OCD

This entry shall be somewhat more recondite than "What I Did on my Summer Vacation," yet somewhat less intense than St. Augustine's Confessions. I'd like to unload about Obsessive-Complsive Disorder. Probably one of the main reasons I started this blog (the other was to be silly without fear of punishment) was to set down in physical and indestuctable form exactly what has been eating me for the last... well, my whole life.

I didn't think to tell anyone about it until last year, when things had gotten so bad that I no longer felt I had a choice but to get help. Once I did, things improved so profoundly that I am forced to look back on my adolescence and early adulthood and wonder... but I try not to do that. Regret is regress. Anyhow, in the few months before I sought help I was thinking hard about the benefits of consciousness. Self-awareness was frightening, because it kept distorting unexpectedly.

Let me give a sort of roundabout example. Picture an enormous white wall, one which occupies most of your range of vision. Now picture your name printed on the wall in letters five millimeters tall. Which dominates your attention: the vast expanse of wall, or the tiny area which has significance to you? Though the face of the untouched wall may be ten thousand times as large as the writing, it will not assume ten thousand times the importance. What's important is meaning. But what if, though you recognized the word as having meaning, you could not shut out the ten thousand spaces which remained bare? If each demanded equal attention?

Such a loss of proportion is not the problem itself, but it creates vulnerability. I started to wonder whether my sister or my mother was occupying my body, and to devise special words which would ward them off. There were also certain thoughts which would prove to me that I was still myself (writing of this disturbs me; even now, medicated, I feel so permeable to invasion). When I interacted with others, I surrounded myself with an imaginary shield to keep their personalities out. I had mental cleansing rituals to clear myself of their influence. All of these behaviours I knew to be absurd and purposeless, yet I needed them.

There is another dynamic. It is the cycle of anger, shame, and self-punishment. Say I'm very angry at my father, so I imagine myself pushing him off a tall ladder. But I can't tolerate this desire, because I also love him. I feel guilty for my thought, and very anxious that this thought might actually have harmed him. So I inflict the injury on myself. Yet the anger remains and keeps beating at my brain, so I must repeat the sequence again and again. After a while I don't even feel the anger any more, not toward anyone. I jump straight to the punishment. Unexpectedly the thoughts descend; my fingers are being crushed, my neck is broken, my throat is slit. And the image repeats itself throughout the hours, the days, the weeks, the months, the years. And I try to fight it, but it fights back. It edges even farther from my grasp, from my agency. I'm afraid the person sitting behind me on the bus is going to shoot me in the back of my head. I'm afraid to stand very long at my window without paying attention to who's passing outside; they might shoot me from the sidewalk. When my loved one is holding a knife, I fear he will stab me. When I'm holding it, I fear I may stab him, or myself. I imagine slicing my stomach open. It would be so easy.

By the time I sought help, I was thinking a lot about killing myself. I didn't leave my apartment much. I thought that I might have damaged my mind irreparably, that I would eventually become totally dislocated from reality. But that didn't happen. Instead, I went to my doctor and told her about a few of the thoughts. It was embarrassing, but then it was over; I had an appointment to see a psychiatrist for an assessment. The assessment was long and uncomfortable, but the doctor was pleasant and respectful. His face didn't show a trace of surprise, amusement or disgust when I answered his questions- a non-response which was more reassuring than any words. I left with a diagnosis, a referral and a prescription. The diagnosis: OCD, R/O Depersonalization Disorder; Schizoid, Avoidant, and Obsessive Compulsive Personality Traits; GAF 51-60. The referral was for Cognitive Behavioural Therapy. The prescription, an SSRI augmented by quetiapine.

None of these results, except perhaps the low GAF, surprised me. I researched all aspects of the diagnosis, applied to the CBT waitlist (eight months to a year), and started on my medication. I also shared some of what had been bothering me with those to whom I was closest, something I'd never before even considered a possibility. Oddly enough, they reacted with concern rather than contempt. And I love them so much more for that.

And guess what? The medication works. The thoughts still come, but they don't carry the weight they once did. I let them drift away. The palette with which I must paint meaning has been narrowed to visible colours. I can have a conversation without flogging myself. I can cut vegetables with only brief flickers of anxiety. I can allow myself to experience emotions without fearing the terrible fallout. Things are as they appear to be, almost.