsense; I am not going to give the cheating thought the time of day or My mind is telling me that I cheated on my exam; I know that this is a typical cognitive fallacy–just because a cheating thought pops into my head doesn’t make it true.
Like your OCD, treatment is not a one size fits all model. It is a mixture of response exposure prevention (REP), mindfulness, and cognitive behavioral therapy (CBT), and dialectical behavioral therapy DBT). But even more than these tried and true techniques, it is an understanding that progress is piecemeal. It takes time to identify the appropriate alphabet soup technique (REP; CBT; DBT)–and more time to implement said technique. It is a realization that breakthroughs are elusive–but that your determination can and will outlast your (OCD) despair.
Even if it takes a long, lonely seven years.