These Spring Evenings

Spring has finally arrived in our area. The plants are blooming and blossoming. The days are warmer and the nights are still cool. The hubby recently completed a project of changing over our landscaping to a more water efficient and drought tolerant one. Consequently, our backyard is a joy to be in right now. Every evening that I get home later than the hubby, I find him sitting in a cozy chair on the back patio just enjoying. Frequently he is flanked by a dog on either side, and both of these appear equally as content as their owner.

Along with spending more time on the patio, the hubby has suggested we move several of our evening meals in the last couple of weeks outdoors. I’ve obliged him, and therein lies the issue for Blake. I’ve shared before that Blake’s Obsessive-Compulsive Disorder (OCD) has played a back seat role to his depression of late, but it is at times like this when it shows itself more.

“Are we eating outside again?” he asks.

“We are.”

“I’m guessing you’d like me to join you…”

“We’d love you to join us.”

I can feel the hesitation, the thinking, the rationalizing, the many things that must be going through his head. When we first realized Blake had OCD it showed itself in fear of contamination. Although it has had many incarnations, his OCD has never quite abandoned attacking him on the issue of things being contaminated. Our patio table is contaminated (it sits outdoors all the time). The chairs are contaminated (ditto). There are bugs out there (they might land on you or, heaven forbid, your food). I think even the outside air feels a little contaminated, but I’m not quite certain about that. It’s no wonder Blake is hesitating.

On one particular night, we have relatives over. We barbecue. I prepare the meal. The hubby prepares the table outside. Blake, as he has for several years now, prepares his own meal. I head outside with my full dinner plate and notice Blake at the indoor dinner table. He’s putting together his plate. One by one, my hubby and our guests all settle in for our meal. I’m guessing Blake will not be there, but I’ve guessed wrong.

Moments later, Blake has a full plate and he carves out space for himself. The rest of us reposition ourselves. He sets his plate down and leaves. He comes back with a can of soda in hand. I know what this is. Soda for Blake is liquid courage; it’s motivation and reward for doing something that is difficult. He joins us at the table. He eats his food. He actually participates in the conversation. At some point everyone except Blake and I have left the table for seconds or for dessert.

“I’m so glad you joined us,” I note. “How are you doing?”

“I’m glad to be here,” he says, and then he answers, “I’m uncomfortable. I’m definitely uncomfortable.”

I ponder this for just a second or two.

“Uncomfortable is good,” I respond – and it is.

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A Different Kind of Obsession and Compulsion

Providing further evidence that Obsessive-Compulsive Disorder (OCD) is not always what we tend to think it is, I submit the following experience from Blake’s recent therapy session:

I don’t frequently participate in Blake’s therapy anymore. In fact, if I do come in for something, he’s taken to asking me to leave at some point now. It’s a far cry from when he began therapy a year ago, or should I say refused therapy one year ago.  But that’s another story one can dig into the archives to read. Let’s suffice it to say that Blake choosing to go into a therapy session and talk with his therapist alone is major progress. Recently, though, I asked to come in for clarification on how the therapist had requested that the hubby and I handle something.

The basic issue was this: Blake had returned to his habit of getting back in to bed or falling asleep on the sofa in the morning. I was growing tired of repeatedly waking him and wondered if our plan needed to be modified. Blake’s therapist was looking to understand what gets in Blake’s way of staying awake. That’s when he shared this interesting anecdote.

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“I work with a woman who cannot begin work in the morning if she has a certain body ache. So, she’s taken to checking herself every morning to see if she has that body ache, and most of the time, she finds it. So, she can’t start working and she keeps monitoring herself until it is gone. Actually, it’s OCD.”

Do you get it? Do you see the OCD? If you don’t that’s okay; I’ll explain it shortly. First, here’s Blake’s response:

“Oh my gosh. I get that,” Blake says. “I wake up feeling miserable in the morning. I’m so tired and I feel sick. I know if I start on anything that it’ll be terrible and I won’t like my work. So, I won’t work if I feel that way.”

“Then what we need to teach you is to work even though you might have that feeling. We have to teach you to work through that feeling,” replied his therapist.

Wait, did my son just admit to some OCD in his life? I don’t know if he realized it, but his therapist just implied that his issue with getting up in the morning had to do with OCD – and he agreed…

Where’s the OCD?

If all that escaped you, or if you just can barely make out the OCD, let me help. Think of obsessions as something that brings anxiety or discomfort up. Think of compulsions as bringing anxiety or discomfort down. It’s that simple. Now, let’s look at the patient the therapist mentioned.

The woman who works from home believes she cannot work if she has a certain ache. The concern she will have that ache is the obsession. That brings her anxiety up. The checking her body for the ache is the compulsion, as are the monitoring and refusing to work. They bring her discomfort down.

Blake holds the belief that he will turn out what he calls “trash work” if he feels tired or sick. That’s the obsession; it brings his discomfort up. His compulsion? Returning to bed or lying down anywhere and just checking out. He’ll only work if he feels “just right.” And that brings his discomfort down.

Is it a stretch? Could an OCD pattern be part of what is holding Blake back right now? Maybe. Maybe not. It’s interesting how he jumped on the therapist’s comparison. So, I wonder in my mind. Is it OCD? Is it depression? The therapist’s notion that Blake needs to work right through his discomfort fits for both – at least that’s what I think. Now, let’s see if Blake starts to do it…

On Ignorance and OCD

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“Mom, come here. Take a look at this.”

Blake summons me to the sofa where he is sitting and watching a video on YouTube. As I approach, I think he’s going to show me a video or something he finds interesting therein. As I lean in, though, he points not to the video, but to a banner running along the bottom.

“Are you OCD? Take the quiz to find out.”

It’s clearly not a true mental health screening. It’s another one of those things that pokes fun at how much you notice things that aren’t neat and orderly. It’s one of those quizzes that sets me off sometimes (See “Just a Little Rant“).

“Ugh,” I note. “I’ll bet that ticks you off.”

“Actually,” he says, “I find it kind of laughable. It doesn’t really bug me.”

“It doesn’t?”

“No. In the past that stuff really used to bother me,” he recalls. “Now…now I look at it as though they’re just ignorant. What I mean is, I don’t think that this is done with an intent to hurt people with OCD. I think about intent. I like to think that they just don’t realize that it can be hurtful; they just don’t realize what OCD is really like.”

Now, I tend to be a crusader for OCD education, and quizzes like this definitely get under my skin because they ignore the true pain that OCD can cause . Our family knows that pain – and nobody knows it more intimately than Blake. While part of me never wants to see these things, perhaps my son has developed a way of coping with them that is positive for him. He attributes it to people not knowing and he considers it without hurtful intent. One might say he’s giving some folks a free pass, yet, at the same time perhaps it’s better that he doesn’t give it a lot of space in his head. I just might learn something from him.

We Have to Want It Less Than They Do

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This week I attended a daylong community OCD event. The venue was completely full, there were terrific speakers, and there were lots of opportunities to connect. At the end of the day, there was a gathering to re-cap and ask questions. One parent stood up to ask a question that grabbed my heart and my attention.

The parent asked about a topic that is near to many of us who have young adult (or almost-adult) children struggling with OCD (or other mental health issues). That is, the parent wanted to know how to motivate one’s older teen or young adult to get serious and use the treatment being offered to them. I immediately felt a kinship to this parent. I wanted to reach across the crowded room and say, “Yes, I want to know that, too. You are not alone.” Yet my heart already knew the answer that was about to come.

A therapist at the front of the room took the question and tenderly noted, “I notice that many times parents want desperately for their child to get better. Yet that seems to keep the child or young adult from wanting it for themselves. They have to want to get better more than their parents want them to get better.”

And there it was. A simple truth. We parents can want what we want for our children. We can lead them to treatment. We can urge, press, plead, make deals…but we can’t be doing more work than they are. We cannot be more invested than they are. We have to want their recovery LESS than they do.

My heart feels heavy for just a bit as I hear what I already know. And my heart aches for the parent on the other side of the room. How do we do this? How do we care less when they don’t seem to care much at all (at least on the surface)? I think the answer is that we have to find a meaningful life for ourselves in spite of their mental health struggles. I think that we have to back off on the pressure and put faith in their ability to decide when enough is enough. And we have to have the courage to not pick up the pieces and make the consequences of their struggle easier – they have to be doing much of the hard work.

This is simple, in theory, but difficult in practice. As parents, we are programmed to respond to our child when we see them suffering. We are oriented toward providing comfort and to removing obstacles. With OCD, anyway, doing our job as parent may be presenting them with the difficult path toward healing, and waiting nearby allowing them the struggle of coming to the decision that there is a better life to be lived.

Just a Little Rant

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I’m passionate about Obsessive-Compulsive Disorder as a cause. I feel strongly about getting the word out and supporting this community – those who suffer with OCD and those of us who love someone who has it. I care about it so much that sometimes I take those clueless OCD humorous remarks personally.

Recently, I began a free support group in my community for adults with OCD. Running it is one of the highlights of my week.  Watching the close community that is rapidly developing in that room warms my heart. So, of course, I want to promote the group so that others can participate and benefit, and I made a flyer. Then I excitedly sent the flyer to every therapist and psychiatrist I could think of.

BUT I MADE A MISTAKE

I put the wrong phone number on the flyer. Somewhat embarrassed, I asked everyone to delete the flyer and I sent out a new one.  And I apologized for my error and for the multiple emails. Then I received this:

No prob. At least we know you are not OCD! If you were, you would have read it 5 times before sending!

This comment came from a therapist with many years of experience. I immediately felt the heat rise in me. I wanted to write back and school the therapist about the ignorance of that comment. I thought of snappy comebacks. I wanted to write, “Or maybe I am OCD, but my compulsions are something different from checking…” And then there’s just the phrase “you are not OCD.” Seriously, a person is NOT OCD. They might have OCD. I want to tell the therapist that, too.

But I Haven’t Said Anything

I haven’t said anything (except to you) because, well, I’m just a little too pissed right now. And I actually would like this therapist to send adults with OCD to the group.  I don’t want to alienate people from the cause; I want to educate. So thank you for letting me rant just a bit. For now, I’m going to sit on my response…at least until my blood stops boiling.

“I Like the Way I Am” – and Why That Might be a Problem

“I understand what you’re saying – and I’m not interested.”

Blake is sitting in a chair in the therapist’s office and he’s frustrated and defensive. The therapist has brought up an issue that Blake has long refused to talk about – his Obsessive-Compulsive Disorder. Right now he is insisting that there is no problem. He’s happy with things as they are.

“I like the way I am. I’ve been this way my whole life and it doesn’t get in my way,” Blake says.

And, at the present time, this is true – for the most part. In the past, Blake’s OCD

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has GREATLY gotten in his way. As a young child, his fear of contamination prevented him from getting work done because the pencils might have been touched by other children. Handball with the other kids was out of the question. A dip in a lake where people might have urinated?  Never. His moral scrupulosity in middle school left me standing at the after school pick up spot for half an hour after all the other parents and children had left. Blake was in the classroom clearing every tiny piece of trash off the floor in response to his teacher’s request that everyone help pick up the room. Despite her repeatedly telling him he had done enough, he would not stop. Of course there was also the religious scrupulosity in high school. He would get stuck in a loop saying prayers over and over, trying to get them perfect, and this frequently made him late to school.

Fast forward to present day. Blake is eighteen, hoping to attend college next year, and working to combat depression. He still does little things that are OCD behavior, but he wants to leave them alone. It’s not a big deal, he says, that he washes his hands immediately if he touches money. So what if he washes his bed sheets because a piece of tissue that brushed up against the dog lands there? It’s not a problem for him if he repeats a prayer a time or two. And he cannot understand why his therapist is raising it as an issue at all right now.

“I don’t mind that I do things this way. Why are you bringing this up now?”

When You Have a History Like Yours…

“Blake,” says the therapist, “you’re right. The things you do now are not a big deal. Here’s the thing: if all you ever did was the things you do now, it would be fine. When you have a history like yours, though, where OCD has taken over your life, it’s downright scary to act like it’s not an issue.”

“I don’t understand. Are you telling me I’m not fixed?”

“It’s not a matter of fixed or not fixed. It’s about staying healthy. People with OCD who do the best after treatment work hard at staying healthy.”

“I understand what you’re saying – and I’m not interested.”

“Instead of rejecting this outright, I’m suggesting you consider the possible benefits to you of doing things to ensure your OCD doesn’t grow,” says the therapist.

“If you guys thought I was so sick, why didn’t you tell me before now?  Has this all been a ploy to get me to do exposures?” Blake is downright angry.

“Blake, nobody is saying you are so sick. It is concerning to your parents and I that you accept your compulsions as they are and that you aren’t willing to entertain doing what it takes to protect yourself. Your attitude puts you at risk for relapse and we all want you to start college in the best way possible.”

I sit uncomfortably in my seat, taking this all in. We have tiptoed around Blake’s remaining compulsions for some time now. Getting him out of bed and functioning seemed a more pressing goal. However, the OCD has been the proverbial elephant in the room, mostly because it has been so under the radar and because Blake has been insistent on not looking at it. The therapist is right, though. In my experience treating OCD, my patients who stay healthiest remember that they have OCD and do maintenance work to keep things that way. The ones who want to pretend that it never happened or that it can be ignored tend to relapse more frequently. My son is in the camp of wanting to pretend it’s not there. He leaves the therapist’s office furious.

“I’m Tired of Being Weak and Scared”

Blake is argumentative and demanding on the walk to the car. He tells me that he realizes coming to therapy was all about trying to get him to deal with his OCD. I explain that this is definitely a part of it, but not the only reason, which I know he knows. I am concerned, I tell him, about his unwillingness to take a look at how it might benefit him to acknowledge his OCD and do maintenance work.

And then the tears come…

“I’ve been weak and scared my whole life,” he says. “I’m tired of being weak and scared. And now I’m crying, which proves how weak I am!”

At this point we can actually have a truly connected talk. My young man is not weak. He may feel scared, but he is actually one of the bravest people I’ve ever met. He has stood up to OCD demons frequently in the past. It was tough and exhausting work. I understand his reluctance to revisit that, which is maybe why it feels better to him to allow some rituals to hang around. At the same time, it is important that he understand what risk he might be putting himself at if he maintains this approach. This, I believe, will be his work in the weeks and months to come.

Miraculous Manatees!

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Smooch. Thanks to our guide for this photo.

We are home from our family vacation. Michael is back at college and Blake, the hubby, and I returned home a little over a week ago. I noted in my previous post that Blake was actually enjoying things we did on vacation. In fact, the rest of us had been tired and had been ready to call off a trip to observe and swim with manatees. Blake told us how it had been a dream of his to participate in this activity. Blake, for whom depression is ever-present, rarely shares that he has any dreams, so we absolutely had to rally and make the adventure happen.

I am happy to follow up and share that the adventure was unbelievable. If you ever have the opportunity to float in the water with these gentle giants, I highly recommend it. We went out in the bay with a well-informed guide and captain. They taught us about manatees and what we could and could not do. After learning that we were not to touch, pursue, or dive after the manatees, we got quietly into the water where several were in the area, and we did a “dead man’s float.”

After a bit of time, a manatee surfaced under my feet and began to swim the length of my body. It was exhilarating, and it took everything in me not to erupt into a fit of giggles. Our little group was very patient and several manatees took interest in us, nuzzling their faces into ours and basically hanging out with us for over an hour. Our captain told us that our experience was not the norm – we had been given a gift.

When the day ended, and we changed back into our clothing, Michael, the hubby, and I thanked Blake for asserting himself. The manatees were a highlight of our time together. Blake agreed. For him, the boy with OCD who used to stay out of the water because it was contaminated, it was a dream come true. In the fog that mental illness has enveloped him in over these last few years, it was one more clear day.

 

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A manatee comes to check out Blake